NOT OK WITH BEING NOT OK

After Covid-19 in particular, an invisible pandemic has been slowly and quietly destroying lives and livelihoods. We either know or have been providing care to someone who is battling depression or anxiety or sleep disorder following bereavement or break-up or loss of income or conflict between work and family. What we probably don’t know is if we too need that care. The psychosocial costs of this pandemic, reflected in the growing number of medical prescriptions and rise in sales of antidepressants, are accruing by the day, warn psychiatrists.Medium108412665 A study conducted by Pronto Consult analyzed 830 medical bills per month from across Gujarat over a 12-month period. The findings were released last month. Dr Karishma Shah, founder and managing partner, Pronto Consult, says, “Medicines including antidepressants, mood stabilizers and sleeping pills were seen in 20-22% of the bills. Sleep disorders may arise from anxiety or even depression in some cases. During the survey, the respondents also spoke about persistent sadness, loss of interest, difficulty in concentrating on work or making decisions.”Medium108412666 “There is a steady increase in the number of people suffering from mental health ailments. Compared to last year, we have seen at least a 12% growth in the number of prescriptions we get for medicines for depression, anxiety, and sleep disorders. Most of these medicines are prescribed in lower doses, which is typically the case when the patients are new,” explained Alpesh Patel, chairman, Federation of Gujarat State Chemists and Druggists’ Association (FGSCDA).Medium108412667 Data compiled by Pharmarack reveals that the moving annual turnover (MAT) in July 2023 for drugs under the central nervous system (CNS) and neuro therapy category in Gujarat rose by 27.5% compared to MAT in July 2019. MAT reflects sales for a 12-month period calculated on a monthly rolling basis.Medium108412669 The market size for these drugs went up from Rs 370 crore during the period between August 2018 and July 2019 to Rs 471 crore between August 2022 and July 2023. Mental health experts based in Ahmedabad attest that cases of psychological distress, depression, panic attacks, anxiety, post-traumatic stress disorder, suicidal behaviour and epilepsy are on the rise.Medium108412670 ‘Each age group has its own issues to deal with’Dr Ramashankar Yadav, an Ahmedabad-based psychiatrist, says that each age group has its own mental health issues to deal with.“In the past couple of years, we have seen children and adolescents coming to us with interpersonal issues, study-related anxiety, addiction and substance abuse. For adults, it is loneliness and financial insecurities due to job loss or business-related uncertainties. Women often come with issues pertaining to family and mobile addiction, whereas the elderly approach us with feelings of neglect and lack of sleep and appetite,” he says.He adds that medications in almost all categories have increased in the past couple of years.“In the past two years, there has been a marked growth in the consumption of antidepressants, anxiolytics and hypnotics/sedatives. Decline in social interactions, other health issues triggered by Covid, and loss of loved ones may have had a deep impact on the mental health of people. The current year shows an improvement in mental health as the growth rate of sales of this range of products seems to have slowed,” says Sheetal Sapale, vice president – marketing, Pharmarack.Antidepressants and mood elevators alone account for 21% of the total medicines sold, says Sapale. The category has shown a 34% growth in the past four years. That apart, medicines used to treat schizophrenia, bipolar disorders, sleep disorders and epilepsy also showed a significant growth during this period.There is a huge global unmet need for care as the World Health Organization’s (WHO) World Mental Health Report published in June 2022, reveals.Medium108412671 Sleep deprivation is a warning signDr Parth Vaishnav, a psychiatrist, says that people have been popping zolpidem, alprazolam, clonazepam and pregabalin with or without medical prescriptions for years now.“Sleep deprivation is often a sign of other underlying mental disorders. We can now quantify sleep quality, and it has clearly been deteriorating over the years. The purpose of medication, however, is to help a patient get back on track. If it is not done properly, it can cause dependence on drugs and other issues,” says Dr Vaishnav.He emphasized a sleep hygiene routine that includes having a meal at least two hours before and putting away all devices 30 minutes before hitting the bed. “It is a misconception that popping a pill helps a patient slip into deep sleep immediately,” adds Dr Vaishnav.Anxiety catching ‘em youngEven children and adolescents are increasingly falling victim to mental health disorders.“We’re well past Covid now, but it continues to remain the primary cause behind mental health ailments. Teenagers in the 13-17 age category often deal with mobile and social media addiction, peer pressure and academic stress that can cause anxiety and depression. Isolated cases of substance abuse and increasing cases of vaping are also coming to the fore,” explains Dr Punita Grover, a consultant psychiatrist based in Ahmedabad, who has seen a 20% rise in new patients over two years.Medium108412673 More awareness, less stigmaAccording to Dr Grover, the younger generation today is more aware of mental health issues, thanks to social media, and the stigma around it is slowly melting away.“Social media, awareness programmes and celebrities opening up about their mental health issues have increased society’s willingness to acknowledge that there is a problem. In many cases, we find parents taking their children to therapists to seek help, which is quite encouraging,” she says.Dr Ajay Chauhan, medical superintendent of Hospital for Mental Health (HMH), opines that while it cannot be said that there has been a sudden spurt in mental health issues, he believes that these were latent issues that were not addressed earlier due to the stigma attached to them. “Today, with an increase in awareness, mental health is no longer a taboo subject. But one must avoid self-medication as it can do more harm than good,” adds Dr Chauhan.Dr Pradip Vaghasiya, director of GIPS Psychiatric Clinic in the city, says that cases of anxiety, panic attack, depression, obsessive compulsive disorder (OCD), mania, schizophrenia and others have increased in the past few years primarily due to better acceptance of these conditions and the patient’s willingness to seek help.“A whole range of antidepressants, anxiolytics, antipsychotics and mood stabilizers are used to treat these illnesses. The new school of thought also identifies them as neurological brain disorders. The medications help improve neural circuits or maintain the balance of chemicals essential for the brain to function normally,” says Dr Vaghasiya.