April 7: World Health Day 2017 – Depression: “Let’s Talk”

New Delhi, April 6, 2017: Depression is the leading cause of disability worldwide and is a major contributor to the overall global burden of disease (WHO, 2017). It is the second leading cause of death among 15-29 year olds. The Theme for World Health Day this year, 2017 is Depression: “Let’s Talk”. The theme is important as it is critical to bring the condition out of the closet and stir conversations around it.  It is important to reinforce that depression can be prevented and treated. A better understanding of what it is, and how it can be prevented and treated, will help reduce the stigma around it and encourage people to seek help.

A range of treatments, health professionals and services are available to help curb depression as well as provide information on what can be done. Dr Samir Parikh, Director Mental Health & Behavioral Sciences, Fortis Healthcare shares some key points on recognizing the early signs of depression and ways to tackle them:

 Early symptoms:

• A depressive episode is characterized by a 2-week period marked by a depressed mood, loss of interest or pleasure in activities
• These symptoms could also be accompanied by significant weight loss, decrease or increase in appetite, sleep disturbances, low energy levels and fatigue.
• A depressed individual might experience feelings of worthlessness or excessive or inappropriate guilt, with a difficulty in concentration, difficulty in decision-making, and recurrent thoughts of death.

Who are affected ?

• According to WHO, over 5 crore Indians suffered from depression in 2015, and globally, more than 300 million people of all ages suffer from depression.
• Men and women alike are affected by depression, though the nature of the stressors and the coping mechanisms adopted by them might tend to differ.
• Increasingly, more and more children and adolescents are presenting themselves with complaints associated with depression and low self-image.
• Regardless of age, gender or occupation, all individuals do experience low moods at many moments of their day-to-day life. It is therefore important to separate it from chronic symptoms.

Causes:

• There is no single causative factor – various genetic, biological and psycho-social factors interact to play a role in the etiology of the illness.
• An imbalance in the regulation of a neurotransmitter called serotonin in the brain is majorly correlated with depression across all ages.
• Many psychological and social stressors such as trauma, loss of a dear one, difficulties in relationships, life-challenges can be a trigger for a depressive episode.
• Repeated stressful experiences tend to compromise the individual’s ability to cope with  situations, especially if the individual does not have adequate support mechanisms in the environment.
• Environmental and psycho-social factors also increase our vulnerability towards depression in today’s times, including fast-paced lifestyles leading to a neglect of time and space for our own self.
• With a shift in family structures, and increased dependence on the media and technology, most of us tend to lose out on adequate support systems, leading to social isolation and loneliness.

Society’s role in fighting Depression:

• Provide support, empathy and a listening ear.
• Give the person a chance to express him/herself.
• Try and empathize with the person and try and understand the emotions that he or she is going through. Do not interrogate or form judgements.
• Convey your genuine concern and support.
• It would also be beneficial if you could help the individual to reach out to the help of a professional mental health expert.
• Be vigilant. In cases of severe depression, it is vital for the family, friends or caregivers to be on the alert for signs of suicidal ideation.
• All dangerous items that are potentially harmful including sharp objects, pills, and poisonous substances need to be removed from the reach of the individual.
• Encourage the depressed person to seek the support of mental health experts to ensure adequate intervention and prevent adverse outcomes.
• “Talk”: We should not hesitate to initiate the conversation with the affected person, as it is important to give a chance to express their feelings and release their pent-up emotions.

Mental Healthcare Bill, 2016

The Mental Health Care Bill, 2016 which has been passed recently, is a big step forward as it redefines mental health as a more inclusive and comprehensive term. With the advent of the first ever National Mental Health Policy declared recently, the widespread stigmatization of mental health related conditions has been clearly recognized. Such initiatives are promising for the progress of mental health within the country. However, despite the growing awareness and realization, there still remains a wide gap to be filled in to ensure adequate support and services for all.