If the 20th century was considered the most tensed-up period in history, the 21st century is set to exceed it by far. Depression is one of the most serious health hazards of today, and has reached epidemic proportions. We live in a disorderly world where people are highly competitive, commercialized and power hungry. This leads to a lot of stress and anxiety. It is estimated that about 40% of the population is on tranquillizers. WHO figures say that 5-12% of people are depressed. In India, there are 50 million sufferers of which 5-10% have major depression. Almost 50-75% of suicides are by people who are depressed. In Zimbabwe, depression is called “shona,” meaning “thinking too much.”
No one is immune to Depression. It affects all ages from young children to senior citizens, manual labourers to corporate heads, literate or illiterate. Winston Churchill who suffered from depression called it the “black dog.” Abraham Lincoln also suffered from bouts of depression. “It hits the most ambitious, creative and conscientious,” says Jeffrey Spellar, a psychiatrist.
Women are three times more likely to suffer from depression due to their varying hormonal cycles, and are vulnerable premenstrually, after delivery, and during the perimenopausal years. Though about 80% of women suffer from post partum “baby blues” which last for a few days and resolve spontaneously, about 20% suffer from severe depression leading to suicidal tendencies, harming or killing their babies, or refusing to breast feed. Irritability, sleeplessness, weeping without reason, are some of the signs that warn of severe depression.
Men are depressed on specific issues like failure in business or loss of a job. The elderly, who live alone or who are totally dependant on others also suffer anxiety and depression.
During adolescence, both boys and girls are equally vulnerable. The transitory period before adulthood is a bewildering time of experimentation. They feel unsettled and out of control and scared because of the physical and emotional changes taking place. About 2-3% of adolescents are depressed.
According to Indian Council of Medical Research in 2001, 12.8% young children are found to be depressed. As they are unable to express sadness, they show it through aggression, refusal to eat, insomnia and other ways. When parents set impossible standards, the constant fear of failure makes them depressed.
Care givers of the ill or disabled, who are under constant stress, also suffer from depression. Stephen Hinshaw a Californian psychiatrist says, “Many people, especially those caring for others, get to a point when there is an imbalance between their own feelings of being human and their confrontation with difficult, distressful issues on a day to day basis. Things go tilt.”
Depression has a genetic component and may run in families. Identical twins are at a greater risk. Environmental factors however, are the main reasons for depression. Loss of a job, divorce, marital friction, bereavement, financial difficulties, fear of failure, unreached goals, too many deadlines to keep, the struggle to keep up with the Joneses, are some of the exogenous causes that trigger depression. Recently there have been many suicides due to disappointment in love.
There are different grades of depression. Dysthmia is a less severe mood disorder, but lasts for about two years. Seasonal Affective Disorders (SAD) occur during winter months when energy levels drop. People become sluggish and tend to eat more sweets and carbohydrates.
Depression may manifest itself as lack of energy, withdrawal, unexplained sadness, feeling of worthlessness, suicidal tendencies, lack of libido, or irritability. In major depression, there may be a total disinterest in food, hobbies, sex and everything that is pleasurable.
All of us go through periods of depression, but we soon bounce back to normal. When symptoms persist for more than two weeks, it is a sign of clinical depression and must be treated. Depression is more harmful than chronic diseases. It aggravates the symptoms of arthritis, angina, diabetes, asthma or other medical problems. A research paper published in the Lancet says, “Depression impairs health state to a substantially greater degree than other diseases.”
Depression is caused by a chemical imbalance in the brain. Neurotransmitters that carry messages to the brain and nerves such as serotonin and noradrenaline are reduced in the synapses along the nerve paths. Thought processes become impaired, and depression sets in. Heavy drinking and drugs reinforce depression.
There are many ways to take charge of one’s depression.
o Tackling the cause of depression and remedying it. It may involve a change in life style, change in attitude to events or situations or people. Focus must be on living positively, and converting anxiety into positive energy.
o Expressing feelings of fear, anger or sadness. Talking to a sympathetic counsellor or a psychotherapist. Talk Therapy or Cognitive Behaviour Therapy is a valuable adjunct to medication. Putting feelings into words makes sadness or anger less intense. It reduces suicidal tendencies. Speaking about one’s negative feelings activates that part of the brain which is responsible for control of emotions. Within the context of a caring relationship, Psychotherapy helps a person to identify the cause of his depression, enables him to cope, by identifying his positive resources and using them to change his attitude to problems. It helps him let go of negative attitudes and teaches him to discipline his mind.
o Regular Exercise. Brisk walking, jogging, cycling, swimming or any kind of physical activity, releases beta endorphins which neutralize stress hormones.
o Listening to music, singing or playing an instrument helps to ease depression by releasing hydrocortisone, which is an anti-stress hormone.
o Putting a stop to multitasking, which makes a person feel out of control. Trying to do one thing at a time will yield better results.
o De-stressing muscles through relaxation techniques, yoga or breathing exercises. The Art of Living guru Sri Sri Ravi advocates a special breathing technique called Sudharshan Kriya, which involves hyperventilation. It is supposed to be a mood lifter.
o Consciously avoiding comfort eating. Stress related fat is very difficult to shed.
o Medication should be under a doctor’s supervision. Drugs alone don’t address the cause, and must go hand in hand with psychotherapy.
o Spending time with the family and doing what is enjoyable. Seeking the company of happy people. Those who stay happy are seldom depressed. “Our brains are designed to reflect and catch the state of the person we’re with,” says Daniel Goldman, psychologist. “An unhappy person floods our minds with negative emotions that trigger stress centres.”
o Hypnotherapy is useful for resistant cases. It relieves tension, helps deal with traumas, fears and phobias that cause stress.
o Meditation and Prayer will increase spiritual well being and help a person understand the meaning and purpose of life. It will change depressive attitudes into positive thinking.