From Darkness to Light
March 1998
By Anupama Bhattacharya
Understanding depression, which in the age of anxiety is threatening to become as prevalent as the common cold, and exploring avenues to fight this dehumanizing infection SYMPTOMS OF DEPRESSION AND SUICIDAL TENDENCIES • Feeling sad or irritable most of the time • Losing interest in things that you enjoyed earlier • Feeling fatigued and exhausted without any exertion • Feeling hopeless about the future • Disturbed sleeping patterns • Becoming sentimental about minor things • Feeling alienated from the world • Losing appetite or a sudden tendency to eat more • Frequent tearfulness • Signs of physical self-harm such as scratch marks, cuts • Asking or looking for possible tools for committing suicide • Communicating thoughts of suicide • Giving away precious belongings HOW YOU CAN HELP A DEPRESSED PERSON• Acknowledge his feelings without trivializing them • Don’t blame him for his morbidity and inability to do normal chores • Give him support and unconditional love and care • Encourage him to indulge in activities he enjoys • Appreciate whatever efforts he makes to fight his depression • Highlight his achievements and efforts • Make him talk and learn to listen to him • If his depression has an immediate cause, help him find ways out of it • Without forcing any expectations, try to create a daily routine for him • Defend him before strangers even if you know he is wrong and gently explain the facts later when you are alone with him • If he talks of suicide, take him seriously and try to talk him If he talks of suicide, take him seriously and try to talk him out of it. HOW TO COME OUT OF THE BLUES • Write down all your feelings in a diary: this will act as a catharsis • Accept the mood, enter into it fully by listening to sad music and gradually change it to light, pleasant tunes • Keep fresh flowers around you, especially roses • Practice pranayama or simply concentrate on your breath as you inhale and exhale • Surround yourself with pleasing colors of nature such as blue and green • Lock yourself in a room and laugh loudly for half an hour • Wake-up early in the morning and meditate • Try to have a change of place • Involve yourself in activities that you like • Go for jogging, or exercise vigorously at home • Take a long bath and wear fresh clothes • Start thinking about things that have made you happy. Like a dark cloud hovering over the sky, the feeling creeps into your being: drowning, devouring all sense of reality. ‘What am I living for, who cares for me?’—you wonder. In a torrent of lashing memories, everything comes back with a renewed vengeance. All the hurt, the pain, the inexpressible emotions, overwhelming in their intensity, pull you deeper and deeper into the fathomless chasms of misery until you lose all desire to live. Only a numbness remains—leaving you empty, devoid of all feeling. Somewhere deep within, we all identify with this state, even if for a split second. What differentiates most of us from those who are clinically categorized as depressed is that at such moments, we strive to gain our equilibrium instead of giving in. But not everyone is so lucky. To what extent the reasons for feeling down are justified is always debatable. What is significant here is that at such moments some people let go of their will to fight back, and if the feeling is allowed to grow, it might lead to nervous breakdown or even suicide. Why do we feel depressed? Why is it that at certain moments we feel ready to face any calamity while at some other time even an apparently insignificant word hurts us so much that it takes us to the brink of despair? FEELING BLUE It is normal to feel depressed at times of adversity and such feelings are as much a part of everyday life as joy and contentment. It is only when the symptoms persist or become acute and self-destructive that professional help is required. Unless triggered by a specific incident or event, depression usually has its root in the deep-seated psychological factors such as upbringing, relationship with parents and siblings and childhood traumas and fantasies. Clinical depression, in particular, for which sometimes the patient himself fails to find a concrete reason, is often a result of years of neglect, repression and feelings of uselessness and incapability, nurtured by uncaring parents and relatives. Depression can be set off by a number of factors; family history of depression, loss of somebody or something, weather, family atmosphere, failing to achieve something, childbirth, marital problems, hormonal changes, prolonged illness, thyroid problems or even diseases like the glandular fever. When the cause of depression is purely biological, appropriate medication and counseling can cure it within a few weeks’ time. The problem arises when it is caused by deep-seated traumas and current setbacks. ‘On the face of it, a person might feel depressed due to something as simple as failing to get a promotion or missing a coveted job,’ says Arpita Anand, counseling psychologist with Saarthak, an Indian voluntary organization. ‘But go deeper and you realize that this person’s sense of worthlessness is actually caused by his assumption that unless he goes on achieving, he is not worthwhile.’ Such assumptions, says Arpita, are nurtured by parents who express love or give rewards only when their child achieves something. Considering the increasingly competitive education system and society, it is hardly a wonder that the number of people suffering from depression is increasing at an alarming rate. SAD PROGNOSIS According to studies conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India, one in every 15 adult Indians suffers from depressive illness. At least 10 per cent of the population suffers from depression that needs professional and medical help, and as much as 40 per cent of the population is demoralized and likely to cross the line to clinical depression sometime. A report released by the World Health Organization (WHO) states that depression threatens to be the world’s most common illness by the end of the century. The increasing stress levels, demands of workplace and nuclear families, peer pressure, mechanization of life, along with disillusionment with the old-world values and systems, make a person a soft target for depression. To add fuel to fire, it is considered uncouth to express sentiments that are not strictly in tune with the dictates of society Creating, in effect, human beings who are expected to behave like assembly-line products. ‘I don’t understand this obsession with trying to sound casual,’ says Seeman Narang, first-year student at Delhi University, India, who recently had a nervous breakdown since she could not adjust to her college atmosphere. ‘My classmates call me melodramatic when I get emotional. I stay in a hostel and miss my parents. But if I express my feelings I’m branded a crybaby. Why should I be expected to behave as though I don’t care when I actually care so much?’ It doesn’t take long to see the truth in Seema’s words. Being unable to express emotions, putting on a façade of sociability and living a life that is more pretension than reality, the modern man seems to have created a cocoon around himself where he is alienated from the world around him and becomes a prisoner of his own dreams. And in a society where everyone is racing to outdo the other, expectations of sympathy and solace are fast turning into a receding mirage. I remember an acquaintance who would turn up with a scarf around his forehead every other day. And each time, he would complain of headache and seek attention. It took me a long time to figure out that he was actually expressing his feelings of depression and dejection through symptoms of physical pain. Depression takes many forms. Starting from lethargy, somatic complaints such as body aches and pain to irritation and anger, depression can encompass the entire gamut of negative emotions. A proud individual who abhors attracting sympathy might express his feelings of dejection through sulking or aggressive behavior. An extrovert, on the other hand, is most likely to express his feelings openly. In children, depression takes the form of increased irritability and social withdrawal, and has to be distinguished from ‘spoilt’ behavior. The communication of depression can also vary from culture to culture. According to Diagnostic and Statistical Manual of Mental Disorders published by American Psychiatric Association, complaints of nerves and headaches are more common in Latino and Mediterranean cultures, weakness, tiredness or imbalance in Asian cultures, and problems of the heart in the Middle Eastern cultures. In depression, appetite is usually reduced though some may have increased appetite and crave for specific foods like carbohydrates. The most common sleep disorder associated with depression is insomnia. Most people have middle insomnia (waking up during the night and having difficulty going back to sleep) or terminal insomnia (waking up too early and being unable to go back to sleep). Initial insomnia (difficulty in falling asleep) may also occur as well as over-sleeping. The psychomotor changes during depression include agitation, inability to sit still, hand wringing or lethargy and slowed speech, along with increased pauses before answering. A morbid self-involvement without consideration for others is another characteristic trait of depression.