Nidhi’s mother shared her diary with me. By this time, her daughter was in the US, in a counselling facility that specialises in providing intensive treatment to severely depressed/suicidal women. Nidhi was lucky; she got understanding and access to medical help in time. Each year, though, thousands of women in India (and across the world) aren’t as lucky. Depression is as dangerous as it is hard to diagnose; add all the layers of bias and misconceptions that exist and you have a bubble waiting to burst. And for those who came in late and haven’t paid attention to stats on the subject—women are congenitally way more prone to the disease.
Most important: Rarely are victims themselves able to diagnose the disease. Which means it may be up to you, as a friend, sibling or daughter, to watch out for the signs in those you love. Here’s a quick download of what you need to know.
DECODING DEPRESSION
According to a publication by the National Institute of Mental Health (NIMH), Maryland, USA, called Depression: What Every Woman Should Know, “Life is full of emotional ups and downs. But when the ‘down’ times are long lasting or interfere with your ability to function, you may be suffering from a common, serious illness— depression.” This is perhaps the simplest way to identify an illness so complex that it can even lead to suicidal thoughts and actions.
Every day, as soon as I wake up, I feel like going back to sleep. It’s as if I have nothing to live for. I jus t feel so tired. I don’t want to go on like this. What is happening to me? |
Spotting the signs
Individually none of these are conclusive, but if you see a combination of these signs—or extended lengths of feeling any one of these, it’s a red fl ag. Watch out for: Feeling persistently sad or constantly ‘empty’; losing interest and pleasure in most activities including sex; being restless, irritable or just crying easily; getting bogged down by immense guilt, worthlessness or hopelessness; sleeping too much or too little; sudden change in appetite, whether it’s eating too much or too little; being tired 24/7; and of course frequent thoughts of ‘ending it all’, they’re danger signs to clue into, and fast!
The different faces of depression
Broadly speaking, depression can be divided into three categories: Major or clinical depression; dysthymia and manic-depression; or bi-polar disease.
Clinical depression: Someone who’s clinically depressed will exhibit all or some of the symptoms we’ve ID’ed for at least two weeks. These bouts could last as long as a few months or more, and could recur several times in a lifetime.
Dysthymia: You’ll see the same symptoms, but in a milder form, however they’ll last at least two years. Dysthymia is basically a condition in which you live a joyless existence, and feel constant exhaustion. You can also experience intense depressive phases.
Bi-polar Disease:It’s perhaps the rarest. It involves days of severe ‘lows’ interspersed with bursts of mania. During manic episodes, you become extra talkative, disproportionately happy, spend recklessly and may be reckless sexually as well.
Do we know what causes it?
Yes and no. Genetic reasons can play a role in whether or not someone is prone to depression but the patchy data available makes it clear that a whole bunch of other causes can trigger it. Research suggests that the brain biochemistry is a signifi cant factor in depressive disorders. Significant loss, a difficult relationship, upheavals in lifestyle, or an acute or chronic physical illness can make you succumb. The big deal here — women are twice as likely as guys to be clinically depressed or get dysthymia.
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Research shows that in girls, there’s a direct connection between the onset of adolescence and depression. Puberty brings more tangible pressures for girls: Bodies change, identities need to be formed, decisions need to be taken for the first time, and sexuality needs to be dealt with.
From puberty to personality problems
“Schoolgirls have many anxieties and confl icts due to their physical and emotional growth. Personality problems like shyness, inhibition, jealousy, sensitivity, and complaints show more strongly in girls. The internet and TV expose girls to liberal lifestyles but societally it’s not like we’ve gone too far from orthodox family values. This situation puts a lot of young girls in a state of fl ux that normally leads to depression,” says clinical psychologist, Pragna Mitra.
Take Naina, 12, a student: A cheerful, bright pre-teen, Naina was a born leader, a gifted athlete, with a strong academic record. You could have called her a rockstar preteen— and then came adolescence with all the angst that goes with it. In Naina, the leadership traits started to turn into rebellion; she hated going to school and, on account of her parents’ inability to deal with the sudden change in her personality, even tried to kill herself. The doctors who treated her confi rmed that she was suffering from severe depression.
Depression is more common in women than in men, at a ratio of approximately 2 to 1. While morbidity is higher in women, mortality in the form of suicide is greater in men. Suicidal attempts (parasuicide) on the other hand are more common among women. |
Rocky relationships
Some researchers also insist that women are prone to depression thanks to the particular dynamics they tackle—juggling home and work, looking after kids, aging parents, in-laws and of course marital/relationship issues. In fact, rates of clinical depression are said to be highest among the separated and divorced. For Sanaa, 21, the world revolved around her boyfriend, Rajat. He was a few years older than her and seemed to think she was god—or at least, worthy of worship. For three months, things were fabulous. Then came a reality check—Rajat started objecting to the clothes she wore, the way she talked, the friends she hung out with. As is typical with control-freaks or emotional abusers, the criticism would come with veiled or direct threats of leaving her.
“He’d keep telling me he was going to walk out and because he seemed so into me, I actually began to believe the problems were actually my fault. Then one fi ne day, he just walked out on me claiming he couldn’t continue the relationship because his family didn’t think I was good enough. I was shattered. I went into extreme depression, had to change cities, couldn’t eat, couldn’t sleep. That nightmare lasted almost two years and still gives me shivers whenever I think of it. The worst part is I’m constantly afraid that I’ll slip back into that darkness,” confesses Sanaa.
Hormonal horrors
Reproductive events such as the menstruation cycle, pregnancy, and postpregnancy; or menopause in some women can also bring about fl uctuations in mood that could lead to depressive symptoms. Women with infertility problems have also exhibited signs of extreme anxiety and stress. Added to this, traumatic events such as child abuse, sexual harassment on the job, and fi nancial insecurity can all foster an acute sense of low self-esteem and a sense of helplessness, self-blame, and social isolation.
WHEN SHOULD YOUGET HELP
One of the most common signs that clinically depressed people show is a feeling that their situation is ‘incurable’. Luckily, this is totally not true: Like with most other ‘ailments’, the earlier depression is treated, the better the chances of preventing it from happening again. If you or someone you love has been through a period of severe trauma or strain, along with a constant feeling of extreme negativity for more than two weeks, you need to recognise that your anxiety and powerlessness goes beyond normal.
The next step? Slotting a visit to a qualifi ed professional for an evaluation instantly. This could be a psychiatrist, a psychologist, a clinical social worker or a mental health specialist. And don’t forget that treatment of depression is a collaborative effort between you and your doctor, so if you’re uncomfortable with the person in front of you, feel free to visit someone else. Your regular physician can guide you in fi nding a counsellor/doctor. Just remember that feeling better is a slow process and you shouldn’t expect miracles in a matter of a few days. The most common methods used to treat this condition include antidepressant medication, psychotherapy, or a combination of the two depending on the severity of the illness.
Having said all this, depression is still a tabboo even amongst the most informed. So if you realise your ‘crabby’ phase has lasted longer than a couple of weeks, or your friend, mother, sister—anyone you know, has been ‘feeling low’ for that long, speak up and ask for professional help. You could be averting serious disaster!
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Bonus trick
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