Depression: Social Stigma to Treatment

What is depression?

People when ‘feeling low’ often say they are in depression. On the contrary ‘depression’ is a serious mood disorder that is usually not characterized by any physical symptoms. However, short-lived emotional responses to everyday challenges may cause sadness but clinical depression is of high intensity and long lasting. Clinical depression may cause mental state of the person to affect the physical activities and can cause abnormal thoughts, behavior, and disruption is day-to-day life actions and habits. At its worst, it can lead to suicidal tendency.

As per WHO ‘Depression is common mental disorder, characterized by persistent sadness and loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks.’

What causes Depression?

Depression is caused by combination of various factors as social, physiological and biological.

(Examples may include, but not limited to: financial problems, job loss, stress at workplace, stressful relationships, breakups, separations, divorce, death of a loved one, unemployment, chronic health conditions or terminal illnesses, social isolation, family violence, low income, living alone, accidents, natural calamities leading to huge loss, and also, chemical imbalances in brain)

In India, the social determinants like employment, education, poverty, living standards, environment, access, equity and others contribute significantly to both causation and recovery.

Depression may affect anyone, irrespective of age, gender, residence and living standards, even though some groups are at a higher risk; only the impact varies. However, the prevalence of depression is more in females than males, while the age group 16-35 years has higher prevalence of depression.

Symptoms of depression

People having combination of the following symptoms, for at least a period of two weeks signifies depression-

• a loss of energy and fatigue
• a change in appetite or weight changes
• sleeping more or very less
• anxiety, restlessness, or frustration
• irritability
• loss of interest in activities or hobbies that used to be enjoyable
• reduced concentration
• indecisiveness
• feelings of sadness, hopelessness, or worthlessness
• guilt or hopelessness
• thoughts of self-harm or suicide

Treatment options

Persons with depression are unable to receive quality care due to limited awareness, availability, accessibility and affordability.

Depression is treatable, with talking therapies (psychological counselling) or antidepressant medication or a combination of these.

In addition, exercise, music, yoga, meditation, indulging in hobby classes as cooking, swimming, gardening, taking care of pets can help in mood upliftment.

Instructions to family members/Care givers (WHO recommends)

• Depression is an illness and not a character weakness.
• Depression can be treated. What treatment is best and how long the depression lasts depend on the severity of the depression.
• The support of carers, friends and family facilitates recovery from depression.
• Patience and perseverance is needed, as recovery can take time.
• Stress can make depression worse.
• Make it clear that you want to help, listen without judgement, and offer support.
• Find out more about depression.
• Encourage them to seek professional help when available. Offer to accompany them to appointments.
• If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better.
• Help them with everyday tasks and to have regular eating and sleeping patterns.
• Encourage regular exercise and social activities.
• Encourage them to focus on the positive, rather than the negative.
• If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a health-care professional. In the meantime, remove items such as medications, sharp objects and firearms.
• Take care of yourself too. Try to find ways to relax and continue doing things you enjoy.

Remember: When you live with someone with depression, you can help them recover, but you need to take care of yourself too.

Also, government should take initiative for aggressive education and awareness campaigns to fight depression at individual, community and the national level. To support patients with depression it should supply effective and affordable drugs in primary health facilities, provide regular training programmes for primary care providers and research on preventive and promotional aspects of mental health.


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