Mental Health Series: Depression

Islamabad – In today's world, the term "depressed" is used, if it has had an argument with a loved one or if it has not been successful, as if depression were synonymous with simple sadness. When the word "depression" is used recklessly for each negative emotional state, the meaning and severity of the illness are lost somewhere. According to the World Health Organization, nearly 300 million people of all ages are struggling with depression each year around the world. In Pakistan, depression and mental illnesses in general are a big taboo to which people do not want to be associated. The lack of dialogue around this critical illness contributes to the stigma that accompanies it. In 2017, depression was at the top of the list of causes of disability and ill health around the world. Depression often occurs in four ways: mood changes, cognitive changes, physical changes, and changes in behavior. It is a common mental illness characterized by persistent sadness and a loss of interest in activities that people normally practice, accompanied by an inability to perform daily activities for 14 days or more. It can be debilitating but can be treated with behavioral / talking therapy, antidepressants or a combination of both, depending on the severity, cause and type of depression. The depression goes back to the time of the Pericles, when Hippocrates attributes the depression to an imbalance of the four moods of the body. He recommended balancing the body's systems with healthy living and relaxation strategies, including bleeding and leeches.

Depression can come from the mind or body. In some cases, the patient develops depression due to hormonal changes and imbalance, for example. Postnatal depression, premenstrual dysphoric disorder, hyperthyroidism and various other diseases. Whereas, in other cases, depression can be caused by severe emotional trauma, changes in the environment, grief, genetics and other personal problems. Feeling suicidal and severely depressed before menstruation is a sign of pre-menstrual dysphoric disorder in which the symptoms are more severe than those observed during pre-menstrual syndrome. In most cases, the symptoms disappear at the beginning of the period or soon after. According to national information on women's health, postpartum depression affects about 10% of new mothers. Depression followed by delivery is very common, especially in Caesarean section patients. 1 in 6 women having given birth is affected. Postpartum depression can be treated with professional help, without which it can last a long time and have adverse effects on the health of the mother and the child. In addition, in women, perimenopause and the reduced hormone levels that result can also trigger depression. In men, depression is associated with low testosterone levels, but researchers have been unable to determine the correlation between the two. Just like obesity and diabetes, men are more likely to develop depression. Long-term use of drugs also leads to changes in dopamine production and has been implicated in the onset of depression that may lead to agoraphobia (fear of dying) in these patients. eating disorders. Depression is a fight that the patient is fighting in the head, so it is sometimes difficult to notice, because those who suffer from it spend extra effort to make their loved ones believe that they are well. But there are signs and symptoms that you can watch around you.

Recently, a famous magnate of beauty, Jeffree Star, YouTuber and Beauty, talked about his fight against depression and self-injury in a series of videos about his life posted on YouTube. His confessions led to a great debate on self harm on social media, especially among young people. People with depression are more likely to be mutilated for help and to express the fact that they are suffering from profound mental agony. These patients tend to say that they cut themselves to feel alive, control the emotional pain and reduce their numbness. If you or someone you know is involved in self-mutilation, please ask for help immediately as this can lead to serious illness and even death. Depression can be a disease that affects not only the patient's life but also those around them, but the stigma associated with mental illness often prevents the patient from obtaining professional help. It is relevant to de-stigmatize depression so that those who suffer from it can ask for medical help, just like patients with any other physical illness.

Saadia Batool, a clinical psychologist, says, "The first step that people are reluctant to take is seeking help, mainly because of social pressure. They irrationally fear others, but proper screening and treatment can improve the quality of It is therefore vital to consult a doctor. It can be very difficult to live with a depressed person, but support from loved ones can help the patient recover from this illness. For patients who are afraid to seek professional help, family members and friends may encourage them to consult a professional and offer to accompany them to their appointments. If anyone you know is thinking about self-injuring or is already intentionally injured, remove items such as drugs, sharp objects and firearms and do not leave them alone. If you think that the patient is in danger, do not leave him alone, immediately contact the emergency services. When you live with a person with mental illness, you can help them recover, but you must first take care of yourself to help them more effectively.

I asked Sara, a medical student and a patient with depression, how we could break the taboo surrounding the illness. "We need to talk about it and normalize the conversation about it. to people we suspect are showing signs of depression, we should not be trying to be their savior, as it weakens those who suffer more. " While telling me about the problems she faced and how other people's behavior changed after discovering that she was suffering from depression, she said, "I sometimes withdraw because most people do not understand it. comparing them to their circumstantial depression, both are devastating setbacks but I find that the external recognition of my pain is often what I need most and now, after cutting off the links of toxic people in my life, I have more.

The stigma and glorification of a disease can be just as harmful, worsening the attention paid to a person who does not actually suffer from depression and can therefore have adverse effects on the support of patients in whom a depression is diagnosed clinically. Cinema, television, and the music industry play an important role in the glorification and romanticization of depression and the drugs that flow from it. Lana del rey, a renowned musician, has often been criticized for idealizing pain and depression, particularly because of her dark lyrics such as "I would like to be dead". Not only Pakistani TV series, but also Hollywood and Netflix series as "13 reasons" have played a role in the romanticism of depression and self-destruction, but the most emotional glorification comes from Tumblr and Instagram. Profiles and groups can be seen glorifying self-harm and depression by using images that can easily entice a person with an addiction to self-injury. The images, hashtags and messages that romanticize the idea of ​​a depressed person for simply having suffered typical alterations of his feelings have made it a trend helped by social media and ease of access . Glorifying or romancing a real mental illness that affects 300 million people worldwide so that it can be narrated and cooled harms society as a whole. This decreases the credibility of the disease and those who work on the destigmatization of mental health. This online culture of a wonderfully tragic life is very sensitive to teenagers, just upload a black and white photo with a quote on agony, and one is automatically rewarded with compassion and pity by the social network friends. This ocean of dark poetry can easily drown those who suffer from a mental illness, especially those of adolescence, when this tendency to be considered deep, dark and mysterious by the "followers" of Tumblr and Instagram can be very tempting, which leads to more teenagers believing that they are actually depressed, followed by self-pity and self-harm.

In low-income countries like Pakistan, private therapies are very expensive and the lack of therapists in public hospitals leaves no room for poor patients but rather for themselves. According to the 2017 WHO Mental Health Atlas, "levels of public spending on mental health are very low in low- and middle-income countries and more than 80% of these funds go to hospitals psychiatric. Overall, the median number of mental health workers is 9 per 100,000, but there are? extreme variation (from less than 1 in low-income countries to 72 in high-income countries) ". It is essential to work on mental health legislation, especially with regard to the protection of the human rights of people suffering from mental illness, involuntary admission to mental hospitals, vocational training. and medical infrastructure.

* The name has been changed to protect the privacy of the individual.