Depression…. Why Talk?

According to the WHO,
India is the most depressed country in the world, with One in Twenty Indians affected by depression.

Clinical Depression disorder is rampant in India, with a mortality rate only behind diabetes and cardio-vascular disease.

As it turns out, clinical depression can be completely treated and very efficiently managed if individuals have all the correct information about their symptoms and treatment options, and all the myths about depression are clarified. The only immunity against depression is information. We need to deal with it at the mental, emotional, political, legal and socio-cultural levels. The Indian Government has played an important role in destigmatizing and sensitizing the public through its various agencies. An important landmark in the area of mental health is the Mental Healthcare Act, 2017, which was passed by the Rajya Sabha on August 2016 and the Lok Sabha in March 2017. For the first time in our country, the Act creates a justifiable right to mental healthcare. The Mental Act provides persons with mental illness protection from cruel, inhuman and degrading treatment, right to information about their illness and treatment, right to confidentiality of their medical condition and right to access their medical records, to list just a few rights. The government is explicitly made responsible for set-ting up programs for the promotion of mental health, prevention of mental illness and suicide prevention programs. It has also effectively de-criminalized suicide attempts by ‘reading down’ the power of section 309 of the Indian Penal Code.

Ironically, in India, the current rate of Mental Health providers is 1.0 psychiatrists and 1.5 clinical psychologists for every 1,00,000 people (Ministry of Health and Family Welfare, 2017). This conveys the critical need for more practicing professionals in the field of mental health not only for treatment purposes but also for the establishment of mental health awareness amongst the masses. Poor mental health literacy limits the implementation of evidence-based mental health care and the task of preventing and helping mental disorders becomes largely confined to mental health professionals. In this era, the human race has become vulnerable to the extremes of stress and is exposed to severe losses, be it economic or social in nature. This has resulted in an increase in the prevalence of disturbed mental health in a developing country like India. The word depression is a part of our everyday language, people use the term to describe the feelings of sadness and have attached their own meaning to it which is far from the clinical picture. WHO has described Depression as a common mental disorder, characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks.

Depression, evidently presents itself as a major public health problem in India, contributing to significant morbidity, disability and mortality along with noticeable significant socioeconomic losses. The high rates of depression among adolescents and young adults, their low rates of mental health related help-seeking, and evidence that a young person’s mental health literacy is associated with their help-seeking practices, highlights the need for examining and improving the depression literacy of the youth. Teachers who work very closely with society also have an active role in fighting against stigma about mental illnesses. Teachers are frontline professionals who have daily contact with the youth and are therefore most likely to have the biggest impact on their students. Initially, teachers need to be aware of their prejudices and labelling practices against people with mental dis-orders. The young generation is on the frontline of our society and their mind-sets are the future of our country, whereas the teachers are one of the most influential professionals in our society whose beliefs and knowledge shape the norms and minds of the youth.

A cross sectional study on depression awareness using the D-Lit” was a research conducted on 2,102 subjects comprising of teachers, high school students and college students. The study concluded that all the college students had the least depression literacy. Whereas, high school students were most literate followed by teachers. It further stated that the sample had least awareness regarding psychotic symptoms (28.55%) and management (22.75%) of depression. The results suggested that people have highest stigma attached to the treatment of depression, through which one can understand the stigmatised help-seeking attitudes of the sample related to therapy and medication. Fear of judgement, lack of empathy, stigma, lack of education and expensive treatment are the key reasons that people don’t seek help.

These results are disturbing because 70% of our country’s population comprises of youth. The WHO states that clinical depression among many individuals has an early onset during young adulthood. Thus, lack of awareness in the youth allows depression to grow into a profound mental health disorder due to the negligence of treating it during its onset.
Udit Thakre, Dr. Nimrat Singh (Clinical &Organizational Psychologist) and Dr. Lalit Vaya (Psychiatrist) founded an awareness model in 2016. It began with an open program on ‘Chats About Depression’ at-tended by around 120 participants on the occasion of World Mental Health Day. ‘Depression let’s talk’ events have been extended to schools, colleges, universities, townships, cafes, corporate and NGO’s de-signed as an elaborate semi-structured conversation between the audience and professionals. This conversation revolves around 9 points namely-Depression and its characteristics (myth vs. reality), Signs / Symptoms of Depression, Sub-types of Depression, Relationship between Stress, Anxiety, and Depression, Effects of Depression, Depression, Suicide and Suicide Prevention. Types of professional treatment available for clinical depression – psychotherapy and psychiatric medicine, Lifestyle tips to prevent and manage depression, How to increase self-awareness, and how to say ‘no’ in the face of abuse and peer pressure. The forte of this project is its structure that allows a fluid conversation about depression between lay audiences and experts with years of clinical experience in addressing mental issues. Reference material from the WHO regarding clinical depression is provided to all participants, along with an audited list of mental health professionals practicing in Ahmedabad. Yet there is a need to formalize our efforts and classify the general population according to their literacy about depression. The findings of this 2000 plus sample hold importance in designing more such programs to deal with the general ignorance on a grave topic of serious concern. We have been avoiding to bring up this topic of depression as a society and the more we resist the more will persists. The question is that – are we ready to take a proactive role to immunize through awareness or are we going to wait for it to take a toll like a natural disaster and then respond to it. The choice is within each one of us. The way forward – is to design and organise workshops, seminars, talks, programs that work on the educational – awareness model which reflects the notion of “Immunization by Information”.