Life beyond Depression

Depression is a common illness worldwide, with an estimated 3.8% of the world population affected, including 5.0% among adults and 5.7% among adults older than 60 years (WHO, 2022). Approximately 280 million people in the world have depression. According to the National Mental Health Survey conducted by NIMHANS in 2016, nearly 9.8 million teenagers suffer from depression and other mental health disorders in India.

Related: Depression is a burden to the Global Economy

Nature has blessed humans with infinite capacities to create a positive difference in their environment in the form of rational, critical and creative thinking, social-emotional skills, logical reasoning, intelligence, self-regulation, goal-setting and decision-making and health is that underlying capacity that orchestrates this functioning. Health needs to be valued, nurtured, looked after and well taken care of. The four main pillars of human health are the Mental, Physical, Social and Emotional domains and the significant aspect is that they all work in coordination and are interrelated.

The imbalance, disparity or disturbance of any kind in this balance, which if not handled effectively at the right time, may lead to illness including mental illness, especially if the disturbance gets prolonged. To give impetus to the objective, World Mental Health Day is celebrated on 10th October every year.

The objective behind the day is to give the issue of mental health a priority in public health agendas around the world and focus on the factors, which may lead to mental illness. When the issue, which is already stigmatized finally makes its way to the table, it helps the community at large to challenge the prejudiced ideas and help the people learn, identify and address the risk factors.

Related: Reduced Social Media Linked to Better Work, Less Depression: Study

In the present article, the idea is to bring to the focus one of the hidden monsters which doesn’t let the people be themselves and no one even comes to know about it unlike physical illness and that monster is carried like baggage by the individual everywhere and every time. That hidden monster is Depression. Depression stays a hidden monster until learnt about, identified and finally addressed and sought treatment for.

The issue received a special attention recently after some of the highly popular people shared their battles with depression as a social responsibility and shared how they came out of it. This inspired millions and a realization dawned that this age-old, centuries-old issue needs to be discussed. Just like any physical illness, depression too can affect anyone irrespective of their age, socioeconomic status or gender and the symptoms vary from person to person.

According to the WHO

Depression is defined as a common mental disorder characterized by persistent sadness and a loss of interest in activities that are normally enjoyable and the inability to carry out essential daily activities and the pattern persists for 2-3 weeks continuously. If these signs are ignored or neglected for a long period of time, it can lead to suicidal thoughts also.

Related: Depression: Symptoms, Causes, Types and Treatment

Irregular sleeping patterns and loss of appetite are a few of the major physiological symptoms of depression. In its illustration of Depression through an animated documentary, which is written, illustrated and narrated by Matthew Johnstone, WHO shows Depression as a ‘Black Dog’. It is very vividly and empathetically expressed that whenever the Black Dog (Depression) makes an appearance, it makes one feel empty for no reason, it makes one look older, ruin one’s appetite, memory and concentration and doing any activity or going anywhere requires superhuman strength.

Related: Research Identifies Strong Link between Exercise and Lesser Symptoms of Depression

But despite all these battles on a daily basis, the biggest fear still is to be found out that one is suffering from Depression, because of the shame and stigma associated. So, an abundant amount of energy is invested in masking it and this emotional lie is really exhausting.

The reality is that Depression is a common disease and can strike anyone which can easily be ignored or misdiagnosed, which is debilitating in itself. There is a dire need to create awareness regarding the signs and symptoms and the treatment of Depression. If the signs and symptoms are ignored for a longer period of time, it can lead to suicidal thoughts. It falls under the family concerns also that if a family member shows signs like loss of appetite, disturbed sleeping patterns, digestion issues, cramps etc. for a relatively longer period of time, then depression can be the one seething underneath.

If family and friends observe any unusual behaviour pattern or the above-mentioned physiological symptoms, then the concerned individual needs to be supported enough to express what he/she is going through at the personal (or mental) level if the person stays under-confident and there is highly repetitive negative thinking in relation to the world, future and the self, there is extreme hollow sadness, pessimism, guilt feelings and a significant loss of interest in otherwise enjoyable activities and if the pattern persists for 2-3 weeks continuously then one needs to seek help.

As Plato puts it the cause of many diseases is unknown to physicians because they are ignorant of the whole as the part can never be well unless the whole is well. This paves the way for the interactive nature of physical, mental, social and emotional aspects of health. It further throws light upon the factors responsible for this whole health. Family support and communication is that factor, which, if perceived positively by the person makes him feel headstrong and ready to face the situation. Perceived family support is one of the most significant factors in a person’s readiness to seek treatment and not surrendering. The family acts as a buffer in this scenario and the most important aspect is that an understanding family does not judge and isolate rather it understands and doesn’t let the person stay alone for his mind to ruminate into self-defeating thoughts.

Related: ISOLATION OR ‘I HAVE SOLUATION

This reminds me of ‘Eeyore,’ a character from Winnie – The Pooh animation series. Eeyore is clinically depressed but he gets invited to participate in adventures and mischiefs with all his friends. They never expect him to pretend to feel happy, they never leave him behind or ask him to change. They just show him, Love.

We, as humans, can do the same to our near and dear ones, who are in the same situation with the added responsibility of providing them with psychological help, of course, with their consent. Watch out for the early signs, discuss, support and if necessary, do not hesitate to visit a psychiatrist or a counsellor. There are certain signs and symptoms, which are common as well as subjective to the sufferers. Apart from Psychotherapy and medication (antidepressants), some of the other aspects of the daily routine can be of immense help:

Adequate Sleep

Not less, not more, just adequate sleep helps improve your mood. Poor sleep may create difficulties in regulating emotions. Sleep and Depression are strongly linked. Disturbed sleep affects the quality of life of depressed patients as the Circadian Rhythm also gets disturbed, which increases the vulnerability to depression. Depression and sleep issues have a bidirectional relationship.

This means that poor sleep can contribute to the development of depression and that having depression makes a person more likely to develop sleep issues. This complex relationship can make it challenging to know which came first, sleep issues or depression. Circadian Rhythm is affected markedly by light and to some extent by temperature.

Related: Sleep Apnea: Definition, Symptoms and Treatment

Bright light in the evening will delay the clock, and natural & bright light in the morning is necessary to synchronize the clock to a 24-hour rhythm. All animals have such a clock. The drive to sleep from the circadian clock in normal sleepers starts to increase slowly at about 11 pm and gradually reaches a peak at about 4 am.

This provides a sleep-promoting process that continues into mid-morning and then provides a wakefulness-promoting process during the day. The person should be careful regarding an afternoon and evening nap if he/she is going through sleep disturbances.

Related: The 5 Stages of Sleep Cycle

Following a Routine

Waking up early and being able to accomplish your daily morning routine effectively is associated with greater feelings of overall happiness and gives a sense of achievement. To maintain the Circadian Rhythm, it’s a good idea to make waking up and going to bed at the same time a part of your daily depression routine, even on weekends, when you may not have a pressing need to get your day started.

It may help to set alarms (for both day and night) and commit to a pattern your body and mind can best rely on. During COVID-19 & subsequent Lockdown, many people either worked from home or were faced with the prospect of an unknown period of unemployment and it was quickly discovered that the constant isolation and lack of a normal schedule can be mentally taxing.

A lack of structure and routine can actually exacerbate feelings of distress. Make your to-do lists, exercise, find out what you like to do and what works for you as well, exercise and meditate. Routines promote health. Routine promotes healthy habits.

Vitamin D

The ‘sunshine’ Vitamin is one of the most effective ingredients for mood regulation. Exposure to direct sunlight for at least half an hour a day is beneficial depending upon the weather. As per research published in the International Journal of Molecular Sciences (2022), vitamin D deficiency has been associated with an increased risk of developing depression and anxiety, and individuals with these psychiatric conditions have low serum levels of this vitamin.

Related: How a Lack of Vitamin D Could be Detrimental to Mental Health

Particularly, antioxidant, anti-inflammatory, pro-neurogenic, and neuromodulator properties seem to contribute to its antidepressant and anxiolytic effects. Another research published in the International Journal on Nutrition, Diet & Nervous System (2022) reveals that Both vitamin D metabolites, D2 & D3 play a significant role in mood regulation. The study provides valuable insights on vitamin D3 and its significant relationship with depression symptoms in the presence of vitamin D2.

The Mental Work

In your fight against depression, a lot of work is mental i.e., changing how you think. When you are depressed, you tend to have a tendency to leap to the worst possible conclusions. Using logic as a natural way to treat depression. You might feel like no one likes you, but have you found the evidence for that? The same goes for feelings of worthlessness, check the evidence for the same. All treatment should involve identifying stress factors and sources of support.

Related: Mindfulness: Why It’s Important and How to Practice

Avoid absolutes like ‘never’ & ‘always.’ Be mindful of your language intensity. Mindful Cognitive Redirection helps. Practice and practice more. You get good at what you practice. And it’s within your reach to keep those negative thoughts under control.

The big change comes from hundreds of tiny steps and they all matter. Interrupting a depressing and hopeless thought with a mindful and hopeful thought like- “What if things work out?” helps Of all the elements in the will to be back to the original self, the asset of hope is the most vital.

Hope is the expectation that one will have positive experiences or that a potentially threatening or negative situation will not materialise, or will ultimately result in a favourable state of affairs (APA, 2021). It is an emotional and mental state that motivates you to keep on living and to look forward to accomplishing things.

It pushes you on the path of growth with an anticipation that sincere efforts will materialise. A person who lacks hope can give up on life and lose the will to live. With a hopeful mindset, a positive attitude can be maintained, determination strengthened, coping skills sharpened, and love and support more freely given and received.

Related: Differences Between Positive & Negative Attitudes 

Yoga, Meditation and Exercise

Are clinically proven effective strategies against Depression. According to various research published in the Journal of Psychiatry and Neuroscience and the Journal of Psychiatric Practice in the years 2007 and 2019 respectively and various other significant research, Yoga is a natural way to increase Serotonin production.

What the research on Depression conveys, which itself is in the early stages that it is the Serotonin production, which plays an important role in the treatment of depression as people with depression have lower serotonin levels. This routine accentuated with breathing exercises helps you calm your mood.

Related: Yoga & Psychology: Bridging Ancient & Modern Wisdom

Socialize

Connectedness helps you love yourself which is well-deserved. Supportive relationships improve the feelings of self-worth and help you feel accepted as socialization lowers the depressive symptoms. Socialization staves off feelings of loneliness and increases the sense of happiness and well-being as well. Human connection has the capacity to heal, replenish, rekindle and rejuvenate!!

Thyroid Gland & Depression

Many factors increase a person’s risk of developing depression. One such common association exists between hypothyroidism and depression. The relationship between hypothyroidism and depression was first described in 1825 by Parry, who noted increased “nerve strokes” in thyroid disease. Studies have demonstrated that somatostatin and serotonin influence the hypothalamus-pituitary-thyroid axis, which links hypothyroidism to depression.

Elevated thyroid-stimulating hormone (TSH), antithyroglobulin (TgAb), and thyroid peroxidase antibodies (TPOAb) levels have all been linked to depression and an increased risk of suicide (Cureus, 2022). Depressed patients have been found to have an underlying hypothyroid status. Hence, screening for hypothyroidism in patients suffering from depression is necessary. The treatment protocol usually entails the treatment of hypothyroidism appropriately.

Related: Blood Test Differentiates Depression from Bipolar: Study

To conclude, it is stressed that mental illnesses are the illnesses of an organ of the body only and that is the brain. Researchers studying mental illness believe that abnormalities in how particular brain circuits function contribute to the development of many mental illnesses. Connections between nerve cells along certain pathways or circuits in the brain and malfunctioning of neurotransmitters can lead to problems with how the brain processes information and may result in abnormal mood, thinking, perception or behaviour.

“You are not really sick, it’s all in your head” is like telling someone with asthma – “It’s not real, it’s all in your lungs”. Just remember one thing, there is no problem on this Mother Earth, which doesn’t have a solution. But we need to make an effort to find that solution. A collective, sincere & dedicated effort from the individual, family, therapist and psychiatrist definitely brings results.

Related: Habits to Help in Avoiding Depression

So, it’s pointless to waste time and wait for things to get better on their own. The results you achieve are in direct proportion to the effort you apply and Health and Mental Health are no exceptions!! The idea is to get the ball rolling and one needs to get oneself of getting used to doing things and the goal is not far…it is treatable!!