By Dr Oishee Mukherjee
Quite rightly the theme selected for this year’s World Health Day has been depression. As is well known, over 300 million people world-wide suffer from depression but the situation in India is even more serious. It is estimated from a recent study that at least 10 per cent of people in the country suffer from depression or anxiety but the numbers in urban sector may be even higher.
Depression is most prevalent among those between the ages of 40 to 60 and ill health could be the primary reason for this. This has been found by the National Mental Health Survey conducted by the Institute of Mental Health & Neurosciences (NIMHANS). Apart from environmental and social issues, biological changes are among the primary reasons according to researchers involved in the study.
It has been found that depression commonly occurs with other illnesses such as anxiety, obsessive compulsive disorder panic disorder, alcoholism, anti-social personality and schizophrenia and eating disorders. This is most common among those between 41 and 59 years of age, according to the National Health Mission.
There are also reports that those with cancer, arthritis, alcohol addiction or chronic lung diseases could be prone to depression. Depression is prevalent among those with non-communicable diseases. This disease affects the brain and when the brain starts to function abnormally, it affects a person’s mood and behaviour. The pessimism in the person aggravates and proper medical treatment is called for.
More than 80 per cent of people who kill themselves suffer from some sort of depression. This is established by the fact that 150,000 people commit suicide in the country; that’s one person in every 15 minutes. But we have only about 3500 psychiatrists and around 7000 psychologists to treat such a large number affected by this disease. Experts have pointed out that paucity of psychiatrists as also poor mental services in the country have accentuated diseases, specially depression.
Sometimes people not quite aware of the treatment needed to cure the disease. There is a general feeling that depression is not a disease and medical treatment is not quite necessary. However, medical science sees depression purely as a disease and prolonged treatment is called for. Moreover, the affected person should not undergo any strain and tension and advised to live a relatively happy life.
The reasons for the spread of the disease may be attributed to recent trends in society where families are breaking up, children do not think it necessary to look after their old parents, and the craving for more and more in the form of material wealth and comforts etc. There is very little happiness in society or in the family. In fact, India is very low in the happiness index as the country has been running after material values, which do not confirm to India’s traditional culture and values.
Another important reason for depression is the growing poverty and squalor in rural areas, where providing education and health facilities to family members has become a big problem. Moreover crop failures, leading to heavy debts cause depression and anxiety and destabilise the family. Corruption also plays a significant part in causing frustration and depressive tendencies are steadily manifest.
In such a situation, experts are of the opinion that depression is bound to increase in the coming years. Though religious worship or even fanaticism has increased, essential values in the family, the community and in society have been witnessing a decline. This is indeed puzzling and some sociologists attribute this to decline in moral and ethical standards.
Like any other disease, depression has to be controlled at the primary stage though such control may not be easy. How many diabetes patients or heart patients can control their ailment? Can we say that if values change or even if there is grass-root development of the people in the lowest tiers of society, the cause for depression or anxiety may be put to check? But making this a reality is indeed a tough task.
One obviously aspires for a healthy society where there is equality, fellow-feeling and love and compassion for at least relatives and friends, if not for the larger community. Achieving this in the modern world will help bring down the incidence of depression and its affect on human health but to make this a reality, there is need to shed a little of our selfishness. This should not be very difficult as Indians inculcate in their family religious and ethical values and just not show or pose to be religious.
The importance for focussed attention came just around two years back when the Medical Council of India (MCI) inducted psychiatry as an elective subject in the undergraduate syllabus. Apart from this, there is need to start an awareness campaign to control hostile behaviour patterns of individuals and open psychiatric clinics in all hospitals in cities and also in the districts for counseling. Taking the help of psychologists for counseling should be made easy. Big corporate houses and governments and educational institutions should be asked to appoint a part-time doctor or psychologist for counseling.
In some States, non-governmental initiatives to treat mental disorders have been coming up. These organisations screen the rural population for psychological problems and offer medical help and counseling. More such organisations at the grass-root level in the sub-divisions and districts should be encouraged to come up where cases of depression at the preliminary stage could be treated and counseling offered.
Coupled with this, there is need to inculcate moral and ethical values in students and youth and also grown-ups so that there is a limit to our materialist desires. The craving for more and more has to be checked. If some change can be brought about in individual behaviour, there is a possibility of reducing depression and anxiety. This could also bring down the incidence of diseases like hypertension, diabetes, high pressure etc.
It may be pertinent here to mention a report of Prof Dong-feng Zhang of the Medical College of Quingdas University. An analysis of 26 global studies involving more than 1.5 lakh people indicated a 17-18 per cent reduction in the risk of depression among those eating fish. The risk reduction was higher in men at 20 per cent and 16 per cent among women. Scientists suggest that omega-3 fatty acids found in fish may alter the micro structure of brain membranes and modify the activity of neurotransmitters, dopamine and serotonin. Moreover, the high quality protein, vitamins and minerals found in fish may help stave off depression.
The trend of increasing depression among all segments of the population is undoubtedly a cause for great concern. Unless social and psychological mind of the individual is restructured, depressive conditions may tend to have a serious and adverse effect on society. Human relations may get disturbed and the very fabric of society may break up. Thus there has to be serious attempts, primarily on the part of the government, to evolve ways and means to curb depression and make life relatively easy and simple. — INFA