‘Mental pain is less dramatic than physical pain, but it is more common and also harder to bear

– C.S Lewis

Why India is the most depressed country in the world? According to the World Health Organisation, India is most depressed country followed by China and the USA. China, India and the US are the most affected countries by anxiety, schizophrenia and bipolar disorder, according to WHO.

India

We have discussed in the previous post how insurgency deeply affected the people of Kashmir and Seven Sisters of northeast.

A study reported in WHO, conducted for the NCMH (National Care Of Medical Health), states that at least 6.5 per cent of the Indian population suffers from some form of the serious mental disorder, with no discernible rural-urban differences.

Unemployment and poverty are the major reasons in the development of depression in India. After attaining higher education youths are unable to have a satisfactory job.

Lack of proper consciousness pertaining to mental health is another cause. I have told about insurgency and the activities of extremists in some provinces of our country. Unfortunately it is a consistent cause which our government has been facing for a uncertain periods.

I think there are several factors ranging from irregular income to domestic abuse causes depression to develop in individuals. Their ability to access counselling or medicine makes it even worse for them, often culminating in suicides

Though there are effective measures and treatments, there is an extreme shortage of mental health workers like psychologists, psychiatrists, and doctors. As reported latest in 2014, it was as low as ”one in 100,000 people”. The average suicide rate in India is 10.9 for every lakh people and the majority of people who commit suicide are below 44 years of age.

A study surveyed over 10,000 Indians to understand how they have been coping with the new normal.

According to the study, 26 per cent respondents were suffering from mild depression, 11 per cent were feeling moderately depressed, and six per cent were facing severe symptoms of depression.

“The last five months have been unexpected. The situation has taken a major toll on the mental health.

With the series of lockdowns, anxiety, job cuts, health scares, and the overall volatile environment, stress levels are at an all-time high.

“Copious amounts of stress can lead to depression. With the current lockdown and lifestyles drastically changing, we have seen that 43 per cent of Indians are currently plagued with depression and are learning to cope with it,” the study said.

To monitor the severity of depression in the respondents, the study relied on self-administered Patient Health Questionnaire or PHQ-9 (a form of primary care evaluation of mental disorders).

It took into account nine aspects of an individual’s daily routine, including interest levels in activities, appetite, sleep cycles, ability to concentrate, and energy levels.

“Our study indicates that an increasing number of people across the country are dealing with mental health issues triggered by the spread of the corona virus.

“The mounting uncertainty is the basis of the high stress index which can be controlled with a balanced diet, changes in lifestyle and appropriate sleep patterns,” said Vishal Gondal, Founder and CEO, GOQii.

Those feeling depressed complained of having little interest or pleasure in doing things, feeling hopeless, dealing with erratic sleep cycles, poor eating habits, low levels of energy, low self esteem, having trouble concentrating, being restless, and having thoughts of self harm.

“More than 59 per cent of the population said they had little pleasure in doing things these days, out of which 38 per cent have this feeling on a few days and 9 per cent feel so more than half of the days. Nearly 12 per cent felt this way almost every day in these times,” the study said.

It pointed out that more than 57 per cent of the respondents complained of feeling tired or having little energy through “at least some days in the last few weeks”.

“At least more than 15 per cent have this feeling more than half of the days. This leads to some people sleeping too much while some others have trouble sleeping.

“With the change in lifestyle, approximately half of the population is having trouble with their sleep,” the study said.

“At least 7 per cent of the population goes through this nearly every day while 33 per cent experience it on a few days,” it added.

Feeling hopeless, on the other hand, was not so common among the respondents. Only 10 per cent of them said they felt “down and depressed” more than half of the days or nearly every day.

The study suggested that adding exercising to one’s daily routine could help improve their mental health.

“Exercising can lead to endorphins (the happy hormone) which can help with depression. The more depressed you are, the more likely you are to not workout.

“But, it is important to cajole yourself into doing more things that make you feel happier,” it said.

Depression in Seniors:

In India, 30 per cent of the 103 million people above the age of 60 display symptoms of depression, according to a recent government survey. It estimated that 8.3 per cent of the country’s elderly population have probable major depression. This means, one in every 12 elderly person in the country have had depression. 

The prevalence figure is 10 times higher than the self-reported diagnosed depression of 0.8 per cent in the elderly population, pointing at the burden of undiagnosed cases, the report said.

Among the people who are of 45 to 59 years of age, 26 per cent show depressive symptoms.

The first chapter of the Longitudinal Ageing Study in India (LASI) was conducted by the Union Ministry of Health and Family Welfare between April 2017 and December 2018 on 72,250 older adults aged 45 years and above. The report was published on Wednesday.

More elderly women (9 per cent) have prevalence of probable major depression than men (7 per cent). Also, the figure is higher among rural residents (9 per cent) than their urban counterparts (6 per cent). The report also says that 10 per cent of the elderly population who live alone suffer from depression.

The study shows 3 per cent of all the elderly have some form of mental impairment.

Fewer people above the age of 60 who have 10 or more years of schooling (5 per cent) have depression than those with less than primary education (9 per cent).  

Over a tenth of the elderly population have probable major depression in Madhya Pradesh (17 per cent), Uttar Pradesh (14 per cent), Delhi (11 per cent), Bihar (10 per cent), and Goa (10 per cent).

Among the older adults above the age of 45 years, over 60% were hospitalised at a private facility in the 12 months prior to the survey. The mean out-of-pocket expenditure in private health facility among the elderly is Rs 31,933 compared to Rs 71,232 among those aged 45 to 59.  

The highest mean out-of-pocket (OOP) expenditure is reported in the state of Arunachal Pradesh (Rs 10,368) followed by

Himachal Pradesh (Rs 3,477), Nagaland (Rs 3,288) and Meghalaya (Rs 3,152). Tamil Nadu (Rs 641), Gujarat (Rs 644), and Puducherry (Rs 645) reported lower mean OOP expenditure on outpatient care.

Around 6 per cent of the country’s elderly population live on their own while 5.2 per cent have said they have faced ill treatment at home in the one year preceding the survey.

How to Overcome Depression?

With the WHO stepping up to encourage people to come forward and talk about depression and making the disease one of the main talking point of World Health Day, 2017. The condition is gradually making itself heard in mainstream conversation.

The government and other NGOs, also mental health workers are now trying to reach out to more people and asking them to come forward with their condition. It’s only then possible to further research about causes and solutions on depression properly.

Government should provide low cost access to mental healthcare and medicine so that the common people can be treated depression and get free it leading a joyful life.

How to battle depression

Finding meaning in life through love and work and being socially connected are important

We became felt immense agony when we listened to a bright star in Bollywood ended his life owing to depression. When a young person who had many years of productive life left, who was a National Olympiad Winner in Physics, and who left a career in mechanical engineering to become a talented and popular actor, takes such an extreme step.

It’s a collective loss to the nation. He was also a budding entrepreneur. It is sad that a prodigious actor and an exceptional citizen is no longer with us.

Also read :

Life is sometimes filled with anxiety, internal conflict, disharmony, uncertainty and fear of the unknown. These thoughts give way to myriad feelings.

One tends to feel like a stranger to one’s self. COVID-19 has acted as a catalyst inducing angst in the life of individuals who are already stressed because of various factors and modern lifestyles.

Stress in modern life

There are many factors that cause stress in modern life. They include more engagement with technology and less with people; more focus on “success” (the ends) rather than the process of learning (the means); never-ending aspirations; relationship issues; impatience while doing tasks.

This is a generation looking for instant gratification; and too many choices and the limitations of the human mind to choose wisely.

With the bridging of gender inequalities, increase in employment of women, growth and development of urban and peri-urban areas, interference of the media and social media in every aspect of life, and disruption in the traditional joint family system, there is an underlying strain on the socio-cultural fabric. Some of this stress, if not handled well, can push human beings into depression.

Some interesting cases and studies throw light on the coping mechanisms for anxiety and depression. Viktor Frankl, who was detained in Nazi concentration camps, studied the source of depression and found that it is the lack of meaning in life.

Individuals who are able to discover meaning tend to achieve the will and strength to endure life.

That brings us to the next question: how do we find meaning in life? Meaning can be found in love and work. Love for fellow beings is what motivates a person to work or take action. If we can base our actions and work on a shared love for family members and society at large, we can find effective meaning in life. ‘The Art of Living’ involves managing the self for others.

We have already discussed about our great poet, Rabindranath Tagore who had to face depression and was going to suicide.

Read here: http://www.kalpatarurudra.org /Rabindranath and depression

Prescriptions for depression and anxiety can be found in the writings of Rabindranath Tagore. Tagore believed that being socially connected was an antidote to the mental estrangement that plague-affected people were undergoing in 1918.

Tagore was aware that such a wildly contagious disease was likely to cause panic among the students. He organised many events in the Ashram which ensured that social connections existed despite physical distance.

In an essay, he suggested that we generate bonhomie between the affected and those who were not, because the ill were not the enemy; the illness was.

For immunity from psychological suffering, what was required was a design of togetherness, which Tagore insisted was ingrained in the famous Rig Vedic dicta, Yatra Visvam Bhavati Ekanidam (where the whole world meets in a single nest) and Vasudhaiva Kutumbakam (the world is one family).

Connecting with friends and family members:

Besides finding meaning in life, social connect is very important. I feel that positive and continuous communication is the key to end the misery of anxiety, depression and stress to achieve higher levels of well-being.

This is an earnest request to all the students and teachers who are under any form of stress, or tend to feel depressed, to reach out and talk to people, whether friends or relatives.

Generally a depressed person may not want to connect initially. Therefore, I appeal to family, relatives and friends to watch out for signs in their near and dear ones of persistent sadness, aloofness, loss of interest in activities and appetite, negative thoughts including about self-harm, and provide immediate support and connect.

We must not stigmatise the condition of mental health issues; it can happen to anyone. Instead, let us support our family and friends to tide over the difficult times with love and care. In doing so, we will overcome from this silent disease.