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Depression: Let's Talk

By Dr Anweshak Das

In 1948, the WHO held the First World Health Assembly. Every year the 7th of April is commemorated as the World Health Day by WHO. It is seen as an opportunity by the organization to draw attention and create awareness worldwide to a subject of major importance to global health each year. This year 2017 the subject taken up by WHO is Depression. The theme is Depression: Lets Talk. Worldwide throughout the year various initiatives and activities will be taken up by WHO to create awareness on depression. 
As stated earlier, WHO takes up a subject of major importance to global health each year. So is depression a cause of concern? Or is depression becoming a major health issue worldwide? What has compelled WHO to take up Depression as their slogan this year? The answers to the above are all affirmative. Yes depression is a major cause of concern. Yes depression is a major heath issue worldwide throughout all communities, throughout all age group that it has sent alarm bells ringing and has compelled WHO to take up this subject. The new estimates released by WHO states that the number of people living with depression has increased by 18 percent from 2005 to 2015. It is the largest cause of disability worldwide. More than 80 percent of this disability is in lower and middle income countries. In humanitarian emergencies 1 in 5 people suffer from depression. The total number of people living with depression in the world is 322 million. Depression is more common among females (5.1%) than males (3.6%).  In India almost 1 in 20 suffer from depression and it is reported to be higher in females in the age-group of 40-49 years. High rates of depression are also reported in the elderly (3.5 per cent). By 2020 depression will be the most common disorder overpowering cardiac disorders and diabetes. So it was time that depression was given importance as a major heath concern in today’s world. Because one very fortunate thing we should all keep in mind that depression is not only preventable but also curable. And for people living with depression talking about it is the first step towards recovery.
Depression is an illness characterized by persistent sadness and a loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities. In addition, people with depression normally have decrease in their appetite and sleep disturbances. There are certain subtle signs that one can observe like irritability, sudden anger outburst, and withdrawn behavior. Depression can affect any age group. It’s a common myth that children donot suffer from depression. But the fact is that childhood depression is on the rise more so in the adolescent age group. A child when depressed will have irritability, loss of concentration in studies, school refusal, dietary changes, stubborn behavior, loss of interest in playing ect. Adolescents can indulge in substance abuse.  Depression can also be found in the old age. A feeling of worthlessness, talks of death, sleep disturbances, crying spells, memory problems are commonly found in this age group. Many a times in this age group depression is overlapped with dementia. With lifestyle diseases like diabetes, hypertension and stroke which is on the rise, depression is also commonly found in people suffering from these diseases. What is worse for depression is that it can lead to suicide which is the second most common cause of death in the age group of 15-29. As depression can be an ‘invisible’ illness, some people find it difficult to understand the effect it can have. They might see depression as trivial or dismiss it altogether. And this can make it harder for those experiencing it to speak openly and seek the help they need.
The most important barrier to prevention or for treatment in depression is stigma. Stigma since depression is a mental disorder. And since time immemorial mental illness has always been attached with stigma. Stigma manifests particularly in a phenomenon known as social distancing, whereby people with mental issues are more isolated from others. Research suggests that the majority of people hold negative attitudes and stereotypes towards people with mental illness. Eradicating the stigma of people with mental illness must be a top public health priority in order to improve worldwide mental health.  Stigma surrounding depression arises from living in a culture where feelings of vulnerability are considered weak and unacceptable. For many people, the stigma of being depressed is compounded by shame and guilt about not being a “productive member of society.” The depressed person may become a “nobody” when his disability makes him unable to work or to earn a living. Many people still try to pretend that depression doesn’t exist, or that a depressed person can be “talked out of it”. The stigmatization of depression does nothing to help or encourage those grappling with depression. In fact, treating depression as a personal problem instead of a real illness can lead depressed people to avoid seeking professional help and instead blame themselves for their depression. Depression is a serious illness, not a sign of weakness or a character flaw. So the first step of prevention and treatment of depression is the removal of this roadblock of stigma. Talking about depression, whether with a family member, friend or medical professional; in larger groups, for example in schools, the workplace and social settings; or in the public domain, in the news media, blogs or on social media, helps break down this stigma, ultimately leading to more people seeking help. The following points that will be highlighted has been given by the World Health Organization to help people come out of depression.
What you can do for people who are depressed:
Make it clear that you want to help, listen without judgment, and offer support. Find out more about depression. Be patient; it usually takes a few weeks to feel better .Encourage them to seek professional help when available.  In elderly people help them with everyday tasks and to have regular eating and sleeping patterns. Encourage regular exercise and social activities. Encourage them to get involved in a social forum. Encourage them to focus on the positive, rather than the negative. If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a healthcare. The same applies when you notice a child who is depressed.  In a child talk to him or her about things happening at home, at school and outside of school. Try to find out whether anything is bothering him or her. Protect your child from excessive stress, maltreatment and violence. Pay particular attention to your child’s wellbeing during life changes such as starting a new school or puberty. Encourage your child to get enough sleep, eat regularly, be physically active, and to do things that he or she enjoys. 
What you can do if you think you are depressed:
Talk to someone you trust about your feelings. Most people feel better after talking to someone who cares about them. Keep in contact with family and friends. Try to relax and engage in  your hobbies.  Exercise regularly, even if it’s just a short walk. If you feel suicidal, contact someone for help immediately. Accept that you might have depression. Seek professional help. Depression can be treated. If you think you have depression, seek help.
 (The writer is Consultant Psychiatrist with Ayursundra Superspeciality Hospital, Guwahati)

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Assam is a northeastern state of India with its capital at Dispur located in the city of Guwahati.
Nagaland is a northeastern state of India with its capital at Kohima. located in the Guwahati city.
Mizoram is a northeastern state of India with its capital at Aizwal. located in the Guwahati city.
Meghalaya is a northeastern state of India with its capital at Shillong. located in the Guwahati.
Manipur is a northeastern state of India with its capital at Imphal.
Tripura is a northeastern state of India with its capital at Agartala.
Arunachal Pradesh
Arunachal Pradesh is a northeastern state of India with its capital at Itanagar.
Sikkim is a northeastern state of India with its capital at Gangtok.
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