The Ministry of Health and Family Welfare poster on coping with depression has drawn protests from doctors and psychologists, who say that it undermines the role of medical intervention and talk therapy for treating the condition. The poster, shared on social media on Monday, lists ten ways to “cope with depression” but does not advise seeking professional help.
Depression is a cognitive dysfunction that affects a person’s ability thinking perception as well as the ability to acquire, understand and respond to information. It is often caused by chemical imbalances in the brain and a reduction of certain neurotransmitters. According to the World Health Organisation, more than 56 million people – 4.5% of India’s population – suffer depressive symptoms.
The health ministry’s tweet carrying the poster says, “Depression is a state of low mood that affects a person’s thought, behaviour, feeling & sense of well-being. One must take up activities that keep him or her boosted in order to cope with depression.” These activities, according to the ministry, are following a routine, traveling, being creative, taking multivitamins, thinking positive, practicing yoga, staying clean, sleeping for eight hours, eating fruit and going for walks.
Mental health professionals have pointed out the glaring gap in the ministry’s advice – seeking diagnosis and counselling from a mental health professional.
“Depression is a disease which needs treatment and the government has turned it into some behavioral problem, ” said Dr Vinay Kumar, honorary general secretary of the Indian Psychiatric Society. “This message from the government is like telling a person with diabetes to walk and not take medicines.”
Kumar and his colleagues from the society are in the process of writing to the health ministry to ask it to withdraw the poster since they fear that it will do more harm than good to those diagnosed or suffering silently with depression. For example, a person with depression finds it difficult to wake up in the morning, said Dr NN Raju, consultant psychiatrist at Visakhapatnam. Instead of recognising this as a symptom of the disease, the person’s family may blame him for not trying hard enough wake up on time as a way to cope with the disease. “We know that depression needs medical attention and the chemical imbalance in the brain can be corrected with medicines and cognitive therapy also helps,” Raju added.
Both Kumar and Raju said that the poster by the government is clearly based on incorrect notions that depression can be treated by changing behaviour. “The poster is an example of wishful thinking,” said Kumar. “How can you expect a person suffering from depression to start thinking positively?”
Mental health professionals said that the posters advice may work to counter stress but not depression. The conflicting message, Raju said, is a result of the government’s own inability to understand the causes of depression. “What they have said in the poster can perhaps help prevent mental illness and are good tips to keep happy but not tools to cope with depression,” he said.
Dr Harish Shetty, a psychiatrist from Mumbai, has also written to Health Minister JP Nadda protesting the poster. “It has trivialised depression and after reading the poster, people on treatment may just stop taking medicines and instead follow advice of the government” on eating fruit and doing yoga.
Clinical psychologist from Mumbai, Rimpa Sarkar said she was glad that the health ministry is talking about depression but was startled by the information on the poster. Activity such as performing yoga can only supplement medication and therapy. “Psychologists and counsellors always have to examine a patient before suggesting any kind of physical activity, so an activity like yoga which is good for relaxation may not be advisable in some situations for patents already suffering clinical depression,” she said. “If we ask them to think positive or be creative, they really can’t do that.”
Doctors are also aghast at the mention of multivitamins helping to treat depression. “There is no scientific evidence that multivitamin can treat depression,” said Raju.
Said Shetty, “Lack of vitamins can lead to depression but we cannot advise people to pop multivitamins for depression.”