India Today Education got into a conversation with Dr Udaya Kumar Maiya, Medical Director of Portea Medical and Dr Shyam Bhatt, Trustee of The Live Love Laugh Foundation for a better understanding of clinical depression, its treatment and how should a patient cope with it.
Q1. What are the early signs of depression? How do you suggest that patients cope with it?
Dr M Udaya Kumar Maiya: Depression is a common form of mental illness. This is a condition that negatively affects feelings, thinking and actions. Some of the early signs of depression include:" Disinterest in activities that were once enjoyable" Changes in sleep schedule - The person may sleep longer than usual, lesser than usual, or may have a blend of both" Sadness is a common sign of depression; however, a person may be depressed without actually being sad" Sense of detachment - The person feels detached from reality" Feeling of hopelessness" Loss of energy" Suicidal thoughts
For coping with this, I would suggest that the person should socialize. He/she should not withdraw from life but should stay in touch. Try to be more active; take up some exercise regime. Instead of avoiding difficult situations, one should face them. Alcohol is not a good way of coping with depression; do not resort to drinking. Eat a healthy diet and stick to a particular routine. If all this does not help, seek help from a doctor.
Q2. How is clinical depression diagnosed? When should the treatment start?
Dr M Udaya Kumar Maiya: To establish a diagnosis of depression, it is important to first recognize it. If the patient reports feeling down, depressed or hopeless and/or has lost interest in things, he/she is subjected to a mental health assessment to review the person's mental state and associated functional, interpersonal and social difficulties. Patients are screened for depression using Patient Health Questionnaires. There is no laboratory test, blood test, or X-ray to diagnose a mental disorder.
Treatment should be initiated as soon as depression is identified. Early recognition and treatment are vital.
Dr Shyam Bhatt: Clinical depression has to be diagnosed by a doctor based on symptoms, functioning and the ruling out of other medical causes that can mimic depression. A diagnostic criteria for depression include either feeling low or sad for most of the day, nearly every day for two weeks or more, and/or decreased interest in activities that one may have previously enjoyed doing for two weeks or more, along with other symptoms such as change in appetite, sleep, worthlessness feeling slowed down and thoughts of death or dying.
Q3. How does the medicine world describe the term depression?
Dr M Udaya Kumar Maiya: The dictionary definition of depression states it as a mental condition that is marked by severe feelings of hopelessness and inadequacy, accompanied by a lack of energy and interest in life. Medical science defines depression in several different ways using ICD-10 and DSM-V. ICD-10 describes depression as a depressive episode or recurrent depressive disorder. According to DSM-V, there are 8 specific disorders described under depressive disorders.
So, depression is a common mental disorder marked by sadness, loss of interest, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration.
Q4. What is the state of mind of a person who is going through depression? When should loved ones get alert?
Dr M Udaya Kumar Maiya: The experience of every person undergoing depression is not same; however, the world seems like a dark place to almost all of them. People experiencing depression can experience intense emotions of anxiety, hopelessness, negativity and helplessness. The feelings stay with them instead of going away. Things that once looked beautiful may now seem ugly. Nothing comforts a depressed person. Such a person cannot obtain pleasure in anything. Nothing seems worth living for. No one seems loving or lovable and everything is irritating.
The support and involvement of family and friends is key to help someone who is depressed. Loved ones, caring for someone with depression, should get alert if they notice signs of severe depression, such as alcohol or drug abuse, sleep disturbance, thoughts of death or suicide or suicide attempts, persistent bad thoughts, and psychotic symptoms (hallucinations or delusions).
Q5. How important is the awareness about depression for the common, larger audience?
Dr M Udaya Kumar Maiya: Awareness is key to fighting depression. People experiencing depression feel isolated and alone, and lack of public education about the disease renders it difficult for those suffering to seek the necessary help. When people with depression fail to receive treatment in time, they resort to other ways of coping with the problem, which can eventually lead to addictions or suicidal thoughts. Increasing depression awareness among the general public and those affected with the illness will certainly go a long way in decreasing the stigma around the disease, and making treatment a more viable option.
Q6. Should a person rely on medication only? How important is therapy?
Dr M Udaya Kumar Maiya: Taking treatment for depression is absolutely necessary. Early recognition and treatment are important aspects of depression management. People feel better within weeks of starting treatment for depression.
Medication is not the only treatment option for people with depression. Besides antidepressant medications, talk therapy, i.e., psychotherapy, and cognitive behavioral therapy, electroconvulsive therapy, transcranial magnetic stimulation, and light therapy are other treatment approaches for a patient diagnosed with depression. Any one, or a combination, of the said approaches can be used to treat a patient with depression.
Dr Shyam Bhatt: Both Therapy and medicines play a role in the treatment of depression. For mild cases of depression, therapy and lifestyle changes alone are usually adequate to treat the depression. However for moderate or severe cases, medicines are required. However therapy is also of great use in these cases when used concurrently.
Q7. What are the challenges that India is facing when it comes to mental health?
Dr M Udaya Kumar Maiya: The extent of the challenge that India faces on the mental health front is huge and requires urgent and impactful interventions. Unfortunately, access to care for those with mental health issues has been abysmally poor until recently.
Q8. Do you think the government should take more measures for the awareness of the masses?
Dr M Udaya Kumar Maiya: We hope is that the introduction of the Mental Health Bill will be a significant step in changing the scenario of mental health in the country. The Bill highlights the government's role and responsibility in ensuring mental health sufferers get the right treatment and care. It is important this care is made available even in the farthest reaches of the country and technology can play a large role in this outreach. We look forward to working closely with healthcare stakeholders to ensure better health: both - physical and mental, is made affordable and easily accessible to all Indians.
Dr Shyam Bhatt: The Mental Healthcare Bill which was recently passed in the Lok Sabha displays the seriousness with which our law makers view the mental health challenge that India faces. It's also heartening to see the PM Modi talk about mental health in his recent Mann Ki Baat address. Depression / mental health is an issue of massive scale in the country and certainly government can play a key role. We need a significant increase in budgets allocated for mental health, and use public forums to talk about the need to speak about the issue and engage key influencers.
- By Chanpreet Kaur
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