Depression: An illness that seeks a friend

NEW DELHI: Arjun Bhardwaj, an MBA graduate from Mumbai, recently jumped off a fivestar hotel, ostensibly because his startup didn't succeed. In Delhi, 54-year-old Harjeet Singh committed suicide at AIIMS Metro station on Tuesday due to losses in business. Could timely intervention have saved them?
Initial investigations revealed that both were depressed and their families knew about their condition.If they were counselled and treated, psychiatrists say, both Bhardwaj and Singh would be alive.
But these are not isolated cases. Depression, which is the theme of this year's World He alth Day (April 7), affects one in every 20 people in India -and is a leading cause of suicide.
Dr Nand Kumar, professor of psychiatry at AIIMS, said cases of severe mental disorders, such as schizophrenia and bipolar disorder, have gone down over the past few ye ars, but depression and related disorders have increased. “It is not limited to lower social strata, as is perceived. We see patients from middleand high-income group also,“ he added.
Psychiatrists blame a fastpaced lifestyle, stress and complexities of living, breakdown of support systems and challenges of economic instability for the rising cases of de pression. “The human psyche has become very fragile and there is a lack of social support. This is pushing many into depression and suicide ideation,“ Dr Sameer Malhotra, who heads department of mental health and behavioural sciences at Max Hospital, said.
Experts say much of this can be prevented with timely psychological first aid, an emerging concept that promotes humane, supportive and practical help to a person in distress. “Physical first aid has been there for years. It is used to reduce discomfort due to bodily injury . But psychological first aid is an emerging concept. It attempts to give healing touch to the mind,“ Dr Nimesh Desai, director of Institute of Human Behaviour and Allied Sciences (IHBAS).
He said PFA can be provided by anyone, including a family member or friend, but there is a need for professionals in this field as well. India needs one psychiatrist per lakh population, but has only 0.5 available in most states, except Kerala.
“A large number of private institutions and professionals are available, but their quality and activities are unclear,“ states the National Mental Health Survey report 2015-16. Dr Achal Bhagat, senior consultant, psychiatry and psychotherapy at Apollo Hospital, said few people realise that depression is a treatable disorder.
IHBAS director Dr Desai said active social and legal action against any discrimination is also needed. “We should focus on success stories and create awareness about the scientific nature of treatment,“ he added. IHBAS received 5,260 patients suffering from depression, 14% of total patients visiting the OPD, last year. The number of patients suffering from the condition who required admission was 78 (3%), said doctors.
Signs and symptoms of depression include disturbed sleep, loss of appetite, guilty feeling, low self-worth, feelings tired and lethargy . It may also manifest as agitation or physical restlessness, substance abuse, reduced concentration and suicidal thoughts or acts, Poonam Khetrapal, regional director of WHO South East Asia, said.
She added that people experiencing depression often find a range of evidence-based coping mechanisms useful, from talking to someone they trust to exercising regularly or staying connected with loved ones.