Overview

Depression is widely prevalent in India. Depression is a psychological or mental state distinguished by long-time and continuous low mood, disinterest and delight in day-to-day activities, constant disturbance, and lower energy, resulting in inconsistent social and occupational dysfunction levels. Depressive disorders are common in all age groups and may be classified depending on the duration, severity, number of symptoms, and degree of functional impairment. In bipolar disorder, a manic episode may have been preceded and followed by hypomanic or major depressive episodes or even suicidal tendencies.

Although there are recognized, powerful treatments for it, most people in India receive no treatment due to:

• The social stigma associated with mental disorders
• Lack of resources
• Lack of trained healthcare providers

In most places, people who experience depression are usually not correctly diagnosed or misdiagnosed and prescribed antidepressants.

Types of Depression

• Depressive reaction. The symptoms of depressive reactions can be excruciating. They will abate over time -- maybe two weeks to half year. However, patient does not need medication or treatment unless they involve added symptoms like changes in sleep patterns and appetite or suicide tendencies. Psychotherapy is recommended at times if symptoms start to interfere with day-to-day functioning.

• Major depression. It is a severe condition that can lead to an inability to function or even suicide. Individual experiences depressed mood and also experiences difficulty in performing daily tasks, loses interest in their activities, high fatigue, sleep problems, or feelings of guilt & helplessness. In severe cases, they can also lose touch with reality, have delusions or hallucinations, and have the possibility of suicide. It can be a cyclical illness, so the recurrence rate is extreme while most sufferers recover sooner.

• Dysthymia. This is a low-level, long-term depression lasting for more than a year for children and adolescents and at least two years for adults. Dysthymia involves fewer symptoms than major depression, but it is persistent and longstanding and often can be as disabling as a major depression episode. 

Causes

There is no evidence what causes depression, although experts say that it appears to be an illness that may result from the combination of many biological and environmental factors.

• Clinical depression involves a syndrome of many physical & emotional or behavioural symptoms that can occur for no apparent reason in people who are biologically vulnerable to the disorder. 
• Depressive reactions, which involves a low mood but not the physical signs and symptoms of a major depressive episode, occur due to a particular event. 
• Depressed moods can also be due to medication, hormonal changes, or a physical illness, such as a flu.

Although the exact causes of major depression and dysthymia are unknown, researchers currently believe that these forms of depression are caused by a malfunction of brain circuits that regulate mood, thinking and behaviour. 

Brain malfunctions concerned to depression can consist of a genetic component, although this alone does not fully explain the risk or occurrence of clinical depression.

Symptoms

During a depressive event, an individual experiences sad feeling, irritability, emptiness or a loss of interest in activities almost all times, for minimum 2 weeks. In addition, there are several other symptoms like poor concentration, feelings of undue guilt or low self-worth, hopelessness about the future, suicide thoughts, disrupted sleep, changes in appetite, and feeling tired or low in energy. 

Some people may reveal their mood changes through visible pain, fatigue or weakness.  

When in depression, an individual experiences evident difficulty in personal, family, social, educational, professional, or other significant areas of functioning. 

Depression can be mild, moderate, or severe depending on the number of times, severity of symptoms and the bearing on the individual's functioning. 

Risk Factors

Many factors or a combination can increase risk factors for depression or make it more difficult to treat if it occurs, including:

• Abuse/substance abuse. Prior physical, sexual, emotional, or substance abuse has been associated with depression later in life among individuals who may be biologically predisposed to depression.
• Some medications. Some drugs used to treat high blood pressure or liver disease can increase risk.
• Conflict. Depression can be triggered by personal conflicts or disputes with close ones.
• Loss or death of a close one. Sadness or grief from the death or loss of a loved one, can increase the risk.
• Genetics. A family history of depression. 
• Major events. Negative and even positive events such as beginning a new job, graduating, getting married, re-locating, getting divorced, or retiring can result in depression.
• Other personal problems. Social isolation due to other mental illnesses or being cast out of a social group can cause depression.
• Serious illnesses. Sometimes depression coexists with a significant illness or may be triggered by a reaction to the illness.

Treatment

There are potent treatments for depression. 

Psychological treatments may be considered depending on the severity and pattern of depressive episodes over time. 

Different medications are used if the person is suffering from bipolar disorder. 

Distinctive psychological medication formats include individual and/or group face-to-face psychological therapies. 

Fact Check

• It is estimated that approximately 56 million people suffer from depression in India. 
• Roughly 38 million people suffer from some anxiety disorder in India. 
• India has one of the highest occurrences of mental illnesses globally. 
• It is found that close to 14% of India's population required active mental health interventions.
• Around one in seven of 15 to 24-year-olds in India reported often feeling depressed or having little interest in doing things.
• According to a survey in 2019, young adults between the age of 20 and 29 years of both genders were the most depressed in India.

PGC Resolution: To reduce mental health concerns in Indian communities. Aim to provide a wealth of services and information to help people overcome depression.