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DEPRESSION

An Overview
What is Depression (and what is it not)?
Depression Self-Screening Test
Seasonal Affective Disorder
Helping a Depressed Friend
FROM DARKNESS TO LIGHT
Suicide? Read This First
If you are feeling suicidal now,
please stop long enough to read,
click the link above,
take only about five minutes.
 Depression - An Overview

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A report released by the World Health Organization (WHO) states that depression threatens to be the world's most common illness by the end of the century. The increasing stress levels, demands of workplace and nuclear families, peer pressure, mechanization of life, along with disillusionment with the old-world values and systems, make a person a soft target for depression.


Serious depression is an important public health problem. More than 19 million adults in the United States will suffer from a depressive illness this year, and many will be unnecessarily incapacitated for weeks or months, because their illness remains untreated. The cost to the Nation in 1990 was estimated to be between $30 - $44 billion. The suffering of depressed people and their families is immeasurable.

Depressive disorders are not the normal ups and downs that everyone experiences. They are illnesses that affect mood, body, behavior, and mind. Depressive disorders interfere with individual and family functioning. The person with a depressive disorder is often unable to fulfill the responsibilities of spouse or parent, and may be unable to carry out usual job responsibilities.

Available medications and psychological treatments, alone or in combination, can help 80 percent of those with depression. With adequate treatment, future episodes may be prevented or reduced in severity. Yet, current evidence indicates that nearly two out of three depressed people do not seek treatment and suffer needlessly.

Research has also shown that depression often co-occurs with medical conditions (e.g., stroke, heart disease, cancer, diabetes, etc.); other psychiatric disorders (e.g., anxiety disorders, eating disorders, etc.); and alcohol and other substance abuse. In such cases, there can be added health benefits from treating the depression.

POINTS TO CONSIDER

  • Clinical depression is a common illness that usually goes unrecognized. When identified, it can be treated.

  • There are effective medications and psychological treatments which often are used in combination. In serious depression, medication is usually required.

  • The majority of clinical depressions, including the most severe, improve with treatment, usually within weeks. Continued treatment will prevent recurrence.

  • Depression is often unrecognized when it co-occurs with other medical, psychiatric, or substance abuse disorders.

  • Depression - Causes

    There is a risk for developing depression when there is a family history, indicating that a biological vulnerability can be inherited. The risk may be somewhat higher for those with bipolar depression. However, not everybody with a genetic vulnerability develops the illness. Apparently additional factors, possibly a stressful environment and other psychosocial factors are involved in the onset of depression.

    Though major depression seems to occur, generation after generation, in some families, it can also occur in people who have no family history of depression. Whether the disease is inherited or not, it is evident that individuals with major depressive illness often have too little or too much of certain neurochemicals.

    Psychological makeup also plays a role in vulnerability to depression. People who have low self-esteem, who consistently view themselves and the world with pessimism, or who are readily overwhelmed by stress are prone to depression.

    A serious loss, chronic illness, difficult relationship, financial problem or any unwelcome change in life patterns can also trigger a depressive episode. Very often, a combination of genetic, psychological, and environmental factors is involved in the onset of a depressive illness.

 

What is Depression (and what is it not)?

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"People who don't know, who say it's self-indulgence, sound callous, but it's not callousness born of indifference; I think it's callousness born of ignorance. That kind of ignorance we've got to get rid of, and little by little I suppose, we will. You say to them, 'It's a pity you don't know. I'm sure that if you knew, I'm sure that
if you knew, not only wouldn't you say that, you'd try to help in one way or another.'" - Mike Wallace, On the Edge of Darkness

Note: I wrote this a few years ago, and it has made its way around the Net uncredited. If you want to reprint it, please make sure you credit Wing of Madness.

What Depression Is:

  • Depression is an illness, in the same way that diabetes or heart disease are illnesses.

  • Depression is an illness that affects the entire body, not just the mind.

  • Depression is an illness that one in five people will suffer during their lifetime.

  • Depression is the leading cause of alcoholism, drug abuse and other addictions.

  • Depression is an illness that can be successfully treated in more than eighty percent of the people who have it.

  • Depression is an equal-opportunity illness - it affects all ages, all races, all economic groups and both genders. Women, however, suffer from depression almost twice as much as men do.

  • At least half of the people suffering from depression do not get proper treatment.

  • Untreated depression is the number one cause of suicide.

  • Depression is second only to heart disease in causing lost work days in America.

  • Unipolar major depression is the leading cause of disability.

What Depression Is Not:

  • Depression is not something to be ashamed of.

  • Depression is not the same thing as feeling "blue" or "down."

  • Depression is not a character flaw or the sign of a weak personality.

  • Depression is not a "mood" someone can "snap out of." (Would you ask someone to "snap out of" diabetes or high blood pressure?)

Depression is not fully recognized as an illness by most health care insurance providers. Most will only pay 50% of treatment costs for out-patient care, as well as limiting the number of visits.       

 source : www.wingofmadness.com
 

Depression Self-Screening Test

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What does depression feel like?

"It was not really alarming at first, since the change was subtle, but I did notice that my surroundings took on a different tone at certain times: the shadows of nightfall seemed more somber, my mornings were less buoyant, walks in the woods became less zestful, and there was a moment during my working hours in the late afternoon when a kind of panic and anxiety overtook me..." - William Styron, Darkness Visible

Sometimes the Depression Self-Screening Test is just too clinical, and the symptoms don't really "click" with you. Some of the criteria are general, and if you're suffering from depression, specifics are easier to understand. I know that I might not have diagnosed myself with depression just on the basis of those symptoms. I had no change in appetite, and no sleep problems (waking up was what was difficult). Below are some un-clinical symptoms.

  • Things just seem "off" or "wrong."

  • You don't feel hopeful or happy about anything in your life.

  • You're crying a lot, either at nothing, or something that normally would be insignificant.

  • You feel like you're moving (and thinking) in slow motion.

  • Getting up in the morning requires a lot of effort.

  • Carrying on a normal conversation is a struggle. You can't seem to express yourself.

  • You're having trouble making simple decisions.

  • Your friends and family really irritate you.

  • You're not sure if you still love your spouse/significant other.

  • Smiling feels stiff and awkward. It's like your smiling muscles are frozen.

  • It seems like there's a glass wall between you and the rest of the world.

  • You're forgetful, and it's very difficult to concentrate on anything.

  • You're anxious and worried a lot.

  • Everything seems hopeless.

  • You feel like you can't do anything right.

  • You have recurring thoughts of death and/or suicidal impulses. Suicide seems like a welcome relief.

  • You have a feeling of impending doom - you think something bad is going to happen, although you may not be sure what.

  • In your perception of the world around you, it's always cloudy. Even on sunny days, it seems cloudy and gray.

  • You feel as though you're drowning or suffocating.

  • You're agitated, jumpy and and anxious much of the time.

  • Your senses seem dulled; food tastes bland and uninteresting, music doesn't seem to affect you, you don't bother smelling flowers anymore.

  • Incessantly and uncontrollably into your mind comes the memory of every failure, every bad or uncomfortable experience, interview or date, like a torrent of negativity.

Note: I wrote this a few years ago, and it has made its way around the Net uncredited. If you want to reproduce it in any way, please look at the terms of the Creative Commons license at the bottom of the page.

Gregor said:

I've reached the conclusion that my depression is a mild case so I can't even begin to imagine what most of you are going through. I've got a great job, but lately, I've found it hard to enjoy it. I just go through the motions and can't give it everything I have. I'm always looking at the darker side of things. It's like a haze is hanging around me, preventing me from seeing truth. I keep feeling that my future is bleak and the easiest thing would be to end it all. That thought keeps wandering through my mind. I know that I'm in a great position in life. One that many people would kill to get. But at the same time, I just feel sorry for myself that I can't enjoy it. I always thought life would be a better place to live, but for the last few years it doesn't seem that way.

Posted by Gregorat May 17, 2004 06:57 AM

Self-Screening for Depression

"I am the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be a cheerful face on earth. Whether I shall ever be better I cannot tell; I awfully forbode I shall not. To remain as I am is impossible. I must die or be better."

- Abraham Lincoln

If five or more of the following symptoms have been present in either you or someone you know for more than two weeks, please talk to your doctor about the possibility of depression being present. Keep in mind that these symptoms could indicate a medical condition other than depression.

Depression Symptoms

  • Feelings of sadness and/or irritability

  • Loss of interest or pleasure in activities normally enjoyed

  • Changes in weight or appetite

  • Changes in sleeping pattern

  • Feelings of guilt, hopelessness, or worthlessness

  • Inability to concentrate, remember things, or make decisions

  • Constant fatigue or loss of energy

  • Observable restlessness or decreased activity

  • Recurrent thoughts of suicide or death

In addition, look for at least three of the following symptoms, which could indicate the manic phase of manic-depression:

  • Inflated ego, envisioning of grand schemes

  • Increased energy and decreased need for sleep

  • Inappropriate excitement or irritability

  • Increased talking and/or moving

  • Sexual promiscuity

  • Disconnected and racing thoughts

  • Impulsive behavior and poor judgment

 

For a more detailed screening, look at the Goldberg Mania Inventory.

Other self-screening tests are at:

Seasonal Affective Disorder

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15 Coping Techniques for Seasonal Affective Disorder
by Frank Salamone, CSW

Living with S.A.D. (Seasonal Affective Disorder) -- especially during the oftentimes stressful holiday season -- can be challenging. Here are some strategies that have worked for me over the years. I hope you find some of them helpful:

  1. Follow the light. Try using a "light box" for thirty minutes every morning, always walk "on the sunny side of the street," and turn on every light in your house (prepare to hear an old parental voice in your head, however, reminding you that "we don't own the electric company!"). Also, sleeping with the shades up will allow the light to wake you naturally (waking up in a dark room will only make early morning - the worst part of a S.A.D. day - much worse).

  2. Make your bed every morning. This will accomplish two things: First, it will remind you that returning to bed during the day when you get the urge to "hibernate" is a no-no. Second, it will help you to stay and feel organized.

  3. Sleep less. Get the recommended eight hours sleep, but avoid sleeping longer than that. Get up at the same time every day, including weekends. Avoid hitting the snooze button until at least March!

  4. Stay connected. Focus on face-to-face contact over Internet chatting. Make plans and keep your commitments.

  5. Do small projects. Staying productive will help your mood. Don't let mail, dirty dishes or laundry pile up. You will only feel worse. And remember your dishes and laundry do not require you to be in a good mood. When you feel blue at holiday parties, offer to help out; I sometimes volunteer to help clear the table and wash dishes, much to my host's delight.

  6. Be realistic about your moods. Don't set your expectations too high, here. You're not going to be the next Pollyanna; just try to keep from turning into Scrooge!

  7. Keep it simple. Don't overplan, overextend or overdo - whatever this means for you. This is not the time to remodel the den, begin graduate school or promise to take your elderly aunt and uncle to the Grand Canyon! Try to limit travel plans to no more than one time zone difference - jet lag is particularly difficult for those with S.A.D. If you must travel, go somewhere sunny!

  8. Eat regularly. Notice I said regularly, not continuously! Also, try to focus on six small meals high in protein and low in "simple"carbohydrates and sugars (especially white flour, honey and sugar). Maintaining a constant blood sugar is especially important during S.A.D. season. Try to eat a protein-rich breakfast within thirty minutes of waking. Limiting alcohol intake to two drinks and drinking extra water will also be helpful.

  9. Help your friends and family help you. They will ask: "What's wrong?" (which translates: "Did I do something to upset you?"). Don't say: "Nothing's wrong." Reassure them that it's not them, it's you (If it IS them, then be clear but tactful). You may have to tell them, politely, that when they say things like: "Snap out of it!" or "What do you have to be depressed about?" it is not helpful. You might say: "I'm feeling a bit low today, but I'd love to hear what's going on with you."

  10. Allow extra time to do anything. You will be moving at a slower pace. And even basic tasks take longer when you're feeling blue. And don't make too many back-to-back commitments; if you must, then allow yourself some "breathing room." Always leave at least fifteen minutes early to go anywhere!

  11. Exercise and fresh air. Try to get outside as much as possible when weather permits. Oxygen and light work wonders!

  12. Limit or avoid sleep aids. Sleeping medications, tranquilizers, valerian root and melatonin make S.A.D. much worse.

  13. Throw yourself out of the house every morning. Don't brew your coffee at home. Go out every morning and buy your brewed coffee and something for a nourishing, balanced breakfast (And, no, a bagel or a danish does not constitute "breakfast!"). The extra cost will be worth it!

  14. Make the final rinse "cold." Finish your shower with a final rinse of cold water. The will have an positive effect on your mood and will also close your pores to help maintain winter health.

  15. Remember that S.A.D. is physiological rather than psychological. The fact that the holidays occur during this time is coincidental, not the cause of S.A.D. Seek professional help if you spend more than a day or two in your pajamas staring at piles of mail, dishes and laundry!


Take note of what is helpful to you; create strategies of your own.

Helping a Depressed Friend or Family Member

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The most important thing anyone can do for the depressed person is to help him or her get appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication.


The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed
person in conversation and listen carefully. Do not ignore remarks about suicide. Always report them to the doctor.

Invite the depressed person for walks, outings to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.

Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it." Eventually, with treatment, most depressed people do get better. Keep that in mind, and keep reassuring the depressed person that with time and help he or she will feel better.
 
 
FROM DARKNESS TO LIGHT

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Quoting Mahabharata, the great Indian epic, Duryodhana, a character from the epic,
 is the epitome of depression: both internal and external.

By Anupama Bhattacharya for Lifepositive magazine

Understanding depression, which in the age of anxiety is threatening to become as prevalent as the common cold, and exploring avenues to fight this dehumanizing infection

Like a dark cloud hovering over the sky, the feeling creeps into your being: drowning, devouring all sense of reality. "What am I living for, who cares for me?"—you wonder. In a torrent of lashing memories, everything comes back with a renewed vengeance. All the hurt, the pain, the inexpressible emotions, overwhelming in their intensity, pull you deeper and deeper into the fathomless chasms of misery until you lose all desire to live.

Only a numbness remains—leaving you empty, devoid of all feeling.

Somewhere deep within, we all identify with this state, even if for a split second. What differentiates most of us from those who are clinically categorized as depressed is that at such moments, we strive to gain our equilibrium instead of giving in. But not everyone is so lucky.

To what extent the reasons for feeling down are justified is always debatable. What is significant here is that at such moments some people let go of their will to fight back, and if the feeling is allowed to grow, it might lead to nervous breakdown or even suicide. Why do we feel depressed?

Why is it that at certain moments we feel ready to face any calamity while at some other time even an apparently insignificant word hurts us so much that it takes us to the brink of despair?

FEELING BLUE
It is normal to feel depressed at times of adversity and such feelings are as much a part of everyday life as joy and contentment. It is only when the symptoms persist or become acute and self-destructive that professional help is required.

Unless triggered by a specific incident or event, depression usually has its root in the deep-seated psychological factors such as upbringing, relationship with parents and siblings and childhood traumas and fantasies. Clinical depression, in particular, for which sometimes the patient himself fails to find a concrete reason, is often a result of years of neglect, repression and feelings of uselessness and incapability, nurtured by uncaring parents and relatives. Depression can be set off by a number of factors; family history of depression, loss of somebody or something, weather, family atmosphere, failing to achieve something, childbirth, marital problems, hormonal changes, prolonged illness, thyroid problems or even diseases like the glandular fever.

When the cause of depression is purely biological, appropriate medication and counseling can cure it within a few weeks' time. The problem arises when it is caused by deep-seated traumas and current setbacks. "On the face of it, a person might feel depressed due to something as simple as failing to get a promotion or missing a coveted job," says Arpita Anand, counseling psychologist with Saarthak, an Indian voluntary organization. "But go deeper and you realize that this person's sense of worthlessness is actually caused by his assumption that unless he goes on achieving, he is not worthwhile."

Such assumptions, says Arpita, are nurtured by parents who express love or give rewards only when their child achieves something. Considering the increasingly competitive education system and society, it is hardly a wonder that the number of people suffering from depression is increasing at an alarming rate.

SAD PROGNOSIS
According to studies conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India, one in every 15 adult Indians suffers from depressive illness. At least 10 per cent of the population suffers from depression that needs professional and medical help, and as much as 40 per cent of the population is demoralized and likely to cross the line to clinical depression sometime.

SYMPTOMS OF DEPRESSION AND SUICIDAL TENDENCIES

Feeling sad or irritable most of the time
• Losing interest in things that you enjoyed earlier
• Feeling fatigued and exhausted without any exertion
• Feeling hopeless about the future
• Disturbed sleeping patterns
• Becoming sentimental about minor things
• Feeling alienated from the world

• Losing appetite or a sudden tendency to eat more
• Frequent tearfulness
• Signs of physical self-harm such as scratch marks, cuts

• Asking or looking for possible tools for committing suicide
• Communicating thoughts of suicide
• Giving away precious belongings

A report released by the World Health Organization (WHO) states that depression threatens to be the world's most common illness by the end of the century. The increasing stress levels, demands of workplace and nuclear families, peer pressure, mechanization of life, along with disillusionment with the old-world values and systems, make a person a soft target for depression.

To add fuel to fire, it is considered uncouth to express sentiments that are not strictly in tune with the dictates of society Creating, in effect, human beings who are expected to behave like assembly-line products.

"I don't understand this obsession with trying to sound casual," says Seeman Narang, first-year student at Delhi University, India, who recently had a nervous breakdown since she could not adjust to her college atmosphere.

"My classmates call me melodramatic when I get emotional. I stay in a hostel and miss my parents. But if I express my feelings I'm branded a crybaby. Why should I be expected to behave as though I don't care when I actually care so much?"

It doesn't take long to see the truth in Seema's words. Being unable to express emotions, putting on a fašade of sociability and living a life that is more pretension than reality, the modern man seems to have created a cocoon around himself where he is alienated from the world around him and becomes a prisoner of his own dreams. And in a society where everyone is racing to outdo the other, expectations of sympathy and solace are fast turning into a receding mirage.

I remember an acquaintance who would turn up with a scarf around his forehead every other day. And each time, he would complain of headache and seek attention. It took me a long time to figure out that he was actually expressing his feelings of depression and dejection through symptoms of physical pain.

Depression takes many forms. Starting from lethargy, somatic complaints such as body aches and pain to irritation and anger, depression can encompass the entire gamut of negative emotions. A proud individual who abhors attracting sympathy might express his feelings of dejection through sulking or aggressive behavior. An extrovert, on the other hand, is most likely to express his feelings openly. In children, depression takes the form of increased irritability and social withdrawal, and has to be distinguished from 'spoilt' behavior.

The communication of depression can also vary from culture to culture. According to Diagnostic and Statistical Manual of Mental Disorders published by American Psychiatric Association, complaints of nerves and headaches are more common in Latino and Mediterranean cultures, weakness, tiredness or imbalance in Asian cultures, and problems of the heart in the Middle Eastern cultures.

In depression, appetite is usually reduced though some may have increased appetite and crave for specific foods like carbohydrates. The most common sleep disorder associated with depression is insomnia. Most people have middle insomnia (waking up during the night and having difficulty going back to sleep) or terminal insomnia (waking up too early and being unable to go back to sleep). Initial insomnia (difficulty in falling asleep) may also occur as well as over-sleeping.

The psychomotor changes during depression include agitation, inability to sit still, hand wringing or lethargy and slowed speech, along with increased pauses before answering. A morbid self-involvement without consideration for others is another characteristic trait of depression.

FORMS OF DEPRESSION

Some women suffer from depression a week before menstruation. It is accompanied by marked fluctuation in mood, anxiety and decreased interest in activity. But this complaint disappears with the onset of menstruation.

In middle-aged women, menopause also brings in its wake depression as well as phobias and hysterical tempers caused by shifting levels of estrogen and progesterone—hormones that affect the mood. Studies indicate that women in urban areas and western countries are more prone to depression during menopause since the modern obsession with youth and beauty makes women judge their worth by similar standards. "It (menopause) is the time to re-look at your life," says Felicity Green, a Seattle-based yoga teacher. According to her, if menopause is welcomed as the phase of liberation, the hormonal changes don't result in depression.

The postpartum blues, or depression after childbirth, generally occurs four weeks after delivery. Along with other symptoms of depression, the mother often suffers from delusions such as the child is possessed, has special powers or is destined for a terrible fate. She might also feel suicidal, be repelled by the prospect of breast-feeding, use violence against the child, lack concentration and suffer from phychomotor agitation, severe anxiety, panic attacks and spontaneous crying. Mothers who have had a family history of depression or have stopped taking anti-depressants because of pregnancy are most vulnerable to such feelings, especially if the child is unwanted. The shift of attention from mother to child immediately after delivery also contributes to post-partum blues. Such cases are rarely severe. However, understanding and patience on the part of family members, especially the husband, is essential to help a new mother through this phase.

Seasonal affective disorder (SAD), a form of depression that affects women and younger people, can be recognized by major depressive episodes at certain times of the year. They begin around autumn and disappear by spring. However, they may also occur in summer. SAD is characterized by hypersomnia, prominent energy, overeating, weight gain, and craving for carbohydrates. It is caused by changes in diurnal cycles as well as patterns of sunlight and can easily be treated with light therapy.

Depression can also be bipolar in nature where severe depressive states are alternated with extreme euphoria known as the manic state. It is marked by heightened self-confidence, restlessness, ecstasy and delusions of being a messiah, and can often be mistaken for a spiritual experience, especially by the patient. Since such patients rarely accept their condition as a disease, it is necessary to humor them without encouraging them, and consult a counselor without delay.

ADOLESCENT BLUES
According to Dr Sharad Chandra, a practicing psychiatrist, depression is an abstract feeling and cannot be recognized as such by children below the age of eight. "A child begins to get an awareness of abstract feelings not until he is eight and it takes him another 10 years for the full growth of his personality," he elaborates. However, that does not seem toward off the menace of depression in children.

New Delhi in India, alone had 15 cases of exam-related suicides in three months in 1997. Saarthak, which set up a 24 hour hotline called Operation Hope for students to cope with exam results in June 1997, received almost 2,000 calls from all over India. Five hundred of these came from teenagers with suicidal tendencies. The youngest child to have called Saarthak was Pooja, a six-year-old girl, who did not even understand what she was going through. She was just howling over the phone, saying that she felt neglected ever since she joined her new school since all her classmates seemed to look down on her inability to converse in English," recalls Arpita. "What made her situation worse was that her parents apparently did not consider the situation worth bothering about, leading to further frustration in the child."

Depression in children is caused by many related factors such as high expectations, increasing competitiveness, nuclear families where working parents often have not time for their children as well as loneliness in case of single children. The most critical period is that of puberty where a child undergoes many hormonal changes and is especially prone to mood fluctuations and social withdrawal. According to Arpita, "in such situations, parents need to understand their children instead of criticizing them for not being up to the mark".

Arpita describes the case of Simmi, 17, who became suicidal after being jilted by her boyfriend and not scoring well enough to match her parents' expectations. "What is tragic about such cases is that instead of giving support to their children when they need it the most, parents tend to burden them with even more guilt and loneliness," she continues.

It doesn't take long to understand the burden. You only have to look at a bunch of students stooping with the weight of their schoolbags to realize the situation. They have to excel in studies, games, art, music, dance et al—who cares if somewhere along the way they lose their joy of living!

THE INDIAN PERSPECTIVE
In traditional Indian beliefs, a man is determined not so much by his actions as by his birth, his stars and his gunas or qualities. This attitude, on one hand makes him less subjective about his personality and allows for detached observation, while on the other hand inculcates fatalism, a fertile ground for breeding depression.

"The doctrine of karma, especially the psychological notions associated with it, exercise a considerable influence on Hindu mental life," writes Dr Sudhir Kakar in his book The Inner World, because of which a person refuses to take responsibility for his actions and reactions to work out the conflicts and psychological problems. Instead, he takes refuge in citing past samskaras or traditions and creates a resistance to psychotherapy.

HOW YOU CAN HELP A DEPRESSED PERSON

  • Acknowledge his feelings without trivializing them

  • Don't blame him for his morbidity and inability to do normal chores

  • Give him support and unconditional love and care

  • Encourage him to indulge in activities he enjoys

  • Appreciate whatever efforts he makes to fight his depression

  • Highlight his achievements and efforts

  • Make him talk and learn to listen to him

  • If his depression has an immediate cause, help him find ways out of it

  • Without forcing any expectations, try to create a daily routine for him

  • Defend him before strangers even if you know he is wrong and gently explain the facts later when you are alone with him

  • If he talks of suicide, take him seriously and try to talk him If he talks of suicide, take him seriously and try to talk him out of it.

"According to ancient Indian texts, depression can be of two types: inner and outer," says K. Santhanam, an electrical engineer and an exponent of the Vedas. "The inner depression is caused by a conflict between the chitta (conscience) and the brain. When a person does something wrong, he might not accept it consciously but his conscience would always be guilt-ridden. This, ultimately, would result in depression and frustration."

Quoting Mahabharata, the great Indian epic, Santhanam says that Duryodhana, a character from the epic, is the epitome of depression: both internal and external.

"His external depression manifested in his ego and his impulsive desire to grab the kingdom, whereas his internal conflict manifested in his aggression, meanness and confused conduct," he explains.

Arjuna, one of the Pandava brothers, also falls into this trap before the epic war. "In Gita, Lord Krishna asks Arjuna how he, a noble warrior, contracted this disease of depression," says Santhanam. "Indeed, in ancient Indian doctrines, depression is considered a disease, a weakness (much as melancholia in western thought). Lord Krishna does not offer Arjuna sympathy or a shoulder to cry on.

Instead, he encourages Arjuna to come out of his unmanly state of mind and fulfill his role as a warrior." Quite a contrast when seen through the eyes of modern psychotherapy which prescribes sympathy and understanding as the primary means of helping a depressed individual.

Santhanam also believes that much of the depression in modern society is because women have forgotten their role as motivators and are trying to be implementers instead, a role traditionally meant for men. "The word ma means the all-encompassing giver who gives without any expectations or demands. But modern women are not willing to give any more." A slightly lopsided concept with a male-centric world-view? I wonder. More so when depression in most Indian women seems to be a result of their inability to cope with the unreasonable expectations of their family and society.

THE FEMININE ANGLE
Though Hinduism reveres the mother image, it also believes that a woman's life is fulfilled only through motherhood, more so if she can bear a male child. The Manu Samhita, an ancient Indian text, proclaims that a woman is first a daughter, then a wife and later a mother. In other words, her existence is recognized only in terms of her relation to men. In The Inner World, Dr Kakar writes that this gender bias results in depressive moodiness, extreme touchiness and morbid sensitivity in urban Indian women. In rural India, this takes the form of extreme fatalism where a woman herself looks down upon female existence and accepts male dominance without a murmur of protest.

For an urban working woman, balancing the job as well as the household may also result in depression. "A working woman has to do better than men to be noticed and appreciated. And if that wasn't tiring enough, a woman is still expected to look after the household by the in-laws as well as the husband," says Maya Srinivasan, an executive in a multinational firm. "This continuous tension of having to balance the two aspects of my life makes me feel useless and exploited. I am not normally prone to depression, but lately, I've begun to feel a certain amount of frustration."

Radha, a housemaid, doesn't understand what depression means. But in her own limited way, she conveys her growing cynicism about life. "I work for at least 15 houses every day. That means getting up as early as four in the morning, preparing breakfast and lunch, getting the children ready for school and then going off to work. My husband, who has lost his job, doesn't help me at all. He only mourns his fate," says Radha. "I'm living only for the sake of my children. There is no happiness in my life."

It has often been stated that women are more prone to depression than men. But Dr. R.K. Singh, professor and head of the department of psychiatry in Lady Hardinge Medical College, New Delhi, India, feels that this might be a wrong assumption. "Men are conditioned to deny their feelings whereas a woman feeling slightly upset is more likely to say that she is depressed. A man may express the same feeling either through anger or alcoholism. This doesn't mean that men feel any less depressed than women, "he argues.

Dr. Sadhana Vohra, a psychologist, feels that by nature women might not be prone to depression, but the society makes them so. "This is most noticeable during adolescence. A girl finds it more difficult to come to terms with the changes taking place in her body, which are much more sudden and obvious that those in a boy. To make matters worse, she is suddenly, treated like a different person and begins to attract catcalls when she goes out. Most fathers think that this is an appreciative gesture and refuse to be bothered by it. Very few try to understand the sense of humiliation and bewilderment the girl feels," explains Dr. Vohra. "As a result, the girl tries to hide within herself, feels insecure and vulnerable, and you have created the perfect setup for depression," she adds.

THE FIRST OTHER
Women play an important role in the psychological development of an individual, especially as mothers.

According to Dr. Kakar, in the first few months of life, an infant lives in a psychological state where there is no clear distinction between 'I' and 'not I'. It is only through the interaction with the mother that the concept of the 'other' emerges. And it is the imprint of the mother-image, the first 'other' that determines whether the outside world would seem friendly, rigid, threatening, rejecting suspicious or loving to the subconscious of an adult. Dr. Kakar further says that the way a child is looked upon determines the behavior pattern of his adult life. For example, a favored child believes in his capacity to win love and success and actually performs well whereas an ignored child often continues to feel neglected throughout life and has to work doubly hard to succeed.

In India, a child, especially a male child, remains in close contact with his mother till early adolescence. Though this makes him feel cared for and worthy of love, it also makes him expect the same selfless care from the people he interacts with later in his life, especially women. And his inability to get it often results in aggression, finally leading to depression. "My wife doesn't care for me as much as my mother used to," says Hargovind, rickshaw-puller. "My wife has so many demands, she wants so much of attention. She makes me feel that I don't matter at all." Comparing wives with mothers is a common phenomenon, where the husband feels neglected since she constantly feels that she can't live up to her husband's expectations.

Evidence from clinical, empirical and ethnological research shows that men have a genetic fear of being left alone which is suppressed in western cultures. In India, this fear is commonly accepted and often encouraged to keep families together. This is interpreted by social scientists as a weakness in the Indian personality. J. Hitchcock, a social scientist, writes in his book Pregnancy and Childbirth: "Training in self-reliance and achievement are conspicuous by their absence (in India). Children are not encouraged to be independent." While this attachment to home and hearth might restrict the adventurous and innovative instincts in a person, it also acts as a social support system against severe depression.

In modern India, however, the demands of the growing number of nuclear families and the necessity to settle in unfamiliar cities break the childhood pattern of easily available support systems without giving any alternative mode of support, adding to the causes of depression. So, it is best to inculcate feelings of independence in a child by letting him be on his own for long stretches of time with the assurance that he can turn to you in need. This would not only give him a firm belief in himself, but also create a lifelong support system against severe depression.

MANAGING DEPRESSION

The easiest way out of depression is popping antidepressants. No wonder medicines like Prozac have become popular. However, if taken without a doctor's advice, antidepressants can have harmful side effects such as continuous drowsiness, addiction and sleep disturbance. Some reports also claim that Prozac may provoke suicidal and homicidal tendencies in a person.

Non-prescribed drugs like ISD also give a feeling of elation and are used by many as antidepressants. However using drugs to ward off depression is like using psychedelics as a short cut to enlightenment. ISD might give experiences that seem startlingly spiritual in nature, but it doesn't bring about lasting effects. The best treatment for depression, according to most psychiatrists, is going to the root of the problem and eliminating it, along with giving the patient support and understanding.

HOW TO COME OUT OF THE BLUES

  • Write down all your feelings in a diary: this will act as a catharsis

  • Accept the mood, enter into it fully by listening to sad music and gradually change it to light, pleasant tunes

  • Keep fresh flowers around you, especially roses

  • Practice pranayama or simply concentrate on your breath as you inhale and exhale

  • Surround yourself with pleasing colors of nature such as blue and green

  • Lock yourself in a room and laugh loudly for half an hour

  • Wake-up early in the morning and meditate

  • Try to have a change of place

  • Involve yourself in activities that you like

  • Go for jogging, or exercise vigorously at home

  • Take a long bath and wear fresh clothes

  • Start thinking about things that have made you happy.

 David Campbell, a clinical psychologist from the Child & Family Department of the Tavistock Clinic in London, who was recently in India to attend a conference on mental health, feels that is necessary to teach families how to cope with depressed individuals.

"Often a person who is called depressed by his family and friends, cannot break away from that image and continues to nurture his depression," says Campbell.

"You should refrain from branding anybody as depressed. Instead, gradually change that person's self-image by asking him to remember moments when he wasn't depressed, when he felt happy. Then build upon that image," he adds.

It is also important to let a person talk. "You have to handle a depressed person with sympathy and understanding. Take his words seriously. Even a person who has decided to commit suicide would communicate this thought at least once," says Dr. Sharad Chandra.

"Sometimes, the words that one uses can be very significant, "says Elizabeth Vatsayan, an activist concerned with women's issues.

"When women feel angry, traditional elders prefer to call it sadness since it is not feminine to feel anger. This creates a lot of frustration in a woman." In a different perspective, a man's sadness is often interpreted as anger to conform to the masculine image, which ends up suppressing a man's feelings and creating frustration.

Nalini Mehta, 51, who has been undergoing treatment for depression since 1969 and is a regular patient at Saarthak, says: "I always had an independent nature but could hardly get my way around due to family pressures and societal demands. All this resulted in a breakdown and I had my first brush with psychotherapy through shock treatment, "she recalls. When she started to take antidepressants, she became addicted to them. "Now I have realized that it is talking and being active that really helps. We need understanding and encouragement, not impatience and ridicule."

Vijay Zutshi, who is working with the Commission of Central Excise, feels that the worst part of depression is the withdrawal symptoms. "You should think of others, who are in a worse state and try to help them," says she. She feels that keeping yourself busy with work helps in getting out of depression. Some women also find shopping or eating binges a great way to beat the blues.

Saarthak, which has opened a daycare center to help people cope with depression, has facilities for pottery, painting, games, learning computers and other creative activities. "Nothing lifts the clouds better than work not routine work but something creative, something that expresses our deepest emotions," says Manideepa Ray, a painter by hobby and an architect by profession. "I've been through depression but now I know how to cope with it. It only takes a little bit of sunshine, a loving word from somebody to see how wonderful it is to be alive."

EXPLORING ALTERNATIVES

Depression, according to esoteric thinkers, has karmic reasons. It is the result of exploiting one's spiritual faculties for limited ends that leaves a vacuous nothingness in its wake. Thus, depression is actually the soul mourning for its lost potential. This condition can only be improved by flooding the depressed person with higher and harmonious energy waves. One of the ways to do this is by Bach Flower Remedies. This system classifies depression into three categories: the negative Gentian (depression for a reason), the negative Sweet Chestnut (active and able to express the despair in words) and the negative Mustard (passive, emotional and sudden depression). These complaints can be treated by their corresponding flower essences.

Yoga, especially exercises that include forward bends, has a calming effect on the mind and helps alleviate depression. Yoga is particularly useful for menopausal depression. A biochemic medicine like Kaliphos also acts as a calming agent though it has no curative properties. "In homeopathy, it is necessary to understand the character and background of a person," says Dr. Poonam Jain, a homeopath. "We have remedies for each kind of depression, but prolonged consultations are required before any medicine can be prescribed," she says.

Herbal circulatory stimulants such as panax, ginseng, rosemary and ginger may also prove beneficial in cases of depression. Eating chocolates could also lift your mood temporarily though it is not recommended very often. However, ensuring a diet rich in vitamins, especially vitamin B, and proteins can give you a cheerful disposition.

Certain scents, too, can change your mood. "The best fragrance to help you come out of depression is rose," says Blossom Kochhar, whose aromatherapy products are flooding the market. She already has a ready product called Happiness that is specifically meant to lift your spirits. "It is a blend of essential oils extracted from Sandalwood, rose, lavender and geranium. You can inhale it, use it for massaging the sides of your temple or put a few drops of it in your bathwater," explains Kochhar.

"Ayurveda classifies people in three categories according to their constitution: vata, pitta and kapha," says Dr Akhilesh Sharma, an ayurvedic physician. "Depression is a vata-related problem and can be cured by specific ayurvedic remedies such as shirodhara (an oil drip on the head). Avoiding tamasik (fried, rotten, over-spiced etc.) food and consuming Brahmi tea can further alleviate depression," he adds.

Vaastu shastra (the Indian version of Feng Shui) offers some further tips. If your are prone to depression, check if your house slants downwards in the south or east. If so, level the ground. "You should never keep any gloomy pictures or an inverted swastika in the room," says Rakesh Chawla, a vaastu expert. He further suggests that keeping plants in the room, painting the walls pale green or dull pink and avoiding dark ceilings can go a long way in lifting your moods.

TOWARDS LIGHT

It is said that the darkest hour is just before dawn. And like everything else, this also passes. But often, in our ignorance and self-pity, we turn our backs to the light and see only the darkness.

Depression is a disease that not only makes us incapable of functioning in this world, but also puts a stop to our spiritual progress. The ancient Indian texts promote the feeling of detachment so that you act without expecting rewards. This enables you to separate your deeper self from the ups and downs of life—giving your soul enough breathing space to connect to the psyche wallows in despair, it forgets all else except its misery.

"As long as I identified with my depression, I could not come out of it," says Arti Chawla, a housewife who had been suffering from clinical depression. "I was nothing more than a weeping, self-pitying wretch. It was only when I accepted my feelings as a disease that I turned to meditation and sought help." It worked for Aarti, more so because she freed herself of her limited identity as a creation of her circumstances.

Any book on psychology can give us innumerable causes and cures for depression, but ultimately, what really helps is our desire to break free of the dark miasma of despair. Not to give in, not to drown—but to seek the strength within, to turn inward and allow everything else to pass by, as if in a dream. If you can believe in that strength, even for a little while, it would not take long to lift the clouds of despair and let the sunshine through. After all, 'tomorrow is yet another day'.

Life Positive, March 1998 Edited by Pravin Chopra

source : http://www.lifepositive.com/mind/psychology/depression/depression.html
 

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