She knew she was going through a phase of depression. She lost interest in everything she once enjoyed.
She felt like weeping over even minor frustrations. She lacked the energy to do anything. The work she previously loved was becoming a burden.
Friends wondered why she had been avoiding socialising and lighter moments for nearly a month. Everyone was shocked when she died by suicide.
As with every suicide, wild speculations about the reasons were aired. The focus was on work stress and deadline pressures. Nobody cared to talk about her depression. Had it been identified and given scientific attention, she might have been alive today.
Can affect anyone
I am reminded of an extraordinary case when a one-year-old was referred from a paediatric unit for evaluation. He was continuously crying and refusing feeds. He was sleepless at night.
The infant had recently been adopted by a childless couple. Abandoned by an unwed mother, he had been reared in an orphanage. He rejected the love of the adoptive parents.
The authorities at the orphanage reported that the child had been cheerful and pleasant under the care of a particular caretaker. When this lady walked in, the child immediately stopped crying and showed signs of emotional connection.
The child was going through anaclitic depression due to the sudden loss of his mother figure.
Depression is reported in children of all ages. Its prevalence increases with age. Depression during menopause and after childbirth is often missed. Depression spares no age group or gender.
It is treatable
Depression and anxiety are emotional states that everyone encounters in life as a reaction to losses or challenges. One may feel sad or tense when confronted with negative life events. Gloom is natural in the face of health issues.
It is human to grieve when there is a loss — be it of money, a relationship, or prestige. The death of a loved one inevitably causes sorrow. During such times, emotional support is vital. A good support system can help ease sadness when it is a natural response to life’s challenges.
Identifying loved ones who may be experiencing depression — and listening to their words or expressions of distress — is key to a supportive relationship. The risk of clinical depression increases in individuals who lack such protective factors. Genetic predisposition also plays a role.
If depressive symptoms are severe or persist beyond two weeks, it is essential to consider whether the person may be suffering from major depressive disorder. A triggering event or a stressful environment should not be used as a reason to avoid seeking professional help.
There is a general reluctance to speak openly about low mood, due to fear of being perceived as weak. Many people suffer in silence. Even those who recognise that they are engulfed in the darkness of depression may be hesitant to seek help.
As a result, depression remains widely undiagnosed, undertreated, or untreated — a serious public health issue. Ignoring it can lead to fatal consequences. Depression is a common factor in the majority of suicide cases.
Two simple questions
Depression is a common mental health problem that can significantly affect quality of life, productivity, and overall health. It is therefore crucial to empower the public to recognise and treat depression. This is also an important step in preventing suicide.
There is a simple method to screen whether one’s depression should be evaluated by an expert:
In the past two weeks, have you had little interest or pleasure in doing things?
In the past two weeks, have you been feeling down, depressed, or hopeless?
For both questions:
Score 0 if not at all
Score 1 if on several days
Score 2 if on more than half the days
Score 3 if nearly every day
A score above three indicates a high probability of clinical depression that needs professional evaluation. This screening is based on the Patient Health Questionnaire-2.
If diagnosed with depression, treatment may involve medication and psychological interventions. These decisions should be made by a mental health expert.
Antidepressants with minimal side effects are now available, though they may take around three weeks to take effect. The duration of treatment varies.
The success of psychotherapy, such as cognitive behavioural therapy, also depends on the individual’s motivation and willingness to remain engaged in the process.
Please remember, it is vital to break emotional barriers and seek help.
Mind space fortnightly column on mental health
The writer is senior psychiatrist at Medical Trust Hospital, Kochi, and former member of the State Mental Health Authority