Understanding depression in an increasingly unequal world

The theme for World Mental Health Day-2021 was 'Mental health in an unequal world'. Mental health care is needed for everyone in all socio-economic classes.

Depression is the leading cause of suicide and many other personal, social and health-related problems. But do we understand how depression is devouring this world?

At present, depression is the largest emotional disability or disability in the world and the leading cause of suicide. This is how the world is consumed by depression due to ignorance and negligence due to lack of timely treatment.

Many of us think low mood and depression to be the same mental state. But the point is, they are not the same. Rather, they are quite different from each other. A low mood is a very normal emotion and we can get upset at any time.

When we are upset, we can improve our minds by engaging in some activities of our choice or by reinforcing ourselves in various ways. But 'Depression' has other characteristics alongside sadness or low mood: one of those is dysfunction. At that moment, maybe doing something temporary may make the mood better. It may seem that a person's depression is gone. But that is only temporary. Because low mood is a part of depression, not the entire depression.

According to DSM-5, depression can have the following symptoms. A person may have a depressed mood most of the day, nearly every day as well as a markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. They might experience significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.

Other symptoms include insomnia or hypersomnia, fatigue or loss of energy, reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down), feelings of worthlessness or excessive or inappropriate guilt, diminished ability to think or concentrate, or indecisiveness, recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide - nearly on a daily basis.

If someone has at least five symptoms including symptoms she/he is suffering from depression and needs treatment. People having this condition for at least two years suffer from Persistent Depressive Disorder or Dysthymia.

The affected people will be doing their daily tasks properly, but life will become a burden to them. As if, life is dragging them back but they don't want to go. At any time, they may have a nervous breakdown that is dangerous for them and the people closest to them.

Depression is also seen in pregnant and new mothers, also known as postpartum depression. The symptoms can be guilt feeling, lack of interest, intense irritability and anger among the mothers. Symptoms may cause serious harm to both the mother and the child in the long run. Children and adolescents may also experience depression due to physical and mental changes, a new environment, or changing circumstances.

Depression begins with one or more events and it is associated with our core sets of beliefs which start developing in childhood. Many of us are not aware of these negative beliefs and many times we do not even know what we are subconsciously cheering. But these beliefs stop us from walking the path, exacerbating our problems or depression.

To find those beliefs that we cannot do by ourselves, and to turn them into positive ones, psychotherapy is needed. A counsellor/clinical psychologist helps a person change his or her negative thoughts through bringing them to the conscious mind and changing the negative thoughts by the person himself. Also, medication can reduce the symptoms of extreme depression though psychotherapy is needed as well. Because if one's thoughts do not change, one will be at risk of falling into depression again.

The source of each individual's problems is different from another because of a person's different underlying beliefs such as different environments, upbringing, perception, childhood, experience, coping strategies, mental state and many more.

So, it is wrong for one to think that the methods used in the clinical practice will be useful to another. Sometimes, when treatment plans for a person work in the clinical field, the people around him/her try to do it for themselves.

They learn to deal with depression from him/her and then try to do it for themselves but repeatedly blame themselves and get frustrated saying, "I tried too hard, no treatment would work for me". But it is not justified to conclude that the same plan will work for them.

A clinical psychologist will neither give you advice nor will tell you what s/he should do or what s/he should not do. S/he will not decide which way to go. S/he will help one to deal with depression in various ways using therapy methods. So, one will not be forced to fight with her/his depression. S/he will overcome depression by her/himself with the help of the clinician.

Before advising others, just think if you are helping them or pushing them into more problems and frustrations. Because you are giving orders or suggestions or advice to depressed people, you are not essentially understanding their problem severity and helping them to follow any scientific method. A depressed person knows how to make her/his mood better. But even then, those methods do not work for her/him or s/he cannot accept them, because of the illness he/she cannot get out of that particular condition. The symptoms of her/his unbearable depression and the thought of 'why can't I' are aggravating the depression.

Those who suggest that problems and illnesses be eliminated through religious prayer or worship, keep in mind that it is an illness, not a deliberate adoption or a weakness or a practice. Just as physical problems and illnesses, a well-established clinical treatment to cure mental problems and illnesses are the blessings of the Almighty. To many, it may seem that mental problems are a very small matter. There is nothing to seek treatment for. Religious worship or prayer will work to cure. But, as we continue to worship alongside treatment of physical illness, we need to continue to worship alongside treatment of mental illness as well. How much can one concentrate on prayer in mental turmoil, if one cannot concentrate fully on worship with a slight headache? If we know the remedy for headache, we take it first thinking that if the headache is removed, we can give full concentration to the worship.

Many people make wrong suggestions without knowing the right information. While fascinating books and drama and cinema characters play roles of persons with disorders or persons dealing with those disorders professionally, they are only for fun and entertainment. They are hardly reliable for treatment. Google has all the truth and lies. Do not believe what you find at the first search. Rather, find the right one. Depression can lead to various mental problems, leading to death and suicide if not treated properly or incorrectly treated. So, by getting proper information, protect yourself and those around you from depression. Be aware, be healthy.

Yesterday, we observed World Mental Health Day 2021. Today we must be conscious about our mental health and the impact of depression on our fellow human beings.

Saiara Subah is the Deputy Manager (Counseling) at the Migration Programme, BRAC.

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.