No textbook of Psychiatry could have taught me better to decode and to comprehend the sufferings of the unrest mind as patients do.
This patient walked me through the agonies of his mind which was fast sinking through unfathomable depths and a mind which kept trying hard with utmost rationality to decipher the reasons behind the struggle. I have never understood Depression better.
"I am no longer what I am doctor..." and thus he started his narration and his ordeal with his mind. It started with nagging headaches and near constant aches that refused to wash away with cups of caffeine or pain killers. Gradually unending episodes of fatigue & exhaustion started sapping me up and I realised that it was not just physical any more. My mind refused to lighten up. The smiles of my children were no longer contagious, music and television appealed to me no more. I stopped reading and talking to my friends..the world no longer mattered to me..The most minuscule acts of daily life like showering or dressing seemed totally overwhelming. I remember the dreadful long hours I looked at the comb with an absolutely shocking lack of will and drive to groom myself. Darkness loomed large and my mind kept rapidly filling up with irritatingly repetitive thoughts of doom, dread and catastrophe. I wished to sleep it all off but I realised that darkness was even more agonising. Sleeplessness haunted me..My wishes to end it all kept growing by the day. I feared the day when my death instincts would overpower my reasons to live. Panic and uncertainty kept ripping through me..I kept cuddling up near my child just like an infant wanting to be nursed. I wanted to be embraced, wanted something or someone to get rid of my soul shattering pain. I failed to find a reason try as I might. I am no longer a father, a husband, a boss ..I am no longer what I am doctor"
The sufferings of a depressed mind cannot be explained better. Depression is a medical disorder. It is one of the biggest public health challenges because of its high incidence. Research globally as well as in India suggests that at least one in 5 women and one in 10 men suffer from major depressive disorder at sometime in their lifetime. Medical science has given neurobiological underpinnings to the disorder. Genes, faulty neural circuits, abnormal levels of chemical messengers in the brain can all be important causal variables. Psychosocial factors like recent losses, relationship failures, and stressful environment intertwine with biological vulnerability leading to this illness. It is time to clear common misperceptions of the illness.
1. It is important to understand that Depression need not have a psycho social cause all the time. In several cases it occurs out of the blue. It is then called an endogenous or melancholic depression which endorses the biological nature of the problem.
2. Having a Depressive Disorder does not equate with 'weakness of mind'. In fact the strongest willed are sometimes more susceptible to it.
3. Depressive Disorder can be treated. Pharmacotherapy, psychotherapy or a combination of both works. What works for whom is decided by the mental health professional on the basis of the severity of the illness, symptom profile and cause.
4. Anti depressants work by helping regulate the disordered brain chemistry and are not sedatives as widely believed.
5. The usual course of treatment is between 6-9 months and not life long as widely misconceived. Being in good health includes being in good mental health.
Let's fight and help fight those with the ache in the psyche. Let's fight depression! Only then you can be truly who you are!
Article by Dr. Yamini Kannappan, Psychiatrist, Kauvery Hospital
