An old friend of mine is going through a crisis and is deeply distressed by certain recent incidents that have happened in her life. As I sat listening to her, I was partly in shock and partly outraged. Here was a girl; amazing, beautiful, educated, intelligent and independent yet had allowed herself to suffer from domestic abuse. Of all the people I have known in my life, she was one of the few who I know would never have surrendered to such mistreatment. The person I knew few years back was a fighter and an inspiration to other girls who lacked the confidence and conviction to lead their own lives. Therefore, I do wonder, what could have happened to make her so vulnerable?
However, today’s article is not about domestic abuse. This time I want to talk about something more impending and an issue that needs to be addressed urgently. As my conversation with my friend concluded, I was left with an overwhelming concern for her mental wellbeing. She had said that she was very depressed and was trying hard to cope with the stressful events that were ‘catastrophic’ in nature. Some symptoms that were evident in her response and behaviour suggested that she needed some kind of intervention, or else she formed the risk of developing a depressive illness. My article is therefore dedicated to her and is an ernest effort to make the readers more aware of depression and that it should be approached with seriousness.
Depression or depressive illness is ranked as the 4th most common cause of disability worldwide, with 30% of the population currently affected by it. According to the Diagnostic and Statistical Manual of Mental Illness (DSM IV TR), people with depression often complain of atleast five of the following symptoms, which have persisted over a period of two weeks:
- Depressed/low mood,
- Diminished interest or pleasure in almost all activities
- Noticeable weight gain or loss, increase or loss of appetite
- Physical agitation /irritability
- Feelings of worthlessness and excessive guilt
- Reduced ability to concentrate, think or indecisiveness
- Significant distress or impairment
People may complain of fatigue or headache or some other somatic problem and not realize that these problems could be linked to an underlying depressive illness. In such cases administering only pharmacological treatment may not prove 100% beneficial. Therefore the possibility of a depressive disorder should be at the back of your mind while addressing issues of fatigue, headache, gastrointestinal upsets, change in weight, insomnia or other such bodily symptoms. In the case of elderly people complaints of agitation, confusion/disorientation, decline in normal functioning could be some signs of depression. In children a remarkable drop in school performance, irritability and social withdrawal are some indicators. Another important signal is ‘self harming behaviour’. This has been observed in people with attention seeking behaviour however it could as well be a warning to indicate depression. People with depression feel a profound sense of sadness and emptiness along with a sense of hopelessness for their present and future. They remain unmotivated to take any action to change their current circumstance, and are most likely to shy away from social interactions, preferring to spend considerable time in bed. It has been reported that the suicide rate among young people, aged between 25-30 years, has steadily increased and 50% of such cases are depression related. That is extremely alarming! Though it is such a common phenomena, there is still stigma attached to acknowledging and addressing depression. Many famous personalities have suffered from depression and it is most likely to affect people from the creative field, with writers at the highest risks.
The following are certain risk factors that can increase one’s vulnerability to depression.
- An increasing body of evidence supports that genetic factors could make one predisposed to depression.
- Poor social or marital support
- Unemployment, dissatisfaction at job, low salary, reduced quality of life
- Adverse life events
- Child abuse/neglect
Moreover, women are twice more likely to report cases of depression than men. One social explanation suggests that women experience more responsibilities and lower quality of life than men, i.e. women tend to have low status/ low salary job and are more likely to be juggling a career along with other domestic roles. Women more often tend to dwell on issues that may lead to depression thereby increasing the imminence of the possibility.
In a study (Abramson et al., 2002), it was reported that students with a negative attributional style were seven times more likely to develop depression than students with a more positive style. According to Beck’s (1979, 1997) cognitive therapy, negative events in childhood create negative cognitive schemata (unconscious, underlying beliefs about self and the world). When we encounter any stressful situation in adulthood, particularly similar to our previous childhood experience, these negative schemata are activated and influence our cognitive response. Beck termed these responses as automatic negative thoughts. These are inaccurate responses to events that affect us. These thoughts are often accepted as true and valid; however, such negative thoughts lead to misinterpretation of events in ways that lead to depression.
Some examples of such thinking errors are :
- Absolute thinking- ‘This or nothing at all’; ‘This is the only way I can prove myself or I am a loser forever’
- Overgeneralization-‘ I always fail, I never succeed !’
- Personalization-‘This always happens to me’, ‘I always get blamed, even if it’s not my fault’, ‘why do these things happen to me only, ‘why me ??’
- Arbitrary inference- Drawing conclusion from insufficient/insignificant evidence to back such a thought. ‘I knew I would not get selected, I could tell from the way they looked at me’.
- Selective abstraction-Focusing on irrelevant details. ‘Though they all said that I performed well but one of the jury members walked out to answer his phone. I think he didn’t like me, maybe others too, but they did not show it’.
There are primarily two kinds of intervention administered to the treatment of depression. One is the use of anti-depressants (only under supervision/prescription) and other is psychological therapy, such as counselling. Most of the therapy involves challenging the formation of negative thinking patterns about self and the world or the feelings of hopelessness. The therapist attempts to break the cycles of repetitive automatic, negative thinking replacing them with more positive thought patterns. Lastly, always talk about issues that may be stressing/deeply bothering you with someone whom you can trust and actively seek intervention if you feel overwhelmingly emotionally disturbed (beyond your normal capacity).
Given the current stressful and fast changing sociocultural environment, depression is prevalent. To cope better with social problems, one must actively identify if there is a likelihood of developing depressive illness and seek intervention to help relieve from its debilitating symptoms. You can always drop in your queries at chillamma and our team of psychotherapists will try to support you in every possible way. Remember your mental wellbeing is also our concern.
Author-Soumya Mania Ranjan