Depression is an illness that many don't know about

Comedian Robin Williams’ tragic death at the end of a long battle with depression is a grim pointer to lurking afflictions of the mind that play havoc with lives, some as illustrious and others not as luminous. But there is HOPE. Right diagnosis and sustained medication can help beat depression.      

Do fame and success protect one from getting depressed? Will talent and wealth protect you from depression? Is being funny and able to make others laugh an antidote to depression? Sadly, the life of the Oscar-winning star comedian Robin Williams, who made millions of all ages all over the world laugh, shows that the answer to all these questions is clearly, NO.
But what is ‘depression’? Everyone feels sad or depressed at some time or the other. A variety of events in our day-to-day life, related to our family, relationships, work, finances and other activities can make us feel depressed. But fortunately, for most of us, such feelings of sadness last only short periods. Short and transient periods of feeling low and depressed are considered as normal variation of one’s emotional state.
However, if such periods of sadness last longer (several days to weeks and longer), it can cause increasing levels of personal distress and interference with one’s work, life, personal and social activities. It can also cause distress to others around. It is then referred to as the disorder or disease of ‘depression’
Other features of depressive disorder can include symptoms such as weakness and tiredness (fatigue), loss of energy, loss of interest and pleasure, disturbed sleep and appetite, poor concentration, loss of confidence, anxiety and worry and feelings of hopelessness about the future. There may be unexplained symptoms such as aches and pains in different parts of the body, headache and backache.
When depression continues unabated, additional features such as feelings of worthlessness or uselessness, unnecessary feelings of guilt and ultimately, feelings that life is not worth living will incapacitate the person. Suicidal thoughts may appear and the person may decide to act on his thoughts.
Depression may be associated with stressful life situations such as bereavement, marital difficulties and divorce, unemployment and financial problems. Depression can also be associated with well-known physical illnesses such as diabetes, heart diseases and high blood pressure, stroke and being diagnosed with cancer.
Depression is a real illness
For a variety of reasons, depression is misunderstood. Many consider it as personal weakness, weakness of will or mere laziness. It is common and widely prevalent, all over the world, including India. In India, on a modest estimate, it is assumed that around 5 per cent of the population suffers from moderate to severe depression. It can affect anybody. It is known to be more among women and more among those who live in cities as compared to rural areas.
It is a brain disorder caused by the interaction of biological (including genetic), psychological and socio-cultural factors. The causative reasons why some people suffer the depressive disorder or the exact mechanisms involved are still not fully understood. Depressive disorders are a major cause of disability for individuals and families the world over.
Projections of disability and burden of diseases globally indicate that by the year 2020, depressive disorders will be a leading cause of disability, next only to cardiovascular diseases. About a third of persons who suffer from depression may also abuse alcohol and mind-altering substances which can lead to addiction. About a third of all people who consult general doctors may have unidentified depression.
It is also quite likely that a large proportion of people with chronic problems who seek alternative systems of treatment and who throng traditional and religious healing centres also suffer from depressive disorders.
In 2013, saccording to the National Crime Records Bureau 134,799 persons killed themselves in India. Many of them certainly would have been suffering from unrecognised and/or untreated depression.
During the past couple of decades, India has been going through a period of ultra-rapid social change. With rapid growth, urbanisation and migration within the country, societal norms, values and patterns are steadily changing.
The role and significance of established traditional institutions such as the ‘family’ and ‘marriage’ are changing. Patterns of communication, consumption, work, employment and lifestyles too are changing beyond recognition.
From a health as well as mental health perspective, these changes have several negative consequences. Physical illnesses such as diabetes, high blood pressure and other cardiovascular diseases as well as a various mental disorders such as stress related and adjustment disorders including depression are steadily on the increase.
In some persons, episodes of depression may be associated with episodic periods of excessive happiness and increased activity – referred to as manic episodes. Such a combination of depression with episodes of excessive activity is called Manic Depressive Disorder, also as Bipolar Affective Disorder.
Another form of depression which is widely unrecognised and with various harmful consequences is the depression that occurs around and following childbirth (post-partum depression). Studies have shown that about a quarter of women in India suffer from depression following childbirth.
Fortunately, depression is a treatable illness. There are various types of inexpensive and effective medications called ‘anti-depressants’ as well as different forms of ‘talk-therapy’ (psychotherapy and counselling)  available to manage depression.
Depression is not widely recognised as a treatable illness. And sadly, even when it is recognized, the all-pervasive stigma surrounding seeking help for emotional problems prevent people from receiving appropriate care. People suffering from depression should at the first level be encouraged to talk about their problems.
It is hoped that the sudden death of Robin Williams — described by his wife Susan Schneider as “one of the world’s most beloved artistes and beautiful human beings” and as one who gave “countless moments of joy and laughter to millions” — will provide an opportunity to educate a large number of people on the signs and symptoms of depression and help advance awareness about this distressing and in some, fatal, condition.

(Dr Mohan Isaac is professor of psychiatry at Freemantle Hospital, Australia, and visiting professor at NIMHANS, Bengaluru)

‘Artistes have less time to heal, pain lingers’ says Shilpa Shetty

Shilpa Shetty

I just think that as a star, there is a lot of responsibility as you are always being watched. As an actor, you may vent your emotions through a film character or by enacting a scene on the sets. Sometimes this works out great but what happens when you come back home to reality?
There are times when you are going through a bad breakup or a bad marriage and there is a scene that you have to perform.
What do you do? You just have to switch off and play the character. An artiste, at times going through several crises, still has to report to the sets. That’s when things get complicated. That artiste is human and with less time to heal, the pain lingers. How much can you hide or cover your real pain? Sooner or later, there is a volcanic reaction; it’s either depression or suicide.
Robin William’s death wasn’t surprising. His persona was happy, he did films that brought smiles on millions of faces but maybe that didn’t change what he was going through.
The most important thing is to have your family supporting you. In my case, I was lucky that my mother was always with me on the sets so I could tell her everything. Whatever be the situation, at the end of the day, she would get me back on track.
Lot of people in the industry today lack that, may be some of them don’t have parents or they come from a small town and are staying away from home. Every situation is different. You are away outdoors for months on a film set with no one to talk to.
I think it also becomes harder for an actor when you are judged. When the actor is going through bad times, so much is written about.
To be a celebrity is a huge thing and it’s a blessing to be there and be loved by everyone. We have all gone through bad phases but when you are loved, you feel very, very special.
Professional or personally, when you’re down, you can’t get away with what’s being written about you. It’s very sad, tragic almost.
I will not be affected by what people have to say about my film or my on-screen persona. There might be bad films, critics might not like them, and all that is at work level and it’s fine. But when somebody is judgmental about who I am personally or during tough times that I am going through, it matters to me and it will affect me.
Work-wise its fine but personally it could get very frustrating. You don’t want your life to be an open book.
 
(As told to Mehul S. Thakkar)