Kochi: The geriatric population of the state, having a very high rate of suicide at 23.9 per lakh, is the most depressed. Studies show that nearly 40 per cent of the elderly are depressed and that emphasizes the need for effective intervention programmes, according to health experts. Even as suicide is the major cause of death in the state, with 8,500 persons per year, authorities are not giving due importance to its prevention and to ensure mental health of society, observe experts.
“Loneliness, physical illness, lack of life partner, loss of power and money are some of the major reasons for the high rate of depression among the elderly. Studies indicate that the depression rate is twice as high among women when compared to men across all age groups. This may be due to their increased life expectancy, poor social support or exposure to psychosocial stressors,” said Dr. T.R John, consultant psychiatrist, Aster Medcity, Kochi and convener of the ‘defeat depression’ initiative launched by the Indian Medical Association, Kochi chapter.
A survey conducted among the elderly, above 65 years, in the Thalikulam panchayat of Thrissur district in 2011 by the department of psychiatry, Government Medical College Thrissur revealed that 39.1 per cent of the aged are depressed. The prevalence rate of severe depression was found to be 8.2 per cent, 15 per cent had mild depression while 15.9 per cent had moderate depression. The increased risk of late-life depression among females has been established in other community studies as well. Living without a male partner can particularly be stressful in old age for women, especially in rural areas, it has been pointed out.
“Being a random sample survey, it can be taken as the general trend in the state. Depression can be easily identified, treated and cured. But, there is a clear lack of awareness and people often ignore mild depression. Society’s attitude should be changed and early intervention is needed to prevent depression which leads to suicide,” added Dr. John. While the state government is spending a huge amount for various programmes on road safety and accident prevention citing the high number of accident deaths, nearly 4000 persons per year, the major cause of death – suicide – remains unaddressed, according to experts.
Suicide tops the list of unnatural deaths in Kerala. But, a proactive approach is yet to be taken in their prevention. Through effective intervention, the three factors, depression, alcohol and drug abuse and poor social and problem-solving skills can be modified to reduce the suicide rate in Kerala, it has been observed. Studies have indicated that more than 60 to 70 per cent people who commit suicide have depression. At the same time, 15 per cent of depressed patients end their life through suicide.
Studies, family depress many
While studies indicate a high depression rate among the elderly, the emotional health of youngsters also is affected by several reasons including academic pressure, stress at the workplace and pressure of familial responsibilities. Data from hospitals indicate that 40 per cent of patients visiting general physicians or family doctors, in a month, have depression. Nearly 50 per cent of them are referred to specialists for treatment as the cases are severe.
“While depression can be genetic, academic pressure and fear of failure is influencing the depression rate amongst teenagers in Kerala. For a state that has the distinction of being the first in the country to attain 100 per cent literacy, the progressive pressure to outshine bright minds and succeed in life is taking a toll on the mental health of teen and young minds,” said Dr. Vivek Ullatil, consultant psychiatrist at Renai Medicity, Kochi. As per World Health Organisation statistics, depression is the second leading cause of disability in the world and nearly 20 per cent women and up to 50 per cent men in their lifetime suffer from depression.
“Now, depression has started to affect the youngsters at a very early stage. With increasing competition in education, the pressure to score higher marks is rising,” he said. According to psychiatric experts, women in Kerala who are coming out of the traditional matriarchal lineage are more prone to depression. Hormonal fluctuations compound the problems and make them more likely to succumb to depressive tendencies. Women suffer from emotional, sexual and physical abuse.
“Statistics have found that while dealing with the issues of family pressures and responsibility towards children, many middle-aged persons fall prey to a depressed state of mind. The stress affects both middle-aged men and women and also tends to put a strain on their inter-personal relationship,” said Dr. Vivek. With disturbed sleep and loss of appetite, depression leads to serious health issues. Since patients feel hopeless about the life and future, they tend to ignore the prescribed anti-depressants or they do not follow dietary regulations which will further deteriorate their physical and mental health condition. They withdraw into a shell and that also impacts their relationships in family and society which results in the loss of social support systems.
