Categories: Mental Health

Depression and Suicide

India tops amongst the rest for numbers of suicides in the entire South-East Asia. Depression amid others is one of the biggest reasons for the age group 18-39 for the people to commit suicide.

Let’s do a grass-root analysis of how the most common and treatable form of psychological illness comes to be the life-threatening factor to someone at such a young age.

What is depression?

It is a type of mood disorder where the person feels sad, sorrowful about everything in their lives. The presentation of depression varies from just sadness to melancholia. Depression is a syndrome that affects all portions of the person’s life- occupational, interpersonal, social, educational and more. Depression if largely familial and associated with an individual’s environment as well as genes.

While men and women are, in general, equally sensitive to the depressogenic effects of stressful life events, their responses vary depending upon the type of stressor. Specifically, men are more likely to have depressive episodes following divorce, separation, and work difficulties, whereas women are more sensitive to events in their proximal social network, such as difficulty getting along with an individual, serious illness, or death.

The physiology of depression

A lot of neurotransmitter chemicals are present in the brain that starts secreting as soon as an impulse reaches the brain. Brain has various pathways for various impulses. The neurotransmitters help the transfer of impulses through the brain to the area responsible.  Areas that play a significant role in depression are the amygdala, the thalamus, and the hippocampus. Studies investigating psychosocial stress and stress hormones, neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate, and gamma-aminobutyric acid (GABA), neurocircuitry, neurotrophic factors, and circadian rhythms show that when positive and negative impulses and chemicals are imbalanced, it may lead to depression. Depression is persistent but the patient may suffer from major depressive episodes where the person’s ability to see any positive stimulus around them is lost. It is their belief that this unhappiness is not temporary, they forget that they had a happy past, time will pass and with deliberation thigs will resolve. The physical and mental pain becomes excruciating. The person may not want to die but the only hope they see for relieving their suffering is death.

There is some organic evidence that depression is associated with a smaller hippocampus. There is reduced nerve growth and reduced formation of new synapses. Anti-depressants don’t work immediately by correcting the neurotransmitters, they take weeks to work to get neuronal growth patterns regularized.

Given the evidences, it is the duty of each one of us to realize the difference between sadness and depression and seek help on behalf of the sufferer. They may not be close to you or best of your friends but saving a soul is so much beyond your ego.

The line between sadness an emotion and depression

A proper diagnosis requires extensive inputs from medical experts like psychologists, psychiatrists and the like but you know it may be depression when

  • The person is obstinately sad
  • The person talks about being hopeless, abandoned, insignificant, negative or remorseful
  • Is involved with substance abuse like alcohol or drugs
  • Loses interest in previously loved activities
  • Anorexia and resultant weight loss
  • Known feeling of
  1. Hopelessness
  2. lack of energy
  • Lack of interest in sex
  1. feeling of worthlessness
  2. bouts of too little or too much sleep
  3. suicidal thoughts
  • Fatigue
  • Demonstrable irritated behaviour
  • Small concentration span
  • Trouble remembering and making decisions
  • Previous known suicide attempts
  • Presence of physical pain not retorting to treatment
  • Children may act unresponsive to most external stimulus and are difficult to console
  1. May harm animals around hem
  2. Anger presented with headbanging, self-biting or self-hitting
  • Oversensitive
  • Teenagers are too self-critical with little self-esteem
  • Elderly may sometimes pursue awkward public behaviour
  • Calling, visiting loved ones and bid farewell
  • Distributing self-use stuff to people around
  • Possibly stocking pills or purchasing a weapon
  • Ignoring prescribed medications

Depression is treatable; a lot of medications and psychotherapy has known to completely treat depression. Most people are not aware of their status as depressives. Those aware do not speak about it due to the attached social stigma. Most parents are not aware that their children are fighting with a monster and need help. As stated above, in such a state of affairs it becomes the responsibility of each one of us to act a little observant and lend that helping hand to all known and unknown. Suicides are preventable. Let us each start playing our required role, in homes, in offices, in schools and in our societies.

Dr. Gaurav Jain, Consultant – Internal Medicine, Dharamshila Narayana Superspeciality Hospital, Delhi

Narayana Health

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