The science behind Depression | Dhruv Rathee

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What is the science behind clinical depression?

What is the cause of depression in human beings?

The science behind Depression

Greetings, friends! After the tragic incident of the day before yesterday, issues like mental health and depression came into the public limelight once again Probably, the people are realizing now how important these issues are, yet not talked about in out our country I feel that this would be the right time to spread awareness about these issues and to make the public aware Because there are a lot of myths, misconceptions, and misinformation regarding depression in Indian society This is why, for the purpose of this ARTICLE, I spoke to Sumaiya Shaikh- a neurologist and a doctor who will tell us in detail what depression and mental health is and what are the most common myths around depression that are heard amongst our friends and family Come, let us see -Dr.

Sumaiya, my first question is something that might come up in the minds of several people If someone has so much fame and so much money that he/she can do whatever he/she wants, How can someone like that become depressed? -Especially within India, there is a common belief that having money ensures happiness So now, it would be said that he had everything and he was happy in all aspects How could he then be affected by depression? We consider depression akin to a disease Or it could be considered to be the manifestation of a disease A lot of things could trigger depression One out of them could be sustained stress that you have been under for a long period of time This could also be a cause for depression But stress is not the sole reason for depression There are a lot of people who do not get depressed despite them being under stress and there are people who can get depressed even in the absence of any stress So this is why it is a biological manifestation.

The different genes, proteins and receptors in our body There are so many activities happening inside our body in the organs at the micro molecular level The combination of these activities happening simultaneously determines whether you will get depression or not And furthermore, when all these activities are placed in a specific environment For example, a very high stress environment for a very long period of time then most of the people might suffer from depression But there are some people that have no cause (to worry about) and still suffer from depression A very good example would be “post partum depression” Many mothers, right after childbirth (suffer from this) Having just completed a pregnancy and delivered a baby and with everything going on smoothly in life They wanted exactly that Despite that, post partum depression is a very common problem and it affects a lot of women So what basically happens is that the state of hormones gets altered because there is a sudden change in the hormones right after the delivery of a child So this is why a lot of women suffer from depression.

Not all of them, though. It does affect several women and it is not recognized because it is assumed that there’s nothing bad that has happened in their lives They should be happy since everything is okay But despite that, they go into depression -So basically you’re saying that this is happening intrinsically due to hormonal changes -Yes, absolutely -.

And that it does not always have an extrinsic relation -There is an environmental relation. There is an impact of the environment on our biology And this environmental impact and our biology together determine whether one will suffer from depression or not Not only depression, there are several other mental health conditions (For example) Schizophrenia, Autism Although genetics plays a larger role in autism rather than environment, but so all these things cumulatively- environmental impact, genetics, hormones and physiology in general interact with one another Biological, psychological and social factors all combined matter.

And not just psychological factors as per common perception. -So the biological factor is very important here Because it can also happen that people under extreme stress and in a completely averse environment never feel depressed -Absolutely.

It indeed happens A population kept under stress perpetually, for a long period of time For example,in conditions like a famine or a world war a lot of people become victims of mental health problems simultaneously So, we can see that sometimes, it can be triggered by things but it depends on the level and the extent of the stress and for how long it is exerted -How can we differentiate a bad mood /low spirits from depression? -A bad mood/low feelings can get alright relatively quickly Low mood spells get over as swiftly as they come They last for a day or two.

At most, it can linger for a few days Depression causes mood swings that last for several days sometimes with reason and sometimes without one There is a mental health condition called “Bipolar disorder” in which there are a lot of fluctuations There are extremely high functionalities when your mood is very good and then there are extremely low functionalities These low functionalities in depression drag on for a long period of time sometimes for weeks altogether and it becomes immensely difficult to break out of it Depression is classified in three categories- Low, Moderate and Severe Every stage has different treatment methods -Speaking about treatment, there are a lot of common treatments that people talk about Be it Sadguru or Shri Shri Ravi Shankar ji or our own Health Ministry There is a tweet of the Health Ministry that suggests the following to steer clear of depression- Follow a routine, travel, be creative Think positive, practice Yoga So, are these really the solution for mild depression? Or are these things of absolutely no help at all? -They indeed help.

The people that are helped by these should absolutely do them But the problem with depression is that it renders a person incapable of doing all this A person feels so debilitated and helpless that they would not be able to travel or do yoga even if they want to These things can make one happy and elevate one’s mood for some time in a mild depression But this is not a long lasting solution Because until you address its core problems- what we call “the neural mechanisms”, things will not normalize They can definitely be addressed by psychology but these are all milder versions We do not know whether the people who claim to be cured by these things actually suffered from depression or not When we look at incidents and single cases of a person being cured of depression we do not know whether they were correctly diagnosed or not The symptoms of depression overlap with the symptoms of other diseases like PTSD, anxiety or even bipolar disorder So we should find out whether the diagnosis was correct or not and what the mechanisms and the root causes are and what their treatment plan should be in accordance with that Telling everyone to do Yoga or to travel would not work Everyone should have their own customized treatment -In general, then all this (yoga/travel etc) is apt for mild depression It is apt to consult a psychologist for a medium depression and in a severe depression, it is apt to take anti depressant medicines -I think it depends A lot of people who suffer from moderate depression also take anti depressants and some with mild depression consult a psychologist for treatment A lot of people who suffer from even mild depression also take anti depressants So it is not necessary that all of them are prescribed anti depressant pills or that all of them require an environment change or a communication Similarly, some people get treatment from a single counsellor and get cured while others require these extreme measures The stigma attached with the anti depressant pills… -That taking medication would induce sleepiness or would lead to other side effects.

Does that hold true? -It is a very misinformed concept.

Just like Type 2, Diabetes cannot be cured- it has to be managed throughout your life So then you would take medication for Type 2 diabetes There are very commonly prescribed drugs like Metformin People take that medication and manage diabetes with it Similarly, depression is managed And when the situation gets better over time, the psychiatrist or whomsoever is being consulted assesses the patient who is then tapered off slowly To say that these are merely antipsychotic medications or sleeping pills or addiction pills would be extremely inaccurate There are pills for anxiety that might be soporific or slightly addictive, and they are very commonly prescribed in India Such medications should be avoided.

The functional medications for depression are neither soporific nor addictive Since they make you feel better and since the extreme bouts of depression can spur suicidal thoughts, this medication should not be stopped abruptly -So the medicines for depression are just like the medicines for any other disease like diabetes or some other disease -Absolutely, this is how they should be viewed.

There should be no stigma attached to it -Another very common talk widely heard in India is that “Getting depressed is a choice” A lot of people say that getting depressed or not is up to ones’ will -The ones who say this do not understand And I lot of people say such things.

We have been hearing it for some time now They claim that it is up to us to give in to depression or to instead do things that will drive away that depression The people that say these things confuse depression with sadness They have no understanding of what depression actually is As I said earlier, there is a strong biological component When the environment gets better, productive and supportive after a low mood spell but if you do not get better despite that, then the problem is something else No one wants to stay in this state Nobody likes staying in that state It makes you feel worthless and makes you feel as if you have no value in life and that you are not worthy of anything and nobody wants to stay in this state So this is not one’s own will.

Nobody is a victim of “self-pity” here You’re either depressed or sad Our language has also trivialized it by using it very loosely- “I got depressed because this happened today” Well that is a different thing -Indeed. Our language uses this term very loosely -Absolutely. For instance, if we dislike someone, we easily label them as a “psycho” Not to mention, we have also elevated suicide so much over the past few days and we have been talking about it so insensitively Nobody likes it.

It is not a “cry for help” because it is also believed that if someone hurts themselves in depression, then it is a cry for help and that he/she is seeking attention and the moment he/she gets it, he/she would not commit suicide This is not so -So is it wrong to say that one should reach out to friends/family if one gets suicidal thoughts? -No, it isn’t. You should definitely reach out.

In fact it recommended to do so One should reach out to a professional first because our system does not have the kind of sensitivity to not judge somebody for reaching out to a friend -They will judge you and label you as attention seeking -Absolutely.

Seeking professional help is much better They would also know what to do further If there’s a trusted friend or a close relative, they can be confided in Especially the generations before us- the one of our parents or grandparents- have a lesser understanding and fewer people of those generations understand mental health issues because they feel like it is a “new disease” ‘It wasn’t there before when we lived’ -This is another widespread perception that depression came with the modern era and that there was nothing like this in the time of their ancestors -A lot happened during the time of our ancestors I read a book of medical history in my undergraduate year which stated that if someone had a pain or discomfort, say a headache, then holes were drilled into the skull because they believed that there were demons inside the head and that they needed to be drilled out In the case of an infection or fever, boodletting was practiced- a vein was pierced the superficial vein was pierced and took out blood in order to drive out the supernatural things So, a lot of things happened.

We did not even know about bacteria or viruses 100 years ago -So depression existed earlier as well? -Depression existed but we did not know how to define it We did not know how to vocalize it with the language we had -But since it has spiked so much today, can it be said that it has increased in the modern world? -It depends.

The world today is very subjective and our experiences are extremely varied It could happen that someone living in the Himalayas or living in a place like Sweden, where I reside or near the North pole has no idea of what is happening in the world And as a result, neither is tragic news being broadcast on his TV nor does he feel threatened by his vicinity And he is economically sound as well, then it might be possible that the chances of depression in places like these are less because the environment that triggers it is absent But it does not mean that there are no cases of depression in these places at all There certainly are! Only the triggers are fewer in number – For the information of the viewers, when do you think one should seek professional help (as you suggested)? Different conditions have different manifestations.

Talking specifically about depression, if you are experiencing such low mood spells where you do not have the motivation to do basic things and this spell goes on for a very long time If you’ve become socially withdrawn and do not desire to meet anyone, unlike before, Some people have personalities like that But in this case, things like these that did not hold true earlier but have begun to manifest Staying quiet, not willing to contribute or the depletion of self-worth and self-value when these things happen acutely and reach a chronic level… -How long are we talking about? -If it persists for several weeks-( 2-3 weeks) then definitely it is something other than the stress I hope you would have found this ARTICLE to be informative.

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