Bose has not been feeling quite well for the past six weeks now. She is tired all of the time, cries for no specific reason, sleeps poorly and has lost her appetite. Her attention is no longer good and she simply cannot bring herself to concentrate on any task. Nothing interests her anymore and she often feels like her mere existence is a struggle – as she is not of any benefit to anyone. Sometimes, she wonders if she is not better off dead, so the world is finally rid of her. She recently discussed her feelings with a psychiatrist who informed her that she is suffering from depression. She is shocked and the following conversation ensues.
Bose: Depression? I am not mad…I am just not myself these days. I don’t even know why I agreed to come and see you.
Psychiatrist: I appreciate your coming to see me, and spending your time to explain all the things going on with you these days. But, I never said you are mad. I am only trying to explain that your very low mood and all the other experiences you have been experiencing is due to low levels the chemicals in your brain that control your mood and emotions. This is what has caused this situation, which we refer to as depression.
Bose: Okay. But if I have depression, what can be done for me?
Psychiatrist: Very good, I like your positive and action-based approach. The good thing about depression is that it is very treatable. It is like someone who is wearing very dark sunshades, such that everything they see, appears dark too. This is how depression affects our thinking – resulting in low self-esteem and negative thoughts; affects our behaviour by making us lose interest in things we used to enjoy in the past, sleep poorly e.t.c.
So what can be done may be grouped into three categories:
- A) Self help
- B) Treatment interventions
- C) Social support
Self-help: You need to commit to accepting help and support from mental health professionals, as well as others who may be in a position to support you. Still using the analogy of the dark sunshades, we can help you remove and replace it with clear sunshades so you can appreciate how bright and beautiful life truly is. However, we cannot achieve this without your permission and active collaboration. We need you to come regularly for clinic appointments and to comply with the drugs or tests required.
Treatment interventions: We are going to actively treat you in two ways – with medications and with psychotherapy.
i). Medications: There are various types of drugs known as anti-depressants, that we can prescribe for you. They are all very effective and they work by helping to restore the balance of the chemicals affecting mood and emotions in the brain. These chemicals are usually low in depression, while the drugs help to bring the levels back to normal – and you will then begin to feel like your normal self again.
The drugs are cheap, effective and readily available. They are also not addictive, so even though you may have to take them for some months (at least), they are perfectly safe. I will use my best clinical experience as well as the type of complaints you have to determine which one will be best for you to go home with it. But if you experience any side effects or discomfort, please let me know so that we can reconsider. Its common side effects include sedation (excessive sleep) usually in the first few days after starting the drugs; and some weight gain.
- Psychotherapy: Here, we will attempt to understand the type of negative patterns of thought that are frequently occurring and which maybe contributing to your feeling so bad, most of the time. Such thoughts are like the different types of dark sunshades that makes you see the world as such a gloomy and terrible place. Identification of these thoughts as well as how to catch and correct them is usually what we would attempt to do in these sessions.
Social support: While all of the above are very important, it is equally necessary to be surrounded by friends, family and close ones. The number is not what is important but that they are people with whom you share a close relationship and that you can trust to be there for you. So you can exchange visits, share happy moments and generally be comforted, knowing that there are people in your corner.
Conclusion: So, Dear Bose, I hope you now have a good understanding of what depression is and how we can all possibly join hands – everyone inclusive, to ensure early detection and prompt interventions.
Bose: Thank you so much, Dr. I now understand better, what my feelings were and the way forward for me.
Psychiatrist: Excellent. I am glad to have been of assistance.