When Sunita, a 20 year old engineering student, was brought to my clinic by her father a few years ago, nothing seemed grossly out of place in the nvestigations that she had gone through. Yet was going right for her. While she had been a topper of her batch in school, she was now struggling to pass the year ending examinations, had developed a repulsion to the college, her books and the hostel, had stopped chatting or going out with friends, and had even started avoiding going home on holidays. She was not sleeping well at night, had lost her appetitie and could not remember the last movie she had seen. My suggestion that she could be depressed met with strong disapproval from her father. He demanded that I certify Sunita to be free of any serious disease, and insisted that she had to work hard and exell in studies to compensate for all he had struggled and invested to get her to become an engineer. I heard that Sunita unable to cope and pull on, ended her life a year later. She was one of the 16000 students who committed suicide in India between 2004-8.
Depression is no longer a rare remote disease; it could be affecting someone in your home or vicinity. Its frequency in youth has increased from 2% to 12% in the last 5 years. WHO has labelled it as the No 1 occupational disease of the 21st century and estimates that 1 of every 3 individuals will suffer it at least once in their lifetime, and could be serious enough in 1 of every 7 individuals to require specialized attention and treatment.
While life has its ups and downs, a rather prolonged, disproportionate phase of lowness should arouse concern about depression. It is characterized by sadness, hopelessness, loss of interest in usual activities, difficulty in concentrating, poor self esteem, feeling of guilt, over reaction to criticism, and sometimes anger or rage. Sleep and appetite are often disturbed. Affected people often start abusing alcohol and drugs.Friends and relatives can often recognize it if they are aware of the symptoms.
Ability to laugh becomes a casualty in this disorder. While children laugh around 300 times, adults laugh only15 to 100 times a day. Depressed people find it difficult to muster a laugh, and when they do, seem to do it sardonically. Also, vague persistent physical symptoms could have their origin in the reduced levels of energy that underlie depression.
Of further concern are studies showing that upto 50% students could be stressed or depressed, 10% seriously so, of whom 72% admit being unaware of how to deal with their feelings. Depression and suicidal feelings are treatable disorders: the child or adolescent needs to have his or her illness recognized and treated. Encouraging group activities, social and family bonding, freqent merrymaking and laughter, and keeping career goals in proper perspective are essential preventive tools.
For parents, it is essential to remain approchable and maintain openness so that their children can share their feelings without inhibition, fear or embarrassment. And if you notice an adverse change in their nature or hear them they say they are feeling low or depressed, please do take them seriously, before it gets too late! If only Sunita’s father had listened!
As published in HT City ( Hindustan Times ) dated 1 november , 2009.
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