First Diabetes, then Tuberculosis to maim India’s population physically, and now Depression as its fastest growing young to old epidemic. What’s happening to urban IndiaIJ DEEBASHREE MOHANTY brings you the story on how the newest mental health problem of depression is shortening life expectancy by an average of 15 to 20 years
lifestyle diseases, safety issues, pollution hazards and the mounting stress in India’s urban jungles has long been playing with the DNA of the nation’s happiness quotient. But it is only recently that a new monster of sorts has invaded common homes all fangs bared — the monster of depression — an ailment that has spawned from being just a lifestyle disease to becoming a scary urban epidemic.
And the alarming thing is not just its epic proportions. Doctors say what is scarier is the disconcerting fact that depression is getting as younger as it is getting older. So, today, you have reports of a boy as young as just nine years old committing suicide because he was depressed about his marks, or because he was depressed about something as trivial as his mother not allowing him to go and play in the park.
The boy was nine. But the girl who made news recently was 15. And Bollywood actress Deepika Padukone blew the lid over celebrity glitz and glamour by stating that she suffered from depression, sought counselling and now is helping out very many others in her industry acknowledge, accept and take help to get rid of this fastest growing, largely unexplained mental blue which has a frequent tendency to turn fatal at a drop of a mood.
Take the case of 15-year-old Kamya Bhushan, a typically metro teenager who had everything going for her. Well-placed and loving parents, a top-end school, brilliant marks, good friends and a happy environment. It was 3 pm on a hot summer afternoon when Kamya, a student of a posh south Delhi school, stepped out of her plush home in Defence Colony. She walked 3 km to reach her destination. Once there, she was escorted to a room and told that someone would soon see her. Nothing happened for the next half-hour. A restless Kamya picked up her wallet and left in a huff.
This was the last her parents heard about her. later that afternoon, she set herself on fire and died instantly, having suffered 99 per cent burns. The maid discovered her charred remains at 7 pm. Her mother, a private bank employee, is still grappling for answers about why Kamya would visit a psychiatrist before killing herself. Apparently, Kamya wanted to meet the psychiatrist because she was suffering from ‘lifelessness’ and a desire to end her life. The afternoon when she was asked to wait, she had told the receptionist that she just wanted help and pills to cure her insomnia.
Her unsuspecting family is in deep shock. There was nothing to suggest that their daughter, a topper in class who had many friends and an envious lifestyle, would be depressed. Kamya’s story is emblematic of the mental problems confronting India’s youth, a society impatient for upward mobility and underprepared for the challenges accompanying modernity. The other problem, counsellors says, is the fact that mental ailments like depression are neither identified in time nor taken seriously enough to be clinically dealt with.
“Most parents don’t see it as a life taking problem. like any other medical issue, if depression is identified early, a life can be saved,” Dr Manohar Joshi, retired NIMHANS psychologist who has been dealing with patients suffering from depression for over 20 years now, tells you. Most of his patients come from the upper class. He says that the cases of depression have increased manifold (he tackles at least 50-60 appointments a day) but what has changed drastically is that more people are now aware of their mental well being and are ready to discuss it.
“Earlier, depression was taboo subject primarily because people did not know how serious it was. But now, with even celebrities having come out of the closet and spoken about their depression, there is suddenly a buzz around the subject,” he says. It’s only 4:30 pm and Dr Joshi has just met his 50th patient for the day, “a Class VII girl who was accompanied by her mother.” Seema, the doctor says, was going through immense depression due to a heartbreak and finding it difficult to come to terms with it.
For him, this kind of depression may be situational but there is urgent need to tackle it before it turns clinical. India has the world’s highest suicide rate among 15 to 29 year olds, ahead of North Korea, according to a report released by the World Health Organisation. For the first time last year, WHO listed suicide as the leading cause of death among young Indian women, overtaking deaths during childbirth. “It is a pan-India epidemic which needs to be curbed immediately. According to a study, just 24 per cent people with mental disorders and 28 per cent with post-traumatic stress disorder get treated, as compared to 91 per cent people with, say, high blood pressure. This is despite the fact that mental health problems are shortening life expectancy by an average of 15 to 20 years,” Shailaja Mukherjee, member of the Psychiatrist Association of India, discloses.
The number of deaths caused by mental or behavioural problems has also been on the rise. According to the National Crime Records Bureau, there has been an overall increase by 10.52 per cent in this segment. So, why is depression creeping up the epidemic ladderIJ Social scientists blame it on cultural issues, discrimination, parental pressure and job competition all of which is combining to create a suicidal epidemic among India’s youth. Asha Khanna (57) accompanies her daughter Mini to meet a student psychiatrist in Mayur Vihar phase 1 every Wednesday and Friday.
The mother-daughter duo has been visiting Dr Murli Dhar for three years now and they are pleased with the progress. “Mini went through a rough period when her father suddenly met with an accident and passed away in 2004. Though she put up a brave front and dealt with all her responsibilities, Mini’s mother noticed subtle changes in her behaviour and approached us for help. Mini is a school dropout because she couldn’t concentrate on her studies and missed school frequently. She lost a lot of weight during this period and went through a break-up with her steady boyfriend. All this took a toll on the girl and she went into a shell,” Dr Dhar whose clinic in Mumbai is frequented by celebrities and models, says.
It took the doctor 16 months to revive enthusiasm in Mini. Today, she is pursuing a course in Jewellery Design from a reputed institute in Delhi. “It took me a long time to understand that Mini needed professional help. She seemed okay to the rest of the family. But the day I got a call from her school saying that Mini had been missing in action for over a week, I knew something needed to be done. That’s when I took an appointment with Dr Dhar and with his help got Mini to vent her inner feelings. She told us in one of those sessions that she used to bunk her classes and visit the accident site hoping that her father’s soul would contact her in some way. She wanted a closure with her father,” Asha Khanna tells you, recalling torrid times.
There are many like Khanna who have taken cognisance of their children’s condition and acted upon it. But more and more such cases need to be highlighted to help build awareness about the issue. Model co-ordinator Shiney Dubey in East Delhi has a Facebook page dedicated to people ‘who feel blah about their life’. Started out as a fun page, Dubey’s initiative today has over 3 lakh friends and counting. “A very dear friend of mine jumped from the fifth floor apartment and injured himself badly. He has never been able to recover from his trauma.
“I started this campaign in order to help people who suffer from depression. The community discusses issues ranging from family problems to dating maladies. In a fun way, we have managed to convince many people to visit psychiatrists rather than dealing with pressure situations on their own,” Dubey says. Nearly 50 million people living in India are hit by mental health conditions. Such conditions cause profound suffering to affected individuals and their families. Mental maladies are associated with poor physical health and with death through suicide. According to the WHO, suicide is the seventh top cause of death globally among women aged 20-59 years.
Explaining the reason for a higher suicide rate among young people from developed and educated States, which otherwise have a sound track record of human development, Joshi says that in a rapidly changing society that brings in newer challenges by redefining the meanings of success and prosperity, the youth get easily disappointed when aspirations are not fulfilled. Peer pressure adds to this grim situation and makes matters worse.
“Depression has never been area centric. In fact, it is the most well distributed malady if we can say so. I get a lot of elite patients and some middle income couples who are striving to deal with stress on a daily basis. Your mental state has nothing to with what section of society you come from. In fact, it is seen that celebrities suffer from more stress than general people. They have to lead a different life and maintain their composure at all times. “They are the ones who have to mask out their emotions from the prying public view.
It is difficult to do that. When they cannot handle this, they slip into their own cocoon. Every top actor goes through this syndrome once in a while,” Anna Chandy, a well known Bangalore-based family counsellor, says. Chandy tells you that stress abets depression. “Everyone is in a big rush to prove himself. There is little or no time left for relaxation. That spells doom,” she says. According to her aspirations are at a much higher level and society around them is not always keeping pace, so the disappointment is much greater.
“Compounding the issue, little help is at hand for those suffering from mental illness. In India, the condition often goes undiagnosed or untreated. We did not even have a national mental health policy until a few years ago,” she says. Joshi also points out that India is facing an acute shortage of mental healthcare resources. The country has about 6000 psychiatrists and even fewer other specialised mental health professionals. “Out of the many in-patient beds, a majority is situated in mental hospitals, where patients are known to undergo custodial care and human rights abuse,” he tells about the pathetic condition of the facilities. The Mental Health Care Bill proposes a series of progressive clauses, including a provision that persons who attempt suicide will now have the right to confidentiality of mental healthcare information.
Under the new Bill, the State is required to take responsibility for the implementation of programmes for promotion of mental health and prevention of mental illness and suicide. Attempting suicide is currently an offence under Section 309 of the Indian Penal Code that can attract punishment of up to one year in jail and a fine. But is this enough to curb an urbane epidemicIJ “Awareness at all levels and better infrastructure to deal with mental patients is the key towards stopping this epidemic,” Joshi says in conclusion.