“It will pass in a couple of days. They cannot keep us under a lockdown for more than a month”
“How will I stay at home all day? What will happen to my work?”
“This is nothing more than the common cold. It will be over soon!”
Did you find yourself experiencing such thoughts when you watched the journalists warning about the covid-19 pandemic? What seemed like a couple of days turned out to be a turmoil from which people are still recovering. Along with the rise in covid cases, you could see a steep rise in the number of people suffering from depression. Humans, who are known to be ‘social’ animals were no better than chickens inside a coop. People were locked up inside their houses, struggling to run their households. Was covid-19 a cause or just a trigger for increasing mental health disorders?
The deteriorating mental health of India
In a developing country like India, mental health is often considered a ‘luxury’. Yet, the National Mental Health Survey (NMHS) conducted by the Indian Government in 2016 sheds some light on the mental health conditions of the Indian population. The survey showed that the prevalence of several kinds of mental health disorders was around 10.6% in adults. The mental health of the Indian population started deteriorating even 4 years before the pandemic struck millions across the globe. A recent UNICEF report suggests that one in seven individuals amongst the 15-24-year-old population reported feeling depressed. Mental health, which was once considered a luxury, according to WHO 2020 report, will lead to an economic loss of about 1.03 trillion USD between 2020-2030 in India.
But what is depression?
Back to the basics
Depression (or clinically known as ‘major depressive disorder’) is not just about being sad. It encompasses a lot of psychological, emotional, behavioral and physical issues. When one is diagnosed with clinical depression, these are some of the common symptoms that a person might experience for two weeks (or more):
Depressed mood
Anhedonia or lack of feeling pleasure in previously pleasurable activities
Severe changes in appetite and weight
A significant amount of psychomotor retardation (or getting ‘slowed down’)
Feeling tired all day lon
Inability to concentrate in any activity
Feeling worthless or experiencing a large amount of guilt
A general sense of being trapped and feeling helplessness
Suicidal ideation
In older individuals, especially from developing countries, depression can manifest through somatic symptoms. Childhood depression is different as sadness is often replaced by irritability. Hence, when you feel depressed it is not equivalent to feeling sad. Depression can manifest in several different ways. Sadness is a basic emotion, depression is not.
“Yeh depression kuch nahi hota? Ghar se nikal ke toh dekh”
Even though the dialogue regarding mental health has started in India, it is still considered a taboo topic. UNICEFreports suggest that compared to 83% over 21 countries, only 41% of the younger generation in India agree that it is okay to seek out help for mental health issues. Is it because of the stigma? Or a lack of mental health professionals?
Along with a lack of awareness, there is a dire need of finding psychiatrists and psychologists in India. The Mental Health Act was introduced to integrate mental health services in all socio-economic strata as a part of the general health-related services. Yet, only 9000 psychiatrists and 1000 clinical psychologists for the entire Indian population. While most of them reside in metropolitan cities, the rural areas are devoid of such facilities. For them, mental hygiene is a foreign term. Struggling to get access to basic healthcare facilities, there is a lack of awareness and resources amongst the socio-economically backward society. The Indian Journal of Psychiatry suggests that around 42 years and 76 years are needed to fix the lack of psychiatrists and clinical psychologists respectively in this country. The Mental Health Act mandates all insurance companies to include mental health issues under an insurance policy. But only a few follow the rules.
All in all, the situation seems grim at the moment. With the proposition of Finance minister Nirmala Sitharaman introduced 23 tele mental health centers, under the supervision of NIMHANS, there seems to be a glimmer of hope. Yet, the meager budget allotted for mental health will not solve the upcoming surge of cases of depression in the coming years. Maslow suggested a hierarchal model of needs where the basic physiological needs require attention before achieving higher needs. In a country where survival is a struggle, taking care of your mental health is a distant dream for many.
If you know someone who is struggling with mental health issues, don’t stay quiet. It is okay to seek help. Taking care of your mental health should be as important as your physical health.
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