An excerpt from the book, Real Stories of Dealing with Depression by Amrita Tripathi and Arpita Anand.

In India, we use a variety of terms for depression. We refer to depression even as stress or tension.

As Mumbai-based psychologist and psychotherapist Hvovi Bhagwagar shares in Hindi and Marathi, we refer to depression as various things, such as dukh, ashanti, udaasi, rona. (sadness, not at peace, feeling low, crying).

Clients often use phrases such as:

  • Hindi: Mann nahin lag raha hai, baar baar rona aata hai, kisi cheez main dhyaan nahin lagta, ghabrahat hoti hai, mann ashaant hai, chidchidahat hota hai, saans phoolti hai, bechaini lagti hai, chakkar aata hai, sar bhaari hai.
    (I don’t feel like it/ I don’t feel interested in anything, I feel like crying all the time, I can’t concentrate on anything, I feel anxious/ scared, My mind is not at peace, I feel irritated, I’m breathless/ can’t breathe, I feel on edge/ restless, I feel lightheaded, My head is heavy)
  • Marathi: Malaa kasantari vatata, mann bechain asta, hurhur vadte, khupa kaalji vadte, mee asvastha aahe, Dokyat khup vichar yetaat, Khup niraash vaatata, Kashaat mann laagat nahi.
    (I don’t feel good, My mind is restless, I’m feeling agitated, I’m feeling very worried, I am not feeling well, Lots of thoughts in my head, Feeling depressed, I’m not feeling interested in anything)

Mumbai-based counsellor Stuti Saxena shares:

  • Hindi – Dil bhaari-bhaari hai, kuch acha nahi lagta
    Heart is heavy/I feel sadness, nothing feels right
  • Marathi – Man lagat nahi, Mala nehmich kalji wattte
  • English – There is a dark cloud over my head all the time, I feel a heaviness for no reason
  • She adds that Afghani clients sometimes say, ‘Dilam tang ast – My heart is suffocating’.

That’s possibly as descriptive as they can make it, and as you can see, it’s not the case that people will use the terminology you’d expect.

Typical complaints are more somatic in nature rather than emotional. For instance, a person may complain about problems like fatigue, sleep and appetite problems rather than stating the way they feel…feeling low with a lack of interest in activities. This is more common in India and other countries and cultures where there is a lack of awareness about depression and/or stigma attached to depression.

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HOW PREVALENT IS DEPRESSION?

Depression is very prevalent and often referred to as the common cold of psychiatry. According to the WHO, it is the leading cause of disability worldwide. In India, The National Mental Health Survey (2015–16) found that approximately one in every 20 Indians suffers from depression. Here are some facts about depression which can give the reader a better idea about the disorder:

  • Around 150 million Indians suffer from depression which requires immediate intervention.
  • 9.8 million Indians between 13–17 years of age are in need of active intervention.
  • 22.4 per cent of the population above 18 years in the 12 surveyed states suffer from substance abuse disorder.
  • There is a treatment gap of 28 per cent to 83 per cent for mental disorders and 86 per cent for alcohol use disorders.

It’s important to understand that there is a difference between ‘depression’, the colloquial term we use for feeling low or under the weather, and the diagnosis of depression, which is a clinical condition.

Depression is a condition that constitutes several symptoms like feeling low (being one), sleep and appetite disturbances, low energy/fatigue, lack of interest in activities, feelings of worthlessness/guilt and suicidal thoughts. It lasts for a period of time and requires medical intervention. On the other hand, feeling low is only one symptom that can be a response to something, may get better on its own and may not be accompanied by other symptoms.

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WHAT CAUSES DEPRESSION?

  • Common causes may be biological, genetic or environmental factors. So either a person may have a risk due to brain chemistry, or family history, or there might be certain stressors in his or her environment that can cause depression. However, it is not only the stressor, rather a response to the stressor that is the critical issue. In other words, how the person responds to the stressors indicates whether they may become depressed. People with inadequate coping strategies or lack of adequate support are more at risk.
  • What are common co-morbid conditions? Anxiety is the most common co-morbid condition and almost up to 50 per cent of people could have both conditions.

HOW CAN YOU TELL IF SOMEONE IS DEPRESSED?

As a friend/ family member: If you see a change in the way a person is behaving. If a person is withdrawn, is not communicating in the ways they typically do, if you notice a particular lack of interest in activities, changes in sleep and appetite patterns, significant loss or gain of weight. Besides these, if a person is clearly stating that they are depressed or suicidal, this must be taken seriously and help must be sought.

  • As a teacher: Notice changes in social behaviour, poor concentration, poor academic performance or absenteeism.
  • As a psychologist: Assess all the symptoms of depression, including the duration and impact of these on the overall functioning of the individual.

Image Credits: Amrita Tripathi/ Simon & Schuster India/Arpita Anand

Excerpted with permission from Real Stories of Dealing with Depression by Amrita Tripathi and Arpita Anand, Simon and Schuster India.

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