Silent Struggles: Unraveling the Complex Web of Depression

Written by Dr. Arun Bhat P., Consultant Psychiatrist
Read time - 5 minutes

 "Doctor! She's not eating or sleeping properly," said the husband, describing his 52-year-old wife. Her face had lost its radiance, eyes were dull but teary, and sorrow filled her demeanor. The husband explained, "Our only son passed away in an accident two months ago. Since then, my wife has been in this state. She constantly cries, blaming herself for our son's death, saying she deserves to suffer in hell."

She neglects personal hygiene, avoids conversation, isolates herself, shows no interest in anything, and recently even attempted suicide. That's why I brought her here.

The woman, as mentioned above, is suffering from depression. Depression as described in the above scenario is not only caused by external factors but at times by internal factors. Symptoms and severity vary widely. External factors may include loss of loved one & grief, social pressure, family tension, financial stress, & substance use. Impairment in brain neurochemicals, hormonal changes during mensuration,  during pregnancy & after delivery, Bipolar mood disorder, OCD, Anxiety disorders, Genetics, Deficiency of nutrients, various physical ailments such as AIDS, cancer, diabetes, hypertension, thyroid issues, paralysis, and disabilities are some examples of internal factors which may lead to depression.

What are the signs of depression?

Continuous feelings of sadness, unexplained fatigue, disinterest in daily activities, lack of pleasure in previously enjoyable tasks, low self-esteem, lack of confidence, shedding tears, losing patience quickly & irritability, dwelling on past events, disturbed sleep, lack of appetite and taste for food, decreased sexual interest, negative thoughts, suicidal ideation, reduced work efficiency, and memory loss are some common signs of depression.

In children, depression may manifest as poor academic performance, excessive anger, disruptive behavior, speaking less, bedwetting, and a desire for solitude.

In elderly, heightened irritability, restlessness, gloominess, and a sense of hopelessness may be observed. 

 According to the World Health Organization (WHO), around 4.5% (approximately 450 million) of the global population was affected by depression in 2015. In urban areas, around 3% of the population is affected. The consequences of depression on a nation's development are immense, with approximately 2%-37% of depression patients attempting suicide. Suicide attempts are more common among individuals aged 15-29. Every hour 1 person is losing his/her life by committing suicide in India. Depression can be seen in all age groups and every age groups has its own causation. Women tend to experience depression slightly more than men.

It is crucial to identify and address depression at the right time, providing treatment through medication, counseling, and psychotherapy as needed. For mild cases, simple interventions like lifestyle changes and emotional support may be sufficient. Severe cases, especially those involving suicidal tendencies, may require psychiatric hospitalization, electroconvulsive therapy (ECT), or other advanced treatments. Recognizing and addressing depression promptly ensures a better long-term prognosis for the patient.