Overcome Depression: 9 Warning Signals You Should Not Ignore

People so often speak of health as the most important aspect of living a wholesome life. But while parents are so willing to expend a great deal at a dentist’s office to fix their child’s crooked teeth to have them perfectly aligned, they are not as unyielding to heed their child’s mental health all the same to have their thoughts perfectly aligned. 

Let me lay down some stats for you. A report by WHO suggested that 7.5% of the Indian population suffers from some form of a mental disorder. If this isn’t enough to get you in a tizzy, here’s another one: Mental illnesses constitute one-sixth of all health-related disorders in the world and India contributes to a shocking 15% of the global mental, neurological and substance abuse disorder burden. There’s more. A treatment gap exists when there are a certain number of patients suffering from a disorder and only a proportion of those people actually get treated. This gap is over 70 percent! 

It is after a great deal of awareness by celebrities, social media and mental health campaigns that mental health issues have finally found a voice today. Not one that specifically says “It's completely okay to speak of depression as a rife topic”, but we’re getting there. 

What is Mental Health and Why is it Important? 

Mental health includes our cognitive, emotional and social well-being. So naturally, it has a direct impact on how we think, how we feel and how we behave. Positive mental health not only allows one to realise their full potential and work productively but also helps them deal with stress and emotions in a healthy manner and entitles one to have a proactive approach to life. A lack thereof, would hence adversely affect your work, relationships, disrupt a routine and meddle with interpersonal connections. Do you see the severity of the problem? 

Studies suggest that to maintain positive mental health throughout one’s life, the following play a crucial role: 

1. Seeking professional help when you need it or think you need it
2. Staying connected with other people - homo sapiens are social beings and human connection is an integral part of who we are
3. Attempting to stay positive using affirmations 
4. Staying physically active (Health experts recommend a minimum of 150 minutes of moderate-intensity exercise per week)
5. Offering help in situations where we can significantly contribute
6. Getting adequate sleep - A good night’s sleep is not only key to a well-rested body but a well-rested mind too. It is because of this that you would notice people on their worst moods when they haven’t gotten enough sleep

The Stigma Surrounding Mental Health

It is not uncommon for people, especially in India, to shy away from a conversation relating to mental health. Anxiety means “to worry about things is a good thing, you’ll get over it”, to be depressed is to be “stubborn”, to be happy is “in your control” and to have mental breakdowns (even if they’re almost every day) is “to suffer from a serious lack of confidence”. 

The problem with our society’s take on mental health issues is that they’re so committed to being in denial of such a concept, they could succeed in convincing an entire generation of the same. This is precisely why people grow up with a whole bunch of messed up psychological problems, not being aware that they had a problem, to begin with - let alone getting around to fixing it. It’s why you’d mostly find people over the age of 40 at a therapist’s office because his/her younger self was strictly advised against believing in what Indian parents so fondly call and I quote “ a myth”. 

A stigma is essentially viewing someone in a different light, a negative light. The stigma around mental health is not uncommon. More often than not, the stigma leads to discrimination that could worsen someone’s condition with an existing mental health issue. Even when the discrimination is not direct or blunt like making a shrewd comment or calling people names because of their illness, it is almost as bad to avoid someone because this might lose them a great deal of self-confidence. 

Harmful effects of stigmatising someone with a mental health condition: 

• It might make them reluctant to seek professional help
• Influence other people’s behaviour towards them and eventually normalise the discrimination
• Lack of acceptance at school or jobs
• Bullying, harassment 
• Health insurance that doesn’t fully cover one’s mental illness treatment (because it doesn’t see a mental health disorder as a “real” disorder
• Triggers one to believe they can never be an equal as the rest of the people in the society 

While it would take me more than just a blog article to cover an exhaustive list of mental health problems prevalent among people in the world, the most common mental disorders are as follows: 

• Anxiety 
• Bipolar Disorders 
• Depression 
• OCD (Obsessive Compulsive Disorder)
• Eating Disorders
• Personality Disorder
• Post Traumatic Stress Disorder (PTSD) 
• Psychosis
• Schizoaffective disorder
• Schizophrenia

This article largely aims to talk about one of the most common disorders faced by people across the globe. The WHO estimates that one in every four people in the world will be affected by a mental or neurological disorder at some point in their lives and most will invariably be linked to depression. 

Depression Does Not Equal Sadness

Depression or clinical depression is a mental health disorder associated with persistently low, depressed moods and a complete lack of interest in daily activities that could cause significant impairment to one’s life. There are various causes of why this could occur - some of the most common include heredity and social distress. 

While feeling low from time to time might be a part and parcel of life, perpetual feelings of hopelessness and sorrow may be a sign of something more serious. You can identify the difference between sadness and depression by questioning the nature of your struggle. If a setback or incident has caused you to feel short periods of sadness, it might not be a cause for worry. But if you notice changes in how you feel, think and respond to normal day-to-day activities and social encounters, interference in your sleep and appetite and a lack of general appreciation for life - this may signal towards a case of clinical depression.

What is important to know is that no matter how hopeless or helpless you feel, there is always a scope of getting better. With an understanding of the causes, symptoms and potential treatment options for depression, you’re already at step 1 of attempting to make things better. 

Signs that you could possibly be suffering from Depression

1. Feeling Sad or empty on most days and being unable to explain why 

Persistent feeling of emptiness is one of the main symptoms of depression. When you lack the motivation to do something as normal as cooking breakfast or driving to work, feel bogged down for no specific reason, it might indicate that you suffer from clinical depression. 

2. Losing feelings of pleasure, especially in activities that you once seemed to enjoy

The inability to enjoy things you usually love doing is yet another sign. Depression can take out the fun or pleasure from all that you once looked forward to - your hobbies, social interactions and even sex. Studies show that a low sex drive, a lack of interest towards sexual activity or even impotence can be possible signals of depression. 

3. Irregular Sleep patterns - Sleeping for too long or too little a time period

Part of the reason that you stop to enjoy the things you normally do is that depression makes you feel tired all the time. While an overwhelming feeling of fatigue and low energy levels can lead to excessive sleeping, depression has also seen to cause insomnia in some people. The lack of restful sleep can even lead to anxiety or worsen other symptoms of depression.

4. A change in appetite - eating too much and too frequently or complete loss of appetite 

A sudden change on the weighing scale (without intent to have made this change) is a common symptom. Different people experience depression differently. While some people notice a surge in their appetite and gain a lot of weight, some might experience loss of appetite and lose weight. If this fluctuation takes place with no dietary or lifestyle change, it might be caused by depression. 

5. Feeling Anxious

Although depression might not necessarily cause anxiety, the two often tend to occur together. Symptoms of anxiety include feelings of dread, danger and panic, palpitations, rapid breathing, restlessness, muscle twitching, increased heart rate and heavy sweating. 

6. Feeling unworthy/self-loathing

Depression causes you to have a hopeless outlook on life. It tends to give you a rather negative perspective on life, completely changing how you think or feel about things. This feeling is often complemented with feelings of self-doubt, worthlessness and guilt. 

7. Irritability 

A common symptom of depression in men, irritability can often be a lot more dangerous than it sounds. Irritability in depression results from escapism, substance abuse and being in denial - all of which happen to be the leading cause of death (by suicide) in men.  

8. Uncontrollable Moods

If you find yourself with unexplainable mood swings - one minute you’re angry, the next you’re crying uncontrollably and your emotions seem to be all over the place -  this is a signal that you might have depression. 

9. Thoughts about death and suicide 

There are 135,000 deaths (on an average) by suicide in India every year. The global average is 800,000. In 2016, suicide was the leading cause of death in India within the age group of 15-39 with the number as high as 230,314! 

Now there’s no saying what the causes of these suicides are but studies suggest that a lot of times, suicide is connected with depression. And people who die by suicide will generally show symptoms of this thought first. It is up to the people around, to be aware in case a known individual suggests an inclination to end their lives. 

All other symptoms such as hopelessness, lack of self-worth and a lack of motivation work in tandem to make one feel like suicide is the only way to escape. So recognising these signs plays a crucial role in avoiding things to escalate.

Warning signs that someone you know might be suicidal: 

• If they speak about killing or harming themselves
• Expressing feelings of perpetual hopelessness 
• An unusual obsession with topics related to death/dying
• Irrational behaviour depicting a lack of value for life- like speeding up aimlessly while driving through red lights
• Leaving goodbye notes or calling to say goodbye for no specific reason 
• Getting all of their affairs in order such as tying up loose ends
• Hinting a lack of belongingness by saying things like “I wish I didn't exist” or “no one would notice if I was gone” 
• Suddenly going extremely anxious and depressed to acting happy and calm

If you’re the slight bit suspicious that a friend/family member is suicidal, express this concern immediately, let them talk to you openly, and try to talk them (without any coercion) into seeking professional help. Sometimes all it takes is a carefully acknowledged, no-judgement conversation to save a life. 

Types of Depression 

Depression is a complex disorder, as are most illnesses that involve the mind. There are various causes of depression. Understanding the types of depression could potentially hint towards its underlying cause.

There are 7 common types of depression:

1. MDD (Major Depressive Disorder)

MDD is what people generally refer to as clinical depression. It is a mood disorder characterized by several factors including a lack of interest in generally enjoyed activities, changes in sleep patterns and weight, tiredness, lack of concentration and thoughts of death and suicide. If these symptoms last for longer than a couple of weeks, it is best to seek professional help rather than try to deal with it on your own. 

2. Dysthymia

Also known as PDD (Persistent depressive disorder, dysthymia is a type of chronic depressive disorder that lasts for brief periods throughout a person’s life, if not treated. Although it might not be as critical as MDD, PDD is still a cause for concern as it disrupts one’s ability to enjoy life. Some common symptoms of dysthymia include feelings of anger and sadness, irritability, loss of pleasure, fatigues, low self-esteem, insomnia as well as changes in appetite. 

3. Bipolar Disorder 

A type of mood disorder that’s resulting in periods of abnormally extreme or elevated moods known as mania, bipolar disorder is an illness that increases a person’s risk of suicide by 15%. Elevated moods can be mild or extreme - in which case, a person loses his sense of reality and has to be hospitalized. Symptoms of bipolar disorder include indecisiveness, anxiety, irritability, insomnia, lethargy and unexplained physical pains/aches. 

4. PPD (Postpartum Depression)

Pregnancy can bring about some major hormonal shifts in a woman’s body that can often adversely affect her moods. Depression can have an onset either during pregnancy or after the birth of the child. 

Postpartum depression is more than just “baby blues” and its symptoms include feelings of sadness and worthlessness, anxiety, trouble bonding with your baby, social awkwardness, panic attacks, thoughts of harming yourself of the baby and appetite changes that last more than a couple of weeks. 

5. PMDD (Premenstrual Dysphoric Disorder)

While symptoms of PMS include food cravings, increased appetite, anxiety, irritability, aches and bloating, PMDD is more complex than that. All the symptoms related to mood are extreme and more prominent such as binge eating, inability to focus, feeling hopeless and having severe crying spells. 

6. Seasonal Affective Disorder (SAD) 

Similar to MDD, but only experienced in certain seasons (like winter) is probably the simplest way to describe Seasonal Affective Disorder. How does this make sense? SAD is said to occur as a result of the disturbance caused in the normal rhythm of one’s body. Light entering your body can influence this rhythm and a seasonal variation can cause a disruption that could lead to depression. SAD can often be treated with what is known as light therapy. 

7. Atypical Depression 

As the name suggests, the symptoms of this disorder are not like ones of “typical” depression. If you experience some symptoms of depression such as extreme sensitivity, oversleeping or binge-eating but still seem to enjoy the occasional meet and greet, you might have Atypical depression. Common symptoms include weight gain due to excessive eating, oversleeping, sensitivity to rejection, weakness and fatigue. 

Causes of Depression

There are a number of factors that contribute to increased chances of depression, but the most common ones are: 

Past abuse: A history of past sexual, emotional or physical abuse can increase the vulnerability of a person to suffer from clinical depression later in life.

Medications: Certain drugs, such as isotretinoin (used to treat acne), the antiviral drug interferon-alpha, and corticosteroids, could increase your risk of depression.

Conflict: Depression could also result from personal conflicts or disputes with friends and family members in the case of someone who already has the biological vulnerability to be depressed. 

Death or a loss: Sadness/grief from the death or loss of a loved one, though natural, may increase the risk of depression.

Genetics: One of the most common causes of depression is genetics. If your family has a history of depression, this may increase the risk of you suffering from the illness as well. It's assumed that depression is a complex trait, meaning that there are different genes that each exert small effects, rather than a single gene that contributes to the disease. The genetics of depression, unlike most psychiatric disorders, are not as straightforward as the ones in purely genetic diseases like Huntington's chorea or cystic fibrosis.

Major Events in One’s life: Sometimes even the good events in one’s life such as being accepted into a chosen university or getting married can lead to depression. So can stressful events like losing a lot of money or a job, getting divorced or moving to another country. However, clinical depression doesn’t allow you to  "normally" respond to such stressful life events.

Interpersonal Problems: Social isolation due to other mental illnesses or being cast out of one’s family or social groups can majorly contribute to the risk of developing clinical depression.

Medical illnesses: Sometimes depression co-exists or could even be triggered by an existing illness or medical condition. 

Substance abuse: Over 30% of people with substance abuse problems also tend to have major or clinical depression. Drugs and alcohol might temporarily make you feel better, but they ultimately aggravate symptoms of depression.

Treatment for Depression 

Although there isn’t a single treatment for depression that guarantees a full recovery and to add to this there’s the fact that not all people respond well to the same treatment methods, there are still a range of effective medications and professionals who can assist you on your path to recovery. 

Broadly speaking, there are 2 widely-used methods of treating clinical depression:

1. Psychological Treatment 

Psychological treatments (also known as therapy) could help you change your thinking patterns and improve your coping skills so you're better equipped to deal with the stresses and conflicts of life. Along with supporting recovery, psychological therapies can also help you identify and change unhelpful thoughts and behaviours. 

There are several types of effective psychological treatments for depression, as well as different options for delivery. Some people prefer to work one on one with a therapist/professional, while others feel like they get more out of group therapy. There’s also a rise in online programs or e-therapies,  available to assist with one with depression today. 

Types of Psychological Treatments: 

1. Cognitive Behavior Therapy (CBT) 
2. Interpersonal Therapy
3. Behaviour Therapy 
4. Mindfulness-based cognitive therapy (MBCT)

Medical Treatment 

The main medical treatment for depression is antidepressant medication. There's a lot of misinformation about antidepressant medication and while there is no simple explanation as to how it works, it can be very useful in the treatment of moderate to severe depression and some anxiety disorders.

If you're experiencing moderate to severe depression, your doctor may prescribe antidepressant medication, along with psychological treatments. Antidepressants are sometimes prescribed when other treatments have not been successful or when psychological treatments aren't possible due to the severity of the condition or a lack of access to the treatment.

People with more severe forms of depression (bipolar disorder and psychosis) generally need to be treated with medication. This may include one or a combination of mood stabilisers, antipsychotic drugs and antidepressants.

Apart from receiving professional treatment, these are some effective natural remedies to treat depression (advised by doctors)

In depression, the smallest things have proven to make huge differences (sometimes even more than medical treatments) Some things to assist a speedy recovery: 

Essential Oils:

People have used essential oils for various treatments in the past. However, it is important to note that these oils aren’t necessarily a cure, they only help in relieving certain symptoms and help manage your condition better. 

Some essential oils that are known to relieve symptoms of depression: 

1. Lavender Oil - relieves anxiety, reduces stress and uplifts mood. 
2. Wild Ginger Oil - activates the serotonergic system and helps reduce stress
3. Bergamot oil - Possesses uplifting and calming properties
4. Rose Oil - Decreases blood pressure, heart rate and helps with symptoms of anxiety 
5. Chamomile Oil - Calming properties, relieves anxiety 

Books To Read: 

1. The Noonday Demon: An Atlas of Depression by Andrew Solomon
2. First, We Make the Beast Beautiful by Sarah Wilson
3. Feeling Good: The New Mood Therapy by David Burns
4. The Happiness Trap: How to Stop Struggling and Start Living by Russ Harris 
5. Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff

A list of feel-good movies that have proven to assist those with depression: 

1. “It’s Kind of a Funny Story”
2. Frozen
3. Silver Linings Playbook
4. Perks of Being a Wallflower
5. 10 things I hate about you
6. Goodwill hunting

A List of Movies made on Depression that couldn't be more candid: 

1. World’s greatest dad 
2. Anomalisa
3. Cake
4. Sylvia
5. The Skeleton Twins
6. Garden State
7. Little Miss Sunshine
8. Helen
9. Prozac Nation 
10. Melancholia

I hope this helps. :)