For example, estimates made by WHO in 2002 showed that globally 154 million people suffer from depression and about 877,000 people commit suicide every year. [break]
Sparsh Dutta, 21, now being treated by Dr Geeta Maheshwari in India, shares one such heart-rending story about this mental disease in her own words: “Nothing in life brought pleasure to me. I spent most of the time on bed, thinking about things beyond the imagination of a normal person.
All I did when I was alone in the house was to think all sorts of weird things and cry bitterly the whole day. But I didn´t know that I was afflicted with psychosis or depression. Apparently, the only solution to my problem was death.”
The case of Sparsha represents only the tip of the iceberg; there are many such cases of youth suffering from depression. According to Dr Sharad Man Tamrakar, Neuropsychiatrist and Psychotherapist at Norvic International Hospital, a 22-year-old boy hailing from Pokhara was similarly afflicted with the disease. The incident came to light when the natives of Pokhara reported the police after detecting the problem in a boy in the locality.
The boy´s family was informed of this and he was quickly flown to Kathmandu. The boy, whose body still bore fresh and old scars, was referred to Tamrakar for a clinical investigation. The doctor concluded that the boy was severely depressed for the past four years. The probe also showed that he had deserted his family and was addicted to drugs.
Depression among the youth is slowly becoming one of the major psychiatric disorders. From the middle-aged youths, depression is shifting to the young adult population. The trend over the past 50 years suggests that more and more young adults are increasingly afflicted by it. The disease although not having any distinct physical characteristic can do serious harm, including increasing suicidal tendencies among youths.
Manisha Chapagain, Senior Psychiatrist at TU Teaching Hospital, informs that among her patients, people aged 20 to 38 years are in the majority.
Meantime, Tamrakar claims that 30 percent of his patients are youth, usually between teens and those aged 30 years.
While the youth are considered the future of any nation, the said figures are definitely not painting a bright picture. The disorder specially requires immediate attention for it has been categorized as one of the major causes of suicide the world over.
A broad categorization
Although there are no specific reasons behind the cause of depression, there are some factors which contribute to this problem. The reasons could be biological, psychological or social. Genetic, polygenetic and hormonal factors are associated with the biological causes, while the psychological reasons include detachment with the mother or family after birth, deprivation during childhood, wars and also economic hardships.
The social causes include political conflicts and deprivation which takes many different forms, according to experts. They also point out abnormal conditions of thyroid hormones and physical illness as contributing factors.
Multiple factors
There is no single factor leading to depression. There are a multiple of causes associated with it. Thus, it becomes impossible to pin-point all the reasons behind its occurrence.
Some types of depression might seem to run in families, suggesting a biological vulnerability. However, the reverse is not true. Not everybody with this type of genetic-makeup develops the disorder. There are additional factors, such as stress along with other psychological factors that are involved in its inception. Additionally, it also occurs in people who have no family history of depression. So, while there may be some biological factors that contribute to depression, it is clearly a psychological disorder.
“A variety of psychological factors play a role in increasing the vulnerability of depression,” informs Tamrakar. Psychological factors, he says, are responsible for temperate depression.
Depression is also likely to occur among people who have low self-esteem, or to those who are readily overwhelmed by stress. “Social learning factors explain why psychological problems appear to occur more often in family members, from generation to generation,” says Tamrakar. If a child grows up in an environment which is pessimistic, with little or no encouragement, that child is likely to develop depression.
He said that a child who is pressurized by parents for scoring a good grade is also vulnerable to depression.
Chronic illness, work stress, relationship problems, family crisis, financial impede, or any life change are other probable factors causing depression.
Says Tamrakar, “Families in Nepal lack an open environment, and compounded by this is the lack of communication which forms the largest reason behind depression.” He elaborates that since sharing problems is the basic step in overcoming depression, it is absolutely essential that people talk to each other. It becomes even more necessary for young people to cultivate the habit of talking and sharing feelings since they are going through immense changes both physically and mentally. “Talking will work like a therapy,” says Chapagain.
Society´s condescension towards people with psychological problems
Although the first psychiatric department in Nepal began in 1970 with Dr BP Sharma as the country´s first psychiatrist, the disorder is still very hush-hush with a handful of people being open about it. “It´s almost like a social stigma,” says Tamrakar. The cases of depression are almost always a result of another doctor referring the patients to psychiatrists, according to the doctor. “The stereotypical image of the society towards those undergoing mental disorders is that they are being mad,” puts in Chapagain.
Is the government turning a deaf ear?
The Ministry of Health and Population has allocated a total of Rs 17.8 billion for addressing the health issues in its annual budget. The investment in the mental health, however, is almost nil. As Tamrakar puts it, “Although the investment in the health sector by the government occupies almost 70 percent of the total national budget, which is enough to buy a jumbo jet, the mental health sector receives a paltry 10 million rupees.” This trifling amount too, he informs, is used in distributing antidepressants which are outdated.
“Although, not expired, these medicines are made using the knowledge psychiatry possessed during the 60´s,” he adds.
The deputy spokesperson for The Ministry of Health and Population, Kavi Raj Khanal, refutes this and claims that the individuals involved in the field and who demand an increased budget a few more times have never furnished proper plans.
Currently, the ministry is considering a sum of Rs 30 million to Patan Mental Hospital -- the only investment in the mental health sector to this date. Khanal, meanwhile, informed that the Ministry plans to carry out trainings and organize camps to increase the coverage of the program and has already included it in the budget prepared for this fiscal year.
WHO states that by the year 2020 AD, depressive disorder will be the number one cause for Global Burden of Diseases (GDB).
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