By Ishita B Saha: I am feeling sad. This might seem like a simple sentence to many, but underlying these four words may lie a stream of lava of volcanic emotions that can cause havoc once it erupts. Nothing conjures up the emotions of a depressed person better than Runaway Train, the rock power ballad about depression by American rock band Soul Asylum which won the Grammy Award for Best Rock Song in 1994:
Can you help me remember how to smile
Make it somehow all seem worthwhile
How on earth did I get so jaded
Life’s mystery seems so faded
I can go where no one else can go
I know what no one else knows
Here I am just drownin’ in the rain
With a ticket for a runaway train
World Health Day is celebrated on 7 April every year to mark the anniversary of the founding of WHO and encourages to mobilise action around a specific health topic of concern to people all over the world. The theme of 2017 World Health Day campaign is Depression: Let’s talk.
I am not a qualified medical expert to write on this topic and have taken the help from our experts, but one thing is certain – I am not dealing with depression as another subject for my article but genuinely sensitive towards it having a close family member diagnosed with depression. I have read a lot on the subject to empower myself with the hope that I can educate the other family members to: firstly acknowledge that Depression is another illness that may also need treatment and medication; and secondly recognise that there shouldn’t be any stigma attached to accepting that the person is suffering from depression. If we don’t feel embarrassed to share that a near and dear one in the family is suffering from hypertension or diabetes, then we shouldn’t feel embarrassed to share that someone is suffering from depression too. However, that is easier said than done. The tragic part of any mental illness is that, most of us (who aren’t in the medical field) don’t have the capacity to recognise what should be the ‘intensity’ of a feeling of sadness to be considered as a medically diagnosed case of depression. Studies show that the society today with it’s increasing obsession to share it’s moments of glory and success on social media, has the tendency to become depressive with the constant peer pressure and the need to validated with ‘likes’ by one’s surrounding virtual society.
According to WHO, ‘Depression affects people of all ages, from all walks of life, in all countries. It causes mental anguish and impacts on people’s ability to carry out even the simplest everyday tasks, with sometimes devastating consequences for relationships with family and friends and the ability to earn a living. At worst, depression can lead to suicide, now the second leading cause of death among 15-29-year olds.’ But the good thing is Depression can be prevented and treated, just like any other illnesses.’
Our #BringBackBalance campaign collaborator, Bupa Global, has come forward with their research along with Tanuka Gupta, a Clinical Psychologist and Wellness Coach and our guest speaker at our second #BringBackBalance event. And as a family member who has witnessed the serious consequences that depression can lead to, do remember – it’s my sincere request not to judge anyone around you – be it a co-worker, friend, neighbour, gamily, friend, acquaintance, or a random stranger – feeling sad and depressed as having a ‘weak’ character who’s not being able to control his/her feeling and who ‘should try to do something positive’. Please be the person that one can talk to!
4 ways to best support a friend or a family member with depression
- Initiate conversation
- Encourage them to seek help
- Be open
- Learn about Depression
The link between Depression & Anxiety
Dr Pablo Vandenabeele, Clinical Director for Mental Health at Bupa UK, tells us more about the link between these two conditions. Anxiety and depression can be seen as two very broad terms. From a general point of view, anxiety may be seen as feeling nervous or uneasy. Depression, on the other hand, is a term that we associate more closely with our mood. Although they are separated as different conditions – associated with their own groups of disorders and symptoms – we often refer to them together. But what’s the link?
Everyone gets anxious from time to time – it’s not uncommon. To a certain extent it can be helpful, allowing us to prepare and go about things with a necessary amount of caution. But sometimes anxiety can become too much. If anxiety is affecting you to a point where it’s not helpful and affecting your daily life, you might have an anxiety disorder.
There are lots of different anxiety disorders. Some anxiety disorders are linked to certain things or situations while others are ‘free-floating’ with no apparent cause. If you have anxiety, you might dread and purposefully avoid certain situations. You might experience panic and have palpitations (a quick or irregular heart beat) or feel faint as a result.
Depression is an affective or ‘mood’ disorder. If you have depression, you may feel down, hopeless and lack interest or pleasure in doing things. You’ll have these feelings most days and for the majority of time for at least two weeks. You might also have other symptoms of depression such as:
- a lack of energy
- trouble concentrating or making decisions
- trouble sleeping
- a loss of appetite
- feelings of worthlessness and guilt
- thoughts about death or suicide
An episode of depression can be mild, moderate or severe, and depression itself can form part of other mood disorders. Depression can also be recurrent, meaning that after a period of feeling OK your symptoms come back.
Anxiety and depression can co-exist. In fact, it’s quite common. You may have:
- a depressive or anxiety disorder with either anxiety or depressive symptoms respectively
- the two disorders together
- symptoms of both depression and anxiety, but neither is predominant enough to make a single diagnosis – this is known as mixed anxiety-depression
Despite anxiety and depression being grouped as different conditions, involving different outlooks and sometimes symptoms, there are some similarities. Similarly to depression, anxiety can cause you to:
- have trouble sleeping (do read our article on why sleep is so important)
- have difficulty concentrating
- feel tired and lack energy
Interestingly, the same treatments are also used for both depression and anxiety, suggesting a similarity between them. Treatments include psychological interventions such as cognitive behavioural therapy (CBT) and anti-depressant medicines. In particular, it’s thought that selective serotonin re-uptake inhibitors (SSRIs – a type of antidepressant medicines) work in a similar way to treat both conditions. To add to this, there’s also some evidence that SSRIs have been effective when used to treat people with mixed anxiety-depression.
But, what comes first – anxiety or depression?
The answer isn’t so clear cut. It’s thought that struggling to cope with anxiety can lead to depression, but this isn’t always the case. Many people with an anxiety disorder report having depression first. Overall, based on their similarities, it’s thought that anxiety and depression are variations of the same disorder. We don’t know the ins and outs, but it’s thought that they could be linked by a common risk factor, which is influenced by our DNA and the emotional centre in our brain called the amygdala.
Mindfulness-based cognitive therapy (MBCT) in treating Depression
By Tanuka Gupta: Pharmacological and psychological approaches form the core bulk of treatment methods for depression. One of the evidence based approaches in treating depression is Mindfulness-based cognitive therapy (MBCT). This therapy is based on the principles of mindfulness, which It involves observing thoughts and emotions from moment to moment without judging or becoming caught up in them.
MBCT first trains the clients to focus on physical sensations (like breathing), but then moves on to feelings and thoughts. MBCT can help to stop the mind wandering off into thoughts about the future or the past, and avoid unpleasant thoughts and feelings. This is thought to be helpful in preventing depression from returning because it encourages the person to notice feelings of sadness and negative thinking patterns early on, before they become fixed. As a result, one is able to deal with warning signs earlier and more effectively.
Studies* reflect that there has been a growing evidence showing that mindfulness based therapy practices are associated with lower rates of depression and anxiety and greater well-being. Some of the reasons why mindfulness can work to help in depression and emotional wellbeing are as follows:
- It helps the person to stay rooted in the “now” and not emotional experiences of the past or the impending future. Being in the present gives people time to pause and not get triggered by old response patterns. Being aware of one’s thoughts, emotions and bodily responses give the person more clarity, responsibility in regulating their emotions and actions.
- Being in a nonjudgmental zone brings back self-confidence, assertiveness and the courage to set healthy boundaries to relationships. The ability to perceive self and others without labels and criticisms make us more compassionate and honest in our approach.
- Being present with others or with the environment enables us to appreciate and enjoy interactions. Our thoughts get infused with more gratitude and positivity and we become more aware of our influence on others. Our attention gradually shifts from pre conceived notions and already existing belief systems to the experience of the moment.
People with depression who practice mindfulness regularly have reported that they were feeling more confident and were engaging with an increased range of social activity and involvement, feeling less overwhelmed by negative emotion, and being in a better position to cope with and support others.
According to WHO Department of Mental Health and Substance Abuse (2012) Depression is a significant contributor to the global burden of disease and affects people in all communities across the world. Today, depression is estimated to affect 350 million people. The World Mental Health Survey conducted in 17 countries found that on average about 1 in 20 people reported having an episode of depression in the previous year.
1) An article in APA based magazine Monitor publishes this article Mindfulness holds promise for treating depression: New research suggests that practicing mindfulness may help prevent a relapse by Stacy Lu 2015, Vol 46, No. 3
2) A new study published in Lancet by Willem Kuyken, PhD, a professor at the University of Oxford in the United Kingdom found that MBCT helped prevent depression recurrence as effectively as maintenance antidepressant medication did.
This article is created with the research by Bupa Global. These articles are a part of #BringBackBalance, a FoodeMag campaign in collaboration with Oman Insurance Company (OIC) and Bupa Global. A series of bespoke events follow at various venues for the next few months, do stay tuned to enter the next competition to join us for our third event. Feature image: Pixabay]