Overview – What is depression

People often think of depression as – I am sad, feeling low, feeling depressed etc. Let us dive deeper to understand depression.

Depression is a mental health condition that is characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. It can also cause physical symptoms such as changes in appetite, sleep problems, and a lack of energy.

“Suddenly mujhe aise laga ki mere paet mein ek ajeeb sa feeling hota tha, ek khaalipan mein mehsoos karti thi (I used to get a very weird feeling, like there was an emptiness inside me). I didn’t feel like going to work or meeting anybody. I did not want to go out. I didn’t feel like doing anything. Many times, I don’t know if I should say this but I didn’t feel like living anymore. I felt like I had no purpose.”

Deepika Padukone in conversation with Shri Amitabh Bachchan in Kaun Banega Crorepati 13

Depression is a common and serious condition that can affect anyone, regardless of their age, gender, or background. If you think you might be experiencing symptoms of depression, it is important to seek help from a mental health professional. They can help you understand your condition and develop a treatment plan that is right for you.

Depression in India

According to the World Health Organization (WHO), depression is the leading cause of disability worldwide, and an estimated 300 million people are affected by the condition. According to the National Mental Health Survey 2015-16 in India, approximately 15% of Indian adults require active intervention for one or more mental health issues, and approximately one in 20 Indians suffers from depression. In 2012, it was estimated that India had over 258,000 suicides, with the age group of 15-49 years being most affected.

Signs and symptoms of depression

The key signs of depressive disorder as per DSM-V includes;

• feelings of sadness, emptiness, hopelessness and appearing tearful
• weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day
• sleeping irregularities – insomnia or hypersomnia
• restlessness or being slowed down – psychomotor agitation or retardation
• fatigue or loss of energy
• feelings of worthlessness or excessive or inappropriate guilt
• diminished ability to think or concentrate, or indecisiveness
• thoughts of death and suicidal ideation

Please note that above symptoms may also be present due to some physical or medical condition, or in case of significant loss e.g., bereavement, financial ruin, losses from a nat­ural disaster, a serious medical illness or disability. In such cases, a consultation with a psychologist or a psychiatrist, will help establish if it’s a case of depression or not.

Depression in children

The signs of depression are similar. But depression in children is more difficult to diagnose because they are unable to express themselves properly. A few tell-tele signs are sadness, irritable mood, failure to make expected weight gain as per age, loss of interest in favourite toys or cartoons, clinginess, frequent complaints of aches and pains, and refusing to go to school.

If you are a parent and you suspect your child is suffering from depression, keep a diary handy and note down the instances when your child shows such symptoms with proper dates. This can significantly help a child psychologist or a paediatrician diagnose the underlying illness.

Depression in teenagers

Transition from childhood to adolescence is a time of great stress – as a struggle to keep one’s psychological balance in the face of crisis of puberty. This stage also involves answering the question – “Who am I?” A teenager is seeks to define their identity and their self in this stage.

In teens and tweens, the symptoms of depression may include;

• Emotional signs such as sadness, irritability, and feeling negative and worthless
• Behavioral changes such as anger, poor performance or attendance at school, and self-harm
• Changes in physical habits such as using drugs or alcohol, eating or sleeping too much or too little, and avoiding social interaction
• Loss of interest in activities that used to be enjoyable
• Sensitivity to criticism or misunderstanding by others

Parenting plays a very crucial factor. It is important to have an open and honest communication with your teenager kids. They should feel comfortable speaking with you about puberty and sexual changes, sex education, alcohol and drug abuse, body image, relationships and breakups etc. Not having conversations around these ‘taboo’ subjects will only condition them to hide it from you. And find unsafe outlets for their curiosity around these subjects.

You can find out your parenting style by taking the Parenting Styles & Dimensions Questionnaire (PSDQ) assessment on the TickTalkTo app.

Depression in adults

According to the World Health Organization, depression is a major global health concern and is responsible for 10% of the overall non-fatal disease burden worldwide. Furthermore, this burden disproportionately affects girls and women. Various studies point out to the gender differences in depression.

Depression in women

About twice as many women as men experience depression. According to the World Health Organization, depression is more common in women than in men, with a lifetime prevalence of 5.1% in men and 9.2% in women.

Women are also more likely to experience more severe and persistent forms of depression, and to have co-occurring anxiety disorders.

Depression in women can be influenced by a variety of factors, including hormonal changes, biological factors, inherited traits, and personal life circumstances and experiences. Some specific examples of these factors include puberty, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), pregnancy and postpartum depression, perimenopause and menopause, and life circumstances and culture. However, it’s important to note that not all women who experience these hormonal changes or life events will develop depression.

Depression in men

Regardless of the lower occurrence of depression in males, it should not be overlooked.

Depression in men may be difficult to recognize because it may manifest as anger or aggression instead of the more typical symptoms of sadness and loss of interest in activities. This can make it harder for their loved ones and even their doctors to identify and diagnose their condition. Furthermore, men are less likely than women to recognize, talk about, and seek treatment for their depression, despite the fact that it is a common mental health condition in men.

Depression in elders and seniors

Depression is a common mental health condition in older adults, and it can have a significant impact on their physical, emotional, and social well-being. Older adults may be at an increased risk of depression due to a variety of factors, such as the loss of a loved one, health problems, or a decrease in physical or cognitive abilities. Symptoms of depression in older adults may include persistent feelings of sadness and hopelessness, changes in appetite and sleep patterns, loss of interest in activities that used to be enjoyable, and social isolation.

Social connections are essential for human survival and well-being, but older adults may be at risk of becoming more isolated and lonely as they age. Research has shown that loneliness and social isolation are linked to an increased risk of depression. This is why it’s important to care for your parents and grandparents. Setting up rituals like having a mean together or just having that morning chai or coffee can make a significant difference. If you have kids, you can also encourage them to spend more time with their grandparents.

Causes of depression

There is no single cause of depression, and it is likely that a combination of factors contributes to its development. Some possible causes of depression include:

• Biological factors: Depression may be caused by changes in the levels of certain chemicals in the brain, such as serotonin and norepinephrine. These changes can affect mood and emotions, and they may be caused by genetic factors, medical conditions, or the use of certain medications.
• Psychological factors: Depression may be caused by cognitive or behavioral patterns that affect mood and emotions. For example, negative thoughts or beliefs, distorted thinking, or coping mechanisms that are no longer effective can all contribute to the development of depression.
• Social and environmental factors: Depression may be caused by stress, trauma, or other challenging life events, such as the loss of a loved one, a difficult relationship, or financial problems. Social isolation, poverty, or discrimination can also increase the risk of depression.

Again, it’s important to note that these are just some of the possible causes of depression, and the factors that contribute to its development can vary from person to person.

Types of depression

There are several types of depression that can affect individuals, including:

• Major depression: This is the most severe and debilitating form of depression, characterized by a persistent feeling of sadness, loss of interest in activities that used to be enjoyable, changes in appetite and sleep patterns, and low energy levels.
• Persistent depressive disorder (dysthymia): This is a milder but more chronic form of depression, characterized by a low mood that lasts for at least two years.
• Postpartum depression: This is a type of depression that can affect women after giving birth. It is characterized by feelings of sadness, hopelessness, and anxiety, as well as changes in appetite, sleep patterns, and energy levels.
• Premenstrual dysphoric disorder (PMDD): This is a severe form of premenstrual syndrome (PMS) that can cause significant emotional and physical symptoms in the week before a woman’s period. Symptoms may include irritability, depression, anxiety, and changes in appetite, sleep patterns, and energy levels.
• Seasonal affective disorder (SAD): This is a type of depression that occurs during the fall and winter months, when there is less natural sunlight. Symptoms may include low mood, changes in appetite and sleep patterns, and low energy levels.
• Bipolar disorder: This is a type of mood disorder that causes alternating periods of elevated mood (mania) and low mood (depression). Symptoms of mania may include high energy levels, racing thoughts, and impulsivity, while symptoms of depression may include low mood, changes in appetite and sleep patterns, and low energy levels.

It’s important to note that these are just some of the common types of depression. Depression can also manifest in other forms.

Diagnosis of depression

Depression is typically diagnosed by a mental health professional, such as a psychiatrist or a psychologist. During the diagnostic process, the mental health professional will ask the individual about their symptoms, medical history, and personal and family history of mental health conditions. They may also conduct a physical examination and order laboratory tests to rule out other medical conditions that may be causing the symptoms.

• Psychological assessments – A psychologist uses some standard questionnaires to diagnose depression and assess it’s severity. Some popular assessments are Center for Epidemiological Studies Depression – Revised (CESD-R), Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS), Patient Health Questionnaire 9 (PHQ-9), Short Form Health Survey (SF-36) and Geriatric Depression Scale (GDS). You can take one of the self-rated assessments on the TickTalkTo app.
• Physical checkup by a psychiatrist – In certain cases, your psychologist may recommend a physical check up by a doctor to see if the depression linked to an underlying physical health condition like pregnancy, hormonal imbalance etc.
• Lab tests – As part of the diagnostic process for depression, your doctor may conduct a blood test called a complete blood count to check for underlying medical conditions that may be causing your symptoms. They may also test your thyroid function to ensure that it is functioning properly. These tests can help your doctor rule out other potential causes of your symptoms and determine the most appropriate treatment for your condition.

Treatment for depression

Depression is treatable, with talking therapies or antidepressant medication or a combination of these.

• Counselling and therapy – Also known as talk therapy, psychotherapy can help you identify and change negative thought patterns and behaviors that may be contributing to your depression. A psychologist can help you identify and change negative thought patterns and behaviors that contribute to your depression and develop coping skills to better manage stress and difficult emotions. Counseling can be done in individual sessions, group therapy, or through online therapy platforms.
• Medications – Antidepressant medications can help balance chemicals in your brain that may be contributing to your depression. It is essential you do not self-medicate but consult a psychiatrist to start medications. You can easily consult with an expert via the TickTalkTo app.
• Alternative therapies – Some people find relief from depression through alternative therapies such as yoga, acupuncture, massage, ayurveda or herbal supplements.
• Self help – Making lifestyle changes, such as getting regular exercise, getting enough sleep, and eating a healthy diet, can also help improve symptoms of depression.
• Community support – Sharing lived experiences in a group setting can be really helpful. There are many communities where people come together and share their struggles and solutions. If possible, be a part of such group in-person. Else there are communities like Now&Me which can help you connect with people with similar experiences like yours.
• Crisis helplines – Thoughts of self-harm are common in depression. If one notices these thoughts, they should not act upon them. Reaching out to crisis helplines like AASRA, iCall etc. can help.

Online counselling & therapy for depression

It takes quite a bit of courage to seek help, especially for the first time.

When one is going through depression, one can find it difficult to talk to family and friends. One might think, “What are they going to think?”, “Will they even understand what I am struggling with?”, “Will I appear weak if I seek for help?”.

Also many a times, we ourselves are not sure if what we are experiencing is depression or temporary sadness.

It’s ok to feel like that. Most of us do.

To support you in such times, you can seek online therapy from the comfort of your home. You can get support without disclosing your identity. While there are many online services available, we at TickTalkTo have curated and trained therapists from all over India. They have a helped tens of thousands of people like you and India Today rated us as the top counselling platform. Check out this review from one of our users,

If you think you might need help, it’s a good idea to speak with a happiness coach, take a depression test and seek counselling;