OPINION

Defeating Depression! 

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By Fidhat Fayaz Drangay 

Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease, with more than 264 million people affected. It is the fourth most significant cause of suffering and disability worldwide behind heart disease, cancer and traffic accidents.  The population-based study from India to report on depression shows that the prevalence of depression was 15.1%. India is home to an estimated 57 million people (18% of the global estimate) affected by depression. At its worst, depression can lead to suicide. Close to 800 000 people die due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds. India accounts for 36.6 per cent of suicides globally, suicide has surpassed maternal mortality as the leading cause of death among women and teenage girls aged 15-19 years.  

There has been a phenomenal increase in psychiatric morbidity in Kashmir due to the long-pending conflict as well as other reasons. The results of a research reveal that the prevalence of depression is 55.72%. The prevalence is highest (66.67%) in the 15 to 25 years age group followed by 65.33% in the 26 to 35 years age group. The difference in the prevalence of depression among males and females is significant. Depression is much higher in rural areas (84.73%) as compared to urban areas (15.26%). In rural areas, the prevalence of depression among females is higher (93.10 %) as compared to males (6.8%) 

Covid19 also happens to be a significant factor in increasing the cases of depression in Kashmir. Suicide cases in Kashmir are rising day by day owing to depression and other mental health issues.  

There are several possible causes of depression ranging from biological to circumstantial reasons and the most common causes include family history, early childhood trauma, medical conditions, chronic illness, chronic pain, insomnia, attention-deficit hyperactivity disorder like conditions, brain structure, drug abuse, besides several risk factors which may increase chances of depression. Low self-esteem or being self-critical are also reasons for causing depression.  

Physical exercise causes our brain to release endorphins which helps us in improving our ability to sleep which in turn reduces stress. Exercise helps in increasing body temperature, which can have a calming effect on the central nervous system. It also helps immune system reduce release of chemicals that may worsen the depression. Use breathing exercises that increase oxygen supply to brain and trigger the body’s relaxation response, which in turn promotes a state of calmness. 

Acute and chronic stress is one of the most avoidable common causes of depression. Avoid over-committing to things. Practice mindfulness or meditation. Learn to let things go that you can’t control. Don’t let go any moment of laughter. Laughing helps in reducing stress. Laughter causes our body to decrease release of stress hormones and increase release of endorphins to promote overall sense of well being. Learn something new or engage yourself in hobbies, it helps us in development of confidence of our abilities or the things we are capable of, which in turn reduces stress. Avoid alcohol and drug abuse, many of people suffering from stress find it as a way to help relieve ourselves from stress temporarily but it can ruin our health in the longer run. Volunteer, helping others in the time of need or feeding the hungry person, helps us to relax and makes us feel good. Good feelings hep us relieve stress. Mediate as  mediation helps you to focus your thoughts and calm the stream of jumbled worries clouding your mind and causing stress. If these self techniques are not coming to your rescue to relive stress, see a doctor and take proper measures. 

Having a strong support system and an active social life is important for our mental health. Moreover, adequate” social support can protect against depression. Make sure that you’re regularly connecting with friends and family, even when your lives are busy. Stay away from toxic people. 

Stay away from anyone who makes you feel worse about yourself. Cut people out of your life who take advantage of you. 

Eat well. Recent research has shown that regularly consuming a high-fat diet can have similar effects as chronic stress in terms of causing depression. Eat balanced meals with lean protein, and lots of fruits and vegetables. Reduce high sugar and high fat foods. Eliminate processed foods from your diet as much as possible. Incorporate more omega-3s into your diet, with foods like fish or nuts. 

Obesity can result in low self-esteem, especially once you start adding in the judgements and criticisms of other people. According to the Centers for Disease Control and Prevention, there is a clear correlation between being obese and experiencing depression. A national survey found that 43 percent of adults with depression were obese. Don’t skip your breakfast, drink lots of water, include dietary fibre in your diet, fight off your hunger with more filling foods, and plan your meals. 

Sleep well. Getting plenty of high-quality sleep is necessary for both mental and physical health. According to the National Sleep Foundation, people with insomnia have a tenfold risk of developing depression compared to those who sleep well. Make sure you have good sleeping habits. Avoid late night caffeine. Avoid seeing screens before at least one hour before going to bed. Mediate before bed.  

Psychologist Barry Schwartz, author of the book “The Paradox of Choice,” describes research that shows that when faced with too many choices, those who aim to make the best possible choice  “maximizers”  face higher rates of depression. The pressure of making the right or wrong choice is thought to contribute to depression. Learn to be decisive more quickly.  

If you’ve already experienced one depressive episode, there’s a decent chance you’ll experience another. That’s why maintaining your treatment plan is so important. Continue prescription medications and never cut off medicines abruptly. 

Meanwhile, WHO also states that the mental health workforce in India is not upto the mark and there is a huge shortage of psychiatrists and psychologists in the country as compared to the number of people suffering from mental health issues. WHO states that in India, (per 100,000 population) there are psychiatrists (0.3), nurses (0.12), psychologists (0.07) and social workers (0.07), while the desirable number is anything above 3 psychiatrists and psychologists per 100,000 population.  Kashmir also lacks proper infrastructure to deal with cases of rising depression. Need of the hour is to properly aware people about depression and its preventive measures. Health camps must be installed in Kashmir to provide medical assistance to patients of depression. Government must pay their heed towards establishing more infrastructure in state for treatment of depression. Rehabilitation centres must be installed to help people dealing with stress, anxiety and depression issues. Government must build enough public gyms and parks in rural areas as a centre of attraction and motivating force to indulge more people in daily exercises. May Allah bless us all with good health! 

The writer is pursuing MBBS at Community-Based Medical College, Bangladesh.

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