One of my patients asked me to change my designation as stress and wellness specialist rather than a psychiatrist. It really surprised me. She was in depression for last 3-4 months and was facing lots of stress at the workplace due to disabilities caused by depression. Three years ago her mother also tried to commit suicide because of depression. Despite knowing all facts about depression, out of shame, she was feeling awkward going to a psychiatrist. She did not take appropriate steps to solve the problem by consulting the psychologist or psychiatrist. Finally she was not able to continue her job and faced many psychosocial consequences.
We are observing these problems on a day to day basis. We observe people wasting their productive years due to repeated episodes of depression. Because of that, I want to mention some myths related to depression and other psychiatric illnesses:
1. Myths- Depression occurs because of psychological weakness of an individual.
Facts- Cause of depression is not purely psychological, it is bio-psycho-social.
A). Biological - biological changes in brain chemistry-
i) change in serotonin, non epinephrine, like neurotransmitters.
ii) genetics - family history of depression.
B) Psychological - this is related to the individual's psychic structures that is his/her personality traits and coping strategies.
C). Social - this is related to individual's circumstances and social support system.
2. Myth - depression can be treated well with physical exercise only.
Fact- physical exercise improves mood and self esteem of the individual, but can not treat brain chemistry completely. So complete remission requires pharmacotherapy, counselling as well as lifestyle modification.
3. Myth - alchohol can treat my depression.
Fact - people start taking alcohol to feel euphoric. Alcohol elevates your mood for transient duration of time, rather it precipitates alcohol induced depression. So it deteriorate depression, and it also causes alcohol induced liver disease.
4. Myth- depression is sadness only and it occurs because of circumstances.
Fact- depression and sadness are two different psychological states.
Depression (abnormal psychological state)
Duration - <2 weeks
Symptoms of depression- Sadness, loss of interest, fatigue decreased appetite, disturbed sleep and experiencing problems in routine work.
Treatment - needs consultation from a psychiatrist.
Sadness (normal psychological state)
Transient - 2 week
Sadness is emotional reactivity to external or internal stressor that resolves itself.
Treatment- stress management strategies
5. Myth - depression is uncommon.
Fact - as per world health organisation, 300 million patients are suffering from depression worldwide. The world mental healthy survey conducted in 17 countries found that an average about 1 to 20 people report having an episode of depression previous year.
6. Myth - medical tests like ct brain / mri brain should be done for depression.
Fact - changes in brain chemistry is not picked by ct brain or mri like investigations. Diagnosis of depression requires clinical assessment and psychological assessment.
7. Myth one should take medicine for depression for short duration. Anti -depressants are harmful.
Fact - treatment of depression is done in two phases. First 2-3 months of treatment is for symptom remission then maintenance phase of treatment is given for relapse prevention. If maintenance phase of treatment is not given to patient, he/she may have more episodes of depression in future.