Depression As We Know It

A few weeks ago, I woke up to news of another suicide from Kota, the coaching hub for entrance exams. The news took me back to my own memories of entrance exam preparations, and how horrid those days seemed in general. While we did put up brave faces despite negative scores on mock tests, and had our share of fun at school, a lot of us felt our confidence had eroded and some of us were deeply disturbed by the intense pressure. As I mulled over the lack of psychological support provided in India, and read stories of celebrities like Biswa Kalyan, or watched with horror the popular series 13 Reasons Why, I realized that depression is even more common in adults, who had never been taught to deal with the struggles of life that often put dents in our souls. In fact, I know of more people who are going through depression in their mid-20s, and that many more are fighting it silently.

In spite of depression being such a common condition, it is only recently that people have started talking about it, and opening up to their loved ones. However, a lot of us don’t fully understand the reasons behind a friend’s depression, and often don’t know how to support them. Wanting to do something about it, I rolled out a survey on Facebook. The survey was short and anonymous, the major questions being:

         1.     Age Group

         2.     Broad reason for depression

         3.     Did you overcome it, and how?

         4.     What could be done to help people with depression?

Sure enough, the sample space was very limited, but I got 26 responses in 2-3 days. The number doesn’t seem a lot, but it also means that there are at least 26 people in my friends list who are going through or have suffered depression. It was also heartening to see them open up, and put themselves in a vulnerable position by giving fairly detailed responses, just so that people become more aware about this condition. I truly appreciate them for their courage, and with this article, I hope to bring their voices to the world by talking about the broad themes from the survey.

The age of depression

About 92% of the respondents to my survey were in the age group of 19-30 years, which is understandable since most of my acquaintances on Facebook fall in this age group. But the majority of these respondents were depressed during their early 20s, the time most of us start living away from home. About 73% said that they were depressed when they were between 19 and 24 years of age. Some 15% said that they were suffering during adolescence, at the rebellious and complicated age of 13-18 years. About 12% respondents said they were going through a tough time during the time they were 25-35 years of age. Keeping aside the inherent bias in the sample space, there clearly is a lot of unsaid struggle involved in growing up, and this struggle is manifesting itself in unpleasant ways. So what is it about growing up that is affecting us so much?

                       

The culprits behind depression

I was surprised to find that the top contributor to depression was romantic relationships. It was closely followed by peer pressure/identity crisis and career related pressures, which were actually my top suspects. As I thought about these results, and read some of the responses, I came up with certain theories about why these are the top culprits behind depression.

    1. Romantic Relationships

We often dismiss romantic relationships, especially during adolescence or early 20s, as unnecessary distractions, as this is the age when we are supposed to “find ourselves”, “make a career”, or “live freely”. But it is the most important thing on our minds, at least for a significant fraction of our time. And while we tend to ascribe it to growing sexual attraction, the need for romantic relationships is often deeper than that. Of course, attraction is an essential aspect of a romantic relationship, but the validation that comes from it goes a long way in giving one a confidence boost. Yes, I know, we don’t need no validation, but did we know that when we were freckled teenagers dealing with body image issues? And the need for this validation goes beyond the physical. Adolescence, and early 20s is usually when we are either rebelling or trying to fit in, and either way we are lost. It helps to have a companion in all this confusion, someone who is going through something similar circumstances, and is accepting you with your imperfections.

One would argue that friends can do the same for you, but this is where Bollywood/Hollywood driven social conditioning kicks in. From a very tender age, we have been seeing stories of people who found a perfect partner, for whom one could say, like Tom Cruise, “You complete me”. And as we start looking for a loyal companion, we hold on to that ideal, even though the reality may be very different from our expectations. And let’s not forget, even our significant others are going through a confusing period in their lives. At this point, it is helpful to remember what Kate Winslet says in this scene from the movie “Eternal Sunshine of the Spotless Mind”: https://www.youtube.com/watch?v=3lvNGhBXTU0

      2. Peer pressure / Identity crisis

As I mentioned earlier, late teens to early 20s are the time when most of us are trying to find ourselves. And more often than not, we find ourselves trying to fit in within a group. There are a lot of internal conflicts going on. As we step out of the comfort zone of our families, we are often face to face with a culture shock, and it takes time to understand what our core values really are. Am I an extrovert, or an introvert? Do I like taking risks and experiment, or do I like making the comfortable choice?

We also meet some people that we look up to, and often change ourselves to like them. Our friend circles also keep on changing, which is natural as people change. But these relationships become all too important at the time, and indirectly affect how confident we feel about ourselves. We see the filtered lives of our friends on social media, and sometimes that also adversely affects how we see our own lives. And while all of this is a part of growing up, there’s no outlet for teenagers and young adults to share these insecurities. There are no guidance counsellors in Indian schools, and not all families talk about feelings as much. I also understand when more experienced adults say that you eventually get over it, but clearly, these struggles affect some people more than others. And that is enough for us to sit up and take notice.

     3. Career related pressures

We are all too familiar with the professional expectations set in India – getting into the best college (where the cut-off is sometimes even 99% marks), getting a professional degree, getting a job that pays well and having a fancy title. In the quest for all of this, there is hardly time to understand what your own skill set and aspiration is. Of course, a lot has been said about it, and beautifully captured in books and movies like 3 Idiots and Tamasha, but sadly not much has been done about it.

A contradictory narrative is also building up these days – that of following your passion, and doing what you love. This narrative judges you for doing a boring, corporate job, and accuses you of being materialistic with no zest for life. While my experience with people in the corporate world has been completely opposite, there’s an increasing pressure to be “unique”. But where does this leave people who have not yet found their passion? Or those for whom a certain lifestyle or income is important?

At the crux of this conflict between a conventional career, and the road less traveled, are two things – the definition of professional success, usually measured by the money earned, and the lack of career counselling provided in schools. While there is a lot of focus on certain subjects (read mathematics and science), and the careers that they lead to (engineering and medicine), there is not enough focus on others. The theory of multiple intelligences, by Howard Gardner, says there are eight modalities of intelligence – then why do we work only on one? This undue spotlight ends up burning students out, and often leads to depression.

     4. Others

I had a host of other reasons listed, including parental or marital issues. But one reason that I missed out was “Health”, and seeing it in one of the responses stumped me, because I, myself had gone through a brief period of medication-related depression. Because somehow, we still haven’t started thinking of depression as a health disorder. Diseases like PCOD and hypothyroidism often have depression as a symptom. Medication for conditions like blood pressure, cholesterol, menopause and even birth control list depression as a possible side-effect. We tend to forget that our minds are also a part of our body, and depression is a mental illness, not necessarily driven by external factors.

Overcoming the Demon

I was happy to learn that most of the respondents had learn to conquer, or at least keep at bay, the demon of depression. About 77% respondents said they had gotten over depression, while 11% said there while it was a recurring phenomenon, they had learnt to tackle it. Some 12% said they were still depressed, and I would urge them to keep believing in themselves, and take help if you need.

                            

In the survey, I had also asked what helped people tame depression. Here are some of the responses:

    1.  Life, or time: While we all face our share of insecurities and vulnerabilities during teenage or early 20s, with time we become more adept at handling them, and more comfortable in our own skin. So, if identity crisis is what you are facing, just hang in there, my friend, for things do get better.

    2.   Acceptance: The first step to solving a problem is acknowledging there is one. It is a difficult task, for people generally dismiss depression as boredom, or laziness. But constant feelings of dejection could also be clinical depression, and recognizing that the feeling is persisting for a long time is vital.  

    3.  Medication/Therapy: The testimonials I received in my survey emphasized greatly the importance of talking to a counsellor. And it makes sense, right, having an impartial person, with no personal role in your situation, listen to your problems and help you solve it? Even if one is not clinically depressed, it is worth talking to a professional about what is bothering you.

    4.    Friends & Family:  We tend to underestimate how much our friends and family care for us, especially when we are trying to deal with our insecurities. The truth is, all of us are involved in our own personal struggle, and often fail to recognize what our near ones are going through. If you are feeling depressed, as much as it angers you to be the one who approaches, you have to sit your people down and tell them what you are feeling. Your friends and family may really surprise you.

    5.   Self-work: Unfortunately, most of the fight is to be fought alone, and needs working on yourself, and your self-esteem. A lot of respondents talked about taking up a new job, or moving to a new place, or taking up a new challenge – basically moving out of the comfort zone. They also talked about watching or reading inspirational content, and working on that one thing that makes you feel accomplished.

What could be done?

So what could one do to help a friend in need, or just the cause of mental health awareness? The survey asked the same question, and here are some suggestions:

   1. Be nice, and don’t judge. As someone who has judged others, and been judged myself, I can say with conviction that the entire process adds no value - zilch, nada. And while one is often tempted to judge others, it is worthwhile to take at least a moment to empathize with them, for everyone is fighting their own battle. And maybe if we knew of their problems, we would gladly accept ours and cherish them.

    2.  Do not gaslight. Putting someone down to feel better about oneself is the way most of us deal with our own insecurities, but it can end up hurting someone far deeper than we thought it would.

    3. Help your friends or family find things that they love, or that make them happy – hobbies, passions or a change in scenery. A friend once confessed that the only reason she didn’t consider suicide when she was depressed was because the 7^th part of Harry Potter hadn’t come out yet, and she wanted to read it before she died. While this is a slightly frightening example, it still shows that life is in the simpler things, which sometimes is all you need to deal with the bigger challenges.

    4.  Listen to them. Don’t preach. Don’t console. Don’t pity. Share your own experiences, if any, but with an intent to help and not brag. A person who talks to you about their depression is putting all their vulnerabilities in front of you, and it’s essential to respect that.

    5.  Encourage them to see a psychologist, without any stigma. Sometimes, it helps to have a third-party listen to your problem without any vested interest. A lot of the correspondents recommended this, and there is no reason why you shouldn’t recommend it to your friend – you want to see them happy after all.

    6.  Stay loyal to them. There goes a saying that a person is the sum of the five people they spend the most time with. But in practicing that, we tend to ignore friends who have now become pessimistic, or cynical or anxious without understanding the reason why. It just may be that these are the people who need your help, and who hang out with you because YOU bring positive energy. Life is full of ups and downs, and sometimes, it is as important to embrace negativity, as it is to be optimistic.

    7.  Raise awareness. There is a lack of infrastructure to tackle mental health issues in India. Neither are we taught how to deal with such issues at school, nor are there enough specialty clinics with professional psychologists to help the depressed. When you are depressed, you are deeply concerned about privacy and anonymity, and there aren’t many channels that offer this. So it is up to us to talk about the need for such platforms, contribute to making them happen. There are companies that offer counselling to employees of different firms that are in contract with them – try to get your firm associated with them. If you are a parent, demand that the school organize sessions by experts to help your children understand and tackle these pressures. And speak up to remove the taboo around seeing a therapist.
    8. Change the narrative. Let’s start to redefine what success and failure are, reimagine who is desirable and who is not. Let’s re-evaluate the ideal that we are striving towards, that makes so many of us feel inadequate or incompetent. And let’s learnt to accept our differences. If nothing else, always be willing to share your chocolate – it may ward off somebody else’s dementors, well, at least temporarily.