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TW: mention of suicidal thoughts
This is the transcript of an interveiw with Dr. Prakash C. Tholar. Dr. Prakash is a psychiatrist & Chief Medical Officer in Sri Matha Hospital, Kundapur, Former President of IMA Kundapur, and actively involved in social welfare and voluntary organisations. Furthermore he is also the medical director of Parivartana.
There is a fine line between depression and sadness. How do you know the difference?
In depression, usually, the sad mood is continuous. We call it a pervasive low mood. If it persists for more than two weeks, then it comes under depression. Things you found pleasurable will no longer be enjoyable, you don't feel like talking to others, and there exists an emotional bluntness.
People often think if someone is depressed, then they are always sad, is that true?
No, it's not true. Like any other disease, depression is an illness that affects our mind, our brain particularly. So when there are some neurochemical disturbances, serotonin, to be exact, affects our emotions and moods. Depression may sometimes last for three months to six weeks; it is an episode like any other psychiatric disorder; once it is cured, you will be out of it. But you may have episodes in between. For example, suppose you are diagnosed with depression at a younger age, like childhood or adolescence. In that case, the chances of having recurrent depression are higher by 60%, meaning you may have depression in adulthood as well.
So if you are depressed, is it like continuously you'll feel sad or disinterested, or maybe suddenly you feel good, but then go back?
Depression can be divided into three categories; mild depression, moderate depression and severe depression. In mild depression, this sad mood is not so intense; you may feel bouts of happiness between the depressive episodes. You may enjoy some activities as well. But in moderate depression, what happens is that the sad moods are severe, and you may not enjoy any other activities, you may not feel like meeting your friends, studying etc. In severe depression, it is so intense that you cannot concentrate on any other things. You'll have suicidal thoughts etc.
Is depression something that can be cured?
Definitely! Depression can be cured. It's like any other illness. It occurs due to a few factors, one being genetic and the other being environmental factors. When genetics is a significant factor, there will be neurobiological changes in our brain, and there will be changes in neurochemical concentrations in our brain. Because of these changes, our brain and mind are affected, so there will be a sad mood and other depressive symptoms.
Why is it essential to seek professional help when you are depressed?
When there is a mild depression, it is such that by sharing emotions with your friends, near and dear ones, when they suggest you to think positively, and they may help you to ware off those negative thoughts, they may try to help you with some positive reviews so there it may be cured. Even by auto-suggestion, you can overcome it when you tell yourself it is not severe. I can divert my mind to other activities to forget negative thoughts, and psychotherapy can cure them. But when it becomes severe, you will have death wishes; you feel hopelessness, worthlessness, and uselessness. What is the use of living? It is better to die. So such thoughts may arise, and even if somebody says otherwise, you may not believe them, or you won't be able to forget these negative thoughts or overcome them. So, that time you need professional help. Professionals may put you on medication based on the severity of the condition, and psychotherapies are there; CBT is there so that the negative thoughts we have, the professionals will try to modify those thoughts. They will change the way we think more positively.
Say, my friend, is depressed; what are some things I can do or should do to help?
Suppose you feel that your friend is depressed; you may notice that they prefer to be alone, they don't talk with their friends, they don't come out of the house and are not interested in studies. Their academic performance declines, and you notice them being irritable, saying things like "I don't feel like living" and " I feel like ending my life". These behavioural changes point toward depression. So what you can do is just give some time to your friend. Listen to what they say. Usually, we think that talking about depression is terrible, that nobody should say that they are feeling sad and that they are thinking negatively. We typically tend to brush it off, saying, "you aren't supposed to talk that way", "you have no problems at your house, you have so much money with you, why are you bothered?". But it is not that way. We should be empathetic. We should listen to what they have to say. So most of the things, most of the sadness and complex feelings can come down to almost 50% when they share the things. So we should give them time. And whatever suggestions you do. What you should tell them is, "see is a temporary thing; the sad mood is because of depression, so we will try to fight it, we will seek some professional help; definitely, you will come out of it, and once you do come out of it, these negative thoughts, these feelings will all come down".That way you should talk to them. Just lend a hand. "I'm with you, whatever you need, just call me, and we can talk". For many people who are about to commit suicide, we can save their lives just by talking to them.
Transcript written by: Anjali Anandavally Varghese