Mental Health and You

-Sohini Dhar, Saptak Chakraborty and Somya Negi

Saniya is a student, she gets up at nine in the morning and works on the screen throughout the day, trying to catch up with the hectic submissions, and their due dates. After finishing that one assignment, she procrastinates a little, until she realizes, she’s going to have to give up on the nights sleep to be able to finish the other one. Saniya is like all the other students, trying to keep up their desired grades in university. The environment of self-isolation and the amount of stress involved in this has led a lot of students and young adults to feel stressed, and anxious. 

People who are overburdened with pressure often feel stressed. Stress is a mere reaction and response exhibited by our body. Some amount of stress can be useful, it can help us push through our comfort zone. However, excessive amounts can leave us overwhelmed. This is what eventually leads to anxiety.

Anxiety is a further reaction to stress. It has no clear cause. But it is treatable. Anxiety may also occur as a symptom of clinical (major) depression. Similarly It's common to have depression that's triggered by an anxiety disorder. Many people have a diagnosis of both an anxiety disorder and clinical depression.

Has the pandemic started this discussion? 

For many of us, stuck at our homes, Covid has not just assessed our physical, but mental health too. Quarantine has caused adults and children to go through a mix of emotions, while many feel overwhelmed, others feel underwhelmed. There can be several reasons, the jobs of adults being affected by the economic recession and the students being stressed about university work pressure. During the pandemic, a larger than average share of young adults (ages 18-24) report symptoms of anxiety and/or depressive disorder (56%) and substance use (25% vs. 13%) and suicidal thoughts (26% vs. 11%). With all of these huge statistics, actions were needed. Many college committees, devoted to mental health have come up. They extend their support to anyone and everyone who contact them. There are pages on Instagram and content creators trying to make people more aware about mental health in general. And with this the taboo related to this discussion is fading away gradually.

The Ancient Belief

The taboo over the term ‘mental health’ has been existent for long now. The idea of depression being caused by demons, evil spirits has existed in many cultures, including those of Greeks, Romans, Babylonians, Chinese and Egyptians. In accordance to this belief, people were often treated with beatings and starvation in an attempt to drive ‘demons out’. During the middle-ages, many people were locked up in the so-called ‘lunatic asylums’. Even during the renaissance era, hunting and executions of the mentally-ill were common. However, some doctors believed depression to be a biological or psychological illness. They did hunch about mental illness to have a natural rather than supernatural cause.

During the 18th and 19th centuries (The Age of Enlightenment), depression was thought of to be a weakness that was seemingly inherited. (genetic) The latter part of this age was the time when doctors did start realizing one of the causes of depression i.e. internal conflict. By 19th and 20th century, the demarcation over manic depression (bipolar disorder) and schizophrenia was brought with loads of explanations for mental illnesses. Psychoanalytic, behavioral, cognitive and biological explanations started coming up. 

Stereotypes

Having come from a generation just talked about, there were other stereotypes as well that might look less severe, however these have played a big role in causing people to never come out of the bubble of sadness, even though all of these have abated with time. Mentally unhealthy groups have been thought of to be away from the healthy ones so that the latter does not get ‘contaminated’. It used to be thought of to be frightening to have a mentally ill person in the neighborhood. Other stereotypes also included mentally-ill people to be thought of to be incapable of handling any responsibility, keeping safe distance from someone who was depressed, mental sickness being contagious i.e depression transferring from mentally unhealthy to mentally healthy if the former sat with the latter. 

In a survey of 3,556 respondents from eight cities across India, a staggering 47% of them are judgmental of people thought to be going through mental illness, according to non-profit The Live Love Laugh Foundation(TLLLF). 26% were afraid of them. 

Changes around us

The feeling of hatred, disgust, annoyance, anger, fear has transposed to empathy, sympathy and at worst Apathy/Indifference with time. Feelings towards mentally-ill people have changed with time, although people being contemptuous towards the treatment of mental illness still exists. The inability to come out of one’s comfort zone and approach someone to openly even acknowledge going through depression becomes an issue when people don’t consider mental illness as grave as physical illness. Physical labor cannot come out in it’s true wholesome self till mental stability accompanies it. 

The cyclical effects (sadness, sleep, appetite, efficiency) of depression are now better understood. A lot of changes have been brought forward with respect to our country. The Indian Psychiatry Society, in the 2019 general elections, had pleaded politicians to not use the word ‘mental’, ‘mad’ etc. while talking to opponents. The change has also been evident with respect to movies where mental illness that was previously dramatized and portrayed with minimal sensitivity in movies like Funtoosh, Sholay etc., however, which has changed to scientifically credible movie Taare Zameen Par.

Parliament enacted the Mental Healthcare Act, 2017 that annulled Mental Health Act,1987, by which "the right to access mental health care and treatment shall mean mental health services of affordable cost, of good quality, available in sufficient quantity, accessible geographically, without discrimination on the basis of gender identity, sex, sexual orientation, religion, race, culture, caste, social or political beliefs, class, disability or any other basis and provided in a manner that is acceptable to persons with mental illness and their families and care-givers."

Did depression exist in past times?

The answer is ambiguous since people have ambivalent views. Due to the aforementioned reasons, the prevalent societal pressure did not let people openly come out of their sadness. Out of being scared of social exclusion or being subject to hostile behavior, people were afraid to even acknowledge their grief or pain. A fortiori why, nothing can be predicted about the mental health of the people.

However, a certain group of people also believe (mostly the preceding generations) that depression did not exist in the past as much as in the present because of upcoming new technology, change in attitudes, behaviors, modernism etc. Although treatment and behavioral aspects of mental illness have been realized, depression too has risen by enough rate to go over and above the benefits caused by change in societal behavior and upcoming new psychological theories depicting different personality types. Proof of invariable existence of depression not only accrues to noticed and realized cases(whereas, cases were unnoticed in past) but the change in lifestyle patterns, social cognition etc. 

Pandemic on the other hand has pushed not just the already mentally unhealthy people, but also the mentally healthy ones into the cyclic effect of depression, affecting the efficiency of people. Having raised anxiety and palpitations, the pandemic has distorted each being’s lifestyle. Starting from diets, insufficient physical exercise, continuous work from home, wastage of potential skill sets that were to-be built or already built and finally the daily morning dose of agitation poured in by  the current world scenario, COVID-19 indeed has tripled depression rates.

"Psychiatrists are the only medical doctors that never look at the organ that they treat." Dr. Amen.

Apart from genetics, surrounding environment and physical ailments there are some internal factors which might hamper a person's state of mental health.

Glutamate, one of the significant chemical messengers in the human body, if is not transferred or produced adequately may have repercussions such as autism, obsessive compulsive disorder (OCD), schizophrenia, Alzheimer's disease and depression. Serotonin, which largely affects our mood, is associated with hunger and sleep. People with depression are found to have lower serotonin levels. 

Dopamine is involved with feelings of pleasure and addiction, low levels of dopamine might result in depression and attention deficit hyperactivity disorder (ADHD). All the above mentioned are neurotransmitters, chemicals which help in transfer of messages and make the nervous system work. When the system fails to operate or mainly the production of neurotransmitters is less antidepressants come to use.

A fact about anti-depressants

Antidepressants immediately boost the concentration of neurotransmitters but it takes time for the patient to be in a better mood. The only possible answer to justify this would be, mood only improves when new connections are established which take time. One can only wonder how dynamic and complex the brain is. When we talk about parenting, Erik Erikson is someone whose theory everyone resorts to. In his theory on psychosocial development, he lists 8 points which are to be followed chronologically. These are namely the qualities that people inculcate and then work on in their future years. He presented them in a way of positive versus the negative and one could go either way in inculcating the traits. Which trait sticks on to the person is dependent on the social encounter he has had in the mentioned time period, his overall environment and the previous traits that he withheld.

Trust vs Mistrust –

Birth to 18 months. 

Autonomy vs Shame and doubt - 18 months to 3 years. 

Initiative vs. Guilt - 3 to 5 years.

Industry vs Inferiority - 5 to 12 years.

Identity vs Confusion - 12 to 18 years.

Intimacy vs Isolation - 18 to 40 years.

Generativity vs Stagnation - 40 to 65 years. 

Integrity vs Despair - Over 65 years. 

To elaborate on this let us take one point from the above. Let us take the third point initiative vs guilt. During the growing years if child is always being controlled by parents and every move of his being directed then he lacks the self confidence in future to take any initiative or lead a pack. At this tender age children should be meeting friends for play dates and parents themselves should listen to them, answer the inquisitive minds and make them feel important even when the room is filled with adults. This bolsters them, they become capable of thinking and develop individuality.

In India, approximately 60 to 70 million people suffer from common or acute mental disorders. This would turn out to be more humongous of a number when the number of ignorant people who are mentally unhealthy get added to the list. People often don't address this gravely serious issue and the onset of pandemic and subsequently the lockdown has a silver lining in the form of making people aware about mental health. India, also known as the suicide capital of the world houses millions who worry about the next day's meal. The problem of unemployment aggravated in this time period, structural unemployment, downsizing of companies and ceasing of manual labour jobs have left a major chunk of population incapable of affording a good day's meal and the rest, who are on the more fortunate side, had to lower their standard of living. The rate of domestic violence has risen as well. This has led to mental distress amongst Bollywood actor Sushant Singh Rajput reaching out to nooks and crannies of India.

Social media saw youths voicing their opinions and being advocates of mental health, several organizations have teamed up with Psychologists to provide free consultations to the ones in need. People have overcome the stereotypes of making their children an engineer or a doctor for a secure life and today there stands more than 700 colleges in India which offer varied courses in psychology. Applications like Cure Fit and Calm apps have had a good financial year with the onset of lockdown for the very same reason.

Most of the people who will read this are better off than the majority. As hard as it is to be mentally fit, we need to be so, because as they say, time and tide wait for none and tough times too shall pass.

How can we overcome this?

As mentioned earlier, anxiety is curable and so are the other aspects related to it. Let’s start by first stating that since it’s a common phenomenon among teenagers and young adults, an increasing number of people are beginning to indulge into discussions openly about it. If it gets to a level that feels excessive, you can approach professional support. Since many schools in India do not have a counsellor, you can talk about it to your parents.

Seeking medical help is the most essential, in such a scenario . We can not go in assuming, and treating a mental illness on a big scale by ourselves. Albeit, we find many sites on the internet, providing us easy and efficient ways to overcome anxiety, they’re not always applicable to everyone.

Same applies for depression. There are several support groups online, these are communities of people who are presumably going through similar problems, and like to share and talk about them.