At age ten, doctors were baffled by an illness which took away my ability to cope with the simplest everyday functions, such as, focusing on my studies for the upcoming College Exhibition examination, playing a game, riding my bicycle or even walking to the corner. There was a total lack of appetite which led to weight loss, a general apathy, and more tears than laughter in my young life. I was taken out of school, removed from extra curricular things like music lessons, with a loss of interest in reading or listening to the radio my days were long and boring, not to mention the trek from doctor to doctor as my anxious parents tried to find out what was wrong. After various mis- diagnoses, one of which said lung disease with the prognosis of death in three months, my mother's boss suggested we try the late Dr Littlepage, who said that from the moment I walked into his office, because of the lack of co-ordination with my feet, he knew it was some sort of nervous disorder. A nervous breakdown it was called in those days.
More than fifty years later, I have now found out that a nervous breakdown can be likened to the generic name for various types of mental disorders. I guess I will never know the type of disorder with which I was affected as a child, especially as it has never recurred. My recent need to find out all there is to know about mental disorders came about because more than one of my relatives/friends have at sometime suffered from depression and stress-related disorders so that an advertised "free" public meeting on Depression Awareness on June 28th with speakers Drs Ian Hypolite and Neleen Baboolal caught my attention in the newspaper. Here, I felt, was a chance to learn how to deal with the depressed. Turned out I was not the only person with interest in the subject, as there was standing room only in the Calypso Lounge of the Crowne Plaza Hotel and on a rainy night at that.
The speakers dealt with the subject in depth, and even invited a patient to share her illness with us. With the help of slides, Dr Baboolal gave the basics on "depression" which affects millions of people in the world each year. It can sap a person's energy, steal the pleasure in life, and even make it hard to eat, sleep, talk, concentrate, or hold down a job. But the good news is that depression is treatable either with medication or counselling, thus it is important to recognise depression in yourself or in someone you care about. Dr Hypolite explained in detail how depression affects the family and can lead to suicide. While Nicole Dyer, a qualified nurse, told us of the effects in the work place from those who suffer from this disorder. Johnny Ramesar, the representative of the drug company Wyeth- Ayerst which sponsored the evening, was not to be left out with his presentation on the "patient."
It cannot be over emphasized that "Depression" is a medical illness, just like diabetes or heart disease. Medical evidence shows that people who are severely depressed experience a depletion of certain chemicals in the brain. This imbalance takes a heavy physical, mental and emotional toll so that when you hear those who do not understand tell depressed people "snap out of it" the patients cannot just "pull themselves up by their bootstraps" any more than people with heart disease can will themselves healthier hearts.
Dr Hypolite, who has been in psychiatry for 14 years, is happy that the previous decade dedicated to Mental Health has helped to bring mental disease out of the proverbial cupboard. And explained in a private interview that there is increasing emphasis on the biological aspect of depression as these chemical changes produce certain changes in behaviour. "A pre-requisite for diagnosing depression is a depressed mood and/or the inability to experience pleasure. We are constantly trying to understand the core reason for depression and the bio-psycho-social model is the one adopted."
Anxiety, which is present In approximately two thirds of depressed people, is a manifestation of conflict among the basic constituents of one's personality and makes depression more difficult to treat and also can make suicide more likely.
The main issue is how does the family cope. With today's progress in diagnosis and treatment, I now know that a youngster would not be kept out of school for three months as many medications have been designed to treat people with depression, and along with counselling which is so readily available, a person's hope, will to live and sense of enjoyment in activities can be restored in almost every instance, although it could take some time. Using antidepressant medication, which is not addictive, some people begin to experience an emerging sense of well-being between two to four weeks.
Support is crucial and the people in these patients' lives must understand the condition and support the recovery. Friends and family should learn as much as they can about depression, such as, establishing realistic expectations with the physician; providing unconditional love and support; maintaining one's daily routine as much as possible; and allowing oneself to get help when you need it. Dr Hypolite was firm "suicide needs to be taken seriously. "We think that people talk about it sometimes to get attention and say they are not going to do it. That is the furthest thing from the truth. Also we have to deal with the taboo in terms of speaking about suicide."
Some of the possible signs are: observing that someone is depressed; take note of things like giving away their possessions; look for feelings of hopelessness; and note if they are talking quite frequently about suicide or are engaging in risk-taking behaviour which is inconsistent with the personality you know. Psychosis which is an inability to test reality can increase the risk of suicide so that you have to be careful with a depressed and anxious person who becomes psychotic and starts to see and hear things and reality becomes skewed. When the responsibility is too much to bear you must seek professional help, and says Dr Hypolite "sooner than later."
Most mentally ill persons balk at the idea of visiting the doctor. "You have to persist" says Dr Hypolite "there may be situations when one may have to invoke the Mental Health Act to have people committed when they are reluctant to voluntarily seek help and could possibly harm themselves or others."
Alcohol is a no-no as it absolutely worsens the depressed condition and the affected person is wont to use alcohol to try to self-medicate. Drug and substance abuse go hand in hand with depression: "the general feeling is if I am down let me take an upper" says Dr Hypolite. One other form of depression occurs as the bi-polar or manic depressive illness which pertains to mood swings.
Dr Hypolite insists "there must be more awareness and since the taboos attached to mental illnesses are gradually declining and the stigmas are diminishing, more people are aware as it is also more talked about on the internet. "
Last Thursday's sell-out crowd at the Crowne Plaza supports these facts when so many people are now willing to come to a public meeting on Depression Awareness. This would never have happened a decade ago."