Forum (Spotlight Weekly)

Depression: More Than A Mental Health Concern

By Dr.NIRANJAN PRASAD UPADHYAY

Nepal is gradually confronting the long-term economic and social costs of mental health problems like depression. Psychologically, depression emerges through improper parenting. A process of socialization that is found and practiced within the family environment, parenting is a precondition for congenial development of personality.

Depression does not emerge within a minute or two. Clinical psychologists say it tends to occur during childhood. Children never say they are depressed. They only show depressive behavior that can include lying, stealing, irritability, frustration, low tolerance level, and sleeplessness. Depression in children is more often pushed by parents who want their offspring to make career choices by the age of 15. The Journal of Pediatrics (1995) states that childhood depression cannot just be thought of as a transient phenomenon associated with normal development.

Psychologists emphasize that parents are key models of children and are vital agents of socialization. If the socialization process is defective, it can increase such mental health problems as depression, sexual distortion, drug abuse, delinquency, stress and frustration. Nepalese clinical psychologists have stated that depression, whether soft or severe, has an impact on the patient's behavior and affects sensory inputs, images, cognition and interpersonal relationships. A World Bank report highlights that depression alone is responsible for more than one in every ten years of life lived with a disability worldwide.

In the modern world, adults as well as teenagers are showing a little bit of their depression through verbal or black and white forms. But some people do not release their causes of depression. Among individuals who disclose their discomforts freely, there is hardly any risk of depression. Because of depression, many teenagers are using drugs. Such problems occur from an uncomfortable family atmosphere. Parents do not provide time to children in solving their problems. Therefore, the children face a vacuum in their lives. An adverse family environment raises depression among children. In later years, they face severe problems in adjusting to their social milieu.

An East-Western Conference on Health and Well-being was held for the first time in Kathmandu from March 23 to 25 last year. At the conference, Jack D., a mental health researcher at the University of Western Washington, presented a paper on lessons and questions concerning depression from a comparative East-West perspective.

In the West, several factors are associated with the onset of depressive symptoms. Researchers found that silencing the self ó the process of keeping one's true thoughts and feelings hidden in order to please one's intimate partner ó consistently associates with depressive symptoms. In Nepal, beliefs about the self and the path to well-being follow very different assumptions.

Because of depression, suicide rates are high among women compared to men in Nepal. Likewise, women face sexual abuse by their own relatives and raise depression within them. In Nepal, females are enormously discriminated against in virtually every area: education, household work, property distribution, marriage and management.

Psychological depression is a disease whose pathology is as vague as the human mind. It is easily dismissed as laziness and lack of will power. Even the symptoms vary. The victim finds it difficult to concentrate, feels guilty, and has reduced sleep, energy levels and sexual urge.

Nepalis are deprived of mental health services because of the scarcity of trained professionals. The Ninth Plan (1997-2002) underlines that about 10 percent of the total population of Nepal is estimated to be suffering from mental diseases. Nepalese mental heath experts have not disclosed detailed data on depression and other mental health problems.

Depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months, or even longer. It interferes with a person's ability to participate in normal activities. It affects his or her thoughts, outlook, behavior and mood. In addition, the person may experience other symptoms like tiredness, irritability, and appetite changes. At its worst, depression can create such feelings of despair that a person thinks about suicide. In depressive reaction, the person distorts reality in degree rather than in kind.

Depression can cause physical symptoms such as an upset stomach, loss of appetite, weight gain or loss, headaches, and insomnia. Before they recognize the root of the problem, many people with depression see their doctor understandably thinking that a medical condition is causing their symptoms. In fact, there are numerous medical conditions that can cause depression. When present, these conditions need to be treated.

According to the World Health Organization, active ageing is the process of optimizing physical and mental well-being throughout life in order to extend life expectancy, productivity and quality of life. In Nepal, however, the general feeling is that an old and retired person must not labour any more but should relax. Such feeling leads ageing citizens to hopelessness and depression, as they start to consider themselves a burden on the family.

Mental health researchers state that organized, inter-related constellation of direct and indirect community services contribute to the maintenance and improvement of the mental health of citizens in a specific geographical area. The treatment for mental disorders is usually accompanied by a 20 percent decrease in the use of general medical services. As the family is the primary source of love and security, people with a mental illness must be provided assistance necessary to help them make the fullest use of their abilities.

Modern health researchers stress that multiple roles are good for women's mental and physical health. Employed mothers often appear to be psychologically healthier. Educational status is also linked to mental health because it permits women to earn a higher salary and support alternative arrangements. Health researchers stress that mental health is primarily a psychosocial and psycho-educational issue that causes a deficit in adaptation to the demands and expectations of society evidenced by the individual's relative difficulty in learning, problem solving, adapting to new situations and abstract thinking.

Mental health care is vital to ensuring good health over the long term. In Nepal, people treat mentally disturbed people with derision and ridicule. Because of this, they are neglected. In recent years, the government has become more seriously involved in this issue. It has introduced clinical psychologist services in treating diverse mental health problems. Tribhuvan University's Institute of Medicine in Maharajgunj is delivering psychological treatment to a wide range of mentally disturbed people. At the same time, the government must generate skilled health professionals capable of treating the mentally ill.

(Dr. Upadhyaya is a psychologist with the Public Service Commission)