Health ministry's 'misguided' tweet on depression an eye-opener; it reflects govt's narrow understanding of mental health

The Ministry of Health and Family Welfare waded into controversy when it tweeted a poster on Tuesday advising people to ‘cope’ with depression by following a routine, travelling, being creative, taking multivitamins, thinking positive, practicing yoga, staying clean, sleeping for a minimum of eight hours, eating fruits and going for walks. Needless to say, this poster has met the wrath of several mental health professionals, and their concerns are not unjustified. The poster describes depression as a “state of low mood”. Low moods can be triggered by a lot of things. However, feeling low or feeling sad or experiencing grief is not the same as depression. Certain life-events, for instance, such as loss of a loved one, the ending of a relationship or the loss of a job can trigger feelings of sadness, loneliness and grief, and there may be some overlap between grief and depression, but there is a need to seek professional guidance in order to differentiate between the two and help the individual get the support and treatment that is needed. [caption id=“attachment_4617861” align=“alignleft” width=“380”] The poster put up by the health ministry. Source: Twitter[/caption] Nowhere in the poster has there been a mention of seeking professional help in terms of getting a proper diagnosis and taking help from a mental health professional to deal with the condition. Around 56,675,969 people in India suffer from depression, as per the World Health Organisation (WHO) in 2015. This amounts to 4.5 percent of the Indian population, and between 2005 and 2015, the total number of people living with depression has increased by 18.4 percent. These alarming statistics clearly indicate that mental health issues need to be addressed, and they cannot be ignored any longer. According to WHO, India has the highest number of suicides in the world – out of the 804,000 suicides recorded worldwide in 2012, 258,000 were in India. Youth in India between 15 and 29 years of age commit suicide at the rate of 35.5 deaths per 100,000 – the highest in the world – and suicide is the leading cause of death among young Indian women. Stigma around depression There is a lot of stigma around seeking help for issues pertaining to mental health in India. Mental health is not a topic that is discussed, therefore, there is a lack of awareness. Deepika Padukone stunned her fans by speaking about her battle with depression and baring her heart out in 2015. Two years later, at a summit in New Delhi, she mentioned that she lost out on some roles after opening up because some people assumed that she could not act because she was depressed. In recent times, the passing of Kate Spade and Anthony Bourdain shocked the world. Padukone shared a post on Instagram via her Live Love Laugh Foundation where she claimed that Spade and Bourdain didn’t commit suicide, depression killed them. She pointed out how the world wondered how could they “fall” into depression when they seemingly “had it all” and appeared “happy”. We never ask people who seem to “have it all” why they met with an accident or developed a terminal illness. Yet, depression is highly misunderstood, and the general misconception is that an individual has control over their illness. People suffering from depression are often victims of insensitive remarks like “snap out of it” and dissuaded from taking help. If the same person had cataract, no one would comment and say “just open your eyes and see clearly”. Nor would they be persuaded against seeing a doctor and/or getting operated. According to the American Psychiatric Association (APA), depression is a serious medical illness that negatively affects how one feels, the way one thinks and how one acts. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Understanding depression Symptoms can vary from mild to severe and can include: Feeling sad or having a depressed mood; loss of interest or pleasure in activities once enjoyed; changes in appetite – weight loss or gain unrelated to dieting; trouble sleeping or sleeping too much; loss of energy or increased fatigue; increase in purposeless physical activity (eg, hand-wringing or pacing) or slowed movements and speech (actions observable by others); feeling worthless or guilty; difficulty thinking, concentrating or making decisions; thoughts of death or suicide. The Ministry of Health in its attempt to over-simplify the concept of depression has actually conveyed misleading and incorrect information. For instance, in some cases of clinical depression, yoga and meditation are actually not advised. According to Ali Webster, associate director, Nutrition Communications at the International Food Information Council ( IFIC) Foundation, there is no evidence to suggest a consistent, clear relationship between vitamin or mineral supplementation and depression or mood. Vitamins and supplements cannot replace prescribed mental health medications like antidepressants or anti-anxiety medications. The poster is also insensitive at a number of levels. Telling a person with depression to think positive is equivalent of telling someone with a broken leg to continue walking. The Ministry of Health would not advise people with diabetes, for instance, to not check their insulin levels at regular intervals. Nor would they advocate being creative and thinking positive as effective ways of coping with diabetes. By mentioning activities of healthy living in general as ways of coping with depression, the Ministry of Health is indirectly communicating to the population that mental health need not require professional help, and people in therapy also may be encouraged to stop medication and treatment and just follow the advice laid down by the government. This poster is an eye-opener of sorts as it makes one realise how the government itself lacks awareness and does not understand mental illness and its real causes. Before educating at the grass-root level, proper dissemination of knowledge and training needs to be given to concerned officials because depression is not a battle that can be won by just following recommendations for positive living. The author is a Mumbai-based counsellor and psychotherapist.