Feeling of Depression versus Clinical Depression in women – A thin line of demarcation

(Originally published in the Times of India Web, June 6, 2020, 7:38 PM IST)

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“I am sad.” 

“I am upset.”

“I feel like crying.”

“I feel disappointed in myself.”

“I am depressed.”

Those could be random disheartening mood swings from daily life. Or, those could be hints towards an impending doom of a clinical disorder that is tiptoeing unnoticed. Ironically, the line of demarcation is so thin and fragile that often clinical depression is passed off as an ordinary mood swing.  And still often, random malady of daily stress passed off as a self-proclaimed depression. 

The fact however remains – ‘feeling of depression’ is hugely different from ‘clinical depression – both literally and figuratively!  Psychiatrists across the globe have been continuously urging us to  understand the difference while we tend to substitute one for the other undermining the severity of latter. 

One major sign of Clinical Depression is when the feeling of misery lasts most of the day, every day, for more than two continuous weeks. If it does, the person needs urgent medical help. 

If it does not, the person might need further observation or social support and kindness to deal with the situation. Sometimes a small gesture, as simple as sharing a good news, can make the person feel better and can help break the chain of distress.

Earlier this month, a close friend lost his wife to clinical depression. She committed suicide at a lone corner slightly away from her home by hanging herself. In a courageous and most honest confession that my friend made to public, he wrote how they had been seeking psychiatric help for last two years, how nothing seemed to work in her favour, and how lockdown worsened it. An outspoken extrovert that she was, we did not get to hear a single complaint, whimper or sign of struggle from her during all these years. It was her personal battle. It was the battle that she fought till the last with a loving husband and doting children helping her get better with each passing moment.  

The gait of depression is as quiet as giant. It does not make much noise until it takes a life away. Sometimes, therapy and medical help also fail. 

Still stranger remains the fact that Clinical Depression tends to hit women twice or thrice as much as it does men. At some point, we do see intersectional convergence of mental health with feminism. As per a report shared by Pew Research Centre, mental conditions like post-traumatic stress disorder, borderline personality disorder, depression, anorexia and even eating disorders have a tendency to  inflict women twice or more as much as men. So much that women are three times more likely to attempt suicide than men.

The reason lies in cultural makeup of our society which is largely patriarchal. For instance, when a woman develops symptoms of a mental condition, she begins to get judged for her illness right at the onset. Even a slight deviation from her expected roles increases her chance of getting called out with terms as ‘crazy’, ‘lost it’ or ‘insane’. This depresses her further, thus, driving her into a vicious, non-ending circle. It is not surprising that in most cultures, not even a word of empathy is shared, let alone medical help. The only tests that families rely on are not laboratory driven experiments but stereotypes set by the society.  

In urban set-ups, where women are mostly working professionals, self-reliant and independent, it becomes increasingly difficult for them to escape the entrapment of commoditized mental health as if it was a commercial package. How bemusing that common lures entice women to treat themselves with an array of fad choices –– try yoga, juicing, sleeping, cutting sugar or gluten, moving country, travelling or installing a meditation app! If that is not all, continuous email spamming by Counseling centres as a one-stop help solution adds to the hubbub! 

In times when we need substantial measures to combat clinical depression, all we get is a gambit of promotional, unverified, commercial choices. 

It is time we ask of ourselves questions that matter. Are there enough rehabilitation centres around us? How equipped are small towns with psychiatry help and counseling? If they are, how long is the waiting queue of patients outside the clinics because often clinically depressed patients need urgent help? Also, are the therapy charges affordable for common people or does it burn their pockets to seek long term Psychiatry and Counseling sessions? Is psychiatry treatment cost subsidized by government machinery? What is the support system for patients to induct them back into a normal routine life once their treatment is over or do we make them re-enter the same scenario which actually led them to a mental condition? 

In turbulent times such as these when the lockdown has forced us to remain indoors, has cut community assimilation, given us more time to let the devil prowl in our mind and restricted social support — the vulnerability to skew towards a mental condition has increased abysmally. 

The only thing that seems to work is a timely medical help! 

Let’s not forget that pain is real but so is hope.