“I've been seriously depressed for a long time. Everything else feels like a distraction, but not actual happy moments.”
According to the World Health Organisation, more than 300 million people are now living with depression – one of the leading causes of ill health and disability worldwide - and as many as one in five people can be affected in conflict and crises areas. Aptly, the theme for this year's World Health Day (April 7) is 'Depression: Let's Talk'.
In Bangladesh, a 2007 WHO and Ministry of Health and Family Welfare report showed that only 0.5 percent of national health expenditure was spent on mental heathcare, and of that,67 percents was devoted to the mental hospital, which caters to all sorts of mental disorders, with no specific focus on depression.
A 2003-2005 national survey reported that 16.05 percents of the adult population of Bangladesh suffered from mental health disorders, but data from the National Institute of Mental Health and Research shows an increase in number of mental health patients between 2007 and 2011. While the data is still unclear, studies show that schizophrenia ranked first among all mental diseases diagnosed, followed by bipolar mood disorder and depression.
But can we talk about it?
According to Joyita, a 30-year-old writer/entrepreneur from Dhaka, depression runs in her family, and she has already seen her brother struggling with depression.
“When I separated with my husband, I had to completely survive on my own, with no family to turn to even. I thought about suicide a lot at the time – everyday felt like a burden.”
Joyita had been diagnosed with clinical depression and even took antidepressants, but gave them up after a month. “In a middle-class family like mine, we don't talk so openly about our feelings to parents, but put on a brave face for their sake. I talk to my friends a lot though, and when people understand and show compassion, that really helps me mentally.”
29-year-old Tahmina also felt like she couldn't open up to family, but didn't want to be forced on it either. “It is so easy to write off depression as melodrama, especially with women, and sometimes I wish people would not just intervene in my life so much.”
“There is definitely a need to talk about it though,” adds Joyita. “I am open about my struggle with depression and as an online entrepreneur, I have had many women reach out to me and share their stories of depression too.”
Is it more difficult for men?
When speaking of his depression and drug abuse, 30-year-old Shamim elaborates, “I don't want to take antidepressants, but I end up doing drugs. Your depression feeds that need and the drugs numb me down, but later I feel worse for taking them, and it turns into a vicious cycle.”
“There have been instances where my family has understood, but they don't believe I have a condition. People are always trying to find some other reason for it, or telling you to cheer yourself up or stop thinking about it. As a guy, you're supposed to have things under control and be the man of the family, and there is that assumption that you're not man enough to control your depression.”
Masum, a 30 year old government staff, also feels that Bangladesh is not ready to have a stigma-free conversation on depression, especially with relation to men. “The support system is so crucial in dealing with depression, and it's very sad that it doesn't get taken seriously.”
What should we do?
“For any kind of mental illness, the support system is essential – the family needs to acknowledge it, know where help is provided and encourage patients to take it,” says Lipy Gloria Rozario, faculty member of the Department of Educational and Counseling Psychology, University of Dhaka.
She also acknowledged the social stigma people with depression face in our societies, especially men. In fact, her ongoing research shows that 53 per cent of men in her data set are depressed, as opposed to 46 per cent women.
However, clinical psychologist Shahnoor Hossain believes that it is difficult for all sexes to talk about depression in our societies – in fact, suicide rates are higher for women than men. He also stresses on the importance of acknowledging the condition, and ensuring that proper support systems exist.
“Many children are growing up vulnerable to depression, because of the constant criticism they face. We often think it is a good parenting method to keep them on their toes, but we need to be able to put ourselves in their places and have some empathy.”
All of the patients we spoke to acknowledged the need for empathy over anything else.
“Just address it with a little bit of compassion but not pity, and actually listen,” advised Shamim.
Singer/songwriter Armeen Musa has always openly talked about her depression, and acknowledged others to do the same.
“We need to remove the stigma around depression being unnatural. We need to seek professional help, and also personally focus on activities that calm you. Exercise is a proven way to release endorphins in your body. Everyone has a different rhythm, and you need to learn how to talk to your own depression – it's like learning a new language. Give yourself time and space, and don't push it away.”