Saturday, 11 April 2015

Depression: T2 article dated 12th April,2015

Do you often feel deeply sad but don't know why? Or, brood over something so intensely that you can't move on in life? All these could be symptoms of depression, a common illness which if untreated for long can drive one to extreme despair. Recently, Bollywood actress Deepika Padukone spoke out about battling depression. And some t2 readers echoed similar concerns to us.

Reader 1: I am unable to understand the exact thing that always keeps my mind occupied and keeps me upset all the time. For the past few months, I have become silent but I was a very talkative person. Many nights I have fallen asleep crying and when I tried to talk about it to my near ones, the only thing I heard is "get over it and stop sulking all the time". There are times when I just crave to sleep as long as I can. Could you explain depression and also ways to overcome it.

Reader 2: I am a student of Class XII, I just sat for my board exams. I often have depression attacks, so my focus gets shifted from my studies. In Class XII, it ruined enough of my time and I failed to give my best in the exams. I feel very lonely too at times. I just can't find a proper reason for this depression.

Reader 3: I lost my father two years back and my whole world came crashing down. I keep thinking about my past... places, memories, and a sense of loss always fills my mind, my soul. Every now and then there is only one feeling — a sense of loss. I didn't qualify for the entrance examinations because I could not focus on my studies. This broke my self- confidence, my self- esteem. I have always had the feeling that I am useless, my self confidence level was always low and now I have lost faith in myself. I feel pain and I feel helpless. I feel so stressed, so depressed that I just feel like sleeping. I feel that as long as I am asleep I am free from all my negative
thoughts, my memories which remind me of ' what I used to have'. I feel I belong to a different planet.

Depression is something that most people encounter at some point in their lives, at least in its mild form.
Yet — and maybe because it is commonly experienced in one form or the other — we have many misconceptions about depression.
It is natural to feel depressed, hopeless, tearful and perceive a bleak, gloomy future after some major upsetting events like the death of a loved one, failing an exam or losing a job. But if the feeling of despair continues and you are unable to move on ( Exogenous depression) like Reader 3, or if the feeling of depression is taking you away from reality though there's no apparent reason ( Endogenous depression) like Reader 1 and 2, then it is a matter of concern.
In such cases, you may not be able to deal with these emotions on your own and it is necessary to consult a mental health clinician. Family members and friends may not be enough. " Getting over it" is a solution, but the way to get over it is a process and you may need professional psychological support and pharmacological ( medicinal) intervention by a psychiatrist.
Like any physical illness, mental illness including depression can happen to anybody and it is okay to try and fight it on our own, but like any physical illness it is also important to consult a clinician, if need be to take a second opinion.

"The Beck depression inventory" identifies eight symptoms of depression. These are divided into four categories... 

A) Mood 
1. Feeling sad or unhappy 
2. Feeling unsociable 

B) Thoughts 
3. Future is gloomy 
4. The feeling that one has accomplished nothing in life, failing as a person 

C) Motivation 
5. Finding it hard to push oneself to do anything 
6. Feeling one would be better off dead 

D) Physical 
7. Losing interest in food 
8. Being unable to sleep

The essential feature of Major Depressive Episode is a period of at least two weeks during which one is either in a depressed mood for most of the day or there's a loss of interest or pleasure in nearly all activities.
In children or adolescents, the mood can be irritable rather than sad. The individual also experiences at least four of the following additional symptoms: change in appetite or weight; change in sleep; decreased energy; feeling of worthlessness; guilt; difficulty in thinking, concentrating and making decisions; recurrent thoughts of suicide or death attempts.
It is important to deal with depression psychologically at all four levels — physical, motivational, thought and mood. Here's what you could do... 

Follow a regimen: A regimental approach where you follow a disciplined lifestyle — for example getting up in the morning, going for a walk or exercise, going for work, joining a hobby class — is important. As the motivation level is low, a regimen helps one follow a healthy lifestyle. Without the regimen and without the motivation, it becomes very difficult to make a healthier and better choice each time. A healthy timetable helps take care of the physical as well as the motivational symptoms of the depression. Make a daily timetable to keep yourself busy and try to follow it. You might not be able to follow it initially. Be patient with yourself and keep trying.

Take responsibility: Engage in everyday responsibilities to feel happy and connected. In your regimen, set aside some time to go and meet people even if you don't ' feel like it'. Pick up a hobby or join a language class just to be in a group.
Every morning draw up a plan of action to make yourself happy.
Actively try to make plans to change the mood. Changing the mood will need sustained effort and again you need to be patient with yourself.

Break the pattern of ruminating: Try to fill your day with a lot of activities. Whenever you catch yourself thinking about the past or just worrying about the future, gently bring yourself to the present.
Focus on the job at hand. Keep yourself busy. Focus on the ' now'. Focus on enjoying the process rather than worrying about the outcome.
For example if you are cooking, instead of focusing on making a dish which ' everybody must appreciate', focus on the process of cooking, mixing the spices, experimenting with the flavours.

Ditch the conditions you impose on yourself: Do away with conditions that you place to appreciate yourself, such as ' I can only feel worthy if I succeed in an exam/ earn money', ' I can only feel connected when people recognise me / appreciate me / love me the way I want them to'. These are unnecessary, self- defeating conditions which make us feel disconnected and worthless.

Dr Sangbarta Chattopadhyay and Dr Namita Bhuta are medical practitioners, psychotherapists and life coaches Share your problems with them at 
dr. sangbarta@ gmail. com

Defining Self: T2 article dated 22nd March 2015

Who am I? This question has probably been around from the time humankind existed. The idea of the ' self ' has undergone several transitions. With each passing generation, we redefine who we are. In modern psychology, the self is no longer considered as just an individual, separate from social contexts and relationships. Rather, the idea of self is seen as embedded in its cultural social and family contexts.

As individuals, we try to gain our worth by being of value to a bigger identity, which may be our family, tribe, community, society or nation. How ' valued' we feel depends on two major factors: 

A) Social comparison: 
We compare ourselves to others or to an idealised version of how we ' should be'. From this we develop our idea of who we are and form an estimation of our worth. This self- judgement serves as a double- edged sword, as it can help bring out the best in us and also pull us down.

B) Feedback from others: We constantly try to define ourselves based on the judgement of others.
The feedback can be actual, such as from parents, teachers, friends and peers, or it may be our presumptions about how others will judge us. This is a problem area as our opinion about ourselves depends upon external validation.

Yogesh, a man in his early 30s, was referred to us by his friends. He came because he had a feeling of " emptiness and purposelessness". Though he ran a fairly successful company, his friends and he had noticed that he was becoming socially withdrawn and morose of late. On inquiry he told us that his elder brother had a manufacturing company which had suffered a massive loss, and so immediately on completing his MBA, he joined his brother to help out.
Yogesh started a safer and lowinvestment assembly unit, which gave lower profits but was more sustainable and gradually they made up for the losses. But of late the manufacturing unit run by his brother had picked up and was once again the main business in terms of financial returns. Here's how our session went... 

Yogesh: I feel that somehow I am not required for anything now. My family is secure and I am not adding anything significant and there is no purpose to my life.
Therapist: Okay, so you are feeling less significant these days? Yogesh: Yes. I know it's very stupid.
Sometimes I question myself if I am jealous of my brother. He's doing very well and naturally we are always talking about his plans, his problems, his achievements.... But I honestly don't feel so. I am extremely proud of him.
Therapist: So, is it possible that though you are not jealous, because your brother's contribution has taken centre stage and when you compare yourself to that, you feel less significant? 
Yogesh: Yes. But that's shallow, isn't it? I also feel that when my family was in a crisis I was ' valued' and now that the crisis is over, I am no longer needed. Sometimes I secretly wish for a crisis… and this makes me feel horrible about myself.

Yogesh's problem was a multilayered one. First, he was feeling a lack of self- worth due to the change of his role in his family. In comparison to his brother, he was feeling ' less needed'. Second, he was judging himself and feeling guilty about being competitive with his brother and finding his sense of self-worth in the family crisis, which was clashing with his moral ideas of how he ' should be'. Though we are naturally inclined to social comparison, we can train our mind to change the criteria by which these comparisons are made.

In the early stages of life, our comparison is naturally goal- centric but as the life situations change we need to redefine ourselves through self- actualisation, i. e through developing and exploring our own ability and potential.

Adapting to new roles: Like Yogesh, a lot of people find themselves at a loss when their role in the social context changes. It can be for a professional post- retirement, or it can be for a mother when her children grow up and become increasingly independent. Situations will always change and it demands that we realign ourselves to the new roles and new responsibilities.

Changing the criteria for comparison: When our role changes, we need to redefine the criteria for evaluating ourselves. If we can focus on doing our best instead of simply focusing on the end result of our efforts, it will become easier to find value. We can train ourselves to focus on our own self- improvement rather than comparing ourselves with others to feel good about ourselves. Yogesh slowly opened up to the idea of finding value by contributing in different ways. He started spending more time with his family and also started focusing on volunteer work.

Self- feedback: That and self assurance can play a major part in redefining our self- worth. As we mature and go through life, we come to be our own person. Ideas of success and failure, being worthy and unworthy — as defined by society — may not be enough to define who we are. 
We gradually need to become comfortable with our own uniqueness and depend less on conventional norms to make us feel valued. We need to find ways to appreciate and reassure ourselves every now and then, and not wait for it to come from others

( Name and details have been changed)

 Dr Sangbarta Chattopadhyay and Dr Namita Bhuta are medical practitioners, psychotherapists and life coaches Share your problems with them 
dr. sangbarta@ gmail. com