- Talking helps
Depression has a way of getting people to make decisions that are entirely contrary to their economic interests and personal well-being. A conversation or a healthy social interaction stings like an antiseptic poured generously over an open wound.
Like the discomfort of a bitter medicine, depression will dissuade you from seeking treatment. It wouldn’t be entirely inappropriate to think of depression as a parasite that may thrive only by deactivating the host’s defense mechanisms. In depression’s case, ‘defense’ is not just psychiatric medication or psychological counselling, but the simple warmth of social support.
A person struggling with depression tends to keep social contact to a minimum. It’s appropriate to acknowledge introversion and the fact that some people are simply happier without constant socialisation. Human are, however, highly social animals. We have evolved not as individuals, but as tribes that have braved the challenges of daily existence hand-in-hand. Socialisation, for humans, is not an option but an imperative.
The word ‘psychiatry’, among many people to this day, invokes disturbing mental imagery of mind drugs and electric shocks. I find this highly unjust. You wouldn’t complain about the ‘drugs’ your grandfather is taking for his heart condition; or the surgeon who cut your sister’s abdomen to remove her stone-filled gall-bladder. But treatment of similar intensity of a mental health disorder sounds appalling to an average person, mostly because these aren’t considered ‘real’ diseases warranting radical therapies.
Public opinion is that psychiatry is the scarier, angrier cousin of psychology; the latter being mostly about lying on a couch and talking to a man with a notepad. This simply isn’t true. A cardiologist’s job, for instance, isn’t just about pumping his patients full of ‘hard’ medication with stomach-churning side-effects; it’s also about non-pharmacological intervention like dietary and lifestyle counselling. Likewise, a psychiatrist is not someone who prescribes pills first and asks questions later. Any mental health expert is mindful of the myriad of social, economic, sexual, or other organic factors that impact mental health.
Working in the United Kingdom as a doctor in the psychiatric unit, the first thing I learned was to exercise extreme caution when prescribing medication. Rarely have I prescribed medication to patients arriving after-hours in the emergency room with some psychiatric concern. More commonly, what I handed these patients were phone numbers of support groups for people with mental health problems. Again, this contradicts the general Pakistani view – and admittedly, my own view several years ago – of how western medical practitioners deal with mental health illness. The belief that western mental health professionals rely heavily on drugs while eastern practitioners rely on socio-spiritual therapies, is untrue. In fact, Pakistani practitioners’ tendency to treat mental health problems as a spiritual crisis – brought on by, say, not praying enough – is deeply disrespectful towards the patient and one’s own religious views.
Depression insists that you withdraw from people like yourself. Do not fall for its divide-and-conquer tactics
A true psychiatrist knows not to treat mental health as a disease that is independent of a person’s circumstances. This is why a (usually expensive) visit to the psychiatrist or a psychologist isn’t enough. There is dire need in Pakistan for paramedical mental health services, usually in the form of support groups and suicide hotlines. These services make up the all-important middle ground between sitting at home untreated, and going to the hospital when things get unbearably out of hand.
A support group for a mental health problem can go a long way towards bridging this gap. Depression, for instance, not only pushes a person towards social isolation, it is also reinforced by it; thus generating a negative feedback loop that causes one to spiral deeper into depression.
Your depression makes your behave differently, but your behaviour also turns around to exert influence on your state of mind. This bilateral link between what you feel and how you act is very important, because this means that one needn’t remain a passive victim of one’s mental health problem.
This is where active socialisation can play a major role. Support groups usually involve moderated sessions of people, like you, sitting in a circle and discussing their progress or struggles with mental illness. While some people with mental health problems reluctantly choose socialisation as mere distraction, a support group allows one to confront the problem and work through it in a controlled manner. One says only what one’s comfortable with sharing with the group, and nothing more. One also hears other people talk about their circumstances surrounding their mental health problems, and possibly learn from their coping strategies.
Depression insists that you withdraw from people like yourself. Do not fall for its divide-and-conquer tactics. Speak up about your struggles with your friends and family. If they do not take your struggles seriously, join a support group. Do not allow yourself to be deceived into private suffering. Do not listen to your depression. Listen instead to its victims and seek solutions the same way humans have done for century: together.