Mental illness still not accepted
An individual, rich/poor, successful/failure, good looking or not can suffer from depression and anxiety. Any mental illness is the disease of the nerves that has been developing since childhood and it needs proper medical treatment.
Young, successful actor, Sushant Singh Rajput, takes his own life on the morning of June 14, 2020, by hanging himself. He was 34. No sooner did the news break, there was hysteria across news channels, social media and people alike. The first few reports mentioned that the actor was suffering from depression and anxiety. But what soon followed was denial. With drama played out on primetime, it was declared Sushant ‘cannot’ be depressed!
Why? Because he was successful, he had money, he had films, and he had a girlfriend. “The Sushant we knew,’ claimed many, “was fun-loving, found happiness in little things. How could he be depressed?”
In claiming so, they ignored that an individual, rich/poor, successful/failure, goodlooking or not can suffer from depression and anxiety.
Instead, the conclusion drawn was that Sushant was murdered! And with that was murdered the much-needed discussion on depression, an openness to and an acceptance of mental health (MH).
It’s almost a year since Sushant’s death, but has anything really changed about how we perceive depression, anxiety or anything related to mental health?
Unfortunately, nothing.
MENTAL ILLNESS NEEDS TREATMENT
Cut to Roland Garros, June 2021. Twentythree-old World No. 2 Naomi Osaka withdraws from the French Open amidst threats and fines. All she wanted was to not attend the post-match press conferences as it made her anxious. But since attending to the press was mandatory, Osaka withdrew citing via social media her mental health, bouts with depression and anxiety brought on by public speaking.
Psychiatrist Dr Ruksheda says, “Until we recognise that mental health is like a physical function of our body, which impacts not only our mind but also our body, acceptance of mental health issues and disorders isn’t going to be a norm. Most people still tend to think of MH illness as a weakness of personality, reactions to life events and an inability to face adversity or even reality. Hence, the stigma, shame and fear, which comes from a place of misinformation and ignorance. Unfortunately, many of us still hold firmly to our faulty beliefs. That’s why we still don’t see a change at systemic and institutional levels.”
MYTHS AND MISCONCEPTIONS
What adds to the already existing stigma is that everyone wants to have a say on mental health, but no one wishes to understand it. Like in the case of Sushant Singh Rajput, from his former girlfriend Ankita Lokhande, to actress Kangana Ranaut along with few news anchors spoke of depression like it was disdainful and a disease that declares one lunatic. And Sushant Singh wasn’t one!
In the case of Naomi Osaka, Roland Garros said in its statement that Osaka was reminded that “rules should apply equally to all players”.
Dr Naresh Vadlamani, Chief Consultant Psychiatrist, Columbus Hospital, Hyderabad, explains that the logic most people use is that many people can ‘come out’ of depression. “So if someone is not able to ‘come out’, then it means they have a ‘weak’ mind. ‘I have a strong will.’ ‘I came out of it on my own.’ ‘I did yoga, which helped me.’ ‘I did oil therapy, which helped me’ — so on and so forth,” points out Dr Naresh. “They cannot imagine nor are they aware of a scenario where the disease of the nerves has been developing since childhood but manifesting only now, even if everything seems alright. This ‘weak mind’ is equated as ‘unfit for sex’. Hence, the stigma. Then, there are misconceptions: Since treatment for depressive disease is long, many believe the medicines are addictive, sedative and/or damage kidneys and liver.”
People want to deny the ‘weak mind’ or simply blame external sources for the depressive disease. Taking us through three scenarios, Dr Naresh explains the stages of depression.
SCENARIO 1
Feeling depressed, sad and low is equal
TWENTY-THREE-OLD WORLD NO. 2 NAOMI OSAKA WITHDRAWS FROM THE FRENCH OPEN AMIDST THREATS AND FINES. ALL SHE WANTED WAS TO NOT ATTEND THE POST-MATCH PRESS CONFERENCES AS IT MADE HER ANXIOUS. BUT SINCE ATTENDING TO THE PRESS WAS MANDATORY, OSAKA WITHDREW CITING VIA SOCIAL MEDIA HER MENTAL HEALTH, BOUTS WITH DEPRESSION AND ANXIETY BROUGHT ON BY PUBLIC SPEAKING.
SPORTS PSYCHOLOGY, WITH ALL ITS ADVANCES, IS STILL MORE FOCUSED ON MAKING ‘WINNERS’ AND NOT AS MUCH ABOUT SUPPORTING ATHLETES. IT FOLLOWS THE CORPORATE, BIG INDUSTRY TRACK. UNLESS WE ADD THE MEDICAL AND SCIENTIFIC ASPECT TO MENTAL HEALTH, WE’LL KEEP HAVING MORE SILENTLY SUFFERING MENTAL HEALTH CHALLENGES AND NOT GETTING TREATED FOR MENTAL ILLNESS, AND MORE LIVES LOST.
to body pains. Anyone can have it, even daily for a few minutes or hours. It resolves on its own. A glass of water, reading a book, sitting under a fan, etc. can help.
SCENARIO 2
You usually walk 5 km per day. You suffer no pain. You run a half marathon in 4 hours. You get leg and body pain, feel exhausted and dehydrated. You seek help from family or friends. They advise fluids, rest
WOULD ONE BE FORCED TO GIVE PRESS INTERVIEWS IF HE/SHE SUFFERED FROM GASTRITIS AND STOMACH PAIN, KIDNEY PAIN DUE TO STONE, COUGH DUE TO TUBERCULOSIS, OR HIGH FEVER DUE TO A VIRAL ILLNESS? NO.
OSAKA WAS SUFFERING FROM ANXIETY AND YET, WAS EXPECTED TO ADDRESS THE PRESS!
“DEPRESSION IS A DISEASE OF BRAIN NERVES. IT KEEPS WORSENING IF UNTREATED — JUST LIKE ARTHRITIS PAIN. NEEDS TO BE TREATED BY MEDICATION ONLY. SINCE IT IS A DISEASE OF BRAIN NERVES’ INTRACELLULAR FUNCTION, THE MEDICINES HAVE TO BE TAKEN FOR A LONG TIME NOT JUST TO CURE FOR NOW, BUT ALSO TO PREVENT FUTURE EPISODES OF SUFFERING.”
DR NARESH VADLAMANI, CHIEF CONSULTANT PSYCHIATRIST, COLUMBUS HOSPITAL, HYDERABAD.
“UNTIL WE RECOGNISE THAT MENTAL HEALTH IS LIKE A PHYSICAL FUNCTION OF OUR BODY, WHICH IMPACTS NOT ONLY OUR MIND BUT ALSO OUR BODY, ACCEPTANCE OF MENTAL HEALTH DISORDERS ISN’T GOING TO BE A NORM. MOST PEOPLE STILL TEND TO THINK OF MH ILLNESS AS A WEAKNESS OF PERSONALITY, REACTIONS TO LIFE EVENTS AND AN INABILITY TO FACE ADVERSITY OR EVEN REALITY.”
DR RUKSHEDA, PSYCHIATRIST
and a good massage. The body pain may last for two days. Then, it heals.
Similarly, a reprimand, an embarrassing situation, missing an event, etc. can upset you, make you feel low, and you have an urge to cry. This is called depression. You need support and are advised counselling, meditation, relaxing techniques, a holiday or therapy. These may work, and you may be back to normal after a few days.
SCENARIO 3
Since birth and through childhood, you have some inconsistencies in thoughts and emotions, greater mood variations than is considered normal, precipitated by stressful situations like a happy event, a loss, a failure. Sometimes there need not be any precipitating event too. A person need not do anything. As in arthritis.
The depressive disease may manifest as a child, during adolescence, adult life or old age.
It’s common in adolescence and young adults. A person becomes depressed, sad and low, feels fatigued, lacks the confidence and interest to do anything, is lethargic, doesn’t feel motivated, struggles to stay focused, harbours guilt and negative thoughts about self, feels
DEEPIKA was one of the first few popular actors who confessed to suffering from depression and was seeking treatment hopeless and helpless, has thoughts of wishing to die and if things turn severe, attempts suicide, and eventually, may even die by suicide. According to Dr Naresh, ‘feeling depressed’ is common in the above three scenarios. But the treatments in each are different because depressive diseases are pervasive with not only feeling depressed but also other symptoms.
TO SPEAK OR NOT TO
Dr Ruksheda points out that while more people today are open to talking about mental health as a concept, it does not translate into real world and real time action. Is that why the French Open officials chose to treat Naomi Osaka the way they did even after she was honest and human in sharing her mental state? “Sports psychology, with all its advances, is still more focused on making ‘winners’ and not as much about supporting athletes. It follows the corporate, big industry track, so no surprise there! Disappointing but not surprising,” states Dr Ruksheda. “Unless we add the medical and scientific aspect to mental health, we’ll keep having more silently suffering mental health challenges and not getting treated for mental illness, and more lives lost.”
In Osaka’s case, Dr Naresh even wonders if one would be forced to give press interviews if he/she suffered from gastritis and stomach pain, kidney pain due to stone, cough due to tuberculosis, or high fever due to a viral illness? No. But the problem is that while Osaka knows she is suffering from Scenario 3, the organisers think it is Scenario 2.”
SUCCESS OR FAILURE—WHAT’S TO BE BLAMED FOR DEPRESSION?
The answer is ‘neither’. Success has got nothing to do with any disease. Like we don’t question a successful person from dying of cancer or heart diseases, in depression, especially in Scenario 3, success or failure is irrelevant. Disease in the brain nerves continue to exist and worsen if untreated, irrespective of one’s success or failure.
However, Dr Fareed Oomer, psychiatrist, Sakra World Hospital, Bangalore, has a wonderful insight. “With success comes the burden of responsibility, pressures of being in the public eye all the time and having to keep up the image of a champion,” he adds. “Eventually, a combination of circumstances pushes an individual over the edge. While diabetes, hypertension, heart disease etc. follow the same multifactorial aetiology, these problems are worn without guilt and accepted with sympathy, which strengthens the bearer’s resolve to pull through. Perhaps, we must ask ourselves if the reason we don’t accept mental illness in those we perceive as successful is because we’re scared to accept that success could be lonely, just failure is perceived to be.”
Treating mental health not only relieves symptoms and improves daily functionality and quality of life but also accords dignity to a person and the family.