BEING STRONG IS KILLING ALL OUR MEN

Robin Williams Depression

Robin Williams ( Academy award winning Actor/Comedian 1951-2014)

Let us imagine a world where everyone talks frankly , loves and supports each other such that everybody’s lives are taken care of . Now think for a moment and tell me, would you find anyone getting depressed and committing suicide in this utopia ?

If you’re one of those few who said yes , I’m sure you would have a member of your family or friends or someone who knew to have a good life but had abruptly ended their own in a manner that will still make you gasp in disbelief . And for those majority saying ‘No’it is imperative that you take time to read on before you let someone slip away by just being oblivious to their subtle calls for help.

Its quite disheartening that in a world with people hardly making eye to eye conversations , and ever deteriorating listening skills that we come across ever increasing cases of suicide where most of the victims are men and almost all of them had inadequate mental health assistance simply because of two very avoidable reasons . One being the gross lack of knowledge about psychiatric illnesses and two being the stigma associated with it . Its natural for all of their relatives to have advised these men to ‘Toughen up’/ ‘Man up’/ ‘take it in the chin’ / ‘Don’t be a sissy ‘ , when in reality it has nothing to do with ones approach to life .

Often a sad man needs a party , needs an outing with his pals or a brisk morning jog in the hills with Pink Floyd playing through the earphones or an ‘awe-inspiring’ TED talk to change the moody blues into hope and motivation eventually lifting the spirits . I totally agree thats exactly what even I’d do if Im not feeling good after a bad day and it helps me every single time . But sorry to disagree , we are in no way talking about sad men . We are talking about depressed men , and yes there is an ocean of difference between these two .

The fact that sadness is one of the universal emotions all must go through and because we often we script our own versions of recovery , through feats of courage and love ,we believe quite logically that its not something one can use as an excuse to call sickness. Agreed.

SAd vs Dep

But we are not talking about ‘sadness’ the emotion here , not that gloomy little blue character from the movie ‘Inside Out ‘. ‘Depression’ is not the same as being sad . The dissappointing use of the word in a very common sense does add a great deal to the demerit of this term. Nevertheless , one must understand we are talking about a disorder of the brain , that at the fundamental neurochemical level has an imbalance due to genetic causes and becomes perpetuated in situations one cannot handle for his level of resilience . To this neuropsychiatric condition , Western physicians since time immemorial have chosen to use this unimaginatively colloquial term called “Depression” . As an Indian , I can quote ancient Vedic literatures talking about ‘Tridoshas’ or humors and description of Depressive illness with a name “Tridoshonmad” or the ancient greeks describing this entity of a human being thrown into fears and despondencies , which Hippocrates named “melancholia” , the root of the word melancholy that we use today for describing pensive sadness.

If at all conspiracy theorists start telling you “Depression” is an illness created by pharmaceutical companies to make profit and you find logic in that argument , ask yourself did these companies exist in ancient greek and Indian civilization . The medications used in treatment on major occasions save lives and like any medication may not work in some despite adequate trials due to issue of treatment resistance , a phenomenon experienced in all fields of medicine due to simple lack of cutting edge molecules unique to that particular individual , something only continued research holds key to unlocking. Conspiracy theorists use these scenarios to keep people in murky waters , and as their TRP ratings remain afloat , real lives continue to sink in these murky waters of misinformed mass media .

All of our natural reactions to suicide remain universally similar in that we start finding answers to one question of “ What stress did he have ?” . Then the whole cascade of hypothesis begins flowing from his sociocultural and economic backgrounds and like a detective we collect clues to connect the dots trying our best to sympathize with what would have caused him pain . On some unfortunate occasions there would be an obvious life scenario challenging enough to face , answering these questions but if you honestly take the effort to empathise and not merely sympathize , very often there is a case of suicide which appears as an overwhelming reaction to a commonly observed challenge . And as soon as the question remains unanswered people snap to the next possible logical query of a homicide despite forensic analysis ruling it out completely . The truth is that most people ( including medical experts without any special training in psychiatry ) are surprisingly unaware of the fact that , depressive Illness can occur to anyone irrespective of his achievements and possessions and environmental supports .

To explain this better , let us look at the very recent suicide of a post graduate junior resident of Radiology in PGI Chandigarh on 26th February ,2018 at India’s top Medical training institute . This is 24 year old doctor Krishnaprasath Ramasamy , who after completing his MBBS , had the tenacity and skill to outshine the best performing residents across the country of billions to secure a merit seat in this country’s most reputed institution . Living among doctors from various speciality and being in a place which has a renowned work ethic and infrastructure with support of several colleagues from his own state in order to help with the language barrier , the man in a mere 2 months had found himself unable to cope .

PGI resident

Dr Krishnaprasath Ramasamy from Tamilnadu

The man had initially joined the department of Internal medicine , which he found difficult to cope and quoted language barrier as an issue and duly in subsequent counselling shifted to more comfortable department of radiology where only limited interactions with people are needed but his 15 days in the new Ultrasound section was not helping him and on monday morning his absence in hospital was noticed which upon subsequent probing lead to the ghastly scene of the man hanging by the noose in his locked hostel room leaving every single ‘doctor’ who lived with him in shock and immediate shame . They did retrospectively recall his subtle cries for help with his unsettled choice of departments and frequent cry of language difficulties in a place where plenty of doctors from his state had learned to adapt with no knowledge of local language at the start . His own mother recalls advising him to give it time and toughen up before choosing to quit . As Ive mentioned above , people still hypothesise all possible external stresses to be the cause without considering the gross negligence of psychiatric knowledge even amidst doctors who claim to have tried encouraging him by taking him on outings . Its like gifting a new pair of sneakers to cheer up a below knee amputee.

In case you recognise the first image in the article , The Oscar winning actor/comedian Robin Williams had it all . His career and personal life had often been enviable and yet the suddenness and unpredictable nature of his suicide has even left the ever conspiring media in deafening silence . He had suffered depression and paranoia in a setting of Dementia . This lack of knowledge can no more be tolerated by any one in the field of mental health for basic understanding of the nature of ‘Depressive Illness’ is a must because unless people begin talking about it openly and empathetically like Diabetis or Cancer, valuable men like Dr Krishnaprasath and Robin Williams will forever choose to suffer in silence because their cry for help would only invite insensitive pep talks and illogical conspiracy theories . The society’s expectation for men to remain tough in difficulties , strong in unfavourable situations and calm under pressure will further keep these sufferings submerged within the walls of his bedroom or his therapists chamber if he was lucky enough to get one . And eventually when he cannot hide it anymore , his desperate cry for help would be made possible by the only act that garners reasonable attention without criticism and simultaneously ending his misery , which is death. Being strong is indeed killing our men.

inktober depression

The destruction caused by the illness ‘Depression’ is real and it will be the leading cause of morbidity by 2020 as per WHO simply because of the delay in treatment people need that in turn is contributed by the Ignorance and Stigma towards the disorder . The Brain of a person suffering ‘ Major Depressive disorder ‘ has innate imbalances in his levels of neurochemicals such as Serotonin , Nor epinephrine and dopamine and many others involved in our neural circuits and this can get onset at any age and soon becomes accentuated in stressful scenarios like a fish falling sick and soon thrown out of water , whose already low coping capacities camouflaged in familiar territories becoming disastrously evident in unfamiliar territory. Always the disorder can be identified by looking for cardinal symptoms that become obvious if we take time to listen non judgementally . These include feeling persistently a low mood , losing interest in previously pleasurable activities (anhedonia) , becoming tired in performing the simplest of routine tasks that previously were being done effortlessly and changes in patterns of sleep and appetite . Continuation of any of these changes for more than a period of 2 weeks warrants instant visit to your nearest mental health expert who can be anyone from a psychiatrist or a clinical psychologist or a psychiatric social worker who are all connected to each other and work as a team to give a multifaceted support in all domains of one’s life .

ALL ONE NEEDS TO DO TO START HELPING IS ,

1.TALK ABOUT DEPRESSION , LIKE HEART AND LIVER , BRAIN CAN FALL SICK TOO.

2.LEARN HOW ITS NOT THE SAME AS BEING SAD .

3.BEGIN LISTENING

smiling dep

Dr .Vel Prashanth Venkatesan is a resident of Psychiatry at the CENTRAL INSTITUTE OF PSYCHIATRY (CIP), Ranchi, India who writes on Indian contexts of psychosocial issues with keen interests in helping towards mental health awareness.

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