As we drive into an apartment complex at Gurgaon, Haryana, a young man is waiting for us. Arjun Gupta is 19 and looks smart in a navy blue tee shirt and jeans. But his eyes tell a different story. They are sad eyes and do not belong to someone so young. Arjun recently started a blog on depression to connect with others. He says he was in class 11 when he experienced signs of the illness, but found it difficult to be open about it with his family. He reached out to friends, but in vain. “They were dismissive. You will get over it, everyone does,” they said. “I didn’t know how to express my feelings of hopelessness,” he tells us. Though his school is one of the few to have a counselor, Arjun did not speak to her. He was aware of the stigma attached to those seen entering the counselor’s room.
Puruvi Baraya, on the other hand, is a vivacious 24 year old. There are no apparent signs that she has struggled with episodes of depression since she was a child. “I was molested when I was about 8. I probably experienced my first bout of depression at that time. You don’t know how to explain it and people around you don’t seem to understand. They think you are acting out because you are in the pre-adolescent stage. I think it happens with a lot of children,” she says. Puruvi was in class 11 when she found it difficult to get out of bed for five days. This time she got her parents’ attention and she was taken to a psychotherapist.
Teenager Savita Sinha recalls the turmoil she experienced a year ago when she had to relocate to India from Abu Dhabi while in class 11. She had to adjust to a new school, new classmates. Making it worse was the pressure to perform well academically. Savita became ill. “My classmates refused to accept me. They said, “Yeh toh bimaar hi reheti hai, ya phir ye drama kar rahi hai.” Savita went into depression and her thoughts began to revolve around self harm.
Psychiatrists say depression is an illness. An illness which is disabling. It affects every area of functioning…moods, cognition and behaviour. It changes the adolescent’s views and perspective about the world, about his or her self. There are low energy levels; sleep and appetite gets disturbed.
Depression among children and adolescents has seen a huge spike. And it is closer than we think. WHO data shows that one in four adolescents have gone through clinical depression by the time they reach the age of 18. In recent months a spate of suicides among students of IITs and engineering colleges have been reported. Almost 70 per cent of them were going through depression. Experts say children and young people who resort to substance or alcohol abuse are more prone to suicide. As are children who are abused physically or sexually. With them, there is a combination of depressionand impulsivity. Other common reasons of adolescent suicide is academic pressure, failed relationships and consistent bullying in school or college.
Could these deaths have been prevented? The reality is adolescent depression often goes unnoticed and undiagnosed, says child and adolescent psychiatrist Dr Amit Sen of the Children First Mental Health Institute in Delhi. Unlike adults who usually have a consistently low mood, mood swings are common among adolescents. “They may plunge into a depressive mode and swing back into a phase where they want to go out with friends, to make their customary phone calls and text messaging. When they are back into their depressive phase, they are irritable, pick up a lot of fights with siblings and friends. They can be aggressive, abusive and take a lot of risks in their behaviour,” he says. Substance misuse, promiscuous relationships, overspeeding their bikes and cars are manifestations of depression and come from a space of despair. When adolescents become depressed, they sometimes cut themselves or starve themselves and may express thoughts of death.
Psychiatrists say what parents or teachers could do best is pick up some of these signs. Like when they see pronounced mood swings, decrease in the child’s functionality with regard to self care and academic performance, loss of pleasure in activities, withdrawing socially, expressing negative or aggressive thoughts. If this happens for over two weeks, parents and teachers should take steps to have the child evaluated by experts.
Why has adolescent depression increased? Experts say it is because of the unprecedented changes seen in our society in the last 20 years, probably much more than the previous 200 years. Changes in the structure of the family, in the kind of things children get exposed to through the media, in the kind of relationships within the family and outside, in the kind of affluence or materialistic pursuits that society is driven towards and the competitivenes associated with it. Adolescents often put themselves in very vulnerable situations in the virtual space where they can get abused and bullied. They have to brave it on their own since adults are not a part of it.
“They lose their childhood very early. A carefree childhood where they could play without thinking who is watching us and whether my selfie is looking good or how many likes do I get in Instagram. This preoccupation with wanting approval and getting everything at the press of a button has an impact on mental health,” says Dr Sen.
According to child and adolescent psychiatrist Dr Jitendra Nagpal, principals, teachers and students must be sensitised towards gender issues, substance abuse prevention, understanding and management of aggression and violence. At the same time, families need to be engaged.
How should depression among adolescents be treated? If there is depression before puberty, the causes are in the environment and are not biological. The causes could be changes in the family, changes in school, bullying, a pet dying or marital disharmony among parents. Pre-puberty children are treated through psychotherapies or family therapy, not medication.
Medication is considered only for adolescent depression. Particularly if the depression is severe or if there are biological symptoms. Psychiatrist Dr Sanjay Chugh, says he would recommend psychotherapy, or counselling in layman terms, to all patients. “The best results can be obtained by a combination of medication and psychotherapy,” he says.
When children and adolescents get professional help and family support, there are positive outcomes. Arjun, Puruvi and Savita are on the path to recovery. Like them, most are able to come out of depression.
– Sutapa Deb is Features Editor at NDTV 24/7 and is passionately committed to stories of human interest.
– Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.