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Depression affects a large number of Indian adults, and most never seek treatment. It responds well to treatment — often better than many chronic physical conditions do.
Recognising it
Depression is more than sadness. It is a persistent change lasting at least two weeks that affects mood, thinking, sleep, appetite, energy and the ability to function. In Indian patients it very frequently presents physically — as body aches, headache, fatigue, burning sensations or digestive complaints — with the low mood mentioned only when asked directly.
Patients often go through several rounds of investigations for these physical symptoms before anyone asks about mood. If your tests keep coming back normal but you continue to feel unwell, that question is worth raising yourself.
Symptoms
- Persistent low mood, emptiness or tearfulness
- Loss of interest or pleasure in activities you previously enjoyed
- Fatigue and loss of energy
- Sleep disturbance — difficulty falling asleep, or waking very early
- Appetite and weight change in either direction
- Difficulty concentrating or making decisions
- Feelings of worthlessness or excessive guilt
- Slowed movement and speech, or agitation
- Unexplained physical symptoms that do not respond to treatment
- Thoughts of death, self-harm or suicide
Worth knowing
Any thought of self-harm or suicide requires help today, not at a convenient time. Tele-MANAS national helpline: 14416, available 24 hours in multiple Indian languages.
What causes it
Depression arises from a combination of biological factors — neurotransmitter function, genetics, thyroid and vitamin deficiencies, chronic illness, some medications — and psychological and social ones: loss, financial stress, isolation, trauma, relationship difficulty and chronic pain.
It is not caused by weak character, insufficient willpower, or inadequate faith. Telling a depressed person to think positively is as useful as telling an asthmatic to breathe harder.
Treatment works
- Antidepressant medication — effective in moderate to severe depression, taking four to six weeks to show full benefit
- Psychotherapy, particularly cognitive behavioural therapy, which is as effective as medication in mild to moderate cases
- Combination treatment, which is superior to either alone in more severe depression
- Regular exercise, which has genuine measurable antidepressant effect
- Treating underlying contributors — thyroid disease, vitamin B12 and D deficiency, anaemia, chronic pain, sleep apnoea
- Structured routine, sleep regularity and reduced alcohol
Common concerns about medication
Antidepressants are not habit-forming and do not change your personality. They restore function rather than producing artificial happiness. They take four to six weeks to work fully, which is why so many people abandon them at two weeks concluding they are useless.
Treatment usually continues for six to twelve months after recovery, because stopping early is the commonest cause of relapse. Stopping should always be gradual and supervised.
Supporting someone with depression
- Listen without offering solutions or comparisons
- Do not say 'others have it worse', 'just be positive' or 'you have everything, why be sad'
- Help practically — with appointments, transport, cooking, paperwork
- Encourage treatment, and attend the first appointment with them if they want
- Take any mention of suicide seriously and seek help immediately
- Be patient; recovery is gradual and not linear
Key takeaways
- Depression frequently presents as physical symptoms in Indian patients.
- It is a medical condition with biological causes, not a character failing.
- Antidepressants take four to six weeks to work and are not habit-forming.
- Tele-MANAS helpline 14416 is available free, 24 hours, in multiple languages.
A note on medical advice
This article is general health education written and reviewed by the Department of Psychiatry at SIMS. It is not a substitute for an examination, a diagnosis or the advice of your own treating doctor, and it cannot account for your history, medicines or reports. If a symptom is sudden or severe — chest pain, stroke symptoms, breathing difficulty, serious injury, seizures or heavy bleeding — call 9281862028 or come straight to the emergency department instead of reading further.
DepressionMental healthPsychiatryStigma
