In late 2016, I was travelling in some remote villages of Zimbabwe to interview women living with depression and HIV/AIDS. Most of the women were either widowed or divorced as a result of the conflict and HIV/AIDS. Despite their dual burden of disease and social isolation, their happiness and entrepreneurial spirit was amazing, an inspiring takeaway for me. I had spent two weeks talking hours upon hours with different groups about their struggles with depression and HIV/AIDS. In one conversation, a middle-aged woman asked me, “Does depression exist in your country?” 

I had never anticipated such a question. It was a simple but profound query. I paused, looked around and asked the same question to the group. The majority thought depression was a unique problem of their society, linked to their fate, culture, poverty, conflict, and social hardship. In their imagination, people in other countries were wealthier, healthier and happier and without any cause for depression. 

Of course I told them that depression does exist in my country. In fact, in the world ranking for the number of women who commit suicide, Nepal comes third. I further explained to those women in Zimbabwe that depression exists everywhere. From rich to poor countries, from white to black societies and everywhere in between, people suffer from depression. The global phenomenon of depression was beyond their imagination. They were shocked.

Does everyone suffer like us?” I found this question difficult to respond to. Could an American, an Asian or an African suffer the same way from depression? I recalled my own childhood days. I was 10 when I first encountered the symptoms of depression. It took seven years for me and my family to accept the problem and seek help. In the interval of seven years, my family spent a good amount of money to diagnose my problem, suspecting all kinds of illnesses related to the heart, stomach or my neurological system. Not once did anyone think it could be a mental health issue. 

my experience, it’s difficult to translate the suffering of depression into words. While hearing stories of others, I found there are similarities in the depth of pain, but there are also vast differences in manifestation of depressive symptoms. 

people suffer from and find a cure to depression is an important conversation to be had for our time. We can not dismiss it. We can not stay mute over it. Every day, thousands of families are losing their loved ones to suicide and disability without even knowing why. The price of not talking is high. A trusted individual with whom one can confide in is often the saving grace for those who suffer. 

is a fast-growing global problem. In the past two decades, the number of people suffering from depression and anxiety increased by nearly 50 percent, and now affects close to 10 percent world population. Depression increases the risk of other diseases and other diseases also increase the risk of depression. For instance, diabetes and cardiovascular diseases may increase depression and vice versa. 

affects people of all ages and geographies. Over 90 percent people who commit suicide are found to have depression. Depression is the leading cause of death by suicide among 15 to 29 year olds. Poverty, unemployment, conflict, negative life events, relationship break-up and physical illnesses are common risk factors for depression.

nature of depression is deceptive. People can hide it for a lifetime. People who suffer from depression may seek help for weakness, tiredness, sleeplessness, headache, heart pain or other ‘strange’ recurring physical symptoms, and these symptoms could be different from individual to individual. 

some people know they are suffering from depression, they do everything to hide it from family and friends. There is strong fear of social isolation and discrimination associated with depression. Therefore, rather than make depression a case for public conversation, people choose to stay quiet.    
In the life of people who suffer from depression silence is the biggest killer. If people do not talk or do not seek help, they never may get help, their problems go unnoticed and they are doomed to suffer in isolation.  

Given the gravity of the matter, the World Health Organization (WHO) in the past few years has been highlighting mental health issues along with other non-communicable cardiovascular diseases, chronic respiratory diseases, diabetes and cancer. Under the umbrella of non-communicable diseases, mental health is easily the most overlooked. 

In this context, to coincide with the World Health Day, 2017, the WHO is launching a one-year campaign on depression with the theme “Depression: Let’s talk”. With depression, talking is the first and the most important step to seek help and eventually find an individualized cure. Therefore creating conducive environment for conversation at home, school, workplace, community and public spaces is vital. 

This is particularly true in countries like Nepal where there is little or no support for depression. Even in high-income countries, nearly 50 percent people with depression do not get support. In all societies, depression has become a huge family, social and financial problem. 

In Nepal, the tragedy is that over 90 percent of people struggling with depression never seek or get help. Of the few who do get help, they would have suffered through 5 to 10 years before they sought out a therapist, a psychiatrist or a counselor. Many sufferers are often in denial and don’t accept that they are suffering from depression. 

The way so many people are affected by depression, we must break our silence and start talking about it. When I started writing on mental health issues in 2008, my dream was to bring mental health into public conversation. I did it by sharing my own experiences. At one level, it encouraged many people to share their stories publicly. The number of people committed to spread depression awareness is growing, which is a promising sign. 

But we are behind the times in tackling depression. We know depression is perfectly curable. And we know how. But the cure starts with acceptance. Just like we cannot deny the existence of other diseases, the same approach must be applied to depression. Let’s accept it. Let’s deal with it. Let’s talk about depression.

jagannathlc@gmail.com

 
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