Was it my fault or did I choose to suffer? Do you know what depression may feel like?

10 September – World Suicide Prevention Day

By– Akanksha Mahajan, 3rd year MBBS ,

Government Medical College, Amritsar, Punjab

“Depression”, probably one of the most popular words of this era, isn’t it? Yet, there’s still so little that we know about it. Because if we did, we might have saved millions of lives. According to Centers for Disease Control and Prevention (CDC) data, depression plays a role in more than one-half of all suicide attempts; suicide, which is perhaps the 17th leading cause of death worldwide, according to the World Health Organisation (WHO).

I got acquainted with this term, “Depression”, when I was like 12 years of age. I was completely drained yet I didn’t know exactly what it was until I started developing the various physical symptoms especially, that fatigue and that stiffness in my muscles which I failed to get rid of. I kept pushing myself to keep working as usual until I couldn’t and then I had to see the doctor. The doctor ran several terrifying tests which I don’t think I can count but astonishingly, everything in my body was so normal and all the doctors I saw ended up diagnosing me with CLINICAL DEPRESSION. 

So, would you like to know the exact words a psychiatrist once said to my parents? Well, here we go- 

“Your daughter is just trying to seek your attention. The more you will pay heed to her, the more of the symptoms she will go on making up. You need to handle her strictly!”

Any guesses regarding what my parents did next? Unfortunately, our relationship was never the same. I was left all on my own with nothing but my anti-depressants to support me as I cried by myself. I have hated myself ever since then, I have always hated myself for who I am. I hated myself every time I had a panic attack and my parents told me that I am not normal and I will never succeed in my life. But it didn’t mean my parents didn’t love me. My father prayed every single day when I was going to have my medical entrance exam so that I could excel despite all the hurdles. But I couldn’t get the desired rank at my first attempt because that fear of failure was so overwhelming that I had a terrible panic attack during my exam. And I justified the words my parents always told me, I couldn’t succeed. I decided to reappear yet I cried almost every night throughout that year but fortunately, I succeeded this time and my dad told me, “you got lucky but you really need to change or else you will never succeed.

Almost 10 years have passed but I don’t think I have totally overcome depression yet because it keeps showing up even when it’s the last thing I want or the last thing I expect.
Trying to fight depression seems more like a roller-coaster ride to me. There were some days when I felt like dying because that seemed so much easier than suffering every next day and then there are days when you wake up feeling better, the days you wish should never end. But at the end of each day, you just wish there was someone who could understand because no one really does. I haven’t had any friends so far because every person saw me as nothing more than a burden, I guess. 

But on the bright side, being in med school helped me realize that suffering from depression wasn’t my fault or choice. So, would you like to know what actually causes depression?

Basically, depression involves changes, mainly in the receptor- neurotransmitter relationships in the limbic system, as well as the prefrontal cortex, hippocampus, and amygdala, which are all responsible for regulating our mood. Serotonin and norepinephrine are thought to be the primary neurotransmitters involved, but dopamine has also been found to be related to depression.

A decrease in the normal balance of these neurotransmitters can cause various types of depression, eg- decreased norepinephrine may cause dullness and lethargy, and decreased serotonin can cause irritability, hostility, and suicidal ideation.

Environmental factors, including coexisting illnesses or substance abuse, may affect neurotransmitters and/or have an independent influence on depression.

Alterations in the balance of neurotransmitters and/or their function can include:

• Impaired synthesis of neurotransmitters
• Increased breakdown or metabolism of neurotransmitters
• Increased pump uptake of neurotransmitters

In addition to these localizable brain chemical changes, it is likely that gene-environment interactions, as well as endocrine, immunologic, and metabolic mediators, play a part in the development of depression.

Chronic stress can also lead to an imbalance in these neurotransmitters, thus, leading to various anxiety and depression-related disorders. 

It’s safe to conclude that depression is not really in an individual’s control.

Above all, one must know that a person suffering from depression doesn’t want your sympathy, they don’t want to seek attention, they don’t even want you to wipe their tears, they just want you to understand and be there for them. Yes, it’s hard to understand what someone else might be going through but it’s not that hard to exhibit a little more empathy.

A few lines that might give you an insight into what it may feel like:

“I am trying, I’m trying my best ;

but my heart is beating like it’s going to burst out of my chest,

my arms are aching and my hands can do nothing but shake, 

my body is so tired and tense as if it’s about to break,

I am really tired of all this confusion, frustration, and self-doubt,

it’s like I’m stuck in a maze with no way out,

it’s like I’m drowning but my body continues to fight,

to fight the water with all its might,

but I know I will heal and I will heal one day,

I know in the heart of my hearts all this pain isn’t going to stay!!!  ”