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Prisons Of The Mind: Understanding Unipolar Mood Disorder

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By Manki P:

After hours of racking my brain and an uncontrollable bout of sneezing, I managed to dig and dust off the oldest memory I have of a mentally disabled person. Surprisingly, it was buried in the single digit years of my life when like most children; I religiously went out to play every evening after finishing homework, in the square opposite our apartment. A lady presumed to be about 30 years old, had the power to stop our play mid-way and frighten the living day lights out of me. My fear stemmed from stories told by playmates, who co-conspired to build a monster out of her and if that wasn’t enough she became the target of daily jeers and snickers because of her left hand that continuously flicked close to her temple. My fear of her was so great that anytime I was alone while she crossed the square, I would run as ‘chicken little’ and hide behind a car or lamppost. After a few years we moved away and as I grew older she faded from my conscious mind. I can’t exactly say at what point in life, my perception of mental disability changed. I guess it must have been the result of education with realization but most of us are not lucky enough to break out of childhood molds.

Anuradha and Sonali’s case might be rare in extremity but it is not an isolated incident. Finger pointing as has been depicted in the media and multiple blog sites is convenient, possibly entertaining but futile and no different from what we did as children. Not surprisingly, there is social stigma and discrimination attached with mental disorders in India with roots deep in culture and ignorance but to accuse an ignorant society is like blaming the blind for their inability to see. Disappointment and loss are part of everybody’s life, what sets us apart is how we deal with them. Clearly, Anuradha and Sonali needed professional help, but the biggest problem was the absences of someone close to them not necessarily a relation by birth, as a support system, to help them recognize just that.

What the sisters might have been afflicted with were mood disorders, which is a broad category of psychopathology that involves disabling disturbances in emotion. These disturbances are defined in terms of incidents in which the person’s behavior is dominated by either clinical depression or mania.

I will limit the scope of this article to major depression to maintain simplicity. Unipolar mood disorder or major depression can be caused by psychological, biological and environmental factors. Life events, such as the death of a loved one, a major loss or change, chronic stress, and alcohol and drug abuse, may trigger incidences of depression. Some illnesses such as heart disease and cancer and some medications may also trigger depressive episodes. The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), produced by the American Psychiatric Association also referred to as DSM-IV, is used for the diagnosis of major depression. The DSM-IV diagnosis of major depression requires the presence of five of the following symptoms for at least two weeks.

  • Depressed mood. For children and adolescents, this may be irritable mood.
  • A significantly reduced level of interest or pleasure in most or all activities.
  • A considerable loss or gain of weight (e.g. 5% or more change of weight in a month when not dieting). This may also be an increase or decrease in appetite. For children, they may not gain an expected amount of weight.
  • Difficulty falling or staying asleep (insomnia) or sleeping more than usual (hypersomnia)
  • Behavior that is agitated or slowed down. Others should be able to observe this.
  • Feeling fatigued, or diminished energy.
  • Thoughts of worthlessness or extreme guilt (not about being ill).
  • Ability to think, concentrate, or make decisions is reduced.
  • Frequent thoughts of death or suicide (with or without a specific plan), or attempt of suicide (Davison et al, 2002)

Sixty percent of individuals with Major depressive disorder also have anxiety symptoms (e.g., anxiety, obsessive preoccupations, panic attacks, phobias, and excessive health concerns) (Levine et al, 2001). Anxiety in a person with major depression leads to a poorer response to treatment, poorer social and work function, greater likelihood of chronicity and an increased risk of suicidal behavior.

Many paradigms have been used in defining and treating major depression example cognitive, behavioral or biological. The cognitive and behavioral therapies for major depression are to alleviate depressive symptoms and prevent their recurrence. This is attained by identifying and reshaping the negative cognitions of the patients about themselves, the world and the future. The two most common biological therapies for depression are electroconvulsive shock and pharmacotherapy/drug therapy. Electroconvulsive therapy (ECT) can often relieve major depression in people who fail to respond to antidepressant medication, psychotherapy or cognitive-behavioral therapy. Drug therapy is the most commonly used biological treatment for major depression. Symptoms of major depression are found to improve in roughly 50% to 70% of patients who take antidepressants however; the side effects from these medicines are sometimes serious (Davison et al, 2002). The most successful treatments for depression involve a combination of therapies. A person suffering from severe major depression would be given antidepressant drug therapy and psychotherapy.

The epicenter of the problem is in being ignorant and failing to understand and recognize the presence of a serious or minor psychological problem. I grew up among friends and family that reiterated time and again that the solution to most problems ‘is all in the mind’ while at the same time ridiculed the need to visit a psychologist. It is important that people grow out of the mind-set which puts having mental stress or anxiety as a disease of the elite or hypochondriac.

REFERENCES

  1. Levine, J., Cole, D. P., Chengappa, R. & Greshon, S. (2001). Anxiety disorder and major depression together or apart. Depression & Anxiety, 14 Issue 2, p94.
  2. Davison, G. C., Neale, J. M., Blankstein, K. R. & Flett, G. L. (2002). Abnormal Psychology. Toronto, ON: John Wiley and Sons Canada Ltd.
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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