Prisons Of The Mind: Understanding Unipolar Mood Disorder

Posted on April 26, 2011 in Health and Life

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.


  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.