Unlike the Novel Coronavirus, Depression is a disease that has existed for almost as long as human beings have been in existence. The issue of mental illness has come to the fore during the current pandemic and the resulting lockdowns. Not caused by any pathogen, depression is an illness that we can not develop a vaccine for.
And so understanding depression is one of the first steps to trying and countering the disease.
The earliest records of cases of depression have been around for more than four thousand years, with written accounts describing an illness with the same symptoms as the modern-day mental illness we know today.
Of course, at that time, we had limited knowledge of our physiology and of the chemical imbalances that caused such mental illnesses in the first place. We did not know what oxytocin, serotonin, dopamine, or cortisol were and were thus ignorant of what was causing the change in moods and behavior in depressed individuals.
Much like most diseases, at that time depression was viewed as a spiritual issue rather than a physiological problem. Individuals that were depressed were labeled as being possessed by the devil, or evil spirits, and the treatment was done by shamans and religious healers. Needless to say, it was not exactly the best time to be developing any sort of disease or wound that could not be externally observed and treated.
As civilization progressed, we came up with an array of possible causes for depression: demonic possession, weak temperament, curses, bile imbalances, internalized aggression or grief, and immorality have all been linked to the development of depression in an individual in the past.
The first step in trying to cure an illness is trying to understand it. It is trying to figure out what is causing it to root it out. Unfortunately, because the proper understanding was not there in the majority of our history, our attempts at getting rid of it have been fruitless at best.
Bloodletting, ostracization from society, beating, whipping, burning, exorcism, and finally imprisoning in insane asylums and subjecting depressed individuals to shock therapy have been used as ways to treat the illness in the past.
Thankfully, none of those treatments are accepted practices in the modern world. The world has changed, and due to modern science and medicine, there are multiple treatments, therapeutic and medicinal, to counter the disease in current times.
Unfortunately, in some places, the ancient misunderstanding surrounding mental illnesses exists to this day. Due to this, an individual would be as unfortunate there to develop depression as they would have been in ancient times. One of these places is our own Pakistan, as depressing as that is.
In this article, we will be looking at depression in Pakistan. The culture, the causes, the socio-economic factors that serve to make it worse, and the unfortunate stigma attached to mental illnesses that have given rise to the mental health crisis in our country. The increasing cases of depression in young people in Pakistan have been the most alarming in this regard.
In 2019, surveys country-wide have concluded that an alarming 20% of “teenagers suffer from major depressive order which can range from mild to severe levels. It results in a lack of concentration, academic decline, reclusive behavior, and at times suicidal thoughts” said Dr. Tania Nadeem, a psychiatrist at Aga Khan University Hospital (AKUH).
“Most common symptoms noticed in depressed students are irritability or sadness, poor sleep, lack of concentration, and lack of interest in activities,” Nadeem said whilst talking to The Tribune, a local Pakistani newspaper. She emphasized that academic stress and family issues are the leading causes of teenage depression in Pakistan.
Socio-economic and Socio-cultural issues are thus the main reasons for the rising tide of teenage depression. Academic stress is generally caused when teachers, parents, and peers of underperforming students begin pressuring them about their grades. Rendering them even more depressed, which prevents them from doing well in their studies.
This puts a lot of children and young adults in a perpetual cycle in the rat-race that is the Pakistani academic system. To make matters worse, the academic culture in Pakistan is inherently more about assessing students based on the rote-learning and regurgitation of dry text rather than teaching our kids about being happy and responsible citizens that can contribute to society.
The taboo nature of mental illnesses in Pakistan has made it even worse. A child does not feel comfortable discussing issues of this kind since the labels of “Paghal” and other pejoratives are used for individuals that confess to feeling such emotions, and so even their parents try to brush them off or even blame them for being depressed. In many of these cases, a spiritual lacking is cited, or the teenagers are told off for being “ungrateful”. As it can be seen, for many of us in Pakistan, depression is treated much the same as it was in ancient times, with phrases like “Iss ko djinn charh gya hai” (he is possessed by a demon) being used to describe people with mental illnesses.
And much like ancient times even our more educated Pakistani parents would rather take their kids to be abused and misled by religious or spiritual quacks for possibly damaging exorcisms than have them be taken for professional help for fear of the stigma attached to those diagnosed with a mental illness.
With the added pressure on our younger generations due to a collapsing economy and increasing academic pressure, it is of the utmost importance for our society to rid the stigma attached with getting help for depression much like they would get help for a wound or a virus.
Unfortunately, the taboo surrounding issues of mental health are so strong that even people who could be considered educated about these matters are hesitant about discussing these issues in the open for fear of being considered weak.
It seems that unless awareness campaigns and country-wide rural and urban outreach programs regarding mental health in general and depression, in particular, are undertaken we might not be able to get out of the gyre that we are in.
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