Stress, stigma and sleep loss during COVID 19 pandemic

Is depression still a social taboo?  Why more and more Indians are falling into the trap, a special write-up by Dr. Sangita Laha

Only just around a month and a half after Irrfan Khan and Rishi Kapoor’s demise, when the fans had still not got over their shock, was the news of another Bollywood actor ending his life on 14th June 2020. The death of Sushant Singh Rajput, the famous Bollywood actor of recent years has left everyone agape and has put some questions across. He had everything — money, fame and wealth in a very young age. Then, why did he commit suicide?  Why such an extreme step? Unbelievable even today, the actor’s untimely death at his Bandra residence in Mumbai has left everyone shell shocked. Soon after the news broke out, the social media were filled with the condolences messages for his family.
Suicide is not a new issue, especially not in celebrity circles. These tragic deaths are also not limited by lines of work, ranging from famous boxers, designers, politicians, sport stars, writers to actors, musicians and entrepreneurs. How shocked is the nation when the news of a celebrity committing suicide is reported in TV channels. As a society, we look up to the people who make a name for themselves in their chosen field. Yet who knows the emotional pain that may lie just beneath the surface of these celebrities that we envy? In many instances, it is not known until after their death that the celebrity who took their own life was a deeply troubled individual. How we perceive them is based on their outward appearance and demeanour, something that is completely inaccurate. This is the takeaway, the lasting message that is so important to understand.
Many who struggled with depression — both celebrities and regular folk — are very adept at hiding their interior battles. Does that mean depression is still a social taboo today? The fact that these people — the crème-de-la-crème of our country, in terms of skills, wealth and fame — decided to take their own life, is what needs to be assessed and addressed. The question that crops in our mind is ‘Why would they want to take their own life, when they had everything”? Or, is it because of the lavish lifestyle; is the price they have pay when they are unable to cope? All these thoughts go unanswered.
According to the Indian Psychiatry Society, the number of mental health cases — including anxiety and depression — has risen 20 percent since the lockdown was first announced, mostly attributable to the decline in social activity and restricted movement.
Initially, not many people were worried about the business loss, job loss and income-related issues when the lockdown had started, people thought that the crisis would end soon. But, when lockdown continued and COVID-19 remained uncontrolled, it led to stress; fear psychosis, depression and sleep-related issues in many people.
The outbreak of Coronavirus has given rise to many mental health issues. Suicide rates continue to rise. Almost seven suicide cases were reported during the first 100 hours of the lockdown in Kerala alone. After which the Kerala government decided to come up with a ‘Parchi’ system to let addicts’ access alcohol with a proper prescription from the doctors.
Report of a man in UP committing suicide also came up as he missed his wife, who was stuck at her parents’ house due to the lockdown. Anxiety, frustration, panic attacks, loss or sudden increase of appetite, insomnia, depression, mood swings, delusions, fear, and suicidal tendencies had become quite common during the lockdown.
An estimated one in seven Indians suffered from mental disorders of varying severity in 2017, a study says. In 2017, 197 million Indians (14.3 per cent of the total population) were suffering from mental disorders, of which 46 million had depression and 45 million anxiety disorder. The scenario surrounding mental health in India has not changed much in 2020. In India, depression remains in many ways a social taboo —- a topic of gossip or a target of ridicule. It isn’t spelt out, until news of a suicide that awareness of the anguish and despair they suffered is revealed.
‘Mental Health’ is not a thing’ in India, nor discussed about. It’s time to speak out, ask, listen and care. There are many observations that show families, friends, and parents don’t want to listen. For instance, if a child goes to his/her parents talking about a mental health issue; it will either be swept under the carpet, or the child may be rebuked or create a more panic situation. In India, parents often go into denial mode when it comes to their child’s mental health, resorting to statements like — “My child has no such problems!” This attitude must go. Parents must understand how fragile their children’s mental well-being is and be proactive in assessing it. Teachers, at the same time, need to be trained in identifying symptoms and patterns of mental issues. A teacher has a great power to bring a positive change in a student’s development. For example, before scolding a child for disruptive behaviour, they must be patient and analyse the reason behind such behaviour. Also, educational institutions must have psychological counselling programs in place to help students deal with their issues in confidentiality and in a comfortable environment. Society, parents, educational system need to join hands for the holistic well being of children. One such step has been taken by the Delhi government by introducing ‘Happiness Curriculum’ in an educational program for students of grades from one to eight in the schools run by the Government of Delhi. Taking inspiration from the curriculum, Andhra Pradesh and Uttarakhand, and countries like Afghanistan, Nepal, and United Arab Emirates are preparing to implement similar programs in their respective regions. In response to the COVID-19 pandemic and a subsequent nation-wide lockdown in India, the curriculum is being delivered to students and their parents via interactive voice response calls and live YouTube classes.

Understanding depression:

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.
According to the World Health Organisation (WHO), by 2030 depression will be leading cause of disability worldwide. Untreated depression that can cause lasting issues that include: constant, irrational fear and worry. Some physical symptoms are like rapid heartbeat, fatigue, headaches, hot flashes, sweating, abdominal pain, and difficulty breathing. Some changes may be noticed in eating styles, either too much or too little. Difficulty with memory, decision making, and concentration including constant feelings of sadness or worthlessness. Loss of interest in hobbies and activities. Feeling tired and cranky. Inability to relax. Panic attacks and Insomnia are other symptoms of depression.
Why don’t we talk about depression?
Some of the reasons are Judgment and Fear- In a society that does not consider mental health an issue, coming forward and speaking about it will take a lot of courage, as one  will be judged, and the fear of being abandoned is always there.
Stigma- Stigma surrounding mental health is still common.  While most people would shy away from admitting it, many others remain unaware of this condition. It is time that people come out more openly and talked about mental health.
Sensitivity and education- There is lack of education on the matter, and a lack of resources to properly mitigate it. We need to educate people, and sensitise them towards the signs and symptoms of mental illness, while normalising the idea of seeking support. We should learn to create an inclusive environment for people with mental health issues.
Expensive treatment
For those who are aware and seeking help, the treatment process is rather expensive. One needs to have a lot of time and money to buy medication, and go for therapy, to avail treatment.


No one knows exactly what causes it, but it can occur for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason. There are a number of factors that may increase the chance of depression; they can range from biological to circumstantial. Common causes include:

Genetic or Family history:

Depression may be an inherited condition. One may have a higher likelihood of experiencing a depressive disorder at some point in one’s life, if one has a family history family member with depression. The exact genes involved are not known. It’s believed that many genes may play a factor in causing depression. Every part of your body, including your brain, is controlled by genes. Genes make proteins that are involved in biological processes. In a person who is genetically vulnerable to depression, any stress (a missed deadline at work or a medical illness, for example) can then push this system off balance.
Mood is affected by dozens of genes, and as our genetic endowments differ, so do our depressions. The hope is that as researchers pinpoint the genes involved in mood disorders and better understand their functions, depression treatment can become more individualized and more successful. Patients would receive the best medication for their type of depression.
Hormonal: Changes in hormone production or functioning could lead to the onset of depressive states. Any changes in hormone states — including menopause, childbirth, thyroid problems, or other disorders — could cause depression.

Seasonal:  As daylight hours get shorter in the winter, many people develop feelings of lethargy, tiredness, and a loss of interest in everyday activities. This condition was called seasonal affective disorder (SAD). Now it’s known as major depressive disorder with seasonal pattern.

Situational: Early childhood trauma, a big change, or struggle in life can trigger a case of depression. Losing a loved one, or marital discord, being fired, having financial troubles, or undergoing a serious change can have a big impact on people. Stress plays an important role in depression.
Brain structure: Popular lore has it that emotions reside in the heart. Science, though, tracks the seat of your emotions to the brain. Certain areas of the brain help regulate mood. Researchers believe that — more important than levels of specific brain chemicals — nerve cell connections, nerve cell growth, and the functioning of nerve circuits have a major impact on depression.
Medical conditions: Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, or attention-deficit hyperactivity disorder (ADHD) and drug use. A history of drug or alcohol misuse can affect more risk.

The Road to Recovery:

Both anxiety and depression can be treated. Effective strategies include: young fitness woman walking at forest trail Stock Photo – 50429401

Exercise: It releases chemicals in the body that make oneself feel good, and can help one relax. Taking just a 10-minute walk may alleviate symptoms for several hours. Try morning walks initially for 15 or 20 minutes and then gradually increasing it. Trust me … it doesn’t cost anything. A walk may help: improve self-esteem, boost mood, reduce stress, reduce anxiety, reduce fatigue, ease depression symptoms or reduce the risk for depression. It may also help weight loss goals and boost confidence.

Yoga and meditation: Yoga therapy can assist people in symptom management and recovery. Sixty minutes of yoga, three times a week improves not only depression but anxiety. So, there seems to be a reason to get off the chair and bed, get moving — perhaps double if one starts slowly and build up. That’s the simplest way. It may begin to work fairly quickly as well.
Relaxation techniques: which include practicing meditation. Spending time to meditate is fantastic.
A daily dose of motivation: Positive affirmations helps a great deal in overcoming the negative chain of thoughts and stay motivated.
Help others: Last but not the least, just like Deepika Padukone, everyone can come out of depression, only if they are aware that there is help available. By helping others, one can cope with depression better

Adding to these are:

Cognitive-behavioural therapy (CBT): This is often used to treat anxiety disorder with depression. CBT can teach people to manage their fears, anxieties, and depressive symptoms by figuring out what’s really causing them; people also learn how to take control of their emotions.
Antidepressant medications: This may be prescribed to help treat both conditions. These drugs are often used in conjunction with CBT.
Organizations offering mental health services: which can include a hospital or support group in one’s community.

Last few words:

Acknowledge your feelings. Once you acknowledge your problem and feel overwhelmed by it, you have an urge to get out of it. When you have an urge to reach a solution, you actually seek help and are on a road to recovery. So take a resolution: Life is too short. Enjoy it.

(The author is an Associate Professor Dean of National University of Study and Research in Law. Views expressed are her own.)