THE DOWNWARD SPIRAL

Adolescence is a most vulnerable developmental stage of life – ripe with mood, anxiety, thought and psychosocial disorders. And, a majority of youth in our country is burdened with exams, undue expectations, peer pressure, violence and looming social tensions. Foremost to mental disorder is Depression, according to statistics. Depression rates in adolescent have increased rapidly over the last decade and today, around 50 per cent of youth affected are under the age of 14 years and around 75 per cent are under the age of 25 years.

Professor Rajesh Sagar, Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), has echoed strong warnings about this condition. "India has the largest youth population in the world and a good number of this population is today impacted by Depression," he said.

"There could be a number of factors and circumstances causing Depression in this age group of people, who could belong to any social or income stratum," he added.

"Today, when there is competition to outdo one another across levels to survive in this fast-changing world, young people are more vulnerable to Depression. Changes in the family system and increased stress levels could be major issues pushing young people into isolation," Professor Sagar pointed out.

A frequent contributor to several health journals including Lancet, Professor Sagar said, "Today's young generation spends most of its time on games and surfing the internet. Most games are full of violence. It is ironic that young people are witnessing violence both in real life and in the virtual world."

There is another negative aspect of the changing family system that reinforces the belief that 'only child is a lonely child'. The practice of having a single child is often playing a detrimental role in the overall development of children. The concept of peer-sharing is learnt with siblings, which is an important aspect of personality development, Professor Sagar also asserted.

"In the present scenario, where crime is becoming a part of everyday life – the rising numbers of divorce, single parent family structures, etc., are often resulting in children failing to cope with the changing world," he further added.

There are many symptoms of Depression, including a lack of interest toward everyday activities, fatigue, sleeplessness, confusion and a visible decrease in cognitive abilities. If any of these symptoms prevails for more than two weeks, medical intervention is essential. Timely medical and psychiatric treatment is the only solution to tackle severe Depression.

"We are all witnessing a staggering rise of suicides among the young population. Suicide is a leading cause of death worldwide. And, mental disorders are among the strongest predictors of suicide. However, little is known about disorders that are uniquely predictive of suicidal behaviour," analyses Professor Sagar.

"Here, at AIIMS, we have a separate cell for young adolescent patients of Depression. The number of such patients is on a rise and a severe condition of Depression is endangering the lives of many youngsters," he added with concern.

"Imagine growing up in our world today. Imagine dealing with human rights violations, wars and violence in homes, schools and businesses on a regular basis. Young people are spending most of their day on the internet – experiencing cyber crimes, cyberbullying and playing violent video games. Suicide and substance abuse numbers have been steadily rising. Young adults are at an age when serious mental illnesses can occur and, yet, they are taught little to nothing about mental health care," World Federation for Mental Health (WFMH) too has said unequivocally.

According to the Ministry of Statistics and Programme Implementation (MOSPI), more than 34 per cent of the population falls under the age group of 15-34 years. But the greater matter of concern is that a significant portion of this population experiences the wicked wrath of Depression. The Lokniti-CSDS Youth Survey indicated that around 37 per cent of India's urban youth population was suffering from Depression. Back in March 2016, in his programme Mann ki Baat, Prime Minister Narendra Modi had also expressed his concern about this massive prevalence of Depression among India's youth.

It is thus essential that major steps are taken to save children from falling into Depression. "Social scientists and governments must pay serious attention to the plight of the youth growing in Digital India," concluded Professor Sagar.

According to a cross-sectional study published in the Indian Journal of Psychological Medicine, mental health literacy in adolescents at the pre-university stage is abysmally low. Only 29 per cent of those surveyed could identify Depression as a medical condition that requires professional intervention. A mere 1.31 per cent could identify Schizophrenia or Psychosis. This clearly indicates how mental health remains neglected and peripheral to general attitudes and pursuits of living. The study mentions that adolescents preferred reaching out to family members, especially mothers, rather than seeking professional help.

In India, roughly 200 million are estimated to suffer from Depression at some point in their lives. So far, Indian insurers do not cover mental conditions in their policies, although a recent circular issued by Insurance Regulatory and Development Authority of India (IRDAI) under the Mental Health Act, 2017, directs them to do so. On the other hand, ironically, mental well-being is a prerequisite for obtaining health insurance.

"Often, teens with Depression will display noticeable changes in their thinking and behaviour. The teenager will typically underperform at school or university, be awkward in social situations, feel frustrated or even angry over small matters, be irritable and easily annoyed, feel hopeless, empty, worthless, be fixated on past failures and indulge in exaggerated self-blame and self-criticism. They may express extreme sensitivity towards rejection or loss and seek excessive reassurance. Concentrating and remembering things would become difficult. A depressed teenager may feel directionless and futureless and indulge in thoughts of dying, pain and suicide," said Professor Nand Kumar, Department of Psychiatry, AIIMS.

"They may have no motivation, staying in their bedrooms for hours. Sometimes they cope by becoming indulgent, spending more time on social media rather than conversing with family and friends. Parents must be observant towards these changing patterns; if found, talk to their school counsellors, develop a friendly equation with kids and engage more socially," added Professor Kumar.

Depression can manifest with physical aberrations too. A constant feeling of tiredness, insomnia, change of appetite, restlessness or a prevailing state of agitation, slow thought processes, speech or movement, frequent complaints of body aches or headaches, social isolation, lack of interest in personal hygiene and appearance and a tendency toward self-harm are some typical behavioural changes.

Parents must understand that Depression in their young adolescents is not a sign of weakness or flaw in character. Depression among teenagers is often ignored because people attribute their angst to raging hormones and constructed beliefs like generation gap. This is a serious medical condition that can affect learning goals, physical activity and productive potential, long into adulthood. Hence, seeking help from a doctor, a nurse or a spiritual leader is always advisable rather than leaving your child to cope on her/his own, Professor Kumar advised.