Brain & Mind Medical

My Anxiety over Depression

Recently brave and candid Ms. Padukone shared her depression with the nation in an emotional interview. Though Deepika may have looked striking, what struck me more was a claim by the interviewer that as many as 36% (45 crore!) Indians could be depressed.

I feel that this incredible number should give even mildest hypochondriac “a pit in the stomach”; as, just like Deepika, on a bad hair day, many of us “feel like crying without reason” or “have emptiness with feeling tired and wanted to just sleep”!

So, are we all depressed?

I am not sure if it is entirely correct to deal with a serious medical condition in a public forum (considering the damage self-diagnosis can cause), but, looking at the fear that half-information may generate; we need to deal with, well, fear itself!

Fear is a brain-response to any survival-threatening stimulus and thus has highest priority in brain. It is one of the strongest emotions that sits in old brain, and when evoked, it overwhelms the brain.

As things that our ancestors feared required us to fight-with or run-away-from, our body is kicked into what is termed as fight-or-flight mode. When we see a threatening stimulus (eg. tiger), the fear response is automatically kicked-in (using hormonal secretions as commands). It is important to note that, this response, when fired as a “blank” i.e. sans a real threat, feels a lot like what Deepika describes.

So, with no tiger in sight, why does Deepika feel this way?

This feeling of fear without a “real” stimulus is known as anxiety, and it is a modern achievement of human neocortex, possible only because our “new” brain can construct imaginary, often augmented, reality. We are now able to simulate threats and cause stress to our older brain by presenting it with a hyper-reality to fear!

This makes anxiety disorders fairly prevalent because they use a brain circuit common to all of us. The “stress” that doctors refer to is a new name of self-constructed (often irrational) fear. An overdose of stress results in the body going through the fear-response again and again, creating havoc in the brain chemistry and giving us the modern urban life-style that we all cherish.

Unfortunately, the expression of anxiety disorders is very similar to depression (actually “clinical depression”, as the word “clinical” or “major” must be added to differentiate the disease from normal blues) and both can co-exist, with intensity of former often resulting into later. This makes it extremely difficult, even for experts to make a correct diagnosis just from few symptoms.

Fortunately for us, what differentiates anxiety disorders and clinical depression is the accessibility of mind. Though distressing, anxiety disorders are due to the “normal” brain chemistry going in overdrive because of irrational fear. So they allow a handle, a doorway into the mind for the psychologist to use counselling aided by a psychiatrist to dampen the chemistry of fear-response through medicines, and making it a curable/manageable condition.

The true blue clinical depression, on the other hand, is a beast of different and more sinister pedigree. It is a disease that has its own autonomous pathology, a chemical locha of highest order that doctors try to manage through medicines. The most distressing part of this condition is the involuntary receding of self that disallows any access for the psychologist to reach inside the mind and help. The helplessness, isolation and the sinking feeling it brings is, may be, the true pathos that often finds voice through art or even leads to suicide.

Clinical depression is, possibly, a comparatively rare neuro-chemical state (than anxiety disorders) that is inflicted upon unfortunate few. Though not fully understood by science in terms of its mechanics, it is entirely possible for experts to identify and help those suffering from it. But Prosac-popping west has proved that public awareness about depression is not a great idea, as anxiety disorders and clinical depression, though similar in “feel”, need completely different medical interventions. In a country like India where it is possible to get virtually every drug over-the-counter, results of self-diagnosis would be catastrophic.

When a disease, not clearly understood even by experts, is described through its symptoms to the masses, it rarely serves any good. It is entirely possible that such generic information can turn a borderline anxious person (like you and me!) into making a potentially life-threatening error.

So, if you are feeling the blues, there is no need to get depressed; just get anxious and see the doctor!

DNA: 28/3/15

I am happy to admit that I have managed surviving till now with minimum effort as all my intellect has be used to avoid doing anything meaningful. As I needed to while all the free time I generated in course of being lazy, science has been my favorite muse that I have enjoyed company of. As an effort to kill time (in a way, to get even with it) one fine day I decided to write a science column, more for my personal amusement than to attract readers. After getting educated about the attention span of modern readers from my editor, it became more like a challenge to tackle esoteric subjects in 600 words that I have managed to remain interested in for more than a year now. I do not want to add my worldly profile here as these are ideas that need to be considered only on the merits they carry and not as an opinion of a certain human being.

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