Public health: Increased prescriptions sign of awareness?

MUMBAI: Depression, though widespread in India, is rarely accorded priority in the public health system, which is burdened with cases of TB and dengue as well as non-communicable diseases such as diabetes and hypertension. In October 2016, the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, released a mental health survey that said one in every 20 Indians suffered from some form of depression. The prevalence of depression has increased to such an extent that it's the theme for World Health Day on April 7.

NIMHANS director Dr B N Gangadhar said, “There is no doubt that people are more open than before to seek help for depression, but a 14% rise in prescriptions could also mean there are more psychiatrists today than before. Roughly 360 psychiatrists graduate annually .“

Mumbai-based psychiatrist Dr Harish Shetty said there has been a tremendous increase in awareness about mental health.“In two years, there has been a 100% increase in the number of patients coming to psychiatrists.“

Goa-based Dr Vikram Patel, attached to the London School of Hygiene and Tropical Medicine, said anti-depressants have low penetration in India. “If there is an increase, it is not surprising as more people seek help these days. This doesn't mean there is an increase in the incidence of depression, but an increase in awareness,“ he said.

A recent survey by a pharma major recently listed family pressure, relationship issues as well as biological changes as the leading causes of depression among Indians. Dr Shetty pin pointed the “rapid shifts taking place in India“ in the fields of finance, education, workplace, family , among others, as the major cause for depression. “People try to cramp in a century of living within a decade. The brain is being challenged beyond its potential, leading to an increase in depression rates. It is like an orchestra being disrupted,“ said Dr Shetty .

Depression is closely linked to social determinants. “Some may suffer due to economic difficulties such as debt while women may suffer due to mental difficulties such as domestic violence,“ said Dr Patel. He said cities witness higher rates of depression as people, many who have migrated from other parts, don't have any social support system. “There is more stress and more aspiration in urban areas, increasing the risk of depression among residents.“