Case study shared by Dr. Avani Tiwari
It all started with my coming to Delhi.
I’m a 29-year-old graduate from a satellite town near Delhi. I had an arranged marriage 2 years ago and moved to Delhi.
I was a very confident, strong girl before marriage with lots of friends. I was the person people came to with their problems. I never worried. I loved shopping, watched music channels incessantly or had earphones in my ears the whole day. I thought getting married and going to Delhi would be fun.
It was. For a few months.
We would be out every evening, shopping at small markets for cheap trinkets, eating roadside stuff, roaming about on bike or cycle-rickshaw. There was a movie every Sunday and a trip home, on the bike, every month.
Gradually the honeymoon ended.
My husband was promoted and got a huge opportunity to lead a team for a project for 3 months and his hours at work increased. I was left alone at home the whole day. I had started to study for my post graduation and figured it would be a good thing to concentrate on it.
But it wasn’t so easy. Gradually, I can’t even tell you when, it started going downhill. First, I’d spend a lot of time doing nothing. No work at home, no studies, no outside errands. Just hours of emptiness. After a while, I even stopped cooking for myself, I’d just make a meal of bread or instant noodles when I felt hungry, which was less and less often. I’d be in my bed the entire morning, rarely bathed before noon and lounged around the whole day in my nightgown.
I didn’t study. Often dinner would be my only meal. I started getting frequent headaches. My husband was busy, but even he noticed something was amiss. He took me to a doctor who prescribed painkillers for headache, sleeping pills and multi-vitamins.
When those 3 months were over, I thought everything would go back to normal. No. It worsened. My husband’s hours remained longer and we started fighting over small things. I thought I was being neglected and he said I was the one ignoring him and our home. I didn’t get up till late, the house was a mess, the daily chores neglected and outside errands ignored. I would be in bed the whole night without sleep, crying or tossing and turning, even with double the dose of sleeping pills. I barely had energy to get up in the morning. I had stopped listening to music. Some days were bad, others were worse.
It was like someone had sucked my life force out of me.
My husband tried to help, to cheer me up, took me shopping where I blamed him for getting me out in such hot weather. He took me to a movie where we fought in the interval and returned, me crying, he fuming.
What’s wrong with you, he asked.
Everything, I answered.
That night I decided enough is enough. I had toyed with the idea of ending my life before. I had tried cutting my wrist a month prior. My husband had no idea it wasn’t a ‘bangle accident’. But I told my mother and she scolded me on my ‘stupidity’. You have everything anyone can ask for, a good husband, no financial trouble, no restrictions. Why would you waste it all away on some mere ‘fitoor’ (whim) of your mind, she said.
Not a fitoor, ma, not a fitoor. I wanted to say. But couldn’t.
I took all the pills I had left from headache prescription and swallowed them all.
I had no idea what happened after but I was told that my husband found the empty strips and suspected something wrong when I didn’t wake up. He got badly scared and I was admitted to the hospital where they pumped out the medicines. I remained in the ICU for 2 days and during that time, my whole family was summoned from hometown. Police came and took my statement. I told them I had too much pain so I’d taken all the pills and I had no intention of dying.
But I had. Or did I?
I was visited by a psychiatrist in the hospital ICU. At first I lied to her also, but she only smiled and said we will talk later when I ‘felt’ well enough to sit.
Did she care about what I felt?
Anyway, on day three, I visited her in her chamber. At first, I didn’t know what to tell her, but she insisted I tell her whatever I could. She suggested I start at the beginning.
Gradually, in parts, between many sobs and crying and even anger, I recounted my story. Even I didn’t know I had so much buried inside me. Our first session lasted hardly 20 minutes. But I was discharged that day and promised to follow up with her only because I wanted to tell her the whole thing. Only because she listened and did not seem to judge.
Now, why is that important?
Because I remembered how my mother had scolded me.
If your mom didn’t understand you, who else could?
But the doctor did. Though I did face the music at home. Two sets of parents, both ready to blame me, my parents angry at me, defensive in front of my in-laws. My husband bewildered. I was asked, explained, advised, suggested, advised, judged, understood, advised. I’m sure they thought I was crazy.
When I went to the psychiatrist for the second time, I asked her point blank. What is wrong with me? Am I crazy?
Then she told me about depression. We talked. She asked, I answered. Then I asked, she answered. I told her how I felt. She told me what could be done to make it better.
Was that possible?
Yes, she told me about medicines and psychotherapy. I was initially sceptical about medicines. Why did I need them? Then she explained to me the concept of neurotransmitters (chemicals in the brain) and their role in depression. How their imbalance can cause mood and anxiety problems.
Reluctantly, I agreed. I didn’t want to feel what I had felt that night.
It’s four months now since I started the treatment and I haven’t felt that way till now. I sleep better, without any sleeping pills. I’m feeling much better, my confidence has returned. I want to listen to music again.
Related reading: How I fought my depression and won
It wasn’t all easy. It took me a couple of weeks to see the effect of medicines kick in. I remember at the end of three weeks I got up and made breakfast. That was when I realised I was feeling better. I started my psychotherapy sessions at 6 weeks. My psychologist and I worked out several of my small daily issues along with my faulty coping styles. She taught me to handle stressful things in a better way. I wish I had come earlier.
My husband supported me all the way. Initially he was also sceptical at the thought of going to see a ‘mad-doctor’ but one meeting and he changed his views. He even attended two of my therapy sessions. He told the psychologist jokingly, when you finish with her then I’ll be next.
I have had total 8 sessions till now, 4 more to go. Two months of medicines remaining. My psychiatrist has assured me I will be weaned off them without much trouble.
It seems she gave me back my life force.
Related reading: CONTACT COUNSELLOR NISHMIN MARSHALL
From the psychiatrist’s desk
According to the World Health Organisation, 4.5% of Indians suffer from depression. It’s the leading cause of disability, even more than cardiovascular disorders.
Suicide is a major risk. Not counting hours spent in misery and darkness and unproductive man-hours to society at large.
Depression is certainly treatable and many times the person may not realise it but close friends and family members can pick up certain cues. If your partner/friend/family member shows one or many of the following signs, your alarm bells should ring.
A low mood is the first cardinal sign of depression.
Though when directly asked, the sufferer may not admit to it (smiling depression). Unusual sadness, decreased communication, slow reactions, delayed responses, low volume of speech, all these are indicative.
Loses interest in hobbies, work.
Stuff that would have excited him/her in past no longer does. Concentration decreases. Memory lapses may occur. They’re irritable when talked to with minimal or no provocation. Lash out in anger over small things.
Changes in sleep pattern.
Delayed, fragmented or disturbed sleep or not feeling refreshed in morning. Feeling lethargic, low on energy, not wanting to move even when awake. Getting fatigued in small tasks like brushing or taking bath.
Decreased or altered appetite.
Eating junk food or comfort food as a way to distract self from depression. Binge eating. Taking up smoking, drinking alcohol or any other drugs. Self-medicating with sleeping pills.
Negative thoughts regarding self, future, world.
Feeling hopeless, helpless, worthless, guilty. Like sinking in a dark abyss. Keeps talking about how fruitless everything is. How useless life is. Has a death wish. Passive/active ideas/plans about suicide. Any attempts at deliberately harming self or ending life.
Remember, depression is treatable. The patient may not have insight or energy and hence may not realise the need for treatment. The onus is on us to make sure that they receive the medicines/counselling needed. It can save your loved one’s life.