Thread by @DaktarBatra

This is going to be another long thread cum rant on Depression and Suicide Please bear with me.

Depression is a disease. Not a choice, not a conscious decision and certainly not "deliberately pretending to be sad".

Depression may not have any overt signs, that can be made out physically. Only self reported symptoms, elicited in a clinical interview can establish this diagnosis of Depression. Even sadness is not a strictly universal symbol.

At times, the only visible change may be a difficulty in able to perform one's duties. These people will often be taken to task for being lazy, for making up excuses and for being irresponsible. And this, in a lot of cases, will add to the stress that a person is already facing.

Depression can arise due to external factors and internal. Not every depressed person will have "something wrong going on in their life". Their may have a perfect life and yet be depressed. That's much more common than you think.

At the root of depression lies a neurobiochemical change. Deficiency of certain neurotransmitters (Serotonin, Norepinephrine & Dopamine) along with neurostructural changes and changes in gene expression are evidence backed explanations at present (it's Science, it evolves).

Both external stressors (love, relationships, work, death, money, health, medications, etc) and internal (systemic disease, thyroid, Anemia, nutritional definition) can start this neurobiochemical change. So a search for "what's troubling you" may not always yield an explanation.

Whatever be the cause, Depression is classified according to its severity, and treated accordingly.
a) Mild : only therapy may suffice
b) & c) Moderate & Severe: Medicines+/- Therapy.
There are other modes of classification as well, but this a therapeutically significant one.

So you see, Medications have a big role to play. Not to imply that therapy isn't helpful, but where medications are needed, they aren't avoidable. Therapy can't replace medicines in most cases, can only supplement them.

Do medicines have side effects? Yes they do.
Is the cost benefit ratio skewed in favour of taking medication? Yes it is. Research bears testimony to that.
This information is usually given at the beginning of treatment, and then periodically.

So then, is there no value in"talking to your friends" , "go out, watch a movie", "lend a non judgement ear" and my favourite "be there for them"? Ofcourse there is. But it's the same value that any of these have for a patient of other illnesses. They alter the mood transiently.

Suicide is a complex BioPsychoSocial phenomenon. Not all people who die of suicide have a Psychiatric illness. Not all people with Psychiatric illness who attempt/die of suicide, have Depression. Illnesses like Panic disorder, Schizophrenia, Eating Disorders also account for many

cases. But whatever be the cause, saying things like "dying isn't going to solve your issues", "how dare you even think of it" and "suicide is for cowards" doesn't help. Listening helps, empathy helps and kindness helps. But most of all, Expert Help helps.

So what can you do if you know someone who Depressed, Suicidal or has some other Psychiatric illness? Be kind, empathetic and supportive. Maintain their dignity and privacy while doing so. Encourage them to seek professional help.

What can you do if no one around you has these symptoms? Be kind to people in general, you don't know who's going through what. Stop labelling people who don't adhere to your norms of "Normal" as "abnormal/crazy/gone case/mental". This is the reason why people don't seek help.

If you are an enabler of online hate and trolling, then you can't be a mental health ally. Those two things just don't go along. Make Social networking a safer place. Many people come here seeking refuge from their real lives, but ceaseless trolling nips that in the bud.

End of rant/thread. #MentalHealthMatters #MedTwitter #SuicideAwareness
As always suggestions, questions and clarifications are welcome. 🙏😄

*symptom

*being able
@Twitter when are you going to allow us to correct our Tweets? These mistakes are irksome. I even screened the thread for this sort of errors, and yet this one crept in.