0

ABSTRACT
Depression is a
disease most of us
think we understand
but know nothing
about, along with the
social stigma and
ignorance that
surrounds it, it is a
very common health
issue today.
By
YUKTHA.B. S
CLINICAL
XI.A
DEPRESSION: ERASE Roll. No. 19
THE STIGMA
ARYA CENTRAL SCHOOL
PATTOM, TRIVANDRUM.

Class XI
A/Y: 2020-2021

Report of
Investigatory Project in Biology Titled Clinical
Depression: Erase the stigma

Roll No: 19
 Certificate

Certified that this is a bonafide report of

Investigatory Project in Biology Titled Clinical Depression: Erase
the stigma by Yuktha. B. S of Arya Central School in
accordance with the syllabus of Class XI.

Teacher in Charge Examiner

(Seal)

Principal
 AKNOWLEDGMENT

I express my sincere gratitude to my Principal Mrs.

Maitreyi Rajesh and my biology teacher Jisha Venugopal
Mam and all the other people who have guided,
supported, motivated, inspired and given suggestions
and criticized me during the project.
It gives me immense pleasure to acknowledge their
cooperation.
I would like to thank the Almighty for helping me go
ahead with this work at times when I felt I was not
capable of doing it myself.
Finally, I express my deepest gratitude to all my friends
and my family whose suggestions and creative criticism
were quite invaluable.

YUKTHA. B. S
XI. A
 TABLE OF CONTENTS

Introduction…………………………5
Types of depression…………………7
Symptoms and signs……………….10
Contributing patterns…………….14
Stigma………………………………16
Effects of Stigma…………………16
Steps to cope………………………20
Erase the stigma………………….24
Conclusion ……………………….23
Bibliography……………………….24
INTRODUCTION

Depression is a common illness worldwide, with more than

264 million people affected. Depression is different from
usual mood fluctuations and short-lived emotional
responses to challenges in everyday life. Especially when
long-lasting and with moderate or severe intensity,
depression may become a serious health condition. It can
cause the affected person to suffer greatly and function
poorly at work, at school and in the family. At its worst,
depression can lead to suicide. Close to 800 000 people die
due to suicide every year. Suicide is the second leading
cause of death in 15-29-year-olds.

Although there are known, effective treatments for mental

disorders, between 76% and 85% of people in low- and
middle-income countries receive no treatment for their
disorder. Barriers to effective care include a lack of
resources, lack of trained health-care providers and social
stigma associated with mental disorders. Another barrier to
effective care is inaccurate assessment. In countries of all
income levels, people who are depressed are often not
correctly diagnosed, and others who do not have the
disorder are too often misdiagnosed and prescribed
antidepressants.
TYPES OF DEPREESION

Depending on the number and severity of symptoms, a

depressive episode can be categorized as mild, moderate or
severe.

A key distinction is also made between depression in people

who have or do not have a history of manic episodes. Both
types of depression can be chronic (i.e., over an extended
period) with relapses, especially if they go untreated.

Recurrent depressive disorder: this disorder involves

repeated depressive episodes. During these episodes, the
person experiences depressed mood, loss of interest and
enjoyment, and reduced energy leading to diminished activity
for at least two weeks. Many people with depression also
suffer from anxiety symptoms, disturbed sleep and appetite,
and may have feelings of guilt or low self-worth, poor
concentration and even symptoms that cannot be explained
by a medical diagnosis.

Depending on the number and severity of symptoms, a

depressive episode can be categorized as mild, moderate or
severe. An individual with a mild depressive episode will have
some difficulty in continuing with ordinary work and social
activities but will probably not cease to function completely.
During a severe depressive episode, it is unlikely that the
sufferer will be able to continue with social, work or domestic
activities, except to a limited extent.

Bipolar affective disorder: this type of depression typically

consists of both manic and depressive episodes separated by
periods of normal mood. Manic episodes involve elevated or
irritable mood, over-activity, pressure of speech, inflated self-
esteem and a decreased need for sleep.
SYMPTOMS AND SIGNS

Major depression significantly affects a person's family

and personal relationships, work or school life, sleeping and eating
habits, and general health.

A person having a major depressive episode usually exhibits a low

mood, which pervades all aspects of life, and an inability to
experience pleasure in previously enjoyable activities. Depressed
people may be preoccupied with—or ruminate over—thoughts and
feelings of worthlessness, inappropriate guilt or regret,
helplessness or hopelessness. In severe cases, depressed people
may have symptoms of psychosis. These symptoms
include delusions or, less commonly, hallucinations, usually
unpleasant. Other symptoms of depression include poor
concentration and memory, especially in those with melancholic or
psychotic features, withdrawal from social situations and activities,
reduced sex drive, irritability, and thoughts of death or
suicide. Insomnia is common among the depressed. In the typical
pattern, a person wakes very early and cannot get back to sleep.
Hypersomnia, or oversleeping, can also happen. Some
antidepressants may also cause insomnia due to their stimulating
effect.

A depressed person may report multiple physical symptoms such

as fatigue, headaches, or digestive problems; physical complaints
are the most common presenting problem in developing countries,
according to the World Health Organization's criteria for
depression. Appetite often decreases, with resulting weight loss,
although increased appetite and weight gain occasionally
occur. Family and friends may notice that the person's behaviour is
either agitated or lethargic. Older depressed people may
have cognitive symptoms of recent onset, such as
forgetfulness, and a more noticeable slowing of movements.
Depressed children may often display an irritable mood rather than
a depressed one, and show varying symptoms depending on age
and situation.] Most lose interest in school and show a decline in
academic performance. They may be described as clingy,
demanding, dependent, or insecure. Diagnosis may be delayed or
missed when symptoms are interpreted as "normal moodiness."

Usually, for depression to be diagnosed, a person must have five or

more of these symptoms:

 Depressed mood for most of the day (feelings of sadness,

emptiness, and/or hopelessness)
o Teenagers may be irritable (they may
get angry easily) instead of seeming depressed
 Feeling much less interested than usual in all, or almost all,
activities; or not getting any pleasure from activities
 Significant weight loss (when not dieting) or weight gain
(generally a change of 5% or more in body weight)
 Sleeping more than usual, or having trouble sleeping
 Moving around more than usual (psychomotor agitation)
or moving more slowly than usual (psychomotor
retardation)
 Feeling tired or not having energy, nearly every day
 Feeling worthless or guilty
 Not being able to think, concentrate, or make decisions
normally
 Thinking a lot about death (not just being afraid to die)
Most people who have not had depression do not completely
understand its effects. Instead, they see it as simply being sad.
Since it is not understood, many people criticize people with
depression for not helping themselves.
Contributing factors and prevention
Depression results from a complex interaction of social,
psychological and biological factors. People who have gone
through adverse life events (unemployment, bereavement,
psychological trauma) are more likely to develop
depression. Depression can, in turn, lead to more stress and
dysfunction and worsen the affected person’s life situation
and depression itself.
There are interrelationships between depression and
physical health. For example, cardiovascular disease can
lead to depression and vice versa.
Prevention programmes have been shown to reduce
depression. Effective community approaches to prevent
depression include school-based programmes to enhance a
pattern of positive thinking in children and adolescents.
Interventions for parents of children with behavioural
problems may reduce parental depressive symptoms and
improve outcomes for their children. Exercise programmes
for the elderly can also be effective in depression
prevention.

Possible causes

There are many theories about what causes depression. These theories
include:

 Heredity (someone's genes): Depression often runs in families.

However, people can get depression even if they are not related to
anyone else who has it.
 Physiology: The amounts of some chemicals in the
brain. Serotonin is the main chemical in the brain that has to
do with happiness. Many antidepressant medications work by balancing the
amount of serotonin in the brain.

 Psychological factors: Low self-esteem and harmful thinking

 Early experiences: Events such as the death of a parent or
guardian, abandonment or rejection, neglect, chronic illness, and
severe physical, psychological, or sexual abuse.
 Life experiences: Losing a job, homelessness, problems with
money, death of a loved one, relationship problems, separation
from a partner, being a victim of crime, or other life problems can
cause depression.
 Medical conditions: Some illnesses, such
as hypothyroidism, hepatitis, mononucleosis, or head injuries, may
contribute to depression.
 Alcohol and other drugs: Alcohol can make people depressed. If a
person abuses alcohol, benzodiazepine-based tranquillizers,
sleeping medications, or narcotics, it can affect how long their
depression lasts and how bad it is. Some medicines like birth
control pills and steroids may also contribute to depression.
 Pesticides: Several scientific studies have found statistical links
between depression and some pesticides.

Stigma
Historical figures were often reluctant to discuss or seek treatment for
depression due to social stigma about the condition, or due to ignorance of
diagnosis or treatments. Nevertheless, analysis or interpretation of letters,
journals, artwork, writings, or statements of family and friends of some
historical personalities has led to the presumption that they may have had
some form of depression. People who may have had depression include
English author Mary Shelley,] American-British writer Henry James, and
American president Abraham Lincoln. Some well-known contemporary
people with possible depression include Canadian songwriter Leonard
Cohen and American playwright and novelist Tennessee Williams. Some
pioneering psychologists, such as Americans William James and John B.
Watson, dealt with their own depression.
There has been a continuing discussion of whether neurological disorders
and mood disorders may be linked to creativity, a discussion that goes back
to Aristotelian times. British literature gives many examples of reflections on
depression. English philosopher
John Stuart Mill experienced a several-months-long period of what he called
"a dull state of nerves", when one is "unsusceptible to enjoyment or
pleasurable excitement; one of those moods when what is pleasure at other
times, becomes insipid or indifferent". He quoted English poet Samuel Taylor
Coleridge's "Dejection" as a perfect description of his case: "A grief without a
pang, void, dark and drear, / A drowsy, stifled, unimpassioned grief, / Which
finds no natural outlet or relief / In word, or sigh, or tear." English
writer Samuel Johnson used the term "the black dog" in the 1780s to
describe his own depression,[312] and it was subsequently popularized by
depression sufferer former British Prime Minister Sir Winston Churchill.
Social stigma of major depression is widespread, and contact with mental
health services reduces this only slightly. Public opinions on treatment differ
markedly to those of health professionals; alternative treatments are held to
be more helpful than pharmacological ones, which are viewed poorly. In the
UK, the Royal College of Psychiatrists and the Royal College of General
Practitioners conducted a joint Five-year Defeat Depression campaign to
educate and reduce stigma from 1992 to 1996; a MORI study conducted
afterwards showed a small positive change in public attitudes to depression
and treatment.

Stigma is when someone views you in a negative way because you

have a distinguishing characteristic or personal trait that's thought
to be, or actually is, a disadvantage (a negative stereotype).
Unfortunately, negative attitudes and beliefs toward people who
have a mental health condition are common.
Stigma can lead to discrimination. Discrimination may be obvious
and direct, such as someone making a negative remark about your
mental illness or your treatment. Or it may be unintentional or
subtle, such as someone avoiding you because the person assumes
you could be unstable, violent or dangerous due to your mental
illness. You may even judge yourself.
Some of the harmful effects of stigma can include:

 Reluctance to seek help or treatment

 Lack of understanding by family, friends, co-workers or
others
 Fewer opportunities for work, school or social activities or
trouble finding housing
 Bullying, physical violence or harassment
 Health insurance that doesn't adequately cover your
mental illness treatment
 The belief that you'll never succeed at certain challenges or
that you can't improve your situation

 Steps to cope with stigma

Here are some ways you can deal with stigma:

 Get treatment. You may be reluctant to admit you need

treatment. Don't let the fear of being labelled with a
mental illness prevent you from seeking help. Treatment
can provide relief by identifying what's wrong and reducing
symptoms that interfere with your work and personal life.
 Don't let stigma create self-doubt and shame. Stigma
doesn't just come from others. You may mistakenly believe
that your condition is a sign of personal weakness or that
you should be able to control it without help. Seeking
counselling, educating yourself about your condition and
connecting with others who have mental illness can help
you gain self-esteem and overcome destructive self-
judgment.
 Don't isolate yourself. If you have a mental illness, you
may be reluctant to tell anyone about it. Your family,
friends, clergy or members of your community can offer
you support if they know about your mental illness. Reach
out to people you trust for the compassion, support and
understanding you need.
Don't equate yourself with your illness. You are not an illness. So
instead of saying "I'm bipolar," say "I have bipolar disorder."
Instead of calling yourself "a schizophrenic," say "I have
schizophrenia."

 Join a support group. Some local and national groups, such

as the National Alliance on Mental Illness (NAMI), offer
local programs and internet resources that help reduce
stigma by educating people who have mental illness, their
families and the general public. Some state and federal
agencies and programs, such as those that focus on
vocational rehabilitation and the Department of Veterans
Affairs (VA), offer support for people with mental illness.
 Get help at school. If you or your child has a mental illness
that affects learning, find out what plans and programs
might help. Discrimination against students because of a
mental illness is against the law, and educators at primary,
secondary and college levels are required to accommodate
students as best they can. Talk to teachers, professors or
administrators about the best approach and resources. If a
teacher doesn't know about a student's disability, it can
lead to discrimination, barriers to learning and poor
grades.
 Speak out against stigma. Consider expressing your
opinions at events, in letters to the editor or on the
internet. It can help instil courage in others facing similar
challenges and educate the public about mental illness.
Others' judgments almost always stem from a lack of
understanding rather than information based on facts. Learning to
accept your condition and recognize what you need to do to treat
it, seeking support, and helping educate others can make a big
difference.
ERASE THE STIGMA

To understand stigma, it is essential to recognise the effect that

depression has on those associated with the depressed individual.
Depressives are both negative and self-involved. For the carer it can
often be extremely difficult to understand why their partner should
be in such a condition. Worse still, depressives are almost totally
negative in all their attributions and also obsessively self-involved
which makes them unattractive company. In an experimental study,
subjects were asked to speak on a telephone with a patient who,
unknown to them, was depressed. Their reports on their
conversation were, not surprisingly, negative.

Other studies confirm that depressed individuals have a negative

impact on those with whom they interact, for example, at work.
When in a position of power, they tend to exploit their position and
in subordinate roles tend to blame others.

There can be no doubt that there is considerable stigma associated

with depression an example of how stigma can present a particularly
difficult problem for sportsmen is provided by the case of a
professional footballer, Stan Collymore who played for England. He
had a severe depression and his career went into a rapid decline. He
says that he can never forgive the Aston Villa manager for the way
he reacted to his depression. He told him to pull his socks up and
that his idea of depression was that of a woman living on a 20th
floor flat with kids. The Sun newspaper said that he should be
kicked out of football as how could anyone be depressed when he is
earning so much money. He bitterly remarks that if you suffer from
an illness that millions of others suffer from, but it is a mental
illness which leads many to take their own lives, then you are called
spineless and weak.

Just as important, perhaps more so, is the self-stigmatisation of

those with depression as it can have serious effects on how
individuals deal with their illness. Those with depression see it as
something to be ashamed of, and so keeps it a secret. One young
woman cannot even tell her father who is a psychiatrist and another
woman could not confide in her brother or sister who knew nothing
of her suicide attempts. One reason is that whoever you tell is
embarrassed and does not know quite what to say. There is also a
sense of failure in not having handled it. That is why depressives
can talk so openly to each other about their experience.

The shame and stigma associated with depression can prevent those
with the illness admitting they are ill. There is also the stigma of
taking antidepressant medication which is perceived as mind
altering and addictive. Stigma may also cause somatic symptoms as
it is more acceptable to talk of stomach ache and fatigue than mental
problems.

A major difficulty in overcoming stigma, and indeed probably one

of the causes, is that it is very hard, perhaps impossible, for those
who have not experienced depression to understand what the
individual with depression is experiencing As Styron wrote ‘the
pain of severe depression is quite unimaginable to those who have
not suffered it’. The experience is almost impossible to describe and
the situation is not helped by the almost total absence of good
descriptions of depression in English novels – I know of none.
Writers have described their own depression but none in novels;
Virginia Woolf, herself a depressive, never does.
CONCLUSION
There are many attempts to account for stigmatisation of mental
illnesses. Mental illnesses are perceived as different as they express
themselves through those very characteristics that make us human –
cognitive and affective and behavioural – and thus differ from
physical illnesses. Mental illness is thus seen as embodying the core
of the person and not just affecting some organ like the heart or
lungs. But different mental illnesses each have their own
characteristics in relation to stigma. For example, unlike depression,
people with schizophrenia or addictions are perceived as being
dangerous. But depressives are seen as unpredictable people who, if
they really tried, could pull themselves together

What can be done to reduce the stigma associated with depression?

There is no easy answer not least because acutely ill depressives are
not attractive company. Perhaps the most important aim would be to
publicise just how wide-spread depression is and that it is a serious
illness. Most important is that it can be cured. It could help a great
deal if those individuals with depression who are well known public
figures were to support such a campaign; Collymore is an obvious
example. That they do not make their condition public is itself due
to stigma which will make their co-operation hard to get. A
neglected area is health education in schools. This is odd as one of
the common illnesses that teenagers suffer from is depression and
yet they are given no information about its nature.
BIBILOGRAPHY
 https://academic.oup.com
 https://www.mayoclinic.org
 https://www.who.int
 https://simple.wikipedia.org/wiki/Depression_(me
ntal_illness)
 https://en.wikipedia.org/wiki/Major_depressive_d
isorder