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Changing Perspectives on Depression

Public attitude towards mental disorders, especially depression, has seen a sharp turn around from sympathy for the sufferer to one of anger, since the recent German wings airline crash in the Alps, in which the co-pilot, suspected to be suffering from depression is alleged to have intentionally crashed the plane killing 150 innocent people on board.

Depression, a mental disorder estimated to affect 350 million people worldwide is indeed common and occurs in up to 20% of us. It is characterized by low mood, feelings of sadness, lack of enthusiasm and negativity. The traditional attitude of medical personnel as well as civil society has been to allow privacy to sufferers, and try and integrate them into the mainstream of life, ensuring they are not discriminated against.

Events such as the recent airlines tragedy, and the mindless killing of innocent school children in USA and Norway by depressed men are however raising uncomfortable questions on how we should respond to individuals with depression.

Permitting secrecy of their condition and treatment details to some to enable them to avoid social stigma may be one thing, but the recent outrage calling for full disclosures of medical history of personnel in sensitive jobs have their equally vocal proponents.

Depression unfortunately does not have a biomarker, such as a blood test or an MRI scan, the diagnosis being made almost entirely by self-reporting of symptoms by the patient during an interview with the psychiatrist. It is therefore quite subjective, one counselors ‘depression’ being another’s ‘normal’.

It is therefore extremely easy for prospective candidates undergoing psychological health checks to conceal their feelings and present themselves as “normal” as their disclosure may affect their employment and promotion. Further, history of having taken mood-elevators is also so common that branding anyone who has required an anti-depressant during a difficult phase of life may not justify a permanent branding.

But when lives are at stake, organizations such as airlines or defense forces are likely to come under intense pressure to screen their employees with imperfect tools. Hopefully this should spurn scientists to look for a reliable bio-marker, such as a functional MR spectroscopy that can measure the levels of neuro-transmitters in the brain, and make a more objective bio-medical diagnosis.

Contributed by-

Dr. (Prof) Gourdas Choudhuri,
Chairman, Department of Gastroenterology and Hepato-biliary Sciences,
Fortis Memorial Research Institute, Gurgaon, Haryana.
The article has been published in HT City, Lucknow.
To read more articles by Dr. G. Choudhuri, please visit www.drgchoudhuri.net

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