Depression often shows up as a backache, not sadness
Many people with depression see a doctor only for pain, tiredness or poor sleep. About 15 crore Indians need mental health care, and most never get it.
When people imagine depression, they picture someone crying, or someone who can't get out of bed. That happens. But very often, especially here, depression walks into a clinic as a headache that won't go, a stiff back, a heaviness in the chest, stomach trouble, constant tiredness, or sleep that never feels restful.
A large international study in general clinics across 14 countries, including India, found that most patients with depression mentioned only physical symptoms when they saw their doctor. Pain and depression also feed each other. Long-lasting pain wears down mood, and depression lowers the body's tolerance for pain. People can go through years of tests, scans, painkillers and tonics while the real cause goes unnamed.
India's National Mental Health Survey estimated that about 15 crore people in the country need active mental health care, and that between 70% and 92% of people with a mental health condition get no treatment at all.
Signs it may be more than physical - Aches that move around, or have no clear cause after tests. - Losing interest in things you used to enjoy. - Feeling low, empty or irritable most days for two weeks or more. - Sleeping much more or much less than usual, or waking very early. - Changes in appetite, trouble concentrating, or feeling worthless or guilty.
None of this means the pain isn't real. It is. But if several of these sound familiar, ask your doctor about depression directly, or speak to a psychologist or psychiatrist. It is one of the most treatable conditions there is.
Where this comes from - National Mental Health Survey of India, 2015-16. NIMHANS. - Simon GE et al. An International Study of the Relation between Somatic Symptoms and Depression. New England Journal of Medicine, 1999.
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