Sunday, 29 January 2017

Lifestyle changes cause: Prescriptions for major depression up 14% in 2016

Indians popped more anti-depressants than ever before in 2016, indicating perhaps that they are now more open to the idea of seeking help for mental health problems. 

Around 10.6 lakh more prescriptions for anti-depressants were written in 2016 than in 2015, shows data collated by health information agencies. While 3.35 crore prescriptions (for new patients) were written in 2015, doctors wrote 3.46 crore new prescriptions in 2016. 
In fact, the number of prescriptions written out only by psychiatrists in 2016 represented a 14% increase from the previous year. Psychiatrists treat patients with major depressive disorders while doctors hailing from multiple specialties treat patients with mild depression or disease-related depression. 
Depression, though widely spread in India, is rarely given importance in the public health system, which is burdened by infectious diseases such as tuberculosis and dengue as well as non-communicable diseases such as diabetes and hypertension. In October 2016, the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru released a mental health survey that said one in every 20 Indians suffered from some form of depression. The prevalence of depression across the world has increased to such an extent that it's the theme for the World Health Organisation's World Health Day on April 7. 

When contacted, NIMHANS director Dr B N Gangadhar said the increase in the number of prescriptions could also be an indication of the increasing number of psychiatrists in India. "There is no doubt that people are more open than before to seek help for depression, but a 14% rise in prescriptions could also mean there are more psychiatrists today than before," Dr Gangadhar said, adding that roughly 360 new psychiatrists graduate annually. 

Mumbai-based psychiatrist Dr Harish Shetty said there has been a tremendous increase in awareness about mental health. "There is a 100% increase in the number of patients coming to psychiatrists in the last couple of years," he said, adding that the increase could be the tip of the iceberg. 
Goa-based Dr Vikram Patel, who is attached to the London School of Hygiene and Tropical Medicine, said anti-depressants have low penetration in India. "If there is an increase, it is not surprising as more people seek help these days. This doesn't mean there is an increase in the incidence of depression, but there is an increase in awareness," he said. 

A recent survey by a pharma major recently listed family pressure, relationship issues as well as biological changes as the leading causes of depression among Indians. Dr Shetty pinpointed the "rapid shifts taking place in India" in the fields of finance, education, workplace, family, among others, as the major cause for depression. "People try to cramp in a century of living within a decade. The brain is being challenged beyond its potential, leading to an increase in depression rates.It is like an orchestra being disrupted," said Dr Shetty. 

Depression is closely linked to social determinants. "Some may suffer from depression due to economic difficulties such as debt while women may suffer due to mental difficulties such as domestic violence," said Dr Patel. He said cities witness higher rates of depression as people, many who have migrated from other parts, don't have any social support system. "There is more stress and more aspiration in urban areas, increasing the risk of depression among residents."