Internal Medicine Doctor, King’s College Hospital, London
Depression is a leading cause of morbidity worldwide with the WHO stating that its prevalence is over 264 million. This means that at any given time, 4% of the world’s total population will be suffering from depression. A proportion of the rise in the incidence of depression can be attributed to an increasing world population. However, it is not as simple as just that.
Firstly, mental health disorders have historically been underreported and under diagnosed globally – this very much happens to be the case in Nepal. There has been a stigma associated with mental health which means that people are less likely to go and get diagnosed and seek help. As a collectivist society, we have traditionally put a lot of importance on what others may think of us, meaning people may not seek help with mental health issues to save face in society. With education and more information regarding mental health being readily available, this is gradually changing. With individuals becoming more forthcoming, we are able to provide more diagnoses, resulting in a rise in incidence and prevalence.
Importance has to be put on destigmatising mental health issues, including depression and empowering people to feel confident enough to seek help when they are struggling.
Another reason for this increase in the incidence of depression is the ageing population – people aged 60-78 years are most likely to suffer from depression and the number of people in this demographic is rising worldwide, including in Nepal. The rise of isolation in this age group and stress are compounding factors.
I feel that the cumulative effect of lockdown, financial and economic instability will mean that we will see this trend increasing. Importance has to be put on destigmatising mental health issues, including depression and empowering people to feel confident enough to seek help when they are struggling. Everyday conversations around mental health have to be normalised, we should all feel empowered enough to speak up when we are struggling, with the trust that we will be taken seriously.
Influencer, Brand Representative, Women’s Health Advocate, Goodwill Ambassador, DfG Nepal, Miss Nepal Universe 2018
Depression is a mood disorder that negatively affects how you feel, think, work and socialise. Some depression symptoms include feeling sad, loss of interest in activities and hobbies, changes in sleep patterns, changes in appetite, loss of energy, self-esteem issues, and thoughts of suicide. Right now we are seeing depression diagnosis spike across the world, especially in teens and millennials. Similar trends can be observed in Nepal. More Nepali youths than ever before are suffering from mental health issues like depression and anxiety.
There isn’t one single reason for the decline in Nepal’s mental health, I believe there are overlapping stressors that need to be acknowledged and addressed. These stressors include financial problems, unemployment, unaccommodating education system with unsure academic schedules, hyper competitive academic culture, family disputes, social media, work-life balance, alcohol/substance abuse, and uncertain future prospects. These mentioned psycho-social factors may have already been experienced pre-pandemic by a certain portion of Nepal’s population, but as the lockdown continued, these psychological distresses increased to lead to depression and anxiety. And without proper education, awareness, and resources to help those suffering from mental health issues this past year, Nepal experienced high rates of suicide. A total of 7,141 suicides were recorded in Nepal in the 2020-21 fiscal year that ended in mid-July, up 14.2% year-on-year amid the Covid 19 pandemic, according to the latest data released by the Nepal police. Almost 90% of suicides are associated with mental health issues like anxiety and depression.
This number is heartbreaking. We need to see Nepal’s mental health crisis as a public health issue rather than a taboo individual issue. We must tackle it in the grass-root level by introducing mental health and suicide prevention curriculums in schools and colleges. We cannot let this staggering suicide number climb higher. I urge you to regularly check-in with your friends and family members and prioritise connection time. Please utilise free online resources designed to improve mental health like Anxiety Social Net, Balance App, and Daylio applications.
A total of 7,141 suicides were recorded in Nepal in the 2020-21 fiscal year that ended in mid-July, up 14.2% year-on-year amid the Covid 19 pandemic, according to the latest data released by the Nepal police. Almost 90% of suicides are associated with mental health issues like anxiety and depression. This number is heartbreaking.
During this pandemic, I have also experienced depressive episodes. I have found myself unable to get out of bed, I didn’t want to leave the house even once the lockdown eased. I had gained weight and was unhappy. I was static in my daily life. After realising that months had passed and I was mentally in the same place, stagnant, I decided to seek help. I needed to wake up. Get my mind to move to do something. It was during this time I saw a few posts on my social media about mental health and depression and I had a hunch that this could be what I was going through.
So, I attended a few webinars on mental health, some of which were organised by Healthy Minds Nepal. I started forcing myself out of bed and going for long walks. I made it a point to listen to affirmations every day, sometimes even twice a day. I began to read for pleasure and journaling. I can say that I am now mentally at a better place than I was six months ago. I am still working to improve my mental health through everyday action. I hope that whoever is reading this will also be able to take steps to seek help and improve their mental wellbeing.
Nina Kant Mandal
Miss Universe Nepal 2020 2nd Runner Up, Miss Asia Russia 2018, Mental Health Advocate, Model
Depression is a complex condition which now is highlighted more than ever as the world is going through a major strike in human history. The pandemic has caused us to live in a new normal. A new normal which triggered behavioural patterns that caused depression. If you are locked up in the four walls of your house, or are stuck abroad not able to get back home, or went through a loss of loved ones due to the virus, of course it will have an impact on how you live your life.
But depression has always been there and I believe that what might have caused it to become so common nowadays (or I would even say more talked about) is the fact that more and more people feel comfortable sharing their emotional experiences. The awareness that so many mental health advocates around the world spread, brings reassurance for those who are suffering that they are not alone in this battle. And therefore so many online services have been created for easier and cheaper access to psychological help for people of any income, which was not there before. This is a beautiful thing that the internet has given us, it has become a tool to spread awareness and fight the stigma which previously (and unfortunately even now) stopped so many people from getting professional help and I was one of those people too once. Yet we shall not forget that constantly being online can also be a trigger and need to always remember about our health outside of the internet. Some things that could help are: meditation, exercising, healthy eating, spending more time outside in nature and with loved ones making real life connections instead of only online ones and of course getting professional help.
Actor & Model
The root causes of depression maybe emotional trauma, abandonment in childhood, sexual assault, etc. I think the rise in depression in today’s world is mainly because of the way it is functioning. I don’t think it is healthy because we want more than we actually need. We live in a very fast paced world where everyone is working and hardly have time for family. Depression is also mainly caused when one is lonely and has no one to talk to. So, it is also very important to have a good circle of people to talk to. Even if most people are working and networking, it is very difficult to trust someone which is completely fine because we cannot connect with everyone as human beings. I think the most important thing is to be inclined to one’s inner-self and understand oneself better.
Ashrayata Karki Chaudhary
Chairperson, Nepal Super League
It is undoubtedly true that depression and mental health issues are on the rise; be it in the media, health policy debates, or social and personnel settings. While depression was not a common currency among people even a decade ago, it has suddenly emerged as something that we come across more rampantly and regularly mainly among the younger generations.
Can this be attributed simply to rising awareness and access to information? Worth speculating but it seems not. Based on a survey, Twenge in his book Generation Me (2014) concluded that while only 1 to 2% of the population born before 1915 experienced a major depression in their lives, this figure is up by 15 to 20% in the millennial.
Strangely enough while we live in a time of extreme privilege brought mainly by the unrivalled access to modern technology, this in-itself could also be a blight on modern society. Access to information has made people more aware of the extensive range of potential that can be attained; whether professionally or materially. But not being able to achieve these aspirations leaves people ungrounded and unfulfilled. Many studies also blame social media for bringing unhappiness and unwarranted social pressure. Perhaps rightly so – regularly seeing others enjoying better privileges, looking beautiful, and having a good time can make those who do not have the same means or privileges feel inferior and empty while others may feel pressurised to keep up.
I also believe that society today is more focused on goals such as money, fame and image and have much higher expectations and ambitions. But there is a growing and worsening gap between the vast ranging potential of what can be attained and the ground reality regarding the means to achieve them leaving people anxious and depressed.
Importantly, relationships and community ties which provide a good safety net in times of crisis has become weaker thus making it harder for the younger generations to cope in an increasingly complex world.
The cost of living is rising alongside unemployment. Many young people juggle between jobs to make ends meet or to achieve ‘a better life’. The lack of employment and the means to achieve their aspirations, are making our young adults desperate to emigrate to bigger and more developed countries. But not everyone is able to find or manage this exit.