#MajorDepression-A True Case History

 This is about Pawan,who came to me for counselling three months ago.I could see at a glance that he was severely depressed.His facial expression,posture,gait,voice-everything proclaimed this to any casual observer.Before starting the session I assured him that according to the norms of us counselors,whatever he told me would not go beyond the walls of my clinic,so that he could rest easy on that score.

He told me he was 60 yrs old,had three sons,and they all lived in a three storied bungalow.He was happily married,and had been an elite performer in his company till a few years ago,though lately it was all becoming too much for him.He felt bowed down with duties and responsibilities.His sleep was very poor and though healthy,he felt very lethargic.He had been on psychiatric medicines since many years.It turned out that he had suffered two episodes of #Depression many years ago.At present He was taking a medicine prescribed by his old doctor but it was not doing him any good.

I asked him what it was,which was troubling him so much.He replied that one of his sons had started construction work in his portion a few days back but he agreed to stop it after the father's  objection.That way,his sons were quite obedient.Besides this he could not state any specific problem which was distressing him.He just felt overworked and incapable of sorting his issues.I asked him to gather his family,reveal his tensions and ask who could do what,to lessen his burden.

I suggested that he should go for a physical check up to rule out any disease which could be the cause of his tensions.I also encouraged him to go for morning walks and do regular exercises.He was asked to be more active during his waking hours,since his official duties were not much to speak of.He replied that he did not have any friends or hobbies so there was nothing for him to do.I told him that he could do small things aroind the house,chit-chat with his family,reveal his worries and ask about their concerns.

He was asked to try his best and report after four days.He did not come after four days but did after two months.He was even more woebegone this time.I recommended a psychiatrist whom I knew as being very competent.Perhaps a change of medicine and approach was needed.

And mere medicine was not enough.In order to get relief he had to change his whole routine and lifestyle.He must interact with those around him,greet people and say a few words to them.Even to the vendors.He should talk about his difficulties to those whom he could trust.Instead of thinking all the time about his own problems he should be more mindful of his surroundings,watch all that was happening around him and take interest in others' lives and problems.Yoga and meditation too,were very good for calming the min.If he started doing all this his track of negative thoughts would be replaced by a better one and his depression would ease. 

He was asked to return after one week.But true to his nature, he did not return after one week.Instead,he came after one month and told me that he felt as if his mind was failing him.He had not consulted the psychiatrist suggested by me.His whole life was in disarray.Uptill now he had striven to earn more and more,without any consideration of it's effect on the whole structure of his and his family's life.The way in which he had expanded his house and let in various tenants,now could not be undone.But it had definitely multiplied his problems.

I asked him to recount the steps he had taken to lessen his anxiety.He replied that he went for swimming in the morning and felt better after that.I explained that physical exercise consumed the harmful chemicals generated through worries and fears,and it was very beneficial for lessening anxiety-he should do more of it. It turned out that he was doing things like clapping his hands or meditating but not reaching out to anyone around him.

I asked him if it was because he felt that his personality had deteriorated and people would look down upon him.He said yes.I told him he was not the only one suffering from anxiety and most people had so much on their minds that they had little time to judge others.His self imposed isolation was doing him more harm than anything else.Those who did not isolate themselves recovered faster.Since his old methods were not showing good results it was time to change them.He was again motivated to go out and connect with others.

I asked him to  clarify his thoughts and come next week.However he did not come.I asked about his wellbeing after one month,but he did not respond.Then I left the onus on him and closed the case.