KARACHI: TRIGGER WARNING!
Depression reveals itself in various forms. There is no ballpark on how to handle the agony. The conundrum can rarely be explained unless one has experienced it themselves.
Even then, it is difficult to find words to exhaustively capture the experience because it impacts each individual in a different manner. For some, the pain washes over in waves through the day and for others its an ever-present feeling of numbness.
Anam Tanoli's suicide urges us to discuss mental health more candidly, so we can identify and help those who see no return, who see no escape from the hapless chaos that engulfs the mind of a depressed individual.
With the digital age subsuming every aspect of our daily lives, research has increasingly focused on one of the leading triggers for mental stress - cyber bulling. Before her death, Tanoli addressed bullying on her Instagram, saying, "Bullying is bad. Don't do it. It's a coward's way out. It's a pathetic way out. Don't let it affect you, don't let it bring you down."
But while the bullies got to Tanoli and escalated her depression, the triggers for depression vary for every person. For 24-year-old budding journalist Azka, depression and suicidal ideation became an unwanted guest when a close relationship ended, opening up a Pandora's box of phantasmagorical demons that had been waiting in the shadows long long before.
She has been battling depression since 2017, and on and off in the years before. She reflects on its impact on her, giving it a narrative tale to explain the unpredictable nature of the illness.
"December: grief, tears, denial, pleading, rejection, emptiness. January: grief, tears, pain, pain. February: grief, tears, hopelessness, self-exile. Now pain is of a different nature- less fluid and more settled, less pricking and more numbing, and more predictable - but not entirely," she wrote on her blog.
Speaking to The Express Tribune, Azka shared how her grief triggered her depression.
"A Pandora's box essentially opened. I felt I was in a constant struggle against these demons, who I couldn't touch or feel, but who followed me wherever I walked. They ate from my plate, and they drank from my cup. I felt so, so alone," she said.
"The struggle hasn't really left me. At the time, when the feelings were particularly strong and all-enveloping, I felt I was a monumental failure. I was in so much pain, I couldn't see anything but it. I felt embarrassed, small, like I was a defected human being. I had lost my partner and my best friend, and (then) I didn't even know why," Azka shared.
Reminiscing the journey of coping, she explained, "I think the hardest part is to accept that you have that illness. It took me a very long time to even be diagnosed with it-giving it a name helped, because then I researched about, I talked to other people, I felt less alone." She added, When people told me, in goodwill and sometimes out of ignorance, 'things will get better with time' or 'stick it out', of course it didn't logically make sense. They didn't see that the illness had changed my concept of time to one of oblivion."
"You don't think you could ever get out, because you're in so deep, time stopped operating in the same manner. And that's the crucial point- it doesn't help, rather it makes things worse, to make cliché suggestions like that to somebody in a lot of pain- which is why medical expertise is so important."
Azka continued, "Sometimes, it is still hard not to look in the mirror and not feel intense disgust. All the bad inner voices- consolidated by my bullies in school- told me to go jump from my window, or fling myself at a metro, or throw myself into the Danube." She went on to share that it took her a lot of strength, friendship, therapy, and medication to keep herself warm during the long harsh winter.
"I knew then so many others felt this way too, and I wondered what I could do to help them. I know now it is to insist on seeking therapy and remove all hints of shame associated with the word. I know I am alive today because of professional help, and the support of my friends and my brother who kept a shining light through the darkness at the time. It is difficult, if not impossible, to tackle depression –particularly clinical depression- and anxiety without an expert's help."
People would tell Azka to distract herself from dark thoughts - by indulging in more social events or listening to music – but it didn't work. "My depression completely changed my concept of time. Depression isn't some temporary sadness. It is a disorder that needs more serious attention."
She concluded, "Now that I've moved back home, I've continued therapy and I can't be grateful enough for my therapist. Pakistan needs better mental health care provision- therapists, psychologists, and psychiatrists that provide counsel and guidance from a young age."
Maham Saeed is a clinical psychologist, who has recently completed her Masters in Psychology from NUST, Islamabad. When asked whether she dealt with many patients struggling with mental health during her internship at Military Hospital, Rawalpindi, Saeed replied, "Pakistan has a very large number of population suffering from depression and anxiety. So if we compare to that, there is a very little number of clients we see who are seeking professional help. You can't really expect someone to understand the ordeal of a person suffering from depression unless you're going through it."
She stated, "The first thing we all need to comprehend is that depression actually exists.”
“There’s a certain stigma attached to mental health in Pakistan. So, first things first, we need to understand that mental health is just as important as our physical health,” she went on.
According to Saeed, the first task is to realise that there's an actual need of professional help. The second is to seek it. And, here is when the role of friends, peers and family comes in.
"People surrounding a depressive person have to be supportive when he/she opts for professional help," added Saeed. "There are various methods of therapies available to cure clients - depending on how serious the disorder is. When a client is getting better, it easily shows. He will become more interactive, will have more energy. Otherwise, there are some tests as well, which can determine whether the treatment is working or not."
PTI Presidential elect, Dr Arif Alvi earlier called for a 24/7 helpline to address mental health issues post Tanoli's passing away. However, a non-profit organisation, Talk2Me, has taken the initiative to help people suffering from depression and grief.
Talking to The Express Tribune, Talk2Me's member of Board of Directors, Dr Sara Farrukh explained, "It's an initiative to help people get a better understanding of mental health."
"The idea of Talk2Me came two years ago to its CEO Adeel Choudry. We're still trying to establish it on a bigger and better scale. We hope that more people reach out to us in case they wish to talk," said Farrukh, who looks after the UK region of Talk2Me.
How does it work?
"Well, basically, what we do is that if someone calls on Talk2Me, we connect them to a counselor. A suitable timing is agreed upon when client and counselor usually interact in a telephonic conversation," she added.
"Talk2Me is completely working on voluntarily basis. We hope to have better resources to expand our initiative and help more people," Farrukh concluded.
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