Annexure 1

SOCIETAL DEPRESSION: “AN ONGOING PANDEMIC”

COMMUNITY DEVELOPMENT PROJECT (GEN 231)

Submitted by:
YUSUPHA SINJANKA

Registration Number:
12111133

In partial fulfilment for the requirements of the award of the degree of

“B. Tech (Computer Science and Engineering)”

“School of Engineering”

PHAGWARA, PUNJAB
Annexure 2
 ACKNOWLEDGEMENT

I would like to express my special thanks of gratitude to my project guide Mr

Aryan Agnihotri (Vairamani Foundation) as well as my university LOVELY
PROFESSIONAL UNIVERSITY which gave us a golden opportunity to do this
wonderful community development project on the topic Societal ‘Depression:
“An Ongoing Pandemic”’ which resulted me to doing a whole lot of research
and really learning many new things.
In successfully completing this project, many people have helped me. I would
like to thank all those who are related to this project.

Finally, I would like to thank my parents and friends who have helped me with
their valuable suggestions and guidance and have been very helpful in various
stages of project completion.

Date: 28th May-8th July

Name: Yusupha Sinjanka

Reg no: 12111133

Roll no: RK21ZN

 Annexure 3

TABLE OF CONTENTS
1. Introduction

2. Problem identification

3. Cause of problem

4. Objective to be achieved

5. Various steps taken to achieve the objectives

6. About the organisation

7. Effectiveness of the project

8. World health organisation report

9. Personal project

10.Testimonial of the work done

11.Conclusion
 INTRODUCTION

As estimated by World Health Organisation, depression shall become the

second largest illness in terms of morbidity by another decade in the world,
already one out of every five women, and twelve men have depression. Not
just adults, but two percent of school children, and five percent of
teenagers also suffer from depression, and these mostly go unidentified.
Depression has been the commonest reason why people come to a
psychiatrist, although the common man's perception is that all psychological
problems are depression. What one sees in most patients is the myth related
to depression. People still believe that it is because of some weakness in
personality, or that one can cure it by oneself, or that medication would
go lifelong and are mere sedatives.

All these are myths, and mostly created by faith healers, or unqualified
counsellors, and non-medical experts for their own vested interest, and
largely by an unaware of society. An increased awareness, and approach to
psychiatrists, has been the main reason for the increase in number of
patients and not necessarily an increase in prevalence. With newer
medication, and better facilities, treating depression has become easier, and
most people respond very well to treatment, and return to
optimum functioning very soon.

Depression is the most common psychiatric disorder reported in most of

the community based studies. It is also reported as one of the most
common psychiatric disorder in outpatient clinic population and in
subjects seen in various medical and surgical setting. It is also reported to be
the most common psychiatric disorder in elderly subjects across various
settings. Studies from India have also shown that life events during the
period preceding the onset of depression play a major role in depression.
Studies on women have also shown the importance of identifying risk factors
like interpersonal conflicts, marital disharmony and sexual coercion.
 PROBLEM IDENTIFICATION AND CAUSE OF PROBLEM

PROBLEM IDENTIFICATION
There has been much speculation about modern environments causing an
epidemic of depression. This review aims to determine whether depression
rates have increased and review evidence for possible explanations. While
available data indicate rising prevalence and an increased lifetime risk for
younger cohorts, strong conclusions cannot be drawn due to conflicting results
and methodological flaws. There are numerous potential explanations for
changing rates of depression. Cross-cultural studies can be useful for
identifying likely culprits. General and specific characteristics of modernization
correlate with higher risk. A positive correlation between a country’s GDP per
capita, as quantitative measure of modernization, and lifetime risk of a mood
disorder trended toward significance.

Mental and physical well-being are intimately related. The growing

burden of chronic diseases, which arise from an evolutionary mismatch
between past human environments and modern-day living, may be central to
rising rates of depression. Declining social capital and greater inequality and
loneliness are candidate mediators of a depressiogenic social milieu. Modern
populations are increasingly overfed, malnourished, sedentary, sunlight-
deficient, sleep-deprived, and socially-isolated. These changes in lifestyle each
contribute to poor physical health and affect the incidence and treatment of
depression. The review ends with a call for future research and policy
interventions to address this public health crisis.

While there are more and more treatments for depression, the problem is
rising, not falling.

From 2005-15, cases of depressive illness increased by nearly a fifth. People

born after 1945 are 10 times more likely to have depression. This reflects both
population growth and a proportional increase in the rate of depression among
the most at-risk ages, the WHO said.
Suicide rates, however, have declined globally, by about a quarter. In 1990, the
rate was 14.55 per 100,000 people, in 2016 the rate was 11.16 per 100,000.

A key reason for the continuing rise in depressive illness is that drugs do not
necessarily “cure” the patient, and other therapies that can make the crucial
difference are usually not in sufficient supply.

Other reasons given for the continuing rise in depressive illness include an
ageing population (60- to 74-year-olds are more likely to suffer than other age
groups), and rising stress and isolation.
 CAUSE OF THE PROBLEM

Major life events, such as bereavement or the loss of a job, can cause
depression. But depression is distinct from the negative feelings a person may
temporarily have in response to a difficult life event.

Depression often persists in spite of a change of circumstances and causes

feelings that are more intense and chronic than are proportional to a person’s
circumstances.

Depression is an ongoing problem, not a passing one. It consists of episodes

during which the symptoms last for at least 2 weeks. Depression can last for
several weeks, months, or years. For many people, it is trusted source that a
chronic illness that gets better and then relapses.

Main causes of depression

 Abuse. Physical, sexual, or emotional abuse can make you more vulnerable

to depression later in life.
 Age. People who are elderly are at higher risk of depression. That can be
made worse by other factors, such as living alone and having a lack of social
support.
 Certain medications. Some drugs, such as isotretinoin (used to treat acne),
can increase your risk of depression.
 Conflict. Depression in someone who has the biological vulnerability to it
may result from personal conflicts or disputes with family members or
friends.
 Death or a loss. Sadness or grief after the death or loss of a loved one,
though natural, can increase the risk of depression.
 Gender. Women are about twice as likely as men to become depressed.
No one's sure why. The hormonal changes that women go through at
different times of their lives may play a role.
 Genes. A family history of depression may increase the risk. It's thought
that depression is a complex trait, meaning there are probably many
different genes that each exert small effects, rather than a single gene that
contributes to disease risk.
 Major events. Even good events such as starting a new job, graduating, or
getting married can lead to depression. So can moving, losing a job or
 income, getting divorced, or retiring. However, the syndrome of clinical
depression is never just a "normal" response to stressful life events.
 Other personal problems. Problems such as social isolation due to other
mental illnesses or being cast out of a family or social group can contribute
to the risk of developing clinical depression.
 Serious illnesses. Sometimes, depression happens along with a major
illness or may be triggered by another medical condition.
 substance misuse. Nearly 30% of people with substance misuse problems
also have major or clinical depression. Even if drugs or alcohol temporarily
make you feel better, they ultimately will aggravate depression.
 Bad parenting. parenting that is negative is associated with an increased
chance of a child developing anxiety and depression in adulthood.  
 Peer pressure. Negative peer pressure can also affect mental health. It
can decrease self-confidence and lead to poor academic performance,
distancing from family members and friends, or an increase in
depression and anxiety. Left untreated, this could eventually lead teens
to engage in self-harm or have suicidal thoughts.
 Social media. A new study concludes that there is in fact a causal link
between the use of social media and negative effects on well-being,
primarily depression and loneliness. The study was published in the
Journal of Social and Clinical Psychology.
 OBJECTIVES TO BE ACHIEVED

Objectives

Individual topic: (depression)

 To spread awareness and safety among people regarding depression
and its dangers.
 To clear doubts about depression and helps youths prevent
themselves.
 To help people know that they are not alone and that many support
systems are available to help them tackle this disease.
 To provides a timely reminder that mental health is essential and
that those living with mental health issues are deserving of care,
understanding, compassion, and pathways to hope, healing,
recovery, and fulfilment.

Common topic: (plant and animal care)

 Taking care of various plants in our surrounding.
 Spreading awareness about the importance of trees and dangers of
deforestation.
 Proper animal care by feeding domestic and stray animals.

Expected outcomes(both)

 our team will be able to ensure awareness among the people in their
respective areas through posters, blogs and interactive videos.
 Educate people through our vast and various topics affecting the society
and giving solutions.
 Plant caring by planting seeds and growing some young plants.
 Animal care by feeding stray and domestic animals.
 Trying to give food to the poor people at least for a day.
 VARIOUS STEPS TAKEN TO ACHIEVE THE OBJECTIVES

This community development project aims to generate social awareness about

depression and other problems in our dear society. I took the decision to work
with (VAIRAMANI FOUNDATION NGO) as a volunteer. I joined the team and
helped several communities to fight various problems in our society. The main
duty of our team was to spread social awareness through our various skills
such as blog writing, through various posters, and efficacious videos.

Vairamini divided all the members into various teams to handle different
aspects of our work. I was assigned to work as a blog writer and distribute food
to the poor people and also starving animals through funds generated and also
my own money. Blog are online journals that are updated frequently,
sometimes even daily. An update (also called an entry post) is also quite short,
perhaps just a few sentences and readers can always respond to an entry
online. Vairamani arranged various meetings regularly to support and guide us.

Health has been defined by the World Health Organisation (WHO) as the
"state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity".
Hence, to promote the wellbeing of all human beings, the World Health Day is
celebrated every year on April 7, marking the founding anniversary of WHO.
This day provides an opportunity for the organisation to rally action around a
specific health topic of concern to people all over the world.

This year, the theme of the campaign is Depression: let's talk.

The condition has seen an alarming rise in the country, as more Indians than
ever carry the burden of the illness today.

The accelerating indicators of depression in India

Globally, the total number of people suffering from depression was estimated
to exceed 300 million in 2015. This is about 4.4 per cent of the world's
population. This is an 18 per cent increase between 2005 and 2015.
Untreated depression is the leading cause of more than 7,88,000 suicides that
occur worldwide every year, roughly corresponding to one death in every 45
seconds.
In India, more than 58 million people (or 4.5 per cent) people suffer from
depression. According to the Global Burden of Disease Study, depression
became India's tenth-biggest cause of early deaths in 2015.
It moved up by two positions from twelfth in 2005.

Moreover, it is a matter of concern that it is more common among

women (5.1 per cent) than men (3.6 per cent), and they are less likely to seek
help or avail of treatment.
This is primarily because those suffering from depression find it difficult to
come forward, and those around them find it difficult to recognise it.
Many in India still don't recognise depression as an ailment that can be treated
and controlled.

According to the data, in 2016, psychiatrists wrote more than 9.4 million
new prescriptions for anti-depressants. This has increased by 12 per cent from
8.4 million in 2015.
Similarly, the data provided by AIOCD Pharmasofttech AWACS, a
pharmaceutical market research company, shows that the sale of these drugs
has shot up by more than 30 per cent in the last four years - from Rs 760 crore
in 2013 to Rs 1,093 crore in 2016.

This Photo by Unknown Author is licensed under CC BY

The way forward

The mental well-being of Indian citizens needs to be prioritised to meet the

requirements and objectives laid down under the Mental Health Action Plan
2013-2020 of the WHO.

They have emphasised on an action plan for the world where "mental health
is valued, promoted and protected. Additionally, mental disorders are
prevented and persons affected by these disorders are able to exercise the full
range of human rights and to access high quality, culturally-appropriate health
and social care in a timely way to promote recovery, in order to attain the
highest possible level of health and participate fully in society and at work, free
from stigmatization and discrimination".

However, as it has been noted, the professional workforce for mental

healthcare in India is not sufficient to address the rising demand.
Also, it is a matter of concern that people aged 15-29 are highly susceptible to
depression and other mental disorders, therefore, the government needs to
advocate for higher awareness about mental health in schools and colleges.
In an article, Satyakant Trivedi, a psychiatrist, had recommended that it should
be added to the school curriculum. As the children will be exposed to these
disorders in their formative years, they will be able to seek help and speak out
if subjected to depression later in their lives. Shaibya Saldanha, co-founder of
Enfold India, an NGO, also shared similar views and also emphasised on the
need for better parenting during emotional crisis.

Moreover, universities and professional work environments in India still

lack adequate counselling centres and well qualified trained counsellors and
psychologists who can assist students and professionals at the initial stages of
depression. However, the measures to provide quality mental care help will
not be possible without the adequate professionals spread evenly across the
country.
Therefore, the government should first increase the budgetary spending on
mental-health research, infrastructure, frameworks and talent pool to meet
the global standards.

Secondly, a greater number of institutions and medical colleges need to be

established to engage and train a greater number of psychiatrists, clinical
psychologists, psychiatric social workers and psychiatric nurses, who can
skilfully handle the mental health-related problems in India.

ABOUT THE ORGANISATION

VAIRAMANI FOUNDATION

Vairamani is a Non-Government Organization, that looks after the welfare of

people and helps them in the fields of Healthcare, Medical and education,
providing help to those in need, in whatever way possible and thus helping
countless peoples, who are deprived of basic amenities. Vairamani believes in
social welfare of animals too, and hence we take steps to ensure welfare of
stray animals and animals in need.
What makes us unique is that, we don’t rely on the funding of government but
instead we incline ourselves towards donations made by others. 
Vairamani believes in social wellbeing of Humans and animals in all the sectors,
including Education, Health care and Awareness. We raise our voice as well as
act to help and to uphold social wellbeing. 

Achievements
 Helping under-depreciated societies
 Putting an end to Child Abuse
  Operating regular camps to help Stray animals
 Helping other communities
 Providing basic amenities to people in need
 Providing help in fields of Education

 C-60, Mandir Park Rd, Mahanagar extension, Shadab colony,

Mahanagar, Lucknow, Uttar Pradesh 226006
 (+91) 708 019 6444
 vairamani.org@gmail.com

EFFECTIVENESS OF THIS PROJECT

Successful implementation and adaptive societal depression preparedness and

response strategies will depend on all society being engaged in the plan, and
strong national and subnational coordination. To provide coordinated fight
against societal depression preparedness and response, national mental health
emergency management mechanisms, including a multidisciplinary national
coordination cell or incident management structure, should be activated, with
the engagement of relevant ministries such as health, education, environment,
social protection etc. in certain contexts, this may be through the support of
national mental health protection body and its authorities. If they had not
done so already, national authorities should, as a matter of urgency, develop
operational plans to address depression in our society. Plans should include
capacity assessments and risk analyses to identify high risk and vulnerable
populations. Plans should include civil society and national NGOs to extend the
reach of public health and socioeconomic interventions. National plans should
also be developed for the prevention of societal mental health risks. Ensuring
that global recommendations and communications are tested and adapted to
local contexts is an essential part of helping the community to own the
response and fight against societal depression.
Informed and empowered populations can protect themselves by taking
measures at individual and community level that will reduce the risk of
transmission. By contrast, misleading, ambiguous, and false information can
have serious negative public health consequences, including by undermining
adherence to quick response and avoiding substance misuse, peer pressure
and encouraging the inappropriate use of potentially dangerous or fatal
curative and prophylactic measures without any evidence of benefit. All
countries must ensure that communities, including the most hard-to-reach and
vulner.
 WHO’s SAY ON SOCIETAL DEPRESSION AND MENTAL HEALTH
Overview

Depression is a common illness worldwide, with an estimated 3.8% of the

population affected, including 5.0% among adults and 5.7% among adults older
than 60 years (1). Approximately 280 million people in the world have
depression (1). Depression is different from usual mood fluctuations and short-
lived emotional responses to challenges in everyday life. Especially when
recurrent and with moderate or severe intensity, depression may become a
serious health condition. It can cause the affected person to suffer greatly and
function poorly at work, at school and in the family. At its worst, depression
can lead to suicide. Over 700 000 people die due to suicide every year. Suicide
is the fourth leading cause of death in 15-29-year-olds.

Although there are known, effective treatments for mental disorders, more
than 75% of people in low- and middle-income countries receive no treatment
(2).  Barriers to effective care include a lack of resources, lack of trained health-
care providers and social stigma associated with mental disorders. In countries
of all income levels, people who experience depression are often not correctly
diagnosed, and others who do not have the disorder are too often
misdiagnosed and prescribed antidepressants.

Symptoms and patterns

During a depressive episode, the person experiences depressed mood (feeling

sad, irritable, empty) or a loss of pleasure or interest in activities, for most of
the day, nearly every day, for at least two weeks. Several other symptoms are
also present, which may include poor concentration, feelings of excessive guilt
or low self-worth, hopelessness about the future, thoughts about dying or
suicide, disrupted sleep, changes in appetite or weight, and feeling especially
tired or low in energy. 

In some cultural contexts, some people may express their mood changes more
readily in the form of bodily symptoms (e.g. pain, fatigue, weakness).  Yet,
these physical symptoms are not due to another medical condition. 

During a depressive episode, the person experiences significant difficulty in

personal, family, social, educational, occupational, and/or other important
areas of functioning. 
A depressive episode can be categorised as mild, moderate, or severe
depending on the number and severity of symptoms, as well as the impact on
the individual’s functioning. 

There are different patterns of mood disorders including:

 single episode depressive disorder, meaning the person’s first and only
episode);
 recurrent depressive disorder, meaning the person has a history of at
least two depressive episodes; and
 bipolar disorder, meaning that depressive episodes alternate with
periods of manic symptoms, which include euphoria or irritability,
increased activity or energy, and other symptoms such as increased
talkativeness, racing thoughts, increased self-esteem, decreased need
for sleep, distractibility, and impulsive reckless behaviour.  

Contributing factors and prevention

Depression results from a complex interaction of social, psychological, and

biological factors. People who have gone through adverse life events
(unemployment, bereavement, traumatic events) are more likely to develop
depression. Depression can, in turn, lead to more stress and dysfunction and
worsen the affected person’s life situation and the depression itself.

There are interrelationships between depression and physical health. For

example, cardiovascular disease can lead to depression and vice versa.

Prevention programmes have been shown to reduce depression. Effective

community approaches to prevent depression include school-based
programmes to enhance a pattern of positive coping in children and
adolescents. Interventions for parents of children with behavioural problems
may reduce parental depressive symptoms and improve outcomes for their
children. Exercise programmes for older persons can also be effective in
depression prevention.