Speak up Mumbai: Depression in terminally ill is a cause of concern

Former Anti Terrorism Squad (ATS) chief Himanshu Roy's suicide created headlines on Saturday. It also brought to the forefront the issue of mental illness in terminally ill patients. Roy, who was ailing with cancer, stated that he shot himself because he was suffering from depression in his suicide note recovered from his residence, stated a statement by the police.

According to psychiatrists, 50 per cent of terminally ill patients suffer from mild depression but they take it for granted rather than seeking help. The mental health situation of terminally ill patients need to be screened every six months in such cases, opine psychiatrists.

Terminal illness can have a strong impact on the emotional being, giving rise to fear, helplessness and anger. Psychological treatment and therapy become necessary for these cases. A recent study released by BMC's public health department also revealed that more than 50 per cent of patients who visits the major civic hospitals (KEM, Sion, and Nair) are diagnosed with hypertension and mental-health problems.

VOICES

Doctors in India are trained to focus only on their field of specialization. Rarely will you find an Endocrinologist / Oncologist also trying to address depression that accompanies the primary ailment. A more holistic and comprehensive form of healing with a cross-functional understanding is the need of the day. The Medical fraternity should incorporate the American system of Medicine.
Anand Shirali, resident of Andheri

Our body and mind are inextricably interrelated. The terminal illness affects psychology and thus increases the chance of depression. Most of the time, the patients neglect it and focus mainly on the primary illness. Neglecting may become very fatal to life. Mental illness is alarming and family members should pay more attention and seek help from professionals on the matter.
Dr Rahul Ghule, resident of Andheri

From a medical point of view, it may be ignored. But the family of such patients should not create an environment of depression. No matter how strong a person is, he/she feels lonely during such situations. Once the number of well-wishers surrounding such patients begin decreasing, it leads to depression. They will realize that they are losing the battle when their support system starts weakening. The quality of life and self-esteem also falls. A problem of depression among terminally ill patients is quite high. Death is the likely outcome of any terminal illness and that is where the problem lies. There should be counseling sessions for these patients.
Dr. Nilesh Baxi, family physician, resident of Tardeo

Depression comes as an add-on along with terminal illness. One can and should seek treatment for depression. There have been cases wherein people have taken extreme step under depression and ended their journey much before than desired. In such cases, the family of the victim plays an important role. The family should read the signs of depression and ensure that the victim is treated.
Robin Sharma, resident of Kalbadevi

I think, when a patient suffers from a terminal illness, he goes through a lot. He/she drains out emotionally and physically. Lack of love can lead to depression. Doctors should check for signs of depression in a terminally ill patient as it can lead to suicidal thoughts as well.
Aishwarya More, resident of Dadar

We need to take extra care of any patient suffering from terminal illnesses. They might look physically strong but the pain takes a toll even mentally. Constant counseling needs to be provided by professional counsellors and even family members need to chat up with the patient so that one finds out what is going on in the patient's mind.
Dr Rita Savla, resident of Goregaon

The role of the patients family is very important if someone is suffering from a chronic disease. A family doctor can also be very supportive. Patients cannot approach or visit the hospital for minor problems, therefore making the family doctorkey in such cases. Family Physician knows the history of the whole family and their relationship and health-related problem.
Dr Vijay Sangole, resident of Chembur

We work with senior citizens who are dealing with health issues. Some of the senior citizens face terminal illnesses like dementia, alzheimer's, parkinson's or cancer etc. Families face lots of hardship taking care of these terminally ill patients. The family often neglect this mental pain and depression. Neglect and ignorance of mental pain by person and family leads to suicidal tendency and frustration in both. We need to have more options of services and facilities like palliative care, long-term care and dedicated counselling services. 'Let's Talk' should be the mission"
Sailesh Mishra, resident of Mira Road

EXPERT SPEAK

Depression in terminal illness is seen in at least 30 to 40 percent cases but it is considered to be part and parcel of disease by patients and relatives. This mindset needs to change. Every patient with the terminal illness should get mental health help. If the psychiatric problem is treated, it definitely helps improve the quality of life of the patient. In some cases, it also helps in slowing down the primary terminal Illness.
Dr Sagar Mundada, psychiatrist

Terminally ill patient are likely to go through the stages of grief such as shock, denial, guilt, bargaining, anger, depression and then acceptance. But many times, a patient lingers in the depression stage and is unable to accept th0e inevitable. Often the depression is coupled with pain caused due to the illness. At such a time treating the depression ends up taking the backseat as the family and friends are also suffering. Treating depression at such a time is as important, and this can be done through medication and therapy.
Dr Neha Patel, clinical psychologist