 Well, hello everyone. When we as Indians imagine ourselves a certain way, how the world looks at us, I think we think of ourselves as this raucous, can-do democracy. And some of us may be shocked to discover that while we are all of that, we are also the most depressed country in the world. I'm not sure how many of you actually knew that, because when I discovered it, it was a real revelation to me that 36% of us as Indians are or will be depressed at some point in our lives. Let me share another statistic before I introduce my guest this morning. 371 people at last count, 371 Indians, killed themselves every day. That was approximately more than 1,34,000 people killed themselves every year in India. And yet the irony is that we continue to see depression and mental health issues as some sort of self-indulgence, as some sort of problem of the rich and famous, as not really where the priority of science and medicine should be. Well, here we are in conversation with two people who are going to tell us why that needs to change and that needs to change yesterday. First up, somebody who actually does not need an introduction. We know her from our cinema. She's one of our most celebrated actors. But she's somebody I admire for a different reason, in addition to her star power and her talent. She decided to go public with a deeply personal and intimate story on her own struggle with depression. In fact, in a one-hour nationally televised interview with me, and then wanted to follow it up with concrete actions. So actually created a foundation to help others who grapple with the same issues. And we also have here Dr. Murli Durai Swami, one of the foremost neuroscientists and doctors from the United States of America who spent a long time researching the science of the why, what and how of depression and mental health issues. Deepika, once again I must compliment you on your courage because it does take courage and it takes courage for somebody like you, even more than all of us in this room, to talk about our struggles because you're in the public gaze. There are a hundred things that will be said, that have been said, including really low level things like, oh she's probably just doing this to promote her next film. Right? And I know, because I was in that conversation with you when you broke your silence on this on television, how difficult it was for you, how painful, how raw when you talk about it. And therefore I'm going to say sorry, I'm going to in a sense put you through that moment again because there are people in this room who may not be familiar with your own story. So let me start by asking you, when did you know that you were depressed? When did you start calling it depressed? And why did you, this fantastical woman on our screens, decide to go public with something so personal? I think it started with just a feeling. It started with just a feeling of not being completely there, of feeling like we spoke about that British feeling in your stomach and just breaking down for no reason. And truly just feeling completely lost and not understanding what was happening to me. And I think it was the intervention of my mother who was visiting me at that time. And I think I lived with it for a while actually. I was filming a movie at that time and I had no idea what I was going through and I'd go to work every day. I'd literally have to pull myself out of bed and go to work. And my mother just happened to visit me completely different context and the day she was leaving I remember breaking down and I was extremely surprised actually today when I think back at how aware she was of what I was going through. And the first thing she did was to call a family friend and Anna Chandy was a counsellor. But today when I think back and of course I was hesitant at that point because I wasn't aware of what I was going through and at the same time for me Anna is someone who is also a family friend so I think that's where I sought comfort. But at the same time I don't know if I would have done the same thing if I didn't have that comfort level. But it was my mother who really identified the symptoms and immediately called her up and in one phone conversation with Anna she sort of understood what I was going through but at the same time I think it's the way she dealt with me and with the situation at that point. She didn't raise any alarms. She made me feel like it was completely normal and okay and that we will get through this. And then of course with her and Dr. Sham Bhatt who have worked on me. So I think initially I was also reluctant to take medication. But I think at one point I was just extremely exhausted. I couldn't do it anymore and I think that's when I decided to sort of I said okay let me start medication let me accept this help that people are willing to give me and today there's a lot more awareness. I don't think I can say that I'm completely over it but it's always a fear at the back of my mind that I might always have a relapse because it's been such a bad experience for me. What was the most, I mean I remember you telling me that you felt that pit in your stomach you felt empty you felt directionless that you would lock yourself in your vanity van and sometimes just cry and you did not know why you were crying sometimes it helped to have people around but sometimes it was the exact opposite. You know that sense of being closed in by a crowd when you're feeling isolated within yourself. It helped having people I was close to and familiar with it was comforting to have them around because then I could break down if I felt like and if I had questions or thoughts in my head I wouldn't hesitate to ask but at the same time if I was in front of the media at an event which happened many many times that's when I'd feel a bit suffocated because I didn't want to break down in public and this is before I made up my mind to go public with what I was dealing with. Today if that happens to me if I ever go back to that space and I hope I don't I don't think I think twice about exposing the way I feel and I think a large part of one's road to recovery is to accept what you're going through and to not challenge it but to embrace it and to actually allow your body and your mind to go through that experience and know that there is a road ahead that will get you out of all of this and it's not an individual I don't think I could have done it on my own but it's important to have that support system so while you know people credit me for coming out and speaking out I think it's equally important for caregivers to acknowledge and for us to acknowledge that it's important for them to be with us on this journey. Now before I get Dr. Rai Swami in I want you to talk a little bit about the continued stigma the continued stigma associated with mental health issues with depression in particular even today if I were to be honest in terms of eliciting responses here even in this room with very educated, very aware people in drawing rooms you will hear lose an idle chatter saying why is Deepika depressed? She has everything she has money, she's fame, she has talent she's going places, she's you know it's depression is treated as a indulgence like you know only people who have no real problems are depressed so when you came out in that conversation and millions of people saw it online on television read about it were you worried that people are going to be horribly mean and were some people horribly mean? No I don't think anyone was mean but I didn't even think about it I didn't think about the repercussions I think the idea... You didn't have a moment of how will this impact my public image? No, not at all I think for me the idea really was to just change the way people in India and in the world look at mental illness and you know give it the respect that it needs you know I think the idea really was to just change the conversation because I had experienced like literally a pre and post and I lived with it for a couple of months without sharing it with anyone and then today I feel so much lighter and so much better when I've come out and I've spoken about my journey and I know a lot of other people who do there's not a single day where I've probably not met someone who has come up to me and said thank you for sharing the story but what's also helped them is the fact that they've then shared their story with someone saying I know what the pika has been through because I'm going through the exact same thing and they instantly feel a lot lighter what was the toughest thing about that phase of your life was it feeling like nobody's going to understand was it the sense of losing control was it the sense of you know surrendering almost like you almost have to surrender to it before you can get better you can't fight it a lot of people think it's mind over matter but actually depression is matter of a kind and I'm going to talk to the doc about it in a second but what was the toughest thing about that phase of your life the phase itself the phase itself I think before the intervention I think before I understood before my mother saw it before anyone else saw it to have to wake up every morning to drag myself to work to put on this face like everything's okay when deep down inside I had no reason why I was where I was and what I was doing and life just says it felt like there was no purpose I didn't feel like it made absolutely no sense just life made no sense so for me I think that was the that was the toughest part and Murti that can be staggeringly lonely what you know the thing about depression is this kind of chicken and egg thing right you're already feeling like shit inside you're feeling what Deepika calls that pit in your stomach and then you feel like if you share it she was I think in a way lucky because she had this really supportive family she had this broader support structure in terms of a family friend who was a trained counsellor Shambhata wonderful doctor but most people are embarrassed about being depressed most of us are just plain embarrassed because we think we'll be judged that's right even though 36% of this country according to the World Health Organization is depressed so it's very well said and first of all I commend you on coming out I think it's a transforming moment in India in terms of mental health and the attitudes and we need more champions like you and I can't imagine a better champion than you so I want to point a few things about statistics that you alluded to you know depression and mental disorders are now the leading cause of disability in the world and they are soon going to become the number two cause of death in the next 10 years or so in India something like 150 million people have mental disorders and especially amongst youth the average age of depression in India is 30 women are twice as likely to have it as men and amongst youth which is sort of defined as people under the age of 25 I think in the previous session Karan said that roughly half of India's population is under the age of 25 and our country depends on them but for all of the accomplishments it's going to make there is one suicide every hour in that age bracket making India maybe one of the leading suicide countries in that age bracket between 18 and 29 and all of the symptoms that Deepika described are classic symptoms of depression there is an enormous treatment gap it takes on average between one to two years for the average person with mental illness to even be sort of recognized that they have the symptoms to seek help and we have something like a 10 to 30 fold shortage of mental health professionals in this country so even if somebody recognizes that they need help it's very hard for someone living in the rural areas or someone who is poor coming from sort of the marginalized sections of society to find the right care and treatment can you speak to exactly on that can you speak to why then depression is treated as seriously as another illness which is more physically identifiable maybe like one of the things that Deepika mentioned was that she resisted medication now that is a very very common response I remember I used to get anxiety attacks and when my doctor told me you need to go on medication I said no I don't want medications messing with my brain now this is a standard response and I was having this response as an educated aware journalist right it intrigues me about the battle against depression is we are not able to cross that collective psychological barrier where even everybody sitting around me the first instinct is this happens to other people hey why would I be depressed this happens to other people so I think Tipar Gore Al Gore's wife suffered from depression and she described depression as the greatest stigma of the 21st century there's two elements of that stigma the stigma of depression is unlike the stigma of illness one is there's a self stigma you yourself feel bad and you think it's a weakness and that sort of almost spreads to others around you your family and your friends and they don't want to talk about it and they kind of hide the problem until they get burnt out themselves and then you sort of you're forced to seek help so it's a two fold and depression affects the core of who we are as human beings you know our emotions or just our personality or cognition all of that and that I think explains why the stigma has been so great and I think things like what Deepika's foundation is doing education is really the core of overcoming stigma especially education at younger age groups and I think PM Modi in one of his radio addresses said very simple expression rather than suppression and I think Deepika exactly she has done that by talking about it by spreading the word by educating people especially in the youth that's the key I think to overcoming stigma is the essence of it in a moment but I want you to talk a little bit about two things one I remember you telling me that at that phase when you slipped into this depression without knowing necessarily that it was depression you had lost a very close friend and I remember you told me that again you thought or you didn't know that this friend was depressed and that if this friend could do this to him in terms of not thinking his life was worth living just imagine how many other people around you might be living with that so can you speak a little bit to how losing that friend maybe in a sense began your own journey of self discovery of what you were going through I'm not saying that was the cause of your depression I'm saying it probably helped you to uncover it well he was a friend of a friend and for me someone I had met socially many many times but I think I think that was when I decided to sort of speak up and to do something about it because I was seeing so many people around me now that that's just one instance we wake up today we read the papers every single day there's a headline and my heart takes because it's preventable it's absolutely preventable and I think a large part of also the stigma comes from the fact that in schools we talk about physical education we have physical education classes I had physical education in my school but we didn't have anything to talk about mental health not one session not a class it's not part of the curriculum so I think if we included that in the curriculum and we introduce just the idea of the importance of mental health at a school level there will be no stigma because it's the same way as a child you're creating you're educating me about so many other things so educate me about the importance of mental health the same way we talk about the importance of physical health but yes I think it was that one experience but it was many many other of course my own experience and then to see someone who had known for so many years and like I said you see it all around you and I've been there so it hurts to know that maybe in a matter of moments or maybe some sort of intervention by friends or family member or maybe that moment could have passed and maybe things would have been very different today and we're actually talking about saving lives here we're not talking about something self-indulgent we're talking about suicide we're talking about people who feel and this happened to your friend or friend of a friend but you yourself had reached that perilous point where you were like I don't want to get out of bed and go through my day this life doesn't make sense to me and that is an isolating and actually it's a very dangerous I want to underline how dangerous that sentiment is it is I think it's so important having been there I think it's so important to identify that moment in your life and to not fight it it's so important to just accept embrace talk to somebody about it I don't know correct me if I'm wrong I don't mind if it's wrong diagnosis I don't mind if I feel like I'm depressed but I actually go to a doctor and he feels or a specialist feels I'm not depressed I'd rather be in that space than underestimate what I'm going through you know when we have a fever we don't think twice about I'm not talking about medication necessarily but when we have a fever when we have a cold we don't hesitate to pick up the phone and talk to someone or casually mention to someone that I'm feeling feverish today my throat is aching today so why don't we talk about how my mind is feeling I'm not feeling well today you know I'm physically fine but my mind is not there why can't we talk about it the same way so why did you resist the medication and the reason I'm pushing you on this is because I know Dr. Rai Swami will bear me out on this this is the most common even people who are able to bring themselves to a doctor and say help me there is a resistance the mind we treat our mind as something we ourselves treat our mind as something different that if somebody tells us we're diabetic and we need genuvia or insulin we will take it and we'll also exercise and we'll lose weight and we'll do all of that but we'll take the medicine but when it comes to mental health we resist why did you resist medication at first I think it's the same stigma that we're talking about it's the same stigma that what if I'm already not feeling great and what if this thing messes with my mind even more it was just the stigma that something else and the day I overcame that I'm fine so how do we know if we're depressed great question I'm not just sad no it's a great question so I think what most people don't realize is that clinical depression is not just your everyday blues or everyday passing sadness we all encounter moments of sort of blues rejections in our work family life accomplishments playing tennis you lose to somebody yeah we're all sad but most of those kinds of everyday blues we're able to snap out of it in a few days in a few hours clinical depression is far more serious far more debilitating typically we define clinical depression in medical terms as someone having five or more symptoms of depression for most of the day for at least two weeks and these symptoms are impairing your everyday functioning both at work and at family life so Google recently put out a screening questionnaire on their search tool called the PHQ9 it's a validated depression screening tool it's not a diagnostic test so you cannot diagnose yourself with depression and hundreds of thousands of people have already taken the screening tool it's not available in India yet all it tells you is if you score low then your mood symptoms are probably just benign everyday blues adjustment if you have stressors if you're scoring on the high end it's time as Deepika pointed out to go seek professional help it may be depression it may not be depression a variety of medical conditions can also mimic depression thyroid imbalances, vitamin deficiencies in the elderly small strokes medication side effects one reason why people don't want to take drugs is many older antidepressants carry a lot of baggage with them in fact a new study just came out on their own so that's the sort of medication not the solution necessarily for depression so milder forms of depression can be treated with therapy can be treated with yoga, exercise lifestyle changes, environment changes family support, reducing isolation there's a variety of things that one can do but you mentioned Google and one of the things I want to talk about is the double edged sword that technology is so we live in this most interconnected yet than ever before and we've all heard of this disaster sort of things like the blue whale challenge that are actually leading young people into this sort of sense of isolation and suicide and death the dangers of being alone in a crowd the dangers of having a relationship only with your phone are these things to worry about more today than before is it true to say that we're in more danger of being depressed in today's world 30 years ago or is it that 30 years ago we simply didn't know what depression was I don't recall what the newspaper said 30 years ago but they probably said things like the Sony Walkman would cause depression I don't know, maybe but yes it's true that so we actually did a very interesting study we monitored internet usage amongst a group of freshmen for a whole semester and just based on their patterns of internet use we could predict who were depressed and who was not depressed and the people who just spent an enormous amount of time just on certain types of video games you can tell by the color of the Instagram photos whether someone is depressed or not depressed explain that just people who have depression or who are going to get depression 3-4 months from now tend to post darker, more muted colors on Instagram, they don't tend to use the brighter colors a study just came out like about a week ago it's not yet, of course these are not diagnostic tests we have a two-way relationship with technology anyone who just spends over too much time with the internet that's everyone here we are all depressed by that that screening test we are all fake that's causing sleep problems which is going to lead to cognitive impairment and dementia late in life so let's not worry about that, that will be another session so kids really who are isolated they're locking themselves up in the room with this amount of time with video games those kinds of things yes, one needs to consider whether this is worrisome or not, parents need to really look at what kinds of games they're playing, if they're violent games if they're all leading to the blue whale kind of thing then sure, there's risk taking teenage brains are not fully developed so that's where I think one needs to be worried on the other hand I think technology can have a positive role because one, you can increase the access to counseling and I'm sure your foundation is going to use technology for education eventually we're going to have apps there's a company in India called WISA that's developed a chatbot to treat depression and they've done a pilot trial with it and it actually helps people so as I mentioned we don't have enough counselors so we can use technology in a positive way to educate children, maybe create gaming maybe create empathy by having virtual reality experiences where they can understand what it feels like to be depressed so the new movie Blade Runner is going to come out I'm maybe revealing a plot line one of the women in the movie actually uses a gadget and says I'm so happy I want to see for once what it's like to be depressed and she's able to like put a few pulses through her brain and spend 6 hours in a state of depression to see what depression feels like and why is this a good thing to have this app that exists I'm not saying, what I'm saying is if you can cultivate empathy one of the ways of cultivating empathy is to understand what the other person is going to go through if there is a way for you to understand better what the other person is going through then sure that reduces the stigma Deepika when you first started taking treatment and I don't and I'm saying even before the medication did you find it really difficult to not outsmart your therapist because what a lot of us who think of ourselves as reasonably intelligent we say we know ourselves we know ourselves and what are you going to tell me some stranger sitting on a couch that I don't already know about myself talk a little bit about that process I mean how difficult is it to walk into this room and start bearing your soul to another person who even if in your case was a family friend there are still barriers and the thing about taking help for depression it's a little bit like when we get a surgery we don't care if our doctor sees us nude because we have to take our clothes off and get anesthesia and get that treatment so this is like bearing your soul it is bearing your soul to somebody and it's tough so talk a little bit about that process of getting help and the obstacles you had to jump over within yourself I think for me there was the stigma before not once you started once I made up my mind once I decided that I'm done I can't live like this anymore and I want to get better I need to get better and then it was a deep dive there's no half way I don't know if there is but it wasn't for me so the day I decided to then seek help and speak about it and speak to my parents speak to my sisters speak to my doctors then I'd share everything with them so there was no no barriers no holding back no no every question that they asked everything they wanted to know past present whatever they wanted to know I shared everything with them but that's unusual because a lot of people even if they're able to cross the first hurdle I don't know if you can bear me out on this the second step is tough right so you you see okay I'm depressed I'm enlightened enough to know that this is a problem I need help but do I really want one person to know everything intimate when I say intimate I mean things in my head that I may not have shared even with my parents or my sister but I now need to share with this doctor to get help no I think it's a very important point Deepika of course was working with people you already knew and trusted and highly qualified individuals so part of what you're talking about is called the therapeutic alliance and it's the job of a skilled counsellor or a psychiatrist to establish that alliance and you have to get a read person so you know there's a saying in medicine you don't treat the disease you treat the person who has the disease you want to know is this person open-minded to a biological view of depression is this person open-minded to more a psychological view what are the triggering factors what are the positive strengths what are the weaknesses you want to boost the positive strengths of the person to make them feel comfortable before you can introduce sort of the core therapeutic psychotherapeutic elements so there's a process it may take a little longer for some people as you pointed out but eventually they'll open up that's why psychotherapy is not a quick fix like one day or two days it may take several sessions over 12 weeks and then sometimes people have to get periodic therapeutic counselling sessions for months or years Deepika one of the things we didn't speak about is you know why did you decide to go public the foundation I'll come to but you you didn't confine to sharing your story to your your mother and father and your therapist you actually took it out to the country to the world and that could not have been easy and I remember one of the things you said was that if I can change even one life this was worth it yeah but you must have wrestled with that choice at some point do I keep it within the home do I take it public and I bring it back to the fact that you live in the public gaze which makes your going public with it a different narrative than from you know if she went public with it so what made you say not just am I going to get better I'm going to tell this story to everybody who cares to listen to it I think it was at multiple levels I think one like I said after having been through what I did if I could share my story and if anyone in the world heard me and identified what I went through and could come out of it or understand and you know if I could make a difference to at least one life I felt at that point I'd you know all of you know going public speaking about it would be justified I also felt like the narrative around mental health in India needed to change and I I can do that today the very reason why we're sitting here today because I felt like when I hadn't and like I said I was also working at that point I was like why can I not tell someone when someone asks me how am I doing like the film that you just saw before we came in is I think what got to me was when people were asking me how are you doing and one day I thought are they really asking me how I'm doing do they actually have the time to listen if I said I'm not feeling okay will they actually give me that moment and understand what I'm going through or is it just superficial when we ask people how are you doing is it just superficial is it just you know formality because that's the way we've been brought up like just asking yeah I'm fine oh great everything's great is it everything really okay and I wasn't okay so I think that's what really got to me because I wasn't okay and it reached a stage where I was like why can't I just tell people that I'm not okay it was just that um and you know and that's when I reached out and that's when I felt like I needed to talk about it I felt like because I felt bottled I felt caged I felt like I felt like I needed to fly or swim or just not be boxed and to feel free and I feel so free today it is you underplay I think the courage that you have shown you have shown extraordinary courage I've said that to you a million times I will say it a million times more why the foundation because I felt like just talking about it um I want to help people I want them to understand what they are going through we want to create awareness we want to tell people that it's it's okay to feel the way you do if you're feeling a certain way it's absolutely alright um so to create the awareness to reduce the stigma which is going to take us many many years um having said that I think in just the last two years I feel like the conversation is really shifted shifted um is it going to happen soon maybe not but have we are we moving in the right direction most definitely um so to create the awareness to reduce the stigma um to go into schools and colleges and educate teachers educate students educate parents that there is something like this that exists it's there it's happening it's happening all around us and do something about it before it's too late um suicide depression is the next big epidemic to hit the world if it isn't already and reach out to corporates reach out to the corporate world tell them that it's so important in your workplace to identify what you're going through because the pressures are so high to identify the people that you work with um you know to help them if you see sort of any symptoms um I think just to create the awareness and hopefully one day we also want to be the happiest country in the world we don't want to be the most depressed we don't want to be the country with the highest suicide rate in the world so workplace I mean we are at the india economic summit of the world economic forum it is a question for workplaces we're entitled to medical leave but I don't know that workplaces offer medical leave for depression yeah this discrimination is part of the stigma again you would call it discrimination? I think so there's no other word I mean that I can use for it at the end of the day there's no economic wellness without mental wellness that's the core of any economic summit is that we're in a cognitive error it's not the building of a company that has real value it's the cognitive skills of their employers ultimately you can't perform well any company that's short-sighted and doesn't offer leave for mental health or doesn't offer insurance for mental health I think it's shooting itself in the foot so the world economic forum has actually developed a toolkit for businesses focused on depression they've actually done pilot studies at a number of companies around the world so if anybody here is interested any corporates here in the audience are interested that would be a useful resource would you advise people in charge at workspaces what is the foundation they pick up for example in courage what do you what do you say to an employer let's say there's an employer in this room and she or he want to know my colleague comes to me and she says I'm depressed what should be my professional yet empathetic response at the workspace so to the individual are you talking about the corporate as a policy but I'm just taking an individual example what would you advise on policy well as policy level first of all I think public-private partnerships are going to be very key so they could partner with a foundation there are plenty of foundations there's Banyan there is Spark there is Deepika's foundation I think education is going to be very important setting in policies that are anti-discriminatory against people with mental illnesses encouraging employees to volunteer because volunteering itself builds resilience against future mental illnesses making available resources for people to get care and accurate diagnosis and treatment giving appropriate vacation making sure when they come back from the treatment of their illness that their career trajectory is not shifted and derailed so let me just be the cynic here and say that when you talk about public-private partnership is one thing for foundations like Deepika's and others to join hands with the private sector but when you talk about people who don't have resources who don't have money like small businesses no the rural India or poor people if you take a trip to the All India Medical Institute you have people waiting out in line whose children are dying of cancer and they cannot get time with the oncologists because the public health system is so streamed can we convince the government of India to actually turn the public health system towards depression given the social stigmas given the overstretched nature given the absence of resources and Deepika will also comment but I'll give you three examples so the FCC which is the Federal Communications Communication introduced a new life-line act which made sure that smartphones were available to every poor person in the US to call the city of Birmingham in London created a public-private partnership with about 20 companies raised 125 million dollars started a 24-7 hotline for college students and high school students to call in on mental health issues they also started a special college where people who have mental health and drop out of colleges can catch up with their curriculum and go back to the original college New York City has started a 30 million dollar public-private partnership to take care of mental health amongst the homeless and amongst the poor so yes it's entirely possible that hundreds of corporates here would be glad to support such an underwear but maybe you want to add to that I think similarly I think it's important for people at workplaces policy makers to sort of like we were talking about leave if I'm diabetic if I have a surgery if I'm pregnant if I'm X, Y and Z you will be allowed medical leave whereas if you have if you go to your boss and say I have depression he's more likely to say I'm going to have to sack you we need to normalize that we need to treat it like anything else I think a large part of the stigma or a large part of even if there's people who want to come out and seek help you need to confide in your boss so you need to confide I think there's the fear of losing your job look at your own life if you had gone to a film producer and said I can't do this film right now because I'm depressed what do you think the response would have been maybe there are people who haven't offered me films and I can't act I don't know maybe I don't know and did that make you ever regret going public I'm in a good space because I can choose the movies I want to do but I don't think everyone has that luxury of choosing where they want to work when they want to work so it's important for the organizations to understand that we need to treat this the same way as anything else I think it's equally important to have frequent sessions in your corporate offices about the importance of mental health I think it's important to have a tie up with a counselor or maybe have an in-house counselor or a yeah maybe not a psychiatrist it's important to have an in-house counselor when your staff is burnt out they need to talk they want to speak to someone, somebody is there or at least make them aware they should and I feel today it's important to just seek help of a counselor anyway because our lives are so fast-paced with technology with so much going on in the world I don't think there's any harm in just seeing a counselor anyway because did you continue to see a counselor even after you got better yeah on and off wherever you needed to friends who've never experienced anxiety or depression but it's very important for them to see a counselor to see their counselor every now and then a lot of people do and we need to normalize that as well a lot of people say I have a meeting you lie about it I'm in the middle of something I'll call you back or just lie and say I went to a general practitioner we need to normalize it it has to be as normal as anything else I'm going to open this up I don't know how we're doing on time we've got 10 minutes the cultural dimension doctor because this therapist thing reminded me a friend of mine recently said to somebody who said I've got a meeting with my nutritionist at one and my counselor at two that you're really living the American life but there is a cultural dimension to it like in India we think of these things incorrectly as these western imports into our country so I want you to speak briefly on that and actually I'm seeing Anna Chandy here who's actually the PICAS counselor so I want to bring her into the conversation but just on that thing of the cultural dimension culture is very important all treatment and diagnosis has to be culture appropriate there are many psychiatric disorders that would be viewed as abnormal in one culture that are normal in another culture I'll give you an example which is somewhat not pertinent but there's a condition called Williams syndrome where people are born with this genetic condition they don't discriminate at all they treat individuals of all races as equal of course in countries where there's a lot of racial discrimination that would be seen as a good thing in America for example people save people with Williams syndrome as something very great in other countries where there's sharp class distinctions people see Williams syndrome as very abnormal so depression has to be treated in a cultural context you cannot treat depression outside of the culture but sometimes you have to push the boundaries of what is culture appropriate as well it was not part of Indian urban culture even 20 years ago to go and see your therapist but today there is a greater acceptance so culture is not static either sure but that's not to say that American or western psychotherapy is the only solution there is a variety of Indian and hybrid techniques that are very important if someone believes in the Bhagavad Gita people may not realize Bhagavad Gita was the original psychotherapy session the crisis psychotherapy session so yoga, meditation all of those are very powerful I think it's a misconception that you have to go with the western psychotherapy we've done studies others have done studies that yoga is just as effective and there's a variety of other techniques as well it's an entire lifestyle change if I may say my life literally pre and post my life post depression is very very different from my life before what's the biggest one biggest difference I take care of myself and I don't feel guilty about it but didn't you always like as an act to take care of yourself or do you mean beyond physically taking care of yourself it's absolutely not a physical appearance but it's important to and especially with women in India I feel that there's a lot of guilt attached with taking care of yourself and doing things for yourself because we're constantly playing roles and constantly doing things for other people and the minute you take that one hour off because you want to go and see your friends for lunch there's suddenly so much guilt it's totally okay taking care of yourself a little bit of meat time whether it's getting frequent massages whether it's sleeping adequate sleep eating well just taking care of yourself in a holistic where not just medication like we talk about is just one of the things and that's the approach I took maybe it'll be different for no one's dissing medication medication can be lifesaving for some individuals I want to make sure that it doesn't work for everyone I need to go into the audience why don't we start with you if you just want to start taking the experience with you as a starting point but what you'd like to say to the people here especially parents for families what should they be looking out for I think in India particularly with the experience of the foundation adolescent children a lot of the symptoms obvious symptoms show up in depression early stages of depression as behavioural and therefore parents and teachers need to have awareness and education that some of the behavioural symptoms if again as Dr. Doriswamy said if they are clustered with other symptoms and they are existing over two to three weeks then we need to look deeper into it for example it was with deep sorrow that last year a young boy in Bangalore was expelled from an international school all that he complained was headaches so he was 17 years old he would put his head on the desk and they expelled him saying misbehaviour so Dr. Bhatt and myself actually called the school after the diagnosis and said he's got depression so can you take him back and said we don't want to deal with mental health issues today the young boy has joined University of Chicago for his undergraduate program so the discrimination and excluding young children you know under the guise of laziness because sometimes there is apathy laziness or labelling them or not wanting to take the responsibility like I can imagine the school calculating if this boy does something to himself we don't want that responsibility we want to take that responsibility we've had a lot of pushback from schools as well when we wanted to take our schools program a lot of schools I have to say were very very open to the idea and in fact we've covered I think more than 300 schools in the last one year but and it's surprising that a lot of schools resist it it'll change and the other thing which I'd like to in continuation of what you said I think India is a context and we look we're a collective society so even when we look at mental health issues I think we need to look at it from a collective thought for example for me as a practitioner in my private practice I insist on systemic view of the issue because the individual is suffering they can't manage this on their own so the system or the collective the family need to be part of that process so what I do is the individual becomes to me the voice of what's happening and the other members also come in for therapy because they also have their own issues and I think this is very very important in India while I'm not disputing that western approaches are important but we also need to remember a lot of the western approaches are individualistic I see that huge difference in terms of context we do one more question which you need to understand in the rural area there are mental health workers that include the soothsayers, the witchcraft people the astrologers as part of the education program and one of the programs that we run in North Karnataka we have actually funding a program in the rural area where the local people become part of the counselling process you have to get the quacks out of the system while being open to alternative modes question there yes I don't know if I missed I came in a bit late you had everything going for you you're good looking you were rich so tell me don't say why are you depressed then I want our conversation conversation has been can depression come to anybody for no reason because somebody who has everything going for her why should she get depressed I'm asking this not from a personal point of view because I know of some people or somebody that is going through depression and I'm not able to figure out what's the reason so I'm asking you can I just preface here one of the things we did discuss was that this is the response that actually hems people in but you've got everything nobody wants to be depressed so it's not like you're wishing it on yourself to be depressed so we don't fully understand the biological roots but there are biological triggers could be partly genetic partly a mix of some psychological social and biochemical factors if there was a way that I could have scanned her brain at the time I could have seen some changes in biochemical circuits etc but at this point in time we don't fully understand it at that level of cellular circuitry alteration all we know is that there's a combination some people it's an obvious response to triggers so for example you just tell someone I don't love you and you spiral into a downward spiral of depression that's an external trigger in others it just comes out of nothing they're doing fine and all of a sudden seemingly nothing I'm going to take here in the front room are we out of time? just last comment in option B Sheryl Sandberg and Adam Grant talk about two phrases I know exactly how you feel and let me know if I can do something for you when you hear these two phrases do you feel comforted or do you feel a cognitive overload because research shows do you feel comforted that you've been understood or do you feel that you have to tell other people that they can help you it's a bit of a confusing question do I feel comforted when somebody asks me in the book they say that one shouldn't actually say I know exactly how you feel got it do you feel people got you with empathy or do you feel like they're patronizing you they don't exactly know how you feel I can tell the difference I can look into their eyes and know you can tell when someone's reaching out because they know either they understand their empathetic and they know genuinely what I've probably gone through or they know someone who's been through the similar experience and then there are the ones who are just faking it I'm afraid we do have to close it there I'm getting the signal that we do have to wrap I think it is fair to say that because public or chronicling of her own story is not just brave but it has a purpose to it let's just say that the foundation the telling of the story is a purpose that the next time somebody says to you that they are depressed please treat them with the respect that that sentiment that that ailment it is an ailment and it is treatable to some degree preventable to some degree like any other physical ailment and that would perhaps be the biggest service we can do to people like Deepika and Dr. Rai Swami who work in this area let's have a round of applause for our guest today thank you very much and to you for brilliant moderation