- National Crime Records Bureau’s 2013 figures show that illness accounts to 19.6% of major causes of suicides.
- Illness also is the second leading cause of suicides in India.
- On an average, over 1 lakh people have committed suicide each year in India between 2003- 2013.
- Maharashtra ranks 9th in states with higher rates of suicides due to illness.
- Maharashtra reported 24.5% suicide due to illness.
Chronic illnesses cause depression
Many people who suffer from chronic disease like tuberculosis (TB), cancer, diabetes, heart disease, kidney aliments, HIV/AIDS among others often undergo depression. A chronic illness is a condition that lasts for a very long time and usually cannot be cured completely, although some forms of depression and other illnesses can be managed through diet, exercise, and certain medications. Depression is one of the most common complications of many chronic illnesses.
“Chronic diseases cause depression and we have to look at it very seriously. In tuberculosis, patients face depression due to various reasons like long-term medicine treatment, restrictions on them like using masks and avoiding crowded places,” said Dr Sagar Karia, Joint Secretary of Bombay Psychiatric Society, which is an autonomous body of mental health professionals in the city.
Explaining further, he added, “Depression is the most common factor in, patients suffering from chronic disease. Anti-tuberculosis medicines also are known to cause depression and some are known to increase suicidal tendencies. So, those who are suffering from MDR- TB or XDR-TB, need more attention. So, doctors send patients for a psychiatric treatment too.”
Diabetes too needs a long-term treatment and therefore, it shares a cause and effect relationship. Diseases like diabetes, where long term medication is involved, patient needs to take regular medicine, secondary illness is more common, it leads to stress and anxiety.
“Having a psychiatric consultation is a must,” Karia added.
Psychiatric counselling crucial
Another problem, which needs to be rectified with more awareness and education, is that many treating physicians don’t refer patients to psychiatrists.
“This leads to increased psychiatric morbidity. So, awareness among general physicians also needs to increase,” Karia added.
He witnesses 10 to 15 chronic disease patients out of total 100 depressed patienats per week. At Sewri TB Hospital psychiatrists have been appointed so that there is lesser burden on psychiatrists in the city hospitals.
Family support helps patient fight disease bavely
Dr Harish Shetty, senior Psychiatrist at Dr LH Hiranandani Hospital, Mumbai, gave his view on importance of psychiatric treatment to chronic disease patients.
“Both patient and the family needs psychiatric counselling. Family support and good counselling helps the patient fight the disease bravely. Corporate hospitals also have their support group of patients where the group shares each other’s problem as well as ways to deal with them. But it is unfortunate that not all chronic patients receive that kind of attention and psychiatric complications can be missed.”
Agreeing to his point Dr Heena Merchant, Psychiatrist at KEM Hospital, said, “Psychiatric counselling is very important for terminally, chronic and prolonged illness patients. In abroad, they have multidisciplinary team to manage these illness and psychiatrists are part of the team. Considering this percentage, one in two chronic illness patients will require professional help. It is extremely important for the treating team to be aware of psychiatric problems in chronically ill patients and be able to pick up the early sign which can then be treated.”
Due to urbanisation, cancer cases have doubled from 30,000 to 60,000 and at least 100 people per lakh are cancer affected. In rural areas, the number is 45 per lakh. As per latest reports, there were 1.01 million new cancer cases (477,482 in males and 537,452 in females) diagnosed in India.