A presentation about Depression & Anxiety

1. Depression & Anxiety
By:
67 SHIRGAONKAR SAAD 120IT3153A
68 SINGH JAYESH HEMANT 118IT1378A
69 SINGH PRATHAM UPENDRA 120IT3239A
70 SINGH VIRAJ VIJAYPRATAP 118IT1148A
71 SURVE JAYESH SANDEEP 119IT1102A
72 SURVE MANDAR 120IT3274A
This Project was successfully Completed under the Guidance of Our Mentor Prof: Sandip Gawai.
Thank you so much for your mentorship. We exceptionally benefited from your guidance.

2. Depression

3. What is Depression?
Depression (major depressive disorder) is a
common and serious medical illness that
negatively affects how you feel, the way you
think and how you act. Fortunately, it is also
treatable. Depression causes feelings of sadness
and/or a loss of interest in activities you once
enjoyed. It can lead to a variety of emotional and
physical problems and can decrease your ability
to function at work and at home.

4. • The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a
person to endure. It is normal for feelings of sadness or grief to develop in response to such
situations. Those experiencing loss often might describe themselves as being “depressed.”
• But being sad is not the same as having depression. The grieving process is natural and unique to
each individual and shares some of the same features of depression. Both grief and depression may
involve intense sadness and withdrawal from usual activities.
Depression Is Different From Sadness or
Grief/Bereavement

5. • In grief, painful feelings come in waves, often intermixed with positive memories of the deceased.
In major depression, mood and/or interest (pleasure) are decreased for most of two weeks.
• In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-
loathing are common.
• In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased
loved one. In major depression, thoughts are focused on ending one’s life due to feeling worthless or
undeserving of living or being unable to cope with the pain of depression.
Depression Is Different From Sadness or
Grief/Bereavement

6. What Are the Causes of Depression?
There are several possible causes of depression. They can range from biological to circumstantial.
Common causes include:
• Family history. You’re at a higher risk for developing depression if you have a family history of depression
or another mood disorder.
• Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.
• Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However,
scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic
pain, or attention-deficit hyperactivity disorder (ADHD).
• Drug use. A history of drug or alcohol misuse can affect your risk.

7. What Are the Causes of Depression?
About 21 percent of people who have a substance use problem also experience
depression. In addition to these causes, other risk factors for depression include:
• low self-esteem or being self-critical
• personal history of mental illness
• certain medications
• stressful events, such as loss of a loved one, economic problems, or a divorce
• Many factors can influence feelings of depression, as well as who develops the condition and who
doesn’t.
The causes of depression are often tied to other elements of your health.
• However, in many cases, healthcare providers are unable to determine what’s causing depression.

8. What Are the Different Types of
Depression?
Major depression is the classic type of depression and what’s diagnosed, or
labeled, as MDD (it’s also known as unipolar depression). People with major
depression have symptoms of depression most of the day, nearly every day, for
episodes of at least two weeks and can experience recurrent episodes throughout
their lives. Under MDD, you can further break down depression into several
specific subtypes:

9. What Are the Different Types of
Depression?
• Seasonal Affective Disorder (SAD) emerges during particular seasons of the year—commonly
winter—brought on from diminished natural sunlight.
• Atypical Depression’s biggest differentiator is mood reactivity. People with this kind of
depression see their mood improve when something positive happens.
• Bipolar Disorder used to be called manic depression and involves alternating between episodes of
depression and extremely elevated energy.
• Psychotic Depression occurs when a person experiences depressive episode so severe they start
having false fixed beliefs (delusions) or hearing or seeing things that others can’t hear or see
(hallucinations).

10. What Are the Different Types of
Depression?
• Postpartum Depression occurs after giving birth. Mothers may feel disconnected from their new
baby or fear that they could hurt their child.
• Premenstrual Dysphoric Disorder is a severe type of depression that shows up during the second
half of the menstrual cycle.
• Situational Depression, or adjustment disorder, refers to depression that is triggered by a
significant life-changing event.
• Persistent Depressive Disorder used to be called dysthymia. It’s a chronic form of depression—
usually with milder symptoms—in which an episode lingers for a long period of time, sometimes
two years or more. It could be described as feeling like you’re living on autopilot.

11. Signs and Symptoms of
Depression
Experiencing a combination of these symptoms—along with at least a low mood or
loss of pleasure—for a period of at least two weeks could signify a depressive episode
• Persistent feelings of sadness, hopelessness, worthlessness, or emptiness. You generally feel
down most of the time.
• Loss of interest in activities—even in stuff you used to love. It’s like you just lose motivation
and feel disinterested.
• Trouble sleeping or oversleeping. You have a hard time falling asleep, staying asleep, or
getting out of bed. We’re not talking the occasional snooze-hitting; this is like your body is
covered in a 50-pound weighted blanket and you can’t get out of bed.
• Appetite or weight changes. You’re overeating, lose your appetite, or experience significant
weight gain or loss without dieting (about 20 percent of your weight). Sometimes people get a
little rush from eating and so they seek that lift and it leads to over-eating; other times though
you may just have no appetite at all.

12. Signs and Symptoms of
Depression
• Fatigue or decreased energy. You feel exhausted all the time, or you feel like you can spend days on the
couch or in bed.
• Difficulty thinking clearly or quickly, remembering details, concentrating, or making decisions. You
feel distracted and focusing seems impossible.
• Irritability, frustration, or pessimism. Your mood and headspace feel negative most of the time.
• Physical aches and pains. You may have headaches, stomachaches, or neck tension.
• Recurrent thoughts of death or suicide, with or without a plan to actually do it

13. How Depression is Diagnosed
• It used to be that all mood disorders were lumped together. Now, a doctor will make a distinction about
the particular disorder or subtype of depression that a patient has. For example, a doctor will determine
whether a patient has major depression, chronic depression including dysthymia, seasonal affective
disorder (SAD), bipolar disorder, or some other type of clinical depression.
• These days, a routine doctor’s visit with your general health practitioner may be all it takes to receive a
diagnosis. Standard screening tools like the Patient Health Questionnaire (PHQ-9)—a survey of yes,
nine items, that physicians use to assess the severity of depression—are becoming widely used in
primary care settings to screen for the condition.
• In fact, “most patients with depression are going to be diagnosed and treated by primary care doctors,
not specialists or psychiatrists,” says James Murrough, M.D., Ph.D., Director of the Depression and
Anxiety Center for Discovery and Treatment at Mount Sinai.

14. How Depression is Diagnosed
Your doctor may determine a diagnosis of depression based on:
• Physical exam. Your doctor may do a physical exam and ask questions about your health. In some
cases, depression may be linked to an underlying physical health problem.
• Lab tests. For example, your doctor may do a blood test called a complete blood count or test your
thyroid to make sure it's functioning properly.
• Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings
and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
• DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

15. What Are the Treatments for Depression?
There are ever-evolving ways to treat depression, and the mix will depend
on everything from how long you’ve had it and the severity of your
symptoms

16. Medications
• There’s no shame in taking medication to manage your depression. People routinely take medication
for physical ailments, and having a mental illness isn’t any different.
• Antidepressants work by affecting neurotransmitters in the brain. Common types of antidepressants
include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake
inhibitors (SNRIs), and norepinephrine-dopamine reuptake inhibitors (NDRIs).
• Depression medication may be the most advertised treatment for depression, but that doesn’t mean it is
the most effective. Depression is not just about a chemical imbalance in the brain. Medication may help
relieve some of the symptoms of moderate and severe depression, but it doesn’t cure the underlying
problem, and it’s usually not a long-term solution. Antidepressant medications also come with side
effects and safety concerns, and withdrawal can be very difficult.

17. Therapy
• If there is no underlying medical cause for your symptoms of depression, talk therapy can be an
extremely effective treatment.
• Psychotherapy (aka talk therapy), sometimes along with medication, can be highly beneficial in
treating, managing, and reducing the duration of an episode of depression.
• “Evidence-based treatments, such as Cognitive Behavioral Therapy (CBT), Acceptance and
Commitment Therapy, and Dialectical Behavior Therapy have been shown to be very effective in the
treatment of depression,” says Dr. Stern. “These psychotherapies are active skills-based therapies that
help individuals develop and maintain skills to manage difficult thoughts and feelings.”
• Trained experts like psychiatrists and psychologists can offer many types of these treatments, from light
therapy for seasonal affective disorder to CBT that works to change your thought processes. One goal
of CBT includes behavioral activation, an effective treatment and technique in which a therapist can
help you schedule more enjoyable activities that bring fulfillment, meaning, or pleasure into your life.

18. Other Treatments
• Device treatments such as Transcranial Magnetic Stimulation (TMS) and Electroconvulsive
Therapy (ECT) may be beneficial and appropriate for certain individuals.
• TMS, ECT, and vagus nerve stimulation (VNS)—a newer treatment that involves surgically implanting
a device similar to a pacemaker along the peripheral nerve in the neck—are all types of brain-
stimulating approaches that may sound very sci-fi but can be effective after first trying therapy and
medication.

19. Healthy Habits
Any treatment for depression should coincide with maintaining a healthy diet, regular exercise, a productive
sleep schedule, and—yes—even mindful self-care practices. These are all helpful in alleviating or reducing the
severity of symptoms.
• Exercise. Regular exercise can be as effective at treating depression as medication. Not only does exercise
boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells
and connections, just like antidepressants do.
• Social support. Strong social networks reduce isolation, a key risk factor for depression. Keep in regular
contact with friends and family, or consider joining a class or group.
• Nutrition. Eating well is important for both your physical and mental health. Eating small, well-balanced
meals throughout the day will help you keep your energy up and minimize mood swings.
• Sleep. Sleep has a strong effect on mood. When you don’t get enough sleep, your depression symptoms
will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure
you’re getting enough sleep each night.
• Stress reduction. Make changes in your life to help manage and reduce stress. Too much stress
exacerbates depression and puts you at risk for future depression. Take the aspects of your life that
stress you out, such as work overload or unsupportive relationships, and find ways to minimize their
impact.

20. Anxiety

21. What is anxiety?
Anxiety is a feeling of fear, dread, and uneasiness. It might cause
you to sweat, feel restless and tense, and have a rapid heartbeat.
It can be a normal reaction to stress. For example, you might feel
anxious when faced with a difficult problem at work, before
taking a test, or before making an important decision. It can help
you to cope. The anxiety may give you a boost of energy or help
you focus. But for people with anxiety disorders, the fear is not
temporary and can be overwhelming.

22. What are anxiety disorders?
• Anxiety disorders are conditions in which you have anxiety that does not go away and can get worse
over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and
relationships.
• In the case of an anxiety disorder, the feeling of fear may be with you all the time. It is intense and
sometimes debilitating.
• This type of anxiety may cause you to stop doing things you enjoy. In extreme cases, it may prevent
you from entering an elevator, crossing the street, or even leaving your home. If left untreated, the
anxiety will keep getting worse.
• Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age.
According to the American Psychiatric Association, women are more likely than men to be diagnosed
with an anxiety disorder.

23. What are the types of anxiety
disorders?
Anxiety is a key part of several different disorders. These include:
• Generalized Anxiety Disorder: may feel extreme and unrealistic worry and tension — even if there’s
nothing to trigger these feelings. Most days, you may worry a lot about various topics, including health,
work, school and relationships.
• panic disorder: experiencing recurring panic attacks at unexpected times. A person with panic disorder
may live in fear of the next panic attack.
• phobia: excessive fear of a specific object, situation, or activity
• social anxiety disorder: extreme fear of being judged by others in social situations
• obsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific,
repeated behaviors

24. What are the types of anxiety
disorders?
• Agoraphobia: This is a fear and avoidance of places, events, or situations from which it may be difficult
to escape or in which help would not be available if a person becomes trapped.
• Selective mutism: This is a form of anxiety that some children experience, in which they are not able to
speak in certain places or contexts, such as school, even though they may have excellent verbal
communication skills around familiar people. It may be an extreme form of social phobia.
• separation anxiety disorder: fear of being away from home or loved ones
• illness anxiety disorder: anxiety about your health (formerly called hypochondria)
• post-traumatic stress disorder (PTSD): anxiety following a traumatic event
• Anxiety, Gender and Sexuality

25. What is an anxiety attack?
• An anxiety attack is a feeling of overwhelming apprehension, worry, distress, or fear.
For many people, an anxiety attack builds slowly. It may worsen as a stressful event
approach.
• Anxiety attacks can vary greatly, and symptoms may differ among individuals. That’s
because the many symptoms of anxiety don’t happen to everyone, and they can change
over time.

26. What is an anxiety attack?
Common symptoms of an anxiety attack include:
• feeling faint or dizzy
• shortness of breath
• dry mouth
• sweating
• chills or hot flashes
• apprehension and worry
• restlessness
• distress
• fear
• numbness or tingling
A panic attack and an anxiety attack share some common symptoms, but they’re not the same.

27. What causes anxiety?
• The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and
your environment may play a role.
• Researchers are not sure of the exact cause of anxiety. But, it’s likely a combination of factors play a
role. These include genetic and environmental factors, as well as brain chemistry. In addition,
researchers believe that the areas of the brain responsible for controlling fear may be impacted.

28. What causes anxiety?
Possible causes include:
• environmental stressors, such as difficulties at work, relationship problems, or family issues
• genetics, as people who have family members with an anxiety disorder are more likely to
experience one themselves
• medical factors, such as the symptoms of a different disease, the effects of a medication, or
the stress of an intensive surgery or prolonged recovery
• brain chemistry, as psychologists define many anxiety disorders as misalignments of
hormones and electrical signals in the brain
• withdrawal from an illicit substance, the effects of which might intensify the impact of other
possible causes

29. What causes anxiety?
Possible causes include:
• environmental stressors, such as difficulties at work, relationship problems, or family issues
• genetics, as people who have family members with an anxiety disorder are more likely to experience
one themselves
• medical factors, such as the symptoms of a different disease, the effects of a medication, or the stress of
an intensive surgery or prolonged recovery
• brain chemistry, as psychologists define many anxiety disorders as misalignments of hormones and
electrical signals in the brain
• withdrawal from an illicit substance, the effects of which might intensify the impact of other possible
causes

30. What are the symptoms of anxiety?
• Anxiety feels different depending on the person experiencing it. Feelings can range from butterflies in
your stomach to a racing heart. You might feel out of control, like there’s a disconnect between your
mind and body.
• Other ways people experience anxiety include nightmares, panic attacks, and painful thoughts or
memories that you can’t control. You may have a general feeling of fear and worry, or you may fear a
specific place or event.
Symptoms of general anxiety include:
• increased heart rate
• rapid breathing
• restlessness
• trouble concentrating
• difficulty falling asleep
Your anxiety symptoms might be totally different from someone else’s. That’s why it’s important to know
all the ways anxiety can present itself.

31. Did You Know?
• Anxiety disorders are the most common mental illness in
the U.S., affecting 40 million adults in the United States
age 18 and older, or 18.1% of the population every year.
• Anxiety disorders are highly treatable, yet only 36.9% of
those suffering receive treatment.
• People with an anxiety disorder are three to five times
more likely to go to the doctor and six times more likely
to be hospitalized for psychiatric disorders than those
who do not suffer from anxiety disorders.
• Anxiety disorders develop from a complex set of risk
factors, including genetics, brain chemistry, personality,
and life events.

32. What are treatments for anxiety?
• Once you’ve been diagnosed with anxiety, you can to explore treatment options with
your doctor. For some people, medical treatment isn’t necessary. Lifestyle changes
may be enough to cope with the symptoms.
• In moderate or severe cases, however, treatment can help you overcome the symptoms
and lead a more manageable day-to-day life.
• Treatment for anxiety falls into two categories: psychotherapy and medication.
Meeting with a therapist or psychologist can help you learn tools to use and strategies
to cope with anxiety when it occurs.
• Medications typically used to treat anxiety include antidepressants and sedatives.
They work to balance brain chemistry, prevent episodes of anxiety, and ward off the
most severe symptoms of the disorder.

33. What natural remedies are used for anxiety?
Lifestyle changes can be an
effective way to relive some
of the stress and anxiety you
may cope with every day.
Most of the natural
“remedies” consist of caring
for your body, participating in
healthy activities, and
eliminating unhealthy ones.
These include:
• getting enough sleep
• meditating
• staying active and exercising
• eating a healthy diet
• staying active and working out
• avoiding alcohol
• avoiding caffeine
• quitting smoking cigarettes
If these lifestyle changes seem like a positive way
to help you eliminate some anxiety, read about how
each one works—plus, get more great ideas for
treating anxiety

34. How does medication treat anxiety disorders?
Medications can’t cure an anxiety disorder. But they can improve symptoms and help
you function better. Medications for anxiety disorders often include:
• Anti-anxiety medications, such as benzodiazepines, may decrease your anxiety, panic and worry. They
work quickly, but you can build up a tolerance to them. That makes them less effective over time. Your
healthcare provider may prescribe an anti-anxiety medication for the short-term, then taper you off or
the provider may add an antidepressant to the mix.
• Antidepressants can also help with anxiety disorders. They tweak how your brain uses certain
chemicals to improve mood and reduce stress. Antidepressants may take some time to work, so be
patient. If you feel like you’re ready to stop taking antidepressants, talk to your provider first.
• Beta-blockers, usually used for high blood pressure, can help reduce some of the physical symptoms
of anxiety disorders. They can relieve rapid heartbeat, shaking and trembling.

35. How does psychotherapy treat anxiety disorders?
Psychotherapy, or counseling, helps you deal with your emotional response to the
illness. A mental health provider talks through strategies to help you better understand
and manage the disorder. Approaches include:
• Cognitive behavioral therapy (CBT) is the most common type of psychotherapy
used with anxiety disorders. CBT for anxiety teaches you to recognize thought
patterns and behaviors that lead to troublesome feelings. You then work on changing
them.
• Exposure therapy focuses on dealing with the fears behind the anxiety disorder. It
helps you engage with activities or situations you may have been avoiding. Your
provider may also use relaxation exercises and imagery with exposure therapy.

36. Anxiety and depression
• If you have an anxiety disorder, you may also be depressed. While anxiety
and depression can occur separately, it’s not unusual for these to mental health
disorders to happen together.
• Anxiety can be a symptom of clinical or major depression. Likewise, worsening
symptoms of depression can be triggered by an anxiety disorder.
• Symptoms of both conditions can be managed with many of the same treatments:
psychotherapy (counseling), medications, and lifestyle changes.

37. Can foods treat anxiety?
Medication and talk therapy are commonly used to treat anxiety. Lifestyle changes, like getting
enough sleep and regular exercise, can also help. In addition, some research suggests the foods
you eat may have a beneficial impact on your brain if you frequently experience anxiety.
• These foods include:
• salmon
• chamomile
• turmeric
• dark chocolate
• yogurt
• green tea

38. Outlook
Anxiety disorders can be treated with medication, psychotherapy, or
a combination of the two. Some people who have a mild anxiety
disorder, or a fear of something they can easily avoid, decide to live
with the condition and to not seek treatment.

39. Mental health and COVID-19 in India

40. • To fully realize the mental health crisis that India faces in relation to COVID-19, one has to begin with
recognizing the very serious situation that existed even before the pandemic. The government’s National
Mental Health Survey reported that about 10 percent of adults meet diagnostic criteria for a mental health
condition (ranging from mood and anxiety disorders to severe mental illness). The Global Burden of
Disease study estimated that nearly 200 million people in India have experienced a mental disorder,
nearly half of whom suffer from depressive or anxiety disorders.
• India accounts for more than a third of the female suicides globally, nearly a fourth of all male suicides,
and suicide has been the leading cause of death in young Indians.
• Yet, the government has spent very little on mental healthcare (estimated at less than one percent of the
health budget), and this expenditure has been almost entirely on doctors, drugs, and hospitals in urban
areas.
• There is little community-oriented mental healthcare anywhere in the country. Unsurprisingly, between 70
to 92 percent of affected individuals have received no care from any source, of any kind, for their mental
health conditions.
• Indeed, there is already evidence in support of this distress. Internet-based surveys conducted between
March-May 2020 show high rates of depression and anxiety in the general population. For example,
the ‘FEEL-COVID’ survey conducted in February-March 2020 with 1,106 people across 64 cities
reported that a third of respondents faced significant ‘psychological impact’ because of COVID-19. A
number of other surveys indicate that such impact may be related to preoccupations with, or anxieties
about contracting the virus, depression, sleeping difficulties, irritability, and loneliness.

41. The pandemic is affecting different groups in
specific ways
• Women: In general, studies report many women suffering from anxiety and depression; this may
be due to them facing the brunt of increased household responsibilities and domestic violence
during the lockdown.
• Children: After speaking with 1,102 parents and primary caregivers, it was found that more
than 50 percent of children had experienced agitation and anxiety during the lockdown. Media
reports indicate that they may be experiencing fears about the virus, worries over access to online
classes, and stress and irritability from being unable to go out.
• Young people: One survey reported that 65 percent of nearly 6,000 youth aged 18-32 years felt
lonely during the lockdown, and 37 percent felt that their mental health had been ‘strongly
impacted’. This is not surprising given that twenty-seven million young people lost their jobs in
April 2020 alone, and 320 million students have been affected by the closing of educational
institutions, and the postponement of exams.

42. • Migrant workers and daily wage laborer: Although there are no studies specifically with migrant
workers, panic reactions have been observed in the millions who lost their livelihood and made
desperate attempts to return to their rural homes. Daily wage laborers have also been heavily affected;
a study of 1,200 auto drivers found that 75 percent were anxious about their work and finances.
• Doctors and frontline workers: A survey with 152 doctors found that more than a third of them are
experiencing depression and anxiety due to the pandemic. Frontline workers are reportedly burdened
by over-work, and anxious about contracting the virus.
• People with pre-existing mental health conditions: The anxieties described earlier have
been overwhelming for people with pre-existing mental health conditions. Problems may also have
worsened for individuals because of the disruption of mental health services and the difficulty of
travel, which led to people reducing doses of prescribed medication.
• People with substance use disorders: The sudden closure of all liquor shops in the country and the
cutting off drug supplies has resulted in withdrawal symptoms in many people with alcohol and
substance use dependence, for example, delirium (confused thinking and reduced awareness of
surroundings) and seizures (sudden, uncontrolled electrical disturbance in the brain. It can cause
changes in your behavior, movements or feelings, and in levels of consciousness). Many alcohol
‘addicts’ distressed by their craving have also consumed poisonous substances such as hand sanitizers
as substitutes and died, or died by suicide.

43. Tips for good mental health
• Take care of your body
• Practice healthy thinking
• Slow down
• Have fun
• Reach out