Story of hope in Nepal: A mother’s experience of depression
Fifty-eight year old Maya Devi Sharma (name changed) a permanent resident of Chitwan is a mother of two daughters and a son. While both her daughters were sent off on their marriage, she is currently living with her son, daughter-in-law and two grandchildren. Few years before, she lost her husband due to chronic illness he had had.
Not long ago, her son, the breadwinner of the family, shared about his willingness to go abroad to earn some money. Supporting his desire, she took loan from the neighbors to send him to Malaysia hoping that he would earn money, clear off the debts and look after his family. To her dismay, her son after going abroad did not contact the family let alone send money back home. On the other hand, she was continuously forced to clear off the debts she had taken from the neighbors. Having invested everything on her son's process, she was left with nothing due to which she started worrying.
As days passed by, her worries multiplied. Most of the times, she preferred to stay alone in a dark room, or just stare blankly at space contemplating about negative things. She was so frustrated with life that she found no reason to live and spent days crying. Gradually, it also hampered her relationship with others as she withdrew from social activities, stopped talking to others and became easily irritated when her grandchildren played around her. Changes in her behavior were marked with unkempt appearance, forgetfulness, disturbed sleep, loss of appetite, loss of interest in doing things she used to enjoy such as listening to radio and watching television. Not only this, her daily activities were also gravely affected as she stopped carrying out household chores and stayed idle throughout the day.
Because she was deeply troubled by these problems, she sought help from the traditional healers thinking that she had been bewitched or someone might have plot something bad against her. Even after consulting the traditional healers for nearly 6-7 months, the problems still persisted, instead it worsened in the due time. Even without doing anything, she was easily fatigued. It was at this point, she visited the health post for general physical check-up. The trained mental health workers at the health post besides conducting her physical check up, also assessed her for depression. When they found depressive symptoms in her, she was referred to TPO's psychosocial counselor.
In the first session, she was assessed for depression by the counselor using PHQ-9. After being identified with depression, the psychosocial counselor involved her in Healthy Activity Program (HAP), an intervention designed specifically for depressive patients. Simultaneously, she was also provided pharmacological treatment by the health workers. During the counseling session, she was made to list out all the activities of her interest and choose any one of the healthy activities to start with. In the same way, using the mood chart, she was encouraged to give continuity to activities that made her happy. Gradually, one after another she activated all her previous healthy activities. Along with it, she was also made to prepare daily activity table, and record all her activities to reflect on it later. Not only that, the counselor also visited her family and conducted family counseling and psychoeducation with the family members. In addition, the counselor also involved her in the relaxation exercise. Her active involvement and cooperation in the counseling session, helped her get out of the web of unhealthy behaviors. After few sessions, significant changes were noticed.
These days she is actively involved in social activities. She has also regenerated her relationship with others, shares her feelings with others confidently and visits her daughters. She is also carrying out her duties responsibly which she had given up previously. She keeps herself engaged by carrying out household chores such as cooking meal, washing clothes, grazing cattle, which has prevented her from thinking about negative things. She has seen the brighter side of life and thinks her life is beautiful and worth living. She is a whole different person than she used to be.
Prepared by Bipan Shah and Prasansa Subba