The article “The cultures of depression” (Oct.19) rightly points to the failure of individual models and cultures to explain all aspects of depression. Part of the problem lies in the way modern medicine is taught and practised. The emphasis on specialisation has deprived medical practitioners of their ability to look at the body as a whole, besides dealing a blow to the concept of family physician. The shocking truth is that except for practising psychiatrists, doctors are unable to detect telltale signs of depression. The government needs to revive the mental health plan in mission mode and set apart enough funds for expanding the mental health infrastructure.

V.N. Mukundarajan, Thiruvananthapuram

Practitioners of medicine need to be aware of the diverse models through which depression can be conceptualised. They should avoid taking the medical route for trivial mood fluctuations and distress.

Psychological interventions and stress reduction strategies (Yoga, meditation, hobbies), which have proved beneficial, are time-intensive strategies. They are hardly utilised in the busy out-patient departments of our hospitals. Besides, cognitive therapies are cost and labour-intensive which require trained professionals. Therefore, in low-resource health delivery settings, it is no wonder that medicines are used as the best armament against depressive symptoms.

G.S. Ramkumar, Bangalore

Although depression is the commonest mental condition, it often goes undiagnosed and untreated. There is still social stigma attached to depression. While some people cope well with adversity, some are unable to come to terms with occasions like bereavement, breakdown in relationships and loss of employment. It is important to be aware of the heterogeneity of depression, the patient’s genetic make-up, the circumstances in which he is living, and the way he perceives his problems for optimal management of depression.

G. David Milton, Kanyakumari

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