Plumbing the depths of despair

Only 8.3 percent of mood disorder patients (mostly depression) would ever get help, and there is no assurance that they are indeed getting the right treatment, according to a survey in six provinces and cities in China by specialist Michael Phillips in 2001-05.

"Depression is curable, but the time lag in diagnosis and treatment often takes a heavy toll on patients," he says.

Patients are often left out in the cold. Wang Ying, using a pseudonym, talks about her bout with depression. She is from Baoding, Hebei province and is in her 50s. In 2010, while undergoing menopause and recovering from a major bone fracture, she started aching everywhere "in her bones".

Local doctors could not make a diagnosis, so she went to famous hospitals in Beijing. Over 18 months, she underwent many tests and tried many types of medication, but her situation got worse.

"The pain became constant and sharp, and I had to retire from work," Wang says. "All the doctors had different explanations and they all seemed justifiable. But the medicine they prescribed just had no effect at all."

In 2012, a doctor at a general hospital finally suggested she seek the help of psychiatrists. Still skeptical, Wang sought treatment and was diagnosed with depression. By that time, her depression was so severe that she was later hospitalized at Beijing Huilongguan Hospital.

Now, Wang is almost fully recovered and about to leave the hospital.

When depression first presents itself, physical symptoms, such as insomnia, pain, fatigue, constipation and diarrhea, may distract both patient and doctor, who may fail to associate these symptoms with a mental condition, according to Han Xueqing, a mental health specialist with Tongren Hospital in Beijing.

Her tenure with this well-regarded general hospital has exposed her to a large number of patients with depression from all over the country. Most of them do not realize the root of their problems is mental, rather than physical.

Patients also tend to conceal the fact that they have depression, for fear of social stigmas.

This is because, Han says, there is a lack of professional help and facilities, as well as the stigma associated with mental disorders, especially in less developed areas of the country.

Chen Lin, the specialist with Beijing Huilongguan Hospital, agrees and points out that the universal lack of trained physicians in China is the main reason why, even when diagnosed, a patient may not necessarily get the correct healthcare.

However, Chen notes that there is a worrisome trend in some rural areas where doctors are still entrenched in disappointingly low levels of awareness and knowledge of mental disorders.

Chen cites examples of doctors in some rural hospitals who prescribe inappropriately strong doses of medication for patients. These may have rapid effect at first, but often do more harm than good in the long term.

Related:At a glance

Lend me your ears, show me the light