Renu used to love painting. Then, suddenly, she stopped. She was also the one who called first, who visited, who showed up. She was surrounded by friends, relatives and the daily noise of a full life. But over a few weeks, that noise began to fade. And Renu, who had once been at the centre of it, began to withdraw. “I used to love painting, but I don’t know why I don’t feel like doing it anymore,” says the 32-year-old homemaker from Faridabad.From the outside, nothing seemed amiss. “People saw me doing my daily activities, but they didn’t know the effort I put into doing them,” she says. Inside, however, she felt increasingly disconnected from herself. “I feel like I am behind a wall. I feel detached from myself. I can see my life moving, but I am just watching it from afar.” Dr Rajesh Sagar, a psychiatrist at AIIMS Delhi, tells The Indian Express that this sense of detachment is a recognised experience in depression, not merely a figure of speech. Patients may describe feeling numb, detached or unreal, as though a pane of glass separates them from the world around them. “Depression is often mistaken for sadness. But Renu’s experience was not simply about feeling sad. It was about feeling absent from her own life,” he says.Depression does not always look like sadness; sometimes, it shows up as withdrawing from friends, abandoning hobbies once loved, or finding everyday tasks unusually exhausting. “I cannot say exactly when it began. There was no crisis, no single bad day. Just a heaviness that settled in and stayed. Gradually, waking up became a task. Talking to people became harder still,” says Renu. Even the chores she had managed for years began to feel like a steep slope she had to climb every day.Also Read | ‘What caused the suicide?’: A question that masks the truthThe exhaustion of explainingRenu began to retreat into silence. But why? “Explaining why I wasn’t feeling well became more tiring than staying alone and quiet,” she says. Her mind, meanwhile, never seemed to switch off. “My mind is always on a roll,” she says. Her world began to divide into two columns: either she was doing everything right, or she was failing. There seemed to be no middle ground. And a question kept returning to her mind: What’s the point?Dr Sagar explains that all-or-nothing thinking and persistent rumination can accompany depression, making everyday life increasingly exhausting. The more the mind loops through the same thoughts, the less energy a person may have for the things that once brought pleasure. For Renu, painting was one of those things.Clinicians call this loss of interest or pleasure anhedonia. For Renu, it meant something more personal: the thing she had once loved no longer stirred anything in her. The joy had gone quiet. At home, the change was visible and difficult for everyone to navigate. Renu put one part of her experience plainly: “I feel like a burden on my husband.” Some days, that feeling deepened into a thought that frightened her — that her family might be better off without her.Dr Sagar says thoughts of this kind can occur in depression. “Renu had no reported history of mania, psychosis or previous psychiatric illness. Something else frightened her, too: what would people say if she sought psychiatric help?”Story continues below this adThe weight of stigmaIn India, that hesitation can be a significant barrier to care. The National Mental Health Survey of 2015–16 found a substantial burden of mental health conditions and major gaps in access to treatment. It estimated that nearly 15% of Indian adults required active intervention for one or more mental health conditions, while approximately one in 20 experienced depression. Treatment gaps varied widely across disorders, ranging from around 70% to more than 90%. Stigma remains one of the barriers that can prevent people from seeking help or receiving timely care.Dr Sagar says that when patients come to outpatient departments with symptoms of depression, clinicians need to look beyond a checklist of symptoms and ask questions that invite them to describe their experiences. “In our OPDs, whenever a patient comes to us with symptoms of depression, we ask the standard questions, questions oriented towards their lived experience, like, ‘What has this been like for you? What have you lost? What makes it worse? What do you want from treatment?’”That’s what helped Renu open up. “Otherwise, everyone kept asking what is wrong with me. I’m always told what to do, but never asked how it feels to be like this.” Her words point to a larger question in mental healthcare: what happens when the process of identifying an illness leaves too little room for the person living with it?Also Read | What’s India’s mental health score? Youth rank 60th across 84 countries, elderly at rank 49, says global reportBeyond the diagnosis“Modern psychiatry rests, rightly, on scientific evaluation: symptom checklists, risk assessment, diagnosis. But in a crowded outpatient department, that evaluation can crowd out the patient’s own account, or push it out of the room. Yet it is so important to listen,” explains Dr Sagar.Story continues below this adA clinician can assess symptoms and risk. The patient, meanwhile, can describe what the illness has done to her identity, her relationships, her sense of meaning and her control over her own life. In Renu’s case, a symptom-focused assessment alone could miss important parts of the picture: her feeling that she had lost herself; the disappearance of pleasure in something she once valued; the strain on her marriage; her sense of being a burden; the stigma she feared; and the emotional detachment that made her feel like a spectator in her own life.Understanding these experiences is not separate from treatment. It can help shape care around what matters to the person receiving it, including her priorities, preferences and hopes for recovery.Ask Renu what getting better looks like, and she does not name a score or a clinical measure. She wants to “feel like myself again”. She wants to return to her daily life, regain a sense of control and have a say in decisions about her treatment.For Dr Sagar, this is where a person-centred approach becomes essential: listening without judgement, validating the patient’s experience, exploring what the illness means to them, and setting treatment goals together. It also means involving family members when appropriate and helpful, recognising that depression can affect relationships and everybody who provides support.Story continues below this adThe aim, ultimately, must extend beyond reducing symptoms to helping a person reclaim the parts of life that matter to them. Renu’s wish was modest. She just wanted to paint again.