SlideShare a Scribd company logo
WELCOME
Depression introduction
DEPRESSION: Let’s TALK
BY
DHARMESH CHATURVEDI
(M.Sc. Nursing)
n/sister (male)
Rmh dahod
Pathogen Disease (pathology)
Modifiers
Lifestyle
Individual susceptibility
Traditional model of Disease Development
Dominance of the bio-psychosocial model
Mainstream in last 15 years
Hazard
Psychosocial Factors
Attitudes
Behaviour
Quality of Life
Illness (well-being)
Rise of the person as a
“psychological entity”
Depression introduction
The World Health Organization
(WHO) has declared Depression
as the theme for the World
Health Day (7th April 2017).
The campaign slogan is
‘Depression: Let’s Talk’, and was
released on the World Mental
Health Day this year (10 October
2016).
What is Depression?
डिप्रेशन हमारी जिन्दगी में िहर घोलने वाला एक महत्वपूर्ण भाव है िो हमारे
दैननक िीवन में कई तरह की समस्याओं के ललए हमारे शरीर द्वारा की गयी एक
बायोलॉजिकल क्रिया है जिसे हम तनाव कहते है िो थोड़े समय के ललए
सामान्यत हर क्रकसी में पाया िाता है लेक्रकन लम्बे समय तक क्रकसी परेशानी के
चलते यह अगर हमारी Habit में शालमल हो िाये तो हमारे ललए घातक हो सकता
है
In addition, people with depression normally have several of the
following symptoms:
a loss of energy;
a change in appetite;
sleeping more or less;
anxiety;
reduced concentration;
restlessness;
–कु छ सामान्य संके त होते है जिस से हम अपने अंदर िमा
हो रही घुटन को समझ सकते है िैसे क्रक
 नींद में कमी
क्रकसी आने वाली समस्या के ललए हमारी िरुरत से
अधिक धचंता
बीमार होने पर क्रकसी भयानक बीमारी की कल्पना करना
क्रकसी अपराि बोि (guilt) िैसी भावना (feeling) में
खुद को अक्षम महसूस करना जिसकी विह से खुद को
नुकसान पहुुँचाने या िीवन खत्म करने की इच्छा होना
ऐसे में ना दोस्त अच्छे लगते हैं और ना ही क्रकसी और
काम में मन लगता है.
जिंदगी ननराश लगने लगती है और positive बातें भी
negative लगने लगती हैं.
आदद कु छ लक्षर् है जिनसे हम समझ सकते है क्रक
DEFINITION
Depression is defined as state of low mood and
aversion to activity that can affect a person's thoughts,
behavior, feelings, and sense of well-being. People with
a depressed mood can feel sad, anxious, empty,
hopeless, helpless, worthless, guilty, irritable, angry,
ashamed, or restless.
“अवसाद एक ऐसी मानलसक जस्थनत या स्थायी मानलसक
ववकार है जिसमे व्यजतत को उदासी, अके लापन, ननराशा, कम
आत्मसम्मान, और आत्मप्रताड़ना महसूस होती है ; इसके
संके त मानस – लमनत संबंिी मंदता , समाि से कटना ,और
ऐसी जस्थनतया जिसमे की कम भूख लगना और अत्यधिक
नीद आना में नज़र आते हैं.”
TYPES OF DEPRESSION
• Major depressive disorder : recurrence of long
episodes of low moods, or one extended episode
that seems to be ‘never-ending.
• Manic depression (bipolar disorder)
• Dysthymic depression:lasts a long time but
involves less severe symptoms. Lead a normal
life, but we may not be functioning well or
feeling good
• Situational depression
• Psychotic depression
• Endogenous depression
Facts about Depression
• Everyone will at some time in their life be affected by
depression.
• About thirty percent of people with depressive illnesses
attempt suicide.
• Women are nearly twice as likely to suffer from a major
depressive disorder than men are.
• 15% of the population of most developing countries
suffer severe depression
• Globally more than 350 million people of all ages suffer
from depression. (WHO)
• Depression will be the second largest killer by 2020
after heart disease- depression is a contributing factor
to coronary heart disease
Untreated depression can prevent people from
working and participating in family and community life.
At worst, depression can lead to suicide.
अवसाद के कारर् / Causes of Depression
• Genetic cause
• Environmental factors
• Biochemical factors : Deficiency of neurotransmitters in
certain areas of the brain.
• Endocrine factors:
• Physical illness: Viral illness, Carcinoma, Neurological
disorders, Pernicious anaemia, Auto-immune diseases
• Side effects of medications : Analgesics,
Antidepressants, Antihypertensive, Anticonvulsants,
Antipsychotics
कु छ factors depression होने के chances बढा देते
हैं:
• अके लापन
• Social support की कमी
• ववत्तीय समस्याएं
• हाल में हुए तनावपूर्ण अनुभव
• वैवादहक या अन्य ररश्तों में खटास
• खराब बचपन
• शराब या अन्य नशीली दवाओं का सेवन
• बेरोिगारी
• Work pressure
Depression. It’s not only a state of mind.
The symptoms of depression
Emotional Symptoms Include:
Sadness
Loss of interest or pleasure
Overwhelmed
Anxiety
Diminished ability to think or
concentrate, indecisiveness
Excessive or inappropriate guilt
Physical Symptoms Include:
Vague aches and pains
Headache
Sleep disturbances
Fatigue
Back pain
Significant change in appetite
resulting in weight loss or gain
Depression introduction
Depression introduction
Depression introduction
Depression introduction
Depression introduction
Depression introduction
Depression introduction
यदद ददए गए symptoms में से एक या अधिक match
करते दीखते हैं तो व्यजतत के depressed होने की
सम्भावना है:
• या तो नीद नहीं आती या बहुत अधिक नीद आती है.
• आप ध्यान नहीं के जन्ित कर पाते और िो काम आप पहले
आसानी से कर लेते थे उन्हें करने में कदिनाई होती है.
• आप hopeless और helpless feel करते हैं.
• आप चाहे जितनी कोलशश करें पर अपनी negative
thoughts को नहीं रोक पाते हैं.
• या तो आपको भूख नहीं लगती या आप बहुत ज्यादा खाते हैं.
• आप पहले से कहीं िल्दी irritate या aggressive हो िाते हैं,
और गुस्सा करने लगते हैं.
• आप normal से कहीं ज्यादा शराब पीते हैं.
• आपको लगता है क्रक जज़न्दगी िीने लायक नहीं है और आपके
मन में suicidal thoughts आते हैं.( ऐसा है तो तुरंत इलाज़
कराएं)
• Reduced self-esteem and self confidence
Mild Depressive Episode
• For at least 2 weeks, at least two of the usual
symptoms of a depressive episode plus at least two
common symptoms.
Moderate Depressive Episode
• For at least 2 weeks, at least two or three of the
usual symptoms of a depressive episode plus at
least three of the common symptoms.
Severe Depressive Episode
• For at least 2 weeks all three of the usual
symptoms of a depressive episode plus at least 4
of the common symptoms some of which should be
of severe intensity.
Treatments for depression
There's no one proven way that people recover from depression, and
it's different for everyone. However, there are a range of effective
treatments and health professionals who can help you on the road to
recovery.
There are also plenty of things you can do for yourself to recover and
stay well.
Professional treatment is
necessary for all these types of
depression.
If you or someone you know has
symptoms of depression…
Take Action!
• See a doctor for a complete check up.
• Go to the counseling center and talk to a
counselor.
• Talk things over with a friend, family
member or a residential life staff member.
• Don’t expect too much of yourself
• Take a break
• Get some exercise
• Avoid extra stress and big changes
Things to do
• Reduce or eliminate the use of alcohol or
drugs
• Exercise or engage in some form of physical
activity
• Eat a proper, well-balanced diet
• Obtain an adequate amount of sleep
• Seek emotional support from family and
friends
• Focus on positive aspects of your life
• Pace yourself, modify your schedule, and
set realistic goals
Things to Avoid
• Don’t make long-term commitments or important
decisions unless necessary
• Don’t assume things are hopeless
• Don’t engage in “emotional reasoning” (i.e.: because
I feel awful, my life is terrible)
• Don’t assume responsibility for events which are
outside of your control
• Don’t avoid treatment as a way of coping
Intervening with a depressed friend
• Be empathetic and understanding
• Don’t try to “cheer up” a depressed person
• Avoid critical or shaming statements
• Challenge expressions of hopelessness
• Empathize with feelings of sadness, grief,
anger and frustration
• Don’t argue about how bad things are
• Don’t insist that depression or sadness are the
wrong feelings to be experiencing
• Don’t become angry even though your efforts
may be resisted or rejected
Helping a depressed friend…
Helping a depressed friend…
• Advocate for their recovery from
depression
• Emphasize that depression is treatable
• Seek consultation
• Encourage them to seek help, go with them
to the counseling center
• Be supportive of counselor or doctor
suggestions
Depression introduction
• मदद मांधगये: यदद आपको लगता है क्रक आप
depression में िा रहे हैं या already depressed हैं
तो इस बात को छु पाइये नहीं, और ना ही लसको
लेकर हीन महसूस कीजिये तयोंक्रक depression एक
बहुत ही common illness है , और इसका उपचार
पूर्णतः संभव है.
• अपनी lifestyle improve कीजिये : ऐसा आप इन
तरीकों से कर सकते हैं: ररश्तों में सुिार ला कर, रोि
व्यायाम करके , सेहत से भरपूर भोिन करके ,
Relaxation techniques प्रयोग करके , नकारात्मक
सोच बदल कर
• पेशेवर से मदद लीजिये : यदद इन सब चीिों से बात
ना बने तो क्रकसी mental health professional से
हेल्प लीजिये . Depression के treatment के ललए
इन बातों पर भी ध्यान दीजिये:
• डिप्रेशन शब्द का प्रयोग कम से कम कीजिये.
• छोटी-मोटी परेशाननयों को भूलकर भी डिप्रेशन का नाम
मत दीजिये. ऐसा करने से आपका अवचेतन मजस्तष्क
इस बात को घर कर सकता है और आपके सच में
डिप्रेशन के मरीि बनने के संयोग बढ िायेंगे.
• अच्छी चीिें पढें िो आपके अन्दर positivity लाएं.
• नकारात्मक सोच रखने वालों से दूरी बना कर रखें.
• इस बात को समझे क्रक life में िबतक असफलता नहीं
होगी तबतक सफलता का मोल भी नहीं समझ आएगा.
इसललए असफलता को हर-एक चीि का अंत मत
समझझये.
• A supportive group environment
• Techniques to boost self-esteem
• Spiritual beliefs
Depression introduction
Depression introduction

More Related Content

PPTX
Mhn ppt ( pritesh )depression
PPTX
Bipolar disorder t
PPTX
Psychiatric emergencies
PDF
Schizophrenia (Psychotic condition)
PPT
Eating disorder . ppt , pritesh
PPTX
Mood stabilizer
PPTX
eating disorder.pptx
PDF
Eating disorders ( Anorexia nervosa and Bulimia nervosa)
Mhn ppt ( pritesh )depression
Bipolar disorder t
Psychiatric emergencies
Schizophrenia (Psychotic condition)
Eating disorder . ppt , pritesh
Mood stabilizer
eating disorder.pptx
Eating disorders ( Anorexia nervosa and Bulimia nervosa)

What's hot (20)

PPTX
ANTI DEPRRESANT DRUGS.pptx
PPTX
Eating disorder
PPTX
Electroconvulsive Therapy
PPTX
Mood disorder Slideshare
PPTX
Milieu therapy
PPTX
Concept of normal and abnormal behaviour 1
PPTX
UNDER FIVE CLINICS.pptx
PPTX
Suicide prevention
PPTX
Anorexia nervosa and bilumia nervosa.ppt
PPTX
Bulimia Nervosa
PPTX
Psychiatric emergency
PPTX
MANIA
PPTX
Nursing management of Substance disorder Unit -I.pptx
PPTX
cannabis related disorder.pptx
PPTX
Hypertension ppt (COMMUNITY HEALTH NURSING)
PPTX
bipolar affective disorder
PPTX
PREVENTION OF ALCOHOLISM
PPTX
Anorexia nervosa
PPTX
Anxiolytics and antabuse ppt
ANTI DEPRRESANT DRUGS.pptx
Eating disorder
Electroconvulsive Therapy
Mood disorder Slideshare
Milieu therapy
Concept of normal and abnormal behaviour 1
UNDER FIVE CLINICS.pptx
Suicide prevention
Anorexia nervosa and bilumia nervosa.ppt
Bulimia Nervosa
Psychiatric emergency
MANIA
Nursing management of Substance disorder Unit -I.pptx
cannabis related disorder.pptx
Hypertension ppt (COMMUNITY HEALTH NURSING)
bipolar affective disorder
PREVENTION OF ALCOHOLISM
Anorexia nervosa
Anxiolytics and antabuse ppt
Ad

Similar to Depression introduction (10)

PPTX
Depression ppt hindi
PPTX
Depression
PPTX
Depression- Mental Health Campaign (Hindi version) by Dr. Feba Percy Paul
PDF
दुख और निराशा से कैसे दूर रहे .pdf
PPTX
मानसिक स्वास्थ्य
PDF
Mental Health Awareness for Transgenders (Hindi)
PPTX
Spiritual approach to cure depression and stress
PPTX
Mental health
DOCX
Sochसोच
PDF
एंग्जायटी (Anxiety) लक्षण प्रकार कारण परिणाम इलाज Symptoms Types Cuases C...
Depression ppt hindi
Depression
Depression- Mental Health Campaign (Hindi version) by Dr. Feba Percy Paul
दुख और निराशा से कैसे दूर रहे .pdf
मानसिक स्वास्थ्य
Mental Health Awareness for Transgenders (Hindi)
Spiritual approach to cure depression and stress
Mental health
Sochसोच
एंग्जायटी (Anxiety) लक्षण प्रकार कारण परिणाम इलाज Symptoms Types Cuases C...
Ad

More from dharmesh chaturvedi (12)

PDF
antimicrobial stewardship for healthcare professional dc.pdf
PPTX
dc hygiene practices for all professionals
PPTX
dc self care practices for healthcare professionals
PPT
dc community health concepts for healthcare workers
PPTX
DC health hygiene and cleanliness in day to day life
PPTX
dc health education for healthcare professionals
PDF
sepsis & asepsis dharmesh ZRTI_compressed.pdf
PPTX
Complimentary and alternative medicines in psychiatric illnesses for nurses
PPTX
A day in the life of an iccu nurse
PPTX
Etiology and pathogenesis of covid 19
PPTX
Protocals in emergency nursing
PPTX
Paradigm shift in nursing profession
antimicrobial stewardship for healthcare professional dc.pdf
dc hygiene practices for all professionals
dc self care practices for healthcare professionals
dc community health concepts for healthcare workers
DC health hygiene and cleanliness in day to day life
dc health education for healthcare professionals
sepsis & asepsis dharmesh ZRTI_compressed.pdf
Complimentary and alternative medicines in psychiatric illnesses for nurses
A day in the life of an iccu nurse
Etiology and pathogenesis of covid 19
Protocals in emergency nursing
Paradigm shift in nursing profession

Depression introduction

  • 3. DEPRESSION: Let’s TALK BY DHARMESH CHATURVEDI (M.Sc. Nursing) n/sister (male) Rmh dahod
  • 4. Pathogen Disease (pathology) Modifiers Lifestyle Individual susceptibility Traditional model of Disease Development
  • 5. Dominance of the bio-psychosocial model Mainstream in last 15 years Hazard Psychosocial Factors Attitudes Behaviour Quality of Life Illness (well-being) Rise of the person as a “psychological entity”
  • 7. The World Health Organization (WHO) has declared Depression as the theme for the World Health Day (7th April 2017). The campaign slogan is ‘Depression: Let’s Talk’, and was released on the World Mental Health Day this year (10 October 2016).
  • 8. What is Depression? डिप्रेशन हमारी जिन्दगी में िहर घोलने वाला एक महत्वपूर्ण भाव है िो हमारे दैननक िीवन में कई तरह की समस्याओं के ललए हमारे शरीर द्वारा की गयी एक बायोलॉजिकल क्रिया है जिसे हम तनाव कहते है िो थोड़े समय के ललए सामान्यत हर क्रकसी में पाया िाता है लेक्रकन लम्बे समय तक क्रकसी परेशानी के चलते यह अगर हमारी Habit में शालमल हो िाये तो हमारे ललए घातक हो सकता है In addition, people with depression normally have several of the following symptoms: a loss of energy; a change in appetite; sleeping more or less; anxiety; reduced concentration; restlessness;
  • 9. –कु छ सामान्य संके त होते है जिस से हम अपने अंदर िमा हो रही घुटन को समझ सकते है िैसे क्रक  नींद में कमी क्रकसी आने वाली समस्या के ललए हमारी िरुरत से अधिक धचंता बीमार होने पर क्रकसी भयानक बीमारी की कल्पना करना क्रकसी अपराि बोि (guilt) िैसी भावना (feeling) में खुद को अक्षम महसूस करना जिसकी विह से खुद को नुकसान पहुुँचाने या िीवन खत्म करने की इच्छा होना ऐसे में ना दोस्त अच्छे लगते हैं और ना ही क्रकसी और काम में मन लगता है. जिंदगी ननराश लगने लगती है और positive बातें भी negative लगने लगती हैं. आदद कु छ लक्षर् है जिनसे हम समझ सकते है क्रक
  • 10. DEFINITION Depression is defined as state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being. People with a depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, angry, ashamed, or restless. “अवसाद एक ऐसी मानलसक जस्थनत या स्थायी मानलसक ववकार है जिसमे व्यजतत को उदासी, अके लापन, ननराशा, कम आत्मसम्मान, और आत्मप्रताड़ना महसूस होती है ; इसके संके त मानस – लमनत संबंिी मंदता , समाि से कटना ,और ऐसी जस्थनतया जिसमे की कम भूख लगना और अत्यधिक नीद आना में नज़र आते हैं.”
  • 11. TYPES OF DEPRESSION • Major depressive disorder : recurrence of long episodes of low moods, or one extended episode that seems to be ‘never-ending. • Manic depression (bipolar disorder) • Dysthymic depression:lasts a long time but involves less severe symptoms. Lead a normal life, but we may not be functioning well or feeling good • Situational depression • Psychotic depression • Endogenous depression
  • 12. Facts about Depression • Everyone will at some time in their life be affected by depression. • About thirty percent of people with depressive illnesses attempt suicide. • Women are nearly twice as likely to suffer from a major depressive disorder than men are. • 15% of the population of most developing countries suffer severe depression • Globally more than 350 million people of all ages suffer from depression. (WHO) • Depression will be the second largest killer by 2020 after heart disease- depression is a contributing factor to coronary heart disease
  • 13. Untreated depression can prevent people from working and participating in family and community life. At worst, depression can lead to suicide.
  • 14. अवसाद के कारर् / Causes of Depression • Genetic cause • Environmental factors • Biochemical factors : Deficiency of neurotransmitters in certain areas of the brain. • Endocrine factors: • Physical illness: Viral illness, Carcinoma, Neurological disorders, Pernicious anaemia, Auto-immune diseases • Side effects of medications : Analgesics, Antidepressants, Antihypertensive, Anticonvulsants, Antipsychotics
  • 15. कु छ factors depression होने के chances बढा देते हैं: • अके लापन • Social support की कमी • ववत्तीय समस्याएं • हाल में हुए तनावपूर्ण अनुभव • वैवादहक या अन्य ररश्तों में खटास • खराब बचपन • शराब या अन्य नशीली दवाओं का सेवन • बेरोिगारी • Work pressure
  • 16. Depression. It’s not only a state of mind. The symptoms of depression Emotional Symptoms Include: Sadness Loss of interest or pleasure Overwhelmed Anxiety Diminished ability to think or concentrate, indecisiveness Excessive or inappropriate guilt Physical Symptoms Include: Vague aches and pains Headache Sleep disturbances Fatigue Back pain Significant change in appetite resulting in weight loss or gain
  • 24. यदद ददए गए symptoms में से एक या अधिक match करते दीखते हैं तो व्यजतत के depressed होने की सम्भावना है: • या तो नीद नहीं आती या बहुत अधिक नीद आती है. • आप ध्यान नहीं के जन्ित कर पाते और िो काम आप पहले आसानी से कर लेते थे उन्हें करने में कदिनाई होती है. • आप hopeless और helpless feel करते हैं. • आप चाहे जितनी कोलशश करें पर अपनी negative thoughts को नहीं रोक पाते हैं. • या तो आपको भूख नहीं लगती या आप बहुत ज्यादा खाते हैं. • आप पहले से कहीं िल्दी irritate या aggressive हो िाते हैं, और गुस्सा करने लगते हैं. • आप normal से कहीं ज्यादा शराब पीते हैं. • आपको लगता है क्रक जज़न्दगी िीने लायक नहीं है और आपके मन में suicidal thoughts आते हैं.( ऐसा है तो तुरंत इलाज़ कराएं) • Reduced self-esteem and self confidence
  • 25. Mild Depressive Episode • For at least 2 weeks, at least two of the usual symptoms of a depressive episode plus at least two common symptoms. Moderate Depressive Episode • For at least 2 weeks, at least two or three of the usual symptoms of a depressive episode plus at least three of the common symptoms. Severe Depressive Episode • For at least 2 weeks all three of the usual symptoms of a depressive episode plus at least 4 of the common symptoms some of which should be of severe intensity.
  • 26. Treatments for depression There's no one proven way that people recover from depression, and it's different for everyone. However, there are a range of effective treatments and health professionals who can help you on the road to recovery. There are also plenty of things you can do for yourself to recover and stay well.
  • 27. Professional treatment is necessary for all these types of depression.
  • 28. If you or someone you know has symptoms of depression… Take Action!
  • 29. • See a doctor for a complete check up. • Go to the counseling center and talk to a counselor. • Talk things over with a friend, family member or a residential life staff member.
  • 30. • Don’t expect too much of yourself • Take a break • Get some exercise • Avoid extra stress and big changes
  • 31. Things to do • Reduce or eliminate the use of alcohol or drugs • Exercise or engage in some form of physical activity • Eat a proper, well-balanced diet
  • 32. • Obtain an adequate amount of sleep • Seek emotional support from family and friends • Focus on positive aspects of your life • Pace yourself, modify your schedule, and set realistic goals
  • 33. Things to Avoid • Don’t make long-term commitments or important decisions unless necessary • Don’t assume things are hopeless • Don’t engage in “emotional reasoning” (i.e.: because I feel awful, my life is terrible) • Don’t assume responsibility for events which are outside of your control • Don’t avoid treatment as a way of coping
  • 34. Intervening with a depressed friend • Be empathetic and understanding • Don’t try to “cheer up” a depressed person • Avoid critical or shaming statements • Challenge expressions of hopelessness • Empathize with feelings of sadness, grief, anger and frustration
  • 35. • Don’t argue about how bad things are • Don’t insist that depression or sadness are the wrong feelings to be experiencing • Don’t become angry even though your efforts may be resisted or rejected Helping a depressed friend…
  • 36. Helping a depressed friend… • Advocate for their recovery from depression • Emphasize that depression is treatable • Seek consultation • Encourage them to seek help, go with them to the counseling center • Be supportive of counselor or doctor suggestions
  • 38. • मदद मांधगये: यदद आपको लगता है क्रक आप depression में िा रहे हैं या already depressed हैं तो इस बात को छु पाइये नहीं, और ना ही लसको लेकर हीन महसूस कीजिये तयोंक्रक depression एक बहुत ही common illness है , और इसका उपचार पूर्णतः संभव है. • अपनी lifestyle improve कीजिये : ऐसा आप इन तरीकों से कर सकते हैं: ररश्तों में सुिार ला कर, रोि व्यायाम करके , सेहत से भरपूर भोिन करके , Relaxation techniques प्रयोग करके , नकारात्मक सोच बदल कर • पेशेवर से मदद लीजिये : यदद इन सब चीिों से बात ना बने तो क्रकसी mental health professional से हेल्प लीजिये . Depression के treatment के ललए
  • 39. इन बातों पर भी ध्यान दीजिये: • डिप्रेशन शब्द का प्रयोग कम से कम कीजिये. • छोटी-मोटी परेशाननयों को भूलकर भी डिप्रेशन का नाम मत दीजिये. ऐसा करने से आपका अवचेतन मजस्तष्क इस बात को घर कर सकता है और आपके सच में डिप्रेशन के मरीि बनने के संयोग बढ िायेंगे. • अच्छी चीिें पढें िो आपके अन्दर positivity लाएं. • नकारात्मक सोच रखने वालों से दूरी बना कर रखें. • इस बात को समझे क्रक life में िबतक असफलता नहीं होगी तबतक सफलता का मोल भी नहीं समझ आएगा. इसललए असफलता को हर-एक चीि का अंत मत समझझये. • A supportive group environment • Techniques to boost self-esteem • Spiritual beliefs