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Published on: Oct 28, 2020
2 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Hepatitis C Nobel Prize

Earlier this month the Nobel Prize in Physiology and Medicine was jointly awarded to Harvey J Alter, Michael Houghton and Charles M Rice for the discovery of the Hepatitis C virus. This helped push our understanding of blood-borne hepatitis, a major global health problem that is one of the leading causes of cirrhosis and liver cancer alongside Hepatitis B. It led the way in introducing new tests for chronic hepatitis as well as new treatments that have saved the lives of millions.

HEPATITIS

Hepatitis is the inflammation of your liver, the largest solid organ in your body. Though there are numerous other causes of hepatitis, including alcohol abuse, drugs and toxins (including paracetamol overdose), and autoimmune disorders (such as Wilson’s disease), viral infections are the most common worldwide causes for hepatitis. Hepatitis A was the first to be discovered, transmitted by polluted food and water, and results in a short-term transient hepatitis. Hepatitis B on the other hand is transmitted through blood and is more of an issue as it can lead to chronic cirrhosis and possible liver cancer. It can remain indolent in a person, causing disease long after the initial infection.

Blood borne hepatitis was first discovered in the 1960s, when it was found that some patients would become ill after receiving blood transfusions. Despite this discovery and new tests for Hepatitis B reducing the number of transfusion related hepatitis, a large number of cases remained.

NOT A, NOT B

Harvey Alter, working at the US National Institute of Health, was studying the occurrence of hepatitis in blood transfusion patients. His team showed that blood from these infected patients could transmit the disease to chimpanzees, resulting in hepatitis. This agent had the properties of a virus, one that was “non-A, non B” hepatitis.

Further investigation into the virus would require the input of Michael Houghton, working for Chiron pharmaceutical. His team created a collection of DNA fragments found in the blood of infected chimpanzees. Though the majority of these fragments were from the chimpanzee, enough were from the virus. They were able to utilise this information to identify antibodies against the suspected virus, and ultimately identify it as the flavivirus Hepatitis C.

The final piece of the puzzle was shown by Charles M Rice, a researcher at Washington University, St Louis – could the virus alone cause hepatitis. He studied the RNA of Hepatitis C to identify regions that may be used for replication, and areas that might hinder replication. This was key as the virus can lay dormant for years, replicating at a slow rate before causing damage to the liver. For researchers, this was an issue as it was not feasible to wait years and see if the suspected virus caused hepatitis. By genetically engineering the viral genome, he developed a variant of Hepatitis C that would only multiple rapidly and have no mechanism to inactivate itself for dormancy. This strain caused rapid changes to the livers of infected chimpanzees; the same changes seen in hepatitis patients.

. ;.,hrvxzThe impact was significant. Prior to this, receiving a blood transfusion was like Russian Roulette. You were receiving life saving therapy, but it coZuld also be a hidden death sentence. Now that hepatitis had been discovered, it became possible to screen patients prior to donation, to screen blood transfusion bags, and to start developing treatments for the virus.

The fight is not over yet. There are still over 70 million people who still live with the virus, and it still kills around 400,000 a year. Its only very recently that we have found treatments that can reduce the viral load in patients to levels that they are considered cured. This treatment remains expensive, and we are very far away from eradication itself.

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Difference Between Sadness and Depression: Understanding Normal Emotions vs Mental Illness

Feeling low or unhappy is a part of being human. However, not all low moods are the same. Many people confuse sadness with depression, which can delay proper support and treatment. Understanding the difference between sadness and depression is crucial for mental health awareness, early intervention and reducing stigma.

In India, mental health conditions are often misunderstood, with emotional distress frequently dismissed as temporary sadness.

What Is Sadness?

Sadness is a normal human emotion.

It usually occurs due to:

loss or disappointment
relationship issues
failure or stress
temporary life challenges

Sadness serves a psychological purpose, allowing individuals to process emotions and adapt.

Key Characteristics of Sadness

Sadness is:

situational
temporary
emotionally painful but manageable
responsive to support and positive events

A person experiencing sadness can still function, enjoy moments and feel hopeful.

What Is Depression?

Depression is a medical condition classified as a mood disorder.

It affects:

emotions
thinking patterns
behaviour
physical health

According to WHO, depression is one of the leading causes of disability worldwide.

Core Symptoms of Depression

Depression involves a combination of symptoms such as:

persistent low mood
loss of interest or pleasure
fatigue
sleep disturbances
appetite changes
feelings of worthlessness
difficulty concentrating

These symptoms last at least two weeks or longer.

Duration: A Key Difference

One major difference lies in duration.

Sadness:

lasts hours or days
improves with time

Depression:

lasts weeks or months
persists despite positive events

Duration helps distinguish emotional response from illness.

Impact on Daily Functioning

Sadness:

allows continuation of work and relationships
may reduce motivation temporarily

Depression:

interferes with work, studies and relationships
reduces self-care and productivity

Functional impairment is a defining feature of depression.

Emotional Experience: Sadness vs Depression

Sadness:

allows emotional range
moments of joy still occur

Depression:

creates emotional numbness
joy and interest disappear

People with depression often describe feeling empty rather than sad.

Physical Symptoms in Depression

Depression is not only emotional.

Physical symptoms include:

chronic fatigue
body aches
headaches
digestive issues

ICMR mental health studies highlight the physical burden of depression.

Thought Patterns and Self-Perception

Sadness:

thoughts remain realistic
self-worth is preserved

Depression:

negative self-talk dominates
feelings of guilt and worthlessness increase

These cognitive changes deepen emotional suffering.

Risk Factors for Depression

Factors increasing depression risk include:

chronic stress
trauma
family history
medical illnesses
hormonal changes

NFHS-5 data indicates rising mental health concerns among young adults.

Can Sadness Turn Into Depression?

Yes, prolonged or unresolved sadness can progress into depression.

This is more likely when:

stressors are ongoing
support systems are weak
coping mechanisms are limited

Early emotional support can prevent progression.

When to Seek Professional Help

Seek help if:

low mood lasts more than two weeks
daily functioning is affected
sleep and appetite are disturbed
thoughts of self-harm occur

Early care leads to better outcomes.

Treatment Differences

Sadness:

improves with rest, support and time

Depression:

requires psychotherapy
may need medication
benefits from structured care

WHO emphasises early treatment to reduce disability.

Role of Social Support

Support systems help both conditions but are essential for recovery.

Depression recovery improves with:

understanding family
supportive workplaces
accessible mental healthcare

Stigma reduction is key.

Mental Health Awareness in India

Mental health remains underdiagnosed in India.

NITI Aayog reports:

limited access to mental health services
low awareness
high stigma

Education helps bridge this gap.

Importance of Early Recognition

Recognising depression early:

prevents worsening
reduces suicide risk
improves quality of life

Delay increases suffering and complications.

Supporting Someone With Depression

Helpful actions include:

listening without judgement
encouraging professional help
avoiding minimising feelings

Compassion is more effective than advice.

Conclusion

Understanding the difference between sadness and depression is essential for emotional wellbeing and mental health care. Sadness is a natural, temporary response to life events, while depression is a serious medical condition that affects thoughts, emotions and daily functioning. Recognising the signs early and seeking appropriate help can prevent long-term suffering and promote recovery. Mental health deserves the same attention and care as physical health.

References

World Health Organization (WHO) – Depression and Mental Health Disorders
Indian Council of Medical Research (ICMR) – Mental Health Research and Burden
National Family Health Survey (NFHS-5) – Mental Health Indicators
Lancet – Depression, Disability and Public Health
NITI Aayog – National Mental Health Policy and Awareness Reports
Statista – Global and Indian Mental Health Trends

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