Depression, common but treatable cause of suicide

Suicide is almost becoming a daily occurrence in Nigeria. Unfortunately, Nigerians are yet to accept the fact that someone can take his or her life because of unhappiness. SADE OGUNTOLA reports that depression, the major reason for suicide, is however treatable.

What could have driven Dr Alilwell Orji, a medical doctor to jump into Lagos lagoon to commit suicide? Did anyone know if he was unhappy? Did he try to speak out or was he scared?

This brings to mind the case of Olisa Nwakobi, yet another story that jolted the society to the reality of depression and hopelessness leading to suicide.

Olisa was a husband, son, uncle and father of a 10 year-old who until his death was a banker. To many people, he would seem successful. But unfortunately, he shot himself dead in front of a priest over a bad bank loan.

Incidence of suicide is becoming a daily affair in Nigeria. Unfortunately, Nigerians are yet to accept the fact that someone can take his or her life because of unhappiness or loss of interest in daily living.

No doubt, sadness, feeling down, having a loss of interest or pleasure in daily activities are symptoms many people are familiar with. But, when these symptoms persist and affect daily living substantially, it may be depression.

According to the World Health Organisation (WHO), depression is the most common illness worldwide and the leading cause of disability. They estimate that 350 million people are affected by depression, globally.

Sadly, WHO added that no fewer than 800, 000 people die due to suicide every year, of which 86 per cent of them are in low and middle-income countries, not excluding Nigeria.

Suicide is one of the three leading causes of death among those in the most economically productive age group (15 to 44 years). It is a public health issue that is estimated to contribute more than two per cent to the global burden of disease by the year 2020, especially in the sub-Saharan African countries where services are scarce.

“One of the key reasons people want to end their life is because life has become burdensome; they no longer find pleasure in it and the world begins to look very dull,” said Dr Yinka Atilola, a consultant physiatrist, Lagos University Teaching Hospital, (LASUTH).

According to him, “it all starts from having an idea to commit suicide; nobody just jumps to commit suicide. But other factors may now help to push you to either to attempt it or push it the idea aside”.

Dr Atilola quoted the new Lagos State Mental Health Survey (LSMHS) that found 7.5 per cent of people in Lagos State often bothered with the thought that they would be better off dead or of hurting themselves in some way.

This survey, carried out between August and September 2015, involved 11 246 adults from the five administrative divisions of Lagos State.

The study also found the female gender and not being married to be significantly associated with suicidal tendency as well as a higher suicidal tendency among people within the lower occupational group.

Dr Atilola, however, stated that the likelihood of committing suicide is higher in mega cities than other cities given that the level of psychosocial problem that can make people have symptoms of depression in many big cities is higher.

Depression is different from the fluctuations in mood that we all experience as a part of a normal and healthy life. Temporary emotional responses or suddenness due to the challenges of everyday life do not constitute depression. Equally, the feeling of grief resulting from the death of someone close is not itself depression if it does not persist.

Depression is real and has claimed many lives. Unfortunately, many Nigerians still confuse depression for spiritual problems’. The fact that someone can take his or her life because of unhappiness looks strange.

Experts say that depression is likely to be due to a complex combination of factors that include genetics, environmental, psychological and social/psychosocial. Children whose parents have depression are six times more likely to have depression themselves.

But some people are at higher risk of depression due to life events like bereavement, divorce and poverty as well as abuse of recreational drugs including alcohol.

Ironically, older adults who live in poor and violent urban neighbourhoods are at greater risk for depression. Also, the Ibadan study of ageing study carried out by Professor Oye Gureje, University of Ibadan, Nigeria and his colleagues indicated that urbanisation increases the risk of major depression in elderly Nigerians.

Nonetheless, despite thousands of Nigerians that commit suicide yearly due to depression, policies on mental challenges remain archaic.

The Mental Health Act, enacted in the 1900s, was last reviewed in 1959 despite medical improvements made over the years.

“I do not know when I can admit compulsorily if there is a patient with severe suicidal ideas; there is no law that is in place to protect me; including this person that has mental health challenge.

“It is not the kind of bill that catches the attention of an average lawmaker even though it will also ensure the integration of mental health care into primary healthcare to improve access to care,” said Dr Atilola.

He added, “beyond building middle level capacity to care for mental health problems, mental health needs to be integrated into the curriculum for training medical doctors. Every medical doctor should have a full understanding of mental health issues.”

Dr Atilola tackling mental health problems as depression alongside other non communicable diseases like diabetes and hypertension was also key to ensuring reducing deaths and ill health also from these diseases.

“A person that is diabetic and depressed is more likely to neglect his diabetes care and this eventually end up with complications of diabetes or even death.

“So we must also put money on what will make people to have the presence of mind to want to do what is needed to be done to keep them physically well.” he declared.

According to Dr Atilola, depression is a treatable mental illness and its three components of management includes support (ranging from discussing practical solutions and contributory stresses, to educating family members), psychotherapy as well as drug treatment.

Aerobic exercise may help against mild depression. It increases mood-boosting chemicals that may reduce some of the effects of depression.

When to seek emergency treatment

Despite a person’s best efforts to manage depression, harmful and dangerous thoughts can sometimes take over. When this is the case, a person should seek emergency medical attention.

Examples of times when a person should call for help include:

•If a person has thoughts of hurting himself.

•If a person hears voices or sees things that aren’t there.

•If a person feels as if he would be better off dead and has thoughts of committing suicide.