Depression doesn’t have to take lives —Experts

As humans, we are bound to express various emotions, whether positive or negative. Just as one can have bouts of happiness, it is also natural for a person to experience sadness. However, mental health experts have called for more attention to be paid when one goes through the emotion of sadness as it can easily progress and be mistaken for a more serious health issue known as depression. According to experts, sometimes it is hard to know if what one is feeling is sadness or depression as one is most times mistaken for the other.

Sadness vs depression

Though depression is wrongly used by laymen to describe their transient feeling of sadness, clinically, depression is diagnosed when there is a pervading feeling of sadness or low mood consistently for a period of at least two weeks. There is also an accompanying loss of interest or pleasure in everyday activities, coupled with other symptoms such as feelings of emptiness, hopelessness, helplessness, worthlessness, anxiety, guilt, and /or irritability, changes in appetite, problems concentrating, remembering details or making decisions, and thoughts of or attempt of suicide, inability to sleep or sleeping too much, aches, pains, or digestive problems that are resistant to treatment.

According to Dr Richard Adebayo, a psychiatrist and Medical Director of the Federal Psychiatric Hospital Yaba, Lagos, “depression is a psychiatric illness or mood disorder which affects the mood. It affects people in different ways.”

Dr. (Mrs) Ahidenor, Head, Social Work Department, Federal Psychiatric Hospital, Yaba, Lagos, adds that “it is state of sadness, hopelessness and helplessness as a result of an   uneventful event faced by an individual which might lead to suicidal attempt.”

Causes

Experts say the cause of depression may be traceable to genetic dispositions. Individuals may be genetically vulnerable, but most times life events usually determine if they will come down with the illness or not. Some of such life events or possible causes of depression include adversity in childhood such as bereavement, neglect, mental abuse, physical and sexual abuse, and unequal parental treatment. Others are life events and changes such as childbirth, menopause, financial difficulty, problems on the job, bullying, loss of loved ones, natural disaster, medical diagnosis (e.g. cancer, HIV), social isolation, rape, relationship problems, separation and catastrophic injury are significant causative factors.

Why depression is a major health issue

Although sadness is a natural human emotion, what makes depression a concern is the fact that it is a major risk factor for suicide. Psychologists say individuals with depression develop a feeling of hopelessness, helplessness, and worthlessness. This makes sufferers despair of life and would therefore prefer to die. Studies have shown that 80 per cent of people who commit suicide have traces of depression.

Dr Daniel Ajayi, a psychologist at the Federal Psychiatric Hospital Yaba, Lagos,  said, “amongst those diagnosed with depression,  studies have shown that key indicators for suicide include previous self-harm, severity of the illness, alcohol or drug abuse, serious or chronic physical illnesses, lack of a partner, anxiety and personality disorders An individual who has depressive symptom and is not managed on time can start having deliberate self-harm, attempted suicide or suicide or a depressed person might start using some wrong coping mechanism like drinking alcohol, smoking and that may be the beginning of mental disorder.”

When you should be concerned

Dr Ajayi said “most people with depression may not willingly seek treatment on their own because of the nature of the illness. Usually, individuals in this condition lose interest in previously pleasurable activities, and in severe condition may not be interested in participating in any activity, coupled with the fact that they have anhedonia, which means they lack energy. This lack of energy always makes them misconstrue it as other form of illness. Some are erroneously treated for malaria and typhoid fever, while others are misdiagnosed as other forms of condition. But, they usually lack interest in any activity and their lack of energy makes it difficult for them to willingly seek help.”

This is where family and friends are important. Family and friends should also start suspecting that a person is depressed when they discover that there is a deviation in the person’s usual behaviour and the depressive symptoms are pervading and last longer than two weeks consistently. Such person should see a mental health practitioner

Most times when people isolate themselves, it could be as a result depression — social withdrawal is one of the symptoms of depression and not necessarily a causative factor. However, studies have shown that solitary confinement has negative psychological consequence and one of them is the possibility of individuals who are isolated can develop depression. When people are forcibly isolated against their wish or by the prevailing circumstances, there is possibility of developing depression. However, people who like to willingly isolate themselves may have other underlying psychological challenges causing such unusual behaviour.

Children are also not left out as Dr. (Mrs) Ahidenor says “children that are highly sensitive such as molested children, children who are subject to inhuman treatment like child abuse or children who are highly sensitive tend to live with depression.”

Who gets more depressed: men or women?

Studies have shown that depression is more common in women than in men. Most of the depressive symptoms are more severe in women, because men are taught not to show emotions. Therefore, they are more  likely to mask their depressive symptoms than women. However, the rate of suicide is about three to four times more common in men than in women.

Management and treatment

Millions of people all over the world are affected by depression. Unfortunately, most believe they are not sick while others believe it is a spiritual problem. However, being depressed is not a death sentence. Dr Adebayo says treatment is available. “It can be treated biologically through medication; psychologically through psychological treatment such as psychotherapy and social intervention. An individual who falls into depression as a result of joblessness or homelessness will not respond to medication until he gets a better job or a means of livelihood. So, the root cause has to be identified. The most important step they need to take is to see a qualified mental health professional who will treat or direct them appropriately as the case may be. Mild cases could be handled with psychotherapy, but severe cases will surely need medication and these are better managed by a psychiatrist.”

Self care is usually difficult in depressive condition, but those that have been in treatment and in remission are sometimes taught by their therapist some techniques to deal with some of their symptoms like irrational thoughts.