As I stated in one of my previous articleshttps://fridahwachiraonline.wordpress.com/2021/02/05/how-the-church-can-be-in-the-frontline-of-mental-health-care/ , there are about 290 mental health disorders in the Diagnostic and Statistical Manual (DSM V)of mental disorders . It is therefore not possible to handle all of these disorders in one article. Today we are just going to look at the most common mental health illness in our country and worlwide.
Did you know?
- In Africa mental health issues are attributed to either witchcraft or spiritual problems
- Depression is the second leading cause of death among the youths in our country
- Depression is the second leading cause of disability worldwide. Last year’s IDPWP theme was ‘’Not all disabilities are visible’’ Depression is one of those invisible and easily dismissed illnesses that can lead to disability.
- In a WHO report in 2017, Kenya ranked 6th in Africa with at least 1.9 million people suffering from depression. Clinical depression is the most prevalent form of mental illnesses.
- Depression is really not an African disease. Think about it; do you have a name for this disease in your mother tongue? Anyone? What would be the response of most of our parents if you told them that you have been diagnosed with depression?
For a long time now, mental illness has been considered a silent epidemic especially in Africa but it is very encouraging to see many leaders, citizens, pastors, professionals and youths now talking about mental health especially depression.
Just recently I came across a Facebook page https://web.facebook.com/BasicNeedsBasicRightsKenya where people living with mental illnesses are encouraged to speak up. The easiest way to break stigma around any illness is by creating awareness and make information available to the general public.
So what is depression?
Depression is not equivalent to sadness. With increased awareness and use we are likely to misuse the term depression. We are likely to misdiagnose what could be grief or normal sadness as depression or dismiss depression as just being sad or blue. Depression is more than an emotion.
Depression is a lay term for what is recognized as Major Depressive Disorder(MDD) in the Diagnostic and Statistical Manual of mental disorders (DSM V). It is a primary mood disorders whose etiology is multi-factorial.
WHO defines depression as a common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration. If unattended to, severe depression eventually leads to suicide.
How can you tell that a person is depressed?
- Depressed mood
When one experiences unexplained or persistent sadness for more than 2 weeks, it shouldn’t be dismissed as normal sadness. A depressed person feels sad, empty or hopeless nearly every day. This is one of the key symptoms of depression.
- Loss of interest/ apathy
Here one loses interest in activities that they previously considered pleasurable. This person no longer enjoys activities that they considered hobbies. This is also one of the telltale symptoms of depression.
People who are depressed are likely to withdraw from activities, work, and school and sometimes even relationships. One begins to drop certain activities from their schedule that they were previously committed to. This happens because the person feels like they lack the energy and motivation to carry out daily or normal tasks. A classmate who was very committed to their school work gradually or suddenly begins to miss classes or fails to submit their assignments. A co-worker who was punctual and organized now seems not care about their work or performance at work. Depression is a mood disorder that makes one lack the ability to attend to their normal life activities
People battling depression are constantly exhausted. Getting out of bed alone can be a daunting task. These people even lack the energy to deal with their relationships. They are tired nearly every day.
- Changes in sleep patterns
A person with depression may have trouble falling or staying asleep (insomnia). In fact, patients who have chronic insomnia are three times more likely to develop depression that those without. Some people may also experience hypersomnia which is excessive sleepiness during the day.
- Loss of weight
People struggling with depression have significant (5% change in body weight) weight loss or weight gain when they are not dieting. They also have changes in their appetite. They either eat too much or have no appetite.
This happens in severe forms of depression or if depression is not attended to. These patients will have recurrent thoughts of death. Suicidal ideation means that the person has been thinking about suicide or wanting to take their own life. This is not just fear of dying. If someone ever expresses that they have suicidal thoughts, never dismiss them. Please find them help ASAP.
Other symptoms include; feelings of worthlessness, guilt and helplessness, restlessness or agitation, Indecisiveness/ Low concentration etc.
These symptoms have to cause disruption in one’s daily life or affect one’s functionality and productivity for a diagnosis to be made.
What causes depression?
It is difficult to point out one particular factor that causes depression. Let’s look at some of the factors that contribute to depression. Most of these factors are still being studied, so as time goes by our knowledge on the causes of depression keeps improving.
- Biochemical factors
This has to do with changes in the neurotransmitters in the brain. Neurotransmitters are chemicals that carry signals from one part of the brain to another. Depression can occur when there are imbalances in the levels of some these neurotransmitters. There are important neurotransmitters that affect one’s mood; nor epinephrine, serotonin and dopamine.
- Psychosocial factors
I am certain that you have said or heard this statement in your lifetime, ‘’life is not fair’’. Unfortunately this saying is very true. Throughout life each one of us has to deal with stressful experiences. Some of these events/experiences can be positive e.g. delivering a child, getting a new job, marriage or they can be negative life events like the loss of a spouse or parent, losing a job, divorce etc. It is different things for different people. For some patients struggling with depression, the stressful events act as triggers. This means that not everyone who goes through a stressful life event gets into depression.
As much as depression is unlikely to happen without a stressful life event, the risk of developing depression can be strongly determined by genetic factors. Studies have shown that the risk of developing depression if a biological parent has the condition is 40%. Depression can therefore be inherited although no single gene has been identified rather a combination of genes.
- There are many other factors;
E.g. personality (some personalities are more likely to get depressed than others), psychodynamic factors (like disruption of the infant-mother relationship in the first 10-18months of life), physical illnesses (e.g. cancer), aging among others.
Can depression be treated?
Yes! The mainstay of treatment for clinical depression is medication and talk therapy. If you experience the symptoms or know someone who is going through depression you should encourage them to seek medical attention.
There is a treatment approach for mental illness known as the biopsychosocialspiritual treatment approach. This is a combined approach where the individual is treated biologically (using antidepressants), psychologically (talk therapy), socially (caregivers or relatives are educated), and spiritually (spiritual leaders involvement)
All these treatment approaches are important and work in synergy to ensure that the affected individual gets back to their normal life, functionality and productiveness. In the next article, we will look at ways to show support to people struggling with depression.
If you are struggling with depression or know someone who is, feel free to reach out to me and lets get you/them some help. Author: Fridah .W. Wachira, 5th Year medical student (MBChB) at Kenyatta University, Kenya and a medical blogger. Contact; Facebook: Dr Wachira Fridah, Email: firstname.lastname@example.org, You Tube channel: Convo with Dr. Fridah and James Wetu.