What Is Depression?
Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed.
Sadness, feeling down, having a loss of interest or pleasure in daily activities – these are symptoms familiar to all of us. But, if they persist and affect our life substantially, it may be depression.
According to the Centers for Disease Control and Prevention (CDC), 7.6 percent of people over the age of 12 have depression in any 2-week period. This is substantial and shows the scale of the issue.
According to the World Health Organization (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.
Fast facts on depression:
Depression seems to be more common among women than men.
Symptoms include lack of joy and reduced interest in things that used to bring a person happiness.
Life events, such as bereavement, produce mood changes that can usually be distinguished from the features of depression.
The causes of depression are not fully understood but are likely to be a complex combination of genetic, biological, environmental, and psychosocial factors.
Depression is a mood disorder characterized by persistently low mood and a feeling of sadness and loss of interest. It is a persistent problem, not a passing one, lasting on average 6 to 8 months.
Diagnosis of depression starts with a consultation with a doctor or mental health specialist. It is important to seek the help of a health professional to rule out different causes of depression, ensure an accurate differential diagnosis, and secure safe and effective treatment.
As for most visits to the doctor, there may be a physical examination to check for physical causes and coexisting conditions. Questions will also be asked – “taking a history” – to establish the symptoms, their time course, and so on.
Some questionnaires help doctors to assess the severity of depression. The Hamilton depression rating scale, for example, has 21 questions, with resulting scores describing the severity of the condition. The Hamilton scale is one of the most widely used assessment instruments in the world for clinicians rating depression.
What does not class as depression?
Depression is different from the fluctuations in mood that people experience as a part of normal life. Temporary emotional responses to the challenges of everyday life do not constitute depression.
Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression can, however, be related to bereavement – when depression follows a loss, psychologists call it a “complicated bereavement.”
The causes of depression are not fully understood and may not be down to a single source. Depression is likely to be due to a complex combination of factors that include:
biological – changes in neurotransmitter levels
psychological and social (psychosocial)
Some people are at higher risk of depression than others; risk factors include:
Life events: These include bereavement, divorce, work issues, relationships with friends and family, financial problems, medical concerns, or acute stress.
Personality: Those with less successful coping strategies, or previous life trauma are more suceptible.
Genetic factors: Having a first-degree relatives with depression increases the risk.
Some prescription drugs: These include corticosteroids, some beta-blockers, interferon, and other prescription drugs.
Abuse of recreational drugs: Abuse of alcohol, amphetamines, and other drugs are strongly linked to depression.
A past head injury.
Having had one episode of major depression: This increases the risk of a subsequent one.
Chronic pain syndromes: These and other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular disease make depression more likely.
Depression is a treatable mental illness. There are three components to the management of depression:
Support, ranging from discussing practical solutions and contributing stresses, to educating family members.
Psychotherapy, also known as talking therapies, such as cognitive behavioral therapy (CBT).
Drug treatment, specifically antidepressants.
Psychological or talking therapies for depression include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and problem-solving treatment. In mild cases of depression, psychotherapies are the first option for treatment; in moderate and severe cases, they may be used alongside other treatment.
CBT and interpersonal therapy are the two main types of psychotherapy used in depression. CBT may be delivered in individual sessions with a therapist, face-to-face, in groups, or over the telephone. Some recent studies suggest that CBT may be delivered effectively through a computer
Interpersonal therapy helps patients to identify emotional problems that affect relationships and communication, and how these, in turn, affect mood and can be changed.
Late last year, 31-year-old taxi driver Hammed Olojo tried to jump into Lagos Lagoon. He was later charged with attempted suicide, and he was far from alone: Nigeria currently ranks 15th in the world for suicides, according to the World Health Organization, though comparisons to older data are made difficult by a lack of accurate record-keeping in the country.
But while attempts like Olojo’s make headlines in the country day after day, they’re also a warning sign of what could be a far greater crisis to come for Nigeria, Africa’s strongest economic powerhouse. According to Nigeria’s first-ever National Depression Report …
60 MILLION PEOPLE — A WHOPPING THIRD OF THE POPULATION — REPORT EXPERIENCING DEPRESSIVE SYMPTOMS.
Nigeria is by far Africa’s most depressed country already, with 7 million people diagnosed with the condition, according to WHO. In comparison, Ethiopia has 4.48 million, while the Democratic Republic of Congo has 2.87 million with depression.
The National Depression Report, conducted by Joy, Inc., surveyed people about their feelings of happiness and depression across Nigeria’s 36 states. More than 1,000 interviews conducted in all five major Nigerian languages found that 31.6 percent of the population reported symptoms of depression and 27.8 percent reported symptoms of anxiety.
Depression is rising around the world: WHO identifies it as the planet’s leading cause of disability, and found that cases skyrocketed 18.4 percent between 2005 and 2015. But Nigeria has further obstacles: The country has long failed to collect data on the mental health of its citizens, which keeps experts and authorities from developing coherent policies to fix the situation.
“To do well in addressing depression, [many] more studies are required. The data and information available through research are far less than enough,” says Dr. Joyce Omoaregba, senior consultant psychiatrist at the Federal Neuro-Psychiatric Hospital in southern Nigeria’s Benin City.
NIGERIA HAS NO MENTAL HEALTH LAWS OTHER THAN THE COLONIAL-ERA LUNACY ACT, WHICH DATES TO 1958.
But far from being a big issue, depression, like other mental health issues in Nigeria, is shrouded in secrecy. Cultural traditions and social stigmas push many sufferers into isolation and away from seeking help.
For Damola Morenikeji, a researcher with Joy, Inc., stigma is a huge problem. “People can’t come out and talk about facing depression,” he says. Beyond confirming the crisis, he says, the aim of the study is to give people the courage to seek help.
Nigeria has no mental health laws other than the colonial-era Lunacy Act, which dates to 1958 and allows legal and medical authorities to detain those deemed to be mentally unhealthy without many guidelines or processes reflecting a modern understanding of psychiatry. In the absence of laws and effective policies, some turn to traditional and spiritual healers for help.
Dr. Bem Tivka, a clinical psychologist with Neem Foundation — a nongovernmental organization offering psychological support of traumatized survivors of the Boko Haram conflict in northeast Nigeria — says many people suffering from depression don’t recognize it as an illness and opt to visit spiritual authorities rather than medical ones. “Sometimes,” he says, “people attribute their mental health situation to witchcraft attacks.” Others turn to street drugs like codeine rather than medications, which are often unaffordable. Without government and community support, Tivka says, these negative coping mechanisms will continue to prevail. Education — and new laws — is sorely needed.
A 2014 WHO study found that on average around the world, there are nine mental health workers per 100,000 people. That’s not the case in Nigeria: Despite a population of 180 million, there are fewer than 200 psychiatrists in the country — or just one for every 1 million people, according to a 2016 study published in BioMed Central. And, says Dr. Gabriel Onyeama of the Association of Psychiatrists in Nigeria, that’s not just an issue of not enough doctors choosing to specialize in psychiatry. It’s also one of brain drain.
“Many of the psychiatrists we produce in Nigeria end up in developed countries,” he says. For those who qualify and choose to stay, there aren’t enough job openings every year. Before Nigeria can solve its doctor shortage, it must first hold onto the doctors it trains.
By Orji Sunday, OZY Author