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Depression: What the experts say

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“Depression is not a new illness. People have reported symptoms of depression from time immemorial. For example many scholars believe that the story of King Saul in the Old Testament actually shows that he suffered from depression. Saul is described as being tormented by an evil or bad spirit which tended to leave him when music was played. (See 1 Samuel 16 ; Verses 14-16 & Verse 23).” Dr Mpho Thula

LAME BOGATSU

It seems only natural that screening for mental health be as standard as getting your blood pressure or cholesterol checked, right? Well, it’s not. According to a report published by the World Health Organization earlier this year, an estimated seven percent of adults suffer from depression every year and that is close to 15.7 million people.
However, despite hundreds of millions of people around the world living with mental disorders, mental health has remained in the shadows. Often times, those who suffer from it often confuse it for “just being under the weather” and for the few that are aware are depressed, getting help or knowing where to go is not public knowledge. But then again, what really is depression, is it a physical illness or a negative habit of thought that can be addressed by talking to behavioral therapists, what leads to it and for those who have it where can they go for help?
Dr Mpho Thula, a Psychiatrist and Hospital Superintendent at the Sbrana Psychiatric Hospital in Lobatse, defines depression as a mental illness. He says, “We all at times feel sad, miserable, fed up and/or stressed due to our circumstances or the circumstances we find ourselves in, with those feelings fading within a couple of days and not interfering too much with our lives or our ability to function. That is normal. Depression is a mental illness and it is when sadness and misery graduates from the normal ups and downs of life to a more persistent and deep seated emotional difficulty where low mood is associated with inner emptiness, hopelessness, helplessness, loss of interest, inability to cope with day to day activities and the whole phenomenon persists for at least two weeks.” He adds, “Depression is not a new illness. People have reported symptoms of depression from time immemorial. For example many scholars believe that the story of King Saul in the Old Testament actually shows that he suffered from depression. Saul is described as being tormented by an evil or bad spirit which tended to leave him when music was played. (See 1 Samuel 16 ; Verses 14-16 & Verse 23).”
Although he admits that, depression tends to be driven by persistent negative thinking, negative expectation and concentration on negative aspects of events.  He however points out that this alone does not fully explain the cause of the illness. “Depression like most mental illnesses is caused by an interaction of genetic predisposition, psychological traumas and stressful events in our social lives. There are significantly increased rates of depression in biological relatives of affected individuals, which shows that there is a genetic component to this illness. Depression is also more common in women than men. The cause of this is not fully understood,” he says.
Thula cites triggers of depression in the people’s psychosocial environment to include; (a) Stressful things that can happen in our lives like bereavement, divorce, relationship break-up, losing a job, abuse or neglect in childhood, violent relationships, (b) Physical illnesses especially life threatening illnesses such as cancer, lifelong illnesses such as HIV/AIDS, illnesses associated with long/frequent periods of physical pain like arthritis, migraine, (c) alcohol and drug abuse people who abuse alcohol and drugs are more likely to suffer depression and indeed to commit suicide.” Other factors that have been found to predispose to depression are, Lack of a confiding relationship with someone, Unemployment, Three or four children under the age of 14 at home, Loss of mother before the age of 11.
He goes on add that depression at times is difficult to notice, especially for people who do not confide, but as the illness becomes more severe it is relatively easy to notice because it significantly affects one’s functionality and relationship with others. “Mild depression might be missed because it mimics normal sadness but knowledge of the symptoms should assist others to notice when friends or family members have depression. The key three symptoms of depression are low/depressed mood, loss of enjoyment or interest in activities and low energy or persistent tiredness persisting for at least two weeks. In addition to these, the individual should also show several (two or more) symptoms from the following list, also persisting for at least two weeks: Loss of confidence or self esteem, Recurrent thoughts of death or suicide, Slowing down of somebody’s thinking and performance in physical activities which is visible or noticeable, Sleep disturbance (usually poor sleep with early morning wakening), Change in appetite (usually loss of appetite),Excessive and inappropriate guilt or worthlessness, Loss of interest in sex and bleak and pessimistic views of the future.”
It is an open secret that cases go unreported and for those that are reported sometimes there is lack of support from the families of those diagnosed with depression. Thula admits that they are aware of lack or no support from family members, “Cases of depression typically present very late because of the tendency to try other approaches such as spiritual healers or to wait it out at home in the hope that it will go away. On average depression accounts for about 6% of admissions and 20% of patients seen in our out-patient clinics at Sbrana Psychiatric Hospital. Assessment of these numbers make us believe that there are still a lot of cases which do not present for care because generally 8-15% of the population is expected to suffer from depression. It’s helpful to have family and/or friends who are supportive as this makes it easier for those with depression to cope or to keep well. Where there is no support, one can get support from the professional services such as Social Workers, Nurses, Counselors, Psychologists, Doctors. When somebody has no support, it might also be necessary to admit them into hospital until they have fully recovered.”
For those suffering from depression, avoiding alcohol and drugs and isolating oneself is definitely a must according to Dr Thula. Other ways of self help he says include, exercising, doing some activity to distract yourself, relaxation exercises like yoga, using other relaxing modes such as music and regular healthy meals. “It’s important to seek help from a health professional (Doctor, Nurse, Professional Counselor) if you are unable to cope on your own. Treatment of depression can either be with counseling alone, medication alone or the combination of both,” said Dr Thula.

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