NIGERIAN MEDICAL ASSOCIATION, KWARA STATE BRANCH.
PRESS RELEASE ON THE OCCASION OF THE 2017 WORLD HEALTH DAY.
Every 7th day of April annually is set aside and celebrated globally as world health day as directed by the World Health Organisation (WHO).
The theme for 2017 is DEPRESSION: LET’S TALK!
Depression affects a significant number of people globally and a major contributor to overall global burden of disease. At its worst, it can lead to suicide.
Depression, though highly stigmatized is preventable and treatable. Let’s talk more about depression in order to break the barrier of stigma so that more people can seek help!
What is depression?
• Depression is an illness characterized by at least two weeks of undue sadness, loss of interest in activities that one usually enjoys and lack of energy to carry out daily activities.
• In addition to the core symptoms above there is; a change in appetite; sleeping more or less; anxiety; reduced concentration; indecisiveness; restlessness; feelings of worthlessness, guilt, or hopelessness; and thoughts of self-harm or suicide.
• It can be mild, moderate or severe.
• It is a treatable condition
• Despite available and cheap treatment method, about 50% of cases of major depression still go untreated (WHO, 2017).
Magnitude of the illness
• Depression is a common mental illness
• Globally, it affects more than 300 million people of all ages.
• In Nigeria, lifetime prevalence of major depressive illness is 3.1% (Gureje et al 2010)
• It is the leading cause of disability worldwide
• It affects more women than men.
Symptoms in children and adolescents
Symptoms may not be exactly as seen in adults but may include;
• Additional signs and symptoms of depression during childhood include; withdrawal from others, irritability, excessive crying, difficulty in concentrating at school, a change in appetite or sleeping more or less.
• Younger children may lose interest in playing. Older children may take risks that they would not normally take (e.g substance abuse, prostitution).
Symptoms in women who have just delivered
• Having a baby is a major life event and can cause worry, tiredness and sadness.
• Usually these feelings don’t last long, but if they persists, it may be a sign of depression.
• Depression following childbirth is very common affecting 1 in 6 women.
• Symptoms of depression after childbirth also include: a feeling of being overwhelmed; persistent crying for no apparent reason; lack of bonding with baby; and doubt about being able to care for self and baby.
• Without treatment, depression following childbirth can last for months or even years. It can affect the mother’s health and the development of baby.
Symptoms in the elderly; (some cultural dimensions)
All symptoms seen in adults
• If the depression is moderate or severe with psychotic symptoms, there may be delusion of guilt (false belief that one has committed an offence that is so severe and unpardonable or responsible for a previous calamity).
• In our culture, these poor elderly women are labeled witches! (absolutely UNTRUE). She is most likely suffering from depressive illness.
Who can have depression?
• Depression can happen to anybody (young or old!).
• Depression is an illness and not a character weakness.
• Depression can be treated. What treatment is best and how long the depression lasts depend on the severity of the depression.
• The support of care givers (friends and family) facilitates recovery from depression. Patience and perseverance is needed, as recovery can take time.
• Stress can make depression worse.
What to do if you know someone with signs and symptoms of depression
• Make it clear that you want to help, listen without judgement, and offer support.
• Encourage them to seek professional help. Offer to accompany them to appointments.
• If medication is prescribed, help them to take it as prescribed. Be patient; it usually takes a few weeks to feel better.
• Help them with everyday tasks and to have regular eating and sleeping patterns.
• Encourage regular exercise and social activities.
• Encourage them to focus on the positive, rather than the negative.
• If they are thinking about self-harm, or have already intentionally harmed themselves, do not leave them alone. Seek further help from the emergency services or a health-care professional. In the meantime, remove items such as medications, sharp objects and firearms.
• Take care of yourself too. Try to find ways to relax and continue doing things you enjoy.
Staying positive and preventing depression as you get older
• The life changes that come with ageing can lead to depression.
• Depression is common in older people but often overlooked and untreated.
• Depression among older people is often associated with physical conditions, such as heart disease, high blood pressure, diabetes or chronic pain; difficult life events, such as losing a partner; and a reduced ability to do things that were possible when younger.
• Older people are at a high risk of suicide.
• Keep up with activities that you have always enjoyed, or find alternatives if previous activities are no longer possible.
• Stay connected. Keep in contact with family and friends.
• Eat at regular intervals and get enough sleep.
• Exercise regularly if you can, even if it’s just a short walk.
• Avoid or restrict alcohol intake and only take medicine as prescribed by your health-care provider.
Can depression lead to suicide?
YES and Do you know that:
• Every 40 seconds, someone, somewhere in the world, dies by suicide.
• It is not uncommon to think about suicide.
• Asking about suicide does not provoke the act of suicide. It often reduces anxiety and helps people feel understood.
• It is okay to talk about suicide.
• Suicide can be prevented
How to know if someone is planning to commit suicide
• Someone saying life is worthless and hopeless
• That pain is too much and no longer bearable
• That everyone will be better off without him/her
• Threatening to kill oneself.
• Saying things like “No-one will miss me when I am gone.”
• Looking for ways to kill oneself, such as seeking access to pesticides, firearms or medication, or browsing the internet for means of taking one’s own life.
• Saying goodbye to close family members and friends, giving away of valued possessions, or writing a will.
Who is at risk of suicide?
• People who have previously tried to take their own life.
• Someone with depression or an alcohol or drug problem.
• Those who are suffering from severe emotional distress, for example following the loss of a loved one or a relationship break-up.
• People suffering from chronic pain or illness.
• People who have experienced war, violence, trauma, abuse or discrimination.
• Those who are socially isolated.
What to do if you know someone considering suicide
• Find an appropriate time and a quiet place to talk about suicide with the person you are worried about.
• Let them know that you are there to listen.
o He/She is not alone. Many other people have gone through what you are going through and are alive today.
o It is okay to talk about suicide. It can help you feel better.
o Having an episode of self-harm or suicidal thoughts or plans is a sign of severe emotional distress (perhaps as a result of the loss of a loved one, loss of employment, a relationship break-up, or experience of violence or abuse). You are not to blame and it can happen to anyone.
o You can get better.
o There are people who can help you.
• Encourage the person to seek help from a professional, such as a doctor, mental health professional, counsellor or social worker.
• Offer to accompany them to an appointment.
• If you think the person is in immediate danger, do not leave him or her alone. Seek professional help from the emergency services, a crisis line, or a health-care professional, or turn to family members.
• If the person you are worried about lives with you, ensure that he or she does not have access to means of self-harm (for example pesticides, firearms or medication) in the home.
• Stay in touch to check how the person is doing (WHO, 2017).
How to treat depression
• Usually treated by mental health specialists (see your doctor who will refer you)
• Treatment involves use of medications, psychological interventions (‘talking cure’) and social interventions among others.
• Suicide is preventable; SEE A DOCTOR TODAY!
Let’s talk about depression to break down its barriers; barriers to stigma, barriers to accept being ill and barrier to seek treatment. Depression is treatable. Seek treatment or help someone today!
Dr. Kunle Olawepo Chairman, Nigerian Medical Association, Kwara State Branch.
Write-up by Dr. A.B Makanjuola; Consultant Psychiatrist, University of Ilorin Teaching Hospital, Ilorin Nigeria.
1. WHO, Handouts on Depression for 2017 World Health Day
2. Kaplan and Sadock’s synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 5th ed. Wolters Kluwer Health; 2011. 1123-1175 p.
3. Gureje O, Uwakwe R, Oladeji B, Makanjuola VO, Esan O. Depression in adult Nigerians: reults from the Nigerian survey of mental health and well-being. J Affect Disord 2010: 158-64