A senior lecturer and consultant psychiatrist with the Lagos State
University College of Medicine and the Lagos State University Teaching
Hospital, Dr. Rotimi Coker, speaks about depression and why awareness on
it is low
What is depression?
Depression is a type of mental illness
that manifest as frequent low moods, loss of energy and losing pleasure
in things that hitherto gave joy. It can also disturb sleep and
appetite. A depressed person can also become irritable, gain or lose
weight. In its severe form, the person with depression can become
confused, the memory, attention and judgment can be impaired. The person
can also hear strange voices saying derogatory things to the
individual. There can be associated feelings of guilt, hopelessness and
worthlessness. These associated signs can make the individual want to
attempt or commit suicide.
How severe can it be?
Depression is a dangerous form of mental
illness because it is difficult to recognise by medical officers,
general or family physicians in private hospitals, general hospitals and
primary health care settings. Sometimes, depression can be masked and
may manifest through physical health conditions such as chest pain, back
pain, sleep disturbances, and weight loss. These symptoms are not quite
suggestive of depression, thus, difficult to diagnose by non-mental
health specialists. This is one of the reasons why those suffering from
depression will be diagnosed as having frequent malaria or typhoid
fever. That is why the World Health Organisation recently claimed that
depression is now one of the most burdensome illness in the world and it
will be second to HIV/AIDS by the year 2020. It is quite possible for
individuals to be suffering from depression without actually being aware
of being ill for many years, thus preventing the individual from being
maximally productive at work or at home. It takes an average of four to
six years for someone suffering from depression to get the adequate
professional care.
Continue reading after the cut....
What causes depression?
There are many issues that can cause
depression. For example, any significant loss can bring about
depression. Significant loses such as the loss of parent, child, spouse,
job or fortune. Others include persistent stress of life that one
cannot cope with, some forms of chronic physical illnesses such as
diabetes, cancer and HIV/AIDS to mention but a few, when ones goals are
unmet, or head injury from accidents.
How can it be managed or treated?
Depression can be managed successfully
with psychotherapy (counselling) and medications referred to as
anti-depressants. In its mild and moderate forms, the person suffering
from depression can be counselled by a mental health expert by using
Cognitive Behaviour Therapy (CBT). However, if CBT does not provide the
healing that one desires, then the individual will be placed on
anti-depressants. There are many types of very good anti-depressants in
Nigeria.
Is there a particular age group that can suffer from depression?
Anybody can be affected with depression. However, it is commoner in women than men.
Why do women suffer it more than men?
Women suffer depression twice as men
because they become vulnerable during child bearing. They suffer more
when they are pregnant and also after delivery. Sometimes, the monthly
menstrual period and menopause could be responsible. Separation,
divorce or women living alone with two or three children to cater for
also make them vulnerable.
The social roles conferred on women in
their careers as wives, mothers, professionals, leaders in the society
also make their stress chronic thus making them to be vulnerable to
depression.
What are the after-effects of depression?
There are no after-affects. Depression is
like any other physical illness; if diagnosed at its early stages, it
can be treated without any after-effects.
How can the stigmas of mental illness be stopped?
The social stigma attached to those
suffering from mental health disorders can only be combated by carrying
out frequent advocacy programmes, awareness campaigns and reach out
programmes in different parts of the country to enlighten Nigerians that
mental illnesses are not caused by demons, evil spirit, charms, or as a
form of punishment from the gods as portrayed in our local home videos.
These programmes will enlighten our people that these mental health
conditions can be cured and also properly managed like most physical
health conditions. We need to also show Nigerians that people with
mental health conditions (even the chronic ones) can also be productive
and integrated back to the society. There is no enabling law to also
protect the fundamental human rights of Nigerians suffering from mental
diseases.
Is there enough awareness about it in Nigeria?
The awareness is limited. This is because
psychiatrists who are the specialists trained to recognise and treat
depression are few in Nigeria and almost all are hospital-based. In
order to bridge this gap, some few states in Nigeria have started
training medical and family physicians on how to recognise depression.
However, the ultimate solution is to integrate mental health care
services into primary health care. This is taking mental health care to
the grass roots. For example, if we have an active primary care centre
that offers mental health care services at Ikorodu, Epe or Badagry (all
in Lagos), sufferers of mental health conditions such as depression
would not need to travel far to the Psychiatric Hospital, Yaba or Lagos
State Teaching Hospital at Ikeja to receive treatment for their
conditions.
How many cases of depression do we have in Nigeria in a year?
The rates vary due to its severity.
Depression can be mild, moderate and severe in its manifestations. I
mentioned that it is difficult for doctors to recognise it. Thus, the
percentages of those suffering from the mild to moderate forms of
depression may be very high in Nigeria. However, the percentage can be
put between 20 to 40 per cent.
Who should a depressed patient meet for counselling?
Mental health experts such as
psychiatrists, clinical psychologists, psychiatric nurses, social
workers in mental health and of course medical doctors. However, these
mental health specialists are quite few in Nigeria that is why we are
trying to also train non-mental health specialists in the community to
counsel those with depression.
How do you think government can tackle the mental illness?
The WHO has directed most low and
middle-income countries including Nigeria to reduce the mental health
treatment gap in these countries. This can only be achieved by
integrating mental health care services to all primary health care
centres such as general outpatients departments of health centres and
general hospitals. The general physicians should also be quickly trained
on the recognition and management of common mental health conditions.
Nonetheless, the Lagos State Government
through the Ministry of Health has started training medical officers in
general hospitals and private hospitals on the recognition of common
mental disorders. The state has also started integrating mental health
services in some Flagship Primary Health Care centres in various local
governments in the state. It is also pertinent to say that, Lagos State
has its own Mental Health Policy. Non-governmental organisations have
major roles to play in assisting the government in integrating mental
health care to the primary care settings. Likewise, the media and home
video producers need to collaborate with mental health experts in
reducing the stigma associated with mental illness.
Symptoms of depression
- Feelings of sadness or unhappiness
- Irritability or frustration, even over small matters
- Loss of interest or pleasure in normal activities
- Reduced sex drive
- Insomnia or excessive sleeping
- Changes in appetite
- Agitation or restlessness
- Slowed thinking, speaking or body movements
- Indecisiveness, distractibility and decreased concentration
- Fatigue, tiredness and loss of energy
-Trouble thinking, concentrating, making decisions and remembering things
- Frequent thoughts of death, dying or suicide
- Crying spells for no apparent reason
- Unexplained physical problems such as back pain or headaches
- Motunrayo Joel/Punch
Share your thoughts....thanks!
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