Despite the number of people suffering from depression, it is still widely a taboo subject. So taboo in fact, that many would rather suffer in silence than admit to needing help. Mental conditions such as depression are rife these days. It may be the stress that comes with everyday life, it could be genetic. Everyone experiences an occasional blue mood but depression is a more pervasive experience of repetitive negative rumination, bleak outlook and lack of energy. It is not a sign of personal weakness or a condition that can be washed away. According to the World Health Organisation (WHO), an estimated 350 million people suffer from depression worldwide. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family. A clinical psychologist, Joab Mudzanapabwe defines depression as a presence of sad, empty or irritable mood accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function.
What contributes to depression?
Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events such as unemployment, bereavement or psychological trauma are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation and depression itself. “Substance abuse, poor stress coping mechanisms and a family history of depression are some of the things that increase the chances of depression,” explained Joab.
The warning signs
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate, or severe. An individual with a mild depressive episode will have some difficulty in continuing with ordinary work and social activities, but will probably not cease to function completely. During a severe depressive episode, it is very unlikely that the sufferer will be able to continue with social, work, or domestic activities, except to a very limited extent Recurrent depressive disorder involves repeated depressive episodes. During these episodes, the person experiences depressed mood, loss of interest and enjoyment as well as reduced energy leading to diminished activity for at least two weeks. Many people with depression also suffer from anxiety symptoms, disturbed sleep and appetite and may have feelings of guilt or low self-worth, poor concentration and even medically unexplained symptoms. Bipolar affective disorder typically consists of both manic and depressive episodes separated by periods of normal mood. Manic episodes involve elevated or irritable mood, over-activity, pressure of speech, inflated self-esteem and a decreased need for sleep.
Joab explains that the symptoms of depression ranges from lasting feelings of sadness and hopelessness, to reduced interest or pleasure in the things that one used to enjoy which is known as anhedonia. Depressed people are constantly tired and feel physically drained. They experience a number of emotional and physical changes, which can result in fatigue, exhaustion, psychomotor retardation and struggle to pay attention. “Sleeping patterns may also be affected by depression, whereby the sufferer oversleeps or struggles with insomnia,” he added. Joab further stressed that if one experiences these symptoms they might be suffering from Major Depressive Disorder. At its worst, depression can lead to suicide. According to WHO, over 800 000 people die due to suicide every year which makes suicide the second leading cause of death in 15-29-year-olds. In Namibia, there have been cases of suicide that were caused by one or two reasons to depression. There are, however, interrelationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.
Dealing with depression
Recovering from depression requires action, but taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can be exhausting. However, there are effective treatments for moderate and severe depression. Health care providers may offer psychological treatments such as behavioural activation, cognitive behavioural therapy and interpersonal psychotherapy or antidepressant medication. Different psychological treatment formats for consideration include individual or group face-to-face psychological treatments delivered by professionals and supervised lay therapists. Psychosocial treatments are also effective for mild depression. Antidepressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. On a personal level it is advised that one cultivates supportive relationships in dealing with depression, especially with friends and family members who make you feel loved and cared for. While isolation and loneliness can trigger or worsen depression, maintaining supportive relationships can be instrumental in overcoming it.
It is paramount to talk to someone face to face. The simple act of talking to someone face to face about how one feels can play a big role in lifting the fog of depression and keeping it away. Keeping up with social activities also has an essence in dealing with depression. Often when one is depressed, it feels more comfortable to retreat into their shell, but being around other people lessens depression. The burden of depression and other mental health conditions is on the rise globally. This is because mental illness is widely misunderstood, stigmatised and even feared. As a result most people are often quick to deny or hide their struggle due to the negative stigma surrounding it. Depression is, however, not something to be ashamed of. It is a very real chronic illness, and like diabetes and cancer, it can be treated and managed. It is just a matter of getting rid of the stigma associated with depression and normalise this disease to have people speak out when they are not feeling like themselves. The key is to start small and build from there. Feeling better takes time, but one can get there if they make positive choices for themselves each day. Joab advises that people seek professional help through a doctor, psychologist, psychiatrist or a social worker.