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Coming To Terms With Depression

In this article, we explore the acceptability of Depression as a medical condition that can be treated.

Why? Because this  (acceptability) is a challenge in some countries -like Nigeria - due to preconceived notions to the contrary.

And makes it difficult to allow individuals and the nation succeed in coming to terms with Depression as a treatable medical problem.

Some illnesses are difficult to characterize. This is important and speaks to their treatment method.

For years, medical professionals have been treating Depression with a varied amount of success in many parts of the developed world.

So it isn't really a new problem, but gradually and certainly, Nigerians are waking up to the reality of this condition and its potential impacts on life as we know it.

This is why its is important to recognize and know how to deal with Depression.

Recognising Depression.

In low and middle income countries though, the very nature of Depression means its presence is subject to misunderstanding.

Even when acknowledged to exist, the condition may be trivialised or stigmatised.

On Sunday 19th March 2017 in Nigeria, a young male medical doctor flung himself into the Lagos Lagoon from the top of the 3rd Mainland Bridge, a popular land mark that connects the island aspect of Lagos state to the mainland.

As with other cases before this and since, the reasons for his action are often not very clear.

Suicide is not new in  Nigeria and there are many motives - Depression being one out of many significant factors.

In the case referenced above, we do not know whether a depressed state of mind led to the act of suicide.

However, an event like this trending on the growing social media presence for many Nigerians means that people ask more questions and are more open to understanding the motives of Suicide.

About Depression.

Today we look at Depression - what it means, how we identify it and to a little extent how its treated.

If you are reading this post, you most certainly have experienced some form of low mood in the past - regardless of your age, sex, education or social class.

Think of the way you feel when you are let down:

  • having lost something precious or been robbed;
  • lost a close relative;
  • failed at an exam;
  • dumped by a boy/girlfriend;
  • experience a marriage ending or divorce;
  • lost a contract you were really anticipating.

We all know to some extent what being 'down' feels like. This is not Depression.

Most people recover from these negative episodes.

Our recovery depends on support mechanisms around us and our internal mindset (optimism vs pessimism).

We feel bad, yes, but there is a period after which we decide to 'overcome' or 'pick up the threads and carry on' that is the experience of most people.

Features of Depression

In Depression however, there is a sense of permanence of that state of mind where pleasure or happiness can no longer exist.

People depressed say they inhabit a dark place - sometimes they can't put it in words what they feel.

They speak of a lack of pleasure in activities that were previously enjoyed, a loss of hopefulness for a positive outcome in their future and a lack of motivation that many of us simply take for granted.

There may be guilt about something - an action or past inaction; which may or may not be related to regrets.

They may also experience a sense that they have let important people in their life down.

There may be an 'emptiness' inside that defies explanation or fulfillment and significantly prevents normal functioning.

Many times, this 'emptiness'  is actually noticed only when an observer (like family or friends) looks for it specifically.

There is some truth to the idea that a depressed person can mask their inner crisis for a long time.

This is unlike physical ailments like asthma, heart disease or cancer when it may be possible to 'sight' the evidence of illness by others.

In the case of mental illness like Depression it is more difficult to do so.

There are no physical tests like blood tests or scans you can take to detect Depression.

Like physical illness Depression has degrees of severity - it can be mild, moderate or severe.

Someone with mild depression may have any of the features mentioned earlier but to a degree that is hardly noticed even by close family or friends.

They may become easily annoyed or irritated by trivial issues, or they may seem less focused on usual tasks.

Its also important to say that while Depression is a mental illness, did you know it can have physical effects?

Physical Features of Depression

Some people with Depression describe a headache like a tight band around the head, for example.

And yes; it can also affect sexual desire (or libido) and sexual performance in both men and women.

In many depressed people sleep is affected - sometimes they have problems managing to get off to sleep.

Commonly, depressed people may  be able to sleep off  initially but wake up several times during the night with the same result - poor, disrupted sleep.

In addition, people with Depression may wake up very early in the morning and struggle to get back to sleep.

As the severity of Depression increases, these symptoms intensify in how strongly they are experienced; and they may additionally affect relationship or work.

Dealing with Depression.

The way a person with any of the symptoms described above will deal with them varies.

Some people may search endlessly - and in futility - for cures to a headache that never goes away, sleep problems or sexual difficulty.

Some people may just 'bear it' - wrongly believing it is their burden to carry in an already challenging and tough environment. Some people feel 'they can't go on'.

This last scenario may result in a suicide.

While we don't know exactly what causes Depression in most cases; there are some instances that are directly liked to certain key events - illness, death, job loss, even pregnancy (have a look at our infogram on Post Natal Depression).

When someone (in the absence of these events becomes depressed), we look at their genetic make up, their upbringing, their social status, emotional disposition etc to see if there is a clue to how the problem started.

Many times there may be some relation but no distinct cause.

Studies and research have revealed the impact of the 'Happiness Hormones', Serotonin and Endorphins.

Serotonin is a chemical  found in the brain which is thought to have a good influence on mood, emotion and sleep.

Endorphins which are also chemicals produced in the brain have been shown to be in greater presence during or after exercise; they reduce anxiety and make you feel good.

Severe Depression is treated by mental health clinicians (psychiatrists and clinical psychologists), but any medical doctor with  the most basic qualification has received sufficient training to at least identify and signpost patients to the right specialist to help them.

Because - YES - Depression is treatable.

Can it be completely cured?

Do we really know?

This is still under consideration but people can have happy and fulfilled lives despite having experienced Depression at one stage or another.

Depression is NOT laziness or stubborness.

We talk of different ways of treating Depression - depending on whether it is associated with an obvious event or stressor (like death or job loss).

In other cases it is less obvious how Depression came about.

We treat Depression as it presents:

If Mild, the only treatment necessary include: acknowledge and recognise the condition before using certain lifestyle measures to adapt one's mood.

These include exercise, counselling or therapy to help the person come to terms and regain a balance with their feelings and life.

Counselling is a lot more than have a chat with a good friend although the value of a strong support network is highly significant in treating ANY type of Depression - whatever the cause or degree.

When Depression is judged to be more moderate or severe then treatments include other methods like medication.

In addition to support with counselling, the benefit of antidepressant medication is supported by strong evidence.

The medications primarily affect the availability of the certain brain chemicals including Serotonin and other chemicals we discussed earlier.

To summarise, recognition and acknowledgement of the condition - is a challenge because of the different ways it presents.

However, awareness is being raised  - in a large part, due to social media exposure which helps to challenge misconceptions.

This means to a large part, more people are coming to terms with Depression as a genuine condition in themselves or people around them.

Treatment is available and should be actively encouraged as it does make a difference and CAN save lives.

If you need to discuss this further, please contact us on info@askawayhealth.org!

Stay Well.

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence based guidance and to help promote quality health care. The advice in our material is not meant to replace management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org


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