I guess we’ve all heard of stories of women who have taken their lives after many years in a stressful marriage. The intervening period between the onset of the marital turmoil and the act of suicide is likely to have been fraught with emotional and physical changes such as moodiness, a pessimistic outlook of life, a loss of interest in the things she used to enjoy, lack of sleep and pronouncements such as “Life is not worth living anymore”. These are symptoms of clinical depression.
Depression is a medical illness that affects how you feel, think and behave, causing persistent feelings of sadness and loss of interest in previously enjoyed activities. Depression can lead to a variety of emotional and physical problems. It is a chronic illness that usually requires long-term treatment.
Our traditional social support system, where we are each other’s keeper, makes us better able to manage the stresses of our lives. But with increasing modernization and the gradual exclusion of the extended family, this support system is gradually being lost. It is therefore not surprising that depression is becoming commoner in our society.
The causes of depression are myriad: chronic or serious illnesses like stroke, cancer, diabetes mellitus, severe trauma and amputations can lead to depression. Depression can also be a result of a broken or unhappy marriage, difficulties/stress at work and school and loss of a loved one. These are problems that we all face every day, but our response and coping mechanisms determine whether or not it will lead to depression. Sometimes though, there is no apparent trigger for an episode of depression.
Certain factors also make certain individuals more susceptible to depression. These include a personal/family history of depression or other mental health condition, female gender, alcoholism and illicit drug use.
The symptoms of depression are many (as listed in the table below), but before a diagnosis can be made, five or more of these symptoms should have been present for at least 2 weeks, and one of them must be a depressed mood or loss of interest or pleasure.
Table 1- Signs and symptoms of Depression
Persistent sad, anxious, or “empty” feelings
Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Irritability, restlessness Loss of interest in activities or hobbies once pleasurable, including sex Fatigue and decreased energy Difficulty concentrating, remembering details, and making decisions Insomnia, early-morning wakefulness, or excessive sleeping Overeating, or appetite loss Thoughts of suicide, suicide attempts
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(Source: National Institute of Mental Health, USA)
Atypical symptoms may sometimes occur. These include aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
If you experience some or most of these symptoms a physician should be consulted; your physician will run tests to rule out an organic cause of your presentation and if you are found to be clinically depressed, appropriate treatment is offered. Treatment is usually in the form of medication, psychological restructuring, electroconvulsive therapy (ECT), or a combination of these.
There is no sure way to prevent depression, but there are certain strategies that will make its occurrence (or reoccurrence) less likely:
- Reach out to family and friends- make use of all the social support you have in times of crises. Talk to your spouse, parents (or children), an elder in your community, your religious leader or a trusted friend. The cathartic effect of such conversations lightens the burden and helps you cope with the stressor. This social support is important in helping us prevent depression.
- Exercise regularly- Exercise releases high amounts of endorphins, which produce a euphoric effect, much like that seen with opioids. Regular exercise therefore keeps you happy, and feeling happy is the best way to ward off depression. Regular exercise also improves confidence and self-esteem, all important ways to keep depression at bay.
- Manage stress- try and avoid stressful situations at work and/or school: don’t wait for work to pile up before you start dealing with it, and delegate where possible. Proper time management (with the help of a planner) may help you manage stress. Stress relieving techniques like meditation, massage therapy, yoga and listening to soft music can also help deal with stress.
- Seek treatment early and remain on treatment as long as prescribed- It is easiest to treat depression when it is in its early stages. Medication given for depression are usually supposed to be taken for a minimum of nine months. When you stop taking your medication before the recommended time (because you feel better), you are making a relapse more likely.
Depression can cause a lot of personal, familial and social distress. When your blues last too long, it is time to talk to someone. When depression is identified early and treated appropriately, a full recovery can be made. A stitch in time will not only save nine, it will save your life.
The conversation continues on Wednesday, 6th May, 2015, on the Citi Health Chat
By: K.T. Nimako (MB ChB)
Dr. Kojo Nimako is a private medical practitioner with an interest in public health and Citi FM’s Chief Medical Correspondent. He is also the Executive Director of Helping Hand Medical Outreach, an NGO focused on health education.
E-mail: [email protected]
Twitter: @KTNimako