Depression is a common mental disorder millions of people continued to battle with on daily basis without knowing it. According to the World Health Organisation, WHO, globally, over 350 million people of all ages suffer from depression. Just like other mental problems, not many people understand depression, a condition WHO describes as a leading cause of disability worldwide, and a major contributor to the overall global burden of disease. More in women than men, if not treated, depression, according to experts, could lead to suicide.
However, many people are still confused about the fact that they feel down or depressed sometimes not knowing that they are suffering from depression just like in the case of 38 years old Janet Egwu.
When Janet moved to Lagos from Enugu, she knew her relocation would be stressful. After all, she was starting a new job and settling into a new apartment. Plus, she had to learn her way around one of Nigeria’s busiest cities. It was a lot all at once for her. Then everything seemed to be falling apart when she suddenly started to suffer from anxiety.
And when the anxiety proved too much to bear, little did Janet know it would affect her body system. She stopped eating, lost weight, and felt tired frequently. Thinking the anxiety from her relocation was at the root of her problems, she did not realize the extent of the problems.

Later, she began to experience depressed mood or loss of interest or pleasure almost on daily basis. She was always feeling sad, empty and irritable.
These continued until insomnia set in. It was then she knew that the changes in her system were not just because of her relocation to Lagos.
Janet found a psychiatrist and, after her first visit, she had her diagnosis. It wasn’t anxiety disorder she was suffering from as she had suspected but depression.
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.
Janet was given a low-dose anti-depressant and another medicine to treat the anxiety. She felt as if she had a new lease on life. Today, she sees her psychiatrist once a week.
Just like Janet, some people don’t realise depression can result in major life changes. Although, Janet’s problems aren’t rooted in abuse, and there is no family history of problems, experts say if you don’t feel right, get help.
Burden
WHO says 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. At its worst, depression can lead to suicide. Statistics from WHO shows that close to 800 000 people die due to suicide every year.
According to WHO, the burden of depression and other mental health conditions is on the rise globally. A World Health Assembly resolution, passed in May 2013, called for a comprehensive, coordinated response to mental disorders at country level. Unfortunately, many Nigerians believe that mental problems are only associated with people walking on the streets unclad.
It affects one in 10 people at some point in life. Unfortunately, although effective treatments for depression are known, fewer than half of those affected in Nigeria and the world at large (in many countries, fewer than 10 percent) receive such treatments.
Many barriers have been blamed for this. While some traced it to lack of resources, trained health-care providers, and social stigma associated with mental disorders, many believe that due to ignorance, many affected fail to seek treatment. Another barrier to effective care is inaccurate assessment. In countries where income levels are low, people who are depressed are often not correctly diagnosed, and others who do not have the disorder are too often misdiagnosed and prescribed anti-depressants.
What it is
Depression is long lasting low mood that affects your ability to do everyday things, feel pleasure, or take interest in the things you normally enjoy. Symptoms can include feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration.
While stressful life events and trauma can make depression more likely, it can affect anyone and it is not necessarily related to external events. It can, therefore, be extremely frustrating for people battling depression to be told they have ‘nothing to be depressed about’.
No one knows for sure what causes depression, and much more research still needs to be done. However, it is generally accepted that it is a combination of genetic and environmental factors. Depression tends to run in families. This could be because of genes, or it could be due to being exposed to other people’s low moods.
Problems in childhood are thought to increase the chances of depression, but many people who have had happy and stable childhood are still affected. Life events such as a break-up, death of a loved one or losing your job can sometimes be ‘triggers’ for the onset of depression.
There are things we can all do to safeguard our mental health in the same way we do for our physical health. Eating a balanced diet, getting the exercise, limiting alcohol and having hobbies are all good for mental health and reduce chances of depression.
Overcoming depression
Depression is treatable and, in many cases, it is possible to fully recover, although some people will have episodes throughout their lives. It is usually treated with a combination of medication and therapies, although medication should not be the first response to mild or moderate depression.
If you think you may be depressed, you should see your doctor. Some doctors are better at dealing with mental health than others and, if you don’t feel listened to, try booking an appointment with another doctor and taking someone you trust with you for support.
Simple things like spending time together and encouraging suspected victims to do things that once gave them pleasure can be really helpful. Just showing that you care and will listen without judgment can be the most powerful remedy.
Types and symptoms
Depending on the number and severity of symptoms, a depressive episode can be categorized as mild, moderate or severe.
Contributing factors and prevention
Depression results from a complex interaction of social, psychological and biological factors. People who have gone through adverse life events (unemployment, bereavement, 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.
There are inter-relationships between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.
WHO says prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children.
Exercise programmes for the elderly can also be effective in depression prevention.
Diagnosis and treatment
There are effective treatments for moderate and severe depression. Health-care providers may offer psychological treatments (such as behavioural activation, cognitive behavioural therapy [CBT], and interpersonal psychotherapy [IPT]) or antidepressant medication (such as selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]).
WHO warns that health-care providers should keep in mind the possible adverse effects associated with anti-depressant medication, the ability to deliver either intervention (in terms of expertise, and/or treatment availability) and individual preferences.
Psychosocial treatments are also effective for mild depression. Anti-depressants can be an effective form of treatment for moderate-severe depression but are not the first line of treatment for cases of mild depression. They should not be used for treating depression in children and are not the first line of treatment in adolescents, among whom they should be used with caution.
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