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10 Feb 2019

Depression is NOT a sign of weakness – by Abeng Emmanuel

Depression (clinical depression) refers to a serious medical mood disorder (illness) which negatively affects how you feel, think, act and handle daily activities including sleeping, eating, or working. Depression is characterized by feelings of sadness, loss of interest in the things or activities you once enjoyed the most.

It also leads to emotional and physical problems both at home and at work. In addition, to be diagnosed with depression the symptoms must be present for at least 2 weeks (NHS UK, 2019; American Psychiatric
Association, 2019).

It is worth noting there is a difference between people experiencing periodic times of feeling down just for a few days. On the other hand, depression makes you feel constantly sad over weeks, months or even years. In this case it is a genuine health condition with clear symptoms.

Depression is never a sign of weakness, a character flaw or something which
can be solved by simply “pulling yourself together” neither can you “snap out of” clinical
depression (National Institute of Mental Health, 2019).

On a global scale over 300 million people suffer from depression, it is among the major causes of disability in the world. Women are mostly affected by depression than men, the ratio of women to men depression is at 2:1 and has been found to affect 1 out of 5 women.

In sub-Saharan African 75% of people who suffer from depression or mental illness do not have access to the health care needed (Rapmund and Moore, 2000; Rand.org, 2019 ; Who.int, 2019). According to the WHO 2019, over 800000 people commit suicide due to depression every year.

Fundamental importance of religion, culture and the African world view inter plays on how depression is viewed. People with depression especially in sub-Saharan Africa face social stigma, this stigmatization affects people with mental disorders in general which makes depression worst for those who suffer from it.

Another issue with depression in this region is due to lack of an effective social circle knowledge about depression. Lack of medical care also leads to depression not correctly diagnosed alongside depression taken seriously.

Trending article: Depression almost took my life

How does depression affect the human brain?

According to the Harvard Medical School 2017, the hippocampus is smaller in some depressed people. A study based on Functional magnetic resonance imaging or functional MRI (fMRI) which measures brain activity published in The Journal of Neuroscience. This research, examined 24 women with a history of depression and it showed

“On average, the hippocampus was 9% to 13% smaller in depressed women compared with those who were not depressed. The more bouts of depression a woman had, the smaller the hippocampus.
Stress, which plays a role in depression, may be a key factor here, since experts believe stress can suppress the production of new neurons (nerve cells) in the hippocampus”.

In addition, there are supposed billions of chemical reactions in the body and brain which constructs the dynamic system responsible for your mood, perceptions, and how you experience life.

What are the causes of depression?

There is no one cause of depression. Depression may occur for so many reasons and it can be triggered for different reasons.

Marriage is among the risk factors for depression in women. Some of the reasons include, gender-specific demands placed on women by their husbands for example excessive house chores and taking care of children single handedly.

Women are also likely prone to depression due to low education, increasing female unemployment, in cases of employment low income is also a factor found to be related to depression.

Sexual abuse during childhood also accounts as a risk for female depression (Weiss, Longhurst and Mazure, 1999; Talbot, 2004).

In sub-Saharan Africa, depression is very common with people living with HIV (PLHIV), the prevalence of depression in this group is up to 32%, but was lesser with those who had access to antiretroviral therapy (ART). Risk factors for depression for people living with HIV included economic hardship. Depression in PLHIV is a big concern in sub-Saharan Africa (Aidsmap, 2019).

Psychological abuse and physical intimate partner violence against women has detrimental effects on female victims’ mental health. 70 per cent of women in their lifetime have been victims of physical and/or sexual violence from an intimate partner. Which is also related to pregnancy lost or abortion and acquiring HIV.

There is a higher occurrence of depression among women who experienced physical and/or sexual violence, the depression rate goes
up to 66.4% (Delara, 2016; UN Women, 2019)

• Stressful events such as death of a loved one or a relationship breakdown.
• An individual’s personality may make them vulnerable to depression, certain
personality traits, like low self-esteem or being overly self-critical.
• Most women are vulnerable to depression after pregnancy (postnatal depression). This is due to hormonal and physical changes and added responsibility of a new baby.
• Loneliness is often a cause of depression, being cut off from one’s family and friends increases the risk of depression.
• Abuse of Alcohol and drugs. Alcohol or some drugs can be considered as “strong depressant”, but they rather make depression worse.
• Protracted or life-threatening illness may pose a higher risk of depression
(Harvard Health Publishing, 2009; nhs.uk, 2019).

As part of the UN Sustainable development goals (SGDs) “leaving no one behind”, SDG3 – Ensure healthy lives and promote well-being for all at all ages. Together we can show more care, raise awareness about depression in our homes, local communities and country. Depression is not a sign of weakness just like malaria is not either.

More ways to combat depression in our communities can be done by encouraging victims to go for medical consultation or checkups, promoting preventive strategies like management programmes for depression without leaving out mental illness as a whole. Another way to tackle depression includes actively providing useful skills and coaching to community health centers, problem solving and stress reduction techniques and most importantly psycho-education (Ngcobo and Pillay, 2008).

Reference

Aidsmap. (2019). Depression highly prevalent among people living with HIV in sub-Saharan Africa. [online] Available at:
http://www.aidsmap.com/Depression-highly-prevalent-among-people-living-with-HIV-in-sub-Saharan-Africa/page/3174984/

[Accessed 9 Feb. 2019].

American Psychiatric Association . (2019). What Is Depression?. [online] Available at:
https://www.psychiatry.org/patients-families/depression/what-is-depression [Accessed 8 Feb. 2019].

Annelle Primm, M.D.: “Many people believe that suffering is a part of life for African Americans, so they should just ‘keep on keeping on.’”

Delara, M. (2016). Mental Health Consequences and Risk Factors of Physical Intimate Partner Violence. Mental Health in Family Medicine, 12(01).

Harvard Health Publishing (2019). What causes depression? – Harvard Health. [online] Harvard Health. Available at:
https://www.health.harvard.edu/mind-and-mood/what-causes-depression [Accessed 9 Feb. 2019].

National Institute of Mental Health. (2019). NIMH » Depression: What You Need To Know. [online] Available at: https://www.nimh.nih.gov/health/publications/depression-what-you-need-to-know/index.shtml
[Accessed 8 Feb. 2019].

Ngcobo, M. and Pillay, B. (2008). Depression in African women presenting for psychological services at a general hospital. African Journal of Psychiatry, 11(2).

Nhs.uk. (2019). Causes. [online] Available at: https://www.nhs.uk/conditions/clinical-depression/causes/
[Accessed 9 Feb. 2019].

Nhs.uk. (2019). Clinical depression. [online] Available at: https://www.nhs.uk/conditions/clinical-depression/
[Accessed 8 Feb. 2019].

Rand.org. (2019). Mental Health Care in Sub-Saharan Africa: Challenges and
Opportunities. [online] Available at: https://www.rand.org/blog/2015/03/mental-healthcare-in-sub-saharan-africa-challenges.html
[Accessed 8 Feb. 2019].

Rapmund, V. and Moore, C. (2000). Women’s Stories of Depression: A Constructivist Approach. South African Journal of Psychology, 30(2), pp.20-30.

Talbot, N. (2004). Preliminary Report on Childhood Sexual Abuse, Suicidal Ideation, and Suicide Attempts Among Middle-Aged and Older Depressed Women. American Journal of Geriatric Psychiatry, 12(5), pp.536-538.

UN Women. (2019). Facts and figures: Ending violence against women. [online] Available at:
http://www.unwomen.org/en/what-we-do/ending-violence-against-women/facts-and-figures
[Accessed 9 Feb. 2019].

Weiss, E., Longhurst, J. and Mazure, C. (1999). Childhood Sexual Abuse as a Risk Factor for Depression in Women: Psychosocial and Neurobiological Correlates. American Journal of Psychiatry, 156(6), pp.816-828.

Who.int. (2019). Depression. [online] Available at:
https://www.who.int/news-room/fact-sheets/detail/depression
[Accessed 9 Feb. 2019].

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