Depression: When To Seek Medical Assistance

The World Health Organisation (WHO), has recently declared depression, which could lead to disability and death, the world’s most widespread illness.For someone living with depression, talking to a person they trust is often the first step towards treatment and recovery, reports APPOLONI A ADEYEMI

Depression is not a new disease condition. It has been in the world from the time of old. Recent events have however brought it to the front burner, prompting attention to be focused on it. World Health Organisation, WHO, last month raised the alarm, alerting the world that depression has risen by more than 18 per cent since 2005.

In 2015, the WHO estimated that 322 million people globally were living with depression, making it the leading cause of ill health and disability worldwide. The agency found that the majority of those with the condition were not receiving adequate care in high income countries; it estimated that 50 per cent of those with the disorder don’t get treatment, while in lowincome countries that number rises to between 80 per cent and 90 per cent. In Nigeria, the story is not different.

Medical experts have similarly harped on rising cases of depression while calling on the authority to tackle it with a view to preventing its backlash. Depression is a mental health disorder, characterised by persistently low mood, feeling of sadness and loss of interest in things happening in the environment.

It is an illness that is debilitating and could be fatal as well if not well managed. To highlight the severity of depression, a Consultant Psychiatrist/ Psychologist and Medical Director of the Federal Neuro Psychiatric Hospital, FNPH, Yaba, Dr. Richard Adebayo said depression is a major factor behind suicide.

“Eighty per cent of people who commit suicide have depression,” he added. Director General of the WHO, Margaret Chan is among stakeholders calling for new approach to address depression. She said, “These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency it deserves.”

It is against this background that medical experts are drawing the attention of the populace to depression and its health outcomes to assist families, friends and colleagues recognise people that are depressed so as to provide them with needed assistance.

These are the focus of a forum to mark the World Health Day organised by the Lagos University Teaching Hospital, LUTH’s Suicide Research And Prevention Initiative in collaboration with the Medical and Dental Consultants, MDCAN, LUTH Branch and the Association of Psychiatrists of Nigeria, APN. The theme of the forum, which held in Lagos last Friday is, ‘Depression: Let’s Talk’.

Symptoms

According to Taiwo Akindipe, a consultant psychiatrist at the FNPH, Yaba, depression is an illness that is treatable and when it develops in anyone, it’s important to note that it cannot be wished away because what is causing it is the mood of the individual.

Symptoms

It is normal for an individual who loses a loved one or experiences a job loss and tragedy to be sad or moody. It’s also normal for this person to fall out of the mood afterwards. However, when this feeling of sadness becomes persistent, lasting for over two weeks and beyond, people around should be concerned, said Akindipe. In identifying depression, he said one should observe in an affected person two core symptoms of depression in addition to two other depression symptoms, all of which span a period of two weeks.

Listing the symptoms, he highlighted them as low mood, feelings of prolonged sadness, loss of interest in things that used to engender joy for the person, being withdrawn, loss of energy, and feeling tired all the time. Other symptoms are sleep disturbances – waking up two to three times before normal sleeping time, not getting enough sleep and sleep-ing too much. Furthermore, loss of appetite, loss of sexual desire which is one of the reasons for marital disharmony, having problems with concentration are signs of depression.

Akindipe said often, persons who suffer depression move in a bleak way, demonstrating feelings of hopelessness, helplessness, and worthlessness and it is at these stages that the thoughts of death and suicide come in and overwhelm them.

He noted that depression could be mild or severe and when it gets worse, the affected persons would begin to hear voices directing them to carry out negative activities including suicide or self-harm on themselves. “Whenever any of these symptoms are observed in anyone,” the consultant psychiatrist advised that the fellow must seek medical help to avert impending danger.

People at risk

There have been misconceptions that it is only adults that could suffer depression. “Adolescents and even children could suffer depression as well,” said Dr. Yewande Oshodi, a consultant psychiatrist at LUTH.

She lamented that often, parents miss saving the lives of their adolescent children some of whom may have exhibited symptoms of depression which include significant change in behaviour, being a bit withdrawn, not doing well in school, taking care of themselves such as indulging in alcohol and self-medication.

According to Oshodi, risks of suicide is high in children and adolescents that are depressed. “If you observe these changes in behaviour of adolescents and children, parents and care givers should intervene”, she advised. These could make it easy for affected young ones to open up and discuss the health problems.

Furthermore, Oshodi said factors that could trigger depression in children include bullying both at schools and at home, physical, psychological and sexual abuse, among others. She affirmed that suicide is common in Nigeria; it is not a new thing.

“We in the Department of Psychiatry at LUTH can confirm that almost all referrals to our department were based on suicide attempts.” Oshodi added: “Every month we have at least four cases of attempted suicide and it has been like that for years. So, these are not new things.” On his part, a Clinical Psychologist at LUTH, Dr. Charles Umeh affirmed that there was a link between depression and suicide.

He said: One condition that takes happiness away from people is depression. It makes you look at your environment and future from the negative perspective; it would not make the person see anything good in what he or she is doing, often resulting in feelings of hopelessness. “

“When it gets to these levels, affected persons try to commit suicide,” he said, adding that while men tend to internalise their own problems, presenting the macho outlook, the women tend to discuss the suicide ideation in them, which may also help in preventing the intending suicide. According to WHO, approximately one million people die by suicide each year globally and for everyone who dies by suicide about 20 more have attempted it. A Consultant Psychologist and Head of LUTH’s Suicide Research & Prevention Initiative and Staff Emotional Care Services, SURPIN/ SECS, Dr. Raphael Ogbolu said based on research by Ogbolu and colleagues, “Over a five-year study period 7.2 per cent of cases referred for Psychiatry Consultation- Liaison Services in LUTH were cases related to suicide.

“It has been reported that during their lifetime, about 3.0 per cent of Nigerians have had thoughts about ending their lives, 1.0 per cent will plan on how to kill themselves and just under 1.0 per cent will carry out an attempt to kill themselves,” according to the study. Based on these, Ogbolu said LUTH recently created the SURPIN/ SECS where people who are hopeless and intend to end their lives could access care and counseling services.

“They could also be treated and referred if necessary,” he added. LUTH’S SURPIN telephone lines are: 0908-021-7555; 0903-440-0009; 0811-190-9909; and 0701-381-1143. Also contributing to factors to check depression and associated suicide in the country, Alhaji Wasiu Ayanyemi, an Islamic cleric urged depressed people who tend towards suicide as a way out, to move closer to God, saying according to Islamic teachings, “It’s a great sin for anyone to take his/her own life.”

He encouraged believers of the Islamic faith to be patient and get closer to God in solving social and economic problems that may pressure them to commit suicide. Similarly, Pastor Animashaun Oladimeji criticised some churches over their penchant on prosperity messages while they hesitate in providing financial assistance for depressed members.

He however urged churches to change these approaches and rather encourage their members to speak up about their personal problems as a way to address depression and prevent suicide. “We should have church communities that assist members, but the churches are not doing these,” he added.

Highlighting factors that would help people prevent depression, a Consultant Psychiatrist and President, APN, Prof. Joseph Dada Adeyemi, said depression may be caused by the genetic makeup of an individual. Also, food, some consumables including medications and drugs could similarly trigger depression.

For instance, he noted that “Even some of the things we take for pleasure could trigger depression. The abuse of drugs and alcohol can affect our mind. Even some drugs and medications for treatment can potentially cause a lot of havoc concerning depression.

“At the end of the day, Adeyemi said that some psychoactive drugs such as cocaine, heroin, and cannabis actually enslave those indulging in them.” Consequently, he encouraged the populace to pay attention to the way the human mind works. “If we invest one dollar in promoting activities that will check depression, it will earn us four dollars,” he added.

By Appolonia Adeyemi