The transcript of a brief lecture delivered on the 28th March, 2019 by Prince Ayo Sanda during a leadership hangout on the occasion of Amb. Agboola Akinola Afeez’s birthday celebration.
What is Depression?
The etymological origin of the word ‘depression’ makes the term very easy to understand. It is a common word in the psychology and psychiatry parlance. Depression comes from Latin word deprimere which means ‘to press down’ or “to bring down in spirit”. Depression is a serious disorder that involves emotional, behavioural, cognitive and physiological changes that are severe enough to change person’s daily functioning. The victims may feel hopeless and think of death or suicide. A depressed individual is no longer in control of his/her thoughts; he is rather being controlled by his thoughts.
One of the best descriptions of a depressive episode was captured in William Styron’s words after he came out of depression. He adopted Dante Alighieri’s poem in The Divine Comedy. “In the middle of the journey of our life| I found myself in a dark wood| For I had lost the right path”
Depression affects the human emotion (excessive sadness), it affects the behavioural repertoire of the victims (loss of interests in one’s usual activities), it affects cognitive ability (thought of hopelessness) and it affects body functions (fatigability tendencies and loss of appetite). Depression is a mental health disorder that is characterized by extreme sadness and or loss of interest in activities that were once pleasurable. Depression is among the health problems which many people experience at least once in their life time. It is the leading cause of disability worldwide in terms of total years lost due to disability and it is predicted to be the leading cause of disease burden by 2030 (And the second leading cause of disability by 2020) (American Psychiatrists Association, 2013).
Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings, and sense of well-being. The clinical spectrum of the disease can range from simple sadness to a major depressive or bipolar disorder. People with depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed, or restless and may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide.
Depression, according to Psychiatrists, is mental health issue. Mental health disorders are not uncommon, and the global burden of mental health disorders is projected to reach 15% by the year 2020. By this time, it is estimated that common mental disorders such as depression, anxiety, and substance abuse-related disorders, will disable more people than complications arising from AIDS, heart disease, accidents, and wars combined. This is an astonishing statistic and poses serious questions as to why mental health disorders are not given much more attention than it currently receives. We all face periods of feeling low and a bit depressed; experiences such as having a bad day at work or hearing some bad news can impact on our mood. Sometimes we might even feel sad for no reason at all. Depression can, however, be related to bereavement – when depression follows a loss, psychologists call it a “complicated bereavement.”
Epidemiological Instances of Depression: Statistics and Numbers
Depression is a global issue ranking third after cardiac and respiratory diseases as a major cause of disability. It is high among youths and is a widespread problem globally. Today, depression is already the 2nd cause of disability in the age category 15-44 years. Depression is associated with the loss of 850 000 lives every year (American Psychiatry Association, 2010). Depression is the leading cause of disability and the 4th leading contributor to the global burden of disease. Research by 20 different researchers, says depression affects nearly 121 million people worldwide. It is the second contributor to shorter lifespan for individuals in the 15-44 age group.
In Nigeria, 25% of young adults suffer from Depression, 26.2% of elderly populations are depressed, 17% of the Internally Displaced Persons (IDPs) are suffering from depression, while 20-59% of the people living with HIV/AIDS are depressed. There are more scary statistics, all pointing to the enormity of depression across the globe.
The effect of depression has differences in its manifestation for male and female. Studies have reported higher depression rate among women than men. This is not unconnected with biological, life-cycle, and hormonal factors that are unique to women may be linked to their higher depression rate. Women with depression typically have symptoms of sadness, worthlessness, and guilt. The burden of depression is 50% higher in females than in males (World Health Organization, 2012). In Africa, 5.95% of females suffer from depression, compared to 4.9% among males. Studies in Nigeria have also reported that being female is a significant risk factor of depression.
Women are mostly victims of intimate partner violence, low socio-economic status and illiteracy. All these have been identified as factors that cause depression. In Nigeria, over 50% of women are illiterates, and not in the labour force (United Nations’ Gender Statistics, 2016), and 28% and 7% of females reported are experiencing physical and sexual violence in their lifetime respectively (National Demographic Health Survey, 2013).
Many new mothers also experience a form of depression called postpartum depression. Studies have reported a prevalence of 14% to 20% among new mothers in Nigeria. Being a single mother and having a female baby are important risk factors for postpartum depression in Nigeria. This emphasizes the role that culture and society play in the prevalence of health problems in the country (Ajayi, 2016).
Causes of Depression:The following (and some others not mentioned here) are the causal factors of depression mood.
- Low self-esteem
- Aftermath of a major stress (war, bereavement, marital violence, marital separation)
- Genetic factors (Gene 5-ATT carries traits associated with depression)
- Cognitive Habits: Rumination and Brooding
- Social causes: Some of the socially related causes of depression are as follows:
- Perceived oppression (This is when you subjectively think you are being oppressed)
- Greed or lack of contentment
- Prevailing economic situation
- Negative mindset
Research suggests that a combination of genetic, biological, environmental, and psychological factors play a role in depression. Depression can occur along with other serious illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. Depression can make these conditions worse and vice versa. Sometimes, medications taken for these illnesses may cause side effects that contribute to depression symptoms.
Signs and Symptoms of Depression
- Feeling bad about yourself; Changes in sleep patterns; Changes in appetite or weight.
- Feeling overwhelmed by pessimism, anger, guilt, irritability and anxiety.
- Varying emotions throughout the day – for example, feeling worse in the morning and better as the day progresses.
- Inability to enjoy life.
- Low motivation to do things that used to matter to you.
- Feeling exhausted.
- Persistent sadness, extreme anxiety, or “empty” mood.
- Feelings of hopelessness or pessimism.
- Feelings of guilt, worthlessness, or helplessness.
- Loss of interest or pleasure in hobbies or activities.
- Decreased energy, fatigue, or being “slowed down”.
- Difficulty in concentrating, remembering, or making decisions.
- Difficulty in sleeping, early-morning awakening, or oversleeping.
- Appetite and/or weight changes.
- Thoughts of death or suicide or suicide attempts.
- Restlessness or irritability.
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment.
Treatment and Solutions: The strategies, if well adopted, can help reduce the incidence of depression in the various societies.
- Self –acceptance
- Social acceptance
- Psychotherapy (also known as talking therapies)
- Drug treatment (specifically antidepressants)
- The best solution to the emotional disorder of depression is “talking about it”. Let us continue to talk about it.
Is depression normal?
Sadness, feeling down, having a loss of interest or pleasure in daily activities – these are symptoms familiar to all of us. But, if they persist and affect our life substantially, it may be depression (this can only be confirmed after series of diagnosis by experts in behavioural sciences, clinical psychology and medicine). Depression is different from the fluctuations in mood that people experience as part of normal life. Temporary emotional responses to the challenges of everyday life do not constitute depression. Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression is not normal but it is inevitable. Its causes are permanent aspects of human lives. The causal factors go with life paripasu. The factors are intertwined with our lives.