Depression: Causes, Management And Prevention

President Muhammadu Buhari and Prof. Isaac Adewole, Minister of Health

Medical personnel believe that depression involves person’s low mood and distaste to activities that can affect thoughts with strong suicidal tendency.
They also note that the state of low mood and other similar disorders in persons bring anxiety that affects individuals in different ways but can be managed to live better.
Admitting this assertion, observers cite the cases of attempted suicide or outright suicide which have been rampant across the country in recent times.
According to them, although any strange development or failed expectations in life can provoke the thought of committing suicide, medical personnel have traced most of the cases to depression.
For instance, Chairman Society of Family Physicians of Nigeria in FCT, Dr. Nicholas Baamlong, expressed concern on the rising rate of depression in the country resulting in suicide attempts, attributing the development to economic hardship and unemployment, among others.
He observed that majority of the populace found it difficult to feed or afford a meal daily after losing their jobs or source of livelihood.
“There is an army of unemployed youths who graduated from schools for nearly three to six years or more, roaming the streets and at the end, suffer depression which can cause them to attempt suicide,’’ he said.
Baamlong further identified other causes of depression as unemployment, economic recession, divorce, loss of loved ones, aging, loneliness, isolation, bereavement, drug addiction and human trafficking, among others.
“Cases of suicide attempt are on the increase and this is not unrelated to the current economic situation.
“The government should, as a matter of priority, try to address the issue of the economic recession so that people can get jobs and get paid for their services.
“It is when the economy thrives that the private sectors that are currently laying off staff will have the financial capacity to retain or employ more people, thereby reducing unemployment in the country,’’ he said.
But beyond economic recession and unemployment, Chief Consultant and Head of Behavioural Medicine, Karu General Hospital, FCT, Dr. Daramola Tayo, said individuals might periodically undergo ups and downs due to loss of loved ones and domestic challenges, the situation that could expose them into depression.
“Depression is a long lasting low mood disorder that affects one’s ability to carry out his or her usual activities or lack interest in his or her daily core.
“There is time duration to depression because in mental health, most of the symptoms we have could be observed even in normal individuals, so there is time duration. These symptoms must have persisted for up to two weeks.
“So if somebody seems to have lost interest in activities he is used to and other symptoms such as low sexual activities which result in series of complaints by the spouse, weight loss that is out of proportion, questions must be asked,’’ he observed.
The psychiatrists further pointed out that depression could be more than just feeling sad but might involve serious mental health conditions that required understanding and medical care.
Tayo identified other symptoms that could be exhibited by patients suffering from depression as feeling guilty, weight loss, hopelessness, worthlessness and loss of confidence, which could result in the thought of self-harm or attempting suicide.
“The 2008 World Health Organisation (WHO) report stipulated that by 2030, depression would be the highest cause of death globally.
“In view of the high prevalence in Nigeria and worldwide figure, there is the urgent need for governments, individuals to redouble efforts in fighting the scourge to reduce its mortality.
“Treatment of depression does not mean drug alone, the treatment is bio-psychosocial which means biological, psychological and social.
“It is only the biological aspect of the treatment that involves medication, the psychological requires you to do investigations, find out the cause and try to address them while the social will include your environment.
“Fortunately, with early detection, diagnosis and a treatment plan consisting of medication, psychotherapy and lifestyle choices, many people get better,’’ he said.
In her view, Secretary Health and Human Services Secretariat,  Federal Capital Territory Administration (FCTA), Mrs Alice Odey-Achu,  said something urgent should be done to reduce the rate of depression, noting that it had caused one out of 10 deaths among teenagers and adults in recent times.
She said other consequences arising from the condition included impaired ability to carry out simple everyday tasks, breakdown in relationships with families and impaired ability to work and earn a living.
“Just like any other disease, prevention is better than cure more so when most people suffering from depression which is a mental disorder are reluctant to seek help due to stigma surrounding mental health.
“This informed the inauguration of a campaign by the Health Education and Promotion Unit of the Public Health Department of FCTA to increase awareness on depression, how to recognise it, where to get treatment and most importantly, how to prevent it.
“Researches have revealed that the best way to prevent illness is still through awareness creation and health education,’’ she observed.
Similarly, a fact sheet issued by the Education Department, Health and Human Services Secretariat, FCTA, indicated that untreated depression could be devastating for patients and their families.
The document identified the causes of depression as heredity, drugs, alcohol use, smoking and life circumstances, among others, assuring the public that although depression could be devastating, it could be prevented in several ways.
For prevention of depression, Dr. Vivian Ofodile, Head of Division, Environmental and Occupational Health unit, FCTA, recommended good health habits, balanced diet, regular exercise, relaxation, talking to trusted family and friends, among others.
These recommendations, nonetheless, some Nigerians expressed concern that in spite of the danger posed by depression in the country, it lacked the attention of the government with regard to healthcare services and manpower.
Chairman, Committee on Mental Health, Nigerian Medical Association, Dr. Christopher Piwuna, said the major challenge in managing mental health disorder included lack of access to affordable healthcare services, achievable by implementing Universal Health Coverage (UHC).
The psychiatrist advocated access to affordable mental healthcare services and adequate personnel, describing it as panacea to managing mental disorders in Nigeria.
However, Piwuna explained that unless the citizens had access to affordable healthcare services as provided for by UHC — accessing health services without financial hardship — the problem would persist.
The expert decried the uneven distribution of health facilities in the country, noting the predominance of health facilities in city centres, while most rural areas were neglected.
He further said that Nigeria has a ratio of one psychiatrist to more than one million people as against one to 100,000 in developed countries.
“Considering the high cost of healthcare to millions of Nigerians, UHC offers us all, particularly, people with mental health challenges, access to affordable healthcare services.
“Government at all levels as well as private sector must embrace UHC as a creed of health for all and not only the professionals.
“Whether rich or poor, urban or rural residents, public or private employees and artisans should have affordable healthcare,’’ Piwuna insisted.
Imohimi writes for News Agency of Nigeria.

Felicia Imohimi