Job Osazuwa
It is indisputable that many people feel sad, lonely or depressed now and then. It is accepted as a normal reaction to loss, disappointment, life’s struggles or injured self-esteem.
But when these feelings become overwhelming and begin to cause physical symptoms, and last for long periods of time, they can keep you from leading a normal or active life or both. It becomes harder to do the things you love. Therefore, that might just be the time to seek medical help.
It is advised that you begin with your regular doctor, where you can be tested for depression and guided on how to best manage your symptoms. Experts have warned that if your depression goes untreated, it may get worse and last for months, even years. It can cause pain and possibly lead to suicide, as it does for about one out of every ten people with depression.
Over the years, it has been discovered that recognising the symptoms is key. Unfortunately, about half the people who have depression don’t know or never get it diagnosed or treated.
Depression is the feeling of severe despondency and dejection. It is a mental disorder that is characterised by a persistent loss of interest in activities, which in turn causes significant impairment in daily routine of the particular individual.
To check a protracted depression and to avoid further complication, family members and colleagues as well as other support groups are to give the necessary support to the patient. At the seminar on mental health in Lagos, a psychiatrist at the Federal Neuro-Psychiatric Hospital, Yaba, Oluwaniyi Stephen, told Daily Sun a number of factors that could lead to depression.
He said; “Depression is a mental issue. There are many people walking around or even going to work with mental health issues. At that stage, it is still not yet a disorder but that does not mean there is no issue.
“The World Health Organisation (WHO) defines complete health as a state of complete physical, mental and social wellbeing. Note, it is not because an individual does not have a disease. For an individual to claim to be in a healthy state, he or she must function optimally in all the points raised in the definition above. WHO also defines mental health as a state of being which an individual is able to achieve his full potential; can cope with normal stresses of life, work productively and contribute to his community,” Oluwaniyi said.
The expert said some of the early symptoms of the ailment are persistent deviation for days or weeks; feeling unhappy; lack of energy to do one’s normal job and irrational thoughts. He called for the need to quickly consult a doctor.
Also contributing, a consultant psychiatrist on adolescent mental health, Federal Neuro-Psychiatric Hospital, Aro, Ogun State, Mrs. Aina Kikelomo Oyekanmi, said for the fact that one is not hospitalised in Yaba or Aro does not mean he or she is mentally stable. She explained that mental health has to do with the functioning of the brain.
“When we are talking of mental health, the reason we are different from other mammals is just our mental functioning. Others’ minds are not as developed as humans. Mental health is like a springboard that will make you achieve your potential in life. And anyone can come down with mental illness.
“The brain is a like a series of electrical wires. Except they are rightly connected, they cannot function. At birth, the brain connection is very small. Between the ages of zero to five, the brain is 90 per cent connected. If you want to inculcate good habits into your child, it is at that time because the brain is still malleable. What determines the mental configuration is what is stored in. This stage is very important because it might be able to change in future,” she said.
According to Oyekanmi, the advent of technology was also mounting unnecessary pressures on many young ones. She stated that youths and teens now have sleepless nights surfing the Internet for irrelevant things.
She said a lot of people that are taking irrational decision, such as suicide, is as a result of their inability to control their impulses, cope with stress, preserver or tolerate frustrations.
Also contributing, a psychiatrist, Edebi Otete, said it was unfortunate that many people delay in seeking solution to mental health issue while others who make attempt prefer other places instead of neuropsychiatric hospital.
He urged doctors and other caregivers to collaborate with NGOs to act as advocates to families who are battling with mental health issues.
Symptoms
There are a lot of signs of depression, but you may not have them all. How intense they are, and how long they last are different from person to person.
Some of the ways it might manifest are: Sadness, emptiness or anxiousness. It will continue over time without getting better or going away.
Helpless, worthless or guilty: You may feel bad about yourself or your life, or think a lot about losses or failures.
Hopeless: You may be pessimistic or believe that nothing good will ever happen. You may even think about suicide.
You may get restless or more cranky than usual. There will be less interest in activities. Hobbies or games you usually enjoy may not appeal to you anymore. You may have little or no desire to eat or have sex.
There is also the problem of being less energetic. You may feel extremely tired or think more slowly. Daily routines and tasks may seem too hard to manage.
Others may include: Trouble in concentrating, remembering details and making decisions, fatigue, feelings of guilt and helplessness. There are also insomnia, early-morning wakefulness or sleeping too much irritability and restlessness.
Other symptoms are: aches, pains, headaches or cramps that won’t go away, digestive problems that don’t get better, even with treatment, persistent sadness, anxious, or “empty” feelings.
There is usually trouble in concentrating – could be tough to focus. Simple things like reading a newspaper or watching television programmes may be hard. You may have trouble remembering details. It might seem overwhelming to make a decision, whether it’s big or small.
Depression often leads to weight gain or weight loss because of the change in eating pattern.
When to seek medical help
Since everyone is bound to periodically experience one form of depression or the other, one question that readily comes to mind is what could be the exact time that one should see a doctor.
In order to avoid complication and its inherent dangers, experts have advised that if your symptoms of depression are causing problems with relationships, work, or your family, and there isn’t a clear solution, then you should quickly see a professional. Talking with a mental health counsellor or doctor can help prevent things from getting worse, especially if your symptoms stay for any length of time.
However, an American children psychologist, Newton George, has said that it was important to understand that feeling depressed doesn’t mean one has depression. He said not until one begin to experience not only changes in mood, but also an overstretched changes in sleep, energy, appetite, concentration and motivation, then depression cannot be said to have crept in.
He advised in his paper entitled, “Ways out of Depression,” saying: “If you have physical symptoms like these and find yourself feeling depressed much of the time for days or weeks, see your doctor.”
Some strong warning signs
Researches have proven that depression carries a high risk of suicide. So, suicidal thoughts or intentions are serious signs.
Other warning signs may include: A sudden switch from sadness to extreme calmness or appearing to be unnecessarily happy. Clinical depression may include deep sadness, loss of interest, repeated trouble sleeping and eating that gets worse.
The patient begins to take risks that could lead to death, such as driving through against traffic or over speeding. He or she might start making comments about being hopeless, helpless, or worthless.
Causes
Experts believe that depression is due to a combination of different challenges. It could, therefore, be difficult to pin it down to a particular factor.
A family therapist and counselor, Mrs. Caroline Adebisi, said recently on a television programme that depression affect different people in different ways.
“It doesn’t always look like what you read on the pages of newspapers or see on television. There is so much peculiarity when managing it. The approach that worked perfectly in case A might fail woefully in case B,” she said.
Brain structure: The way certain nerve pathways or circuits in your brain send information may not work properly. Scans show that the parts of your brain involved in mood, thinking, sleep, appetite and behavior look different when you’re depressed, but scientists aren’t sure why.
Genes: Scientists are studying certain genes that may make you more likely to get it. But even if you have them, you may not get depressed. And depression can happen in some people even when they don’t have that genetic makeup.
Depression can run in families, but that doesn’t mean you’ll develop depression just because someone you’re related to has it. And you may have the condition even if no one else in your family has it.
Life events: Something disturbing that happens to you may trigger depression. It may be the loss of someone close to you, a difficult relationship or a stressful situation. Other things, like your finances, where you live, and whether or not you’re married may also have an impact. But remember, there doesn’t have to be a “reason” for your depression. Sometimes it happens without an obvious cause.
Childhood problems: People who have disturbing experiences in childhood are more likely to have depression. It may be from brain changes caused by trauma at a young age. Sometimes, though, such big stresses can bring serious symptoms of depression.
Other conditions are illness, long-term pain, anxiety, sleep problems and attention deficit hyperactivity disorder may also be linked to depression.
Some common triggers or causes of clinical depression include: Loss of a loved one through death, divorce or separation, social isolation or feelings of being deprived.
Other causes are traceable to job change, retirement, personal conflicts in relationships, either with a subordinate or a superior, physical, sexual or emotional abuse.
Substance abuse: Nearly 30 per cent of people who abuse drugs or alcohol have depression. Some people misuse substances when they feel down. For others, heavy use of alcohol or drugs can bring on depression symptoms, especially later in life.
Major depression
Most people feel sad or low at some point in their lives. But clinical depression is marked by a depressed mood most of the day, sometimes particularly in the morning, and a loss of interest in normal activities and relationships – symptoms that are present every day for at least two weeks.
A constant sense of hopelessness and despair is a sign you may have major depression, also known as clinical depression.
With major depression, it may be difficult to work, study, sleep, eat, and enjoy friends and activities. Some people have clinical depression only once in their life, while others have it several times in a lifetime. Major depression can sometimes occur from one generation to the next in families, but often it may affect people with no family history of the illness.
It is estimated that between 20 per cent and 25 per cent adults may suffer an episode of major depression at some point during their lifetime.
Risk factors for women
Almost twice as many women as men have major or clinical depression; hormonal changes during puberty, menstruation, pregnancy, miscarriage, and menopause, may increase the risk.
Other factors that boost the risk of clinical depression in women who are biologically vulnerable to it include increased stress at home or at work, balancing family life with career, and caring for an aging parent. Raising a child alone will also increase the risk.
Diagnosis
There isn’t a depression test a doctor can use to see if you have it. So, figuring that out often starts with a thorough history and physical examination of the person.
The medical expert will look into when your symptoms started, how long they’ve lasted, how severe they are, if depression or other mental illnesses run in your family and if you have a history of drug or alcohol abuse. And you will also be asked if you have had similar symptoms of depression before, and if so, how it was treated.
A health professional, such as a primary care doctor or a psychiatrist will perform a thorough medical evaluation. You might receive a screening for depression at a regular doctor’s visit. The professional will ask about your personal and family psychiatric history and ask you questions that screen for the symptoms of major depression.
There is no blood test, x-ray, or other laboratory test that can be used to diagnose major depression. However, your doctor may run blood tests to help detect any other medical problems that have symptoms similar to those of depression. For example, hypothyroidism can cause some of the same symptoms as depression, as alcohol or drug use and abuse.
Treatment
Too many people still believe it’s not a real medical disease. But research shows that it is. Experts believe it’s caused by a combination of things and advised that if you are experiencing symptoms of depression, you should see a medical or mental health professional. They also warned that you could be strong and still be depressed.
If your doctor rules out a physical cause for your symptoms, he may start you on a treatment or refer you to a mental health professional. This specialist will figure out the best course of treatment. That may include medicines (such as antidepressants), a type of therapy called psychotherapy or both.
Adebisi said people with depression might not want to share what they feel. Therefore, she believes that learning more about depression can help someone who has it.
She noted that not all people with depression need to take medication but simply counselling and change of lifestyle. But for those who do, she advised them not to delay further and assured that there were many good medication options available that can help them feel better. The situation can be handled be talk therapists and brain stimulation therapists.