“It is a white people’s disease,” people like to say, adding, “Africans have way too many problems to suffer from made-up problems like depression.”
This is a wrong perception. The most common psychiatric disorder that doctors in Uganda encounter is depression. Depression is so widespread that it is expected that by 2020, it will be the second most common diagnosed condition, after heart diseases world over, Uganda inclusive.
Dr David Basangwa, a senior consultant psychiatrict at Butabika hospital says that today, almost all physical and other psychiatric conditions present with associated depressive symptoms.
And, with depression prevalence set to rise by 2020 as has been projected, due to life becoming much more difficult, doctors are advising people to lookout for signs of depression.
What is depression?
Dr Basangwa loosely defines depression as the act of persistently feeling sad or low usually for a period of two weeks or longer.
We often hear people say: “I am depressed” when they are sad for, say two hours. This is not necessarily depression. One has to be sad or low for a minimum of two weeks to be described as depressed.
There are three types of depression: mild, moderate and severe. With mild depression, one does not need treatment; it can be corrected by talking to friends, counsellors, teachers, friends or someone that cares.
However, with moderate or severe depression, one may need to get admitted for treatment. Depression is treated with psychological support and antidepressants, which Basangwa describes as safe medicines.
Signs and symptoms
Signs and symptoms include feeling sad or low, losing interest in what one was previously interested in, poor concentration, insomnia (one stays up having bad thoughts), low appetite or in some instances, increased appetite, loss of libido, neglect of personal hygiene, having suicidal and negative thoughts, slowness in life’s activities, development of psychotic symptoms say confusion, hearing of voices or seeing morbid scenes like deaths and burials (hallucinations).
A depressed person feels like they are useless to the world, the world is cruel and they want to leave it usually through an act of suicide.
Elderly at higher risk
Every person gets depressed once in a while because according to Basangwa, life is about hustling.
However, there are people more prone to suffering from depression, especially if they are of an advanced age.
Dr Basangwa says out of 100 old people, 80 or more suffer from depression. This is because as old age sets in, the diseases set in, people retire and children leave home, leaving parents feeling lonely.
Sometimes, it is a spouse who dies, leaving the surviving partner, who was once agile, feeble and lonely, a perfect backdrop to depression.
Other people at risk include children whose mothers die before they are two years old, those who have a family history of depression, the sick, especially those suffering from prolonged periods of illness, caregivers of the sick, women (studies show that women are more prone to depression than men), those that have undergone trauma or grief in the past or in the present, people who abuse medications and substances like alcohol and people living in stressful conditions such as those undergoing divorce.
The good news is that depression can be mitigated. It is important to ensure that a depressed person seeks medical help from the nearest health facility or qualified health worker.
How to avoid depression
Is it possible to prevent depression? Yes, it is, Dr Basangwa says. The first step is to identify those at most risk.
When such people are identified, it is important to pay attention by offering an opportunity to talk about their problems. In a busy world, it is easy to ignore a friend or family member that needs help, even when they attempt to talk about their problems.
The doctor also points out the need to offer psycho-social support to such individuals. Talking is part of this support but so is giving material support to an individual that is at risk of becoming depressed due to over worrying about how to make ends meet.
Such an individual could be an orphan who has to go to school but he/she lacks books and other necessities. A family member providing this support saves the child from worrying.
Also, individuals at risk of becoming depressed should be encouraged to engage in leisure activities, fellowship with friends and take on sport so that their minds are redirected from having negative thoughts.
Websites that give tips on how to prevent depression emphasize the need for individuals to cultivate a positive mental set, not to be too critical of self, reliant on others for one’s happiness, to do good to others (this creates positive energy) and keep busy.