Depression

by Stepney Emeh
edited by Juwah C. Awele

What is depression, is there a clear cut definition? How do you know when you are depressed? What do you do when you or someone you know is feeling depressed? This short piece will try to answer these questions and more, we proceed.

First we will start with what depression is, or is not, and for the purpose of this article, I will make use of the medical term for depression, Major Depressive Disorder (MDD). Significant research has been made into MDD and different guidelines have been put out with which one can determine if a certain person is clinically depressed or not. These guidelines can be found under the following;

§  International Classification of Diseases (ICD) 10th edition; and

§  Diagnostic and Statistical Manual of Mental Disorders (DSM) V

I will be using the DSM V classification for this article due to personal preference. The DSM V says that before a person can adequately be classified as having MDD, the following diagnostic criteria must have been fully checked:

1.     Depressed mood most of the day, nearly every day as indicated by either subjective report (e.g feeling sad, empty, hopeless) or observations made by others (e.g appears tearful).

2.     Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly everyday

3.     Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly everyday

4.     Insomnia or hypersomnia nearly everyday

5.     Psychomotor retardation or agitation nearly everyday

6.     Fatigue or loss of energy nearly everyday

7.     Feeling of worthlessness or excessive or inappropriate guilt nearly everyday

8.     Diminished ability to think or concentrate or indecisiveness nearly everyday

9.     Recurrent thoughts of death, recurrent suicidal ideations with thought out plans

At least five of the aforementioned symptoms must have been present during the same two week period and represent a change from previous functioning and at least one of the first two symptoms must be present before a clinical diagnosis can be made.

I put up these criteria to underscore the fact that it takes quite a number of things to add up before a person can be considered depressed. Depression requires prompt medical attention and as such the term should not be used loosely. Although there may be situations where the criteria may not necessarily fit, that determination should be left to a health professional.

Suicide

This is a very important aspect of MDD, in fact, it is its major sequelae. From a research done in 2014 by Centre for Disease Control (CDC) in the US, the following facts about suicide in the United States, which may give insight to potential issues and trends here in Nigeria, West Africa or Africa in general, are worthy of note:

§  3.5 - 4% more males die due to suicide than females

§  Suicide is attempted 3 times as often by females

§  Suicide is the 10th leading cause of death currently in the US

§  Suicide was the 2nd leading cause of death for adults between the ages of 10 and 34 in the US

§  Doctors and Dentists have the highest suicide rate among the working class.

According to the World Health Organization (WHO) Mental Health Atlas survey in 2014, the suicide rate in Nigeria is at 6.5 per 100,000 and the Society of Family Physicians of Nigeria also came up with a report that about 7 million Nigerians are living with depression which of course is a risk factor for suicide. It begs the question, why is mental health not being spoken about, why is there such a taboo regarding issues bothering on mental health? It is unfortunate that in our environment these issues are quickly shrugged off as attention seeking but still; what can we as individuals or as a people do to help others, or even ourselves, whenever we see them, or ourselves, falling into that dark space?

As the old saying goes, “Prevention is better than cure.”

We should always check up on friends, family and loved ones as a lot of the time there are subtle cries for help. The DSM V criteria can be used as a detector for these cries and whenever signs point towards the extreme, professional help should be suggested. Again more fora should be made available for the discuss on mental health, especially depression, and persons who have fought the severest forms of this unimaginable mental battle should be given the opportunity to speak and share their stories which could very likely help other people going through similar issues.

Always remember that not everyone who smiles is happy and so it is good to pay attention to the little triggers. Never shrug off anyone who says s/he is feeling depressed or suicidal, rather help in any way you can and always suggest professional help.

Finally, the journey back from a mental breakdown can be long, tedious and very frustrating and patience is required when dealing with issues of the mind; No one should be expected to, "just feel better".

Overall, pray for your friends and family always.

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