Sometime last year, the Guardian UK –in error-published a personal essay by the multiple awards winning- Nigerian writer, Chimamanda Adichie. Beyond the opportunity to freely enjoy Ms. Adichie’s elegant prose, the Guardian’s error turned the switch and brought much-needed light to bear on the subject of depression, and the Nigerian woman.
According to the World Health Organization (WHO),
depression is a mood disorder ‘‘characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration’’.1It is also known as ‘‘Clinical Depression’’, or ‘‘Major Depressive Disorder’’.
While changes in mood and mental tone are common to all human beings, depression is ‘sadness on steroids’; worse still, it is sometimes sadness without any visible or definite cause, leaving its victim empty, hollow, paralysed and feeling hopeless. Depression can be chronic (long-lasting), recurrent (coming and going, like a seasonal visitor) or incidental (following a major life event like a death, divorce, or any emotional event like a delivery). Presentation may be mild, moderate or severe. Regardless of its course, however, it is debilitating and can be deadly if left unmanaged.
Depression is twice as common in women compared to men.
And even though it is an issue that is often stowed away in the closets –beside other taboo topics like sex and divorce, depression is very common among Nigerian women. The age-standardised disability-adjusted life year (DALY) rate for depression among Nigerian women is 736.038 per 100, 000 people. For comparison, the rate in Ghanaian women is 730.842/100,000, and among South African women, the rate is 725.772/100,000.
Even though depression affects both sexes, it affects women differently. The cumulative effect of hormonal, physiological, and psycho-social forces pulling at the psychological frame-work of women often steers depression in this population along a different clinical course, compared to men folks.
While depression is the focus of this article, however, it is only one end of a spectrum of mood disorders covering dysthymia (a longer lasting, but less severe form of depression), and manic depression (depression with mania).
Symptoms of depression
A diagnosis of clinical depression rests on several symptoms occurring together, over a period of time.These include: low mood (sadness), reduced or loss of interests in things that an individual used to love, sleep problems (inability to sleep, early morning wakefulness or even over-sleeping), eating problems (lack of appetite or over eating), persistent feelings of guilt, hopelessness and/or worthlessness, sudden weight changes (loss or gain), inability to concentrate, and make decisions, irritability and restlessness, constant tiredness, body pains or digestive problems, and suicidal thoughts or constant thoughts of death.
One in every ten people suffering from depression commits suicide, so it is imperative that anyone having these symptoms should seek professional help.
In his book, Male Menopause, Jed Diamond made a fine attempt to differentiate depression in women from its presentation in men.
Women are more likely to ‘‘blame themselves’’, ‘‘feel sad and worthless ‘’ ‘’be anxious and scared’’ and to ‘‘use food, friends, and attention to self-medicate’’, compared to men who are more likely to ‘‘blame others for how they feel’’, ‘‘act irritable, angry and pompous’’, entertain paranoia and general suspicion’’ and to ‘‘use alcohol, drugs, TV, sports, and sex to cover the void they feel within’’.2
This categorization does not fit all cases however. Depression affects individuals, differently.
The major hinderance to care for women suffering depression is the conspiracy of silence and shame woven around mental health conditions in Nigeria.
And that conspiracy is not of God. Individuals who are dealing with depression do not need to be blamed -as if they are somehow responsible for how they feel- encouraged, with lame psychology and platitudes, or even pitied. They -like people who have diabetes, hypertension or even a mild headache- need to be treated by people trained to do so.
That treatment may sometimes be one of several ‘talk therapies’ requiring no drugs such as ‘‘Cognitive behavioural therapy ” – which focus on changing thought and behaviour patterns, ‘‘problem-solving therapy’’ –just as stated. It identifies problems and helps the individual tackle them, and ‘‘Interpersonal therapy’’ – which focuses on helping individual relate better with others. The doctor may also prescribe medications and other treatments depending on the severity of the depressive symptoms.
In conclusion, there is no shame in seeking help for depression. Christ has redeemed us from shame too, and all things –knowledge, medical advances, and technological innovations- exist to make our lives more productive and effectual for the Master. –Dr. Luke
1. World Health Organization (WHO). Age-standardized DALYs per 100,000 by cause and Member State, 2004
2. Diamond, Jed. Male menopause. Sourcebooks Incorporated, 1997.