Depression is a common, but serious mood disorder, which is characterized by recurrent low mood, and loss of interests in previous pleasurable activities. Generally, it affects a person’s capacity to function at work, school, and family and to enjoy life. We all feel sad or low at one point or another, due to life challenges, but we are supposed to bounce back and feel happy or relieved after a while. If the sadness persists for a period of 2weeks or more, one can query depression.
This disorder has been found to be a major contributor to global disability and burden of disease. About 280 million people worldwide suffer from depression, with an estimated 3.8% of the world population affected (global health data exchange, 2021). It affects an estimated 1 in 15 adults (6.7%) in any given year, and 1 in 6 people (16.6%) will experience depression at some time in their life. Research has also proved that more women are affected by depression than men, but is a disorder that affects both genders and can strike at any stage of life.
Symptoms of depression
A lot of times, people mistake depression for physical or spiritual conditions, because of inability to recognize the symptoms, as they may resemble other health conditions. Some persons have spent so much money conducting one laboratory test or another and treating malaria or typhoid, all to no avail, but only experienced relive when depression is treated.
One of the major features of depression is recurrent feeling of sadness or low mood. This negative mood has to persist for a period of 2weeks. The individual might also experience weepy spells, having to cry or be tearful.
This can be associated with feeling of emptiness, hopelessness or helplessness. The person may feel worthless, and incapable of getting out of his/her current situation. It may feel like there is no end to the present misery and no light at the end of the tunnel. There can also be reduced interest in pleasurable activities like hobbies, sports, sex etc. Engaging in these activities may feel like a burden or hard task to do and one may avoid them at all cost.
The individual may also find it difficult to sit still or at a place, pace up and down or feel anxious. Snapping or getting irritable over little provocations is also a common recurrence. The person may become impatient and upset with family, friends, colleagues and even pets. He may get fixated on his past mistakes and blame himself for his wrongs and even that of the significant others.
Furthermore, there can be changes in eating behaviour, as one can eat too much, resulting in weight gains or eat less, leading to weight loss. The same is true for sleep patterns, as one can sleep excessively or too little, or even experience interruptions in sleep (waking up at intervals). Sometimes, there can be unexplained pains or aches or unusual bodily sensations like hot flashes or crawling sensations. The pain can occur at any part of the body, but is not a symptom of any physical illness.
Getting easily fatigued or making extra effort to carry out small tasks can be a sign of depression. Focusing or concentrating in a task is usually a challenge when one is depressed. T his is because, the mind is filled with a lot of thoughts about the past (mistakes) and the future (unknown). The person might experience difficulty processing information, making decisions and responding in a conversation. Forgetfulness is also common, as one finds it difficult to remember important events or things.
For example, forgetting to carry out a task, pick a child from school, attend a programme etc. There can be excessive use of psychoactive substances like cigarette, cannabis, cocaine and alcohol, as a means to cope or escape an adverse situation. Similarly, some people wished or attempted to take their lives in a bid to get it over with. They may wish that they were never born; sleep and never wake up, the world should come to an end or even plan to harm self. Men are more likely to show signs of irritability, anger or aggressiveness, instead of feeling of sadness. They can also engage in more risky behaviours, become irresponsible at work, family and other important activities. Some may withdraw from friends and become socially isolated. Children and adolescents can also get easily irritable or angry or cry more frequent. They can get too sensitive to rejection and criticism, resulting in social withdrawal. There can be associated decline in school performance, frequently getting into trouble at school or refusing to go to school. They can engage in acting out or rebellious behaviours, give away their possessions or experience frequent accidents.
Causes of depression
So many factors play a role in the development of this disorder. Firstly, depression is genetically transmitted, i.e. it runs in the family. If a parent has depression, there is likelihood that one of the offsprings may develop it at one point in their life. Secondly, depression has been linked to imbalances in chemicals like serotonin, norepinephrine and dopamine in the brain. The pattern of thinking of an individual also plays a key role in the manifestation of depression. People who are negative, or pessimistic or self-critical, that ruminate over issues are more prone to depression. Other factors include stress; use of alcohol and drugs or death of loved ones.
Even though this disorder can be genetically transmitted, the symptoms can be reduced by consciously changing some unhealthy lifestyles. Communal life and frequent interaction with family and neighbours gives us the support and warmth we need to thrive. Spending quality time with loved ones and people that makes us feel safe goes a long way to cushion the stress of life. Face to face interactions or video calls are more effective than chatting or audio calls, because laughter is contagious, so when you see another smiling, there is a high tendency that your mood will improve.
Participating in social activities, society and organization meetings, even when one does not feel like, increases the opportunity to spend time with others. Extending helping hand to people in need, either in cash or kind or simple words of encouragement, can make one feel valuable, fulfilled, and the joy eliminates every sorrows and swallows every pains.
Quality sleep is necessary to mitigate the effect of multiple life pressures. It is recommended that an adult should aim towards 7 to 9 hours of sleep per night. This enables the brain to adequately shut down and recuperate. When we do not sleep well, there is tendency to get irritable, edgy and rash out on people. In addition, take some time off your stressors.
There are some challenges that lasts longer than we expect or are very intense, so one needs to learn to temporary move focus away from them to something else (interesting or pleasurable) in order to get some relief. Similarly, plan to take vacations from work, business, and studies in order to relax. Schedule to regularly do things you enjoy, as busy work activities can cloud time for leisure activities. Hobbies are like oil that lubricates our system to function smoothly.
Absence of pleasurable activities can bring a person to a halt, the same way a machine breaks down. In a situation where by one has a large project or goal to accomplish, breaking it down into smaller actionable tasks makes it manageable, and comprehensible; as big tasks can be overwhelming when viewed holistically. This also helps one to be able to measure and monitor progress, thus enhancing motivation to keep up the good work.
Furthermore, relaxation techniques like deep breathing and mindfulness has been found to be useful tools in reducing depression. Deep breathing is an exercise that allows one to take in a lot of oxygen, while exhaling toxins (carbon dioxide), thus relaxing the body. The pressure to meet up with demands of life makes us to breath faster than expected, but this exercise ensures stability; hence reducing blood pressure and stress levels.
This can be achieved by simply sitting or standing comfortably, breathe in through your nose for about 3seconds or more and feel your stomach or sides of waist expand by the air. Hold the breathe for a while, then exhale longer than you inhaled for about 4seconds or more and feel your stomach gently contracting. It is advisable to repeat it 3 or more times on a spot, 2 to 3 times a day, to enhance its impact. Mindfulness is a technique that enables one to be at the present, while ignoring the demands of the future and guilt of the past.
The fears about the uncertainties of the future expose one to anxiety, while the mistakes or failures of the past generate depression. So, this strategy protects one from the effects of both experiences and helps the mind to be at peace for a moment. It can be achieved by focusing on whatever you are doing at the moment, it can be your breathe, the food you are eating, water you are drinking, music you are listening to, fresh air you are feeling etc.
Try to describe and appreciate the features like its temperature, taste, texture, colour, sound, movement etc.; while minimizing any distraction. Even if your mind wanders away to other things, gently bring it back to the anchor (what you are focusing on).
Moving our muscles has a lot of mental benefits, especially in issues of depression and anxiety. Research has proved that regular exercise improves the mood. This could be because exercise helps to improve sleep, which is known to protect us from the effect of stress. Also, engaging in regular exercise can help one to return to meaningful activity, which was earlier reduced or halted by depression, thereby creating a sense of fulfillment.
In a similar way, adopting a healthy eating habit improves both our physical and mental wellbeing. Eating balanced diets that comprises vegetables, fruits, whole grains, plant proteins, fresh herbs, can enhance the mood. On the other hand, the consumption of caffeine, saturated fats, alcohol etc. can temporarily alter one’s mood. For example, caffeine is a stimulant which can cause sleep problems, hence making the person irritable or anxious and worsening the mood.
Basically, depression is not a direct effect of difficult or traumatic life events, because there is always a thought process that mediates between them. This thought process or perception is usually the cause of the changes observed in the mood. So, to prevent experiencing negative emotions, one needs to look at every situation in a positive light, and find alternative explanations to the situation. You can ask yourself, “How can a friend, neighbour, colleague, or a neutral person see the same situation?” Also, people ruminate or get preoccupied with worries or guilt or regrets of the past, which depresses them.
These thoughts can be substituted with other positive things, by mentally switching the negative off and turning the positive on by touching soothing things, smelling good fragrance, watching interesting or funny programmes or beautiful pictures or nature, eating tasty food or taking refreshing drinks. Do not forget to be kind to yourself as you can be to a distressed friend, family, neighbour or colleague.
Talk to yourself with compassion and care, forgive yourself for whatever mistakes you must have made and always reassure yourself that all will be well, no matter the situation. Comparably, our faith plays a good role in enhancing our mental wellbeing and mood in particular, because faith is related to how we think about the world, our role and the powers related to it.
Religious beliefs encourage hope and optimism, give connectedness, establish trust and develop a sense of purpose, which have been shown to boost mental health. In so many verses of the bible, God gives us hope, warmth and support. For example, Deuteronomy 31:8, says “the Lord himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged”.
Also, in John 16:33, Jesus said “I have told you these things, so that in me you may have peace. In this world, you will have trouble, but take heart, I have overcome the world”. In addition, religion encourages compassion, forgiveness and gratefulness which are qualities that are thought to be associated with decreased stress and increased resiliency. God urges us to love others as we love ourselves, which is being compassionate to self-first and subsequently to others.
He also encourages us to be grateful and thankful in every situation, hence making us sensitive to the good around us, which depression blinds one to. So, our belief in God and religious practices could reduce the symptoms of depression and improve wellbeing. Management of depression When one is already experiencing some of the symptoms discussed for more than 2weeks duration, then there is need for treatment, because depression is a real medical condition.
The treatment options include both medication and psychotherapy. The person will need to see both a psychiatrist and a psychologist for assessment, diagnosis and treatment. Antidepressant medications alleviate the symptoms of depression, while psychotherapy helps the person to change irrational thinking pattern, solve problems and function better in the society. In conclusion, depression has been of great concern to the world in general, due to its grave impact to the individual, family, economy, the church and the world at large.
Thus, there is need for us to adopt a healthy lifestyle, reach out and support one another, renew our hope and faith in God, in order to forestall depression.
• Mary-Pauline. Uchechukwu Okafor is a Lagos based Clinical Psychologist. She can be reached through okaforuch@gmail. com (07031234615).