Tuesday, 19 April 2016

Depression: Nigeria’s Most Misunderstood Sickness


by Eromose Ileso
                                                               
photo credit: leadership.ng

To Most Nigerians, depression is a ‘white man’s sickness, because the death attributed to it is always in the public domain. 
To them, they can’t understand why a person living a 'comfortable' life should be depressed. 

When popular personalities like Robin Williams commits suicide as a result of depression, and other personalities that have died from overdose of anti-depressant coupled with the fact that news of these death are splashed in the media, it further gives credence to the wrong view that it is a white man’s sickness. It is easy to see why many here see depression as a white man’s sickness. Often, you seldom get to see any physical symptoms associated with it and most people that suffer from it are often well of. Although, there are exceptions as there are persons who are struggling in all indices of life that are suffering from the ailment.

However, this widely held notion that depression is a white man’s sickness has been negated by the rise in cases of suicides related to depression. There was a case recounted by a radio personality in Lagos, of a man who had no debts, had a good job, but over a period of time, he withdrew from his friends, and became a recluse. He complained that he was depressed to several persons, but what they advised for him was that he needed prayers. He sent his wife on an errant one evening, and before she returned, he committed suicide.

Nigerians see depression as a ‘spiritual problem’ in local parlance, dem dey wori am, some would say. Because, they cannot understand why a person that has no physical problem that is visible to the eye, would suddenly start experiencing mental disorder. It is this belief that has led to calls for more prayers for persons who are suffering from depression rather than a visit to see a therapist.

A 23 year old lady known to this writer had bouts of depression in 2014 and 2015. She went on Facebook to post suicidal thoughts, for which she was severely criticised by family and friends. Nobody could decipher what was wrong with her, until somebody drew the attention of her parents that she was depressed. 

At first it sounded strange as nobody saw it that way. While the mantra of prayers was adopted initially. She ended up seeing a psychiatrist at the Neuro-Psychistrist Hospital, Uselu, Benin City. It was there they gave her some drugs. She would often complain to me at the time, that the medications made her to sleep a lot. However, she became much better, and eventually came out of it. Today, she is a student studying Biochemistry at the University.

There are persons who have had training in the field of psychiatry who can quickly point to the fact that something is wrong with a person. A Consultant Psychiatrist Nurse who retired from the University of Benin Teaching Hospital (UBTH) mentioned how she noticed the display of a person who had never behaved in such a way having known that person for over 40 years. She was able to notice it because of her training. It was she who called the attention of the person’s family, and drugs was administered, and that person subsequently improved.

I was with the resident pastor of the local church I worship in 2013; I went there to see him about somebody who had  reported me to him. After several minutes of saying how this particular person behaves, he concluded that the person was depressed. He went further to give an instance of a woman he knew that was well off financially and happily married, but committed suicide, because she was suffering from depression. Her swashbuckling life was just a façade that covered her inner ailment.

Nigerians often see a visit to the psychiatric hospital as something that is laced with stigma. Whenever there is mention of a visit to see a psychiatrist, there is a wrong impression that it has to do with insanity. There is nowhere, where it is asserted that depression is insanity. This is another reason why many don’t like talking about depression, and more, because treatment for it would make a person to see a clinical psychiatrist. To the society, any person that has an appointment with a psychiatrist is not normal.

According to the World Health Organisation (WHO)
·         Depression is a common mental disorder.
·         More women are affected by it than men.
·         At its worst, depression can lead to suicide.  
·         Depression is different from usual mood fluctuations and short lived emotional responses to challenges in everyday life.
·         It can cause the affected person to suffer greatly and function poorly at work, at school and in the family.
·         Barriers to effective care include a lack of resources, lack of trained health care providers, and social stigma associated with mental health disorders.
·         Another barrier to effective care is inaccurate assessment
·         During depressed episodes, affected persons suffer loss of interest and enjoyment, reduced energy leading to diminished activity.
·         Other symptoms include anxiety attacks, disturbed sleep and appetite and having feelings of guilt or low self-worth, poor concentration.

In the study titled Depression in adult Nigerians: results from the Nigerian Survey of Mental Health and Well-being by Gureje O, etal, 2010, it was stated that profiles and detailed studies of depression among Africans are still sparse. Yet that work was carried out six years ago. The landscape in respect of this discuss is gradually changing.

In a study by several Nigerian academic titled Prevalence of Depression among Resident Doctors in a Teaching Hospital, South East Nigeria by Aguocha GU, Onyeama GM, Bakare MO and Igwe MN published in the International Journal of Clinical Psychiatry, 2015, it was observed that there was an increased rate of depression amongst resident doctors. 

The study concludes that there was high prevalence of depression among resident doctors. There was no gender and marital status significant variations in depression among the resident doctors. The reason for this was cited as the stressful nature of the residency programme and the increased expectations and responsibilities placed on them.

The result above was on the prevalence of depression in resident doctors. There is a perception here that every doctor is well off. These are persons that are expected to carter for patients in the hospital, and with depression, it portends grave danger for the overall health institution and health care providers in the country.

There are enough reasons why most Nigerians could easily relapse into depressed episodes, with the state of affairs in the country where there is little or no electricity, endless queues in filling stations, increase in prices of goods, pressure to meet the needs of the nuclear and extended families, lack of job opportunities and the absence of equity to address perceived wrongs. 

With this, it is easy for any person irrespective of the status of the person to fall into depression. Yet, most Nigerians would put up a brave face, and would rather seek audience with a clergy instead of seeking a section with a medical professional. 

The inaccessible nature of such health care and the nature of the society makes this a difficult discuss. Few wouldn't spend anything on an ailment that is not visible to the eye when the average person can barely feed properly.

As long as many Nigerians take depression as a sickness that has a spiritual colouration, and the stigma that comes from the society, it would continue to be a misunderstood ailment.

It would take adequate awareness for people to change their perception about an ailment that has become a silent killer.

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