Contrary to popular belief, Africans, and indeed Nigerians are subject to depression in much the same way as people in industrialized countries. As modernization continues to occur, it is to be expected that clinical cases of depression will become more prevalent. For Nigerians though, a sad truth must be acknowledged in that the resources to diagnose and treat depression are sorely lacking. Combined with the fact that many people will succumb to the perception of shame that accompanies depression and who will not attempt to seek help, it should be recognized that depression is far more prevalent in African communities than is generally thought.
Symptoms of Depression
Symptoms of depression are varied, but the clinical diagnosis of depression will involve an individual who has experienced constant feelings of sadness for at least two weeks. Depression can be severe, mild or moderate and the feelings of sadness can be accompanied by:
- poor concentration
- suicidal thoughts
- losing interest in things that previously brought feelings of happiness
- low or increased appetite
- libido loss, as well as the development of psychotic episodes such as hearing voices, confusion and hallucinations.
Depressed people often feel useless and can believe that the world is a bad place, as well as cruel. The can believe that the only way to escape these feelings is to leave the world behind by way of suicide.
Causes of Depression
There have been many theories put forward as to what causes depression and one of the most common theories relates to an imbalance between the brain and the spinal cord with regard to naturally occurring substances. In terms of depression as it relates to Nigerians, this may be of lessor importance than other factors.
Social conditions can also cause depression and these can be related to financial, relationship and other lifestyle issues such as divorce and stress. The social stigma attached to depression in African communities can cause the depression to worsen because the condition will remain hidden and untreated.
Epidemiological Causes of Depression
This is important to consider in any discussion of depression as it relates to Nigerians. In many African communities, it is thought that anyone who suffers from depression has been possessed by a spirit or has been cursed. This implies that an external force has caused the depression and anyone so afflicted would never admit to it. Obviously, this additional dimension creates a huge barrier to treating the condition.
Who is At Risk?
It is normal for most people to become depressed for short periods however some are more likely to develop long term depression than others. Elderly people are particularly prone as they retire from the workforce, succumb to various diseases and live alone after their children leave home. It may be that a spouse has died, leaving their partner to survive alone. A once agile person can quickly become lonely and feeble as depression sets in.
Depression can sometimes run in families too so that family members are at risk. People who suffer from chronic illnesses are also at risk as are those who care for chronically ill people. Women are more likely to suffer from depression than men too, as are those who are dealing with past and present grief and/or traumas.
Lifestyle and relationship issues such as stress and divorce, moving house can also be prone to onsets of bouts of depression. Substance abuse can also result in periods of depression.
Can Depression be Treated?
Depression can be treated if those at risk are able to be identified within the community. This is often easier said than done because of the stigma attached to depression. Mild depressive episodes can be treated simply by way of talking things through with friends and family. Counselors and teachers can also provide this support.
If possible, material support can also help if the person is depressed due to financial or other material stresses. Relief of material burdens can relieve depression and stress. Sporting and other leisure activities can also help to encourage a positive mental attitude in those suffering from depression.
Friends, family and counselors can also encourage mildly depressed people keep busy, as well as help them to learn how not to be too hard on themselves, while at the same time trying to help others less fortunate. Learning to be self-reliant in terms of being happy, as opposed to relying on others for happiness, is also an important self-help skill that can make a difference.
For moderate and severe cases of depression, antidepressants and/or psychological support will be necessary. This is where medical intervention becomes not only important, but necessary in terms of treating more severe depressive episodes. In some instances hospital admission may be required and treatments such as ECT can be administered.
As Nigeria continues to modernize and its people continue to live in communities with less than stellar housing, electricity, clean water and access to medical facilities, as well as access to employment that can provide a living wage, Nigerians will continue to battle with depression. Aside from the myth of being ‘possessed’, depression can perhaps be seen as a common illness between Nigerians and those of industrialized countries.