The road to depression and how it makes some suicidal
Mwelu, a single woman aged 30 years, has for the last six weeks been finding it hard to get out of bed in the morning for work. She has been feeling quite tired and nowadays describes her sleep pattern as disturbed. She wakes up at night and cannot get back to sleep until daybreak.
Mwelu has for many years been playing volleyball because it is fun and a way of keeping physically fit. She has not been to the scheduled practice sessions for several weeks now, citing loss of energy and lack of her usual enthusiasm.
Her boss is concerned about her productivity and lateness at work these days. Her friends and parents are getting worried. It is clear to all who know Mwelu that she has lost interest in things she used to be fond of.
Mwelu has noticeably lost body weight. Her fiancée is seriously thinking of leaving her, complaining of her sudden loss of interest in intimacy and closeness. He was quite frustrated during their last encounter because Mwelu hardly talked the whole time and could hardly keep eye contact.
This was out of character for her. It’s like she was pushing herself to be with him. She, too, didn’t seem interested in eating her favourite serving of chips and sausages, confiding in her fiancée that her mother has been complaining about her poor appetite.
After contacting several of her friends, suspecting Mwelu could be dumping him, they told him she has been like that in all situations lately. He was confused by the unexplained disappearance of her love for pleasure and fun.
Mwelu has exhibited other unusual behaviours in the last month. Sometimes she weeps for no apparent reason and tends to isolate from people. She shocked her mother the other day after reading a newspaper story about a man who committed suicide.
She told her that a thought to do what that man had done had crossed her mind a number of times. Since she began to notice and experience these changes, family members also have commended that she sleeps poorly and that she has been talking of how worthless and painful life is.
Mwelu blames herself for the problems between her mother and father without any justifiable reason. She has deep-seated feelings of being dirty and worthless and an insatiable need for forgiveness from God, despite being assured by her pious mother that she has done more in repentance than is required by her faith.
Image: HANDOUT
NOT WEAK WILLED
Any skilled mental health practitioner would diagnose Mwelu with clinical depression, also known as major depression. Clinical depression is a mental condition marked by changes in mood, thought and behaviour. It affects people of all ages, skin colour, socioeconomic class and cultural groups. It can occur at any age, but the illness most often surfaces between the ages of 25 and 44. Research the world over shows depression occurs more in women than in men.
The World Health Organisation believes more than 300 million people worldwide now live with depression. It is one of the major causes of severe suffering in the world and contributes greatly to the global burden of disease. The world loses billions of dollars a year because of the disability depression causes to populations.
For depression sufferers like Mwelu, the experience could be recurring over a period of time. For others, it is a single episode lasting for a while. For others, the duration with the symptoms is as long as they can remember.
Some people could be genetically predisposed to depression. This is why it runs in families and so it is good for the sufferers to check their family tree to see if a male or a female relative once had or continues to have symptoms.
Quite a number may be depressed because of a substance they are abusing, for example, alcohol or prescription drugs. Others due to what may be termed as a social environment, for example, relationships with significant others, workplace issues, life disappointments, sickness, and so on. Postpartum depression is a special type of depression that affects some women during and four weeks after delivery.
In the developed world, mental health services exist alongside physical health services in health care delivery systems. This is where we are aspiring to be as a country, but not yet fully there.
Information on mental health illnesses and available remedies ought to be spread and availed alongside physical medical problems. Time has come for us to have awareness campaign drives about depression and other mental health problems like there are for polio, malaria and HIV-Aids.
Depression can be debilitating and can make one’s life a huge burden as well as that of loved ones. It can lead to job loss, marital and relationship discord and even death through suicide.
Just as is the case with other diseases, Kenya loses millions or possibly billions of shillings every year in the form of service not rendered by depression sufferers. The losses are compounded by hospital commitments and drugs administered to them as a result of their condition being misdiagnosed or confused with other illnesses.
The hopeful part about the depression story everywhere today is that it is a treatable illness. There are proven ways of addressing it. There are drugs that can be given to the sufferer by a qualified medical practitioner.
There is also counselling or psychotherapy as for treating clinical depression. Best treatment outcomes most of the time are achieved through both use of medication and psychotherapy or counselling.
Depending on the cause of depression, it can be fully brought to full remission or it can recede enough to allow the sufferer to function fairly satisfactorily in many areas of life.
So, depression is real and help is possible. Refuse to be told it is all in your head, that all you need to do is to pull yourself together and move on. Those telling you so take depression as a case of weakness of your will or your faith. This is simply not true.
DISORIENTED CHILD
For James* (not his real name), life changed for the worse when his parents separated. He was known to be one jovial and playful child. James, now, 23, still is and has been fighting depression for as long as he remembers.
“I think I was in Class 2 when those feelings of sadness and feeling sorry for myself started,” he says.
He was the only child then, when his mother left his father and moved in with another man. This change brought confusion to him, as he had to start calling another man ‘dad’, something he found very peculiar.
“I was too young at that time to understand they had separated,” he said.
“And that sudden shift of places really affected me psychologically since there was this life I was used to, and moving into a person’s home I barely knew didn’t seem right to me.”
He maintained communication with his biological father, who told him he was out of the country and would one day come back for him.
With his parents barely noticing, he slowly transformed into a quiet, antisocial child. By the time he was in primary school, his mother had another child. It is then that all communications with his biological father stopped.
Having accepted his new family situation, he asked his mother to take him to a boarding school, and everything changed.
James met his best friend Eric, whom he fondly refers to as Rico, when he was in Class 5. Rico, an orphan living with his grandmother in Lower Kabete estate, has been his go-to person whenever he feels sad.
“We shared a lot of our experiences. He made me feel safe and not alone.”
James was not clinically treated for depression, but his best friend made him aware and he did his research and knew how to handle the situation.
In high school, he began using marijuana as an escape whenever he felt those feelings of sadness.
“Depression gave me a hard time interacting with people as I always overthought before I could speak. That is why I preferred staying indoors than going to parties and concerts like guys my age that time.”
He knew some of his cousins were going through the same but he never opened up to them.
Until his staying indoors made him do one of the most regrettable things.
“I wanted to end it all once and for all, so I took a razor and slit my wrists wide open, hoping to bleed to death. My parents were the last thing on my mind that time,” he recollects.
He got weak and passed out, only to wake up the next day having bled on his bedding. He cleaned it behind his parents' backs.
"Later that day, I deeply thought about my actions and how it would have made my family feel," he said.
On average, James said he is 30 per cent suicidal and finds listening to music therapeutic. He tries to avoid his possible stressors and opts to journal or turn his thoughts into music.
“I'm done with school, and a lot of pressure, from being the firstborn, my parents’ expectations and trying to make ends meet. Sometimes it gets to me, but it's okay to have such times,” he said.
He regrets trying to take his life and says it was such a selfish act.
“I am okay with my family not knowing I am depressed and it’s the last thing I’d want them to find out.”
Sharing with his best friend has helped him navigate through his depression.
WORSENED BY CORONA
Dr Philomena Ndambuki, a psychologist, says depression can be mild to moderate, with symptoms of apathy, little appetite, difficulty sleeping, low self-esteem and low-grade fatigue.
It can also be major depression, with symptoms of dull mood most of the day, diminished interest in daily activities, weight loss or gain, insomnia or hypersomnia (sleeping too much), fatigue, feelings of guilt almost daily, and recurring thoughts of death or suicide.
“It is now that we see people seeking help online rather than visiting a professional counsellor. That is extremely dangerous because people react differently to situations and some might not take the situation seriously,” Ndambuki said.
Depression is the largest cause of disability worldwide. More than 80 per cent of this disease burden is among people living in low- and middle-income countries.
Rising cases of Covid-19 have greatly affected the social and economic part of Kenyan citizens.
There has been a spike in cases of people, including schoolchildren, committing suicide or murdering their loved ones, as well as increased theft and substance abuse.
Although not all these cases are attributed to depression and other mental-related disorders, a good number have been confirmed to result from this.
“Humans are social and emotional beings, and this pandemic seems to be erasing that part of our lives,” Ndambuki said.
Her advice to Kenyans and those going through depression is to seek counselling as soon as they notice the signs as it will help them identify the degree of depression.
She also cautioned them on secluding themselves from other people and advised parents to be there for their kids mentally and emotionally.
“A child may be going through a lot but it is easy to ignore as 'it is just a child',” she said.
Fr Francis Ngungu is a Catholic priest, Kitui Dioceses Father in-charge of Kwa Vonza Parish. BY THE STAR
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