Depression

Depression is a mood disorder associated with persistent feelings of sorrow and loss of interest. It is also termed as clinical depression or depressive disorder, and it affects how a person feels, thinks, and behaves.

Depression can lead to various physical and emotional problems because one feels as though life is not worth living. Depression affects the normal everyday activities of a person including eating where sometimes the person is unable to eat due to the feelings of sadness and sorrow.

Facts and Figures

World Health Organization reports on the same by explaining that depression is the most common disease in the world and the leading cause of disability among people. WHO estimates depression to affect 300 million individuals globally. At least 800, 000 people lose their lives due to suicide caused by depression every year.

In Kenya, at least 1.9 million suffer from depression which represents 4.1% of the total population in the country. Kenya ranks 6th among the depressed countries in Africa with Djibouti leading with 5.1% of its population affected.

The number of suicides reported in Kenya went up by 58% between 2008 and 2017 to reach 421, the majority of which are attributed to depression.

Symptoms

The signs and symptoms of depression vary from mild to severe, and they include:

  • Changes in appetite – weight gain or loss unrelated to dieting
  • Feeling sad and having depressive mood
  • Trouble sleeping or sleeping too much
  • Loss of pleasure or interest in activities once enjoyed
  • Increased fatigue or loss of energy
  • Increase in purposeless physical activity or slowed speech and movements
  • Feeling guilty or worthless
  • Difficult concentrating, thinking, or decision-making
  • Thoughts of suicide or death
  • Anxiety, restlessness, agitation
  • Irritability, angry outbursts, and frustrations

Symptoms in Children and Teens

  • Sadness
  • Aches and pains
  • Irritability
  • Reluctant to go to school
  • Feeling worthless and negative
  • Extremely sensitive
  • Poor academic performance
  • Use of recreational drugs or alcohol
  • Sleeping or eating too much
  • Avoiding social interactions
  • Self-harm

Causes

Many factors can lead to depression:

  • Genetics: Depression can run in families. For instance, if one identical twin is depressed, the other has a 70% probability of having the same illness sometimes in life.
  • Biochemistry: Variance in certain chemicals in the brain may contribute to symptoms of depression.
  • Environmental factors: Nonstop exposure to neglect, violence, abuse, or poverty may make specific individuals susceptible to depression. 
  • Personality: Individuals with low self-esteem that are easily overwhelmed by stress and are generally pessimistic seem to be likely to experience depression.

Risk factors

  • Traumatic experiences: Such as being involved in a bizarre accident where most people lose their lives, losing family members, etc.
  • Being LGBT and having genital organs that are not clearly male or female in unsupported situations.
  • History of other mental disorders such as eating disorders, PTSD, or anxiety disorder
  • Abuse of alcohol or recreational drugs
  • Serious chronic illness such as stroke, cancer, heart disease, HIV, etc
  • Certain medications such as sleeping pills

Treatment

The good news is that depression is among the mental health disorders that are highly treatable. Between 80 and 90% of depressed people who are put under medication respond well and heal within time.

The first step is diagnosis where the doctor diagnoses the patient based on physical examination, lab tests, psychiatric evaluation, and/or DSM-5.

Medications

  • Selective serotonin reuptake inhibitors (SSRIs):These drugs are highly safe and cause fewer non-bothersome side effects. They include citalopram, fluoxetine, escitalopram, paroxetine, vilazodone, and paroxetine.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs): They include desvenlafaxine, venlafaxine, lovomilnacipran, and duloxetine.
  • Atypical antidepressants: They include mirtazapine, bupropion, vortioxetine, trazodone, and nefazodone. Note that no all of these drugs fit into any other antidepressant categories and thus, make sure you use them through recommendation and close monitoring by a doctor.
  • Tricyclic antidepressants: They include doxepine, imipramine, trimipramine, amitriptyline, protriptyline, and desipramine. They can be very effective but are associated with severe side effects compared to newer antidepressants. They are not often prescribed until other antidepressants fail – they are used as the last form of action.
  • Monoamine oxides inhibitors (MAOIs): They include tranylcypromine, isocarboxazid, and phenelzine. Just like tricyclic drugs, these drugs can only be prescribed when other drugs fail to work because of their serious side effects. For example, using these drugs requires strict diets due to dangerous (or deadly) interactions with food.

The doctor may recommend a combination of two or more antidepressant drugs to enhance their effects and lead to the desired outcomes.

Note that most of the mentioned depression medications are available in Kenya but can only be used after seeing a doctor and under prescription by a qualified doctor.

Prevention

The following strategies may help prevent depression:

  • Take steps to control stress: Boost your self-esteem, engage in interactive activities
  • Reach out to friends and family: When you feel in crisis, seek help from friends and family to reduce the chance of turning stress into depression
  • Get treatment the earliest you realize signs of depression: It helps manage the problem before it gets worse
  • Consider getting long-term maintenance treatment: It helps prevent a relapse of signs and symptoms.

Sources

https://www.who.int/en/news-room/fact-sheets/detail/depression

https://www.kenyans.co.ke/news/38402-kenyans-among-most-depressed-africa-who-report

https://www.businessdailyafrica.com/datahub/Kenya-suicide-rate-hits-ten-year-high/3815418-4628496-7bgj9pz/index.html

https://www.psychiatry.org/patients-families/depression/what-is-depression

https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013