Today’s discussion is a continuation of last week’s post but from the perspective of a psychiatrist. It illustrates some of the forms depression can take and how it can be managed, prevented or treated.

Kay is a 34-year-old married employed father of two. He comes from a religious family and is surrounded by supportive friends. However, whenever he is alone, he feels terrible and unworthy. He does not understand why he feels this way. He cannot explain it to himself let alone to anyone else. What he is certain of, is that he is not worthy to have the kind of life he lives. He feels he does not deserve to have love, peace and prosperity. He thinks it will all be taken away from him someday. He feels he is a fraud and will soon be punished or exposed. Sometimes he is unable to sleep, unable to move, unable to cry and just stares at the ceiling; trapped in a world, not sure what is fantasy and what is real.

Nana is 71-year-old widowed retired grandmother. She lives alone but often keeps in touch with her children and grandchildren. Over the past few months, she has being losing a lot of weight. She initially excused it as dieting but in reality, she barely eats. She neither bathes nor washes her clothes, even her home is dusty, musty and littered. She spends all day lying in bed or sitting on a sofa. Recently, she told the children she cannot wait to go to Heaven and be with her husband again. In response, they promised to pay her more visits but she declined their offer; preferring to be alone.

Mo is a 15-year-old schoolgirl who just found out the love of her life is leaving her. She has been begging and warning him not to abandon her. Only two weeks ago, she was flying high and looking forward to the upcoming exams but now she cannot pay attention in class. Her friends are telling her to move on and forget about him; she is too pretty and brilliant to be stuck on a boy. However, Mo cannot hear them, instead, her thoughts are occupied with ways she can compel him to return to her as she cannot see a life without him.

Human beings experience highs and lows all through their lives; sometimes dictated by relationships, finances, acceptance and self-actualisation. Sometimes the lows take place too often and last for too long. Sometimes the lows seem to stay and become the norm.

Depression is a low that lingers and refuses to go away. It might have been triggered by some bad news or nothing at all. There are cases where it runs in the family or is associated with an impoverished part of town or a particular type of occupation. However, it is unique to each sufferer.
The common symptoms of depression include sadness, tiredness, hopelessness, poor appetite and poor sleep. While others might notice a lack of motivation to do formerly pleasurable activities and even a lack of interest to maintain personal hygiene. The victims might seek succour in alcohol, drugs, violence and plain denial. When these do not work, the outcome is a decision to end their own life. It doesn’t have to get that far.
Depression can be managed, prevented and treated. Options including medication, therapy and social interventions are available. The first step is to recognise the problem and accept a need for help.

As it turned out, Kay sought out help and started feeling better after starting medication. The medicine works by balancing some chemicals in his brain. It took some time for them to kick in but he was patient and is grateful for it.

Nana simply moved in with one of her children and felt a new zeal for life. She spends the day bathing, feeding and cleaning after grandchildren. She enjoys it and has found her own reasons to bathe, feed and clean up after herself as well.

Mo survived an attempted overdose and commenced therapy that focussed on stopping negative thinking. The Therapy helped her realise she was young, gifted, attractive and had time in her hands. She had been thinking there was no point to life but the Psychotherapist guided her to identifying several positives in her life.

Reference: MRCPscych Dr. Fadahunsi A. 2020 “What is Depression”.