Mental health is a state of well-being in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a meaningful contribution to their community.
Mental health is a critical component of individual, family, community and national wellbeing and prosperity.
Rates of depression have been increasing over the last few decades, but in the period following the Covid-19 pandemic, the world has seen a 25% increase in rates of depression.
Depression has become one of the leading causes of disability worldwide affecting over 300 million people globally.
Depression is also becoming a challenge locally. We need to better understand what depression is, what causes it and what we can do to address the challenges it brings.
What is depression and how can it impact me, my family, my work and my nation?
Depression is a mental health problem that affects one’s mood, energy levels, motivation and drive for life.
When depressed, you can feel very low or sad and struggle to experience or express any joy or other positive emotions.
Some people may, however, feel irritable and easily angered.
You may lose interest in life and activities that you used to enjoy, you may struggle to stay motivated and engaged with family or with school or work.
You may feel tired all the time even after adequate rest.
You may, however, struggle to sleep or in some cases sleep excessively.
Your appetite may decrease leading to concerning weight loss or in some cases you may eat and gain significant weight.
Your sex drive or libido may also decrease leading to relationship or marital problems.
You may struggle to focus and concentrate at work or school, even at home.
You may find yourself struggling with a loss of self-confidence and poor self-esteem.
You may feel helpless and powerless to change the circumstances of your life.
At its worst depression can result in feelings of hopelessness and thoughts of self-harm and suicide.
Depression can, therefore, affect how we function physically, cognitively, emotionally and socially.
- Physically, depression can cause debilitating fatigue and decreased capacity to perform physical activities and this can affect capacity to function at home and at school or work. Often this can be mistaken as ‘laziness’ or insolence or insubordination leading to serious impacts on how one is handled at school or work and at home.
- Cognitively, depression can cause mental slowing or ‘brain fog’, difficulty concentrating, remembering things and focusing on tasks at hand. This has resulted in depression being a major factor in presenteeism (being at work but not being productive)and absenteeism (not being able go to work).
- Emotionally, depression limits our ability to experience and express positive emotions and this affects us and how we relate to those around us and the quality of our relationships. Depression can often be an underlying factor in relationship and marital difficulties.
- Socially, depression can lead to social withdrawal and social isolation. Loneliness and isolation can be a cause of depression but often are also a consequence due to the relationship dysfunction that can happen.
What causes depression?
Depression results from an interplay of biological, psychological and social factors.
This also means the interventions that can help with depression need to be multi-modal taking into account biological, psychological and social factors.
Biological factors that can contribute to depression include genetics (depression can partly be inherited).
Genetic and other factors such as childhood upbringing and adversity can increase the risk of brain chemical changes that can then cause depression.
Hormone changes particularly in women can also contribute to depression as well.
A negative perspective of ourselves, others, the world around us and the challenges that come our way can contribute to the psychological factors that increase our risk of depression.
Multiple life stressors, difficult relationships, marital problems, domestic violence, financial challenges, adversity and poverty are common social factors that cause depression.
Poverty can create a vicious cycle with adversity and lack causing depression which in turn makes one less functional and less able to earn a living leading to further financial problems.
Financial challenges also limit access to treatment and appropriate care further decreasing chances of sustained recovery.
What can we do as a society and as a nation to address the impact of depression?
- Increase awareness and understanding about the risk factors and symptoms of depression, how to prevent depression where possible and treatments available when needed.
- Improved awareness and understanding about depression will also help tackle stigma about it and decrease barriers to getting appropriate care.
- We often fear what we do not understand, by improving understanding we can reduce unnecessary fear and myths concerning depression.
- Investing in integrated mental health care services that will improve access to screening, early recognition of common mental health problems and adequate, appropriate care.
- Depression and other common mental health problems could be recognised and managed at community or primary health care facility level with cases needing more specialised care being stepped up in the health care system.
- This would effectively reduce costs to the individuals and to the health system.
- Invest in school and workplace mental health programs. Depression and other common mental health problems significantly impact an individual’s ability and capacity to be effective and productive in the learning or working environment.
- Depression has an impact on individual, family, community and even national productivity.
- Studies have shown that workplaces can realise a significant return on investment if they put resources towards mental health awareness and training programs and support for affected employees.
- It has been shown that for every US$ 1 invested in scaling up treatment for depression and anxiety, US$ 4 will be realised in better health and better ability to work and be productive.
Depression is having a significant impact on us as individuals, our families, our workplaces and ultimately our nation, what are you doing to address the impact of depression in your community?
If you think that you or someone that you know may be struggling with depression, please contact your nearest health care provider and get help.
* Dr. Chido Rwafa-Madzvamutse is a consultant psychiatrist. Feedback: Whatsapp: +263714987729