Some illnesses are difficult to characterise.

This is important and speaks to their treatment.
For years, medical professionals have been treating Depression with a varied amount of success in many parts of the developed world.

So it isn't really a new problem, but gradually and certainly, Nigerians are waking up to the reality of this condition and its potential impacts on life as we know it.


Recognising Depression.
In low and middle income countries though, the very nature of Depression means its presence is subject to misunderstanding; and even when acknowledged may be trivialised or stigmatised.

On Sunday 19th March 2017 in Nigeria, a young male medical doctor flung himself into the Lagos Lagoon from the top of the 3rd Mainland Bridge, a popular land mark that connects the island aspect of Lagos state to the mainland.

I have not come across any information that indicates why this event occurred. Suicide is not new in  Nigeria and there are many motives - Depression being one out of many significant factors.

In the case referenced above, I do not know whether a depressed state of mind led to the act of suicide, but an event like this trending on the growing social media presence of many Nigerians means that people ask more questions and are more open to understanding the motives to Suicide.


About Depression.
Today I look at Depression - what it means, how we identify it and to a little extent how its treated.

If you are reading this post, you most certainly have experienced some form of depression in the past- regardless of your age, sex, education or social class.

Think of the way you feel when you are let down:
lost something precious or been robbed; lost a close relative; failed at an exam; dumped by a boyfriend; divorce; lost a contract you were really anticipating - we all know to some extent what being 'down' feels like.

Many people bounce back from these negative episodes - depending on our ability to cope, the significance or impact of the events or just support from someone who helps you get through the pain of the negativity.

In Depression there is a sense of permanence of that state of mind where pleasure or happiness can no longer exist. People depressed say they inhabit a dark place - sometimes they can't put it in words what they feel.

They speak of a lack of pleasure in activities that were previously enjoyed, a loss of hopefulness for a positive outcome in their future and a lack of motivation that many of us simply take for granted.

There may be guilt about something - an action or past inaction; which may or may not be related to regrets and especially feeling they have let important people in their life down.

There may be an emptiness inside that defies explanation or fulfilment and significantly prevents normal functioning - and many times, only when you look very closely.

There is some truth to the idea that a depressed person can mask their inner crisis for a long time, so that unlike physical ailments like asthma, heart disease or cancer when it may be possible to sight the evidence of illness by others; in the case of mental illness like Depression it is more difficult. 

Like physical illness Depression has degrees of severity - it can be mild, moderate or severe.

Someone with mild depression may have any of the features I have mentioned earlier but to an extent that is hardly noticed even by close family or friends. They may become easily annoyed or irritated by trivial issues, or they may seem less focused on usual tasks.

I think its also important to say that while Depression is a mental illness, did you know it can have physical effects?

Some people with Depression describe a headache like a tight band around the head; and yes, actually it can affect sexual desire (or libido); and sexual performance in both men and women.

In many people their sleep is affected - sometimes they have problems managing to sleep; in other occasions they sleep off but wake up several times during the night with the same result- poor, disrupted sleep.
In addition, people with Depression may wake up very early in the morning and struggle to get back to sleep.
As the severity of Depression increases, these symptoms increase in how strongly they are experienced; and they may affect relationship or work.


Dealing with Depression.
The way a person with any of the symptoms described above will deal with them varies. Some people may search endlessly - and in futility - for cures to a headache that never goes away, sleep problems or sexual difficulty.

Some people may just 'bear it' - wrongly believing it is their burden  to carry in an already challenging and tough environment. Some people feel 'they can't go on'. This last emotion is what may result in a suicide.

While we don't know exactly what causes Depression in most cases; there are some instances that are directly liked to certain key events - illness, death, job loss, even pregnancy (Have a look at our infograph on Post Natal Depression).

When someone in the absence of these events becomes depressed, we look at their genetic make up, their upbringing, their social status, emotional disposition to see if there is a clue to how they started to become depressed.

Many times we find some relation but no distinct cause.
Studies and research have revealed the impact of the 'Happiness Hormone', Serotonin and Endorphins. (Read more here).

Serotonin is a chemical  found in the brain which is thought to have a good influence on mood, emotion and sleep.  Endorphins which are also chemicals produced in the brain have been shown to be in greater presence during or after exercise and they reduce anxiety and make you feel good.

Severe Depression is treated by mental health clinicians (psychiatrists and clinical psychologists), but any medical doctor with  the most basic qualification has received sufficient training to at least identify and signpost our patients to the right specialist to help them.

Because - YES - Depression is treatable.
Can it be completely cured? Do we really know? This is still under consideration but people can have happy and fulfilled lives despite having experienced Depression at one stage or another.

We talk of different ways of treating Depression - depending on whether it is associated with an obvious event or stressor (like death or job loss); or where it is less obvious how Depression came about.


We treat Depression as it presents:If it is mild, the only treatment necessary may be to acknowledge and recognise the condition before using certain lifestyle measures to adapt one's mood. They can include exercise, Counselling treatment to help the person come to terms and regain control of their feelings and life.

Counselling is a lot more  than have a chat with a good friend although I must emphasise the value of a strong support network is in treating ANY type of Depression- whether mild or severe or whether associated with a significant life event or not.

When Depression is judged to be more severe then treatments can start to include - in addition to support with Counselling, the use use of medication which primarily affects the availability of the certain brain chemicals including Serotonin and other chemicals which was discussed earlier. 

To summarise then, recognition and acknowledgement of the condition - is a challenge because of the different ways it presents - but more awareness is being raised due to social media reaches.

Treatment is available and should be actively encouraged as it does make a difference and CAN save lives.

I hope this helps.

If you need to discuss this further, please contact info@askawayhealth.org!

Stay Well.



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All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence based guidance and to help promote quality health care. The advice in our material is not meant to replace management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org