World Mental Health Day Message – October 10, 2012“Depression: A global crisis”

by Sr Peggy Da Silva,
Senior Nursing Officer,
Mental Health Rehabilitation Centre

Living in the Caribbean makes us all acutely aware, especially at this time of the year, of a weather phenomenon called a tropical depression. We have come to realize that if it develops and passes where we live, the damage could be astronomical. So, once we are told that a depression has been identified in the Atlantic, we take out our weather charts and begin tracking; we listen to every weather bulletin, we even check to see whether we have sufficient food in the house. WE DO NOT TAKE CHANCES.{{more}}

In the area of mental health, there are also depressions, but sadly, our approach to them is not as informed.

Unlike a tropical depression where special satellite equipment and aircraft are used to identify, confirm and track, mental depression is more subtle, less easy to identify, but no less destructive if left to run its course.

To bring into focus this often sinister, destructive health issue, it has been decided that on this the 20th Anniversary of the commemoration of World Mental Health Day, October 10th, 2012, the day be observed under the theme “Depression: A Global Crisis.” The Ministry of Health, Wellness and the Environment joins the international community in observing this day!

World Mental Health Day is used to raise public awareness about mental health issues. The observance of the day helps to encourage open discussion of mental disorders, its causes, the signs and how they can be dealt with. This year the prevalence of depression in the global community has put this issue firmly on the agenda.

While we know for sure that hot air moving off the continent of Africa and meeting with warmer than usual water in the Atlantic is what puts a tropical weather depression into motion and that when the conditions are right, this develops into a destructive hurricane over time, the same level of certainty as to what causes mental depression does not exist.

Mental depression results from complex interactions between the mind, brain, body and the environment. Something such as a sudden loss of a job, combined with hard economic times, to which is added a stressed out personal relationship, mixed with a generous dose of a sense of hopelessness could set a mental depression into motion.

Mental depression is no respecter of persons and can affect anyone regardless of age, ethnic background, socio-economic status or gender.

It is now estimated that 350 million people globally are affected by depression. Research shows that two per cent of children under 12 years of age experience depression and this rises to five per cent among teenagers, which means that there is at least one depressed child in every classroom. Also, one in 10 adults will experience depression at some point.

According to the World Health Organization, the trends indicate that depressive mental disorders are expected to become the leading cause of the global burden of disease by 2030, hence the push to increase awareness of the disease and its consequences.

One of the most troubling consequences of depression is suicide or attempted suicide. Suicide is now a global health concern. According to the World Health Organization (WHO), every 40 seconds, someone around the globe commits suicide.

Research has shown that 90 per cent of the people who kill themselves are depressed. Almost one million lives are lost yearly due to suicide, which translates to approximately 3,000 suicides every day. And for every person who commits suicide, 20 or more may have attempted to end his or her life (WHO, 2012). Suicide is also the fourth leading cause of death in the 15 to 44 years age group.

If someone you know is talking about suicide, TAKE THEM SERIOUSLY AND SEEK HELP FOR THEM. DO NOT LEAVE THEM ALONE. One life lost through suicide is one too many!

In St Vincent and the Grenadines for the year to date, we have had five cases of suicide involving young adults and an unknown number of attempted suicides. This is significant as depression is a definite risk factor for suicide.

Some episodes of depression can begin suddenly with no apparent cause, while others may be associated with a difficult life situation or experiences, such as a death in the family, termination of employment, or a chronic illness, like diabetes or cancer. A feeling of hopelessness is the perfect breeding ground for depression. These factors can be minimized by a strong and supportive family and community environment.

Weathermen know that if they detect a weather system where the pressure is falling, a circulation is formed around an eye and the winds begin to blow in a certain direction, they have a tropical depression on their hands. But how can we readily identify a mental depression?

Here are some signs to pay attention to. A person:

o not wanting to do things that you previously enjoyed
o not wanting to meet up with friends or avoiding situations
o sleeping more or less than normal
o eating more or less than normal
o feeling irritable, upset, miserable or lonely
o being self-critical
o feeling hopeless
o maybe wanting to self-harm
o prolonged feelings of tiredness and not having any energy.

Just as a bright sunshiny day could slowly or suddenly change into a foreboding heavily overcast day as a tropical weather system approaches, similarly a person suffering from depression could experience a sudden or gradual onset of what seems like a heavy cloud that comes over their life, mood and spirit threatening to snuff out every glimmer of light and joy.

Too often we simply tell persons like that to “snap out of it.” Such advice is useless and might even aggravate the person being given that advice, sending them deeper into depression. Depression cannot just be “snapped” out of. It is a real biological disorder affecting the mind and body and must be treated as such. It is therefore a treatable condition which gives hope to everyone afflicted with the condition.

Here in St Vincent and the Grenadines, the Ministry of Health, Wellness and the Environment recognises depression as a common mood disorder that can be reliably diagnosed and treated by non-specialists as part of primary health care. Specialist care is needed for a small proportion of individuals with complicated depression or those who do not respond to first-line treatments.

In light of this, the Ministry is continuing its drive to integrate mental health care into the primary care system by reorganizing our psychosocial services. A psychologist has been incorporated into the general hospital staff and health counsellors have recently been assigned to the various health districts with the goals of:

(1) Providing clients with easy access to mental health care in the public sector
(2) Ensuring a holistic approach to the health care of clients and
(3) Ensuring that appropriate referrals are made on behalf of clients

The management and treatment of mental disorders in primary care is a fundamental step that would enable the largest number of people to get easier and faster access to services. We are aware that many are already seeking help at this level; however, there remains a gap in treatment.

We are therefore underscoring that there is also need for action at the individual and community level.

In closing, we invite you to be more observant, first, of your own emotions and those around you. If you sense the most common symptom of depression, which is a persistent ‘sad’ mood, a feeling of being down in the dumps or being in a deep dark place and this persists for several weeks at least, it’s time to take action and get help. Sometimes just telling a really good friend openly how you feel could work wonders.

If you have been battling a feeling of pessimism, hopelessness or helplessness and being critical of yourself for never being good enough at anything, no matter what you do, then you may be suffering from depression. Depression can lead to a lack of interest in things you normally enjoy.

Feeling like you are lacking in energy and drive, even for sexual intercourse, is another recognizable symptom of depression that can slowly be re-enforced over time. Trouble with sleeping and eating are symptoms that most people would not usually associate with depression, but are most definitely tied to it.

If any of the above describes you or a loved one, don’t let the depression deepen, because, just as with tropical depressions, the lower the pressure falls, the more destructive the storm. The deeper you go into depression, the harder it is to get out and the more destructive the outcome can be.

Depression is real. It is treatable and recovery from the condition is possible and achievable. Act now! Don’t become a global statistic!