Depression on the prowl among young Nigeria

Tragedy struck last Sunday in the Bariga area of Lagos State when Ajala, a father of two and a taxi driver, committed suicide.

Eyewitnesses said due to his wife’s ill health, Ajala was under immense pressure taking care of the children and then providing for the entire family.

According to his wife, who is down with obesity, the deceased came back from work but with an unusual attitude. “Without talking to anyone, he walked into the bathroom and hanged himself. He wasn’t sick. In fact, he was very healthy,” said the wife.

But experts would argue that Ajala’s case is just one in several that are suffering from depression.

According to the World Health Organisation (WHO), no fewer than 800, 000 people die due to suicide every year, of which 86 per cent of them are in low and middle-income countries.

Suicide is the second leading cause of death in 15 to 44-year-olds. Around 20 per cent of the world’s children and adolescents are estimated to have mental disorders or problems. Most low and middle-income countries have only one child psychiatrist for every one to four million people, confirms the world health body.

General Practitioner at Vantage medical centre, Dr. Adeolu Fadeyibi, explained that for every successful attempt of suicide, 20 more people have attempted and failed.

Fadeyibi said: “A lot of people go undiagnosed for depression. In Lagos, while a lot of young people are depressed. About 37 per cent of patients inherit depression from their parents,” he said.

Consultant psychiatrist at the Lagos University Teaching Hospital (LUTH), Dr. Adebayo Rasheed Erinfolami, added that four out every 10 people in Lagos are depressed and do not even know it.

“They do not want to be rejected, so they hide it,’’ Erinfolami said.

In his word: “The burden of depression is 50 per cent higher for females than males. In fact, depression is the leading cause of disease burden for women in both high-income and low- and middle-income countries.

Depressive disorders often start at a young age; they reduce people’s functioning and often are recurring. For these reasons, depression is the leading cause of disability worldwide in terms of total years lost due to disability,” said WHO

A Consultant Psychiatrist, Dr. Rotimi Coker, said that unrecognized symptoms had hindered effective management of depression in Nigeria.

WHO figures show that the burden because of depression is likely to increase – so much so that in 2020, this will be the single biggest cause for burden out of all health conditions.

Erinfolami further said: “Depression is a huge problem in Lagos. In the cause of practice, it is a lot more than what is expected in terms of the proportion of people presenting with depression. It comes in many forms. It is usually masked but underneath it has depressive features.

“It takes an expert to really tease out this part of it. So, a whole lot of our patients present to our medical centre with physical symptoms like headache, crawling sensation, lack of sleep and all that.

In the recent times a whole lot of people are coming down with depression. Depression in the real technical term is a mental illness.”

Depression is much more common than some other diseases that are more widely feared such as Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS), malaria or cancer.

Depressive disorders, which include major depressive disorder (unipolar depression), dysthymic disorder (chronic, mild depression), and bipolar disorder (manic-depression), can have far-reaching effects on the functioning and adjustment of young people.

Among both children and adolescents, depressive disorders confer an increased risk for illness and interpersonal and psychosocial difficulties that persist long after the depressive episode is resolved; in adolescents there is also an increased risk for substance abuse and suicidal behavior. Sadly, these disorders often go unrecognized by families and physicians alike.

The increasing burden will be a particular problem for developing countries because they have fewer resources to allocate to mental health.

A whole lot of people who are depressed and also families whose members are depressed tend to hide the problem or been in a state of denial. A lot of people believe that depression signifies a weakness or mere sadness.

A street hawker, known as Bola, said: “For me, depression is when somebody does not have money, food and even have headache on top of it said Bola street hawker.”

Lateef, a plumber, said: “It is when a person is always weak and unhappy, in fact, only a pastor or Alfa can treat the person.”

Mrs. Okafor, a primary school teacher, also said: ‘’I cant explain it but it leads to madness it happened to my landlords wife, it is spiritual.”

In Africa, the very idea of mental illness is unacceptable and few people will admit to having it.

Adolescence is a time of increased vulnerability for developing depression, particularly for girls, and particularly for those exposed to stress.

It could also be a time of opportunity to prevent biological changes that set up a life-long vulnerability to depressive disorder.

Children whose parents have depression are six times more likely to have depression themselves. Studies of identical and non-identical twins show that there is a clear genetic component with an estimate that genetics accounts for 40 per cent of the risk and environmental effects accounting for remaining 60 per cent.