You & Your Health: Oppression

You & Your Health: Depression


You & Your Health: Oppression
You & Your Health: Oppression
 Dr. Vwoke Akpubi on depression
Dr. Vwoke Akpubi (MB BS, MRCPsych)

In these times of economic depression with losses of jobs and finances, more and more people are turning up at the GP complaining of being “depressed”. But what exactly is this amorphous illness called depression.

What is depression?
Depression is a clinical syndrome in which there is a decrease in positive well-being, lack of interest in usually pleasurable/enjoyable activity and loss of energy or fatigue nearly every day. The lowering of mood is different from that of someone who is sad or distressed as the low mood persists for up to two weeks as against a few days for someone who is sad or distressed. In addition the person who is depressed loses self-esteem has inappropriate guilt feelings, becomes lethargic and may feel suicidal.

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What causes depression?
Most depression is endogenous i.e. no clear causative factor can be pinpointed. However in some cases depression can be “reactive” as a result of negative external factors such as bereavement, loss of social status, reduction in finances etc. interestingly there is evidence that being a refugee immigrant or someone with indeterminate status has been shown to increase the propensity to depression.

How else can a person be identified as being depressed?
In addition to the features stated above there is also loss of appetite with consequent weight loss, loss of appetite for sexual activity, low mood worse in the morning and getting slightly better as the day goes on . Sleep is also disturbed with nightmares and increased frequency of sleep paralysis( known as ogun oru in south west Nigeria and kanashibari in Japan, where the individual wakes up from a dream and finds that he is unable to move his hands and feet and feels an oppressive presence or weight on his/her chest.) There is also increased frequency of anxiety and panic attacks.
In severe depression the person may become psychotic with delusions of guilt, punishment, shame or a belief that internal organs like the intestines is rotting away.

Can depression be treated?
Depression is treated very easily and effectively treated using medication known as anti-depressants. These medicines correct an imbalance of certain chemicals (e.g. serotonin, dopamine) found in the brain that occurs when an individual becomes depressed.

Some individuals can be treated using only psychological techniques like cognitive behaviour therapy (CBT). However most individuals respond to a combination of biological (tablets) and psychological techniques. It is however important to recognise these symptoms early and begin treatment as the longer a person stays depressed the harder it becomes to treat the depression.

Can people who are depressed recover fully and live normal lives?
Yes. An individual adequately treated can achieve his/her former level of functioning and lead their normal lives. It is important to adhere strictly to the guidance provided by your GP or Psychiatrist as regards treatment and follow up care.



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