Friday, April 7, 2017

April 7 - World Health Day: Depression, Let's Talk

Every year on the 7th of April, the World Health Day is celebrated.

Each year comes with its own theme and this year (2017) the theme is "Depression - Let's Talk"

 And this theme could not have been more apt, especially in Nigeria where the suicide rate in the past one month has jumped to 55% from a mere 2% before then.

What is Depression

Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being.

People with a depressed mood can feel 

- sad
- hopeless
- helpless
- guilty
- irritable
- angry
- ashamed
- or restless.

They may
- lose interest in activities that were once pleasurable
- experience loss of appetite or overeating,
- have problems concentrating, remembering details or making decisions,
- experience relationship difficulties
- and may contemplate, attempt or commit suicide. 

digestive problems
or reduced energy may also be present

Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal temporary reaction to life events such as bereavement, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.

A DSM diagnosis distinguishes an episode (or 'state') of depression from the habitual (or 'trait') depressive symptoms someone can experience as part of their personality.

People who pursue long term courses tend to have more symptoms of depression than those who pursue short term courses e.g Medical Students

People who are constantly under stress and pressure tend to be more depressed than the general population e.g. Medical Doctors

Blacks in the USA tend to be more depressed than Whites

Women tend to be more depressed than men but men tend to have more suicide tendencies as a result of depression then women


1.      Life events

Adversity in childhood, such as bereavement, neglect, mental abuse, physical abuse, sexual abuse, and unequal parental treatment of siblings can contribute to depression in adulthood.

Childhood physical or sexual abuse in particular significantly correlates with the likelihood of experiencing depression over the life course.

Life events and changes that may precipitate depressed mood include

- financial difficulties
- unemployment
- work stress
- a medical diagnosis (cancer, HIV, etc.)
- loss of a loved one
- rape
- relationship troubles
- jealousy
- separation

Adolescents may be especially prone to experiencing depressed mood following social rejection, peer pressure and bullying.

2.      Personality

High scores on the personality domain neuroticism make the development of depressive symptoms as well as all kinds of depression diagnoses more likely, and depression is associated with low extraversion.

3.      Medical treatments

Depression may also be iatrogenic (the result of healthcare), such as drug induced depression.

Therapies associated with depression include interferon therapy, beta-blockers, Isotretinoin, contraceptives, cardiac agents, anticonvulsants, antimigraine drugs, antipsychotics, and hormonal agents such as gonadotropin-releasing hormone agonist.

4.      Substance-induced

Several drugs of abuse can cause or exacerbate depression, whether in intoxication, withdrawal, and from chronic use.

These include

sedatives (including prescription benzodiazepines)
and illicit drugs like heroin),
stimulants (such as cocaine and amphetamines)

5.      Non-psychiatric illnesses

Depressed mood can be the result of a number of infectious diseases, 
neurological conditions 

and physiological problems
including hypoandrogenism (in men)
and cancer.

6.      Psychiatric syndromes

A number of psychiatric syndromes feature depressed mood as a main symptom.

The mood disorders are a group of disorders considered to be primary disturbances of mood.

These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode.

Another mood disorder, bipolar disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also involve one or more episodes of depression.

When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder.

Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode: and post traumatic stress disorder, an anxiety disorder that sometimes follows trauma, is commonly accompanied by depressed mood.

Depression is sometimes associated with substance use disorder.

Both legal and illegal drugs can cause substance use disorder.


Mental Health Providers use questionnaires and check lists to detect and assess the severity of depression


Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments.

A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition which may benefit from treatment.

Different sub-divisions of depression have different treatment approaches.

In the United States, it has been estimated that two thirds of people with depression do not actively seek treatment.

The World Health Organisation (WHO) has predicted that by 2030, depression will account for the highest level of disability accorded any physical or mental disorder in the world (WHO, 2008).

Source:     Wikipedia