According to the World Health Organisation, depression is a common illness worldwide, with more than 264 million people affected. Depression may become a serious health condition if one does not recognise and react to the problems that it may be causing an individual. At its worst, depression can lead to suicide, with 800 000 people dying due to suicide every year. Suicide is the second leading cause of death in 15-29-year-olds.
Depression does not distinguish between race, sex, cultures and nationality, so anyone can suffer from depression. This is particularly true in such a diverse nation as South Africa.
One may ask: “Why do depression sufferers not seek help? “
Most people do not get the help they need because:
• they do not see depression as “a real illness"
• Many people blame themselves and feel guilty; they do not want to be seen as being “weak"
• Stigmatisation (self and external) factors lead to delay in seeking help
What is Depression?
Depression involves disturbances of mood and thoughts, often leading to physical symptoms like disrupted sleep and eating problems. It affects the way one functions in everyday life and the way one feels about oneself. The onset is often over a long period of time, so one may not react to the above problem immediately, like one would do when faced with a physical problem. Depression is not the same as ordinary, everyday blues that we all feel sometimes. Functional difficulties occur at work, at school and in relationships. These problems just worsen if not addressed timeously.
Depression symptoms and signs:
• One feels “sadness" and hopelessness most of the time.
• Feelings of guilt, or feeling helpless.
• Loss of interest activities that you previously once enjoyed,
• Sleep disturbances, like early-morning awakening, or excessive sleeping, not wanting to get out of bed
• Weight fluctuations, either losing weight by not eating or gaining weight by overeating.
• Constant lethargy, fatigue and feeling “slowed down"
• Suicidal ideation and/or previous suicide attempts
• Often accompanying anxiety symptoms, even anxiety about the current depressive state – “I don't feel myself…"
• Difficulty concentrating, remembering things – patients often worry about “hyperactivitity and concentration disorders"
• Multitude of physical symptoms including headaches, stomach pain, chest pain, etc – one can actually complain of “any symptom under the sun", all exacerbated by the depressive state
Causes of Depression
Depression has many inter-related causes. Sometimes a negative life event may lead to depression and often depression comes on for no apparent reason, even for people whose lives are seemingly “going well". Some possible reasons include:
Life events: eg the break-up of a relationship/ loss of a loved one, a traumatic event, financial/ legal worries, loneliness (especially during lockdown for the COVID-19 pandemic), retirement – these can all result in depression.
Family History: close family members who have had diagnosed and treated depression sometimes may make one more vulnerable to have depression as well, especially 1st degree relatives.
Depression is also believed to be caused by an imbalance of brain chemicals, which is what the antidepressant medications seek to stabilise. Other medical illnesses eg HIV, and other health problems, can also cause depression. Some medications, like treatment for high blood pressure, birth control pills, and steroids may also aggravate depressive tendencies.
Depression is a very treatable mental condition and the majority of people recover completely after a course of treatment. We always suggest that you see your GP to exclude other causes as indicated above.
The majority of people with depression will make a good recovery on medications, especially if combined with psychotherapy or counselling. If one medicine doesn't work for you, the GP will suggest another one. Anti-depressants don't work quickly - it takes 2-3 weeks to start feeling better, and there is also a 2-3 weeks taper period once you wish to stop the medications. It is very important not to stop taking the pills abruptly. The medications may cause mild side-effects like a dry mouth, headache, nausea or dizziness, which usually pass in a week or two. Always tell the doctor if you are pregnant or have any other illnesses. Call your doctor if you have a question about any medicine or visit your local clinic.
Psychotherapy or “talk" therapy
Psychotherapy (or talk therapy) with a psychologist, social worker, or counsellor gives people the skills to cope with their illness in the short- and long- terms.
Support Groups are a very good way to get support and advice from people who have been through the same experiences as you have. They are often run by patients for other patients as a safe place where you can share experiences and ask for assistance.
Call SADAG 0800 20 51 21 for contacts in your area. Read the SADAG brochure here.
Other Relevant contacts:
SA Depression and Anxiety Group 0800 70 80 90; 011 262 6396
SADAG www.sadag.co.za; SMS 31393
On Stellenbosch Campus:
Campus Health Service Stellenbosch 021 8083496; Tygerberg 021 9389590; Emergency 076 4310305
CSCD Emergency 082 5570880;
ER24 Emergency 010 2053032 (all students)
HR Stellenbosch University 021 8082753 (all staff)