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Depression: A leading cause of suicide

health talk:with Dr Johannes Marisa

I want to welcome everyone back to our health column after the long holidays. I do hope no one lost their dear friends or relatives from suicide during the festive season. Depression has been implicated as a leading contributor to suicide and during our medical practices, so many poisons are attempted ranging from rat poison, pesticides, detergents and many more. World Health Organisation estimates that about 264 million people of all ages suffer from depression with women being more affected than men. Depression is, thus, a leading cause of disability worldwide and is a major contributor to the overall global burden of the disease. Close to 800 000 people die due to suicide yearly globally.

What is depression?
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Depression is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Affected people can suffer greatly and function poorly at school, work or at home. At its worst, suicide can come.

Symptoms of depression
Episodes of symptoms occur most of the day, nearly every day and can be severe enough to cause noticeable problems in day to day activities and these may include:

lFeeling of sadness, tearfulness, emptiness or hopelessness.

lAngry outbursts, irritability or frustration even on small matters.

lLoss of interests in normal activities like sex, hobbies or sports.

lSleep disturbances including insomnia or sleeping too much.

lTiredness and lack of energy.

lAnxiety, agitation or restlessness.

lFeelings of worthlessness or guilt, fixation on past failures or self-blame.

lFrequent thoughts of deaths, suicide.

In children, there may be other symptoms different from adults. Be careful with your children and as a guardian or parent check for the following symptoms on your children:

lIn younger children, symptoms of depression can include sadness, irritability, worry, aches, pains, refusal to go to school or being underweight
lIn teens, symptoms include sadness, irritability, anger, poor performance at school, using recreational drugs or alcohol, eating or sleeping too much, loss of interest in normal activities, avoidance of social interaction.

Risk factors for depression
Depression often begins in the teens, 20s or 30s although it can come anytime. There are some factors that increase the risk of developing depression and these include:

lPersonality traits such as low self-esteem, being self-critical or pessimistic.

lTraumatic events such as physical or sexual abuse, bereavement.

lStressful events which include financial problems, difficult relationship.

lAlcohol or drug abuse.

lHistory of depression in the family.

lSerious or chronic illness, including cancer, stroke, chronic pain or heart disease.

lCertain medications like opiates or sleeping tablets like diazepam.

Prevention

Although there is no sure way of preventing depression, the following strategies may help:

lTake steps to control stress: Increase your resilience and boost your self-esteem.

lReach out to family and friends especially in times of crisis in a bid to come up with solutions.

lGet treatment at the earliest sign of a problem to help prevent depression from worsening.

lAvoid drug abuse.

lPlan and budget well in order to avoid unexpected financial disasters.

lRemain prayerful. Remember God has solutions to our problems.

lConsider long-term maintenance treatment to prevent a relapse of symptoms.

Diagnosis

Clinicians may determine a diagnosis of depression based on:

Physical examination: Can be done and questions asked about your health. In some cases, depression may be linked to underlying conditions like HIV and Aids. Proper counselling may be required then.

Blood tests: Common tests like thyroid function tests and full blood count can be taken.

Psychiatric evaluation: Your mental health professional asks about your symptoms, thoughts, feelings or behaviour patterns.

Treatment

Medications and psychotherapy are effective for most people with depression. Many people with depression benefit from seeing a psychiatrist, psychologist or other mental health professional.

Drugs include serotonin reuptake inhibitors like fluoxetine, paroxetine, sertraline, Tricyclic antidepressants like Imipramine, Amitriptyline, Trimipramine, Monoamine oxidase inhibitors like Phenelzine, Isocarboxazid.

Find your clinician to assess you. This is January for everyone. Do not get depressed because of financial issues. School fees are imminent and food is needed at home. Take the best financial decisions which will not be detrimental to your health. Do not commit suicide merely because you have gone for two weeks without eating beef, be careful beef can increase your cholesterol levels with resultant heart attack!

Know your health in 2020.

lDr Johannes Marisa is a medical practitioner, an educationist and a public health expert who can be reached on doctormarisa@gmail.com

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