Depression: 10 signs to notice

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Thrice, Dele Bandele attempted suicide but failed. Sadly, the fourth attempt sent the digital strategist on ‘a journey of no return’ one week after his birthday and left his family hugely devastated.

Bandele had been declared missing by his friends after he was last seen at Omole Phase II, Lagos, only to be found dead on January 13 in circumstances suspected to be a suicide. His last known location was said to be at the Third Mainland Bridge – a notorious suicide spot inwards Lagos Island.

In a suicide note he left behind, Bandele disclosed that he had fought depression for seven years and attempted suicide on three occasions but was discouraged by thoughts of the consequences to those around him, especially his mother.

The note read in part, “I have battled with depression for seven years, and now that battle is over. I couldn’t continue to live the way I did and make the same bad choices again. The noise got too loud but now the noise can stop again.

‘‘P.S: I didn’t send my mum a note because l couldn’t bear it. If you’re reading this, then you probably know how much she meant to me. The thought of her would have discouraged me. I couldn’t let it. Not for the 4th time.”

He further likened life to a party that should have ended the moment it’s fun faded, hoping to “finally find peace and rest” in heaven.

Sadly, Bandele’s case was one suicide too many in Nigeria and globally, with depressed youths – students and young lovers – falling victim in many cases.

Depression, which is an integral aspect of mental health disorders, is one of the leading causes of disability worldwide according to the World Health Organisation.

The WHO reveals that three of the 10 leading causes of disability in people between the ages of 15 and 44 are mental disorders, ranking depression third after cardiac and respiratory diseases as a major cause of disability.

In a 2018 article published in Archives of Medicines and Surgery, a doctor at the Department of Obstetrics and Gynaecology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Dr Aisha Dabana, noted that “depression is a debilitating and pernicious cluster of symptoms that may persist for a period of weeks, months, or even years.”

If left untreated in the early age of occurrence, Dabana said it could lead to, among others, conduct disorder, delinquency, eating disorders such as anorexia and bulimia, panic attacks, substance abuse and ultimately, suicide.

At present, depression is viewed as the most mental health problem globally, said Lead Therapist and Chief Executive Officer, Therapy Consult Bysalem, Mrs Salem Ogunlowo.

Ogunlowo stated that depression manifested in different degrees and various ways, enormously impacting on a person’s ability in how they function at work, relationships and other areas of their lives.

She added, “According to the 2019 World Mental Health Day report, 1-4 people suffer from depression and 800,000 kill themselves every year due to lack of mental health awareness globally.

“WHO also estimated that, by the year 2023, the second world’s most debilitating condition, will be major depression. It claimed only cardiovascular illness will cause more health disability. Depression not only affects one’s quality of life but the ability to function and also one’s physical health.”

Ogunlowo and a United States-based psychologist, Dr Timothy Legg, warned that being unhappy is not the same as being depressed, noting that depression is often used loosely to describe how one feels after a bad week at work when going through a breakup or battling personal weakness.

“But major depressive disorder – a type of depression – is much more complicated. There are specific symptoms that determine whether it is a depression or the sadness we all sometimes experience in life,” Legg wrote in an article published on healthline.com.

Being a common health problem, experts warn that one needs to be on the lookout for the following depression symptoms to determine when to see a mental health professional.

Hopelessness

Legg maintained that major depression is a mood disorder that affects the way one feels about life in general, adding that having a hopeless or helpless disposition about life is the most common symptom. He identified other feelings as worthlessness and self-hate which sometimes manifested in utterances such as “It’s all my fault,” or “What’s the point?”

Also, a psychiatrist at the Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Prof. Adeoye Oyewole, said a depressed person exhibits undue sadness, looking at the past with a sense of unnecessary guilt, feeling worthless about his present state and feeling hopeless about the future.

Loss of interest

According to experts, loss of interest in usual activities such as sports, hobbies, and social withdrawal are essential pointers to depression. Another area where one may lose interest is sex with one’s partner. “Somebody who used to be public before, but for no reason says he is no longer interested may be depressed,” Oyewole said.

He added, “The person can also wear the same dress for a whole week. They think there is no need to change the dress. Some can actually lock themselves up in their room; they won’t go out and may not have their bath for days. Somebody who used to be bubbly and fashionable would stay in the room. Once somebody gets to this point, the person is clinically depressed and should be thinking of seeing a doctor.”

Loss of energy

This stems from loss of interest. Part of the reason one might stop doing things one enjoys is boredom. Depression often comes with a lack of energy and an overwhelming feeling of fatigue, which can be among the most debilitating symptoms of depression. This could lead to excessive sleeping or insomnia (sleep disturbances), Ogunlowo said. The lack of quality, restful sleep can also lead to anxiety which fuels depression.

Changes in appetite, weight

Weight and appetite can fluctuate for people with depression and the experience may vary for persons. Some people will have an increased appetite and weight gain, while others won’t be hungry and will lose weight. If changes in one’s diet are not intentional, it may mean that depression is at work.

Mood swings

When one is enmeshed in unpredictable emotions for a considerable period, it may be about time to seek help on depression. As such, one minute may be an outburst of anger and the next may be occasioned by uncontrollable crying. “Nothing outside of you prompted the change, but your emotions are up and down at a moment’s notice,” Legg stated.

Substance abuse

Depression can affect the sexes differently, Legg submitted, noting that research shows men with depression may have symptoms such as irritability, escapist behaviour, substance abuse, or misplaced anger.

Suicidal thoughts

Depression is, on many occasions, connected with suicide. People who die by suicide usually show symptoms first. The thought of ending it all constantly creeps into their mind and they often talk about it or make the first attempt before succeeding in ending their life. Oyewole advised that in a situation whereby someone exhibits serious suicidal ideation, the person may need to be admitted and monitored.

“Beyond the tablets, there may be a need for counselling. At times, there are many stressors: it could be socioeconomic, marital and financial or workplace politics. So, you also want to investigate the social circumstance of that individual,” he said.

Repeated complaints over illness

The psychiatrist stated that some of the above symptoms might not be apparent in some depressed persons. Instead, such people may complain persistently of physical illness with no diagnosis.

He said, “They keep going back to doctors and keep complaining. Some may be having symptoms like internal heat but externally, their body is not hot. Some may say something is crawling inside of them.”

Religiosity

As a Nigerian factor and African in general, the professor said a depressed person might get more religious and have a feeling of emptiness, thinking there is nothing in life again. “Religion can mask it,” Oyewole warned. “People may not know it is depression but it could be depression. Somebody may keep begging people for wrongdoings that are past and resolved. They will keep going to pastors for prayers.”

Absenteeism

Absconding from work regularly without any genuine reason could also be a symptom of depression. On some occasions, such a worker may not be meeting the basic minimum expectations at work or be suffering from diminished ability to think and concentrate.

“According to the medical model, if a person experiences at least five of these symptoms for one month they have major depression. Mild depression would typically be defined as having two to four of these symptoms for over one month,” Ogunlowo pointed out.

Legg affirmed that for anyone who has some of the identified symptoms for more than two weeks, the person might be suffering from a major depressive disorder. “Recognising that you’re depressed is essential to getting the right help,” he concluded.

PUNCH

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