Depression Don’t keep it silent

• According to WHO, 350 million people worldwide suffer from depressionIn
• Sri Lanka an estimated 800,000 people have depression
• Depression  affects people of all ages and all walks of life 

For World Health Day this year, the World Health Organisation (WHO) has focused its attention on an important mental health issue, depression, which is increasing in magnitude both locally and internationally.

  
According to WHO data, some 350 million people worldwide, including 800,000 in Sri Lanka are known to suffer from depression. Depression affects people of all ages and all walks of life and if left untreated, may lead to suicide. Patients and caregivers must be made increasingly aware that depression is a treatable illness and that there is no reason to feel ashamed to seek treatment.  

 
At a recent media seminar co-sponsored by the WHO and the Health Ministry on the theme ‘Depression: Let’s talk’, the emphasis was on the need to spread awareness on the disorder which is still stigmatized in Sri Lanka.   

 From left to right: Suveen Thirapathy, Dr. Neil Fernando, Dr. Chithramalee De Silva and Dr. Belinda Loring 
Pix by Kushan Pathiraja

800,000 Sri Lankans, young and old of both genders suffer from depression

WHO’s Acting Country Representative Dr. Belinda Loring, who spoke on the prevalence of depression, said, “The topic chosen this year is of particular global health importance. Depression is a big problem, depression is a growing problem and depression is a human problem. People are suffering unnecessarily.”   

She said the number of people suffering from depression had increased and that the WHO considered it to be the leading cause of disability worldwide. She added that patients should not suffer in silence.   
“In some countries, stigma and misinformation are the main reasons people don’t come forward to seek help. In Sri Lanka, 800,000 people,  including young and old of both genders suffer from depression. They can lead happy, normal lives if only they get the help they need,” Dr. Loring said, adding that while depression could be treated without medication, it was important to seek timely help without neglecting it. 

IN SL 3,000 commit suicide each year

Health Ministry’s Director of the National Mental Health Directorate, Dr. Chithramalee De Silva spoke about the problem from a Sri Lankan perspective.  

 
“In Sri Lanka, 10% of the population have mental health disorders, while some 2% have major psychiatric disorders such as severe depression, schizophrenia and bipolar disorder with nearly 3,000 people committing suicide each year,” she said, highlighting the fact that the main causes for depression are diverse and included biological, psychological, social, environmental and economic factors.   

Dr. de Silva outlined the progress made in combating this disorder and highlighted further measures that could be taken to control it.   

She said much was being done to curb depression and to spread awareness about it and that the available mental healthcare provisions include Consultant Units, Acute Psychiatry Inpatient-Units and Intermediate Care Units. “Mental health awareness is also being carried out in schools, at the workplace, among the elderly and for pregnant mothers. Some of the measures taken to promote mental well-being among these people include life skills development, stress management in the workplace, mindfulness programmes and social activities. For the elderly there are daycare centres while maternal mental health awareness and early childhood care and development are carried out for mothers,” Dr. de Silva said.   

She said substance abuse such as drugs and alcohol were some of the methods used by patients to cope with depression and pointed out that this should be avoided at all costs. “As a preventive measure, alcohol rehabilitation is being carried out, while domiciliary visits and follow-up visits are being carried out to check on patients with mental problems. Rehabilitation includes the promotion of hobbies such as horticulture while occupational therapy and other lines of work are also encouraged. Cultural shows are also held with recovering patients being given the opportunity to participate,” Dr. de Silva said.   

She also pointed out the importance of the media in promoting community awareness on mental health and eliminating the stigma and discrimination attached to mental disorders, while emphasizing on the need for responsible and ethical news reporting so as to avoid negative outcomes among the populace. Investing in mental health, she said, could prevent disability and premature death.  

Depression is on increase

WHO Mental Health Officer Suveen Thirapathy focused on the key factors concerning depression in Sri Lanka. He said people suffered from both mild and severe depression, with women being more prone to the problem.  

 
“Depression has been gradually increasing over the past few years since 2015. It can affect anyone between the ages of 5 and 70, with those between 50 and 69 years being in the majority. Only 40% of people suffering from depression obtain treatment while others are hesitant because of the stigma attached. There are comprehensive mental health programmes but only a few benefit from them,” Mr. Thirapathy said.   

He described the symptoms of depression as sadness, loss of energy, loss of interest in daily activities, loss of appetite, difficulty in concentrating and irritability and restlessness, eventually resulting in suicide if left untreated. Mr. Thirapathy spoke about the somatic factors of mental disorders and about Sri Lankans being hesitant to admit they were depressed and complaining about chest pains and headaches instead. 

He said the best cure for mild depression was to talk to someone while psychiatric treatment should also be sought for more severe forms. “Having a supportive network consisting of family members, friends or family doctors is helpful. With the right kind of support and treatment, depression can be overcome easily. Meditation and exercise are other ways to deal with the problem,” Mr. Thirapathy said.  

Talking about Depression is the best cure

Kothalawela Defence University’s Consultant Psychiatrist and Senior Lecturer of the Faculty of Medicine, Dr. Neil Fernando spoke on community-based perspectives on mental health. He explained how negative thoughts could lead to negative emotions and finally to negative behaviour and suicide. He pointed out that the best cure for depression, or ‘vishadaya’ in Sinhala, was talking about it. Talking not only spreads awareness on the problem but also helps get rid of the stigma.

  
Dr. Fernando said depression was nothing unusual and gave examples of famous people including Abraham Lincoln, Sir Winston Churchill, Beethoven, Edwin Aldrin and in Sri Lanka, actress Anoja Weerasinghe, who were known to have suffered from the disorder.    “Among those most prone to suffer from depression are women, especially mothers, who are vulnerable to both prenatal and post-partum depression. There have been cases of mothers committing suicide with their young children following suit. Midwives have now been trained in Sri Lanka to detect symptoms of depression in mothers” Dr. Fernando said. She added that other victims of depression include students who have to deal with school pressures and are pushed to perform well in their studies, urging teachers to advise such students if signs of depression were detected.

  
He said men were usually the most reluctant to discuss their emotions and most likely to turn to alcohol and drugs but that they too should be encouraged to talk about their problems rather than keep them hidden.   

Dr. Fernando said another important section of the population vulnerable to depression are the elderly. “The elderly population in Sri Lanka is increasing with most of them suffering from loneliness with no one to talk to. It is important to detect any signs of depression in them,” he said.    Referring to preventive measures, Dr. Fernando said early recognition was important in preventing suicide while staying connected to family and friends and seeking professional help were also necessary.    He said depression was a result of chemical changes occurring in the brain and that daily physical exercise such as walking for 30 minutes in the morning was beneficial and would help a person get through the entire day. “Exercise also helps release endorphins in the brain. It is a feel-good hormone that will greatly reduce negative emotions,” Dr. Fernando said.   

He highlighted the need for people suffering from depression to engage in some useful activity or hobby.   

 “Depressed people will feel like they don’t want to go anywhere and stay in bed. This worsens the problem. Do the opposite of what you want to do. If you want to stay in bed, go out instead. Do something you enjoy, it will help get rid of negative thoughts,” Dr. Fernando said and added that it would be difficult to get into this pattern but it would be helpful in the long-run.   
He said depression could be almost as disabling as cancer if nothing was done and there was an urgent need to spread awareness on how best to overcome the disorder.