“No be for Naija, We Love Life”: Demystifying Depression in Nigeria

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Editor’s Note: This week’s Thought Leadership piece comes from Dr. Mike Adeyemi Lawal, he is a physician with experience in Global health, operational research and advocacy. He demystifies the misconceptions that many Nigerians have about depression through a simple question and answer format and reminds us all that depression “no dey show for face.” 

End of year festivities are always a great time to hang out with friends and family, reflect on the events in the year and catch up on all the activities that you have missed out on in others’ lives. At one of those hangouts, the topic of depression and suicide popped up and I was quite shocked at the level of misconception surrounding this topic.
 
Depression is a common and serious medical illness that affects how you feel, the way you think and how you act. It is different from usual mood fluctuations and short-lived emotional responses to challenges in everyday life. Especially when long-lasting and with moderate or severe intensity, depression may become a serious health condition. It can cause the affected person to suffer greatly and function poorly at work, at school and in the family.

While working as a junior casualty doctor in the Accident & Emergency section of a tertiary facility in Nigeria, a teenage girl died a few minutes after arriving at the facility with a history of ingestion of the insecticide popularly called “sniper”. The incident resulted from an unresolved argument with her siblings and because no one bothered to listen to her, she killed herself. The trigger for suicide from a depressed mind could be as simple as this.
 
Sadly, I have noticed that in suicide cases, the victim is seen as the villain. It is not uncommon to hear comments like “That was so selfish. Why would he/she do that? That’s not fair on his/her spouse, children or parents”. To demystify depression and hopefully help people understand why a depressed person would want to take their life, I decided to do a Q&A on this topic devoid of technical medical terminology.

Depression is a common and serious medical illness that affects how you feel, the way you think and how you act. Photo credit: Nigeria Health Watch

What is the noise about depression, after all, everyone feels sad?
No, depression is way more than just feeling sad. It is an illness that requires a great deal of care; however, unlike illnesses that affect physical health, depression, on the other hand, affects mental health and in its worst form, can lead to suicide.
 
It is evil to think of suicide or even commit suicide, what is wrong with this generation?
Suicide resulting from depression is not a form of martyrdom or a way of abdicating responsibility. Severe forms of depression bring about suicidal thoughts which the individual cannot control. In some cases, the individuals hear voices urging them on and this does not make them witches or wizards. It is an imbalance in what is referred to as neurotransmitters. These are types of hormones in the brain that transmit information from one nerve to another.
 
Why the sudden increase in the number of suicide cases?
According to WHO, depression is a common illness. Globally, over 300 million people are affected and 7 million of these cases might just be your neighbours, friends or family members if you live in Nigeria. Depression is a leading mental disorder among those who die by suicide and for every suicide, there are more than 20 attempts.

Image credit: Nigeria Health Watch

No be for Naija, we love life!
Really! Depression is not new to our society. Although the paucity of data and sociocultural beliefs reflect otherwise, Nigeria is currently ranked 15th in the world for suicide with a risk of one suicide in every 6,000 population. Depression has been culturally stereotyped, and suicide extremely stigmatised and these have presented a huge obstacle to accessing care and collating quality data. Nonetheless, the advent of social media has led to increased ease in disseminating and sharing of information.
 
Why would someone be depressed to the extent of committing suicide, particularly a young person with good prospects in life?
Suicide is the second leading cause of death among young people and depression is a major risk for suicide. There is no one single cause of depression; however, it flourishes on several risk factors. Top among them is a family history of depression, loneliness, traumatic experiences like rape, emotional assault/abuse, loss of loved ones, job loss or failed investments with no proper care.
 
How do I identify signs of depression?
As is commonly said in Nigeria, “e no dey show for face”. Signs of depression are often not obvious but these behavioral changes could be pointers; feeling of worthlessness and hopelessness, as well as loss of interest and energy. Others include withdrawal, poor sleep patterns, poor eating habits, a feeling of guilt and poor concentration. All these may not become obvious at the same time but they are often a continuum culminating in suicidal thoughts.

Suicide is the second leading cause of death among young people. Photo credit: Nigeria Health Watch

How do I help?
There are 7.7 billion people in the world. Loneliness and lack of emotional support are increasing. Relationships and communal support are becoming shallow. That neighbor who has suddenly become withdrawn might need someone to talk to and you might just be the right person. You can also help by becoming familiar with organisations and experts who offer mental health support, so that you can point someone to the right direction if they are struggling. For instance, Mentally Aware Nigeria Initiative (MANI) raises awareness on mental health and illnesses and connects people with mental health illness with mental health professionals.
 
Suicide is preventable, and depression is treatable. Depression, like most illnesses, requires the care of specialists. Some of these thoughts wouldn’t go by wishful thinking, and a specialist can help you understand and deal with the root of depression.
 
Are you or somebody you know experiencing some or all the signs listed above? Don’t despair, depression is treatable. Organisations like mentallyaware.org, Talk Mental Health Naija can help connect you to specialists, or you may reach out to a mental health expert close to you.

BIO: Mike Adeyemi-Lawal is a Medical Doctor with Medicins Sans Frontieres (MSF) with professional experience in Programmatic Health Systems Strengthening, Humanitarian Emergency Response and Population-based surveys in resource-limited settings. He is @AdeyemiML on Twitter.

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