Unpacking Depression: It is more than just sadness

Dr Chido Rwafa Mental Wellness

As discussed in previous articles mental health is defined as a state of well-being in which an, individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a meaningful contribution to their community.

One of the most common and sadly one of the most debilitating causes of mental ill health is depression. Depression is however, commonly misunderstood.

Some mistakenly think it is just a temporary sadness, that it is not a “real” illness, that it is the Western people’s illness or that it is some form of emotional weakness. All these are misconceptions.

Depression is real and it is found across many cultural and societal groups.

Sadness is a big part of what depression is. Depression is much more than having a bad day or feeling sad. Sadness is a feeling we can all experience when we lose someone or something we love, when we are disappointed or we face challenges in life but depression is much more than sadness.

Depression is not about moral weakness, it is a challenging condition that many courageous people face and can overcome.

What is depression?

Depression is a mental health condition where you feel sad, low, discouraged or irritable. This sadness, discouragement, low mood or irritability usually happens slowly over weeks or even months and is present on most if not all days. It does not need to have a trigger or obvious cause.

Depression comes with a feeling of fatigue, tiredness that does not go away even with adequate rest. Depression causes a profound loss of motivation and drive and a lack of enjoyment of most if not all aspects of life. Depression can affect your ability to sleep, even if you do sleep you may not feel refreshed.

This condition affects appetite; some lose their appetite and may even lose weight while others may have an increased appetite, comfort eat and gain weight. Depression may affect your ability to focus and concentrate at work or school and can result in difficulty coping with tasks and responsibilities. Some people with depression describe a type of ‘brain fog’ that interferes with their ability to think clearly. Depression can cause a crushing sense of helplessness, guilt and loss of hope.

You may not want to talk to anyone about it, you may even withdraw socially and prefer to be alone.

Those who are spiritual may feel spiritually dry and experience “dark nights of the soul” as described by St John of the Cross and Thomas Moore.

At its worst, depression can make one think that death may be a solution. These thoughts of death may then lead to thoughts to harm oneself or suicide.

Depression may also look different in different cultural and societal groups depending on how emotional illnesses are perceived in that community.

Some people with depression may have many physical symptoms, aches and pains with no defined physical cause. This may be because in some cultural and social situations being physically unwell is much more acceptable than being emotionally unwell.

Depression may look different in men vs women vs children; older people vs younger people. Depression symptoms also occur on a spectrum; it can start off mild with little effect on functionality, it may sometimes become more severe and can be debilitating and cause severe dysfunction in relationships, in our ability to work, in our ability to study and learn, in our ability to contribute to our communities.

What causes depression?

Depression like many other mental health challenges, is caused by an interplay of biological, psychological, social and sometimes spiritual factors. Biological factors that can cause depression include our genes. Depression may sometimes run in families as a partly hereditary condition.

These genes can cause us to be more vulnerable to depression particularly if we are put under stress.

Life stresses can cause us to view ourselves, others and life itself negatively, this also can contribute to depression. Difficult past and current social circumstances can also contribute to depression.

This can be a difficult childhood, difficult relationships with family or loved ones, severe grief, loneliness or even severe hardship.

Situations that cause us to lose touch with our sense of spirituality, our sense of a purpose and meaning for our lives or situations that make us feel like we have crossed our own conscience can also contribute to depression.

Ultimately all these factors can cause a strain on the brain resulting in abnormalities in brain chemistry and this results in the symptoms of depression described above

What do I do if I think I may be depressed?

  1. Acknowledge the problem: It is important to acknowledge when we are not okay. It is okay to admit that we are struggling emotionally. Often, we wear masks pretending that we are doing okay when we are actually far from that. Acknowledging that we may have depression requires us to be more emotionally aware.

It requires us to learn more about emotional health and well-being and become more emotionally literate. Keeping a journal of our thoughts can be very helpful to keep us grounded and aware of our emotions, so that we know when we need to get help. A big barrier to getting help is often our own misconceptions and misunderstanding of what depression actually is and this can hinder us from getting the help that we need.

  1. Try to make some moderate lifestyle changes: In milder forms of depression, moderate daily exercise can help to lift the mood as exercise does help our bodies to release endorphins which are natural hormones that can make us feel better. A healthy balanced diet can also help.
  2. Open up to someone you trust, ask for help: In as much as loneliness can cause depression, the situation can also make us socially withdraw and isolate ourselves and this makes depression only get worse. It is important to reach out and ask for help if you feel you may be depressed. Human beings are interdependent, relational beings. We cannot and should not live in isolation. You do not have to face the storms and challenges of life alone. Talking to someone, especially a trained health care provider can help alleviate the suffering.

Treatment of depression is multifaceted and works to address the biological, psychological, social and spiritual aspects of this condition. Treatment will involve psychological therapies (‘talk’ therapy), psychosocial interventions and may include medication in severe cases.

Reach out to your nearest healthcare provider for more information and assistance if you think you may be depressed.

Look out for next week’s article as we continue to demystify mental health and wellness when we will unpack depression in men and how men can get help.

l Association of Health Care Funders of Zimbabwe (AHFoZ) article written by Dr Chido Rwafa Madzvamutse +263714987729 www.ahfoz.org ; [email protected]

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