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Health & Fitness

Depression and mental illness link

Depression
There are millions of people in the world who suffer from depression every day. FILE PHOTO | NMG 

“How can one tell between depression and other forms of mental disorder? I have a colleague who has drastically changed from a loud mouth to a quiet and withdrawn person and some of her friends suggest she could either be depressed or having some sort of mental condition”

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There are millions of people in the world who suffer from depression every day. Sadly, only a small number is recognised to be depressed, and even a smaller number receives the treatment they deserve.

Both, the World Health Organisation (WHO) and American Psychiatric Association (APA) have clear definitions of what a depressive illness is, and a quick google search will answer your question. That said, it is important to state that the way depression presents depends on many factors.

In children for example, the child (or teenager) might not show classical symptoms of sadness and withdrawal. A teenager might present with marked mood swings and a drop in school performance. Many boys and girls who receive punishment for “bad behaviour” and or poor class performance turn out to be depressed. A clever child with poor grades is often clinically depressed.

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A few months ago we saw a 17-year-old girl who, in the space of a few months , had changed from being a model child and top student to an adolescent out of parental control. She skipped school, smoked and went to nightclubs with “all the wrong company”. She was clearly posing grave danger to herself and the parents enlisted the help of the extended family to bring her to hospital. Following further evaluation, it was established that she was suffering from a depressive illness.

The main symptoms in her case resembled, “normal adolescent behaviour” and included extreme irritability, fatigue, change in sleeping patterns (sleep during the day and awake at night), mood swings, and marked social withdrawal (spent all her time in her room and away from the rest of the family). During her stay in hospital, she confessed to episodes of extreme hopelessness, feelings of guilt as well as thoughts of killing herself.

Once, she had jumped in front of a matatu, but was not hit because the driver swerved out of her way in the nick of time. She was slapped a few times by the angry passengers! They had failed to see her attempt at suicide as an illness! All they could see was a “spoilt brat”.

A combination of Cognitive Behaviour Therapy (CBT) and medication got her back on the straight and narrow. She is back to school, at the top of her class and now runs a school group on the early recognition of depression in adolescence. Her parents and teachers continue to talk about their amazement at how quickly she changed back to her old self.

At the other extreme of life was a 77-year-old grandmother who was brought to our attention because “she had lost it”. She could no longer be trusted to live on her own because she had become very forgetful and kept losing things in the house.

A year earlier, she was the perfect grandmother. All her teenage grandchildren loved her company and often spent weekends with her. Her house was neat, her meals delicious and her stories of life in the 50s and 60s were most entertaining. They, in particular liked to hear her talk about her life in Nairobi, where she often went dancing wearing miniskirts and how boys wore shoes called platforms and trousers called bellbottoms. She told them of stories about the lost glory of the City in the Sun.

Within a year, she had become a shell of herself. She lost appetite, her stories dried up and her cooking became appalling. Her house was no longer clean. She was irritable and wanted to be left alone. The first doctor diagnosed Alzheimer’s disease and said nothing could be done. A granddaughter who was a medical student insisted on another opinion.

It turned out that the old lady was going through a depressive illness. It was further established that she had been through two previous episodes of depression. The first, after she left home and went to Makerere University for the first time, and the second, following the death of her mother. She was admitted to hospital and put on treatment. In the space of three months with medication she was again back to her normal self.

In the hope that you have done a google search on depression, you will already know that classical symptoms of depression include persistent sad mood, feelings of hopelessness with marked social withdrawal and disturbed sleep among other symptoms.

If in the case of your friend these symptoms have lasted more than two weeks, then the possibility is that she is depressed.

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