Depression By Dr Kuma Gbanan
Depression is a very common condition most especially in this era of economic recession, insurgency, and kidnappings etc. At-least 1 in every 10 persons has depression.
Depression is a mental disorder characterized by persistently low mood or loss of interest in previously pleasurable activities causing significant impairment.
The core symptoms of depression include low mood, loss of interest or pleasure in activities that are normally pleasurable, decreased energy or easy fatiguability.
Other symptoms of depression include reduced concentration and attention, reduced self-esteem and self-confidence, ideas of guilt and unworthiness, bleak and pessimistic view of the future, ideas or acts of self-harm or suicide, disturbed sleep, and diminished appetite among others
The morbidity (burden) and mortality (death) that is associated with this mental condition is so huge ranging from economic loss to even death.
Some individuals might have bipolar depression (people who have had prior episodes of elevated or expansive or irritable mood); some have depression with psychotic features like delusions, hallucinations; others could have depression with concurrent conditions.
It is pertinent to state here that other conditions could have similar presentations like depression. Such conditions include anaemia, malnutrition, hypothyroidism, some drugs.
Patients who have stroke most of the time have some form of depression also.
The management of depression involves a history taking, physical/mental state examination and then treatment.
In the treatment, the biopsychosocial model is used.
Psychoeducation is very important here. Emphasis is laid on the fact that effective treatment is possible. The importance of continuing with previously pleasurable activities is helpful, the importance of maintaining a regular sleep cycle, the benefit of regular physical and social activity should be emphasized also.
People with depression should be educated so as to be able to recognize thoughts of self-harm or suicide and seeking for help when these occurs.
Medications(antidepressants) could also be used. Common medications include tricyclic antidepressants, selective serotonin reuptake inhibitors.
If there is no response to two antidepressants or no response on one adequate trial of antidepressants then consult a specialist.
Reference: mhGAP Intervention Guide For Nigeria version 1.0