This is with reference to Dr. Farman
Nizar’s Letter. in which he has raised very important concern of
clinical mental illness known as depression among female in Chitral
which is often neglected, misunderstood or confused with other physical
symptoms.
Before going into further details about this topic, I would like to
acknowledge Dr. Nizar for initiating discussion and raising awareness
about this very important mental health concern.
Depression is a very old phenomena and very well recognized across the
continents. It affects both genders, male and female. Some of the
research indicates that worldwide, depression affects 15% men and 25%
women at some point in their lives which accounts for more than one
hundred million individuals. But, having learnt from Dr. Nizar’s letter
that 60% of Chitrali women are suffering from depression was definitely
quite alarming. However, depression is not isolated to Chitral. While
researching this topic, I was very shocked to find out that three
million Canadians have serious depression and only on third seek help
(Mood Disorder Society of Canada).
There has been a tremendous amount of research done in this area in
various countries and undeniably there are many factors that have been
identified which contribute to depression. Contributing factors are
influenced by social, spiritual, biological and psychological factors.
At this point, it is difficult to determine the factors leading to an
increase in depression rates in Chitral, without further research. The
health care institutions in Chitral must look into this problem
systematically and figure out what can be done to control the early
onset of depression as well as, explore the many treatment options
available in treating women who currently have this condition. Immediate
attention needs to be paid to this area as research in this particular
field indicates that depression among women is passed onto their
children thereby leading to a cycle. Before going into further details,
let’s first briefly define depression.
Clinical depression is a serious mental illness that intensely affects
how we feel, think and eventually behave. In severe cases, depression
can last for years and rob lives or can cause permanent disability. It
is deep, painful and distressing disorder that it best managed with
external support mechanisms. It is an illness that needs to be taken
seriously and needs instantaneous attention. Each individual manifests
symptoms of depression in her/his own distinctive way and the causes and
affects are also unique for each individual.
There are so many symptoms associated with depression. Some of the
common symptoms include: change in appetite, decreased energy, sleep
disturbances such as sleeping all the time or having difficulty in
falling asleep, feeling weakness, headaches, muscle aches and pains,
having difficulty in remembering things, personal inadequacies,
hallucination, loss of interest, hopelessness and excessive guilt.
Regrettably there is no scientific tool such as ultrasound or X-ray
machines to diagnose depression. Only a series of questions can be asked
by the physician to determine the condition and in diagnosing the
severity of the illness. As the learnt, Dr. Nizar indicated in his
letter (for further reading of this letter, refer to Chitral Times) that
patients come to District Headquarter Hospital Chital and complain of
physical symptoms such as pains and aches however upon complete physical
examination through X-rays or blood tests, the person doesn’t seem to
have any underlying ailments to cause these symptoms. This is the first
indication that the person may be confusing physical symptoms with
depression.
There is no proven evidence as to what exactly causes depression.
However, there are a number of different theories referring to the
varying factors that may cause depression such as chemical imbalances in
the brain or family history. It also linked to stressful events such as
death in the family, job loss, over use of medication, negative
thinking, lack of will power, history of childhood physical and/or
emotional abuse, trauma, medical illness, lack of social support, low
income, unemployed and stigmas attached to unmarried individuals. In
women particularly, factors that may possibly cause depression include
oppression, childbirth and menopause. Regardless of what causes
depression, it is important to know that depression can be successfully
treated if the individual seeks help and is properly diagnosed.
Some of the treatment options involve medications, psychotherapy,
cognitive therapy, interpersonal therapy, peer/social support, and in
severe cases, hospitalization to ensure the safety of the individual
themselves as well as the safety of others. Each of the treatment
options have not been elaborated in this article due to limitation of
time, however if there is further need or interest, more in dept
information on above treatment options can be provided.
Depression is a treatable disease that can intermittently affect any of
us throughout our lives as it caused by either external or internal
factors. Knowing the symptoms and taking action, early on, to seek help
will assist in controlling symptoms and in enabling one to live a
productive and fulfilling life. Support from family and friends are
another strong tool in dealing with depression. I agree that the launch
of a mental health program in Chitral, one specifically targeted to
different gender and age groups, is the big step towards successful
rehabilitation of individuals experiencing depression. An extensive
network of players within the health care system in Chitral will need to
collaborate to support and advance this initiative.
Below, you will find websites including the World Health Organization
which contains videos, research papers, resources and tools to deal with
depression effectively. More importantly, some of the literature
contains questionnaires to determine the contributing causes of
depression and gauge the severity of the condition.
http://www.depression.com/understanding_look.html
http://www.who.int/mental_health/management/depression/definition/en/
Another website is of the Brigham and Women’s Hospital, Boston , MA ,
USA , a Harvard Medical School Teaching Affiliate, which again provides
a comprehensive study called “Depression, Taking care of your emotional
health.”
http://www.brighamandwomens.org/patient/Depression.pdf
Mir Hassamuddin
Milton Ontario, Canada
13 April 2010.
