By Macdonald Nyirenda:
If you were still celebrating Malawi’s recent impressive efforts to have reduced new HIV infections by 63 percent, end the celebration because Malawi has another silent epidemic that affects between 6 and 8 percent of its young people.
On one hand, Malawians can be excused for being excited with success registered in the fight against HIV and Aids, especially after the 2011-16 Global Information and Education on HIV and Aids Report indicates that the country has registered a decline in the number of new HIV infections and Aids-related deaths.
On the other hand, however, the problem of depression among youths is getting out of hand, affecting the youth and, by extension, the most productive age group in Malawi. The 2018 Population and Housing Census indicates that over 66 percent of the national population is made up of youths.
According to the American Psychiatric Association, depression is a common and serious mental illness (disorder) that negatively affects how one feels, thinks and acts.
In a mist of workload on his desk, Harry Kawiya, one of psychiatrist clinical officers at Zomba Mental Hospital— the only public referral mental hospital in the country— says cases of mental disorder are increasing in the country.
“On a daily basis, we register at least six to seven cases of mental disorders. And it’s very unfortunate that the majority of people have no knowledge of depression as a serious disease,” he says.
Kawiya took third-year journalism students from The Polytechnic on a tour of Zomba Mental Hospital to appreciate the situation of mental health at the hospital.
During the walk, the students saw no less than 15 patients at the hospital receiving 4 o’clock tea while others were getting psycho-treatment from their hard-working nurse-guardians.
“The worrying thing is that most cases of depression are missed by clinicians in primary and secondary health facilities. Many patients who are suffering from depression end up being given LA as if they were suffering from malaria. In some instances, they are advised to take strong pain killers to treat body pains when, in real sense, the person is depressed,” Kawiya says.
If only youths knew the extent of depression in Malawi, they would timely seek treatment and other forms of support.
“The biggest challenge is our traditional way of conducting physical diagnosis that encourages clinicians and nurses to ask patients to tell their physical body feelings when they visit hospitals for treatment. This increases the chance for clinicians and nurses to miss symptoms of depression in a patient because most of depression symptoms are similar to symptoms of malaria,” Kawiya says.
The essential features of depression include depressed mood (feeling sad, hopeless, and empty) and loss of interest or pleasure in nearly all activities most of the day, nearly every day, for at least two weeks. Depressed mood (or irritability for kids) and diminished pleasure are the primary symptoms people are cautioned to look for when depression is suspected.
According to Kawiya, while those symptoms certainly are red flags, the truth is that depression does not always look like debilitating sadness. Some symptoms of depression can be far more subtle. Those same symptoms can also mimic other medical conditions or be dismissed as normal everyday problems.
“Identifying and understanding symptoms of depression are important first steps towards getting proper support in place to work through. Some major symptoms of depression are nausea, headaches, chronic pain, sad or empty feeling for over two weeks, feeling hopeless or helpless, losing interest in things one usually enjoys, changes in appetite, change in sleep (sleeping too much or not sleeping at all), withdrawing from friends and family, inability to concentrate, being stressed out or anxious, constant fatigue and thoughts of suicide,” he explains.
Different factors and life circumstances can contribute to anxiety and depression in young people.
“Fights with family or friends, changing schools or starting secondary school, being bullied, experiencing a relationship break-up, recent death, abuse or neglect. Sometimes depression is caused by genetic factors or biological factors like chemical imbalances.
“But studies have shown that the major cause of depression in young people is adolescence, which is a biological factor. During adolescence, young people experience changes in their bodies and social life which lead them to experiment. Many of the youth indulge in drug and substance abuse and, as a result, find themselves suffering from depression,” Kawiya says.
Left untreated, depression can lead to significant impairment in an individual’s ability to enjoy life.
According to a mental health expert and lecturer at College of Medicine, a constituent college of the University of Malawi, Chiwoza Bandawe, the effects of depression can range from minor annoyances, madness and can lead to death.
“The effects include poor coping skills, sexual dysfunction, attempts to self-medicate with drugs or alcohol, anxiety which affects performance at school, workplace and other development activities, decreased immune system functioning, family and marital problems, rejection at school or work, social isolation, self-mutilation, premature death in medical conditions and the most prevailing it leads to madness and suicide,” Bandawe describes.
Furthermore, the World Health Organization (WHO) found that depression is the second greatest reason for disability in the world.
Unfortunately, only 10 percent of these people ever receive any effective treatment.
May be it is high time interventions such as ‘Mental Health On Air’, an initiative funded by Grand Challenges Canada led by Farm Radio International in collaboration with Farm Radio Trust and the World University Service of Canada— aimed at raising awareness about teenage depression— were supported to help Malawi fight the challenge that is depression among youths.
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