Rawalpindi: More than 300 million people are now living with depression, an increase of more than 18 per cent between 2005 and 2015. The number of persons living with common mental disorders is globally going up, particularly in low-income countries including Pakistan, because population is growing and more people are living to the age when depression and anxiety most commonly occurs.
Lack of support for people with mental disorders coupled with a fear of stigma prevents many from assessing treatment they need to live healthy and productive lives. Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ in connection with World Health Day, which is celebrated on April 7 every year with different themes to mark the anniversary of the founding of World Health Organization in 1948.
The theme for World Health Day this year is: “Depression: let’s talk”. The overall goal of campaign is that more people with depression, everywhere in the world, both seek and get help. Depression is single largest contributor to global disability with 7.5 per cent of all years living with disability in 2015 and major contributor to the overall global burden of disease.
Dr. Ashraf said it accounts for 44.6 per cent of total disease burden from mental illness in the Eastern Mediterranean Region (EMR). Depression is also a major contributor to suicide deaths which number close to 800000 per year, means one suicide every forty seconds. Suicide is the second leading cause of death among people aged between 15 to 29 years globally. Depression is more common in females (5.1%) as compared to males (3.6%), he said.
To a query, he said mental disorders including depression are taking an alarming toll on people in Pakistan also because of social adversities, political instabilities, lawlessness, denial of justice, terrorism, economic disparity, problems with security and safety and afflicts 10-16 per cent of population; with a large majority of those affected being women. Depressive disorders are affecting 4.2 per cent of total population in Pakistan and percentage of total years lived with disability (YLD) are 7.1 per cent whereas studies carried out in capital cities show that 34 per cent people are depressed, said Dr. Ashraf.
He added Pakistani women face even greater risk as frequent targets of domestic violence, toxic-in-laws, and are constant victims of gender inequality. With such a volatile environment; one can only foresee that mental diseases will be a growing problem, he said.
The risk of becoming depressed is increased by poverty, social isolation, conflicts, terrorism, unemployment, life events as the death of a loved one or a relationship break-up, physical illness, losing job or income, getting divorced or retiring, chronic pain and problems caused by alcohol and drug abuse. Stress can make depression worse, said Dr. Ashraf while talking about causes behind depression.
He added that there are strong links between depression and other non-communicable disorders and diseases. Depression increases the risk of substance use disorders and diseases such as diabetes and heart disease; the opposite is also true, meaning that people with these other conditions have a higher risk of depression, he said.
It is worth mentioning here that mental health in Pakistan is a neglected field and a little or no money is allocated to mental health services. There is acute shortage of mental health workers. Moreover, most mental health workers in our country are not conversant with modern methods of treatment of mental illnesses and often do not possess the necessary skills to deal with it.
Dr. Ashraf said depression can be effectively prevented and treated. “You can take various measures if you think you are depressed. Talk to someone you trust about your feelings. Most people feel better after talking to someone who cares about them.”
However, stigma surrounding mental illness including depression remains a barrier to people seeking help throughout the world, he said. He added that in addition to talking, seek professional help. Keep up activities that you used to enjoy when you were well. Stay connected. Keep in contact with family and friends. Exercise regularly, even if it is just a short walk. Stick to regular eating and sleeping habits. Avoid alcohol intake and refrain from using illicit drugs; they can worsen depression, suggested Dr. Ashraf.
To a query, he said although there are known, effective treatments for depression, however, even in developed countries fewer than half of those affected are not diagnosed or treated and percentage soars to between 80 and 90 percent in less developed countries. Barriers to effective care include a lack of resources, lack of trained health-care providers, and social stigma associated with mental disorders, he said.
He said effective community approaches to prevent depression include school-based programs to enhance a pattern of positive thinking in children and adolescents. Interventions for parents of children with behavioural problems may reduce parental depressive symptoms and improve outcomes for their children. Exercise programs especially for the elderly can also be effective in depression prevention. Surely there is peace of heart in remembrance of Allah. Do not lose hope in Allah’s mercy, he said.
He added that government needs to dedicate more of their health budget to mental health. Moreover, medical colleges should give incentives to their students to specialize psychiatry training. Instead of providing care in large psychiatric hospitals, mental health should be integrated into primary health care, should be provided in general hospitals and community-based mental health services should be developed, said Dr. Ashraf.
He suggested that public awareness programs addressing mental health issues should be launched through media. Raising awareness about contributing factors of depression and training physicians to look for behavioural manifestation of depression are some very effective measures, concluded Dr. Ashraf.