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High Prevalence of Depression amongst Females
in Chitral
This is with reference to Dr. Farman Nizar’s Letter published in
Chitral Times on March 25, 2010. The title of the letter is High
Prevalence of Depression amongst Females in Chitral. In his letter
Dr.Nizar raised very important concern of clinical mental illness
known as depression among females 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 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/
http://search.who.int/search?ie=utf8&site=default_collection&lr=lang_en&client=WHO&proxystylesheet=
WHO&output=xml_no_dtd&oe=utf8&q=depression&Search=Search&sitesearch
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
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