De­pres­sion ex­acts a heavy toll on peo­ple

China Daily (Canada) - - LIFE -

De­pres­sion is a men­tal con­di­tion char­ac­ter­ized by a per­sis­tent low mood ac­com­pa­nied by feel­ings of guilt, low self-es­teem and loss of in­ter­est in nor­mally en­joy­able ac­tiv­i­ties. It is a se­ri­ous and com­mon men­tal dis­or­der that may lead to sui­cide in some and en­tails sig­nif­i­cant eco­nomic and so­cial costs.

China’s rapid eco­nomic growth, along with grow­ing so­cial and eco­nomic pres­sures, has in­creased the aware­ness about de­pres­sion and the num­ber of peo­ple it af­fects. The World Health Or­ga­ni­za­tion es­ti­mates 350 mil­lion peo­ple of all ages suf­fer from de­pres­sion. Although re­li­able data are dif­fi­cult to ob­tain, an es­ti­mated 26 mil­lion peo­ple in China are af­fected by de­pres­sion. In the United States, ac­cord­ing to the Na­tional In­sti­tute of Men­tal Health, 16 mil­lion adults had at least one ma­jor de­pres­sive episode in 2012.

In 2009, WHO said men­tal ill­ness — which af­fected 7 per­cent of the pop­u­la­tion — had over­taken heart dis­ease and cancer as the big­gest bur­den on China’s healthcare sys­tem. Among its causes are psy­cho­log­i­cal, ge­netic and bi­o­log­i­cal fac­tors. In ad­di­tion, long-term sub­stance abuse could lead to or worsen de­pres­sion.

Peo­ple who have painful ex­pe­ri­ences such as un­em­ploy­ment, be­reave­ment and psy­cho­log­i­cal trauma are more likely to de­velop de­pres­sion, which in turn could lead to greater stress and dys­func­tion. This could be­come a vi­cious cir­cle, and needs to be bro­ken.

De­pres­sion is par­tic­u­larly com­mon among peo­ple above 65 years of age, for whom un­ex­plained mem­ory loss, sleep prob­lems or with­drawal may be signs of de­pres­sion. This is par­tic­u­larly rel­e­vant in China, since the num­ber of Chi­nese peo­ple above 65 is ex­pected to rise from about 100 mil­lion in 2005 to more than 329 mil­lion in 2050, which is more than the com­bined pop­u­la­tions of Ger­many, Ja­pan, France and Bri­tain.

In­creas­ingly, how­ever, younger peo­ple also are be­ing af­fected by de­pres­sion, per­haps be­cause of the chang­ing eco­nomic and so­cial dy­nam­ics. The eco­nomic slow­down in China, and the changes on the ed­u­ca­tion and so­cial fronts put in­creas­ing stress on the younger gen­er­a­tions, and those who can­not cope with it could de­velop anx­i­ety or de­pres­sion.

Among ado­les­cents, symp­toms of de­pres­sion in­clude in­som­nia, fa­tigue, loss of ap­petite, lower at­ten­tion span, ap­a­thy and lack of pos­i­tive ex­pec­ta­tions. If they show th­ese symp­toms for more than two weeks, they are prob­a­bly suf­fer­ing from de­pres­sion.

In some cases, de­pres­sion can lead to sui­cide. While in­Western coun­tries sui­cide is more com­mon among men than women, in China it is more com­mon among women, par­tic­u­larly ru­ral women. Un­like in the US, where many men use firearms to com­mit sui­cide, ru­ral women in China use strong agri­cul­tural pes­ti­cides that are kept in the house to take their lives.

Be­sides, stigma against men­tal dis­ease— in­clud­ing de­pres­sion— is still a so­cial prob­lem in China, as well as in most coun­tries around the world. Clinical de­pres­sion is treat­able and, if not ad­dressed, can give rise to se­ri­ous com­pli­ca­tions, in­clud­ing sui­ci­dal ten­dency.

So ef­fec­tive treat­ment that in­cludes psy­chother­apy and the use of med­i­ca­tion should be made read­ily avail­able to pa­tients, wher­ever pos­si­ble. In ad­di­tion, the use of lo­cal health ed­u­ca­tors who can reach out to ru­ral com­mu­ni­ties will be an im­por­tant step in iden­ti­fy­ing de­pres­sion among those who do not have ac­cess to men­tal health re­sources close to home.

The au­thor is a pub­lic health con­sul­tant for sev­eral in­ter­na­tional or­ga­ni­za­tions.

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