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Nigeria is a country that is growing and evolving at a rapid pace. For those who live and work throughout Nigeria, the change sweeping the country is both good and bad.

In terms of good, it can be seen in the perceived increased opportunities for students and professionals as well as, a growing marketplace that allows entrepreneurs to sell their goods in order to grow the new economy. On the flip side, the bad comes into play when people try to figure out how they fit into the new Nigeria and try to cope with the difficulties that arise with changes in their way of life; especially if it is unwanted.

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The recent and unfortunate suicide of Dr Orji, who jumped off the Third Mainland bridge in Lagos, was greeted with shock by many Nigerians. Here was a man who seemed to have it all, the right job, a car and other trappings which no doubt made him the envy of many. Since Dr Orji's suicide, numerous other cases of successful and attempted suicides across Nigeria have come to light: business women, students, showbiz personalities, professional men and women. All living in the silent hell unable to tell the world about their pain and helplessness.

Understanding and Accepting Depression

In Nigeria, the idea that depression is a clinical condition that requires treatment is almost unheard of. However, as the country's lifestyle continues to evolve, it is shown that 4 out of every 10 women and one out of every 10 men are being diagnosed with some form of clinical depression.

The most common response to depression, especially among Nigerian women, is that depressed people should "get over it" and "get on with life." This attitude represents a chronic misunderstanding of the difference between stress (which is generally emotional) and depression (which is clinical).

Depression is a recurring feeling of emptiness and loss that can become serious over time. Unipolar depression is characterised by long bouts of sleeplessness, anxiety and even suicidal thoughts that do not dissipate. Bipolar depression incorporates the same symptoms as unipolar depression but with added manic behaviours such as: violent mood swings, paranoia, substance abuse and unexplained aggression.

Stress is the mind's negative response to a seemingly, overwhelming amount of daily responsibilities. As Nigerian society advances, the stress people feel is also increasing. On a positive note, stress can be handled by simply focusing on important tasks or deciding to become more organised in one's daily life. Depression, on the other hand, cannot be “explained away” nor can it be treated by a simple to-do list. Depression affects the body chemically, emotionally and psychologically and only a trained expert can properly treat it.

The Real Face of Nigerian Depression

Depression can affect anyone; it does not discriminate based on: gender, religion, social status or geographic location. Take as an example the true story of a Nigerian student named Gabriel, who seemed to have had the whole world in his hands. Gabriel's best friend tells the story of an ambitious, young man who was confident in himself; ambitious in his goals and was looking forward towards the future. Gabriel's friend started to notice changes in him when they both entered secondary school. Gabriel made indications that he was unsure of himself and was no longer enthused about the future. From the friend’s point of view, something was wrong with Gabriel but no one could put their finger on it.

Gabriel started to display the classic symptoms of depression that included: irritability, violent outbursts, inability to focus on his schoolwork and a constant feeling of confusion. Gabriel was prone to problems with typhoid and malaria and these recurring issues allowed Gabriel's friends and family to dismiss his mood swings and considered them to being a part of his medical challenges. However, things changed drastically when Gabriel was in university; he sought treatment for what he thought was salmonella. The doctor told Gabriel's parents that their boy was clinically depressed- the news hit everyone hard.

It wasn't until after Gabriel's diagnosis that his best friend learned that Gabriel was also suicidal. The shock of hearing this news caused Gabriel's best friend to rethink his perception of depression. The face of depression in Nigeria, in this case, is that of a young man with a bright future. If depression can strike Gabriel, it can strike anyone.

The Causes of Depression

In Gabriel's case, his depression was caused by his confusion about his place in the world. This can be one of the most common causes of depression, especially in the 20 percent of the Nigerian population that has been diagnosed as being clinically depressed. As society changes, people no longer understand what is expected of them, this can lead them to the early symptoms of depression.

It is important to know that even people who are confident in who they are and what their future holds can become depressed. The growing Nigerian economy means that finding a job can be a challenge, even for people who spend years getting what they consider to be the right education for their professional futures. When people experience a significant failure, such as not being able to find the job they want, they can sink into a depression. People who are unhappy with their jobs, their current relationship or the events taking place within their family, can also start to experience depression.

In some cases, depression is a genetic condition. Some people are just prone to fall into that deep hole of depression and not being able to find their way out. Gabriel's example could very well be a case of genetic depression, as his problems seemed to come out of nowhere.

Anyone can get depressed for a short period of time but clinical depression can go on for weeks or even months. If you are depressed because your favorite sports team lost then that is something you will recover from within a few hours. Whereas, if you are clinically depressed, you will exhibit symptoms indefinitely until you are put into a treatment program.

The Symptoms of Depression

One of the biggest challenges for Nigerians who display symptoms of clinical depression is that the people around them often dismiss the symptoms as problems that everyone faces and has to deal with. It is true that the most common symptoms of depression happens to just about everyone- at some point but it becomes problematic and leads to clinical depression when those symptoms refuse to go away.

The most common symptoms of uni-polar depression include:
  • Unexplained episodes of crying
  • Loss of appetite significant enough to lead to weight loss
  • Episodes of pain or stomach cramps that do not respond to any type of treatment
  • A consistent feeling of irritability
  • Lack of energy
  • Bouts of hopelessness and feelings of being emotionally empty
  • Noticeable changes in sleeping patterns
  • Lack of sex drive
  • Inability to focus on work or make decisions of any kind
  • Suicidal thoughts
Bipolar depression has the same symptoms as unipolar depression but with added manic episodes of:
  • Talking too fast
  • An excessive amount of energy
  • Inability to relax
  • Chronic denial of obviously bad situations
  • Severe mood swings in short periods of time
  • Inability to sleep
  • Overestimating one's abilities
  • Unexplained unusual behavior that lasts for long periods of time
  • Sudden outbursts of aggressive behavior or the chronic use of profanity
  • Noticeably poor judgment
  • Unusually aggressive sex drive

Most people suffering from clinical depression will display one or more of these symptoms for weeks at a time. There can be moments of clarity but those moments neither last long nor occur very often. It is possible that a depressed person may seem to suddenly "snap out of it" for extended periods; however, the symptoms will reappear and may be stronger.

It is important to be able to discern symptoms of unipolar or bipolar depression from the unique characteristics of an individual. Some people just have poor judgment hence, it is important to observe as many symptoms as possible. People who only show signs of poor judgment are not necessarily clinically depressed but if they show other symptoms of depression along with their poor judgment then that would be a reason for concern.

Many people who are conscious of their symptoms will often try to hide them or avoid social contact so as to prevent people from noticing any problems. People who are normally sociable in some way and suddenly withdraw from contact with others, are showing another trait of clinical depression. When people withdraw from social contact because of depression, it can become extremely difficult to get them treatment.

How Your Individuality Affects Depression

People get clinically depressed for a variety of reasons and the manner in which depression affects them can be impacted by who they are. Women are susceptible to a form of unipolar depression called postpartum depression. This is a form of depression that can only occur in new mothers; it can lead to tragic results if not treated immediately. Women suffering from postpartum depression display many of the common unipolar depression symptoms and they also show little to no interest in taking care of their new child.

There is another common form of depression that strikes teenagers; it has more to do with their confusion about who they are and what they want to do with their lives. Gabriel experienced depression as he was entering his teen years which caused him to question his own future. The parents of Nigerian teens are also caught up in the sweeping changes that are happening in the Nigerian society, which makes it difficult to guide their teens into adulthood. This is forcing many Nigerian teens to try and figure out their place in life on their own, which further leads to an increase in teen clinical depression.

Nigerian women are also expected to act with grace and stability in spite of the increasing pressures of their daily lives. As a result of that it has created new levels of depression among women. Furthermore, older generations chastise the younger generations for trying to use clinical depression as an excuse to not remain pillars of strength; thus, creating a contributing factor that causes many young women to experience higher levels of depression.

From the very wealthy to the working poor, every economic class in Nigeria is affected by depression. While there are new opportunities opening up for the working poor throughout the country, the intense competition to take advantage of those opportunities is creating more cases of depression. The wealthy are finding it difficult to cope with a progressive society that no longer accepts the gap between the rich and poor to become what we call a normal part of everyday life.

Age, gender, religion and status all create different challenges for Nigerians when it comes to clinical depression. With a dynamic society, people tend to become more confused as change becomes more prevalent. With confusion comes depression and the constant need to remain competitive in a growing economy is also causing people to falter under the pressure in order to find their way in the new Nigeria.

Why do Nigerians Suffer in Silence?

When we say that 40 percent of women and 10 percent of men are diagnosed as clinically depressed, we recognised that those numbers are not all inclusive. Many Nigerians prefer to suffer with depression in silence as opposed to getting clinical help or even reaching out to their community for assistance.

The stigma attached to admitting clinical depression comes from this transitional stage that Nigeria is currently in. When someone shows signs of depression, many people attribute it to the effects of the mass who is suffering from many of Nigeria's working poor experience. Since everyone feels like they are suffering, no individual is allowed to single themselves out as suffering to a greater degree than others. It is the Nigerian’s public's lack of understanding when it comes to the real dangers of clinical depression that force people to suffer in silence.

Nigerian doctors are now starting to understand how to properly identify and treat clinical depression. Treating depression is not a simple task and it takes dedicated medical experts to be able to offer the right kind of treatment for each individual case. It was not until recently that Nigerian doctors accepted the idea that clinical depression is not only real but it is also extremely dangerous.

As the medical community continues to take depression seriously, the hope is that depressed people are no longer forced to deal with their condition on their own due to the stigma attached to it. Clinical depression is not something a patient can handle on their own. When the misguided public opinion of depression causes sufferers to stay silent, the results can often be tragic.

How to Treat Depression

Depression can be treated in three primary ways: community support, psychological therapy and medication. In some cases, doctors will recommend a treatment regimen that includes all three of these options, while other cases can only be handled using the proper types of medication.

Community support can come from family members, friends and the local religious communities. More church groups and community support organisations around the country are recognising the importance of treating clinical depression and they are offering help in a variety of ways. The promising news is that most of these groups realise that treating depression is a delicate process; that is what has led to the inspiring the creation of a variety of support options.

Psychological therapy is something that should only be done by a licensed and trained professional. A professional therapist will work with the patient's primary doctor to help uncover the reasons for depression and then determine the right course for treatment. Psychological therapy can be an extremely complicated process but it can get results that medication and community support cannot get.

In some cases, medication is necessary to address physical elements that cause depression. The term "chemical imbalance" is common and is an accurate representation of what depression medication attempts to do. Furthermore, there are common medications that doctors use to address certain types of depression as well as, there are other medications that help to enhance the anti-depressants and give the patient the clarity they need in order to get past the physical side of their condition. In many cases, the use of medication is coupled with community support and/or psychological therapy so that the best results can be attained.

Nigeria's society is rapidly evolving and those changes are not easy for many people to handle. Stress comes from feeling overwhelmed with daily responsibilities and can be handled in a variety of simple ways. Clinical depression is a medical condition that requires professional treatment and emotional support for it to be handled properly.

In contrast, there is a stigma surrounding clinical depression that forces many Nigerians to suffer in silence. The public in general sees clinical depression as a way out of taking responsibility for one's obligations; that attitude makes it difficult for sufferers to seek out help. As Nigeria continues to evolve, there needs to be a movement to help depressed people to better be able to speak out comfortably about their condition as awe as, to seek the help they need in order to become productive members of the new Nigeria.

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This is the feature article in this week's NB Weekly
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While it is true that not all human beings react act the same way to the same situation: health, economic or social status. It is most likely that health challenges like infertility among other causes of depression may lead the sufferers, aided by family pressure, to commit suicide

Suicide itself is a confessional act that life is not worth living. But the people who place value on their life irrespective of any challenge would have overcome the absurdity in contemplation of suicide.
 
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