All of us, at some point in our lives, will, according to Chairman of the National Mental Health Commission, Rev. Dr. Marcus Lashley, experience depression.

This common mental disorder, characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration, impacts an estimated 350 million people across the globe and is the leading cause of disability worldwide. The magnitude of the problem led to this year’s Mental Health Day, observed on October 10, being held under the theme:?? Depression:?? A Global Crisis.

Dr. Lashley noted that although it was not an easy task to give a single straightforward analysis on what depression was, one of the earliest definitions was still appropriate. "And, that is," he said, "the person having a deeply personal experience of living in a fog. That’s how most persons suffering with depression will tell you how they feel… It is the body responding to several different things, but it is where the individual is withdrawing from society and from things that give them pleasure.?? So, there is isolation and the body is in a state of almost shock, where it is difficult for them to operate under normal conditions," he explained.??

A person who is depressed, apart from isolating themself, might display a number of symptoms that vary depending on age and the individual.?? They might no longer show interest in things that would normally be of interest to them; may be irritable and not capable of thinking as clearly as they normally would, thus resulting in impaired judgment and cognition.

The Clinical Psychologist indicated that regular, yet unfortunate life events could also lead to depression, such as the loss of a job, a relative or a friend.?? Dr. Lashley, however, cautioned that in terms of the loss of a loved one, persons needed to distinguish between "normal grieving" and depression.

"…When people go outside of what is normal, either for that person, or the culture in which they live, then it can lead to depression, where there is a sense of helplessness, that life is worthless, and there is nothing to live for.?? In addition, you get the other symptoms associated with depression; for instance an inability to get up on mornings and start the day, [attention to] personal self-care and grooming, the inability to coordinate things that you would normally be able to coordinate before," he indicated.??

The condition can be linked to external, as well as internal biological factors.?? In countries where there are changes in seasons, for example, persons might develop seasonal affective disorder, which may lead to depression if they do not receive treatment. People who move from one country to another might also experience adjustment disorder because they may not be able to adapt quickly enough, and that too, could lead to depression.?? ??????????

Illness, caring for someone who is sick for a prolonged period; dealing with ageing and changes in a person’s life, could also cause depression he said, adding: "I know a number of persons are involved in the care of elderly relatives especially with Alzheimer’s and seeing that person slip away from you, you can’t identify them anymore, the person is gone and they don’t recognise you anymore.??

"And, of course there are the internal factors where there is a change to yourself, either physically or biochemically. So, stroke victims, persons who have had heart attacks, persons who are going through cancer treatment, amputees, persons who have lost parts of their body, through mastectomies and so on, those are persons who can very easily go into depression and have to be monitored for such.?? And, of course, as you get older your capacity to remember things diminishes.?? Many persons may become depressed because they are not as sharp as they used to be and life is a little bit more stressful in doing some of the everyday things that they did before with tremendous ease."

There is also a link between times of financial difficulty and depression as persons struggle with the capacity to earn and ???make ends meet’.

"If there is an absence of money because of either the loss of a job or regular income, then it can impact how you feel and that can also lead to depression.?? If people are doing well and the economy is good, then people are able to have a certain standard of living and they are less concerned, at that point, about where the next cheque is going to come from. They are ok. They are in a good mood.?? Depression is about mood and, therefore, it puts them in a mood where they are extremely concerned about the future, their capacity to live now and also their sense of happiness in their future," he remarked.

The mental health expert noted that pharmaceutical interventions could work for some persons, but were more successful in certain types of depression and with particular age groups.?? He, however, emphasised that relationships played a significant role in the quality of a person’s life and how they dealt with depressive episodes.??

"There is a tendency to downplay the fact that how we live with each other impacts our psyche, especially in the workplace.?? In Barbados, for example, I can tell you beyond a shadow of a doubt, that many of the people who take time off from work do so not just because of a physical illness but because they just can’t deal with the persons sitting next to them anymore," he observed.

Dr. Lashley advised the public to take note of the changes that were taking place in their lives and their emotions and also urged those who were feeling depressed to first be tested to ascertain if it was indeed depression or just a "case of the blues". He suggested that persons who have been diagnosed as depressed should explore confidential talk therapy with someone who is trained in psychology, to discuss the motivation behind their temperament, how it impacts they and how they process information.

Where you go for help will depend on the nature of the problem, your symptoms and what best fits you. Often, the best place to start is by talking with someone you trust. Also, ask for referrals and recommendations. These may come through friends, family, clergy, health care providers, or other professionals whom you know well and consider trustworthy.?? There are also trained consultant psychiatrists at the polyclinics or you may speak with your private medical practitioner.????

The National Mental Health Commission, established in 2008,?? is according to its Chairman, working diligently to help persons in the community to recognise and champion mental health issues.?? They have so far trained first responders, members of the faith-based community and persons in various industries.

"The goal is to have, in every major industry, at least one person who will raise mental health issues… The Commission is looking at the continuation of training of persons and focusing on community-based work – helping people in the community to understand the importance of mental health and possibly the creation of facilities to help people transition back into everyday life," Dr. Lashley surmised.??

The Commission was established to act as advisor, facilitator, enabler and supporter of the National Approach to the Mental Health Reform Programme.?? It’s mission is: To heighten public awareness and increase sensitivity to the various issues affecting persons suffering from mental health issues.

Commissioners include clinicians from the mental health field and representatives from the faith-based community, the Ministries of Housing and Lands and Social Care, Constituency Empowerment and Urban Development and the Royal Barbados Police Force.?? There is also an attorney-at-law, a social worker, President of the Barbados Alzheimer’s Association and a patient advocate who has utilised mental health services.

For more information on mental health, depression or the National Mental Health Commission, visit http://mentalhealthcommission.gov.bb/.


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