Tuesday, May 13, 2014

Depression is never the patient’s fault

By Lukoye Atwoli
Sunday Nation 11 May 2014

It is heartening that Kenyans are beginning to see the importance of mental health, and many are beginning to ask questions about how they can improve it. The media has been extremely helpful in this regard, with pieces in the print and electronic media tackling this difficult subject. In this regard, one could safely conclude that the citizens are ahead of their government.

As the government dithers and prevaricates, Kenyans continue to suffer from the debilitating effects of mental ill health. Suicides, homicides, road traffic ‘accidents’ and incidents arising from illicit alcohol use are just some of the outcomes that have become very prominent lately. In response, the government prefers to tackle only the symptoms.

Brewers and consumers of all kinds of alcohol are arrested and processed through the criminal justice system, while nothing is done to deal with the underlying causes. Suicide attempt is still a criminal offence under Kenyan law, although prosecutions and convictions are rare largely due to humane interventions by prosecutors and judicial officers. Interestingly, in the midst of this mental health crisis, the government saw it fit to disband the Division of Mental Health in the Ministry of Health despite clear legal provisions for it.

Increased media coverage obviously cuts both ways. The media can serve to inform and educate the public about mental health, but occasionally some misleading information may be sneaked in, often by good-intentioned individuals. This can only be prevented by inclusion of experts who would then moderate the message and ensure that only accurate information is fed to the public.

A case in point is a recent programme discussing depression and suicide on one of our local TV stations, in which the moderator kept asking participants why they got depressed. In summing up the discussion, one of the panellists suggested that depression can be prevented and even managed by a simple change of attitude. It was in fact stated that ‘depression is a choice’, and that a depressed person can choose not to be depressed.

This is an unfortunate assertion that does more harm than good. Depression is a mood disorder characterised by a profoundly low or irritable mood most of the time over a significant period of time. Other features of depression include changes in sleep and appetite, impaired attention, concentration and memory, a sense of worthlessness and hopelessness, excessive and inappropriate feelings of guilt, slowing of thought and even developing ideas of suicide.

A normal person would never wish to feel depressed, because the pain and anguish associated with depression is so severe that it is often considered more debilitating than physical pain. A depressed individual will initially try all interventions available to them to deal with their depression. They will pray, try to be ‘strong’, use herbs and even try to adopt a positive attitude.

The fact that their depression persists and gets more and more severe is evidence that all these interventions have been unsuccessful, and they need professional help. Throwing the ball back into their court and suggesting that they are responsible for their illness only serves to make things worse, and can drive some to contemplate suicide. It exacerbates their feelings of guilt and may just push them over the edge.

People with depression need supportive family and friends, but above all, they need professional help. 

Dr Atwoli is a consultant psychiatrist and senior lecturer at Moi University’s School of Medicine. lukoye@gmail.com


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  2. Really interesting point of view! I've never thought about it, but I reckon that music can also help to get rid of depression, read an article about it on https://tuko.co.ke/192298-horses-and-boots-how-frequently-listening-to-music-can-affect-your-life.html
    Guys, what's your opinion on music therapy?

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