It’s okay not to be okay! Seek help for depression promptly

In my work with children, I have found parents to be resistant to seeking help for their children when faced with a mental disorders like depression and other conditions like anxiety. Like other physical ailments, delay in seeking help means poor prognosis and the earlier one seeks help, the better the prognosis. I am writing this paper with the hope that one or two people will take heed. While disorders like depression may be seen to affect mood and behaviour, that is just the surface. For the these to be seen, a lot of damage happen under the current in the long run. A keen look at the damage that can be occur after long spells of untreated depression could help spur people into seeking help, could spur parents into seeking help for their children.

Depression seems to be more frequent more and spoken about in the recent past. A staggering 1 out of 4 persons who seek healthcare in Kenya have a mental health condition. That is a huge number out of the hundreds of thousands presenting themselves at casualties and outpatient clinics in Kenya. Depression is common and there are increasing rates of substance and alcohol use disorders(WHO). These numbers cannot be said to be accurate because not many people seek medical help when they experience symptoms that suggest mental disorder. Furthermore, depression is misunderstood because it seems to be evident through a person’s behaviour. It is therefore much easier to use culture and religious lenses to interpret people’s behaviour. ‘In our family we don’t behave like that’ or If you were a Christian you wouldn’t struggle to smile’, etc. Depression is a real medical condition. It may be exacerbated by experiences in our lives but, it is real, it is treatable and manageable. In this short article, I want to point out just a little bit of why you should take the first opportunity to get assessed and treated for a depressive disorder if it ever appeared within your radar.

Depression causes neurocognitive problems that are more difficult to treat if left unattended. Harvey et al., 2004; Marvel and Paradiso, 2004; Porter et al., 2007; as cited by Bastos et al., (2013) suggests that previous studies have reported neurocognitive problems being mainly related to data processing and organization of perceptual information, working memory, attention, executive functions and inhibitory processes, as well as cognitive processing speed. This premise is supported by (Godard et al., 2011) pointing out that previous studies have revealed psychosocial and cognitive impairments in patients during depression. It is well established that depression is characterized by dysfunction across a range of neuropsychological domains including attention, executive functions, learning and memory (Bearden et al., 2001; Castaneda et al., 2008). Changes in cognitive functioning are more likely to occur when depressive episodes are recurrent and to abate to some degree during periods of remission. It is therefore key to seek treatment at  the earliest opportunity possible. However, with accumulating frequency and duration of depressive episodes, cognitive deficits can become enduring, being evident even when mood improves. Such changes in cognitive functioning give depression links to mild cognitive impairment and thereby with neurodegenerative conditions, including Alzheimer’s disease, Parkinson’s disease, Schizophrenia, and Multiple Sclerosis (Gałecki et al., 2015). This makes adherence to treatment key for overall wellbeing and as early as possible like. There are a lot of myths that take people off treatment like ‘the medication will change my personality’, or ‘I will add weight’ or ‘ I will become dependent on medication’, etc. These are not things people say about other chronic conditions like diabetes or high blood pressure. This is a challenge posed by stigmatization of mental health illnesses. I dare to say mental health comes way up the ladder above the rest of our health.

I say this because our mental functioning controls the rest out physical functioning, from sleeping to awakening and get on with our day. According to Panza and colleagues, an episode of severe depression increases the risk of progression from MCI to Alzheimer’s disease fourfold. In a study of 436 women, aged 70–79, Rosenberg and colleagues demonstrated that symptoms of (recurrent depressive disorder (rDD)  positively correlated with an increased incidence of mild cognitive inflammation (MCI) among individuals in whom, prior to a diagnosis of depression, no cognitive deterioration was evident (Rosenberg et al., 2010).

My appeal to parents, families, friends, and family is to seek help early enough. And when is early enough. Early enough is when depression is suspected. Early enough is when a friend mention that they are concerned that a family member may be depressed. Early enough is when the school counsellor suggests that you take your child to assessed and possibly treated for depression. I am sorry for the very academic excerpts, but I really need to put this through. There is no health without mental health!

References

Bastos, A. G., Pinto Guimarães, L. S., & Trentini, C. M. (2013). Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy. Journal of Affective Disorders, 151(3), 1066–1075. https://doi.org/10.1016/j.jad.2013.08.036

Gałecki, P., Talarowska, M., Anderson, G., Berk, M., & Maes, M. (2015). Mechanisms underlying neurocognitive dysfunctions in recurrent major depression. Medical Science Monitor, 21, 1535–1547. https://doi.org/10.12659/MSM.893176

Godard, J., Grondin, S., Baruch, P., & Lafleur, M. F. (2011). Psychosocial and neurocognitive profiles in depressed patients with major depressive disorder and bipolar disorder.  Psychiatry Research, 190(2–3), 244–252. https://doi.org/10.1016/j.psychres.2011.06.014

World Health Organization (WHO)