BIG READ: Don’t despair, misery is treatable — psychiatrist

Diagnosing patients with depression is a common encounter for Dr Njagi Kumantha, a psychiatrist and director of Brightside Rehabilitation Centre.

Speaking to the Star in an interview, Kumantha said depression has been scientifically proven to be a health condition. He said although the disease is treatable, it is a long-term condition that requires patience.

"Depression in the 21st century is a treatable condition with an excellent treatment rate. Unfortunately, only 30 per cent receive adequate treatment," Kumantha said.

"It is health condition demonstrated when some chemicals in the nerves are affected. One is Serotonin (a neural transmitter such that as soon as it goes down, you are not able to be happy) and Norepinephrine (determines your mood, when it goes down you are sad, when it is normal you are happy)."

"Someone who is depressed is feeling very low and sad, and if you remain low for more than two weeks, that is when you know something is wrong."

It is normal to be affected when something goes wrong, but if the feeling persists, whether you know the reason or not, you should seek a professional opinion, Kumantha said.

He said treating depression is expensive but hopes that with the Universal Health Coverage, the government will reduce costs to enable people to access medication. The condition is also covered by NHIF, so is counselling.

PATIENTS AS YOUNG AS 13

Curing the illness is done in four phases: Promoting a healthy lifestyle, preventing depression, treatment, and rehabilitation, if the disease is too persistent.

Psychiatrists use different models to treat the disease: pharmacotherapy (prescribing medication), psychotherapy and physical therapies, such as ECT (electroconvulsive therapy). However, the best treatment is a combination of pharmacotherapy and psychotherapy.

"If you are given antidepressants and you feel good, it does not mean you are cured. The medicines have just controlled you but you need to be controlled long enough for the body to revert to its normal functioning," he said.

He said good lifestyle changes could also help in improving one's mental health through exercise, sports and diet change.

Kumantha, who receives patients as young as 13 years and as old as 70, said the reasons for depression differ for each age group. For teenagers and youths, the doctor said depression normally starts when they start reevaluating themselves during adolescence.

"This is the time young people look at themselves, their stature, whether you are beautiful or ugly and form ideas about yourself. If you have a concept of what you think you should be, and that is not who you really are, that is when anxiety and depression might start," he said.

He said it is important that young people do a lot of introspection and get feedback from close ones to help them know who they really are. Parents and teachers support them instead of putting too much pressure on them.

During these difficult moments is when the younger generation start using drugs to escape reality and elevate their moods. "When you see people going to rehab, 75 per cent of them have an underlying anxiety or depression," he said.

For the elderly, he said depression arose because they felt neglected by their family, or were going through a crisis like financial constraints or illnesses.

Moreover, depression can be caused by other health conditions, for example terminal illnesses like HIV-Aids and cancer, which tend to cause stress and anxiety to the patients.

A CRY FOR HELP

The doctor said there are different types of depression. Mild depression is when a person is having problems in life, and there is too much pressure causing a mixed anxiety depression.

"But when it persists for too long and you feel you can't make it, you become hopeless and attempt suicide, it is severe depression," he said. "Sometimes those who attempt suicide are really not serious about it, just that it is a cry for help."

The other type of depression is psychotic, where one loses his mind completely, hallucinates and is no longer able to communicate amicably.

Kumantha said suppressing depression may turn out to be bipolar, where people would do irrational things.

"When things are not working, they develop a coping mechanism where they have flights of fancy. You are full of energy, misuse all your money by drinking with all the money you have, sell your land and misuse the money," he said.

He said relapsing is very common, especially if the patients goes back to an unconducive environment, which is why he also counsels family and friends of the patients.

Kumantha said that though psychiatrists are few yet the cases are many, there is a big need to equip general health practitioners, teachers, and human resource managers with some psychiatric input in their training.