A strong desire to escape despair and pain can often trigger suicidal thoughts.
In South Africa, mental illness remains largely stigmatised, preventing people from seeking help and talking about what they are experiencing.
The suicides of rapper Riky Rick (Rikhado Makhado) this week and veteran actor Patrick Shai in January have reignited an all-important conversation about mental health.
Makhado, who died on Wednesday, had openly spoken about his battle with depression.
Before Shai passed on, he was castigated on social media for a viral video in which he had hurled insults at rapper Cassper Nyovest’s mother.
Clinical psychologist Nevern Subermoney told City Press that depression was not usually caused by only one thing.
“It’s caused by a multitude of factors. There’s what we call a biopsychosocial approach, where you try to understand the causes of depression in terms of biology, involving things such as neurotransmitters. If you have less serotonin or dopamine than you should have, you might become depressed,” he said.
As it does in many other illnesses, genetics can also predispose a person to depression.
SA Depression and Anxiety Group (Sadag) clinical psychologist Sharon Auld wrote in Mental Health Matters: “Despite profound sociocultural changes we have experienced since the beginning of the new millennium, mental illness continues to be stigmatised. It is equated to labels such as ‘being defective’ and ‘failure’.”
For these reasons, many South Africans still do not access mental healthcare services, fearing the stigma and being perceived as weak.
SIGNS OF DEPRESSION
After a loved one commits suicide, many blame themselves for failing to see the signs in time and prevent the tragedy. However, depression is largely considered a “silent killer” because these signs are not always easy to identify.
Subermoney said that, while they differed among people, the most common symptoms included:
. A loss of appetite/excessive eating;
. A loss of motivation;
. An inability to derive pleasure from things one used to enjoy; and
. Fluctuations in sleep patterns.
While the psychological factors that frame depression include negative thinking patterns and no desire to engage in activities, the social factors include not having a support structure in place.
Although depression could be identified in all age groups, those who struggled with it the most were middle-aged people, said Subermoney.
“Happiness across one’s lifespan is like a U-shaped curve. It’s a high when you’re young. It slowly starts to drop in middle age and then increases again. So, the elderly and children are generally happier,” he explained.
Depression is one of the most prevalent mental disorders, globally and in South Africa.
A 2012 report by the Word Health Organisation predicted that, by 2030, depression would be the worst epidemic when weighed globally against other diseases.
“When only the disability component is taken into consideration in the calculation of burden disease, mental disorders account for 25.3% and 35.3% of all years lived with disability in low- and middle-income countries, respectively,” the report read.
According to Sadag, pre-Covid-19 statistics revealed that one in three South Africans had or would have a mental health problem, but that only one in 10 of these would access mental healthcare services.
The Covid-19 pandemic has probably increased these figures, due to the unprecedented lockdown restrictions that curtailed regular interactions at work and home, as well as heightened levels of anxiety.
Auld recognised the major lack of social awareness within communities about mental illness and its potentially traumatic effects on those battling with depression.
She added that depressed people tended to be dismissed because their mental illness could not be seen by others. This aggravated their depression, increasing their loneliness and despair.
Describing the unpredictable nature of depression and how it could be triggered by many factors, she wrote: “A young woman came to see me, extremely perplexed; she had achieved all her goals and was newly married, had been promoted at work, had moved into a new house and had had a baby, yet she was extremely unfulfilled and unhappy.”
Because mental illness is often related to an imbalance of neurotransmitters in the brain, this woman’s success had no impact on her illness.
WHEN AND WHERE TO GET HELP
If you are unable to cope with feelings of despondency, can no longer function at work or have had suicidal thoughts, seek help immediately.
The following institutions provide mental health support free of charge:
. Sadag: 080 012 1314
. Adock-Ingram Depression and Anxiety Hotline: 080 070 8090
. Life Line SA: 086 132 2322
. Befrienders Bloemfontein: 051 444 5000
You can also consult your general practitioner, who will either prescribe medication or refer you to a specialist, counsellor, therapist or support group.