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Depression: let’s talk

🕔 Friday, 28 Apr 2017 om 01:32

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On April 7th, World Health Day, a panel discussion about depression was held at the Institute for Graduate Studies and Research (IGSR). The objective of the evening was to bring awareness to mental health issues, in this case depression, and to discuss the possible ways to address mental health in Suriname. Depression is one of the leading causes of disability in the world. Unfortunately, there still remains a stigma and an air of silence around depression in Suriname. People are not always comfortable talking about it. A study done by Psychiatrisch Centrum Suriname (PCS), researching alcohol consumption, anxiety disorders and depression in Paramaribo and Nickerie, shows that in both districts there are high numbers of depression, women being in the majority. Only a small percentage (3%) is getting the help they need. This leaves an alarming number of people living with untreated mental health issues. Depression can affect a person’s physical health, productivity and in worse cases can lead to suicide. It is often referred to in metaphor: a dark cloud hovering over you, a feeling of always being in the dark or a black dog. Depression is not a physical ailment that you can see, like a broken arm. It is something happening inside a person which makes it difficult for others to understand. This, in turn, has contributed to the ignorance and stigma surrounding depression and mental health. It is, therefore, important to understand: what depression is, to be able to talk about it and to recognise when someone might need help.  

Depression is being in a constant state of sadness for an abnormal amount of time. It’s a medical condition in which your brain chemistry, function and structure are negatively affected by environmental or biological factors (Porter, 2016). It is not always caused by a negative incident in an individual’s personal life. It can happen to any age group, children to elders. Depression can cause unexplained periods of hopelessness, sadness and lethargy (Porter, 2016). It is important to realise that this is a real illness which cannot be cured simply by telling people to “snap out of it” or to “think positive thoughts”. How we talk about mental health is important in creating openness, acceptance and awareness. 

It’s popular for people to say “I’m feeling depressed” to express that they are feeling sad. It’s an exaggeration of their feelings but not depression. It’s also a common thing to call PCS patients “crazy” or to make jokes about being taken away by the PCS-bus when a person does something silly. This is problematic because it is dismissive of an actual mental illness. It might seem like a micro issue in the grand scheme of things. However, how we use language in our daily lives has effects on the people around us. Phrases like “that’s depressing”, “think positive” or calling PCS’s patients “crazy” make light of mental health issues. It perpetuates the idea that “depression” is just being sad and to seek out help is something to be ashamed of. It keeps certain stigmas alive and generates the taboo around talking about depression. Language can also function in a way to exclude people from groups, imagine your light hearted comment making somebody feel like they can’t talk about their depression. Fostering healthy, open and honest lines of communication is important to a person’s mental health. This is important because simply being able to talk about depression can be the first step to recovery and getting help. 

In the age of digital technology, it is easier to talk to people and to seek out help. Social media helps create awareness, stimulates discourse, it gives encouragement and hope to those living with depression and removes some barriers of isolation (Nelson, 2015). Similarly, it is easier for people to look up information and to educate themselves about depression. The online environment has contributed to the discussion of mental health and depression by allowing everybody the possibility to engage in dialogue online. Getting the public involved in conversations about mental health is critical for building community and ending stigma (Nelson, 2015). Today because of social media more people are aware of mental health and change how they talk about it and can educate themselves and others. 

As many as one in ten persons both men and women in Suriname suffer from one of the common mental health problem such as depression, anxiety disorders and mood affecting disorders. The burden of mental ill-health is most prominently noticeable in the growing suicide problem. Suicide is in the top 10 causes of death in Suriname (Gebre, 2017).
Depression is not something that will just go away, it can lead to self-harm and suicide. The “let’s not talk about it” culture we seem to have in this country is detrimental to the health of our society. This needs to change so people suffering can feel free to talk about depression and to feel comfortable about seeking help. The silence around depression only enhances the feelings of disappointment and hopelessness those with depression already feel. The rise in suicides is not only the problem of individuals but of a society that does not recognise mental health as an integral part of a person’s wellbeing. We feel ashamed of seeking psychiatric help, we make fun of people in PCS and we fail to adequately employ qualified psychiatrists. Lets’ talk more about mental health, about depression, and educate ourselves so we can identify the early signs and create a culture of consideration. One where we show support, compassion and empathy for those with mental health issues. Most importantly as Drs. Shin Young-Soo1 put it, “let’s move mental health out of the shadows because there is no health without mental health”. 

What are your experiences and thoughts on mental health in Suriname? Let me know in the comments below. Let’s talk.

Mental Health hotlines: Het Psychiatrisch Centrum Suriname (PCS)
Link: http://pcs.sr/website/home.asp?menuid=2 
E-health.sr biedt zelftests en zelfhulpprogramma's die helpen bij het minderen of stoppen met het drinken van alcohol en bij het verbeteren van uw stemming Link: https://data.ehealth.sr/Home/ 
Crisishulplijn 114: 1x 24 uur telefonische hulpverlening

 Sources 
1. WHO regional Director for the Western Pacific 
Dwarkasing, R., Jadnanansing, R., Tilon, E., Menke, J., & Dawson, J. (2017). World Health Day 2017, Panel Discussion Depression. Paramaribo.

Gebre, Y. (2017, April 7). World Health day Message from Dr. Yitades Gebre, PAHO/WHO Suriname representative. Retrieved from www.paho.org: http://www.paho.org/sur/index.php?option=com_content&view=article&id=538%3Aworld-health-day-2017&Itemid=477

Nelson, C. (2015, December 17). Twitter gets real about mental health with #WhenIThinkOfMentalIllness. Retrieved from www.dailydot.com: https://www.dailydot.com/irl/mental-illness-hashtag-twitter/

Porter, E. (2016, September 16). 9 Myths on depression. Retrieved from www.healthline.com: http://www.healthline.com/health-slideshow/9-myths-depression#4
Comment
Risma BissesarWhat causes depression isn't clear since it's complicated to pinpoint. It's happening in a person's head (biological) and there are several other factors that can differ per person. In Suriname alcohol abuse, stigma and suppressive cultural characteristics are a contributing factor. A person suffering from depression can feel an increasing sense of hopelessness and lethargy (not wanting to do anything). Stigma, in turn, is a problematic barrier, especially in Suriname, because it adds to that sense of hopelessness and can increase the risk of self-harm.

Personal experience, the level of education and upbringing play a part when it comes to mental health. I wouldn't say they were a direct cause. thanx for the question! @jean-lucvancharante
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Jean-luc Van charanteThanks for sharing Risma Bissesar! Mental health is a big problem, both in Suriname and in the world.

I was wondering: What causes depression (are the leading causes) in Suriname? What causes hopelessness, sadness and lethargy? Personal experience? Education? Your upbringing?
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