Tag Archive for sustainable mental health

Building Resilience Against Depression

Everyone feels down from time to time but depression is more than sadness or feeling ‘blue’. It is a common mental disorder which affects males and females, young and old, rich and poor. It is a treatable health condition that is found across cultures.

Depression can affect the way you think, move and speak. It can affect your physical health. It can also affect your ability to care for yourself, relate to others and enjoy life. Young people with depression can fall behind with schoolwork, miss out on friendships and struggle to find the energy to keep up with sports and leisure activities. In adults of working age, depression can make it difficult to concentrate at work, keep on top of finances, care for children, and maintain homes in order. Older people who are depressed may become socially isolated, forget important appointments and lose interest in work and hobbies. Some people with depression experience severe loss of appetite or thoughts of suicide and self-harm which can occasionally lead to death.

It is important to recognise and treat depression early to reduce suffering and prevent worsening of the illness. Despite advances in depression care, many people cannot or do not access help and they continue to suffer quietly and alone, hoping and praying the depression will one day disappear. Without additional support, some suffer for much longer than is necessary and later look back on their lives with regret over the lost months and years. This should not happen anywhere in the world.

Today we have a holistic understanding of health and this means people with depression can be helped by a combination of: medication, social support, psychological therapy, exercise, nutritional therapy and spiritual care, depending on the severity of depression and the individual’s needs and preferences. These treatment options address the multiple factors which are associated with depression, such as resilience. While being highly resilient does not eliminate all risk of depression, research findings from both higher and lower income countries show that building resilience can help prevent and treat depression.

Depression causes suffering and loss for those who live with it and for their family and friends. Depression can also cause death. With modern, evidence-based approaches to tackle depression, no one should suffer in silence without hope. Depression care can be tailored to the individual who should expect to make a good recovery, build resilience against future episodes of depression, have better physical health and enjoy a fulfilling life.

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Dr Anne Aboaja MPH MRCPsych , University of Edinburgh, Global Health PhD Network

Global mental health – its time to pull together

The recent report from the UK’s All-Party Parliamentary Group on Global Health and Mental Health (MH) is very welcome. Not only does it describe the parlous state of MH services in many parts of the world, it presents an evidence-base for global action. It is important to acknowledge, for example, that patients can be caged, chained or subjected to abusive traditional approaches and that Western mental health services are not all bad. The report summarises the growing body of research showing that there are cost-effective solutions to mental health problems that even the poorest countries could implement and benefit from. These include improving social and economic environments, integrating mental health into general health care, using trained and non-specialist health workers to provide culturally appropriate community care, increasing access to self-help and empowering people with mental health problems to support and advocate for themselves and each other.

Further, and more specifically, the WHO (1) have previously shown that interventions such as psychosocial and antidepressant treatment are ‘very cost-effective’ interventions for panic disorder and depression throughout the world, and that psychosocial treatments plus older antipsychotic and mood stabilising drugs are ‘cost-effective’ for schizophrenia and bipolar disorder.

Another report released in November, from the Overseas Development Institute (2), gives a complimentary perspective – mental (ill) health does not receive due policy attention due to stigma and a lack of coherence across the mental health community. The time has come for the mental health community to work together to achieve shared goals such as reducing stigma and increased funding for MH services across the globe.

 

 


Professor Stephen Lawrie, Head of Psychiatry, University of Edinburgh


 

1.Chisholm D, on behalf of WHO-CHOICE. Choosing cost-effective interventions in psychiatry: results from the CHOICE programme of the World Health Organisation. World Psychiatry 2005; 4: 37-44.
2. Mackenzie J. Global mental health from a policy perspective: a context analysis. Overseas Development Institute 2014.