Feature

Depression: The ignorance, the stigma

‘It’s mental illness, nothing to be ashamed of– Gureje, professor of psychiatry
People are being controlled using an African traditional technique, says Ifa priest

While medical experts seem to agree on depression as the possible cause of most suicide incidents, Ifa priests, perhaps unsurprisingly, maintain a different stance from the arguments canvassed by orthodox experts. Isioma Madike, in this report, aggregates these opinions

Suicide seems to be rampant these days in Nigeria, even among students of higher institutions across the federation. It cuts across sex, religion and ethnicity. Just recently, a 47-year-old accountant, identified as Afolake Abiola, died by suicide after she was said to have drank a pesticide.

The incident occurred on Friday, May 27, at her 1, Abayomi Kukomi Close residence in Osapa London, Lekki, Lagos. Saturday Telegraph gathered that Abiola was single, childless and had suffered depression for a while before she took her life. A family source, who craved anonymity, also confirmed that.

“She had battled depression for a while on account of no husband and no child,” the source added. Before Abiola’s case, a 200-level student of the Department of Political Science at the Adekunle Ajasin University, Akungba Akoko, Ondo State, Feranmi Fasunle, had reportedly taken her life by drinking sniper in her room. Although the reason for her action could not be ascertained by this reporter, insinuations were rife that she did so because she had a relationship issue, a claim some of her close friends refuted as they confirmed that she had no boyfriend as at the time. Also, a man in Osogbo, Osun State capital, reportedly jumped into an overfilled Osun River where he died. The incident, which happened about 4:00pm on the Gbodofon Bridge, on Gbongan/ Osogbo Road, drew the attention of motorists and passers-by, who gathered around the scene but could not help the drowning man. The deceased, whose identity remains unknown till today, rode his motorcycle to the middle of the bridge. According to eyewitnesses, he received a phone call but he then tossed his telephone into the water before taking the fatal jump. The police in Jigawa State had earlier disclosed that a 25-year-old man, Nura Muhammad, equally died by suicide. He was said to have hung himself in the Dutse Local Government Area of the state. Before then, a 16-year-old 100-level student of Microbiology at the Obafemi Awolowo University (OAU), Ile-Ife, identified only as Mercy, had killed herself. According to a PremiumTimes report, Mercy allegedly took ‘Sniper’ days after she wrote on Facebook that she wanted to see God’s face and speak with him face to face. In what is fast becoming a fad among students of higher learning in Nigeria, Niyi, who was studying microbiology from the University of Lagos, allegedly died by suicide also because he had failed some of his courses. His was said to be the second time a student of the department of Microbiology in UNILAG died by suicide in a space of three years. Niyi’s sudden death came some weeks after another final year B. Agric student of Michael Okpara University of Agriculture, Abia State, was found dead in his room. He was said to have died by suicide after he hanged himself. From Abia to Nsukka where another final year student killed himself, it’s been harvest of suicides for Nigerian students. The final year student of the University of Nigeria, Nsukka, was studying Agric Economics before he took his life. But this time around, the young man reportedly killed himself over a debt. Some reports speculated that he may have lost some money to betting. There was also a student of the Niger Delta University in Bayelsa State, identified simply as Daniel, who was said to have died after reportedly drinking Sniper (a deadly insecticide) upon discovering that he had about four carryovers. However, in all the suicide occurrences highlighted above, there seems to be the connecting line of depression, which many are ignorant of and as such lack the needed knowledge to deal with it. Most people feel sad or depressed at times, according to medical experts, but believe it’s a normal reaction to loss or life’s struggles. Yet, experts said that when intense sadness — including feeling helpless,hopeless, and worthless — lasts for many days to weeks and keeps one from living his or her life, it may be something more than sadness, at that point, they said, one could have clinical depression –a treatable medical condition. According to the DSM-5, a manual doctors use to diagnose mental disorders, one has depression when five or more of these symptoms last for at least two weeks: A depressed mood during most of the day, especially in the morning, feeling tired or having a lack of energy almost every day, feeling worthless or guilty almost every day and a hard time focusing, remembering details, and making decisions. Others are sleeplessness or sleeping too much almost every day, having almost no interest or pleasure in many activities nearly every day, thinking often about death or suicide (not just a fear of death), feeling restless or slowed down, lost or gained weight. WebMD also shows that sadness, sleeping problems, irritability, and more may be signs to seek help for depression.

It could equally occur when one feels irritable and restless, overeat or stop feeling hungry, have aches or pains, headaches, cramps, or digestive problems that don’t go away or get better with treatment, feeling sad, anxious, or “empty” feelings. While these symptoms are common, not everyone with depression will have the same ones, said Oye Gureje, a Professor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, University of Ibadan. How severe they are, how often they happen, and how long they last, he said, can vary.

He also said that symptoms may happen in patterns. For example, de-pression, Gureje said, may come with a change in seasons (a condition formerly called seasonal affective disorder). He nonetheless said it’s not uncommon for people with depression to have physical signs of the condition. They may include, according to him, joint pain, back pain, digestive problems, sleep trouble, and appetite changes. One might have slowed speech and movements, too. The reason, the experts said, is that brain chemicals linked to depression, specifically serotonin and norepinephrine, play a role in both mood and pain.

He said: “Depression may have other specific features, such as anxious distress. That is worrying a lot about things that might happen or about losing control. Another typical feature is when one can feel good after happy events, but also feel hungrier, need to sleep a lot, and are sensitive to rejection. It could also be psychotic in which one believes things that aren’t true, or sees and hears things that aren’t there.” Gureje said that depression is a mental illness, which no one should be ashamed of. He believes that ignorance and stigma attached to mental health are the drivers of the scourge which often leads to suicide.

“We live in denial in this part of the world. When people are going through depression, they usually would first want to reject such suggestions, some may even take to prayers instead of seeking medical attention. But again, we attach stigma to mental issues in this clime. “Imagine seeing someone around where people refer to as ‘Yaba left’, immediately such a person would be termed ‘mad’. Yet, this is one issue that could easily be nipped in the bud if professionals trained to handle such are called in on time. It’s something therapy or medication could solve.” According to the professor, depression seems to be more common among women than men.

He listed other symptoms to include lack of joy and reduced interest in things that used to bring people happiness. He said that life events, such as bereavement, produce mood changes that can usually be distinguished from the features of depression.

The causes of depression, he further said, are not fully understood but are likely to be a complex combination of genetic, biological, environmental, and psychosocial factors. There are other signs and symptoms. For instance, “delayed psychomotor skills, slowed movement and speech fatigue or loss of energy, feelings of worthlessness or guilt impaired ability to think, concentrate, or make decision, recurrent thoughts of death or suicide, or attempt at suicide are others,” Gureje added.

He said that depression is likely to be due to a complex combination of factors that include: Genetics, biological, which are changes in neurotransmitter levels, environmental, psychological and social (psychosocial). Some people, he said, are at higher risk of depression than others with risk factors such as life events: These include bereavement, divorce, work issues, relationships with friends and family, financial problems, medical concerns, or acute stress. It could also be personality in which case those with less successful coping strategies or previous life trauma are more susceptible. He said: For genetic factors, having first-degree relatives with depression increases the risk; childhood trauma also.

Some prescription drugs, including corticosteroids, beta-blockers, interferon, and other prescription drugs could cause one to be depressed. Also, abuse of recreational drugs, abuse of alcohol, amphetamines, are strongly linked to depression. “A past head injury or having had one episode of major depression could also increase the risk of a subsequent one, while chronic pain syndromes and other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular disease make depression more likely.” Another professor of psychiatry, College of Medicine, University of Ibadan, Olayinka Omigbodun, told this reporter that diagnosis for depression should start with a consultation from a mental health expert.

She defined it as a mood disorder characterised by persistently low mood and a feeling of sadness and loss of interest. “It is a persistent problem, not a passing one, lasting on average 6 to 8 months. Diagnosis of depression starts with a consultation with a doctor or mental health specialist.

It is important to seek the help of a health professional to rule out different causes of depression, ensure an accurate differential diagnosis, and secure safe and effective treatment. “As for most visits to the doctor, there may be a physical examination to check for physical causes and coexisting conditions. Questions will also be asked – ‘taking a history’ – to establish the symptoms, their time course, and so on. Some questionnaires help doctors to assess the severity of depression,” Omigbodun said. A psychologist, Dr. Yemi Atibioke, said preventing suicide is a collective responsibility and that everyone needed to work together by playing their roles.

He said governments, employers, landlords, parents and other family members have roles in not driving people to die by suicide. He said that individuals should be sensitive to what could trigger mental health complications in their lives. Atibioke said, “A woman that is already frustrated at home and gets to the office only to be under constant condemnation and frustrated by her employers could resort to suicide. When children are experiencing condemnation from their parents, such as comparing them with some of their friends, they resort to suicide when they can no longer cope.

So, it is good for parents to play their role. “When the government also plays its role, the survival of the people would not be defeated and they would then be able to cope with stress whether physiological, physical or economic. Nigerians should equally assist in preventing suicide by increasing empathy, keeping in touch with families and neighbours as well as checking up on people both near and far.” The experts, however, pointed out that depression is different from the fluctuations in mood that people experience as a part of normal life. “Temporary emotional responses to the challenges of everyday life do not constitute depression.

“Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression can, however, be related to bereavement – when it follows a loss, psychologists call it a ‘complicated bereavement.” Counseling or therapy, according to experts, may help a person manage the symptoms of depression. It is a treatable mental illness, they insist. The experts said that there are three components to the management of depression: Support, ranging from discussing practical solutions and contributing stresses, to educating family members.

There is psychotherapy, also known as talking therapies, such as cognitive behavioural therapy (CBT). Another is drug treatment, specifically antidepressants. Suicide, experts said, is among the top 20 leading causes of death globally for all ages. Unfortunately, it is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In contrast, some Ifa priests, have dismissed such insinuations when they said that suicide is mostly caused by evil manipulations and because people often live in denial, solutions have somewhat become essential commodity with many dying at the times they were not supposed to die. This may be the reason Chief Omo- Oba Olorunwa Ayekonilogbon, the priest of Ifa deity, thinks science may never have solution to the issue of suicide. To the Ifa priest, such a theory could just be a smokescreen.

Traditionally speaking, he said, only one theory could suffice in this case. “It’s simple; people are being controlled using an African traditional technique. “This is Africa where a lot of happenings cannot be explained by science. There is African science which people use to manipulate the destinies of others. Some use it for good while others use it to cause harm and change destinies. It is called African remote control. So, when issues like this are in focus, it can only be unlocked through the traditional means.

Anything short of that is a mere waste of time,” Ayekonilogbon said. Also, Chief Yemi Elebuibon, another well-known Ifa priest, spoke in a manner that suggests that people could actually be programmed (hypnotised) to do what they were asked to do. Eedi, he explained, is a bad omen in Yoruba land. “It is a great offence for a person to die by suicide; it’s an abomination. Whoever does that is considered to have brought dishonour to his/her family. Yet, the traditional belief behind suicide is that some people do not just commit the act on their own, but for some mystical interventions.

“However, some people could find themselves in critical and unpleasant situations, and opt for suicide as the last resort instead of living to face the problem. Whenever it happens, proper inquiry is set up, and an Ifa priest is mostly called upon to prescribe atonement to cleanse the city,” he said. Elebuibon nevertheless agreed that it is possible for a person to harm himself or herself without any diabolical undertone.

“We live in a world where we all have personal battles. We tend to overcome them each time they arise as a result of our mental strength but sometimes they conquer us. When this happens, a person may consider suicide as his/her last resort,” the priest told Saturday Telegraph. He said it could be diagnosed through a session of Ifa consultation. When a person consults Ifa, according to him, the past, present and future will be revealed. “Ifa gives warning about incoming dangers and the priest analyses the root cause of a certain predicament.

Signs of hypnotism can range from change in attitude, manner of speaking and so on and only people close to the person can discover this. “However, a person suspected or confirmed to be under hypnotism should seek help immediately as failure will wreak havoc and may eventually lead to awful death of the particular person and many others. “Without proper spiritual care, sometimes, the repercussions of some actions can influence a person’s life negatively. Such a person will begin to act under the control of mystical forces,” Elebuibon added.

The renowned traditionalist also said there is history of suicide in Ifa mythology and that hypnotism can only be prevented through constant consultation with Ifa for spiritual fortification. The founder and bishop of Wisdom Chapel Church, who doubles as President, Inter-Faith Ministers Network, Steven Ogedengbe, linked the increasing suicide rate in the country to a lack of effective national suicide prevention strategies and non-passage of the mental health bill.

He explained that a comprehensive suicide prevention policy is a whole document that includes measures such as addressing social, psychological, mental health, and infrastructural determinants, which involved improvement in mental healthcare services. Ogedengbe called for restricted access to chemical agents used in suicide and firearms; changing the ways the media report suicide and making it not only patients’ friendly but using reporting of suicide to educate the public. Ogedengbe Elebuibon Omigbodun Ayekonilogbon Late Abiola

 

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