One in five Nigerians suffer chronic depression

By accounts from those who knew him, Dr Orji was a brilliant doctor. He worked at Mount Sinai Hospital in Surulere and was described as ‘gentle,’ by his neighbours. But he also struggled.

Reports say he was still coming to terms with the death of his father some years before and that he had suffered from seizures which hindered his ability to practice medicine the way he wanted. It was also reported that he allegedly tried to commit suicide years earlier. In March last year, Orji asked his driver to pullover on Third Mainland Bridge, exited the car and jumped into the Lagos lagoon. The incident sent shockwaves throughout the country and sparked a debate about mental health and suicide.

Nearly 800,000 people die each year due to suicide, it’s the second leading cause of death among 15-29 year olds. Close to 80% of global suicides happen in low and middle income countries. According to 2015 data provided by the World Health Organization (WHO) Nigeria has 20.3 suicides per 100,000 people per year. Improved health and wellbeing is number three of the 12  2030 UN Sustainable Development Goals, mental health and suicide are part of this commitment to improving global health. The UN aims to ‘reduce the rate of premature mortality from non-communicable diseases’ by a third, through improved mental health and wellbeing.

Before we can tackle suicide, it’s important to tackle the factors that contribute to it, among that list is depression.Often referred to as “the black dog,” depression is more common than you think. It’s estimated that 300 million people worldwide suffer from the condition and it’s the leading cause of disability worldwide.  Depression is more than just a bad mood and can greatly impact daily activity and at its worst it can result in suicide.

In Nigeria, chronic depression affects one in five adults according to research by the World Bank’s Mind Behaviour and Development unit.  Chronic depression or Dysthymia is defined by The Mayo Clinic as ‘a continuous long-term form of depression’, these feelings come and go over a period of time with varying intensity.

In Nigeria, the report revealed that chronic depression is often linked to negative events like ‘shocks, deaths or conflicts,’ experienced by two out of every five Nigerians. The report also reveals that those in the bottom 30% of income earners are more likely to suffer from chronic depression. Unsurprisingly, the effects are damaging and far-reaching. According to the report, those who are clinically depressed are less likely to engage in work and less likely to invest in their children’s education.

So why aren’t more people talking about it?
There is still a lot of misinformation regarding depression and it’s still a misunderstood ailment in many parts of the world. In Nigeria, mental health issues are often covered up, ignored or countered by rebukes and rejections as opposed to medical attention, often times, a result of shame and the fear of stigma.The ‘suffering and smiling’ nature of Nigerians might be a contributing factor. Nigerians are known for being resilient and optimistic that things will somehow get better, even if all evidence points to the contrary.  Last year’s World Happiness Report (WHR) ranked Nigerians as the 6th happiest people in Africa, and the 95th happiest in the world; how does this tally with a nation where one in five are chronically depressed?

The availability and the affordability of mental healthcare treatment is also a factor. As of 2011, there were 44 outpatient mental health facilities and 8 mental hospitals available in Nigeria. There are 0.028 beds available in outpatient mental health facilities per 100,000 Nigerians and 0.06 psychiatrists per 100,000. In a newspaper interview, Professor Taiwo Lateef Sheik, the Medical Director of the Federal Neuropsychiatric Hospital said that 80% of Nigerians with mental health problems do not have access to treatment.

While not huge, 20% is a sizeable number of the population and respective state governments and commentators have raised alarm of the increasing rate of suicides. According to the World Bank report ‘chronic depression will have both short and long term effects on welfare in Nigeria’ and will also affect social mobility. The report goes on to list recommendations for the government and also suggests the need to change ‘social norms related to communication about and treatment of depression.’

Although pressure can be put on the government to increase the availability of mental health services, we have no real control over what policy is implemented to combat this issue, but collectively we do have control over the discourse about depression: how we talk about it, how often we talk about it and most importantly, tackling the stigma and shame attached, so that we can create an environment where people feel safe enough to speak out and seek the help they need instead of continuing to suffer in silence.