Three million Ugandans are depressed

Nov 10, 2007

ABOUT three million Ugandans are suffering from depression, according to a survey carried out by psychiatrists at Makerere University.

By Flavia Nakagwa

ABOUT three million Ugandans are suffering from depression, according to a survey carried out by psychiatrists at Makerere University.

Dr. Seggane Musisi, the head of the psychiatry department at the Faculty of Medicine, said the survey revealed that 10% of Uganda’s population is suffering from depression. If untreated, depression could progress to severe mental illness, he cautioned.

“The significant factors contributing to mental illness are poverty, substantive abuse like domestic violence, post traumatic stress disorder mainly among people who have been exposed to war, rape, sexual abuse, child abuse and HIV/AIDS,” he said.

Seggane warns that depression is rapidly gaining ground and by 2020 it could become one of the leading health problems.

We are talking about depression as a clinical condition,” said Seggane.
“Most of the people in internally displace camps have been traumatised and, as a result, developed post-traumatic stress,” he added. Despite the growing mental health problems, Uganda has only 25 psychiatrists. That means there is only one psychiatrist for every 120,000 patients suffering from depression.

“Psychiatric services are not well funded in the country, yet psychological disorders are a major disease burden,” Seggane said.

While it can be triggered by a particular event, like the loss of a job or a loved one, depression can also occur for no apparent reason, he explained. It can be the result of stress, which affects different people in different ways.
The survey found that the majority of Ugandans are not aware that psychiatric care exists. “They end up going for help from unscrupulous practitioners,” he said.

Seggane advised people to stop linking mental health to witchcraft, because this was misleading people who needed urgent medical attention. “People need to know that mental illness occurs irrespective of tribe, race or profession.

It occurs everywhere and affects members of all ethnic groups. However, children and women are more susceptible to discrimination and men seem to have more psychological disorders,” he said.

People who are depressed tend to have a change in mood and lose interest in pleasurable activities. Some experience weight loss, changes in appetite, lack of concentration, disturbed sleep patterns, loss of confidence and self-esteem, inappropriate guilt, thoughts of death and suicide.

“It’s unfortunate that we use the word depression for two different things — a low mood and a diagnosable illness. It means people often fail to recognise the symptoms of depression and don’t get treatment for it. At its worst, severe depression can end in suicide,” said Dr. Elialilia Okello another psychiatrist.

Okello, in a separate survey, found that depression was one of the most common mental illnesses, accounting for 30% of cases at mental health clinic. “However, delays in seeking treatment, misdiagnosis and non-specific treatments have compromised appropriate care for people with depression,” he noted.

Like Seggane, he pointed out that there was a gap between the need for mental health services and their availability.
“The problem is even more serious in settings that are already labouring under the burden of inadequate resources and shortage of health care personnel,” he added.

Prof. Emilio Ovuga at the psychiatry department reckons between 20 and 25% of Ugandans experience some form of psychiatric disorder.

He believes the provision of mental health care is hampered by cultural concepts and myths surrounding mental illness, stigmatisation, fear and denial.

Alcohol is both a cause and a consequence of depression, according to Seggane. People who are depressed tend to resort to alcohol, while alcohol tends to worsen the depression.
Uganda is ranked the world leader in alcohol consumption according to the 2004 Global Status Report on Alcohol of the World Health Organisation. It has a per capita alcohol consumption of 19.47 litres.

Though more research is needed, the leading cause of depression in Uganda is considered to be poverty. “Poor people become unhappy when they realise that they have failed to look after their families and cannot pay for their medical care,” says Seggane. Depression can also affect rich people, he noted. “Material possessions do not address psychological distress. Empty materialism is not an answer to those suffering,” he said.

Depression is curable, all experts agree. Contrary to the widely held belief that people with mental illnesses never recover, Godfrey Mabirizi, a KCC monitoring officer who works closely with Butabika Referral Hospital, says: “I have had the opportunity to witness people adequately recover from severe mental illness and regain productive lives,” said Mabirizi. “We have rehabilitated over 600 people.”

He calls upon the Government to translate the mental health policy into a law and provide more resources to the sector. “Many people suffering from mental illnesses are being stigmatised and segregated in our society. The draft policy should be tabled before parliament and help these people,” Mabirizi said.

Symptoms of depression
  • Feeling generally miserable

  • Variation of mood during the day. It is often worse in the morning, improving as the day goes on.

  • Disturbed sleep.

  • Slow thoughts, speech and movement

  • Anxiety

  • Tearfulness

  • Short temper

  • Weakness and constant exhaustion

  • Inability to enjoy anything

  • Lack of concentration

  • Difficulty making decisions

  • Being forgetful

  • Negative thoughts about the future

  • Feelings of guilt

  • Loss of identity

  • Blaming self and low self-esteem

  • Feelings of hopelessness and despair

  • Unrealistic sense of failure

  • Loneliness, even when around others

  • Becoming preoccupied with illness

  • Loss of appetite and resulting loss of weight

  • Reduced desire for sex.


  • Helping yourself
    You can notice signs of depression in your life and prevent a mental break-down. Here are the things you should look out for and what you can do to keep the stress at bay:
  • Notice exaggerated negative thoughts.

  • Balance frightening thoughts with reassuring statements.

  • Occupy your mind.

  • Exercise.

  • Pay attention to the way you look.

  • Eat a balanced diet.

  • Avoid alcohol. It's a depressant.

  • Investigate alternative treatments.
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