A piece I wrote for Expat Assure for World Health Day 2017.
Depression is the single largest contributor to ill health and disability globally. Over 300 million people are estimated to be suffering from depression, which is equivalent to 4.4% of the world’s population. The estimates have been released by the World Health Organization (WHO) in the lead up to World Health Day on 7th April. The aim of the day, which this year is centred on the theme of depression, is to promote a better public understanding of the ‘invisible’ condition and push more people to seek help.
WHO’s decision to shine a spotlight on the issue is a relief for the one in five of us who will experience depression at some point in our lives, as well as the many people with loved ones suffering from depression and anxiety disorders. Campaigners, charities, mental healthcare specialists and researchers have long been calling for more prominence in the treatment and understanding of mental health. WHO, along with many other charities and organisations, hopes to inform and educate as many people as possible about mental health disorders, as well as the ways people can seek support or help those suffering.
Mental health is determined by a range of socioeconomic, biological and environmental factors. Depressive and anxiety disorders are the two main categories for common mental disorder diagnoses, with the severity, symptoms and duration varying from person to person. These disorders are typically characterised by persistent sadness, loss of interest or pleasure, feelings of low self-worth and disturbed sleep or appetite, with severe symptoms including suicidal thoughts and self-harm.
As diagnosable health conditions, the feelings that mental illness sufferers experience are far removed from the passing negative emotions of sadness or stress that most people may experience in life. Mental illness can have implications on a person’s relationships, lifestyle and ability to cope with their usual daily life, meaning friends and family of those suffering are often left unsure of what actions to take or how to emotionally support their loved ones.
Depression can strike at any time and affects people of all ages and from all walks of life, and the number of people suffering from mental health disorders is increasing. Depression is the major contributor to suicide deaths, and someone dies by suicide every 40 seconds somewhere in the world. Lack of support for people with mental disorders, coupled with stigma, prevent many from accessing the treatment they need to live healthy, productive lives. But there are effective treatments for depression whether through medication, talking therapy, or a combination of the two.
Despite the existence of various treatments as a proven way to alleviating symptoms, WHO estimates that nearly 50% of people with depression do not get treatment, even in high-income countries. A major barrier to accessing care is the social stigma associated with mental disorders. Tackling stigma through education is a vital target of UK-based mental health charity SANE.
Along with the scientific and psycho-social research the charity conducts into mental illness and its consequences, SANE implements community and school-based programmes and promotes access to help through the Black Dog Campaign: named after a bygone metaphor for depression referred to by Winston Churchill and ancient Roman poets. However, their fresh and forward-thinking approach to mental health is anything but old-fashioned. The ongoing campaign aims to increase visibility and reverse prejudice as well as encourage people to seek help rather than suffer in silence. SANE provides confidential, specialist emotional support and expert information to anyone affected by mental illness, including the family, friends and carers of those suffering.
For many people, coping with symptoms of a loved one’s mental illness can be challenging, and may leave them feeling helpless or frustrated. “Mental illness can make relationships difficult,” says Adrian Garcia, leader of the Black Dog Campaign. “The person who is suffering might push away those closest to them. This can be particularly tough for loved ones, as they just want to help. It sometimes takes perseverance, as recovery can take time, but have patience, and keep trying.”
Depression and anxiety can manifest in many different ways, and it is helpful to learn as much as possible about a diagnosis to better understand what an individual is going through, as well as how treatments and medications can help. If you are concerned about someone’s mental health but they are feeling unwilling or anxious about seeing their GP, encouraging them to go and offering to accompany them might be the push they need to seek help.
Reassure your loved one that talking about what they are feeling, whether to you or to a professional, can help on the journey to treatment and recovery. Adrian advises finding an appropriate time and place to talk to the person you are worried about. “Make it clear that you want to help and you will listen to them without judgement,” he says. “Everyone’s experience is so unique, but for a lot of people, if they don’t talk about their mental illness their negative feelings can become internalised, and they can magnify. If they don’t talk about it, they aren’t going to get help. Making yourself available as someone they can trust is an invaluable way of showing support.”
Advancing the public understanding of the realities of mental health disorders is a key focus for the Black Dog Campaign. “The most important thing is for a person not to be denied their suffering. That can take a lot of different forms, but shrugging it off as ‘just needing to cheer up’ is damaging. Acceptance of mental illness as a serious condition is vital,” Adrian says. “The stigma that mental illness is associated with scary Victorian asylums: that’s changing. More people are aware that it comes in many different forms, and it can develop from something physical, biological or psychological.”
“There can be hesitation about how to act around someone suffering with depression, and a lot of people’s worries stem from not knowing what to say,” Adrian says, “But actually, saying something is a lot better than saying nothing. Any form of mental illness can be incredibly isolating, so staying in touch, checking how the person is doing, and showing you care can be of great comfort.”
Whether the support you are offering is emotional encouragement or helping with everyday practical tasks, it’s crucial that you take care of yourself too. “Providing this support can be emotionally overwhelming,” says Adrian, “So try to find ways to relax and continue doing things you enjoy. You need to consider your own support needs, especially if you are caring for someone full-time who is suffering from a mental illness.”
Many people find it helpful to attend support groups for those affected by a loved one’s mental illness. It gives the opportunity to meet others in similar positions and help you realise you are not alone in your situation. It can be helpful to share experiences with those who may be going through similar feelings that you are, as well as gaining ideas of what other people have found helpful to them.
SANE helps 750,000 people per year, all without government funding. Adrian and the rest of the team have high hopes that soon, mental conditions will be perceived in the same way as physical conditions, and will hold the same importance in terms of priority, range of treatments, research, funding and public attitude. Adrian says: “Physical health has been researched and funded for hundreds of years, whereas mental health is a very recent interest in terms of research. So we think mental health should be given a boost in funding to have at least the same as physical health, so it can catch up!”
Only 3% of government budgets, on average, is invested in mental health (WHO estimate). Economically, investment in mental health makes sense. A WHO-led study on future health outcomes showed that in 36 low, middle and high income countries, the current low levels of both access to mental healthcare and recognition of mental illnesses would be predicted to result in a global economic loss of a trillion US dollars per year. This amount would be incurred due to people out of work through mental illness, employers suffering financially through absenteeism and low productivity, and governments’ welfare expenditures. A strain is also put on healthcare systems, as depression increases the risk of substance use disorders and diseases such as diabetes and heart disease. With better access to mental healthcare and, therefore, a vastly increased number of people in employment, every US dollar invested in improving mental healthcare has a return of four dollars.
SANE offers confidential emotional support services from professional staff and trained volunteers. Specialist knowledge, emotional support and information is available to anyone affected by mental illness, including family, friends and carers. If you think a person is in immediate danger, seek professional help from the emergency services, a crisis line, or a healthcare professional.
Helpline: 0300 304 7000 from 4:30pm – 10:30pm every evening
Textcare: Allows you to arrange for messages of support at times that are right for you
Support Forum: Available 24 hours a day to share or read experiences with other members and give and receive mutual support
Social media: Facebook and Twitter communities are a good source of support and sharing
Write to SANE at: SANE Services, St. Mark’s Studios, 14 Chillingworth Road, Islington, London, N7 8QJ
Call Samaritans on 116 123 any time of day or night. The service provides confidential emotional support for people who are experiencing feelings of distress, despair or suicidal thoughts.
Visit Samaritans website
Social media: Facebook and Twitter
Follow Adrian Garcia on Twitter: @cicbdc
Opinions expressed are those of the individual and do not necessarily reflect those of SANE.