By Nr. Chika Jones RN, RM, RPHN, BNSc. Freelance writer and DatelinehealthAfrica Volunteer.
Edited by: Victoria Iyeduala. Freelance Health Writer. Medically review by the DLHA Team.
Young African women dancing in happy moments. Image by Freepik. Click on image to enlarge.
You may think you have depression when you occasionally have mood swings, sadness, or irritability, but depression is more than that.
Depression is a common mental disorder that presents with a persistent feeling of sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
Women regularly face mood swings or irritability due to their hormonal shifts, but they can adapt to them, and it does not affect their lives. Pathological depression occurs when adaptation is ineffective.
Depression can also be known as major depression, major depressive disorder, or clinical depression.
This article aims to enlighten you on depression among African women, its symptoms, risk factors, treatment and the challenges to treatment.
Learn more about the Risk factors for major depression
The three most common types of depression affecting African women, according to available data, are:
This is the most common type of depression globally and in Africa. It is characterised by a combination of symptoms that reflect depressed mood and loss of interest in pleasurable daily activities, plus others that interfere with the ability to work, sleep, eat, or enjoy motor activities. The symptoms must have been displayed consistently for two weeks.
Major depressive disorder is a significant cause of self-harm and suicide. For this reason, it is critically important to identify the condition early and to seek care promptly.
It affects mothers at least two weeks after delivering their baby. Postpartum depression (PPD) symptoms are identical to those of major depression, but the major difference is the symptoms manifest after childbirth.
Studies show that one in seven women can develop postpartum depression. The estimated prevalence of postpartum depression in Africa is about 18%, but studies in individual countries have reported a higher rate. African women with PPD might also develop psychotic symptoms such as delusions and hallucinations (for example, hearing voices threatening to harm the baby).
It is a severe form of premenstrual syndrome (PMS) that affects African women of reproductive age. PMS is a group of changes that occur during ovulation or before the start of a menstrual cycle.
PMS starts before and wanes after the menstrual period. Most African women experience symptoms that do not affect their way of life, but for some, they do. Those who experience symptoms that affect their way of life deal with PMDD. PMDD is a severe and chronic form of PMS.
Studies have shown that 2–8% of women experience PMDD. Although the studies on the prevalence of PMDD in Africa are unknown, individual studies done in some African countries reported a higher rate of PMDD. A Moroccan study reported that the prevalence of PMDD was 50.2%, while a Nigerian study reported PMDD rate of 38.3%.
These include:
To be diagnosed with depression, your doctor will obtain your detailed medical history and perform a comprehensive examination (psycho-social). Your doctor will be looking to know if you have experienced symptoms every day for at least two weeks. One of the primary symptom of major depression, is anhedonia (loss of interest in daily activities), which must be significant enough to cause impairment. It's best to seek medical treatment for proper diagnosis if you think you have depression.
There is no significant data on the treatment of depression among African women. Because of the negative socio-spiritual belief systems and stigma associated with mental health problems in most African societies, African women with depression are more likely to seek care from traditional healers and religious establishment than from an orthodox mental health professional like a psychiatrist. Studies have shown that the first course of treatment is either self-help or psychotherapy. If you or a loved one has symptoms of depression, visit with a primary care doctor or a mental health professional at your earliest opportunity. The classical orthodox approach to the treatment of moderate to severe depression includes a combination of psychotherapy and medications.
The peculiar difficulties that prevent African women from accessing treatment for depression are discussed below:
Though mental health and its importance are a topic that is gradually accepted, there is still a lot of community-level education work to be done. Stigma devalues people with mental disorders and prevents them from getting access to treatment. Most African women may be afraid of the stigma they will face from their friends and family once they know they are mentally ill. Other African women may not be properly educated about mental health and are held down by their own beliefs.
This may be a major barrier to getting treated for depression. Most antidepressants might only be bought with a doctor's prescription and may not be easily accessible.
The brain drain of medical workers is significantly impacting Africans, and psychiatrists are affected. Statistics indicate that Africa has one psychiatrist per 500,000 people, while the global standard is 1 to 10,000 patients. This shows that psychiatrists in African countries potentially have to handle fifty times the standard number of people and in poor health facilities. Such pressure could cause psychiatrist to leave Africa for greener pastures abroad.
Poverty leaves the African woman handicapped with no way to provide for themselves and their family. According to statistics, in 2022, 431 million people live on $2 or below daily. This makes it difficult for an African woman and her family to get the basic amenities. Due to the cost of personnel and medications that are needed to treat depression, some African women are not be able to afford the cost of orthodox care, and may opt to seek care from traditional or religious leaders. It is important to note that for antidepressants (drugs used to treat depression) to be effective, you must take them consistently for at least three months and much longer thereafter. This is a challenge some African women living in poverty face. For this reason, depression may remain untreated.
To ensure African women have unrestricted access to mental health treatment, the challenges affecting them must be resolved. Ways to achieve this are suggested below.
There needs to be mass awareness about depression and mental disorders among all sectors, especially in rural areas. Health workers in primary care should be given periodic education on mental disorders and what they can do to help at their level.
Trained medical personnel
Governments in different African countries should establish policies that promote mental health and allocate budgets for mental health care. They should also update existing mental health policies to eradicate stigma and create awareness. Better mental health facilities should be built and properly maintained. Health workers should be paid adequately and provided conditions for job satisfaction to prevent disinterest in their work and resultant brain drain.
One of the challenges that African women face is poverty, which can contribute to the root cause of depression. Women empowerment programmes can be organised to equip African women with the support and skills they require to be economically self-sufficient.
Some African women may be uneducated and unable to get a job to provide for themselves or their families. Such women can be taught various life skills like hairdressing and tailoring or given scholarships if they want to return to school. Efforts should be made to provide them with the full support they need.
Women empowerment should not only focus on the economic aspects, but also the social and legal areas. An African woman who faces gender-based discrimination in her environment should receive the support that she needs to address the situation rather than be discouraged and face depression.
Although there is little data on the effect of domestic violence on depression among African women, some African women who are victims of domestic violence may likely face depression later on in life.
An important approach to fight against domestic violence is for the government to enact laws to promote support and justice for African women facing domestic violence.
There should also be mass awareness of the rights an African woman has and debunk myths that say a woman is inferior and can be subjected to domestic violence.
Depression is a serious common mental health disorder in which women are more at risk. Africans generally and the African woman in particular need to be educated on mental health issues so as to reduce the stigma commonly associated with it. They should be encouraged to address their mental health disorders properly rather than be silenced.
Governments in different African countries have significant roles to play to ensure that African women get adequate social, financial and treatment support for major mental health disorders like depression. Mental health is just as important as physical health and it is worthy of all the attention that the later gets.
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Published: January 15, 2024
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