THE local COVID-19 victims, in excess of 660 persons to date, have left behind their bereaved family members to face life’s challenges without them. Apart from the number of persons associated with the death toll, over 27,000 persons who were infected would have gone through some period of stress not fully confident of their recovery; “a second chance” for which they ought to be extremely grateful.

In the US, during the pandemic, elevated levels of poor mental health were reported such as substance abuse, suicidal ideation, anxiety and depressive disorders. Such disorderly outbursts were seen in the 4,184 cases reported by the Federal Aviation Administration where “strange” behaviours were displayed by passengers which caused fights, abuse and drama.

Although stats were not published in Guyana on mental health for the corresponding period, you can conclude that these challenging times determine who sink or swim to shore. The synergistic crippling effect of the pandemic and climate change on the economy has impacted negatively on the individuals’ earning capacity fuelling depression. Further, working under stressful conditions, especially the front line workers who make daily sacrificial choices to help others, contribute to mental breakdown.

Depression is a chronic medical condition which occurs when the brain reacts to the stressors (those situations which trigger stress) thereby creating a chemical imbalance. The brain is wired like a circuit to transmit information via neurotransmitters known as serotonin, dopamine and norepinephrine. In a depressed patient’s brain there is a serotonin deficiency.

RECOGNISING DEPRESSION
Emotional symptoms include sadness (not just a temporary mood), uncontrollable crying, loss of interest in the things you once liked doing, feeling guilty or unworthy, restlessness, cannot concentrate and make decisions. Physical symptoms are fatigue, lack of energy, changes in weight due to changes in eating patterns (some overeat while some lose their appetite). Additional symptoms may include irritability, anxiety and thoughts of death and suicide. Note that these are not signs of personal weakness.

In a different era, some of the most intelligent, talented and famous persons suffered from depression. We were either inspired, charmed or entertained by these well-known persons shown in the photos below, without an inkling that they struggled with depression at some point in their lives. Two of the four highlighted have passed on. Therefore let’s reach out to those suffering in our midst by recognising this chronic illness.

Just to understand what a depressed person go through, take a peek into the low moments of these phenomenal and talented souls.

Princess Dianna Jim Carrey Asley Judd Michael Jackson

Princess Dianna
In a 1995 interview conducted by the BBC, Diana revealed that she had suffered from post-partum depression after her first son, Prince William was born. She admitted to self-injuring due to the pressure she felt trying to adapt to her role as Princess of Wales, but said it backfired since rather than getting her the help she needed, it made people believe she was attention-seeking and unstable. She also confessed to secret binging and purging of food to help her deal with her marital problems.

Jim Carrey
In the 60 Minutes interview he explained, “There are peaks, there are valleys. But they’re all kind of carved and smoothed out, and it feels like a low level of despair you live in. Where you’re not getting any answers, but you’re living OK. And you can smile at the office. You know? But it’s a low level of despair.
Ashley Judd
Spoke about her problems with food addiction which was spotted by her sister’s counsellor. For the first time someone was validating the emotional pain that Ashley felt. She quoted in Glamour “I was unhappy and now I’m happy. Now, even when I’m having a rough day, it’s better than my best day before treatment.”

The lyrics of Michael Jackson songs speak for itself.

Some red alert quotes you will hear from a depressed person:
“I feel sad all the time and just don’t feel like myself.”
“I don’t enjoy being with my friends and doing any of the things I usually love to do.”
“I’ve been having a lot of trouble sleeping lately.”
“Sometimes I feel like my life is not worth living anymore.”
“I feel like I don’t have any energy.”
“I’m not really interested in eating.”
“Even after a long day I still feel restless.”
“I feel so indecisive and that I can’t make any decisions.”

So how do you help? By showing a little more compassionate and less judgement, giving unconditional love (love without any conditions or requirements which we impose or expect as a parent, spouse or partner), encouraging exercise, meditation and prayers, giving positive counsel and engaging in discussion especially if suicidal thoughts are mentioned and most importantly, suggesting that the depressed person visit a doctor. Medications may be required in moderate or severe cases. If the patient is put on medication he /she must be monitored since it has been established that some of these antidepressants have induced suicidal ideation.

Anti-depressants are POMs (prescription only medications) and follow up for patient monitoring is advisable since it may take 2-3 weeks before the optimum effect is reached. This explains why you need this same time lapse before switching any treatment regime. There are three prevalent categories of anti-depressants today namely SSRI (selective serotonin reuptake inhibitors), SNRI (serotonin and norepinephrine reuptake inhibitors) and NDRI (norepinephrine and dopamine reuptake inhibitors). In the earlier days MAOI (monoamine-oxidase inhibitors) were prescribed but to a lesser degree than the tricyclics due to their side effects and drug interactions with other medications and certain foods.

Some popular SSRI are fluoxetine, sertraline, paroxetine whilst the popular SNRI are Cymbalta and Effexor XR. However in Guyana the tricyclics are most commonly prescribed such as amitriptyline and imipramine. Wellbutrin marketed by GlaxoSmithKline is a NDRI which is not only indicated for depression but also cessation of smoking.

The most common side effects of antidepressants are headache, dry mouth, dizziness, diarrhea / constipation and insomnia or drowsiness.

For further advice consult the pharmacist at Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.