You may think you have depression when you occasionally have mood swings, sadness, or irritability, but depression is more than that.
Key facts
- Depression is nearly two times more common in women than men.
- Depression affects 5.95% of women and 4.9% of men in Africa respectively
- Women face depression more due a variety of factors that include hormone related conditions, life circumstances and culture.
- Depression brings about self-harm and suicide.
What is depression?
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.
Factors causing depression among African women
- Genetic: This has proven to be a key factor in the cause of depression. People whose parents have depression are three times more likely to develop depression than the general population. However, because depression is associated with a combination of triggers, the fact that you have a family history of depression does not necessarily mean that you will have it,
- Personality traits: If you have low self-esteem or you’re overly critical of yourself, you may be more vulnerable to depression. This is often due to nature and/or nurture factors.
- Social Factors: Social events such as bereavement, divorce and family and relationship issues may trigger depression in women.
- Culture: Several African societies have many cultural practices that are hostile towards women and place immense pressure on them. Examples include a negative outlook and expressions about women who are late in marrying or having children. If a woman is of marriageable age and unable to settle down, she encounters pressure. Some African women who have been married for some years and are labelled barren because their marriages have not produced children are shamed by their families and face different kinds of backlash. This is because some African traditions or religions consider “barrenness” to be shameful and believe that giving birth to children is the pride of an African woman.
- Economic Factors: African women face significant financial hardship. Some might be the sole provider of their families, which causes them considerable stress. They struggle to provide the basic amenities for themselves and their family. Others may be home-bound and therefore solely dependent on their male spouse for economic survival. Africa women, like their compatriots globally, also face pay disparity and unequal access to economic resources and financial wellbeing.
- Pregnancy and Childbirth: The hormonal and physical changes that occur in pregnancy, as well as the added responsibility of a new life, can trigger depression in some women. When the depression occurs before childbirth, it is referred to as antenatal depression. When it occurs after childbirth, it is referred to as postnatal depression.
- Menopause: This is a condition that occurs in women between the ages of 45 to 55 years. It reflects a time in your life when your stops due to low hormone levels. It may trigger depression, particularly within the first few years. Note that menopause can also cause mental health symptoms like sadness and mood swings. These are not the same as depression.
- Isolation: Living in isolation and being cut off from family and friends can increase your risk of depression.
- Sexual abuse and Domestic violence: Statistics indicate that 51% of African women report domestic violence by their husbands for either going out without permission, refusing to have sex or arguing back. Studies have shown that around 35–70% of women subjected to domestic violence are diagnosed with depression later in life.
Common types of depression among African women
The three most common types of depression affecting African women, according to available data, are:
Major depression
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.
Postpartum depression
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).
Premenstrual dysphoric disorder (PMDD)
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%.
Symptoms of PMDD
These include:
- Appetite changes
- Mood swings
- Low self-esteem
- Severe anxiety
- Extreme fatigue
How depression is diagnosed among African women
To be diagnosed with depression, you must have experienced symptoms every day for at least two weeks. The primary symptom is anhedonia (loss of interest), which must be significant enough to cause impairment in activities. It’s best to seek medical treatment for depression if you think you have depression.
Treatment for depression among African women
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.
Challenges affecting the treatment of depression among African women
The peculiar difficulties that prevent African women from accessing treatment for depression are discussed below:
Stigma and discrimination
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.
Limited trained medical personnel
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
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 high cost that is required to treat depression, some African women are not be able to afford the cost of orthodox care, including the medications 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 three months. This is a challenge some African women living in poverty face. For this reason, depression may remain untreated.
Solution to the challenges that affect the treatment of depression among African women
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.
Education
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.
Adequately 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.
Women Empowerment
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.
Action against Domestic Violence
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.
Conclusion
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.
Resources
Adeyemo EO, Oluwole EO, Kanma-Okafor OJ, Izuka OM, Odeyemi KA. Prevalence and predictors of postpartum depression among postnatal women in Lagos, Nigeria. African health sciences, 2020. 20(4), 1943–1954. https://doi.org/10.4314/ahs.v20i4.53
Baloyi, ME. Gendered character of barrenness in an African context: An African pastoral study. In die Skriflig, 2017. 51(1), 1-7. http://dol.org/4102/ids.v5.
Bhowmik D, Kumar S, Srivastava S, Paswan S, Dutta AS. Depression-symptoms, causes, medications and therapies. Pharma Innov.. 2012. 1. 32-45.
Eldeeb SM, Eladl AM, Elshabrawy A, Youssef AM, Ibrahim MH. Prevalence, phenomenology and personality characteristics of premenstrual dysphoric disorder among female students at Zagazig University, Egypt. African J. Prim Health Care & Fam Med. 2021.13(1), :e1-e9. doi: 10.4102/phcfm.v13i1.2924.
Gao M, Zhang H, Gao Z, Cheng X, Sun Y, Qiao M, Gao D. Global and regional prevalence and burden for premenstrual syndrome and premenstrual dysphoric disorder: A study protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022 Jan 7;101(1):e28528. doi: 10.1097/MD.0000000000028528.
Mughal S, Azhar Y, Siddiqui W. Postpartum Depression. In: StatPearls [Internet, Updated 2022 Oct 7]. Treasure Island (FL): StatPearls Publishing; Accessed 2024 Jan- 10. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519070/
Murray RL, Crane JS. Scabies. In: StatPearls [Internet, Updated 2023 Jul 31.] Treasure Island (FL): StatPearls Publishing; Accessed 2024 Jan- 10. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544306/
Nathanson AM, Shorey RC, Tirone V, Rhatigan DL. The Prevalence of Mental Health Disorders in a Community Sample of Female Victims of Intimate Partner Violence. Partner abuse, 2012. 3(1), 59–75. https://doi.org/10.1891/1946-6560.3.1.59
WHO. Depression. [Internet. March 31, 2023]. Accessed 21st December 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/depression
WHO. Reversing suicide, mental health crisis in Africa. [Internet. October 2022] Accessed 19th December 2023. Available from: https://www.afro.who.int/news/reversing-suicide-mental-health-crisis-africa
Published: August 20, 2024
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