Depression has no boundaries, “Let’s Talk” about it!

A health provider counsels a Syrian woman at an IRC clinic in Mafraq, Jordan. Melissa Winkler/IRC

A Syrian adolescent girl is living in besieged Damascus. She witnesses unthinkable acts of violence and is forced to stop attending school, which is being targeted by bombings. She lost her appetite recently and is unable to sleep. Her recent weight loss worries her uncle who now takes care of her. Once an exuberant girl, now she sits and stares out the window and secretly thinks about ending her life (a silent killer accounting for the second leading cause of death among 15–29 year olds).

An Afghani woman living in Denver, Colorado recently resettled with her family and is attending a local mosque and learning English. Lately her neighbors appear to be speaking in hushed tones when they see her, and she thought she heard someone make a derogatory comment about her hijab on the bus. She feels increasingly anxious when she leaves the house, and notices her appetite is diminished. She experiences guilt for having these feelings because she is now living in a ‘safe’ place in the US and is struggling to tell her resettlement caseworker that she thinks she needs some extra help.

A South Sudanese man living in a refugee camp in Northern Uganda, among 511,000 other refugees and asylum-seekers, experiences persistent headaches and stomach aches, has little interest in engaging in livelihood activities, and has developed hypertension. He visits the local facility but no mention of possible depression is made and even if it was, he holds the belief that only weak individuals experience halat ikti’ab (depression in Arabic).

A new mother in Liberia feels confused by her low energy levels after giving birth, with pervasive sadness and bouts of extreme anxiety. No one warned her that being a first time mother could feel like this. Fear of being deemed an unfit mother and confusion causes her to keep these feelings to herself, while each day she struggles with an unknown condition that she doesn’t have the words to quantify.

April 7th, 2017 marks the 67th World Heath Day. This year, the world is reminded of the staggering impact of depression across low, middle, and high income countries. Depression is now the leading cause of ill health and disability across the world, affecting more than 300 million people.

Depression has no boundaries, impacting individuals and families across all of the contexts in which the IRC works and lives. We share this burden with those we serve, as well as with our loved ones.

It is notable that more women are affected than men, as depression following childbirth is quite common (affecting 1 in 6 women who have given birth). Despite the lack of attention to mental health in most government budgets, the economics of providing care make sense — every $1 invested in treatment for depression leads to a $4 return in overall increased wellness and ability to maintain a livelihood.

IRC provides mental health and psychosocial support across US and International programs to help address depression’s impacts on individuals and families. In US Programs, community support groups are implemented in office and garden settings to promote emotional health and wellness, thereby reducing stigma associated with mental health. Groups also foster existing social supports within communities. Access to appropriate individual and group therapeutic clinical support is key, but culturally competent care (with appropriate language support) is not available consistently across the United States.

In IRC’s health programming, the WHO mental health gap action (mhGAP) programme guidelines provide an evidence-based approach to assessment and management of key mental health concerns, inclusive of depression, for IRC non-specialized health and community-based providers. IRC adheres to the mhGAP guidelines, by providing group and individual therapeutic services to women, men, and children, to prevent and treat depression.

The WHO marks this year’s World Health Day with the tagline, “Let’s Talk.” “Let’s Talk” symbolizes the importance of having a conversation, and the goal of the campaign is for more people to seek and get help. “Let’s Talk” is a call to action: let’s have an open conversation about depression, whether with a family member or a friend, in schools or in community settings, or with a medical professional. Let’s bring depression out from under the shadow and into the light.

This post is authored by IRC Mental Health Technical Advisors Ashley Nemiro and Annie Bonz.

The International Rescue Committee responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is at work in over 40 countries and 26 U.S. cities helping people to survive, reclaim control of their future and strengthen their communities.

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