Growing burden of disease takes its toll on sa’s mental health

The number of South Africans facing mental health challenges as a result of the country’s growing incidence of chronic disease is rising at a worrisome rate, warns experts.

Mariska van Aswegen, spokesperson for Pharma Dynamics – a generics pharmaceutical firm specialising in the treatment of depression and anxiety – says the country’s increased demand for antidepressants over the past few years is likely to be attributed to the surge in chronic illnesses such as HIV/AIDS, diabetes, cancer and cardiovascular disease plaguing the country.

“People with chronic medical conditions are at risk of developing symptoms of depression. It is estimated that nearly a third of individuals with a chronic illness have a mood disorder, such as depression and anxiety,” she says.

Chronic diseases are becoming the highest cause of death in developing countries and already account for 40 % of deaths in SA. It’s a sad state of affairs with 6.3 million South Africans suffering from high blood pressure, resulting in 130 heart attacks and 240 strokes daily. A further 47 000 lives are lost annually to cancer and 3.5 million people suffer from diabetes.

With SA’s alarming upward trend in chronic disease prevalence, so too the demand for antidepressants in the country has increased by a staggering 39% over the past five years.

What causes depression to co-exist with chronic illnesses? Van Aswegen says depression itself can be caused by a combination of genetic, biological, environmental and psychological factors. But, having a chronic illness, which usually results in tremendous life changes and interferes with how well you function, can be a major contributor to depression. It’s completely normal for people with a chronic illness to feel despair.

“Although any illness can trigger depression, the risk of chronic illness and depression gets higher with the severity of the illness and the level of life disruption it causes, especially if it causes pain and fatigue or limits a person’s ability to interact with others.

“The risk of depression in individuals considered to be healthy, is usually 10% to 25% for women and 5% to 12% for men, but those with chronic illnesses face a much higher risk — between 25% to 33%. Research shows that 40% to 65% of heart-attack patients, 40% of Parkinson’s patients, 25% of cancer patients and 30% to 54% of patients with chronic pain syndrome develop depression.

“It can be a shock to learn that you have a chronic illness,” says Van Aswegen, “but as you learn more about your illness and how to take care of yourself, your feelings may change. It’s important to recognise too that a combination of factors can cause depression when you have a chronic illness. These include the situation itself, changes in appearance, mobility, independence, pain and fatigue and/or side effects of medication and other treatments.

“To cope with chronic illness, you need to rethink your goals and creatively find opportunities in your new reality. If you can’t manage as much as you used to, don’t be hard on yourself. Learn to set yourself reachable goals while keeping your situation in mind.

“Isolation only leads to depression and it is easy to isolate yourself when you are feeling low. Don’t be afraid to ask for help and don’t say no when people offer assistance. If however your symptoms worsen, explore psychotherapy (talk therapy) with a healthcare professional, which will also help to determine the severity of your mood disorder,” she adds.

Those who are managing a chronic illness and are overwhelmed by feelings of worthlessness, constant fatigue, insomnia, suicidal thoughts, loss of appetite or interest in activities that used to bring you joy, speak to your doctor or contact Pharma Dynamics’ toll-free helpline on 0800 205 026, which is manned by trained counsellors who are on call from 8am to 8pm, seven days a week. 



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