In this podcast episode I interviewed Dr Omotolani  Aregbesola, a Senior Registrar at the Federal Neuro-Psychiatric Hospital, Yaba in Lagos, Nigeria.

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It leads to so many things, even first from the family. It leads to isolation. People don’t want to associate with the individual because the regular picture we have in mind, for someone that has mental illness, is oh the person is going to wear rag, the person is going to bite me, the person is going to hurt me, the person is going to wander about. So, the person actually suffers from rejection and isolation. Moving down to the work place, the person doesn’t even want to disclose to anybody that he or she has the mental illness because of the consequence of that; the person will be laid off or even identified with one status that is not going to be satisfactory. Now, look at the person’s marriage, if the person is married, that could lead to breakup in marriage or if the person is single, he or she may actually not get a companion, so, it goes on like that till old age, that’s usually how the person continues.

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It’s just trying to explain to everybody that look, whoever is coming down with depression or any other mental illness; it’s not his or her fault. Looking at the physiology, I mean the causes now, in psychiatric we always refer to it as bio-psycho-social – bio for biological causes, psycho for psychological causes and social for social causes.

For the biological causes, I’ve already mentioned part of it which is the genetic predisposition, here; we are talking about some individuals who have some chemical imbalance in their brain. There are some chemicals that are there to control one’s mood and one’s energy level, so if there is an imbalance, it actually disposes individuals to developing depression. Also, there are some organs in the brain, if they’re not well developed or they’re under functioning or over functioning, it actually disposes individuals to having depression. Also on biological causes too, I also mentioned that there are some chronic illnesses which could actually make somebody become depressed. For example, people having cancer, also, people having endocrine problems like having low cortisol level or very high cortisol level. These are things that could actually make an individual being disposed to having depression.

Then, going to the psychological causes, we’ll be talking about things like grief, some people who lose their loved ones, after grieving it normally goes beyond the normal grief, they could actually come down to depression. Things like early maternal loss, an individual that loses his or her mother at a very tender age, now, not able to adjust well while growing up, later could come down to depression.

We’d now be talking about the social factors which are very common around us here; talking about things like poverty, unemployment, cost of accommodation, so many other things like marital disputes, disharmony. So, it’s usually multi factorial, really, we really can’t identify that oh this is one single thing that is causing it, it’s usually so many things because if you are able to identify the predisposing factors, you’d also look for something that’s actually prerequisite to the individual coming down with depression at this time, and also looking at some factors that are actually maintaining it that are not allowing depression to be resolved on time because some people could snap out of it very easily, while for some people, it persists, so, these are factors we’re trying to identify in individuals as it goes beyond just identifying one thing, hence, it’s usually multi factorial.

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My advice is that if you are feeling sad and you realize that it is getting prolonged, and it occurs for most part of the day for, at least, two weeks and together with that you are having low energy level, you lose interest in things you used to enjoy and you realise that when there are happy events around you, your mood does not lift, we also have some other symptoms like … having low concentration, not eating well; you should talk to somebody.

It might just be a friend who might actually know what next to do because it is actually very difficult for people to just come on their own to psychiatric hospital. Most of all that do stay in our hospital are those that they’ve gone to so many places before finally coming to us. The pathway to care is so long, such that they’ve gone to a lot of religious homes, traditional healers before they come [to the hospital].

So, really it’s just like talk to somebody who would actually know what to do. But all the same, the person you are talking to, by experiencing similar symptoms, the fact that you are actually voicing it out is helping a lot. Don’t feel people will laugh at you, just talk to somebody and if you think there is nobody to talk to, you can walk to [someone at] the psychiatric hospital or better still any Doctor around [you]; you can just talk to the individual, the person should know what next to do or just come to the psychiatric hospital. You don’t really have to come to the registrar but just talk to somebody [at the psychiatric hospital] and the person will know what to do.

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In this conversation, we discuss many issues, amongst which are on:

• Culture
• Mental Health
• Public Spaces
• Stigmatisation
• Social Media
• Suicidal Thoughts

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