Mojo, a successful CEO in his forties, lost his confidence and became anxious.
Her appetite disappeared along with her sexual desire and she lost nearly nine pounds.
Mojo believed his symptoms were nothing more than an expected response to his financial burden.
But after his wife insisted he needed help, he consulted Richard Friedman, professor of clinical psychiatry and director of the psychopharmacology clinic at Weill Corney Medical School, after he began to believe it could be a hindrance in the life of the his family and that he would have been better off without him.
In fact, Friedman diagnosed Mojo with “clinical depression,” noting in an article for “Washington Post‘, that his patient’s belief that his pain was just “normal anxiety” is very common.
Maher Dabaa, a professor of psychiatry at the American University of Cairo, explained to Al-Hurra that “clinical depression” means that the patient needs the help of a specialized psychiatrist and that he may not be able to cope with his condition. get out of it alone.
With the advent of the Corona pandemic, the climate crisis, rapid weather fluctuations, economic conditions, political conflicts and wars affecting the entire world, rates of depression and anxiety have increased, according to opinion polls.
Between 2019 and 2022, rates of anxiety symptoms in adults increased from 8 to 29 percent and rates of depression symptoms increased from 7 to 23 percent, according to the “Family Pulse” survey conducted by the National Center for Health. Statistics in collaboration with the Centers for Disease Control and Prevention.
In the Arab region, according to a survey conducted by The Arabic BarometerOut of 25,000 male and female citizens in the Middle East and North Africa, published in September 2020, 35% of them said they often feel stressed.
Tunisians (53%), Iraqis (49%) and Jordanians (42%) were among the most frequently or most frequently reported feelings of stress. Meanwhile, citizens in Egypt (27%), Algeria (27%), Sudan (22%) and Kuwait (12%) are less likely to report their feelings of stress.
Three out of ten people (29%) reported suffering from depression.
According to the survey, Iraqis (43%) and Tunisians (40%) reported the most depressive episodes, followed by Palestinians (37%). In comparison, citizens of Algeria (20%), Morocco (20%) and Sudan (15%) are less likely to admit to depression.
Dabaa told Al-Hurra that there are studies indicating that 80 percent of Egyptians suffer from depression, an exaggerated number, noting that he believes six out of ten Egyptians have experienced a period of depression in their life.
Hyena believes there has been a significant increase in cases of depression recently, “although we generally have a high rate mainly due to the many challenges and difficulties in our society, including social ones such as stumbling marriage or economic pressures,” noting that there is another depressive illness that arises from organic substances, such as taking certain medications that cause side effects.
He pointed out that many depressed patients do not seek a psychiatrist for treatment, and the condition persists for a long time, “due to popular misconceptions, including religious ones, that those suffering from depression are stigmatized as weak in faith, and it is it is said: ‘You are sad, because our Lord has no place in your life’ “, considering that this is a condemnation of normal feelings and a misrepresentation of depression as” sadness “.
How do you know if you are depressed or just plain sad?
Friedman considers depression a syndrome that involves much more than sadness and that, apart from sad or flat moods, depression typically causes insomnia, loss of libido and appetite, social withdrawal, low energy, feelings of hopelessness and thoughts. suicidal feelings, and actions.
“If you’re not sure, just ask yourself two questions: How many times in the past few weeks have you lost interest and pleasure in doing things? How many times have you felt discouraged or hopeless?” Says Friedman.
indicated A questionnaire specific to the patient’s health, saying, “If your score is three or higher, there’s a good chance you’re depressed, not just distressed.”
Hyena points out that there are two factors by which she can know whether the condition is considered just depression or extreme sadness.
He said: “All people go through periods of sadness, grief and frustration, but if these feelings continue to the same extent for about 14 days, depression can be diagnosed, especially if the issue affects the person so that they can no longer experience it. his life normally “.
On the indicators and signs of depression and what it means not to be able to lead a normal life, she said: “During this time, this person may not be able to go to work, unable to deal normally with people, avoid others and not being able to sit with his family and not having the ability to think well if his job requires mental effort, i.e. his inability to have an analytical view or a strong logical conclusion, and there are often physical pains resulting from psychological influences.
Depression is a disease
“There is abundant scientific evidence that clinical depression is associated with distinct brain changes in the circuits that regulate mood, sleep, energy and appetite,” says Friedman.
He said: “Brain imaging studies have identified multiple areas where there is altered activity or structure in people with depression. For example, in people with major depression, there is a decrease in the volume of the hippocampus ( or hippocampus), a region of the brain important for learning and memory.The longer and more severe the depression, the greater the contraction of the hippocampus.
The hyena, for its part, indicates that depression can result from psychological conditions or an organic cause, “meaning that there is a chemical disorder in the brain, which can be due to age groups or drugs that cause certain side effects. , which leads to disease. ”
Explain that “psychological conditions have different causes, such as a big problem for which he cannot find a solution, or a wife who is insulted or abused by her husband and always underestimates her, or a person who fails in her job and is always threatened. deportation or receives an insult from his manager or colleagues “.
There is no specific test or blood work, for example, that shows whether this depression is psychological or organic, according to Hyena.
“We still don’t understand why biological abnormalities in depression occur in the first place, but we think they’re caused by a complex interplay between genes and environmental stress,” says Friedman.
To find out if the depression is organic or psychological, a hyena starts with its patients to look for if they have a deep problem in their life and to work to solve it, “how to reform a marriage or change the dialogue a person who does not trust himself herself, then let’s see if the depression has diminished and has returned as a person to lead his life in a semi-normal way, or not.
He said: “If we find that all of this has not led to a result, there is a possibility that this depression is due to something organic,” noting that “these organic symptoms are suddenly related to a drug, for example, or a problem has occurred in the person’s body. ‘
Major depression affects 17 percent of Americans in their lives and is a major factor in suicide, with estimates suggesting that 2 to 15 percent of depressed people can die from suicide, according to the Washington Post.
Psychotherapy or drugs?
Hyena points out that depression resulting from organic conditions is treated with medication, while depression resulting from psychological conditions is treated with psychological treatment by changing the way you think or deal with marriage, reform marriage and the like.
Ma said: “We can resort to drugs from the start if the person is unable to respond to psychological treatment, even for a temporary period, and then stop treatment if it is proven that the disease is related to life circumstances. “.
“Both psychotherapy and antidepressants are very effective in treating depression,” says Friedman.
But he points out that “psychotherapy is the first-line treatment for people with mild to moderate depression, but when depression is severe, meaning psychotic symptoms or suicidal thoughts and feelings, a combination of treatment and antidepressant drugs is the most appropriate approach. safe and effective. ”
In 2019, the Centers for Disease Control and Prevention (CDC) estimated that 15.8 percent of Americans take mental health medications, but that number jumped to 25 percent last July.
“Antidepressants are not a cure for everyday unhappiness or distress and will not make you happier unless you have a form of clinical depression with associated biological changes,” Friedman warns against taking drugs for people who they feel very sad.
“Overusing antidepressants to treat natural distress is like using an antibiotic to treat a cold caused by a virus,” he said.
Friedman recommends exercising, noting that it has significant effects by releasing endorphins that help treat depression.
On how the drugs work, Hyena said: “They often inject themselves with a substance serotoninassociated with a feeling of happiness and that a person feels reconciled with his circumstances.
He added: “When serotonin decreases, a person cannot live his life normally,” noting that there are things other than medicines that increase this substance in the human body, such as chocolate, travel or changing living conditions and sometimes music, or sports and many other means, but the loudest AND the fastest is medicine.
He felt that “these drugs have good results, but they need experiments and there is a margin for error, which means that we try the drug and then we see its result after 14 days or more, then we reduce or increase the dose and in most cases where a person needs more than one drug and coordination between them helps reduce depression.
As for Mojo, Dr. Friedman’s patient, he was surprised and relieved when he explained that he suffered from severe depression rather than normal sadness or anxiety.
“My patient started taking antidepressants, his sleep and appetite improved within the first week, and by the end of the three weeks his dread and catastrophic thinking was gone,” says Friedman.
