Sadly, we still live in a time when not everyone understands antidepressants and depression in South Africa. In some cases, people disclosing their mental health issues have been labelled “crazy”, “pretending to be sick” and “not strong enough”. This kind of attitude can lead to patients not seeking help, which can deteriorate their mental health further.It’s a troubling reality in a country where a quarter of South Africans are thought to be depressed. Of those, a majority never receive treatment. Antidepressants are a powerful tool in alleviating the symptoms of depression, anxiety and other mental health conditions, but misconceptions about the meds persist. Per the South African Society of Psychiatrists (SASOP), “the stigma associated with mental illness, as well as the misconception about the benefits and use of antidepressants serve as major barriers to people seeking assistance.”In the interest of breaking the stigma that permeates mental health in South Africa, here are things to know about antidepressants and depression, from SASOP.Nobody chooses to be depressedFirst – and most importantly: depression is not a choice. “It is a common misconception that depression is a condition that can easily be overcome by simply ‘snapping out of it’,” says Dr Gagu Matsebula, specialist psychiatrist and member of SASOP. “However, no one chooses to be depressed. Depression is not a sign of weakness; a result of wallowing in grief or sadness, a lack of positive thinking or self-pity. It is a medical condition that negatively impacts brain function due to biological or environmental factors.”Depression comes in different circumstancesWhile it’s not a disease you can “catch”, there are triggers:Genetics – strong medical evidence shows that genetic factors up the risk of depressive disorders.
Anxiety – studies show that depression is linked to other mental health disorders and that higher levels of anxiety can, over time, predict higher depression levels.
Trauma and early adversity – It’s widely acknowledged that traumatic events (including loss, grief, stress and abuse) can lead to depression and PTSD.
Socio-economic status – evidence shows a link between a lower socio-economic position and mental health issues. A 2019 study of South Africans noted a cycle: “people could get trapped in a vicious cycle in which poor socio-economic conditions lead to depression, which, in turn, can cause further damage to their economic prospects.”READ MORE: More People Are Using Ketamine For Depression – But How Safe Is It?Symptoms of depression can differ“Depression manifests as a persistent feeling of sadness as well as a loss of interest in previously enjoyed activities, and it typically lasts for more than two weeks,” explains Dr Matsebula. “It affects thinking, memory, motivation, eating and sleeping patterns, and can lead to substance abuse as a coping mechanism.”Other symptoms of depression include:Prolonged feelings of irritation or restlessness
Persistently feeling sad and empty
Poor concentration, memory or decision-making abilities
Feelings of excessive guilt or low self-worth
Hopelessness about the future
Thoughts about dying or suicide
Disrupted sleep (including insomnia or hypersomnia (oversleeping), or early morning awakening)
Changes in appetite or weight
Feeling very tired or low in energy
Increased usage of alcohol or drugs
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
Deterioration of social relationshipsMost notably, when you’re depressed (and not just sad), those feelings last most of the day, almost every day and at least for two weeks.Depression looks different for everyoneThe World Health Organisation notes that not one person’s experience of depression is like another’s. Depressive episodes can be mild, moderate or severe; they can occur once or repeatedly; people’s abilities to do things can differ. For example, some people with depression can retain the ability to focus, while others can’t.READ MORE: 4 Proudly South African Apps For Mental Health SupportHow to get helpIf you suspect you have depression, it’s critical (we underlined it because it’s *that* important) that you seek professional help. Even a GP will be able to assist – they can also prescribe antidepressants. But a good GP will refer you to a psychiatrist and psychologist for specialised care. If you have medical aid, take heart: Prescribed Minimum Benefits mean that with any medical aid scheme (regardless of the plan), you’re able to access a number of mental health resources, like psychiatrist or psychologist sessions – for free.These resources are there for *you*These avenues are accessible and available for you, in any situation. Never feel afraid to reach out.SADAG
This national organisation has resources, helplines and more for anyone looking to get treatment for depression or anxiety.
Humanitas
Humanitas offers counselling services for anyone for free. Your counsellor will be a counselling intern with a degree in either psychology or social work.
Headroom
This site is a database with legs. It allows you to access psychologists, counsellors, and social workers and to book therapy sessions.
How antidepressants workOnce you’ve spoken to a doc or psychiatrist, they may prescribe antidepressants. The technical term is selective serotine reuptake inhibitors (SSRIs). You may have heard of some of them: sertraline (Zoloft) or fluoxetine (Prozac).Here’s how they work: “SSRIs work by increasing the levels of serotonin in the brain, a neurotransmitter that carries signals between the brain’s nerve cells, ultimately improving one’s mood,” explains Dr Matsebula. In some people, serotonin can be “dumped” by the body, creating a deficit that causes mood to plummet. SSRIs work to prevent that action. “This medication prevents the reabsorption of serotonin into nerve cells, thereby increasing its availability and improving message transmission. The ultimate goal of antidepressants is to restore the balance of deficiencies of serotonin and other neurotransmitters that may be causing the depressive symptoms.”For many people, it’s a total game-changer, improving energy levels, happiness and contentment. “Some people fear antidepressants, but it is safe to use. There are several types of antidepressants, with different side-effect profiles,” says Dr Matsebula.You might need to change medsBecause of those side effects (and efficacy), it’s totally normal to have to change meds sometimes. Per SASOP, while many individuals respond well to the first prescription of antidepressants, some may need to try several different antidepressants before finding the one that works best for them.This is also why it’s crucial to stay in contact with your doctor. They will be able to take note of your symptoms and any possible side effects and tailor a solution for your body. Regular sessions (every three months) are critical. If your memory sucks or you generally don’t pay attention to your body, keep a journal! Every little thing counts.READ MORE: Many Women Are Battling Depression During Pregnancy. Here’s What To Know, If You’re StrugglingAntidepressants don’t work overnightUnlike headache pills or antibiotics, antidepressants are long-acting treatments, meaning they take a long time to work. We’re talking weeks.“It is crucial to be patient when using antidepressants and to take the medication daily as prescribed by a doctor. It may take several weeks for the medication to take full effect and it is important to continue with the prescription for at least six months to prevent symptoms from recurring. Every person responds differently to antidepressants and some individuals may require long-term usage,” says Dr Matsebula.Also, if you’re feeling better: don’t stop your treatment. It’s not like a cold; if the meds are working, so you should keep taking them. “It is vital not to stop the medication or reduce the dosage independently, even if feeling better. Unlike other medications such as sleeping tablets, antidepressants do not cause physical dependence or addiction. A doctor’s guidance is crucial when increasing or reducing the dosage or ending the treatment,” says Dr Matsebula.Antidepressants don’t “cure” depressionDr Matsebula says it is important to note that depression is treatable through medication to address the underlying biological issues contributing to the condition. The most common treatment approach combines medication with talk therapy (psychotherapy). Plus, this approach tends to have the best outcome for patients.Talk therapy (chats with a licensed psychologist or counsellor) is highly beneficial in addressing depressive symptoms by exploring, and processing, past and current experiences with a trained professional such as a psychologist. This approach is particularly useful for situational depressive episodes (such as the loss of a loved one or partner conflict) or childhood trauma, as it helps the patient gain clarity and an understanding of the root causes of distress.You don’t have to feel depressed foreverLastly, it’s important to remember that you can get help – and feel better. Remember, seeking professional help is crucial in managing depression effectively, and there are resources available to support you throughout your journey to recovery and living a healthy, fulfilling life.To get help for your friends, family, colleagues, or yourself, please speak to your GP, or contact the South African Depression and Anxiety Group (SADAG) on 0800 12 13 14, or send an SMS to 32312 and a counsellor will call you back.
Michelle October
Michelle is the features editor at WH. She’s immensely curious about the world, passionate about health and wellness and enjoys a good surf when the waves are good. Find her on Instagram here. More
