Posted on: Wed 10-07-2019

Increase In Depression/Suicide In Nigeria: A Ticking Time Bomb.  A Paper Presented By:  Wellington Omorogbe Ogieriakhi (RN, RPN, BNSC. PGDE), Federal Neuro-Psychiatric Hospital Benin City. At The 2019 Annual Feast Of Barracuda/Free Medical Mission of National Association Of Seadogs (Pyrates Confraternity), Arabella Deck At Ankor Point, Plot 52, Iguosa Federal Housing Estate, Iguosa Benin City On Saturday 29th June, 2019.

A TICKING TIME BOMB: A problematic situation that will eventually become dangerous if not addressed.

DEFINITION OF DEPRESSION: It is defined as a state of psycho-motor retardation. It is regarded as a psychiatric emergency because of suicide or suicidal attempt.

HAPPINESS RATING: According a BBC publication on Thursday, 2nd October 2003, of over 65 Countries surveyed, the happiest people on earth were Nigerians; but in 2019, Nigeria ranks 85 on the annual Global happiness index as at March 2019 and the 8th most depressed nation in the world after China, India, USA, Brazil, Russia, Indonesia, Pakistan,

CAUSES OF DEPRESSION:

• Heredity
• Trauma
• Drugs
• Frustration
• Life's events like starting a new job, marriage, graduating, losing a job or income, getting divorced, or retiring, rejection, it could be triggered by a medical condition. However clinical depression is not a normal reaction to stressful life events.

TYPES OF DEPRESSION:

• Reactive depression
• Psychotic depression
• Puerperal depression
• Senile depression
•  Involutional melancholy.

SYMPTOMS OF DEPRESSION:

• Agitation
• Anxiety
• Constipation
• Hypochondria
• Insomnia
• Intellectual impairment
• Physical immobility
• Loss of pleasure in things
• Change in appetite
• Feeling worthless or guilty
• Loss of concentration
• Indecisiveness
• Contemplation of suicide

DEFINITION OF SUICIDE:

Suicide is the act of causing one's own death intentionally. It is otherwise referred to as self-murder. Most people love their lives too much. So, they prevent their lives from suffering too much by taking it and the suffering stops.

TYPES OF SUICIDE:

Egoistic suicide: suicide caused by lonely life due to rejection, past crime, helplessness, illness, Hopelessness etc. Fatalistic suicide comes from societal oppression, convection of one's property by oppressors, economic downturn, and lack of political will to better the life of citizens. Affected individuals are mentally and physically repressed. Victim feel oppressed due to imprisonment, insult, kidnapping, armed robbery and police brutality. Anomic suicide: individuals in this group usually feel they have made a grievous and inevasible mistake in life. Sometimes it borders on unutilized opportunities and perhaps age has caught with the individual. It could also be committed as a result of social embarrassment such as sexual assault or severe financial embarrassment. This is the type common with teenagers. Altruistic suicide: caused by severe influential control by society or a group of people over an individual or individuals The people in this group are suicide bombers and soldier who sacrifice their lives for the.. glory of their country. Others commit suicide in cult groups to appease a leader, the gods, or for a spiritual cause.

INCIDENCES

• Age: ages 10-24, and ages 44.
• Young adult males are more like to commit suicide.
• Males are four times more likely to commit suicide than females.
• Substance abuse
• Poverty.
• History of sexual and physical abuse.

CAUSES OF SUICIDE:

• Chronic or terminal illness.
• Sexual or physical abuse.  
• Incarceration or ex convicts.
• Domestic violence.
• Mental illness like depression.
• Loss of loved ones.
• Verbal assault.
• Divorce.
• Feelings of not progressing in life.
• Loss of job.
• Loss of huge amount of money.
• Loss of custody of children or child.
• Severe pains.
• Kidnapping.
• Low self esteem.
• Hopelessness in a trapped situation.
• Injury from accident.
• Drug abuse.
• Alcohol abuse
• Family rejection  
• Perceived humiliation
• Severe incapacitation
• Bad parenting
• Law resilience.

Suicide rating: Nigeria was ranked 5th on annual suicide list of the World Health Organization as published by Spectator Index on July 29th 2018. Nigeria placed fifth with 15,000 suicides in every 100,000 suicides. However, the list was topped by South Korea with 24,000,000 followed by Russia with 18,000,000.

SIGNS OF SUICIDE IDEATION:

• Changes in a person's behaviour,
• Social isolation
• The person talks about death or more about suicide
• Always talking about feeling trapped
• Talking about being a burden to others
• Increasing the use of alcohol or other drugs
• Sleeping to little or too much
• Showing rage or talking about seeking revenge
• Displaying extreme mood swings
• Putting things in order, like writing or changing wills
• Saying things like "it were better I wasn't here  
• Visiting or calling people to amends or to say goodbyes
• Loss of interest in former hobbies
• Having a death wish by taking deadly risks
• Buying and hoarding lethal drugs
• Purchasing a fire arm should be a cause for alarm

PREVENTION:

Defusing the Bomb

• Family cohesion and open-mindedness
• There is a need to talk to someone about it if you fee pressured.
• There is need to speak out if you see signs in anyone.
• Guide those that fear are at the risk to seek professional help
• Show more compassion and support for the person you suspect committing suicide
• Stop stigmatizing those with mental illness.
• Giving hope to those with depression.
• Psychotherapy.
• Effective treatment of associated causes like depression and substance abuse.  
• Social and family support
• Resilience and coping skills
• Religious faith
• Restricted access to lethal means
• Unobtrusive observation
• Create a therapeutic environment
• Ensure patient takes his or her drugs as and when due.
• Listen to the content of his or her conversation if they are laced with suicidal ideation
• Keep sharp instruments away from the reach of the patient
• Ensure you monitor what when he or she eats the food served, otherwise the patient may adapt the means of hunger strike as an alternative.
• Admission to the hospital for expert management is necessary.

REFERENCES

Wijkstra, J; Lijmer, 3; Balk, F3; Geddes, JR; Nolen, WA (2006). "Pharmacological treatment for unipolar psychotic depression: Systematic review and meta-analysis". British Journal of Psychiatry. 188 (5): 410-5 Schatzberg, AF (2003 New approaches to managing psychotic depression. The Journal of Clinical Psychiatry. 19-23 Stedman's Medical Dictionary (28th ed.). Philadelphia: Lippincott Williams & Wilkins. 2006.

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