Breaking the silence

22nd September 2021

Mental health issues have been placed firmly in the spotlight as the Covid-19 pandemic sweeps through the world. But has this had any effect on those who suffer in silence?

I’m a journalist, through and through, and feel more comfortable reporting about something than writing about myself. I actually don’t like doing the latter at all, but I do feel it’s time to break the silence …

I live with depression. Sometimes it’s a shadowy passenger (in the back of my mind) and, every so often, I truly suffer from it. Usually I have it under control, but it took years of therapy and medication before I reached that point.

My road to recovery started in 2018. When Covid hit, I was (luckily) in the “having it under control” part of the cycle. For other people, this was not the case. We know of one company that has lost three staff members to Covid in the past six months. However, Covid won’t be specified on their death certificates – since they all committed suicide.

When mental health started making the headlines, I remember thinking to myself: “This is great. People plagued by mental health issues might find some respite as doors are being opened for them to start the necessary conversations.”

But that isn’t how it works. That isn’t how my depression works. When you’re stuck in the darkness, the mere process of continuing with your existence zaps whatever energy you have left. So, while the doors might be open, someone who needs help might not use the opportunity. (Truth be told, it took years before I even realised that I had depression. The abyss consumed so much of me that I truly thought that the way I felt was just part of normal existence … So, I didn’t even think of reaching out to someone.)

And I am, sadly, not alone. Loyiso Maqubela, a clinical psychologist practising at Akeso Milnerton, a private mental health facility in Cape Town, notes that men are facing a “silent crisis”. This is underscored by the World Health Organization report that men in South Africa are four times more likely to commit suicide than women. “This should indicate far higher rates of depression among men in South Africa, and yet we see significantly more women seeking help for depression,” he says.

This accords with the professional experience of Alexander Oosthuysen, a clinical psychologist at Akeso Parktown in Johannesburg, who notes that about 80% of the general population seeking help at the mental health facility for conditions such as depression is female. “On the other hand, approximately 75% to 85% of those receiving treatment for substance abuse and similar disorders are male.”

It happens to everyone

Maqubela points out that everyone, at times, faces enormous changes in life, which may trigger mental health difficulties. These include major events, such as marriage, becoming a parent, relocating, changing career, divorce, losing a job, change in financial status, or the loss of a loved one.

“These types of events can affect how you view yourself and can trigger a very wide range, or a particularly intense experience, of emotions. It is important for an individual to be able to express and address these feelings. Emotions are just part of the contract in this thing called life,” says Maqubela.

When to get help

Oosthuysen likens seeking help to driving a vehicle: “If you are at the wheel and it’s starting to get a little dark but you’re unsure whether you need to have the lights on, you should turn them on. Therapy is much the same – if you are starting to wonder whether you need it, you probably do.”

According to the experts, there are some warning signs that tend to present in people experiencing mental health issues, such as:

An inability to function normally on a daily basis.
Decreased self-care.
A change in relationships.
Dramatic changes in sleep patterns.
Unintentional changes in eating patterns.
An increase in risky behaviour.
Increased apathy.
Being emotionally dysregulated (an emotional state or response that is not normal for the individual and would be considered deeply worrying).

But these symptoms might not be apparent. It can be difficult to spot signs in someone with high-functioning depression. They often appear completely fine on the outside. My nearest and dearest didn’t even know that I had depression until I had a complete breakdown one Sunday afternoon.

Finding the right fit and feeling supported

When it comes to therapy, Oosthuysen notes that finding the right therapist is a very personal choice. “It is not like buying paracetamol and any pharmacy will do. You need to find a therapist who you are comfortable with,” he says.

“Bear in mind that an individual is more likely to try therapy if someone else they know has had a positive experience with it. It may also mean looking at different types of therapy. Group therapy in different settings, such as a hike in nature, can often work well.”

This rang true for me. I spoke to an old friend, who also lives with depression, before I gave therapy a try. I still send her a message from time to time if I feel the darkness creeping back.

It is important to break the silence and to realise that you are not alone.

You can contact info@akeso.co.za or visit www.akeso.co.za or www.copetherapy.co.za if you are in an emotional crisis, would like some more information about concentration and memory concerns, or to access mental health services.

In the event of a psychological crisis, emergency support can be reached at 0861 435 787, 24 hours a day.

The South African Depression and Anxiety Group (SADAG) also offers some amazing resources at www.sadag.org.