What is Depression?

Discuss about the Anti-Depression Campaign in UAE.

Depression can be defined as a mental health disorder that affects how an individual develops negative feeling about himself. It is a serious medical illness. It affects how an individual thinks and how he acts in different strenuous situations. Depression is seen to cause feelings of sadness where an individual also loses interests in the activities that he or she used to enjoy before. Depression is often seen to lead to a number of emotional as well as physical problems (Eldredge et al., 2016). These problems in turn reduce the capability of a person to function properly both in professional and personal domains. These lead to the development of a poor quality life. With the passing of days and life becoming more complicated in professional, academic as well as personal fronts, chances of individuals being affected with depression is also increasing. Often people are not being able to understand that they are affected by the symptoms are depression. They consider themselves to be going through a period of sadness and isolate themselves from their social lives. They are often now aware of the symptoms of depression for which they can identify their present mental health condition. As a result, they tend to procrastinate and cannot recognize the need to get mental health. Therefore, many individuals are often seen to live a poor quality life without knowing that there are mental health interventions that can cure them (Merkur, McDaid & Sassi, 2015). Therefore, it is important to take initiatives to make people aware of the different symptoms of depression. They should be also made to know how they could handle such symptoms by taking proper help from the healthcare professionals, communities, family members and many others. In case of children and young adults, it becomes very important for the parents and family members to identify the symptoms and guide their wards in proper manners through specific interventions. This will help in making the communities aware of the symptoms and help them fight depression and lead better quality lives.

There are large numbers of symptoms that often accompany individuals who suffer from depression. Identification of these symptoms is extremely important for the individuals suffering from depression or for those family members, friends and acquaintances who are spending time with the depressed individuals. Identifying symptoms is the preliminary step, as proper identification only will lead to the proceeding of individuals towards getting healthcare aids. Constant feelings of hopelessness or pessimism are one symptom of depression. Such individuals have persistent sad as well as anxious mood. Irritability is one another symptom that is also noticed in depressed individuals. Many individuals who are supporting from depression also develop feelings of guilt, helplessness as well as worthlessness. Individuals are also seen to lose interests as well as pleasure in different hobbies and activities (Naidoo & Wills, 2016) . They also show decreased energy and prolonged fatigue that they cannot overcome anyhow. Different researchers conducted by researchers over the years have also noted that such patients talk or move slowly in a restricted manner. They also feel restless and might face trouble sitting still. Such restlessness should be identified to be one of the symptoms of depression. People who are suffering from depression also face difficulty in concentrating, remembering as well as in making decisions. They also face difficulty in sleeping. They cannot have early morning awakening and oversleeping such individuals are also seen to undergo severe weight loss as well as changes in weight. They also have different sorts of thoughts of death or suicide. They are also seen to take attempts in suicide that affect their lives and lives of those members who are attached with her mentally and emotionally. Various physical ailments that also accompany such individuals are aches and pains, cramps, digestive problems, headaches and many others without a clear physical cause. Such physical disorders do not even cease with the treatments.

Symptoms of Depression

Researchers often note different types of factors that pay an important role in depression. Biochemistry plays an important role in depression. Different types of traumatic life events can trigger depression. Besides, poor diet, imbalances in blood sugar, different genetic conditions, hormonal imbalance. Medical illness, drug and alcohol use, lack of exercises, medication and digestive difficulties are some of the causes of depression. These triggers are mainly seen to contribute to different types of neurotransmitter imbalances. Researchers are of the opinion that biochemistry of the brain plays an important role in depressive disorders. Several studies have revealed that individuals who suffer form massive depressive illness also exhibit dysregulation of different types of brain chemicals like neurotransmitters. Neurotransmitters are different chemicals that are significant as they carry different signals to brain and different nerves. When the messages are not delivered properly, it can lead to depression s and other mental and physical problems. In addition to this factor, genetics are also seen to play an important role as researchers state that when depression is seen to run in the families, wards are also exposed to chances of being affected by depression. A British research team is seen to develop a research article where they had conducted a survey of many families with recurrent depression. The chromosome 3p25-26 is seen to occur in more than 800 families who were diagnosed with recurrent depression (Mak et al., 2015). Recent statistics state that 40% of the depression can be traced back to genetic link whereas environmental factors and other factors make up for 60% of the depression cases. Personality can also play an important role as risk factors for depression. Stress easily overwhelms individuals who have low self-esteem. Pessimistic individuals appear to experience depression at higher rates than other individuals who are not pessimistic. Such individuals cannot manage stress effectively. Many individuals are gradually able to overcome stressful events like death of loved one, an illness, loss of jobs, when relationships spiraling downward and many others. However, people with los self esteem and low self-confidences cannot overcome stress allowing it to play an important role in depression. Stress again has its own physiological consequences. It mainly causes triggering of the chain of chemical reactions and different types of responses in the body. If the stress is seen to be short lived, the body usually comes back to the normal function. When the stress becomes chronic, the system is stuck in overdrive, changes in brain, and the body takes place (Bartels et al., 2015). This results in the individuals to suffer from depression. Environmental factors are also the factors that play major role in occurrence of depression. Different types of exposure may lead to the occurrence of depression in individuals. This includes exposure to violence, abuse, neglect, poverty and many other situations. All the factors are interconnected leading to depression in individuals.

Causes of Depression

The studies conducted by World Health organization has found out that more than 300 million people are affected globally due to depression. In certain cases, depression in individuals had also led to result in several cases of suicides. About 80,000 people are seen by WHO to die due to suicide in every year. Suicide duet to depression had lead to second largest cause of death in 15 to 29 years old in the different regions of the world. The proportion of the global population who suffer from depression in the year 2015 is found to be about 4.4%. Moreover, depression is also seen to be higher in case of women that accounts to about 5.1% in comparison to males that is about 3.6%. Out of the 322 million people, half of the people are seen to be present in the south east Asian region as well as in Western Pacific Region. Moreover, WHO has also stated that between the years of 2005 and 2015, the estimated number of people living with depression has been seen to be increased by 18.4%. This reflects the overall growth of the disease burden globally. About 9% of the depressed individuals are from the African region that accounts for about 29.19% and 16% of the individuals are from eastern Mediterranean region that account for about 52.98 million people. 12% of the depression cases are from European region that account for about 40.27 million of people. 155 million people of 322 million people are found to be present from region of the America that accounts for about 48.16 million people from the 322 million people having the disease burden. Moreover, 27% of the cases are seen to be noted in the region of south East Asia (Bartels et al., 2015). In this region, the total number of cases of depression is seen to reach a number of 85.67 million people. 21% of depression cases are noted to be in the western pacific region. Here the totals number of cases I seen to be around 66.21 million. Therefore, depression has indeed become the major contribution of diseases burden globally, which had affected quality lives of millions of people.

Figure: pie chart for prevalence of depression globally

An article published by Gulf News Society in the month of February on 26^th in the year 2018 had given data about the statistics of people suffering from depression. This article has been published by the work of Dr. Tara Wyne who is a clinical psychologist as well as the clinical director at Lighthouse Arabian in Dubai. This Dubai-based health expert has stated that about 4 to 5% of the population of UAE has been suffering from depression. She is of the opinion that mild depression is affecting around 15 percent of the population of UAE. She is of the opinion that adjustment disorder as well as different issues with relationships is the most commonly observed causes for depression in the regions of the UAE (Carolina D’Souza, 2018). Moreover, there also remains a huge pressure on the adolescents and young adults to excel in life and derive a better life in the future. The region is also stated to be fast paced where the focus of the life mainly revolves around work and other achievements. Individuals face a large number of challenges and transitions in their lives that creates stress in the individuals. Dr Tara Wyne are also of the opinion that support systems and support mechanism are not present which could help the individuals in such situations. There has been social stigma associated with the disorders and therefore, individuals try to either hide their situations or try to keep the situation a secret. They are often seen to feel lost and unsupported for which they can never get the opportunity to overcome the disorders. Another article from the Gulf News Society states that currently depression has been ranked as the fourth of the ten leading causes of the global Burden of diseases.  This has been noted from the comprehensive and global assessment on the count of mortality and disability from amount diseases and injuries. Dr Talaat Mattar is a consultant psychiatrist at the ministry and conference speaker. He had stated to Gulf News that especially clinical depression cases are mainly on the rise and therefore effective health promotion campaigns for identification, awareness and support should be established. Dr Matter had clearly stated that depression is the mental disorder that has the highest number of cases in UAE (Report, 2018). This is then followed by the disorder of anxiety disorders and then by bipolar disorders. The disorder that ranks fourth is schizophrenia according to him.

Diagnosis of Depression

A leading daily of Abu Dhabi, called the National has published an interesting article on the February in 2018. The paper had successfully identified the cohort who had been most exposed to the symptoms of depression in the present generation. On the world Health Day, doctors had been seen to advise parents on the different warning signs of depression as well as anxiety in the young children and teen. They want the parents to learn about the different aspects of depression that is faced by children, adolescents and the young adults. They should make sure that they could help them with proper guidance and interventions about how to overcome the different issues properly. The article had stated that the young people are increasingly reliant on the social media and any other unvetted access to information online. This had resulted in increased rates of depression and other mental health issues. World health organization had state that UAE has been exhibiting the highest rank in the regional level of depression with 5.1 percent of population. The Emirates had also been ranking highest for anxiety in the tables displayed by WHO with 4.1 percent of population admitting of the problem. Moreover, it was also seen that in the year 2015, there were 444,016 cases of depression that was reported in the primary health centers. 354,199 people had sought for help due to their sufferance from anxiety (Olarte-ulherr, 2015). It is becoming common is adolescents and the young adults who are the most vulnerable patients for depression. A rate of about 4% of depression cases are notified among the children with that of the figure reaching to 20% in the adolescents and young adults. Experts have mainly blamed the stress of school life and social media is to have been the main reasons for depression in the adolescents. The work and career pressures of the young adults and the emotional turmoil in the relationship faced by them in such tender ages create huge stress among the cohort. Another interesting fact has been stated in the article by psychiatrist Dr Rasha Bassim. He is the clinical director of the Priory in Dubai Health Care City. He had been heard stating that the often there are different cultures which work and live in the same environment in Dubai. This can also lead to the creating of stressful mainly in case for young people. Social media has the capability to affect the study as well as the concentration of the individuals in their classes. Parents rarely have any mediums of control about what their children are exposed to the social networking sites. Many researchers are of the opinion that it is indeed true for the children to get their freedom to explore but is again a challenge to keep them safe from such situations. Young people are seen to share many personal things online that affect their social lives and harm the individuals emotionally. Patients are found to be busy nowadays and do not have proper ideas about how to handle the issues of depression in their sons and daughters nowadays. Even many of the parents are seen not to be able to distinguish between depression and sadness of their children and consider them as phases of their lives which will move on. Again, in many cases, guardians even cannot understand that their wards need support. Lack of proper communication and bond may result in such situations.  Therefore, it is extremely important for the healthcare professionals as well as social workers to develop health promotion programs that would help in targeting adolescents and young adults properly. Moreover, family members would be involved so that they can cat as guides to the affected individuals effectively.

Treatment of Depression

It is very important for different health care workers to select proper healthcare models by which they can correctly address the different aspects of the target audience. The health care campaigns would be such that it would include interventions at all important levels and help in overcoming the barriers that come in the pathways. Different types of healthcare programs can be developed based on a number of models. These are the ecological models, health belief models, relapse prevention models, theory of reasoned action, stages of change model, social cognitive model and many others. Researchers have stated that it is also very important for the healthcare workers to identify the correct models that can help them to cover up the necessary aspects of the disorder and help in managing the disorder in the target audience properly (Hyun, Son & Stark, 2017). For the mental health issue of depression in the adolescents and young adults in the nation, the ecological model would be the best-suited model. This model helps in focusing on five important aspects which when handled sequentially could lead to proper changes in the target cohort. This would prevent the target audience from getting affected by depression.

Steps:

The first step of this health model is taking intervention for the modification of the interpersonal or the individual factors. Such factors are mainly responsible for the influencing the behavior of the cohort such as their knowledge, personality, attitudes and personality. The second step is called the interpersonal factors. This step would mainly involve considering the interactions with different stakeholders. The healthcare promoters would mainly develop interventions and accumulate strategies that help in providing social support to the cohort. They will also help in overcoming barriers to different forms of interpersonal growth that helps in promoting healthy behaviors. The third aspect is the institutional as well as organizational factors. This mainly comprises of the different rules, regulations, informal structures and policies that helps to promote or contain healthy behaviors. The fourth aspect is the evaluation and modifying of the community factors, which mainly involves the different formal and informal social norms that exists between the different individuals, organizations and groups which limiter enhance healthy behaviors the last aspect is the development of a public policy which will mainly include local., federal as well as state policies and laws. This would help to regulate as well as support different sorts of health actions and practices for diseases prevention (Gilbert, 2016). The public policy will have detailed guidelines of early detection, control and management of depression in the cohort. The interventions that would be taken should cover all the five aspects in a complete and detailed manner.

Depression Worldwide

The first stage would mainly include conducting a social analysis. Communities would be selected and statistical data needs to be collected to identify urgency of the issues. For this, the easiest and the cost effective procedure would be to conduct surveys. The surveys would be closed ended and would be of two types. The first type would be for the adolescents and the young adults. This would be a multiple-choice questionnaire where the answers would be helpful in identifying the different symptoms of the adolescents. The answers, which would be selected, by the adolescents and young adults will automatically help in understanding whether they are suffering from depression. The questionnaires would be requested to be distributed in the schools and colleges so that the adolescents and young adults can properly fill them and submit back to their teachers. Before that, the schools and colleges would be properly made to know the rationale of the health promotion campaign so that the professors and teachers can also contribute to the health promotional campaign by equal participation. The next set of survey would be conducted of the parents of the communities. The questionnaire will be an open-ended questionnaire where the healthcare workers will be able to develop ideas about the knowledge and ideas of the parents about depression, whether they can distinguish between depression and sadness of their wards, their interventions when they find their children depressed, their communication with their children, their bonds with them and many others (Karp, 2016). These would be helpful in developing ideas about how the parents handle situations when their child is depressed, their procedures of identification of their depression and many others. The surveys mainly would take two and half weeks following which the data would be collected for social analysis.

The second step would mainly incorporate introduction of several strategies that would help in spreading awareness of the disorder of depression and thereby help in identification of the different symptoms of depression. One of the preliminary ways of developing awareness is preparation of pamphlets and brochures. These brochures and pamphlets would be developed in ways by which the parents and family member can relate the symptoms with their wards. A checklist would be provided to them so that they can check the symptoms and thereby decide whether their wards need help or not. They should also be provided with brochures that would have detailed pathophysiology, risk factors and symptoms of depression in details. Care should be taken so that the brochure that is developed properly is free from jargons and can be easily understood by all. The better the health literacy of the parents and family members, they would be able to handle their wards properly and will be able to provide them with proper guidance. Therefore, the parents should be requested to go through the pamphlets and brochures ensuring that they gather preliminary knowledge on the topic of depression and can identify if their wards are depressed.

Conclusion

The third stage would be to work in partnerships with the colleges and schools and help the institutions to set up the screening centers within their campus. The adolescents and the young adults would be properly screened to find out if they are undergoing symptoms of depression. They would be also asked about the different activities they do throughout the day, the pressures and stress they develop and the different types or coping mechanism they are aware of. These screening sessions would help in identifying the different interventions that need to be taken in the next step so that the students can gradually overcome the issues properly (Costello, 2016).

The fourth stage would be to conduct conferences in the community halls. Mental health experts would mainly conduct the conferences. They would be describing the issues in details and help the parents and family members to understand the importance of proper identification of the disorders. They would be also given advices about how they could properly help their wards when they undergo depression. They are also given the advices of the different community and support services that they can undertake to help their wards in overcoming depression. Another important area that is very important within the health promotion campaign is the arrangement of counseling sessions within both the cohorts. There would be separate dates which would be given to the target cohort and that the parents of the wrong adults and adolescents. The first counseling sessions would be mainly conducted to help the cohort overcome the symptoms and depression and introduce new means of modifying their lives for betterment. The second counseling sessions would be for the parents and family members. This would not be entirely a counseling session but would be a combination of counseling and education sessions where the parents would be actively participating. In such sessions, the parent’s idea of depression, their well-being, their relationship with their wards would be made to know. Their thinking procedures should be reflected in the duration of the counseling and following their thinking procedures, the counselors would then plan their education procedures. The parents should be educated in the sessions separately according to lack of knowledge at an individual level, so that the parents become the best support to their wards during their crucial times. The parents would be also advised to set up proper communication with their wards and develop deep bonds so that the wards can share their feelings, emotional and their stress with them.

The fifth stage would mainly be including the interventions that would be done at the social and political levels to develop an environment that would help the target cohort in overcoming depression. In order to raise awareness among the community members, proper advertisements would be preapared that will help the community dwellers to realize depression as a form of mental health disorder that requires attention and treatment. There can be placards which will contain the time and venue about when counseling sessions would be help, conferences where mental health experts who provide their view point  and many others. These advertisements will help the dwellers not only to know that depression is curable but would also help them to be aware of the venues where they can go to get help. Often societies are seen to stigmatize depression and other mental health related issues in ways by which they isolate the members and exclude them from the societies. Therefore, many of the individuals are seen to hide their issues from the society and keep themselves excluded from their social lives. The parents also remain unaware of the issues and cannot understand how to help their wards in such crisis. Therefore, changes in the society are also necessary. Important interventions should be taken so that there is a change in the thinking procedures of the society and the society itself becomes a part of the healthcare campaigns supporting such individuals properly. These would make the individuals of the cohort express their concerns and issues that would help in tackling the issues of depression properly in the communities. Therefore, one of the most important intervention that would be taken is this regard is the development of a social policy. A social policy would be developed which would help in giving detailed description of the issue of depression in adolescents and young adults. This policy would be written directed to the entire society that will help the society gain knowledge of the disorder properly. This policy would contain information of the statistical data conducted in the communities of UAE. Following this information, proper knowledge about the risks factors should be included. Different symptoms should also be included along with the clear explanation about the patho-physiology of the disorder. This information will help to remove the stigma of the society and help them to understand how they could extend their help to the affected individuals. Different interventions, support services and community workshops would be introduced in the policy guidelines by which the society can provide support to individuals. The parents would be also expected to go through the policy properly so that they can be huge support to the wards in their crucial times and follow the guidelines to help them overcome the issues.

The sixth stage is mainly consists of modifying the causes which results in occurrences of depression in the cohorts. The most important source that causes depression among the individuals is the social networking sites. Exposure of the individuals to the contents on the internet makes them vulnerable to development of different types of feelings among the individuals. These may result the young adults or adolescents to develop feelings of hopelessness when they see their peers to possess things that they do not have. They also are exposed to different forms of cyber bullying and harassments that lead to development of severe depression. Harmful behaviors of bullying often seen online include posting of rumors, sexual information of an individual, threats, personal information of the victim and many others. These result in the pressure on the victims who become quite concerned about their social image, personal and professional lives, their relationships with near, and dear ones. These make them vulnerable to develop depression when they remain exposed to such issues at a constant rate. When victims remain exposed to different forms of cyber bullying, they are seen to develop lower self-esteem. They are seen to remain depressed and anxious about the same time and often get exposed to different forms of crimes. Many individuals develop hopelessness when they cannot fight such issues properly or does not possess the same poprerties that are possessed by other members on social networks. Such intense feeling of depression results in increased suicidal ideation. This also results in development of a variety of emotional responses that include being scared, angry, depressed and frustrated. Denigration also takes place largely on social sites. This includes sending or posting of cruel rumors and falsehoods. These in turn has resulted in damaging of reputation and friendships. This also results in affecting the different the individuals to large extent and makes them suffer from depression. Moreover, impersonation and exclusion result in adding to the stressful situations of the individuals. Therefore, it becomes an important initiative for the health promotion campaigns to develop proper strategies by which such crimes can be stopped and further occurrence of depression can be prevented.

The strategies that need to be taken for preventing the occurrence of depression are to prepare their parents to be their best companions in times of cyber-bullying. The parents should be counseled and educated in ways so that they can handle the different issues faced by their wards. They can make them confident by sharing their concerns. When wards find their parents as the biggest support they can overcome many issues of cyber bullying successfully. Therefore, the health promotion program will be taking up certain strategies like making parents as the greatest support of their wards (Miller & Riahson, 2016). Another strategy that should be incorporated is conducting classes by which they can overcome barriers in their social lives by proper strategy formulation by them. Separates brochures can be prepared by which all the important strategies to handle cyber-bullying will be shared. Proper time of disengagement from social sites, logging off on the correct time, blocking of haters and harassers, using privacy settings, taking screen shots, reporting it to cyber crime departments and many others can be included in the brochures. The society and other stakeholders should understand the factors and should never blame the individuals who are the victims.

The last phase of the campaign is the evaluation phase. Until the different strategies that is taken in the health promotion campaign is evaluated properly, the health promotion program can never be considered as the successful one. For effective evaluation, monitoring committees would be set where the stakeholders would have respective duties. They would conduct open-ended interviews about the condition of the wards after the health promotion programs. Moreover, the individuals who were counseled for overcoming their depression would be monitored and their follow up sessions should be noted. The reports of the individuals developed by their counselors in the communities and their screening mentors in the schools would help us to know how better the young minds are faring in their lives. Moreover, in the schools, a discussion forum would be arranged every week so that the cohort can express their concerns, their likings and disliking of the campaigns.  They would be asked about their relationships with their family members and how they are helping them in battling their depressions. Open-ended questionnaires can also be prepared for the parents discussing how they have helped their wards in coping with depression. They would be also asked about their moods and behaviors of their wards that can also reflect the success rate of the campaigns. Evaluation of the effectivity of the brochures in fighting depression and cyber-bullying can be tested by observing the reaction of the individuals on the same and knowing how they had helped the individuals.

Conclusion:

From the entire discussion above, it becomes clear that depression has been one of the most common mental health disorders that had contributed to the disease burden in the entire world. It has also been found that the nation of UAE, depression had affected a large number of population out of which the adolescents and the young adults are the most vulnerable. Huge number of mental health experts is of the opinion that the huge exposure of the cohort to the social networking sites and the world of internet had been the main reason of the situations. Another issue that often affects the situation is the ignorance of the parents or the improper communication and attitude of the parents in the strenuous situations, parents are often seen to be judgmental or they fail to identify that their wards are under pressure and are suffering from depression. The society further aggravates the situations by stigmatizing the issues and making the individuals excluded from the social circles. Therefore, in order to develop the quality of lives of the cohort and to give them a proper future, health promotion campaign should be arranged. The health promotion campaign should be based on a proper health promotion model so that all the aspects can be handled properly. Ecological model is the selected model that mainly comprises of five important domains where the interventions should be applied. These are intrapersonal factors, interpersonal factors, organizational factors, community factors and public policy. The different strategies which are prepared are the conducting of surveys for both parents and wards so that their ideas and knowledge about depression can be analyzed. The screenings should also be arranged in schools and colleges to find out whether the individuals of the cohort are suffering from depression. Proper counseling sessions would be developed for the students where mental health experts would help them to overcome depression. Similar education sessions would be arranged for parents where tactics to handle their wards effectively in their crucial times would be taught. Moreover, pamphlets and brochures will be prepared – one of them would be entirely based on patho-physiology of depression, identification symptoms, risk factors and many others and the other would be on cyber bullying and different strategies to overcome cyber bullying. All these would ultimately help in overcoming depressions in effective ways. Proper policy would be prepared by which the society can overcome the stigma of mental health and can follow the policy guidelines to understand the different symptoms of depression and help the affected individuals through community support and services. Effective evaluation would then be conducted to ensure success of the health promotion campaigns. This would ensure high quality lives of the cohort.

References:

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