Is South Africa a depressed nation? Statistics say we are

“Is mental illness the new global pandemic?”

Wednesday was World Mental Health Day and provided an opportunity to interrogate this issue and what it means for South Africans. Posing this question to the audience and a panel of experts at the Discovery headquarters in Sandton, facilitator Bongani Bingwa, journalist and host of the Breakfast show on 702, reminded those in attendance that mental health is not a “nice life problem”. “It’s a national question,” he said.

Around the world, including South Africa, depression is the most common form of mental illness. According to South African Depression and Anxiety Group (Sadag) operations director Cassey Chambers, one in three South Africans have or will have a mental health issue in their lifetime. Only one in 10 people with a mental health issue will be able to access treatment.

Economically, the severity of the problem costs South Africa about R161bn a year, with one in four employees diagnosed with depression. 

Discovery Vitality head of wellness Dr Mosima Mabunda provided a simple definition of depression: “Depression is a mood disorder characterised by a persistent feeling of sadness. You lose interest in activities of daily living. It also affects how you think, how you feel and how you behave. It’s not something you can just ‘snap out of’; it’s a medical condition.”

Discovery Life chief medical officer Dr Maritha van der Walt  said when depression affects your daily life it may look like an inability to perform daily activities, work or sometimes get out of bed.

“Depression is the primary driver of mental illness and young adults, adolescents and children are particularly vulnerable,” Chambers said. In South Africa, the youngest recorded suicide was a six-year-old.

“It is most often diagnosed in women because they are more likely to screen and reach out for help. Undiagnosed and untreated, depression is the leading cause of suicide in South Africa and globally. In South Africa, men are four times more likely to die by suicide than women.”

It is not to say that depression and mental health struggles did not exist before Covid-19, but the pandemic severely escalated the issue. According to Chambers, pre-Covid-19 Sadag received about 600 calls a day on its national helpline. Three years after, they receive 3,000 calls per day, with hundreds more reaching out via SMS, email and social media channels.

“Contributors to depression include everything from day-to-day stressors to trauma, loss, abuse, gender-based violence, the effects of crime, divorce and separation, financial stressors and more,” said Chambers.

Discovery Health chief clinical officer Dr Noluthando Nematswerani said mental health has been a pandemic for many years. “Mental health has always been an [unrecognised] problem. [But] depression is preventable and manageable.

“You could have symptoms you don’t think are depression. With regular screenings, you can detect this before the problem becomes harder to take care of.”

“Prevention is better than cure,” added Van der Walt “And when it comes to mental illness, for prevention to be possible, we need people to be aware of everything, from the risk factors for depression to the signs and symptoms people might experience and the help they can access. People also need to see depression as a disease and realise something can be done about it, ideally through a holistic approach that treats depression as a whole-body condition.”

If you need assistance, the panel of experts offered advice:

• It need not be a complicated matter to access treatment. Seek care from your GP who is in a position to make sure patients access the necessary care.
• If your medical scheme offers preventive screenings, make sure you do these regularly.
• Regardless of what medical scheme you’re part of, accessing mental health assistance falls under prescribed minimum benefits.   
• According to Mabunda, even small amounts of exercise have been associated with lowering the risk of depression.
• Many people living with mental illness don’t necessarily present with the typical symptoms. They may present with physical manifestations such as chronic pain and other chronic conditions. Mabunda said it’s important to be screened for mental health conditions such as depression if you present with symptoms such as insomnia, high blood pressure or cardiovascular conditions.
• Treating depression is not as simple as taking a tablet. It requires a holistic approach that involves gaining access to additional tools which may include adequate nutrition and exercise.
• If you need immediate assistance, contact Sadag on one of its 24-hour toll-free helplines. You can phone its suicide crisis helpline on 0800-567-567 or visit the website for more information and channels to contact.