Depression remains a complex health issue that according to medical experts can physically manifest in many ways. In Rwanda, just like in many parts of the world, the challenge of dealing with depression starts with correct diagnosis.

Psychiatrists are now asking the public to consider regular consultations in order to avoid diseases related to depression.

According to research done last year by Ndera Neuro-psychiatric Hospital, depression accounts for 23 per cent of psychiatric disorders in the country.

But Dr Rutakayire Bizoza, a psychiatrist at the hospital, says that this figure is just the tip of the iceberg. "We saw a big number of patients come to consult in the hospital with different complaints like continuous headache or lack of appetite and that is just a fraction of those who should seek medical care,” he said.

He adds that many people have not sought help, ending up in addiction or suicide. "Some of the people in Icyizere Rehabilitation Centre [in Kicukiro] are there because of depression; so if people can prevent it they can avoid such a scenario,” Bizoza said.

What is depression and what causes it?

Bizoza explained that feeling depressed can be a normal reaction to loss, life’s struggles or injured self-esteem.

"But when feelings of intense sadness; including feeling helpless, hopeless, and worthless lasts for many days or weeks and stop you from functioning normally, then your depression may be something more than sadness,” he said.

Other symptoms include loss of interest in social activities, sex and general loss of ability to feel joy and pleasure.

Significant weight loss or gain – a change of more than 5 per cent in a month is also something to worry about.

Other symptoms include insomnia, especially waking up in the early hours of the morning, anger or irritability, feeling agitated, restless, or even violent.

If your tolerance level is low, your temper short, and everything and everyone gets on your nerves, loss of energy, sluggish, and physically drained then you need to consult. And when your whole body feels heavy, and even small tasks are exhausting or take longer to complete; you engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports, then depression may be having its toll on you.

Most at risk

Although depression is common in today’s society, there are groups that are most affected such as those in prison, people living with HIV and those with marital problems.

Officials from correctional services say that inmates are some of the people who are sometimes faced with this condition. That is why the correction services have put in place different mechanisms to help them overcome the condition. These include counseling, participating in different activities that enable them avoid isolation.

Boniface Harerimana, the manager and mental health clinician at Icyizere Centre, said that most cases are managed by working hand in hand with the family members of patient.

"We engage family members to treat cases of depression, because they are with them in most cases,” he said.

General statistics

Statistics from Ndera , the only referral facility of the kind, show that the number of people consulting for mental illnesses increased by 26 per cent between 2012 and 2013.

The data gathered from the hospital and its two affiliate clinics; Caraes-Butare and Icyizere Centre, indicate that they increased from 39,069 in 2012 to 49,161 in 2013.

Epilepsy and Schizophrenia (plus other psychotic disorders) were found to have the biggest occurrence, with 29.7 percent and 19.6 percent respectively.

The report from the hospital adds that cases of mental illness were higher in adult females at 44 per cent compared to 40 per cent in adult males, and 16 per cent in children. 

It adds that April of every year usually registers the biggest number of patients, due to Genocide-related trauma. April 2014 registered 5,137 cases, a high increase from 2, 770 in February. 

The report however points out, that mortality of mentally ill patients reduced from 27 in 2012, to 24 last year.