Analysis of Depression in Rural Areas - Term Paper Example

Depression among the rural populations Name Course Tutor Date Depression among the rural populations Abstract All over the country and at certain place, a person has felt or undergone depression, loneliness, and misunderstood. WHO (2008) state the condition of depression is common for everybody at a certain point in time and is a natural response to life difficulties, a loss and a dispirited self-worth. When this sort of feeling of grief turns intense, takes a longer period, and it stops someone from living a usual life, it is time the depression disorder require to be examined more strongly. Agency for Health Care Policy & Research, claim that “depression is under diagnosed & untreated by majority of medical doctors, in spite of the reality that it can nearly always be treated effectively”. If not checked, The World Health Organization (WHO, 2012) warns that by 2020, depression could be the second major source key of disease in the whole world. Depression affects 20% of all American citizens, even without some knowing it during life time. Depression rates vary extensively across regions but the research indicates that there is high rate of the disease among the rural populations. Table of Contents Depression among the rural populations 2 Abstract 2 Table of Contents 3 1.0 Introduction 4 2.0 Overview on depression 5 3.0 Causes of depression in rural population 5 4.0 Symptoms of Depression 8 5.0 Strategies and supportive care strategies for Depression 9 6.0 Further research questions 11 7.0Conclusion 11 8.0 References 12 1.0 Introduction Depression is a common clinical disorder which affects thousands of rural population each year. Depression has very serious impact on rural population far much more than various chronic diseases and is presently the primary basis of disability globally. The economic effect of mental disorders generally, inflicts a number costs on families, individual in the rural areas. The WHO (2012) approximates that about 300,000 people in rural areas of Ireland experience depression. Depressive disorders stands at 16 percent of every admissions to psychiatric hospitals in Ireland in 2006 (Boydell et al, 2006, p.186) and 13 percent of admissions to community health facilities in 2006. However, it is approximated that depression has a combined community incidence of 15-30% of the rural population in Australia (Boydell et al, 2006, p. 187). In relation to these realizations, the key concern of this paper is to outline what the disorder ‘Depression’ is, overview on the illness, investigate its causes, its implications on rural population, offer strategies and supportive care strategies for this disorder. Finally the paper will generate a possible question for further research investigation. 2.0 Overview on depression Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) argues that an individual who experience this illness ought to have a depressed disposition, or have lost focus in activities that may bring them pleasure; for a least two weeks. This makes an individual to different behaviors from the normal one and it could not be resulted from by a general medical state (APA, 2013). In a nutshell, Murray, Buttner & Price (2012) define the term depression as a condition of sad, it is an illness which conquers the capability of feeling emotion, whether bad of good, at all. Depression not just involves the brain it also occupies the body and thinking. In different rural areas some people complain of too much headache and great pain which is determined as depression, modest or if not. This illness could be led down via genes or may follow external activities or can be resulted from a chemical difference in the mind. All human beings are faces the risk of depression. However, people in living in the hardship areas like the rural areas are more likely to experience more compared to their counterpart in the urban centers. Another research also women likely to be depressed compared to men, i.e. three times more than men. Some believe that women do a lot of social role in the rural areas and also that their hormones enable them to be more vulnerable to depression (Minas, Klimidis , Ranieri et al. 2008, p. 63). Men are more subjected to keep secret their emotions inside them since of their responsibility in the social order and the society do not permission them to utter their feelings candidly. 3.0 Causes of depression in rural population The symptoms for depression are complex to determine. However, generally symptoms include laziness and tiredness. The primary cause can less frequently be examined. The most general causes of depression consist of financial problems, past trauma, peer pressure, death in the family, relationship problems, and stress among others (APA, 2013). In rural areas, depression is a slow venom that may bear severe effects on individual’s health if not treated. The question is; what causes high rate of depression among the rural populations? Rural population or individuals living in remote areas normally contend with long-standing causes of stress like climate unpredictability such as the drought, floods, fires, cyclones, pest plagues, isolation and financial worries. For people earning their income from tilling the land in rural areas, there is indication suggesting that the farm setting is dangerous to mental health, with farmers undergoing higher rates of depression (AC, 2013). The research demonstrate that male farmers in Australia die by committing suicide at rates considerably higher compared to the general population of non-farming urban males (WHO, 2008). Farmers go cultivate their land because they have the passion for farming, so loss of crops implies a loss of individuality. This is also their source of income that puts huge economic burdens on them and can ultimately press them into a depression. Natural disasters also take toll on the people living in the rural areas. Extreme weather situations can harshly affect the life of rural populace, in particular during drought and floods seasons (AC, 2013). Additional natural disasters such as fire and cyclones can result to permanent harm to fertile land. Therefore for farmers, they are left poor quality of their major source of income and in greatly stressful situations most of them turn to suicide or experience other health disorders. Most of the rural populations are farmers. Since group of people have an insufficient source of living, hence in their endeavor to generate a better income for they go for debt. Debt could also be into farm maintenance, land expansion and acquisition of machinery among other activities. Unpredictable negative outcomes, in form of harsh droughts make them financially stressed. Family inheritance issues are another major source of depression amongst the rural populations (AC, 2013). Emotional stress because of family disagreements also destabilizes the mental condition of farmers particularly when the matter of inheritance emerges. Siblings or children could fight over the land ownership and choose for frantic measures, which tries the emotional susceptibility of the rural dweller. Conversely, a rural dweller frequently wish that one of his or her children will assume the operation of the farm someday, so when children depart rural areas for the urban areas and comes back to demand the ownership of the land, he can ultimately meet the wrath of his siblings who has since then occupied the land (Boydell, et al 2006, p.187). Laborious working conditions and severe climatic conditions put much pressure on rural dwellers. Such extreme physical activities lead to physical stress, weariness and less or no time for relaxation. Following that kind of an unhealthy lifestyle and longer time continuous work expose them to depression. Social isolation members of the family members stay abroad while others reside in rural areas is a source of depression (AC, 2013). This is because most of the time family members in rural areas stays disconnected from their loved ones deriving them of social dependence and interaction. Poor infrastructure and communication facilities further raise the gap of social remoteness. Jobs in rural areas are usually paying low income. Having a lot of responsibility of providing food, education and clothing to themselves and the children becomes a source of depression to parents living in rural areas (Boydell et al, 2006, p.185). Poverty and inaccessibility of health care facilities burdens on rural populations and are related to high risk of behavioral, emotional and drug abuse disorders (Boydell, Ket al, 2006, p. 184). This state of situation makes the victim feel depressed. Rural women working away from home frequently experience a second shift at the time they arrive home which is family and farm duties. The situation cause high rate of depression in women than men amongst the rural populace. 4.0 Symptoms of Depression There are several signs of depression. Loss of satisfaction and sadness are perhaps the most recognized symptoms. Beatty-Brooks et al (2006) claim that depression is a sign of an apparent reluctance, lack ability and will of man to get over himself, and live. Will is what drive life and give the desire for one to live. An individual, who suffers from depression, loses his energy and motivation to operate in normal life. The word "depression" sometimes can be confusing since most people can use it to describe a short-term depressed feeling some go through (WHO, 2008). From the definition of the term “depression” which include sadness and feeling of emotion, symptoms of depression can be examined from types of depression. Major Depression is considered the most relentless condition of depression (Bachman, Swenson, Reardon & Miller, 2006, p.83). Individuals who are Majorly Depressed experience confusion with great sadness. Other symptoms of major depression are emotional imbalance, hypersensitivity, bleak vision of reality, tendency to dramatize and loss of appetite (Sadock, Sadock & Kaplan, 2003). An individual undergoing a major depressive incident normally exhibits a low mood that encompass all facets of life, and an incapability of experiencing pleasure in events that they were previously enjoyed. Meanwhile, Dysthymic Depression is considered a low level depression which lasts up to a minimum two years. The symptoms of Dysthymic Depression are similar to those of major depression however; they are not intense (Murray, Buttner & Price, 2012). The symptoms comprise sadness, emotional imbalance, loss of pleasure and weight loss. Bipolar Depression also called Manic Depression is another form of Depression. This form is different Major Depression or Dysthymia in terms of symptoms. Murray, Buttner & Price (2012) postulates that the Bipolar Disorder symptoms have both high and low level mood swings. A person having Manic Depression can be very happy today day and tomorrow they are in a severe depressive disposition. This variation of mood can take place over hours or days. Other symptoms ignored are loss of appetite and insomnia. Not getting adequate sleep could be associated with guilt and stress. Stress is another big aspect of depression. Stressful experiences or activities like cultivating the land can kindle depression in individuals who are predestined to disorder. Corruble et al. (2009, p.332) claim that even though both people living in urban centers and rural all are susceptible depression, rural populations are more vulnerable to this illness. This is may be because of the way of life and climatic conditions. The numbers of deaths resulting from suicide has risen significantly over the years because of depression. The number of deaths every year is approximately similar number to deaths from HIV/AIDS. 5.0 Strategies and supportive care strategies for Depression Even though depression is not easy to prevail over there is care and medication for this illness. Depression has an impact on one’s body, brain, thinking, behaviors, emotions, and habits. A blend of strategies such as medication, counseling, self-help and group support is frequently the best method of treating a depression. According to Bachman, Swenson, Reardon & Miller (2006, p. 79) 70 % of the people who suffer from depression are responding quickly and well to antidepressants. There are several categories of antidepressants such as Monoamine Oxidase (MAO) Inhibitors and Selective Serotonin Reuptake Inhibitors. When using antidepressants it is extremely recommended to seek help also from a psychologist or counselor simultaneously. This is because the psychiatrist or counselor who advises on the medication recognizes if the medicine is useful to the patient and if they are improving. A person’s treatment could comprise of support groups at the local who understand the feelings the person is going through (Boydell, et al 2006, p.183). Local medical center may provide quick solution to the rural population bearing in mind that depression may be severe and getting to urban centers may be a bit difficult or expensive. Other treatments strategies may be personal counseling, and, at times, medication. The patient should seek for help from their family, friends and community. For people having mild depression, there are various forms of therapy, support and counseling is that they can seek. Interpersonal Psychotherapy (IPT), Cognitive Behavioral Therapy (CBT), Supportive Counseling, Couple Therapy and Group Therapy could be very effective (Cuijpers et al. 2009, p.56). These methods could be applied with medications in severe or moderate depression. A peer support group could assist rural dweller link with other people who are undergoing the same feelings. These support groups are normally led by a qualified facilitator. The support group can offer a safe and sound environment for one to find emotional support, meet new friends, and find out strategies to assist them cope at the time of these challenges in their life. Some of the cases where therapy have been tried and prove to be effective include Chile, India and Uganda (WHO, 2012). A trial performed in rural Uganda, for instance, demonstrated that the group interpersonal psychotherapy considerably decreased the symptoms and predominance of depression amongst 342 men and women meeting based on subsyndromal or major depression (Araya et al 2006, p.1385). A trial also performed in Chile on 240 low-income women experience major depression to study the efficiency of a multi-factor intervention which consisted of psycho-educational group therapy, systematic and structured follow-up and drug medication for people having severe depression (Araya et al 2006, p.1381). In India, a trial was carried out to examine the efficiency of interventions done by health therapists in primary care to enhance results for individuals with depression disorders. The interventions comprised of psychosocial interventions and case management conducted by a qualified lay health psychotherapist. (Patel et al, 2010, 2091). 6.0 Further research questions Depression is an illness that many people confuse with temporary sadness and just loss of normal pleasure. Question that many will still be asking is; how can someone differentiate between temporary sadness and sadness associated with depression? Research point out that Bipolar Depression tends to be resistant to treatments. Hence the questions what is the appropriate treatment for this type of depression? All these questions are directed at researchers on the field Psychiatry and medicine in general. 7.0Conclusion Depression is a disease that involves the mind, body and thoughts. It influences the, manner in which an individual eats, sleeps and feels. Sadness is not transient or a temporary mode. People having depression are unable to restore to health of ourselves. Without appropriate treatment the symptoms could last for a longer period of time; weeks, months and even years. Proper treatment can assist to over 80 percent depressed. 8.0 References American Psychiatric Association (APA), (2013). Understanding Depression and Effective Treatment. Retrieved from http://www.apapracticecentral.org/outreach/depression.pdf Australia Counseling. (2013). Depression in Rural Australia: What are the Causes?. Retrieved from http://www.australiacounselling.com.au/mental-health-articles/depression/depression-rural-australia-what-are-causes/ Araya. R., Flynn T., Rojas, G., Fritsch, R., & Simon, G. (2006). Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago, Chile. Am J Psychiatry. 163, 1379–87. Asarnow, J., Jaycox, L., Duan, N., LaBorde, A. & Rea, M. (2005). Effectiveness of a quality improvement intervention for depression for adolescent depression in primary care clinics. Journal of the American Medical Association, 293, 311-9. Bachman, J., Swenson, S., Reardon, E. & Miller, D. (2006). Patient self-management in the primary care treatment of depression. Administration and Policy in Mental Health and Mental Health, 33, 76-85. Beatty-Brooks, M., Hettema, J M., Pandurangi, A.K., Pandurangi and Anand K. (2006). "Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment". Am. J. Med., 119(5), 383–90. Boydell, K., Raymond, P., Tiaiana, V., Tilleczek, K., Wilson, E. & Lemieux, S. (2006). Family perspectives on pathways to mental health care for children and youth in rural communities. National Rural Health Association, 22(2), 182-188. Corruble, E., Lancon, C., Chanson, P., Maison, P., Terra, JL et al. (2009). "Drawing up guidelines for the attendance of physical health of patients with severe mental illness". L'Encephale, 35(4), 330–9. Cuijpers P, van Straten A, van Schaik A, et al. (2009). Psychological treatment of depression in primary care: a meta-analysis. Br J Gen Pract, 59, 51-60. Murray ED, Buttner N, Price BH. (2012). Depression and Psychosis in Neurological Practice. In: Neurology in Clinical Practice, 6th Edition. Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.) Butterworth Heinemann. April 12, 2012. Minas H, Klimidis S, Ranieri N, et al. (2008). Relative prevalence of psychological morbidity in older immigrants. Int J Cult Ment Health. 1, 58-72. Patel,V., Weiss HA., Chowdhary N., Naik S., Pednekar S., Chatterjee S., De Silva M.J., Kirkwood B.R. (2010). Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): A cluster randomised controlled trial; The Lancet, 376(9758), pp. 2086-2095. 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