Depression in Refugees - Term Paper Example

Depression in Refugees Name Institution Introduction Depression can be defined as a sense of low moods and the aversion of the activities o and individuals which affects the psychological, feelings and sense of well-being of the individual (Becker & Kleinman, 2013). This sense of sadness is related to different causes. Among the causes of depression include events of an individual life which include loss of employment, menopause, childbirth, loss of a relative or family member and natural disasters such as hurricanes an earthquake. It can also be caused by illnesses, such as suffering from infectious diseases, neurological conditions, and cancer. According to Papadopoulos (2011), there are also certain medical treatments such as those used to treat hepatitis C are associated with depression in human beings. Additionally, depression can be caused by social factors such as poverty, neglect by parents or relative. There are different symptoms and signs that are indicative of depression. These include lack of socialization, difficulties in getting sleep, general body weakness, use of drugs and low spirits (Lindert et al., 2009). The refugees are exposed to different life situations that force them to undergo mental torture as well as psychological traumas that subjects them to depression and trauma in their lives. There are various reasons and factors that contribute to the increased rate of refugees in various parts of the world (Kraft, 2008). This means that addressing these factors will help in ensuring good management of the depression in these refugees (Nickerson et al., 2011). Thesis statement: Depression affects the lives and socialization of refugees in camps. This is because in nether refugee camps, refugees are subjected to different life situations and thinking which subjects them to depression. This paper will focus on the prevalence of depression among refugees in various camps. In addition, the paper will discuss the assessment of depression among refugees and suggest the supportive strategies that can be used in order to reduce the effects associated with depression among then refugees in various camps in the world. Prevalence and Incidence of Depression in Refugees A refugee is an individual who has crossed the international borders of a country to another country as a result of fleeing from the war in the home country, persecution that is racially based, belonging to a certain religious group or political party or alliance, and nationality. These individuals are protected by international convention. These refugees are settled in foreign country where they are offered to shelter and other assistances from both international humanitarian organisation as well as individual sponsors. The exposure to traumatic experience and life at the refugee camps exposes these individual to depression and post-traumatic stress disorders. The life in the refugee camp is filled with a lot of uncertainty and fraught, since the refuges are largely robbed of their freedom and are living in a foreign country far away from their homes and family members. Additionally, the refugees are protected in the camps and disconnected from the outside world (Lindert et al., 2009). This makes the refugees to struggle in a bid to make a purpose and maintain a sense of their lives. The prevalence of depression is higher in refugee populations in different parts of the world (Alexander et al., 2013). However, the rates also vary depending on the causes that lead to one to be a refugee. The most affected by depression include women and children who are neglected by their parents for different reasons. In current times, there are over 43 million people worldwide who are refugees in different countries. With the projected increases in the number of refugees in the world from war and civil hunger, and refugees may not be able to return to their homes. This means that the prevalence of depression is likely to increase. Additionally, depression is believed to account for around 4. 4 % of the total disease burden in the world. Most of the people with depression are seen in primary health care systems but around 60% of depression cases are not detected in any health care systems. Although the rate of depression varies from one country to another, the aspect of the migration is crucial in establishing the causes of depression in refugees and immigration. Therefore, this means that although migration cannot be directly linked to an increase in refugee’s depression, there are certain stressor factors and challenges that contribute to the increased rate of depression among the refugees (Nickerson et al., 2011). Factors Causing Depression in Refugees The major factors that have contributed to the increased cases of refugees in different parts of the world is civil wars and strife that displaces people from their original homes and seek refuge in other parts of the world. The civil wars in these countries have forced many people to migrate hence largely responsible for the mass epidemic (Lindert et al., 2009). As a result of the conditions that lead to migrate to other parts of the world, refugees are individuals who are vulnerable population which is at high risk of mental health problems. These include traumatic experiences such as torture, rape, loss of their loved ones while they watch, escape from their countries, difficulties life at the refugee camp, transit experiences on the way to their camp, differences in cultures that bring cultural conflicts, destruction and burning of their homes and properties, multiple loss of family members and problems in adjusting to new environmental conditions in resettled countries (Turner & Herlihy, 2009). In addition, the poor living conditions in the refugee camp and lack of enough food are also a factor that has contributed to mental suffering among the refugees. Poor diet is a factor that contributes to depression. Since the food in a refugee camp is not enough and balanced in most cases, the refugees end up lacking crucial nutrients in their diet. These nutrients are crucial in maintaining a normal psychological condition of the human being (Steel et al., 2009). Psychological Implication of Refugee Experience As a result many of the refugees are living with traumatic violence experiences that subject them to depression and stress. The period before refugees are resettled is characterised by trauma experiences that leads to different psychological problems including depression, stress and post-traumatic stress disorders. In most cases, the depression on individual refugees affects their moods and makes them sad, feeling of anger and guilt, fear and substance abuse (Kastrup, 2011). This makes the refugees feel neglected and suffer from different mental torture. In some cases the refugee’s attempts to commit suicide due to depression and feeling of loneliness in the camps. This implies that depression makes an individual to have suicidal thoughts. Such individuals are frightened about them and have the feeling of harming themselves since they feel like everyone is against them. This is because the emotions of the refugees are affected by the depression experiences. Permanent mental retardation in children has also been associated with increased depression among the refugees in their camps. Studies have shown that there is an increase of schizophrenia cases among individuals who are in refugee camps as compared to those exposed to different experiences. Research has shown that when an individual is depressed it’s not possible for this individual to share their thoughts with others that are around him or her. Hence, depression in refugees is associated with different psychological problems that need intervention in order to reduce the causes of depression in refuges. Inn addtiotion, there is also the need to support and manage de[pression among the refugees in different parts of the world (Turner & Herlihy, 2009). A critique of the Assessment process The assessment process for depression in refugees should involve the same procedure and techniques in all refugees. These assessments should focus on common problems and cultural issues that have affected the refugees during their way to the resettlement camp. In most of the assessment process, the rate of depression is based on the immigrant’s rate from countries that are affected by wars and hunger. These assessment procedures focused on the challenges that have resulted in depression. This is not the case since the challenges may also result from anxiety, stress and other psychological conditions. In addition, the establishment of the prevalence of depression in the world is conducted using a small study group. This does not reflect the actual prevalence since different countries have refugees who are depressed by different economic, social and psychological as well as physical challenges that lead to depression. The assessment of depression in refugees is done according to the educational history and unique characters in order to determine the effects of refugee experiences. This is because educational assessment programs in depression among the refugees do not consider cultural backgrounds of the refugees. This is because most of the refugees come from different cultural backgrounds that have different levels of education and cultures. This implies that there are a number of factors that should be considered in the assessment of the refugee population. For example, poor cognitive functioning among refuges has been associated with psychological experience in past experiences (Lindert et al., 2009). Additionally, traumatic events can result to abnormalities in neurological problems that may amount to depression and other mental issues. Most of the refugees undergo traumatic events that are hard to recall them at once. This means that the assessment procedures that are used to assess depression in refuges focus on the racall memory of a refugee. This is because recall is a critical factor in assessing the cognitive impairment in a refugee. Therefore, most of the assessment criteria find it difficult to evaluate the evidence from the refugees. This makes it hard for researchers to determine and establish the credibility and problems in conducting the hearing. In addition, there are problems in coping with post-traumatic stress which leads to uncontrolled emotions that manifest itself in poor knowledge and poor representation of war and misunderstanding of insecurity in various parts of origin. According to Elsass (2012), there is the need for more developments in assessing depression in refugees in order to evaluate the psychological and mental problems experienced by refugees (Elsass, 2012). Strategies and Supportive Care Strategies for Depression on Refugees The management of depression in refuges is dependent on the assessment criteria in the refugee camp. Poor assessment methods will mean that the intervention and strategies that will be offered to the refugees will not produce the desired effects. There should be proper approach that should ensure physical assessment, social assessments, psychological assessment and cognition assessment in order to develop a strategy to intervene the depression in refugees (Robjant & Fazel, 2010). When refugees arrive at the refugee camp, the refugee should be provided with security and a sense of comfort in order to ensure effective intervention approaches. This means that once refugees arrive at the camp is to achieve asylum. There are different supportive and intervention strategies that have been proposed and used in reducing the effects of depression in refugees. In most cases the support strategies focus on single challenge and fail to focus on the general experiences and individual experiences that contribute to depression in refugees. This is because different refugees have different experiences that contribute to depression before and during their resettlement. According to Bughra et al (2010), there are different supportive strategies that can be used for depression patients in refugee camps (Bughra et al., 2010). Cognitive Behaviour Therapy This is a behaviour learning therapy that is used to treat a variety of psychological and behavioural issues among different categories of people. This therapy has also been used to reduce the effects of depression among the refugees. This is because the methods are associated with the interpersonal behaviour of an individual. Refugees have a problem to relate to one another when in depression hence the use of this therapy is aimed at improving the relationship between refugees in the camp (Becker & Kleinman, 2013). This therapy ensures that the refugees are able to learn new experiences by exposing them to activities that makes them forget their past experiences. This includes learning social and communication aspects that are crucial in solving problems. This means that the therapy is necessary in improving the cognitive ability of the refugees. This therapy has been found to reduce negative thinking in depressed refugees since it exposes them to positive thinking. This is because refugees who are depressed have negative thoughts such as committing suicide. Therefore, it reduces the depression symptoms in refugees (Biro, 2012). Medication or Pharmacological Intervention There are different medications that are used in treating depression among the refugees. The antidepressants are medication which works on the brain serotonin and lifts the moods of the depressed refugees (Kraft, 2008). As a result of the traumatic experiences, refugees' experience low moods which affect their socialisation (Papadopoulos, 2011). According to Papadopoulos (2011), antidepressants are not able to cure the depression in the refugees but only lifts the moods temporary. This means that theyb do not heal depression in refugees in the long term. In addition antidepressants have been shown to cause various side effects. This makes it an alternative intervention in the presence of other therapies for depression (Nickerson et al., 2011). Narrative Exposure Therapy This is a therapy that involves the telling of life stories by refuges in order to expose their life experiences that cause depression. The aim of this therapy is to expose the trauma and emotional reactions that are related to trauma in the refugees. This method has been effective in a number of refugee camps (Schauer et al., 2011). However, there are different causes of depression among the refugees. This implies that retelling the life story and experiences of a refugee may not be effective enough in exposing the emotions that are related to trauma in the depressed refugee. However, during the narration, the therapists are required to show sympathy to the victim in order to fully understand his or her emotions (Robjant & Fazel, 2010). Befriending and Exercise There are other supportive interventions which involve talking to the refugees who are undergoing depression and encouraging them to think positive and encourage themselves in various activities. Physical activities have been shown to relax the mind of an individual hence refugees can use this strategy in order to reduce heal or reduce the effects of depression (Turner & Herlihy, 2009). This is because the victim will be able to expose the traumatic event to the other person he or she trust for help. However, there should be proper guidelines that should be followed in doing exercise so that refugees do not engage in unnecessary exercise that will not be beneficial but more harmful to their psychology and physical wellbeing. This includes exercising in a gymnasium which has a proper schedule and procedures. This can also be done in the presence of a physiotherapist (Catani et al., 2009). Arts Therapies This is where music and other form of arts are used in treating the psychological problems in human beings. These therapies have been used to express the feelings among the refugees and help them in talking. Depression in refugees is also associated with poor interpersonal interactions which can be reduced by the use of art and music. In addition, arts such as drama can be used to reduce traumatic events and experiences in the mind of an individual. Moreover, there is the art of writing that has been used to treat depression among refugees. Writing about the traumatic experiences in the life of a refugee helps to ease the stress and depression of the individual writer (Nickerson et al., 2011). Therefore, a number of strategies and intervention have been tested in treating depression in refugees including cognitive behaviour therapies, native exposure therapies, art and music among others. However, most of this therapeutic intervention has only focused on study groups and lack of a control population (Papadopoulos, 2011). Research Question Does depression result to increased rates of mental problems and inhuman activities in refugee camps? There is no existing literature that is documented in order to show the relationship between the increased mental problems and depression among refugees in refugee camps. This is because depression is associated with other mental illnesses and poor interactions. This research question will focus on the causes of mental illness among the refugees in refugee camps. This will include the prevalence of mental illness and depression in refugees and effects of depression refugee cognition. Conclusion Depression is the mental problem in which an individual experiences changes in moods and personal interactions. Depression has been witnessed among refugees in various refugee camps. There are about 43 million people who are suffering from depression in the world. Refugees undergo different experiences in their lives which contribute to depression. The main factors that contribute to depression in refugees include loss of family members, rape, and loss of their loved ones while they watch, escape from their countries, difficulties life at the refugee camp, transit experiences and trauma. Hence, depression in refugees is associated with different psychological problems. In order to intervene and treat depression, there is the need for proper assessment techniques in order to achieve desirable outcomes. However, most of the assessment techniques are not effective in assessing depression in refugees. However, there are a number of supportive and intervention methods that have been used to treat depression in refugees. These include cognitive behaviour therapy, native exposure therapies, art and music and pharmacological treatments. The recommended intervention is the use of cognition behaviour therapy that is seen to be effective in changing the cognition and behaviour of refugees. However, there is the need to combine both pharmacological therapies and cognition behavioural therapies in order to achieve desirable results in reducing depression in refugees. References Alexander, B., David, E., & Grills, N. (2013). High prevalence of anxiety disorders among adolescent Tibetan refugees. Asian Journal of Psychiatry, 6(3), 218-221 Becker, J., & Kleinman, A. (2013). Psychosocial Aspects of Depression. London: Routledge Biro, P. (2012). Helping Refugees Cope with Depression. IRC Blog. Retrieved from http://www.rescue.org/blog/helping-refugees-cope-depression Bughra, D., Craig, T., & Bhui, K. (2010). Mental Health of Refugees and Asylum Seekers. Oxford: Oxford University Press Catani, C., Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T., & Neuner, F. (2009). Treating children traumatized by war and Tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka. BMC Psychiatry, 9, 22. Elsass, P. (2012). Treating Victims of Torture and Violence: Theoretical Cross-Cultural, and Clinical Implications. New York: NYU Press Kastrup, M. (2011). S36-02 - Manifestation and symptomatology of depression in refugees and asylum seekers. European Psychiatry, 26(1), 2138 Kraft, J. (2008). 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(2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. Journal of American Medical Association, 302(5), 537-549. Turner, S., & Herlihy, J. (2009). Working with refugees and asylum seekers. Psychiatry, 8(8), 322-324 Read More