Breaking the Silence!

12 Jul 2018
POSTED BY Alvin Thomas

Rates of depression and mood disorders are on the rise in Oman. Or are they really? Mental health continues to be one of the least-tracked and least-reported-on medical statistics in the Sultanate. What we do know is that more cases of depression are coming to light as more people begin to break the silence. Y’s Alvin Thomas asks the question: Are we really happy?

Few health conditions carry as much stigma and misconception as depression. “Depression is not the same as having a bad day,” says Abia, a 26-year-old mother of one from Bahla. “Depression is real. Depression has – and continues to – consume my mind and my life.”

Abia’s fight with the mental condition – one that she says she’s “losing” – began when she witnessed the death of her father in a car accident. She was only nine years-old.

The incident, she says, changed her life – and it’s rarely that she speaks of it in public for fear of judgment and the trauma it brings back. We were able to interview her with the help of her friend and mentor.

Abia tells us: “My father’s passing broke down the family. My mother was never really herself after that.

“She even stopped talking to us [Abia and her two brothers],” she adds.

“And that’s when I saw depression for the first time ever. I classified it as that when I saw my mother break down. The doctor in our town in Bahla declared her schizophrenic.

“She would see abbie [father] and talk to him, which made my brothers very sad but also angry at her.

“This made the people around the village stop interacting with us…and my brothers soon left home,” she tells us.

By the age of 14, Abia was already taking care of her mother while her brothers left the family, sending money home each month to support them. To those around them, it seemed that life for the family was returning to some semblance of normality.

Picture for illustrative purposes only.

What no one realized was that Abia was hiding something deep within: Depression.

According to the American Psychiatric Association, depression (major depressive disorder) is defined as a common and serious medical illness that negatively affects how you feel, think, and act.

Depression has been associated with feelings of sadness and a loss of interest in activities that a person once enjoyed.

During the interview, Abia isn’t comfortable revealing further details about her condition. Instead, what ensues stuns us, as the conversation quickly takes a turn.

“If it weren’t for my mother, husband, and my child, I would’ve considered the worst [suicide]. Yes, I know it’s haram [forbidden], but from the time I wake up to the time I close my eyes, I’m consumed by pain.

“Nothing brings me happiness. Absolutely nothing,” she tells us. The tears that subsequently roll down her cheeks signal the end of our interview.

As per her mentor, the young mother is not seeking professional attention due to the stigma associated with mental illnesses.

In truth, however, Abia is only one among many Omanis who are undergoing depression but are not treated for it out of fear of being judged – or worse, abandoned by their families.

Support for all

Today, depression is recognized globally – and there are several organizations and individuals working together to help patients manage their condition and improve their daily quality of life.

Talking about it is also no longer taboo. Using their spotlight as a platform, celebrities have come into the open to reveal details of their battle with depression and other mental health conditions.

Actors such as Dwayne ‘The Rock’ Johnson, Johnny Depp, Anne Hathaway, and Angelina Jolie, are just a handful of actors who have come forward to discuss their condition publicly so that it could be talked about and, perhaps, also help others in the process.

But what if you’re not a celebrity? Do you still have the chance to receive support?

“Well, yes. And that’s where the misconception lies,” says Dr. Amira al Raaidan, the Director for Health Education and Awareness Programs, and Head of the Mental Health Department in the Ministry of Health. “You’re not alone. We’re all here to help and there are clinics across Oman that can help you deal with your troubles.

“Anyone who thinks they’re undergoing depression should consult a doctor. It’s a very dangerous condition that needs to be treated on-time, else it can progress into something far more serious.

“One should also remember that depression is treatable if diagnosed at the right time,” she explains, before adding that by the year 2020, depression will take over as one of the biggest forms of mental illness.

According to the World Health Organization (WHO) Mental Disorders Fact Sheet for 2018, a staggering 433 million people worldwide exhibit cognitive, emotional, and social impairments (CESI).

These impairments include depressive illnesses (300 million), bipolar affective disorder (60 million), schizophrenia and other psychoses (23 million), and dementia (50 million).

During our interview, Dr. Amira reveals, “Depression and anxiety disorders can rise from factors such as emotional and physical trauma, accidents, relationship troubles, workplace tensions, and many other factors.”

Signs of depression in children can be bed-wetting, biting nails, and aggression, but it varies extensively in adults. The signs of an adult suffering from anxiety or depression can be irritation, aggression, mood swings, restlessness, emotional instability, pessimism, and hopelessness.

Dr. Amira adds: “One suffering from these conditions can also experience other problems and diseases like obesity, hypertension, heart diseases and, in some cases, substance abuse.”

Unfortunately, there are no statistics available of patients suffering from depression in Oman, but Dr. Amira believes that the numbers are rising as more Omanis and expats come forward to seek help.

More facilities in the pipeline

As per WHO-AIMS (World Health Organization- Assessment Instrument for Mental Health Systems), the “density of psychiatrists in and around the largest city (Muscat) is 2.42 times greater than the density of psychiatrists in the entire country”; meaning, mental healthcare is harder to access in other areas of the country.

That’s worrying, considering that depression, on average, affects an estimated one in 15 adults (6.7 per cent) in any given year, and one in six people (16.6 per cent) will experience depression at some time in their life.

The greatest pitfall is that depression can strike anyone at any time, but on average, the first onset can appear during the late teens to mid-20s.

Studies conducted by the World Health Organization (WHO) also show that women are more likely than men to experience depression.

“But the infrastructure is slowly starting to take shape,” says Dr. Amira.

“We’re in a transition phase as [Oman] develops the behavioural consultation facilities in the country. It’s not an easy process – and it should take a few years.

“We’re in dire need of human resources to conduct all of these services too. But we’re going to be bringing in more specialized doctors from the country as well as from abroad to help meet our needs,” she adds.

Picture for illustrative purposes only.

Aaron, a part-time life coach and a marine living in Muscat, tells us, “There are several reasons why we see many individuals keep their feelings bottled in. The primary reason is people think that they can solve the problem themselves.

“But these people only begin to suspect that they’re depressed when it reaches a stage when they have to actually face it. Until then, most people don’t suspect a thing.

“And often, people who come to me for help have single episodes that usually can be treated even without the need for a medical professional.

“Then, we have those who are suffering from moderate to severe depression – and that’s a whole different scenario.

“Sitting down with patients who suffer from severe depression can be difficult, as most of them have been bottling down their feelings and emotions for years, if not decades. One therapy I make use of is the ‘Primal Scream Therapy’ – and sometimes it helps these individuals face their feelings.

“This form of therapy is one where the patient recalls a disturbing experience and expresses their anger and frustration through unrestrained screams or hysteria. It’s like reaching into the core of your problem and setting it right.

“Sadly, most patients who seek my help and are under severe depression are those who were assaulted sexually or physically during their childhood. These scars are ones that usually stick with you for life and can also change your mind-set during your formative years,” he adds.

Recalling the story of one of his patients, Aaron tells: “Back in 2015, when I had just started coaching one particular patient, I remember him telling me about how he was assaulted by a family member as a child.

“The trauma from his childhood stuck with him and there were multiple instances when he tried the unthinkable; he tried to commit suicide. It was the first time I had come across such a situation and I knew that I had to help him out.

“It took two years – and several sessions of therapy with a medical professional from a leading medical center in Oman – but he came back on-track and decided to make an effort to live a normal life.

“I still keep in touch with him, and I only respect him for coming forward and accepting that he had a condition to fix. “That has made him the man he is today,” he concludes.

The statistics

Unfortunately, examples like Aaron’s are not the case for the 25 people who decided to take their lives in Oman in 2016. The statistics are yet to be updated by the Ministry of Health, but it must be noted that the suicide rate in the Sultanate is below that of the world average.

Close to 800,000 people die worldwide due to suicide every year, which is one person every 40 seconds. Many more attempt suicide but fail to succeed.

Oman bore witness to the suicide of international DJ Avicii in April, stunning the music industry.

Also read: Workplace depression in Oman

“Avicii’s death rings so many bells surrounding depression,” says Aaron. “Even the most popular of celebrities can be struck down by this condition which forces them to take their own lives.”

“What you need to realize is that you’re not alone. Not now. Not ever,” he adds.

Who can you talk to?

Anyone in need of medical attention can make use of health facilities such as the Al Masarra Hospital, Whispers of Serenity Clinic, and Al Harub Medical Centre among several other healthcare clinics in Oman.

Sayyida Basma, the founder of Whispers of Serenity Clinic in Muscat, is also one of the leading therapists in the country.

And for those who take to social media in a cry for help, Facebook is also making use of Artificial Intelligence (AI) to track individuals contemplating suicide. The number of Facebook users who see support content for suicide prevention has reportedly doubled since the company switched on a detection system.

But keep in mind that if social media is the root cause of your depression or anxiety, it’s best to stay away from it.

Unfortunately, there’s no suicide hotline in Oman for those who are in need of assistance. If you feel that you’re contemplating self-harm, reach out at once to your nearest healthcare clinic or hospital’s emergency department for immediate assistance.

You have nothing to lose and everything to gain by opening up – so let’s talk and break the silence.

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