Chronicle Editor
Andile Tshuma
The rise of the #MeToo movement has seen a renewed energy to tackle issues of sexual violence, harassment and structural inequities that contribute to the pervasiveness of gender-based violence.
For some, it has also awakened memories of sexual violence or harassment and has revealed a surprising truth: even when bodies heal, the mental health toll often endures.
Mental health services are sometimes not available for survivors of violence, and, where available, they are rarely integrated into the primary health care system. Providing survivors, particularly women, with comprehensive and gender-sensitive mental health services can allow them to take back control of their bodies, sexuality, and lives.
Depression is one of the common manifestations of mental health problems among both men and women.
It is a common mental disorder that affects mood and can affect children, adolescents and adults with women mostly affected compared to men.
In its mildest form, depression can mean just being in low spirits. It doesn’t stop you from leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, major depression can be life threatening because it can make you feel suicidal or simply give up the will to live.
Mental health is therefore as much of a topic to be discussed in terms of the law as is domestic violence. For a start, more discussion on mental challenges with a particular focus on challenges like depression which are sometimes considered to be un-African needs to be done. The more dialogue on these taboo topics, the less likely we are to see women or men losing their lives to this silent killer.
The physical scars of gender based violence may heal, but the emotional damage is elusive and takes a lot of effort and time to heal. Survivors may look fine at one time, and then be reported to have taken their lives the next moment.
In many cases, the first time someone becomes depressed, it would have been triggered by an unwelcome or traumatic event such as being sacked, divorced, physically or sexually assaulted.
In some cases, some people call depression suppressed or frozen anger. You may have experienced something which left you angry and helpless and if you were unable to express your feelings at the time – perhaps because you were a child or your feelings were unacceptable to others – the anger becomes internalised and is expressed as depression.
Childhood experiences, physical conditions, side effects of medication, diet, street drugs and alcohol, genetics and chemical changes in the brain may also cause depression.
People with depressive illnesses do not all experience the same symptoms.
The severity, frequency and duration of symptoms vary depending on the individual and his or her particular illness.
Depression presents itself in multiple forms and it can be difficult to tell that someone is depressed because people often wear happy faces yet they are in emotional distress. One may not realise what’s going on because the problems seem to be physical, rather than mental or emotional.
The signs and symptoms include persistent, sad, anxious or empty feelings, feelings of hopelessness or pessimism, feelings of guilt, worthlessness or helplessness and loss of interest in activities or hobbies once pleasurable including sex.
They may also include fatigue and decreased energy, difficulty concentrating, remembering details and making decisions, insomnia, early morning wakefulness or excessive sleeping, over eating or appetite loss, thoughts of suicide, suicide attempts, aches or pains, headaches, cramps or digestive problems that do not ease with treatment.
People who have depression along with other medical conditions tend to have more severe symptoms of depression and the medical illness, more difficult adapting to their medical condition and more medical costs than those who do not have coexisting depression. Treating the depression can also help improve the outcome of treating the co-occurring illness.
If you are starting to feel depressed, it can be very easy to set into a cycle of automatic negative thoughts that then become difficult for you to challenge; you get depressed and then you get more depressed about being depressed.
Pay attention to your personal appearance, set yourself goals that you can achieve and that will give you a sense of satisfaction, be cautious with tobacco, alcohol or other drugs which make depression worse, and a lot of caffeine which may make you a bit jittery.
The Ministry of Health and Child Care recently announced plans to re-establish a community based mental health programme to promote access to rehabilitation services.
Health and Child Care Permanent Secretary Dr Agnes Mahomva said the strategy is in line with the Ministry’s National Strategic Plan of strengthening psychiatric services in the country.
“The community based mental health care programme seeks to offer clients a community-based environment for effectively dealing with mental illness. Children and the elderly best respond to care in familiar environments and this community-based care is best for them. The Friendship Bench is one of the mental health programmes and the Ministry seeks to increase the services.”
Dr Mahomva said the Ministry will partner with other stakeholders in implementing the strategy to ensure accessible and effective rehabilitative services.
When it comes to mental health legislation, the Mental Health Act [Chapter 15:12] protects or safeguards the rights of mentally challenged persons with an emphasis on treatment while in custody.
The Mental Health Act allows for the institutionalisation of mentally challenged persons by even a family member. Medical practitioners are also required to examine such persons before such order is granted. Several reasons or factors including mental disorders, depression, financial challenges, marital problems and terminating pregnancy, which was as a result of rape can be cited as factors that lead to the death of women by suicide.
Acts such as the Domestic Violence Act [Chapter 5:16] protect women from different forms of abuse. Women face the challenge of being economically dependent on their spouses. This often leads to power struggles and depression related to financial issues.
Many women when faced with these challenges turn to family members who shun them and tell them that a woman should be strong and bear it all.
These women suffer in silence with rarely any outlet to vent out their frustrations or concerns. The World Health Organisation 2017 statistics show Zimbabwe ranked as number 19 in terms of deaths by suicide.
The introduction of the Domestic Violence Act provides women and men with a platform to protect themselves from abuse, which may result in mental disorders such as severe depression and anxiety, eventually leading to suicide.
Tackling gender based violence cannot be fully done without looking into the issue of the adverse impact of gender based violence on mental health. — @andile_tshuma
Online Reporter