What’s in it for me?
How are anxiety and depression affecting our young?
Dr. Nabeel Akram
Ernest Owens interviews suicide attempt survivor Jack Park
Few years ago, a UPenn student named Jack Park from Seoul South Korea, made news by appearing in a video that went viral, and openly talked about his experiences with depression and his attempt of taking his own life twice, while he was still a student at University of Pennsylvania. Jack survived the suicide attempts and then went on to become an advocate for the students, encouraging them to speak up about their anxieties and depression, and to be open with friends and family about the mental state through which they are going.
The story also sparked an interest in me to try to go deeper in the subject and what I uncovered was even more staggering. It is clear that the young demographic is faced with all sorts of challenges in their lives, from academic or peer and social media problems to bullying, or from learning disability to attention deficit/hyperactivity disorder (ADHD), or in other cases, from being overly self-critical to being gay or being bisexual in an unsupportive environment. However, the data on the effects of these issues on their moods and behavior is scant and limited in different settings.
Busting the myth that depression doesn’t affect people in the poor countries: The Guardian: the long read
It is a common belief that the depression is a disorder of the West and more affluent societies are the ones which carry the burden of the mental disease. I have traveled in Asia extensively in the past decade and have been in conversation with different academics and professionals in several countries. Anecdotally, the issue of anxiety and depression seems rampant everywhere, however, it needs to be understood that the common term used as depression is not always necessarily the mental disorder and should be delineated with common grief. At the same time this needs to be recognized that even though the data is scarce on anxiety and depression in developing countries, it is a significant issue to be tackled and studied on a more urgent basis to employ the remedial actions. Tina Rosenburg, in her recent article in the Guardian and in podcast, the Long Reads, busts the myth that depression doesn’t affect people in poor countries. The researchers are convinced that the single largest cause of disability worldwide is mental disorders with anxiety and depression being the common illnesses with these disorders. Rosenburg further terms mental disorders as the greatest ‘thief of productive life’ as much as in poorest countries as it is in the richest ones.
“ In the poorest countries as well as the richest, and at every socioeconomic level in between, mental disorders were the greatest thief of productive life.”
According to a latest survey of US teens conducted by Pew Research Center https://www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/, seven-in-ten teens see anxiety and depression as major problems among their peers followed by bullying, drug addiction and alcohol consumption.
While teen pregnancy is also seen as a major issue by the adolescents, it is not surprising that, according to a survey of 6,400 Canadian women published in the journal Pediatrics in May 2012, the highest incidence of postpartum depression occurred among girls age 15 to 19 – at a rate twice as high as postpartum depression in mothers older than 25. There is limited data available but postpartum depression among teenagers is expected to be high and on the rise https://www.ncbi.nlm.nih.gov/pubmed/28574297
Though the Pew Research Center’s study and the numbers from Canada represent teens of the developed countries, the situation, in greater likelihood, will not be very different in other countries of the world, including the developing countries and in low-and-middle income countries or LMICs. To Rosenberg’s earlier point that such conditions are not confined to the western world, US News published the ranking of the most depressed countries and even though US ranks among the top three depressed countries, it is interesting to note that India, China, Indonesia and Pakistan also make to the top ten list. https://www.usnews.com/news/best-countries/articles/2016-09-14/the-10-most-depressed-countries
To illustrate further, one of the leading newspapers in the country, Myanmar Times, urged the experts in Myanmar to make a concerted effort to curb the alarmingly high rates of suicides in the country, of which a large proportion of the victims are young adults. In its story, the newspaper reported that a gay couple in Mandalay found no other way but to take their lives by ingesting pesticides since their parents did not approve of their union. In another case, according to the same paper, a law university student hanged himself to death since he could not take the pressure of academic studies anymore. WHO estimates that Myanmar has higher suicide rate (13.1) than global average of 11.4 per 100,000 people. Such stories of victims of anxiety and depression are not very different in other countries as well.
Way back in 2000, Sunita and Zuberi published a study in the Journal of Pakistan Medical Association https://www.ncbi.nlm.nih.gov/pubmed/11242710 and concluded that half the women studied in rural Pakistan suffered from depression and anxiety. Early marriage, early motherhood, multiple pregnancies, and adjusting to life with in-laws were quoted as possible factors. Unfortunately, things have not changed much since then.
While there are various ways to address the issues of anxiety and depression among young, there is extreme paucity of skilled counselors, psychologists and psychiatrists in many countries. Lancet published its landmark series of articles on global mental health in 2007 drawing attention to the issue at a large scale https://www.thelancet.com/series/global-mental-health and WHO recognized child and mental health as a major problem that, if not addressed timely, can “severely influence children’s development, their educational attainments and their potential to live fulfilling and productive lives.” https://www.who.int/mental_health/maternal-child/child_adolescent/en/
“WHO estimates that Myanmar has a higher suicide rate (13.1) than the global average of 11.4 per 100,000 people. Such stories of victims of anxiety and depression are not very different in other countries as well.
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Even though the task at hand to address the issues of mental health is enormous, it would be unfair not to mention that there are some impressive efforts in various parts of the world, to take on the challenge. The key to the issue is meaningful engagement with the young and stay connected with them without judgement, as they carve their pathways to adulthood and find their passion and meaning in life. Recently, for example, I came across the work of Teen Mental Health and their resources for adolescents and youth in Malawi and Tanzania (teenmentalhealth.org). The group engages with adolescents and youth through radio shows, school programs and clinician training. I particularly liked their videos on YouTube in an effort to simplify the issues for the young (Ellie’s Depression https://www.youtube.com/watch?v=i8EPzkxAiVw). There are many such efforts but, of course, a lot more needs to be done as well.
Speaking of staying connected, this is what Jack Park also talks about in his Ted Talk at TEDxPenn https://www.youtube.com/watch?v=ur8TZf6HWSs&list=LL16mS6-KIq2sQCww1IRmZWA, as he sheds light on student depression. We got to make sure that our kids are open to their friends and their families, and they have the channels to communicate about what they are going through and when they need help and support. ‘You don’t know where depressed people are’, so you got to show love to all. “In the end”, as Jack says, “love heals.”