Explainer Series – Depression

SAFMH News Room

As we come to the end of World Mental Health Awareness Month 2021, it’s clear that we need to be doing much more to raise awareness and speak openly about the mental health issues our communities are grappling with.

 Depression is a serious and common illness worldwide, affecting, an estimated 3.8% of the population, including 5.0% among adults and 5.7% among adults older than 60 years. Approximately 280 million people in the world live with depression.

 Source: WHO

In our new explainer blog series, we will be unpacking specific mental health conditions and sharing stories of those with lived experience. In this edition, we are looking at depression.

According to The World Health Organisation (WHO), depression is characterised by “persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities. It can also disturb sleep and appetite; tiredness and poor concentration are common.” (WHO, 2021

A South African Stress and Health study revealed that more women than men are affected by depression, with researchers estimating that as many as 1 in 4 women will experience a depressive episode during any given year. From 2005-2015 there was an increase in depression prevalence rates by more than 18% worldwide, listing depression as a leading cause of disability and ill health.

During the COVID-19 pandemic these numbers continued to rise, with reports that 33% of South Africans were depressed during the first lockdown period last year. As we continue to grapple with COVID-19, these numbers are likely to continue rising.

Miss Bachelorette SA Semi-Finalist, Akhona Gczasa, has lived with depression for four years now. Whilst she always knew that she could get really sad, it was only thanks to a significant effort from her mother, who encouraged her to finally see a doctor after a traumatic event, that she sought help.

“When I was diagnosed in 2018, I wasn’t that surprised. I had lost so much of myself, my ambition, and who I was. From that my life took a sharp turn. I went from being one person to being a person I didn’t even know”.

Akhona’s feelings are similar to the way lots of people with depression report feeling.

Depressive symptoms can range from mild to severe and can include:

  • Sadness
  • Loss of interest or pleasure in actives you used to enjoy
  • Feelings of hopelessness, worthlessness, and pessimism (expecting only bad things to occur)
  • Irritability
  • Difficulty sleeping
  • Changes in appetite

There are many reasons why someone may experience depression, including a complex interaction of social, psychological, and biological factors. Research shows that those who have lived through difficult life events such as unemployment, trauma, bereavement, are more likely to develop depression. If untreated, depression can lead to more stress, often worsening the affected person’s life situation and the depression itself.

“Living with depression is quite challenging. It is exhausting. I mean, mental health is still misunderstood so when you go through your mental breakdowns, from my own point of view, I usually have ¾ breakdowns in two weeks and so I have to find a way to balance my emotions. As a single mother of three children, it can be really challenging to take care of myself. I do a lot of reading, which helps”.

Whilst depression is commonly spoken about, getting an actual diagnosis can be a big challenge. In South Africa, two recent studies conducted in KwaZulu-Natal show how patients with depression are falling through the cracks.

One study published in 2020 found that clinical nurse practitioners successfully detected depressive symptoms in just under half of cases. Of those detected, just over 1/3 were referred for treatment and of those referred, only 1/4 received any depression counselling.

Another study from 2021 found that very few professional nurses working at primary healthcare level felt they had the necessary time to properly assess patients with depression.

The Director of the Centre for Rural Health in KZN and co-author of both studies, Professor Inge Petersen, said that in addition to insufficient time and a lack of confidence in making a diagnosis of depression, another common reason for low rates of diagnosis included a poor understanding of the symptoms of mental health conditions and treatment options.

Not understanding what is going on with your body is especially difficult.

“The day I was diagnosed, I did not understand and I did not want anything to do with it. I think this was because of the misinformation, and stigma. I left the doctors room and just cried. Will my children be okay? What does it meant to take anti-depressants?”

Although there are known, effective treatments for mental disorders, more than 75% of people in low- and middle-income countries receive no treatment.  In countries of all income levels, people who experience depression are often not correctly diagnosed, with some people being misdiagnosed and/or prescribed antidepressants when they don’t actually have depression.

WITS University psychology researcher, Tasneem Hassem, says:

Unfortunately, low awareness of the symptoms of depression means that many people do not know when they are depressed. During our research and through interviews with stakeholders, we determined that an online screening tool would help raise awareness of depression, reduce the stigma and facilitate quality conversations between people and health professionals.

This online screening tool was chosen from eight in the final pitch of the latest Prospector@WITS course run by Wits Enterprise. Hassem goes on to explain: “Our tool is specifically adapted to capture the unique depression symptoms experienced by South African individuals. The user receives instant, downloadable feedback that provides resources for seeking treatment or care and can be used in the comfort of one’s home, on any smartphone, tablet, laptop or computer.”

When asked if she would use this online tool, Akhona said:

“For me, if I had access to this tool years before, it would have also made things easier. If we could have easy access to the tools for our mental health, it would make things much easier. I really think and believe it would have helped before, and I believe tools like this need to be easily accessible for the larger population”.

An important aim of the online depression tool is to improve understanding and encourage more conversations that empower communities to openly discuss mental health disorders, like depression. The truth is sadly though that, despite how far as we have come in terms of diagnosis and treatment, stigma and discrimination still abound when it comes to depression.

Stigma can prevent people from seeking the help they need. Before COVID-19, sharing mental health struggles was often seen as a shameful thing. This is not true. We all have mental health, just like we have physical health. Just like with physical health, there are some days where we feel better than others, and it is therefore just as important that we safeguard our mental health as we would our physical health.

Despite her daily struggles, Akhona made the decision to enter Miss Bachelorette South Africa this year.

Started in 2019, Miss Bachelorette SA is a women empowerment project that is presented in a pageant approach. Its main goal is to “give unmarried, mature women recognition and honour, through philanthropy, fashion and beauty’’.

“Not every day is the same and I am still learning and navigating through my journey while living with my mental illness but my focus and my thoughts have started to shift to something more exciting. When I wake up, and I think ‘oh my goodness I have things to do for Miss Bachelorette’ it excites me and helps me focus my mind away from the negative thoughts I fall so easily into”.

Akhona entered the competition with the aim of using the platform to raise awareness about mental health and women empowerment, two matters that are very close to her heart. She hopes to use her journey as an example that you can continue to live a hopeful and fulfilled life whilst managing your mental health condition.

“It doesn’t mean that because you’re living with a mental illness that there is something wrong with you. If I were to give advice it would be: We all have mental health needs. At some point we need to look after our mental health. We need the tools to help us to look after our own mental wellbeing. Mental Health concerns all of us, those who are living with it and those with loved ones living with it”.

Akhona ends by reminding people:

“You are not the only one. It’s okay to go through your phases, to go through your journey, whilst allowing yourself to navigate what works for you as an individual”.


If you suspect that you or someone you know may be experiencing depression, always seek the help of a mental health professional. If you are interested in connecting with the organisation in your province, feel free to reach out to us via our enquiries Help Desk. For those who are looking for more guidance, you can head to our website and check out our Information Library.

If you or your loved one is feeling hopeless and/or having suicidal thoughts, please call the SADAG Suicide Crisis Line on 0800 567 567 or SMS 31393. These numbers are free and counselling is available in all 11 official languages.

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