 being genetic causes, the way an individual has been wired from day one, the way people have been born. And we are talking about the genetic part of us. There are people who have been born and have been wired to be just the kind of people who just suffer from depression, meaning their DNA composition has been wired that way. Now, maybe there's nothing much you can do about it, but we say once we know that an individual like that, we can come up with preventive measures to make sure that that is not a situation that will make them suffer for the rest of their lives. And then we go to another reason that we say it could be biological, meaning that somewhere along the line, diseases, this actually amounts to diseases that the brain diseases may be as a cause or the cause of their depression. And we say that that one can be treated, of course, using medication and many other ways that are possible there out there. And then we go to the other way of saying it's psychological, that there are some people who suffer from depression out of psychological issues. And this comes with things like the way we think, the way we analyze situations may make us actually suffer from depression. We are different and our perception of situation is so different that for some people the way they perceive situations, they perceive things, may actually lead them to depression. And then we go to another bold part of it that we call environmental. Environment itself is enough to cause us depression. I may not be depressed today, but I'm almost there because it's a bit hot outside. Even the heat that we experience may actually cause us depression, but not really, it's a very minimal extent. But yes, all right. You just mentioned about diseases and I'm like recently we've had cases of cancer and I'm imagining someone with cancer or maybe a family member affected by cancer patients, they could be depressed. Is this true? It is very true, Hilary, because this situation is actually both like two sides of a coin. One may lead to the other. Now, a person who has this suffering from depression from all these causes that I've mentioned may also be prone to getting these other diseases. So these other diseases may come in because of depression or depression may come in because of these other diseases. So cancer being one of them as you mentioned or these others like diabetes, first of all we say mostly chronic diseases. Chronic diseases may cause depression and the depression may also cause chronic diseases. Let's put it that way in simple terms. Meaning one may cause the other. All right. And how often or how simple is it for depression to cause a disease? It is possible because for example when one suffers from depression, this person may have for example these characteristics or behaviors that we say. For example lack of sleep, what we call insomnia, or what we call sleep apnea, or what we call narcolepsy where one would be just be sleeping here, there. One may actually suffer from what we call either too much appetite, meaning this person will be eating a lot. Now we know what comes from eating a lot and when we talk about eating a lot for somebody who suffers from depression, they don't care about their diet. They just eat to fulfill that void, that particular part that is missing something. So they may not care of their diet. Now what happens when you don't care about your diet? We just eat to fill our stomach. It means that nutritional value in our bodies will have deteriorated. Many we may suffer either from malnutrition or we may suffer from obesity or we may suffer from these all these other diseases that may come with improper balanced diet. So you can imagine yes it is possible. Oh all right I didn't know that, please now I know. Now how can you tell someone is depressed and okay that's a family friend or someone I know. How can I tell this person is depressed and the individual? How can they tell they are depressed? Okay maybe I can start with the first one where this is a person standing on the side and they want to know is my daughter my mom my dad or you know my uncle are depressed. Now there are signs that we look at and they may sound actually very simple if we are always there to get to know the behaviors of this individual because the most important thing is do we understand our people that well. One of them could be insomnia as I started with. It's very simple that this person has been doing so well sleeping very well but all of a sudden they're suffering from irritability they don't get sleep. Some of them will be sleeping too much meaning that you have this for example a grown-up in the house be it a man be it a dad. All of a sudden waking up is a problem they go to bed for example early and even as they go to bed they are looking very tired so that again is another sign that something you know persistent you know a situation where they just fall tired they just become tired for no apparent reason that one can is able to identify then you say this is a sign that something is not right. Then that sleeping is too much where they'll be waking up very early during these other days but all of a sudden they just want to sleep. This other person the other area is for example the hygienic part of that of them that they don't care so much about hygiene so you realize um when you before they used to take maybe shower take care of the grooming generally but right now they don't care they don't care to the wind um they just come in maybe outside the way it's so you know dusty right now but they come and just get to bed and you're like something is not right with them. Then again the major one where we say this one cuts across but and at least we say one out of five people may go through this it is the suicidal thoughts that some individuals may develop so research is telling us that at least five I mean one out of five individuals may actually have suicidal thoughts and um some of them may actually not not just be thought but they may go ahead and try and this is where now we say we really need to be uh understandable we really need to understand our people or the significant as the people we live around with be it at work be it in our homes because what when we understand when something like this comes up we don't just look at it like they're just doing it because you cannot just try to kill yourself for fun true you can't do that when you do that we say normally it's a cry for help this person is crying for help and this is the only way they know of how to do it of how to cry so basically these are some of the things we look at some people will eat a lot of people eat a lot some will sleep a lot some will come to be hyper vigilant some will have lost interest in the things that they used to do a lot some will isolate themselves from the rest of the public then they say something is not right and those are some of the things we need to look at all right to be getting to how do you now help someone who is crying for help keep it y254 health when is the takes a break here on y254 when we come back we look more into that stay tuned y254 imagine me on y254 Many thanks for keeping us company, this is Y254 health, Wednesday I am the river Hillary and I am speaking to Zakia Rashid as a psychologist, we are talking about depression which is our mental health and now before we took that break we had addressed major factors and we looked into how do you tell someone is depressed and now we want to see this person who tries suicide they are crying for help. How do I help this person now? Okay first of all after understanding that this person we cannot just be there in the house and say that for sure we are so sure that this person is depressed. We need to also go for medical intervention because the doctor has to really assess this person and be able to tell that this person is going through depression. Now when that one has been established then first thing that will happen is the doctor will have to work out that like what are the modalities that are going to be there to help this person. Is it medical intervention where this person has to get treatment and this treatment will depend on the severity of that depression meaning this person can be given antidepressants to be able to work that situation out and these are not the drugs that are given just once. This person will be on medication for quite some time. Now apart from that again that's where we say we need to as counselors we come in and say we need also to come up in therapy where we help this individual you know try to shape up his or her life in a manner that you know you know we say that even as this person is using medication they also need to understand that they are cognitively and psychologically. So when therapies come in as counselors they are there to establish their psychological part of you know their well-being. How are they thinking and here we can introduce now what you call cognitive behavior therapy where we help them you know deal with their irrational thoughts. Maybe there are situations that are happening in life that are causing them thinking to think the way they think. Some of them will be loss of a job. Loss of a job can even cause some depression because you can imagine if this person is a breadwinner even when they are not breadwinners somebody will want to have a good life and something and have a good life. So that is itself is enough to make somebody you know get got into depression if they are trying to look for a job they can't get. So when we bring them for their obsession you want to tell them that you may not have a job but depending on what kind of a job we want or the kind of a job we want do you want to be employed can you come up with something it's better you know even if you want to be employed if you can't be employed is at the end of it can you maybe try to employ yourself you know that is self-employment what is it at your good at what is it that can do so that way we are helping them to able to deal with their irrational thoughts of what they think that without a job I can't live and that way they are able to grow and go past those irrational thoughts. So therapy does really work for the medication does really work and these two have to be they have to go hand in hand we cannot just have one and deal because when it goes to clinical depression then these people have to get into treatment. Alright now with WHO it is showed that the review or the editor showed that men are most affected compared to women and now we know naturally men are introverts they just don't speak now for our man because they had had shells how do you tell these man needs help because they won't speak. For that case we are looking at the coups what we had just mentioned because this person will not talk to us and tell us I'm going through one to three but then being a member of your family for example you are able to tell when this person has changed you know the way they've been living and that is enough to tell because this change happens gradually so today you realize that this person does not care about his hygiene this person maybe eats too much or does not care what this what he or she eats especially now this is a he it's a man or this person comes and they'll always say they're very tired and want to go to bed this person may be used to have friends but all of a sudden this person does not care about friends this person has been hasn't been drinking or has been drinking very little but now they've really plunged into alcohol and they are taking that or even other substances because it can be alcohol some people will even result into other substances then we see these are some of the things that we really need to look at and they are so obvious if they are very obvious by the way if you really understand your person then you can really tell when the changes these changes appear you can listen and say this is not normal and they need help now do we have stages of depression we say that we have we do really have them because depression what is depression it's depression actually starts with stress this is chronic stress right so it all starts with acute stress where somebody is saying we know we don't like saying out there I'm having stress oh I'm stressed out because I didn't take tea in the morning and you start wondering tea and stress where does that come from it doesn't come from but we are aware differently what I think is stress it's your treasure what you think is treasure is my trash so we do not we should not sit there and overlook this cool that we hear and say because this person is just saying they are stressed out then we just say I know we look at this and say for how long have you been stressed out because this acute stress will eventually move to chronic stress and when now it moves to chronic stress that's how we start seeing the situation now changing drastically meaning all these situations that you are talking about are starting now to come out during acute stress we hardly see changes so we just see somebody talking and laughing about it and we think this is normal but no so from acute stress now we go to chronic stress now we go to this depression and now this depression because chronic stress is already depression but now we move now from this depression to major depression what we call clinical depression so these are the stages that we follow and say if we get to understand from day one then it may we may not go to our individuals may not go to major depression all right those are the stages now we have seen people commit suicide because of depression other than committing suicide which other other areas or what else can we see now this one is serious due to depression as in the scenario which is the worst scenario okay we say that the worst case scenario could be somebody okay all these things that we mentioned are very serious if you have an individual in the household who does not sleep because they're stressed out or crying because there's a little bit of talk and they're just there crying or a little bit of a situation they cry then you just realize you can imagine a grown-up crying then you start wondering what is going on with you then you know that this is not normal this is a depression then when an individual plunges into drug and stabs some abuse then this is a serious situation and to say this is a call for help there's something wrong with this person and mostly depression when individual has decided to isolate himself of course it's not conscious it is unconscious that's an individual just pulls away from the crowd pulls away from members of them and we pull pulls away from friends then we say this is serious when an individual used to like doing this particular activity and all of a sudden they draw away from this particular activity of choice then we say this is serious when people now start absconding work they are not going to work and we've seen that a lot that all of a sudden and if you just decide I'm not going to work they've not decided something is wrong with them and in mostly it is depression so I was just look at what is causing this depression but these are the signs that are so obvious especially not going to work not participating in activities of choice in finding an individual now involving himself in drug and substance abuse then these are some of the things we look at are you just saying someone with the drawing from other people and we have seen young people immediately they withdraw from others and they sink to your to their phones and to an extent even the phones have resulted to depression now would you say social media for that case would cause depression and if it does what do we find young people most of them with the drawing from others and going to their phones okay social media yes unfortunately I'm sitting here this is social media because there's a positive and negative side of everything so we cannot say that social media is bad but what we are looking at is basically especially the youngsters what are they looking for in in these gadgets these you know electric devices and when do they get to depression because of them they are getting depressed especially we these days we have Facebook we have Twitter we have especially Instagram people post photos there and they want to see feedback from from others these are people you don't even know but you still consider them very important people in your life so when people do not get feedback from what they post they really feel bad so they start feeling bad and start analyzing themselves if there's something wrong with me that's why I'm not getting feedback maybe before they used to get and then all of a sudden the trend is you know changing what is happening with me and it's enough to keep them away then again the very same gadgets what kind of a gadget do you have and what kind of a gadget do I have you have a sleek phone I have my milikamizi that is already depression setting in because now I go talk to my parents maybe they not that they don't want to buy but they feel like maybe they cannot afford yet I don't understand because most of the time they use the teenagers don't understand and it's not because they don't want to it's because they have been born at this time when everyone is having everything so they feel like if my parents cannot provide there's something wrong with them not with me something wrong with them because they need to give me whatever I want I need to get I have to get so that assumption that I have to get so what is being posted there what the feedback that we get from public it's really affected especially the youth because they really care they are in this stage where the peers matter most true more than even the parents more even the more than the relative so for them the public response is much more important that what you get in the house so that one for them is something that is so very important and the response will actually determine whether they're acting the way they're supposed to be or they get it because once they're not getting pressed but once twice thrice and they're not getting what they want the feedback that they want they've posted or they may actually get feedback but it's negative maybe somebody has given a very bad comment on social media that one is enough to depress someone because it can depress even you and me maybe if I've done it once so you can imagine these people are always there and you see when breakups you know relationships things are happening in social media people just want to air everything in social media so the feedback and I keep on telling especially the youth when I talk to them I tell them you do not just go and air everything there because no this people don't know you they can say anything true and they have no apologies to make because after all they don't know you and they entitled the opinion entitled to their opinion so just as you're entitled to your opinion and to do whatever you think you are you can do so are they so when you get negative feedback don't start falling sick and doesn't look at it like why did this person say to me you did not tell them that you are posting something thought they had liberty to do whatever they want so if you didn't care about post it don't care about the feedback that you get it's as simple as that move on with your life you get negative feedback suck it up and move on you get positive feedback don't you know you know cause a lot of jubilation because you never know when you come back to hound you so take it as it is but try to minimize we tell the youth try to minimize on what you post the comments that you give don't air or you know all the dirty laundry there because what goes around would almost come around and it will get hit you really bad speaking of social media now let's talk about a socially in terms of relationships your partner doesn't understand you and now it could lead to a breakup and now because of this you are depressed now how do you help such a person because they have been depressed because of someone not something exactly in most cases we say in fact depression may come from you know very the very same people that we really care about and it's possible it's normal so we cannot say that we are expecting just things to happen to us because they've been caused by something but someone in fact more than often we may actually be depressed because of especially relationships relationships are sad because we have inter and intrapersonal relationship we have relationship with ourselves how much do we hold of that yeah how much do you want to relate with ourselves that one is even enough to cause us anxiety and then that may this exactly lead to depression because how we perceive ourselves the way we've been why the way we've been made our body ideal body that we want the way we want to look that is between us no one is judging us that is interpersonal intrapersonal relationship so how do we deal that it's even enough to cause us a lot of depression so when we go again to interpersonal relationships we are talking about us me and someone else it is possible and when it comes to relationship issues it's not easy because once you start a relationship whichever because we are not just talking about a relationship about boy girl or you know marriage relationship we are talking about that kind of interact it could be a liking it could just be friendship but when it breaks then it causes a lot of anxiety in this individual because when that relationship was forming there was a bond that was forming and now imagine we are breaking this bond this relationship was not formed overnight it took time to be formed so it will again take a lot of time when it breaks it takes and you know most of the time relationship break that's pop and then we go back to the media and whatever the phone somebody just send you a message it's over no like and you are like how how now how is it over and they just say you and sometimes I didn't even respond we just tell you it's over switch off their phone or even block you that is where now problem starts so we say that yes it can cause a lot of anxiety and a lot of fears and all these things put together they may lead to depression now when we help how do we help we help this individual by making them understand that relationships are not permanent if somebody to come to me as a counselor and say okay this is a what has happened first of all I said by saying relationships are not permanent these we form a relationship with a different person and this person was for some you are not even related maybe they're just friends from my even different background so you do not expect that this relationship is a mass that it has to last forever so that expected expectation that relationship do not last if at all a person will have it from day one it will not cause a lot of trouble when this relationship breaks but sometimes we will move into relationship with a lot of expectation and we are so sure that this is it this will last so when you are there and with that mindset when it breaks it becomes a problem because it's hard to deal with that negative part of it so we let people understand that relationships are there they'll always be there they are not permanent and when it does happen then give yourself time to digest all that has happened gets to know what is it that you benefited from that relationship that you can take into another what have you learned what are the lessons that you've learned before you move into another relationship so that whatever happened to this one does not happen to the next one all right now I want us to conclude giving your recommendations now Kenya is ranked sixth in Africa you in suicide cases and WTO these early these expressed concerns with Kenyan hospitals how they treat these people with mental problems because they say the legislature that is there dates back to 1989 now how do you think as a nation we can pull it back and help our people without mistreating them because they have mental problems as we wind up thank you Hillary that one is very important and I would say that it's so unfortunate that even the people we entrust our lives with who we expect to have understood the whole thing about a depression do not or they just don't want to understand because things have changed we are not living in yesteryears where we are running our lives in a very different way you know for example the social media wasn't there electrical devices weren't there things have changed and we've moved on you call ourselves millenials some of these people you know the dot coms and all these things so these things have come with its baggage meaning the way we've been treating individuals then it is not the same as the way we should individually we should understand that first of all what is really causing these this depression or mental in it because we depression is mental illness when we understand the causes we are able to deal with either the prevention or treatment and me I keep on saying we should not just start with treatment we start with prevention before we go to treatment meaning if we understand the causes of depression then we can start by psychotic cutting the community on how to prevent where I don't get a job let it not stress you where I don't have a job you can actually do extracurricular activities go volunteer you know do something that is so productive even if it does not give you a penny and you'll still enjoy go do what you enjoy exercise eat well and eat well meaning eat balanced diet don't start until you fall sick then you start now placing your meals in you know cards where you say today and eat this it's already too late so we say that the medics and the people in the hospital these are the medics they are the very same people who should psychoeducate all those who are coming there to make them understand that this is a disease and the way they treat them should be very should be you know you know you know put in a different angle that for them to understand that this is a disease they even need to talk to these to their clients that this is not normal this is it yeah we unfortunately we are out of ten many things for coming and sharing and speaking to us about depression and how we can go about it as she has been my guest as a key a russia a counselor I'm hoping back home you have learned something thank you so much for keeping us company my name is Dereva Hilary see you on a friday goodbye