30 August - 5 September 2001
Issue No.549
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Al-Ahram Weekly Online 30 August - 5 September 2001 Issue No.549 |
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Managing the malady
Following actress Soad Hosni's death two months ago, psychiatrist and neurologist Mohamed Abdel-Wahed Riad sent me an open letter about manic depression, a condition that has gained enormous ground in the past 20 years, particularly among women, residents of the provinces and, increasingly, among children. Riad's letter was written in response to press commentaries on Hosni's depression, and the depression her death induced or encouraged in millions.
Still, its relevance covers a far wider range of issues, for, as he points out, while the ostensible cause of depression can be any matter, private or public -- in the case of the latter, at least, there is no shortage of potential causes -- the real causes (and hence the cure) have been open to question since ancient times. A variety of factors thought to contribute to depression have been identified in sufferers; they include sexual or emotional frustration, failure and, most importantly, disillusion. Riad's letter attempts to fill the gaps in information available to the lay audience, and indirectly criticises the prevailing ignorance of psychological problems bred by the social stigma attached to them.
Depression has been a common disease since God created man, Riad writes. Ancient Egyptians depicted it on the walls of their temples; the ancient Greeks and Persians both referred to it in their literature. Genes have an important part to play in the dynamics of manic depression: 60 per cent of those suffering from this partly hereditary disease take after their parents in this respect, while having a depressive father increases one's chances of being so oneself by 300 per cent. In research projects conducted throughout the world in the past 30 years, depression has also been linked to the serotonin produced by the brain; it can be thus be seen as a neurochemical imbalance requiring medical intervention. One problem with depression is that its classic symptoms -- isolation, insomnia, suicidal thoughts and apathy -- are not always obvious. In over 70 per cent of teenagers suffering from depression, for example, it expresses itself in behaviour ranging from aggression to inertia and from panic attacks to violence.
One theory holds that depression is the consequence of another psychological ailment, anxiety, which results from the fear of losing the object of the patient's love. If the object of love actually is lost, according to this theory, the patient suffers from depression. Disappointment and disillusion are also thought to be the most immediate causes of manic depression, taking the form of an aggression directed either toward the outside world or against the sufferer. Another theory holds that society is the main factor in cases of psychosomatic depression, in which patients suffer from physical pains and complications that have no physiological cause. The desire to conform to social expectations is thought to drive the patient to repress depression, unconsciously converting it into physical symptoms.
But whatever the theory to which one adheres, and whatever medication the psychiatrist prescribes, Riad concludes that it is in his or her capacity as a psychiatrist that the physician is most able to diagnose and treat depression. Riad's letter urges the medical establishment and the media to raise awareness of depression as a partially curable sickness like any other.
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