The deep dark hole of depression

Any form of prolonged illness can cause untold suffering to a family or even strain it to the point of breaking up. It is even worse when the ailment is associated with mental illness, such as depression.

Ask Susan Catherine Keter. She has walked through the thicket of depression – which runs in her family – and come out on the other side to tell her story. She is lucky because her family has not caved in from the pressure of grappling with this heavy illness.

When depression set in, in 2001, Susan, a 42-year-old mother of six, was unable to carry out her motherly duties.

The illness must have found fertile ground in which to nurture itself earlier – in 1999 – when Susan was experiencing a particularly stressful period due to illness that had affected two of her children.

Critically ill

Her then two-year-old son had fallen critically ill and needed surgery. She was two months pregnant at the time and the constant worrying about her son weighed heavily on her and she developed high blood pressure.

She gave birth in November 1999, while still caring for her ailing toddler. But instead of the birth bringing joy, it brought more worries – the baby was born with a birth defect and had to undergo life-saving surgery five days later!

“Unfortunately, those who were close to me did not give me a shoulder to lean on. Instead, they were busy looking for reasons that might have led to the children’s illnesses,” says Susan.

Her marriage was affected because intimacy took a back seat. “I could not function as a wife. I suffered some degree of sexual dysfunction and this placed a lot of strain on our relationship.”

Before the depression, she was close to her children and a good wife to her husband, but things changed and she became highly irritable. “Every time the children played and made noise near me, I would scream at them to leave me alone,” she says.

As her illness started to take a toll on family life, her husband decided to learn more about depression. “He researched a lot on the internet and found helpful information on the disease,” Susan says.

One site suggested counselling, but this did not help much. “Some of the counsellors seemed to blame us for the difficulties in our marriage and family. They did not seem to understand the issues and we were forced to drop them.”

The symptoms of stress began to manifest physically. “I developed severe backaches and headaches, and I could not sleep at night.”

She was given sleeping pills and other drugs to contain her blood pressure and to ease the headaches. Later, she had numerous tests to establish whether she was depressed.

The results confirmed this and she was put on anti-depressants immediately, but this only made her put on weight and feel drowsy and tired all the time.

“My frequent sleeping did not go down well with some of my relatives who complained that I was just being lazy,” she says. To appease them, she stopped taking the drugs. As she struggled to get back on track, she discovered that she had to take the bull by the horns.

“I faced up to my illness and my personality handicaps and really tried to sort myself out,” she says of the illness that tormented her for almost six years. “My husband and I decided to seek psychotherapy help. It was difficult but we had to do it as we were determined to reclaim our family life,” Susan says.

She also overhauled the family diet after discovering that a diet high in fats and calories and low in whole grains, vegetables and fruits can increase the risk of depression.

She also started exercising regularly to keep the depression at bay. Slowly, as the road to recovery became less foggy, a major setback occurred. Her second child was diagnosed with depression.

Sarah, now a Form Two student at Aga Khan Academy in Nairobi, was in boarding school then and she used to cry a lot for no apparent reason. She also started fainting and was once admitted to hospital after collapsing in school.

Typical of depression patients, Sarah was also very aggressive. “We lived in fear at home whenever she was around. She could not stand her younger brother and would sometimes even try to strangle him. She also could not stand me being in the house,” says Susan.

She says her daughter’s depression set in immediately she was enrolled as a boarder in 2005, when she was in Standard Seven. The girl did not appreciate this move. “I hated my mother because I thought she was the source of my problems. She put me in boarding school against my wishes,” Sarah says.

She was later moved to a day school where she improved a lot, but in December of the same year, the depression climaxed and Sarah attempted to commit suicide.

“I was feeling very stressed and I just wanted to die,” she says. “So one day I gulped down some dry-cleaning liquid and hid from my family to die in peace.”

Waiting to die

But as she lay there waiting to die, the thought of dying without anyone knowing what had caused her death prompted her to call her father, who was home at the time.

Her mother was also at home and they both rushed the girl to hospital. She was treated and put on medication and even as she sat her Kenya Certificate of Primary Education (KCPE) exams a year later, she was still taking medicine.

She performed well despite her prolonged absence from school, and was admitted to Form One at a private boarding school in Nakuru.

But before long, her health started deteriorating again and her suicidal tendencies crept back. This time she tried something different.

It was opening day and the school bus was waiting to pick her from the bus stop but she was nowhere to be seen. She had locked herself in the bathroom at home and slit her wrists with a razor and then sat back to watch herself bleed, hopefully to death.

While Sarah had been receiving psychiatric treatment earlier, one of the psychiatrists diagnosed Susan as still suffering from depression. “I was once again put on anti-depressants,” Susan says.

And as she grappled with her own as well as her daughter’s illness, she stumbled on information at a clinic run by one of the psychiatrists who had, coincidentally, also treated her father for dementia between 2001 and 2004.

Dementia is the progressive decline in cognitive function due to damage or disease in the body beyond what might be expected from normal ageing.

It affects higher mental functions and in its later stages, the person may become disoriented, not knowing what day or month or year it is, or where he or she is. Sometimes the person cannot even recognise him or herself, or other people.

“Unfortunately, my father passed away in 2004. By then he could not recognise any of us,” Susan says.

The psychiatrist dug into Susan’s family medical history and startling revelations were made. Her father’s step-sister had also suffered from depression, as had her grandfather.

“This news hit me like a thunderbolt, but there was more,” she says. The psychiatrist went deeper and found that Susan’s husband also had a family history of mental problems.

A study carried out by the American Science Daily, a health journal, found out that there is a strong link between mental disorders in parents and their children and future generations.

In addition, there is a significant association between depression in parents and patterns of dysfunction in their children. No wonder Susan’s children were also affected by the condition.

Apart from Sarah, Susan’s older daughter was diagnosed just last year with Attention Deficit Hyperactivity Disorder (ADHD). “This is another form of mental illness,” Susan explains.

Although the girl refused medication after the diagnosis, she is currently taking prescription drugs and is sitting her Form Four final exams this year.

When Sarah tried to end her life the second time, her mother was called from work and she sped home.

Fortunately, her daughter was not seriously hurt and three days after the incident, she was taken back to school. But things did not improve and her parents eventually decided to transfer her to a day school. This worked miracles.

“Sarah is now okay and wakes up very early every morning to prepare to join her schoolmates in the school bus for the ride to school,” says Susan. “She has not had any problems related to depression since we transferred her to the new school.”

The medical discoveries about her family fired a desire in Susan to help other mental illness patients in whatever way possible.

In 2007, she got together with like-minded people and set up an organisation known as Users and Survivors of Psychiatry in Kenya (USP-Kenya) whose offices are in Kangemi, Nairobi.

“In the short time the organisation has been in existence, we have dealt with our fair share of crises, especially when a member suffers a relapse of their condition ,” she says. “We team up to support the person in the crisis.”

Besides accessing loans to help in economic empowerment, the organisation also plans to have members trained professionally in funds management in order to improve their chances of being successful in their ventures. USP-Kenya also plans to establish a suicide crisis line.