Depression is a common and serious illness that negatively affects someone’s feelings, thoughts and actions. Depression affects an estimated one in 15 adults (6.7%) in any given year and one in six people (16.6%) will experience depression at some time in their life. Depression can strike at any time, but on average, first appears during the late teens to mid-20s and women are more likely than men to experience depression since studies show that one-third of women will experience a major depressive episode in their lifetime.

It is normal for feelings of sadness or grief to develop in response to difficult experiences for a person to endure, but being sad is not the same as having depression. The Diagnostic and statistical manual of mental disorders 5th Edition (DSM 5) from American psychiatric association explain depression when there is lowered mood (personal baseline) or loss of interest and pleasure in daily activities for more than two weeks. This goes far and start affecting social, occupational and educational functions negatively.

Depressed people may not only appear tearful, but also they may have significant weight change or change in appetite, become sleepy most of the time or agitated, fatigue, with negative feelings like being worthless, guilt, unable to concentrate with or without suicidal ideas.

Besides that depression is now being diagnosed and treated, it results from a course of life difficulties, which may start in childhood (child abuse) and underpins adult depression. Form of abuse experienced in childhood may be either physical, sexual, emotional or often, a combination. Researchers revealed specific changes in key regions in and around the brain parts controlling our behaviors and emotions (hippocampus), to support why young adults who were maltreated or neglected in childhood bear a long standing pain.

Disease development

With respect to gender difference of 2:1 ration in women and men respectively, depression is found in almost all countries around the world, with a big toll on developing countries, Rwanda is included.

Focusing on and rehashing negative feelings, affected people are more likely to ruminate when they are depressed. However, rumination has been found to maintain depression and even make it worse. Studies show that women are more likely than men to develop depression from overwhelming repetitive stress at work, school, or home.

The input from social causes affecting menalso play a part in causing depression in women along with lifestyle choices, relationships, and coping skills. These may include: Marital or relationship problems; balancing the pressures of career and home life Family responsibilities such as caring for children, spouse, or aging parents, experiencing discrimination at home, work or not reaching important goals, losing or changing a job, retirement, Persistent money problems, Death of a loved one or other stressful life event that make to feel useless, helpless, alone, or profoundly sad and childhood abuse either sexually or discriminated.

The role of biological and hormonal causes of depression affect mostly women in premenstrual problems, hormonal fluctuations during the menstrual cycle which can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. Pregnancy and infertility can contribute to depression, particularly in women already at high risk. Miscarriages and unwanted pregnancies do play a role in depression as postpartum periodwhich is not uncommon for new mothers to experience the "baby blues, it is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression and this condition is called postpartum depression.

Perimenopause and menopause period may increase risk ofdepression and mostly if associated with health problems like chronic illness, injury, or disability as can crash dieting or quitting smoking.

What to do if you experience symptoms

With the fact that genetic and early environmental risk factors can produce long-term increase in the sensitivity of individuals to depressogenic life experiences, preventive behaviours are encouraged. Avoiding childhood emotional, physical, and sexual abuse and providing psychological support to all is recommended. For adults who risk depression from different factors discussed above, consulting a specialised centre to seek prior therapies is advised, but symptoms carriers are recommended to seek psychological help and may be profit from early diagnosis and treatment.

Since many Africans are prone to a stressful life, knowledge on its consequences may guide the break off from the depression course and cause.

The writer is a fifth year medical student, and young researcher at University of Rwanda