For a long while, Umuhoza had issues with anguish. It all started out with a loss of appetite, lack of sleep and a lack of joy in things that used to interest her. It only occurred to her that she could actually be depressed when she started having recurring thoughts of taking her own life. 

The 35-year-old wasn’t sure what was causing misery in her life. She had a loving husband, children she adored and a career she was proud of. But her life had turned so gloomy she barely recognised who she was.

 "Of late, I have had struggles with understanding the meaning of life, at times I find no meaning in existence and I feel like living is too much of a burden for me to bear.”

Though she hasn’t sought professional counselling, she says she has tried to open up to a few close friends, and that this has somewhat made a difference in her life.

Umuhoza is just one of the many people who are battling the endemic of depression. This is because cases of mental health recently raised urgent concern.

Why gender?

According to the World Health Organisation, depression is a common mental disorder. 

Globally, more than 264 million people of all ages suffer from depression and it is a leading cause of disability worldwide and a major contributor to the overall global burden of disease. 

Information from WHO also indicates that gender is a critical determinant of mental health and mental illness. It determines the differential power and control men and women have over the socioeconomic determinants of their mental health and lives, their social position, status and treatment in society and their susceptibility and exposure to specific mental health risks.

Counsellor Innocent Kabera says that women are about twice as likely as men to develop mood disorder-depression and that they are more likely to show symptoms than men. 

According to him, the major causes of depression include heredity factors where some people get it from generation to generation through genes.

However, he also adds that when it comes to women, hormonal changes have a big role to play.

Young women enter into puberty at an earlier age than men and as hormones change, this brings about the possibility of unforeseen depression. This vulnerability can also be experienced in pre-menopause and in the menopause period, he says.

Information from The National Institute of Mental Health Information Resource Centre website supplements this by indicating that certain types of depression are unique to women at different stages of their lives.

Data shows that most people are familiar with the term premenstrual syndrome which entails moodiness and irritability in the weeks before menstruation and the symptoms are usually mild. But there is a less common, more severe form of PMS called premenstrual dysphoric disorder — this is a serious condition with disabling symptoms such as irritability, anger, depressed mood, sadness, suicidal thoughts, appetite changes, bloating, breast tenderness, and joint or muscle pain.

There is also perinatal depression-depression during or after (postpartum) pregnancy where women deal with morning sickness, weight gain, and mood swings. And perimenopause depression (the transition into menopause), a normal phase in a woman’s life that can sometimes be challenging.

Other major causes according to Kabera include stress. 

He points out that women are likely to be more stressed than men. This, he says, is usually caused by unequal power and status, work overload experienced by single women who work in different jobs while also raising children at home. And mainly poverty seen in single mothers, especially.

 "Some other key causes include different experiences like early child sexual / physical abuse, adult sexual assault, loss of a job, loss of a family member, loss of a partner, domestic violence. Traumatic experiences especially early in life can have a long lasting effect,” he says.

Societal and cultural factors

Isabella Akaliza, the founder of #FreeThePeriod Initiative, says though men and women can both experience depression, it is more common in women. This could be a result of biological reasons such as hormones and genes, however, the higher rate of depression in women isn’t due to biological reasons alone. 

She believes life circumstances and cultural pressures also play a significant role. 

"Although these factors also affect men, it’s usually at a lower rate. Factors that may increase the risk of depression in women can be: Unequal power and status. Women are much more likely than men to live in poverty, causing concerns such as uncertainty about the future and decreased access to community and health care resources. These issues can cause feelings of negativity, low self-esteem and lack of control over life,” she says.

Akaliza also adds the factor of work overload. "Often, women are employed outside the home, and return to carry out home duties. Also, the responsibility of caring for their children while also caring for sick or older family members usually falls on them.” 

Furthermore, Akaliza notes that women who were emotionally, physically or sexually abused as children or adults are more likely to experience depression at some point in their lives than those who weren’t abused. Women are more likely than men to experience sexual abuse.

According to Diana Tumuhairwe, the modern woman plays various roles and that this comes with a set of challenges.

"On top of having a lot of work to do, they have to meet societal expectations of being a wife, a mother and that too comes with judgement,” she says.

Dealing with depression 

Kabera says it is important to look out for signs and symptoms such as sudden mood swings, fatigue, a decreased interest in usual activities; hobbies and other activities, sadness, guilt or hopelessness, sleeping disorders, irritability, anger or increased conflicts with others, among other factors.

He says when one notices such signs, it is important to reach out to that person and offer help.

He cites an example of his mother who, because of lack of early intervention, is now suffering from chronic depression.

"I have seen it affect my mother who has been depressed since her early childhood. She had no one to care for her, or access to social support and now it has become a chronic disease,” he narrates. 

Kabera warns against the tendency of assuming that mental disorders, especially depression, is a normal feeling — explaining that it’s a disease that has grave effects.

He, therefore, advises those who are close to someone with depression to be by their side, be patient, listen to them and engage them in social activities. 

"As an individual you can also take care of yourself by engaging in some activities, like reading about managing emotions and stress. This can also be included in school-based programmes to enhance a pattern of positive thinking in children and adolescents. Exercise programmes for the elderly can also be effective in depression prevention.”

"There is no strong approach to this issue but support is important. If you see someone with the above signs and symptoms, recommend them to a doctor, remind them about their appointments with their doctors.”

What’s the best way of overcoming depression?

Depression is a serious mental illness which negatively changes how we feel, act and think. Yet it is often overlooked and untreated, due to stigma, fear and lack of awareness. I think people, in this case, women, need someone they trust such that they open up and know the cause of their depression or how they are feeling at the moment, this will help them feel relieved. The second thing to do is to find a counsellor; through therapy one can find healing.

Women can be helped to overcome depression by first of all listening to them. Women need to be allowed to be vulnerable, and in their vulnerability, they will discuss whatever it is frustrating them and weighs them down thus prevention of depression in the long run. Fear to disappoint your children, husband or even parents can lead you into depression but if we know that we can all sometimes fail and if society doesn’t judge us harshly for things we have not done/are not doing right, then this will minimise depression in women especially those who have a lot of other people looking up to them. Society doesn’t have to expect less from women, but it can understand when women don’t meet their expectations to a dot. We are only human after all.

Women can be helped to overcome depression by listening or trying to understand them instead of judging them. People who are close to them can help them accept their situation and can also make them feel that they are capable of doing anything. But also showing them some love and encouraging them to work hard is vital.

One thing is that women meet many issues that affect their self-esteem but it is important to know that your life is yours as long as you are still under the sun. This is the best motive and it is best to preserve it and choose not to let sorrow and other bad thoughts get in. This requires a lot of sensitisation to women for them to be more understanding, about how hard life can be.