Stuck in a hole

Depression is on the rise among Omani adolescents. According to the Ministry of Health’s 2016 annual report, there had been 4,991 cases of children with mental health issues in the tender age group of 0-11, while the number of cases 12-19 age group reached 4,978.
A study by the Behavioural Medicine Department at Sultan Qaboos University (SQU) on students showed that 27 per cent had depression of varying grades.
Another study by the department investigating depressive symptoms among secondary school students in Oman found that 17 per cent of the respondents showed the symptoms.
“The increasing number of cases of depression among young Omanis is a matter of serious concern and appropriate measures need to be taken for screening, early detection and management of these cases”, said Dr Hassan Mirza, Consultant, Child and Adolescent Psyschiatrist at Sultan Qaboos University Hospital. “Depression can run in families, and factors such as peer pressure and friendship difficulties, high academic expectations, early childhood trauma and separations, and long-term illness can cause depression”, reveals Dr Hassan. According to the ministry’s report, those depression cases in the age up to 11 included 3,386 girls and 1,605 boys. In the age group of 12 to 19 and 20 to 44, there were more females than males.
“Adolescents are going through a phase of significant physical and hormonal changes during puberty, resulting in emotional and behaviour changes, such moodiness or rebellions”, points out Dr Hassan.
As a result, sometimes it may be difficult to differentiate between what seems to be “normal teenage behaviour” from depression. Studies have shown that a noticeable proportion may report feeling sad or miserable at some point during adolescence. However, clinical depression differs from normal sadness as having greater severity, longer persistence, and the young person describing the mood as qualitatively different from the ordinary sadness.
Associated cluster of symptoms in depression include reduction or loss of ability to experience pleasure, poor concentration, lack of energy, feelings of helplessness and hopelessness, changes in appetite and sleep, and suicidal thoughts and acts. Similarly, refusal or reluctance to attend school, irritability, and associated abdominal pain and headache may be part of the depression. Moreover, some or most of these symptoms may be present, but in order to be described as depression, one should experience them persistently for at least two weeks.
“The management of depression is multidisciplinary, and involves working closely with the young person, the family, and school”, Dr Hassan says. “It is our standard practice to liaise with schools whenever we assess a young person with any mental health needs, being it for bullying or related to learning difficulties”, says Dr Hassan. However, at times, stressor can’t be possible to identify or abolish, warranting further interventions such as a form of talking therapy, and if this fails, then a trial antidepressant medication can be considered.
“In all, maintaining good hobbies, a balanced diet, good sleep and rest, regular exercise, and most importantly preserving social connections with family and friends can shield against symptoms of depression”, Dr Hassan adds.