‘Social stigma deterrent for Arab women seeking treatment for emotional issues’

DUBAI: According to the World Health Organisation (WHO), depression in the UAE is the second leading contributor to poor health and shorter lifespan among people between the ages of 15 and 44.

Experts at the upcoming Obs-Gyne Exhibition & Congress, taking place from April 1-3 at the Dubai International Convention & Exhibition Centre, will discuss this issue of depression among women in the Middle East, as well as appropriate screening and treatment methods for this health concern.

For the second year, Informa Exhibitions is partnering with the Arab Association of Obstetrics & Gynaecology Societies (AAOGS) drawing more than 100 regional and international speakers from around the world.

According to Dr Saliha Afridi, clinical psychologist and MD at The LightHouse Arabia, and speaker at the Obs-Gyne Exhibition & Congress, the ‘social stigma’ associated with going to see a mental health professional still acts as a strong deterrent for women seeking treatment for their emotional issues.

“The Arab and Asian world is very private with religion playing a strong mediating role in coping with mental health issues. For some, it is not considered to be acceptable to discuss family problems with an ‘outsider’.

“Women will often go to primary care physicians to report psychosomatic symptoms who will then refer them to psychiatrists or psychologists as it is much easier and more socially acceptable to admit that there is something wrong with the body than it is to admit that they need help coping with depression,” says Dr Afridi.

Lack of awareness is the main reason why women in the Arab world do not seek appropriate treatment for symptoms of depression.

“Many women are unaware of the different ways that depression can present itself, and, being away from their support systems can often leave them alone to cope with life’s challenges.

Stress is also a major issue trigger as women try to adhere to traditional gender definitions while juggling the high demands of family, work, and social responsibilities,” Dr Afridi explains.

According to Dr Afridi, prescribing antidepressants is only an effective form of treatment when the individual is treated holistically.

“Antidepressants may alleviate the symptoms of depression; however, they will not treat the life choices and patterns that the person is involved in that resulted in the depression.

“Emotional health is very important as the patient must learn how to heal their wounds, learn their relational style, achieve work-life balance, know what their impact is on those around them, take accountability for their role in their depression, and feel empowered to make life changes,” she explains.

Courtesy : Gulf Today

Depression stalks Emirati students

ABU DHABI // Nearly one in four Emirati university students may suffer from depression, a rate at the upper end of global levels, a new study shows. The two-year research project was meant to find links between thinking patterns and depression to better prevent the condition.

But while studying 450 students at Zayed University, researchers also found a “surprisingly high” rate of depression. The study found that 20 per cent of the students were likely to be suffering from “moderate” depression and three per cent showed “severe” depressive symptoms. “The results were very surprising,” said Dr Justin Thomas, an assistant professor for natural science and public health at the university, who led the study.

“Initially I had to go back to the literature because I thought, ‘This is just too high’.” Rates for depression globally range from about 1.5 per cent of the population in Taiwan to about 20 per cent in the US. Most of those surveyed in the study by Dr Thomas were under 25, the average age of onset for depression. The expectation was that the rate of depression among the students would be lower than was found, he said.

However, recent surveys in the region have also show a high prevalence of the condition. A study in Kuwait, published late last year, found 10 per cent of university students were severely depressed and 14 per cent moderately depressed. A study of Emiratis over the age of 60 published in 2004 found a depression rate of about 20 per cent. Dr Thomas said the cause of the high depression rate in the Gulf may be due to “cultural transition” and the upheavals caused by rapid development.

“I expected the UAE to be nearer the middle of the global range,” he said. “But when there’s change there’s always loss, and the rate of depression is linked to loss. In this case it may be a loss of connection to family, to tradition, to how things used to be. That’s one theory.” That theory gets some support from a survey conducted among elderly Emiratis which split the results geographically. In Dubai, the rate of depression was found to be 29 per cent, far higher than in Al Ain and Ras al Khaimah, where rates of development have been gentler.

Another unexpected result of the study was that the results were similar across gender lines; globally, rates of depression among women are usually higher. Dr Thomas said that Zayed University women might be a “biased sample” because of a sense of achievement in having reached the university. “One of the reasons hypothesised is that if in the society historically there have been limited opportunities for women to go to university, women that make it will be relatively more psychologically healthy,” he said.

The purpose of the survey was to discover if certain “thinking styles” could predict depression. Those with “dysfunctional attitudes” such as closely tying their self-worth to achievement and acceptance from others or those who respond to sadness by focusing attention on the cause of the mood, are “powerfully” linked to higher instances of depression, the research showed. Dr Thomas said because of the correlation between dysfunctional attitudes and depression, “you can identify people who think in this way” and categorise them as at-risk. “This means you can focus on prevention rather than curing depression,” he said. “The way in which people think can be changed.”

Dr Thomas argued that it was important for educators to work with the health sector to ensure young people developed healthy “thinking styles” and prevent mental illness. The Ministry of Health recently began a study to isolate psychological problems suffered by teenagers in schools. Psychologists are increasingly looking at preventive measures because the World Health Organisation predicts that by 2020 depression will be the second-leading disability-causing disease in the world.

Delegates at a mental-health conference in Dubai in June announced that 75 per cent of mental illness in the UAE is linked to depression and anxiety.

Heavy Drinking Rewires Brain, Increasing Susceptibility to Anxiety Problems

ScienceDaily (Sep. 2, 2012) —

Doctors have long recognized a link between alcoholism and anxiety disorders such as post-traumatic stress disorder (PTSD). Those who drink heavily are at increased risk for traumatic events like car accidents and domestic violence, but that only partially explains the connection. New research using mice reveals heavy alcohol use actually rewires brain circuitry, making it harder for alcoholics to recover psychologically following a traumatic experience.

“There’s a whole spectrum to how people react to a traumatic event,” said study author Thomas Kash, PhD, assistant professor of pharmacology at the University of North Carolina School of Medicine. “It’s the recovery that we’re looking at — the ability to say ‘this is not dangerous anymore.’ Basically, our research shows that chronic exposure to alcohol can cause a deficit with regard to how our cognitive brain centers control our emotional brain centers.”

The study, which was published online on Sept. 2, 2012 by the journal Nature Neuroscience, was conducted by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and UNC’s Bowles Center for Alcohol Studies.

“A history of heavy alcohol abuse could impair a critical mechanism for recovering from a trauma, and in doing so put people at greater risk for PTSD,” said NIAAA scientist Andrew Holmes, PhD, the study’s senior author. “The next step will be to test whether our preclinical findings translate to patients currently suffering from comorbid PTSD and alcohol abuse. If it does, then this could lead to new thinking about how we can better treat these serious medical conditions.”

Over the course of a month, the researchers gave one group of mice doses of alcohol equivalent to double the legal driving limit in humans. A second group of mice was given no alcohol. The team then used mild electric shocks to train all the mice to fear the sound of a brief tone.

When the tone was repeatedly played without the accompanying electric shock, the mice with no alcohol exposure gradually stopped fearing it. The mice with chronic alcohol exposure, on the other hand, froze in place each time the tone was played, even long after the electric shocks had stopped.

The pattern is similar to what is seen in patients with PTSD, who have trouble overcoming fear even when they are no longer in a dangerous situation.

The researchers traced the effect to differences in the neural circuitry of the alcohol-exposed mice. Comparing the brains of the mice, researchers noticed nerve cells in the prefrontal cortex of the alcohol-exposed mice actually had a different shape than those of the other mice. In addition, the activity of a key receptor, NMDA, was suppressed in the mice given heavy doses of alcohol.

Holmes said the findings are valuable because they pinpoint exactly where alcohol causes damage that leads to problems overcoming fear. “We’re not only seeing that alcohol has detrimental effects on a clinically important emotional process, but we’re able to offer some insight into how alcohol might do so by disrupting the functioning of some very specific brain circuits,” said Holmes.

Understanding the relationship between alcohol and anxiety at the molecular level could offer new possibilities for developing drugs to help patients with anxiety disorders who also have a history of heavy alcohol use. “This study is exciting because it gives us a specific molecule to look at in a specific brain region, thus opening the door to discovering new methods to treat these disorders,” said Kash.

Study co-authors include Kristen Pleil, Chia Li and Catherine Marcinkiewcz of UNC and Paul Fitzgerald, Kathryn MacPherson, Lauren DeBrouse, Giovanni Colacicco, Shaun Flynn, Sophie Masneuf, Ozge Gunduz-Cinar and Marguerite Camp of NIAAA.

Video: Study Reports TMS Therapy Helps Patients With MDD

By Laurie Martin, Web Editor | May 16, 2012

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In a scientific poster presented at last week’s American Psychiatric Association (APA) meeting, new data show that patients with unipolar, non-psychotic major depressive disorder (MDD) receiving transcranial magnetic stimulation (TMS) achieved significant improvements in both depression symptoms and in quality of life measurements.¹

In an open label study of 307 participants receiving acute TMS over an average period of 5 weeks, 58% had a positive response, with 37% achieving remission from their depression. Researchers reported the most noteworthy improvement was seen in the mental component summary score measured by the Short Form 36-Item Questionnaire (SF-36). Neurostar TMS^®—the only FDA-approved TMS device—was used in the study. It is currently being studied in the treatment of postpartum depression, PTSD, OCD, and schizophrenia.

Here, Ian A. Cook, MD, an investigator in the study, briefly explains the findings. Dr Cook is Professor of Psychiatry at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles.

75 % of mental illness cases in UAE are linked to depression and anxiety, reveals mental health conference

 

The recently concluded Mental Health Conference in Dubai revealed      that the average patient’s spend on mental illness treatment in the UAE exceeds Dhs20,000 per annum, with 55% of patients denying that they are ill.

It also emphasized that poor compliance leads to failed medical treatment and drug-resistant conditions.The conference, attended by patients, doctors, nurses, psychologists, social workers and members of the public, said that stigma was the first reason that prevented patients from seeking diagnosis and treatment.

It also urged people who feel the symptoms of mental illness to see a doctor, adding that while there is inadequate health insurance coverage of mental illnesses in the UAE, the treatment fees and medicines are supported by the government in local hospitals where it is free for locals and almost negligible for expatriates.

The conference, organized by AstraZeneca, revealed that 75% of the cases were linked to depression and anxiety.

Dr Bahjat Balbous, Specialist Psychiatrist, Al Amal Hospital, Dubai said:

“There are only 180 specialist psychiatrists working in the UAE. Only 10% of them are doctors know how to use hypnosis in treating patients for critical cases. Global percentages for schizophrenia are 1%, and the UAE is not far away from this percentage.”

Dr. Khalid Shirazy, Medical & Regulatory Manager, AstraZeneca Gulf added, “The major issues that face mental illness disease in the UAE includes how well patients are on drug compliance and how well a patient follows the instructions for taking the medication.”

Dr Shirazy said, “We must raise awareness of the several mental and physiological illnesses among the community. With all the pressures and the fast pace of life that the Gulf community is being subjected to, no one is immune from these illness.”

The existing strategies used for treating mental illness are still limited, in particular in the Arab world, the conference pointed out.

Dr Balbous added, “The lack of understanding by patients about the chronicity of mental illness and the need to take the medication as well as the stigma attached mental illness results in late diagnosis. This puts on us all the responsibility to put extra efforts in fighting mental illness diseases.”

A UK expatriate patient talked about his personal experience and how compliance of treatment had produced good results and helped him complete his education and pursue career growth.

Praising the expatriate patient speaking out at the conference, Dr Shirazy added that addressing public events could motivate others facing similar challenges to come out in the open.

Dr Balbous added, “Stigma is a real barrier to cure people who have a mental illness. It is by definition a negative judgment based on a personal trait. It was once a common perception that having a mental illness is dangerous. It is something we need to eliminate from the patients mind and the surrounding mind as well.”

Dr Shirazy added, “Having a mental illness doesn’t mean that someone is violent or dangerous This can lead to feelings of anger, frustration, shame and low self-esteem as well as discrimination at work, school and in other areas of the patients life which will lead that he will hide his mental illness or illness denial or treatment refusal.”

“The conference urged the outside world to treat a mentally ill people with understanding and support. We shouldn’t say that someone is bipolar rather that he has a bipolar disorder,” Dr Balbous argued.

“While the government is helping a lot, we need to increase the number of non profit agencies and programs support people who have mental health conditions,” the conference pointed out.

Dr Mona Issa Jakka, Specialist Psychiatrist, Obeid Allah Hospital, RAK, said:

“Similar to other chronic diseases such as Diabetes or Asthma, mental health disorders can be controlled and managed by early visits to a psychiatry clinic and seek treatment. Treatment helps patients to re-enjoy their family life, work and social activities. Therefore, relapse and progression of mental health disorders could be prevented by regular follow up with the psychiatrist and maintaining on taking the medication properly and continuously.”