Any one of us can feel depressed for a while – for example about losing out on love, being unemployed, worrying about family conflict. It would be unusual to never, as the saying goes, ‘feel blue. But this story deals with something different, something that is a very serious disease that is not always healed by time or changed circumstances.
Sometimes this depression goes on to become a ‘terminal illness’, ending in suicide. In The Silent Killer, tragedy is only averted because Lungile’s suicide attempt is discovered in time.
Depression is common, and this important story is an accurate window into the suffering of someone we probably know, young or old, right now. We all need to be aware of and educated about depression. That is so we can give, or seek, the right kind of support, and treatment.
In September 2020 IOL online newspaper reported via the South African Depression and Anxiety Group (sadag.org) that, “… according to WHO, 800 000 people commit suicide every year … suicide is the third leading cause of death in teenagers in the 15-19 age group.” And, “In South Africa, there are 23 recorded suicides a day, and for every suicide there are a further 20 attempted suicides.” The SADAG helplines receive many thousands of calls.
This wonderful local organisation works to make depression and suicide, (and other mental health conditions) less taboo subjects. They have many online resources.
Why is depression ‘a silent killer’? Look at Lungile’s life: she’s attractive and smart, with a stable, well-off family, she’s made it to university, has a lovely boyfriend. Yet she is in invisible mental pain, anguish.
To the people around the sick person, depression is inexplicable, a mystery. There is no infection, nothing to see or hear; there is no ‘reason’ for the behaviour. It is easy to assume that the person is lazy, or selfish, or just unfriendly, bad tempered and uncaring about others.
Look what her frustrated mother says, and can we blame her?
“What time is it, Lungile? Is this a good time for a decent human being to wake up? Your sister has been cleaning the house by herself for hours while you were snoring the whole morning! Stop this laziness right now, Lungile! I can’t stand it!”
Lungile has ‘clinical depression’. As her psychiatrist said, in some vulnerable people, it can be triggered “… by a traumatic incident. It can also be caused by a chemical imbalance in the brain. In that instance it is because of a shortage of chemicals that bring joy.”
At first, and unless they see a health professional, even the sufferer may have no idea what is happening. They wonder why they feel so bad for no apparent reason. Later on in the story, Lungile comforts her father:
“Don’t worry about it, Baba. You didn’t know. It also took me a long time to understand what I was suffering from,” says Lungile.
But it is also a silent killer because if you are diagnosed with depression it is hard to tell people. The reason is that there is severe stigma around the disease, like there is with HIV. Lungile’s mother and father are shamed by her self-diagnosis; don’t want to accept it.
Lungile cannot even tell her boyfriend what is happening. Look at this interaction:
“So why don’t you have time for me anymore? Why are you no longer answering my calls?” There is pain and confusion in Menzi’s eyes.
“I have a lot on my plate. I have … I don’t know what to …”
Lungile fears Menzi might reject her due to the depression. But also it is very hard to put into words what depression feels like: “I can’t tell you. I don’t know what to tell you. How to tell you.”
The story shows us how this disease is misunderstood and stigmatised. Lungile’s mother and father first simply refuse to accept what she is telling them. They insist that there is no such thing as depression. Her mother says, “In all my years on earth I have never heard of such a disease. Who else has this disease in all of our area? Don’t play with us, Lungile”.
Then, her father is appalled at the idea of his child being ‘insane’: “Over my dead body! No child of mine will go to a doctor who treats the insane. Plus no child of mine will be treated by white doctors. I will deal with your illness in a way I see fit. Are we clear?” Sibiya’s rage rings out in the lounge.”
Of course, attitudes like this only make the depressed person feel that they are a worse burden. They feel that the ripples of their disease spread out and make their whole family miserable. Look what Lungile says: “I don’t know, Baba. But I just feel like my life should end. I just want to die because I’m a burden to all of you.”
Even after she has attempted to kill herself, Lungile’s parents can only react with shame and anger. They say she has wasted their money and is ungrateful for her good life.
Let us be clear: this story is set in a fairly traditional black family but misunderstanding of depression, and stigma around it, can happen in any group of people.
Something else to note is that clinical depression is in a different category to illnesses such as schizophrenia and being bipolar, that we associate with ‘insanity’. Sufferers of these mental illnesses may have a very distorted view of reality during an episode. They may be unable to work, and have to be hospitalised for long periods.
Some people do find comfort in prayer, or in getting support from traditional healers, and this may help them deal with mild depression. This is if the person themself wants this support, unlike Lungile in our story. But for clinical depression, medication can be very helpful. The respected Mayo Clinic says: “… clinical depression symptoms, even if severe, usually improve with psychological counselling, antidepressant medications or a combination of the two.”
Lungile wants to go to a psychiatrist. This type of highly qualified medical doctor can assess which, and how much, anti-depressant drugs a patient needs. She may also need psychological counselling. A psychologist is skilled at helping a person gain insight into their feelings, and learn ways to cope. They may not give scripts for medication.
Eventually, as their daughter fails to improve, the family accepts that her life is at risk:
MaKhumalo … sighs. “I have tried everything with Lungile. We need to take her to a psychiatrist otherwise she will die,” she says softly.
“Lungile is not mad, MaKhumalo.”
“Yes, she is not mad, but she is suffering from depression.”
Lungile, in turn, realises that the more informed her loved ones are, the more they can help her. That is why she asks the psychiatrist if her parents may attend the first appointment with her.
At the end of the story Lungile is on the way to being her usual self, and we are so glad of Menzi’s beautiful promise:
“Now I know the part I need to play in your journey of recovery. I will love you when you find it hard to love yourself. I’ll fight for our love. And one day we will get married and have babies as beautiful as you.”
Tell us: Have you ever experienced depression yourself, or in someone you know? How did you/they seek help? What kind of help?
Here are helpful contact numbers in a crisis or if you need to talk to a trained person:
SADAG Suicide Crisis Line 0800 567 567
SADAG Mental Health Line 011 234 4837
Lifeline 0861 322 322/ 011 728 1347
Find out about student helplines where you are.
Thanks to SADAG for checking our information around mental health issues in these Talking Points.