Kuwait MD: Depression

Post by Dr. H – A family medicine resident working in a polyclinic in Kuwait

Its been a while since I’ve posted due to the fact I’ve been on holiday. Now its back to reality and I was thinking about what my next blog post would be, when I saw this patient and realized that it should be on the least discussed ‘taboo’ topic in kuwait – depression.

I see so many patients who are truly suffering with this disease, however with the lack of supportive services in Kuwait, they continue to suffer in silence, told by their families to ‘become more spiritual’ or ‘just snap out of it’.

So first off.. what is depression? Depression is a mood disorder that causes a persistent feeling of sadness, and a loss of interest. There are many other associated symptoms, such as trouble sleeping and loss/gain of appetite. There are many theories on the etiology (cause) of depression, one is biological – So it basically says that there are certain ‘chemicals’ in the brain, and when you have depression, these chemicals are a bit off, so you get symptoms. Its multifactorial, theres a lot of other theories, it’s still poorly understood what causes it.. but the bottom line is that it’s a disease. Yes a disease. Just like asthma is a disease.. ever asked someone to ‘snap’ out of asthma?

So.. back to my patient.. I saw a 30 something year old lady, who has been suffering with lack of sleep, low mood, anhedonia (loss of interest), and has been this way for the past 3 months. She was miserable. It was taking a toll on her work, her marriage, and her kids. She did every medical test out there, most importantly her thyroid (gland that produces hormones, when dysfunctional can mimic depression), all her tests came back normal. So I started discussing depression with her, and the treatment options available. I was met with ‘shno depression? lesh tgolin 3ani maynona’ ‘what depression? why are you calling me crazy?’. She refused to discuss treatment or medication and stormed out. This just highlights a huge issue in Kuwaiti society, the taboo of mental illness.

Depression can be very successfully managed with medications and lifestyle modifications, but mention an antidepressant and 90% of patients will refuse.

You must be thinking.. what about psychiatrists? doesn’t Kuwait have a new mental health centre? A centre dedicated to mental illness? Why not refer patients there? What is their role in improving mental health and increasing awareness?

Here’s a fun little fact.. people who get treated at the Kuwait mental health center wouldn’t be considered for jobs in sensitive positions, such as parliament, certain ministry of interior jobs, army, etc. that does a lot to defeat the taboo right? What a good way to move forward Kuwait! Its one step forward two steps back. On the one hand the ministry of health is improving mental health care, on the other they’re saying if you have a file in the mental health center or problems with your mental health then you’re banned from certain jobs. What kind of image does that project?

I was thinking of ways that mental health can be improved, and ways to increase awareness, and I remembered when I was in med school abroad, we had a student hotline and a suicide hotline. These were 24 hour hotlines that you call, free of charge when you feel suicidal, sad, overwhelmed, or unwell. You would call and there would be someone to hear you on the other end of the line to offer supportive services. I think implementing something like this in Kuwait would be a huge step forward, and easier to set up than changing the politics behind being banned from jobs for following up with a psychiatrist.

We’re a long way away from defeating the taboo of mental health in Kuwait, but I think small changes and an increase in awareness would go a long way. So if you’re reading this, and you notice that you or a friend or relative has been suffering with low mood, loss of interest, change in appetite, trouble sleeping, or anything similar, please go to your polyclinic and discuss it with your family medicine doctor. There are a lot of resources out there, antidepressants can be prescribed by your family physician in the polyclinic, and you can be referred to a more specialized clinic if need be. Please do, thats what we’re here for!

(If anyone has any questions, or is suffering with anything similar please do not hesitate to contact me, I’m more than happy to help)

Post by Dr. H – A family medicine resident working in a polyclinic in Kuwait