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Security, economic fears push Lebanese into depression

Depression is a complex syndrome with symptoms that affect not only emotions. David Cheskin/PA

BEIRUT: Recent security and economic concerns are pushing more and more Lebanese into depression, according to psychiatrists.

While there are no readily available national statistics, a number of experts in the field say anti-depressant sales are on the rise and more Lebanese are experiencing depression as the country’s security and economic situation becomes increasingly precarious.

“People are definitely taking more anti-depressants as a result of many things,” said Dr. Roula Houry, a psychotherapist who practices in Beirut. “The situation in Lebanon is making people very anxious and they are under stress, which leads to depression.”

Depression is a “brain disease” according to Dr. Abboud Assaf, a psychiatrist who studied and worked around Europe and the Middle East.

“Depression is a very complex neurobiological illness that affects not only your brain but also your body,” he wrote in an essay on his website in 2012.

For Assaf, depression is a complex syndrome with symptoms that affect not only emotions, but also cognition, neurovegetative functions including appetite, sleep and energy levels, and socio-professional functioning.

In Lebanon it is hard to know how prevalent depression is as “there are no final numbers,” Assaf said.

He added, however, that close observations show that the levels of depression in Lebanon are likely only “slightly higher” than those of the United States and Europe.

“One out of six people will develop depression,” Assaf said, adding that in Lebanon it “should be higher” due to a number of variables.

The country has struggled to deal with a spate of car bombings that struck at the rate of nearly once a week in late 2013 and early 2014. Other car bombs also detonated over the summer at a sporadic and less frequent rate. Meanwhile rockets have been raining down on certain areas in the Bekaa Valley and clashes broke out in the Sunni border town of Arsal, pitting the Lebanese Army against extremist militants aligned with the Islamic State of Iraq and Greater Syria (ISIS).

In addition to the security situation, Houry describes three other major factors that contribute to depression among Lebanese.

“The political situation, the economic situation and misdiagnosis,” she told The Daily Star. “It is affecting all of the Arab and third world.”

But interestingly enough it seems as though depression is affecting the youth more than the older generation, despite trauma from the Civil War having affected at least 49 percent of the population, according to a 2006 World Mental Health Survey Initiative conducted by the World Health Organization.

According to experts, advances in technology and the extreme mobility of today’s society have led youth to lose access to a real and comforting social network, and this causes feelings of stress and loneliness.

“The economic situation is a major cause because people can’t afford daily life,” Houry said. “People already on anti-depressants definitely are taking more now and some of those people are misdiagnosed.”

“Depression has many underlying causes,” Houry explained.

Psychiatrists may push a drug too easily for marketing purposes, she said, though that is more common abroad in countries like the United States, where there is a more profitable market for such drugs.

Houry also said anti-depressants are likely the most commonly sold prescription drug at pharmacies.

In Beirut, pharmacists explained that sales of antidepressants have always been consistent but increase in times of turmoil and tensions.

Dr. Bassam al-Samad from Hamra’s Wardieh Pharmacy checked sales for June, July and August and confirmed they were normal.

Samad said several brands of antidepressants are favored by the Lebanese, and highlighted that most don’t need a regular prescription.

“The rest such as Xanax, for example, are not over-the-counter and the prescription needs to be renewed periodically,” he said.

Marwan, a pharmacist in the Beirut neighborhood of Kantari, explained that Xanax Prozac, Seroxat and Remoron Cypralex are among the most popular antidepressants in Lebanon. He added that most have a generic version too.

Houry said that lifestyle changes, including an improved diet and increased exercise, can help Lebanese counter their current depressed state, as can seeking professional help.

But there is still a stigma for seeking professional help in Lebanon. “There is a 20-year delay,” Assaf said, between the West and Lebanon on attitudes toward therapy. But he said the bubble is slowly starting to burst.

“There has been a dramatic change in the last 16 years,” he said.

“The taboo went and people accepted that it’s not crazy to go to a psychiatrist, and now there is more awareness that it is a disease.”

And the level of change varies according to geographic area, education, economic status and culture, he said. Still, the lack of official figures makes it difficult to get a fully comprehensive grasp of the situation.

While universities and private psychiatrists might record statistics and help provide some insight, Assaf isn’t optimistic regarding the state’s ability to ever distribute any official figures on depression. “I doubt there will ever be any,” he said.

But he did have another message to send: “If people feel empty or ... pessimistic, it is not necessarily a phase. It’s better to see a psychiatrist.”

 
A version of this article appeared in the print edition of The Daily Star on August 21, 2014, on page 4.

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Summary

Recent security and economic concerns are pushing more and more Lebanese into depression, according to psychiatrists.

While there are no readily available national statistics, a number of experts in the field say anti-depressant sales are on the rise and more Lebanese are experiencing depression as the country's security and economic situation becomes increasingly precarious.

Depression is a "brain disease" according to Dr. Abboud Assaf, a psychiatrist who studied and worked around Europe and the Middle East.

In addition to the security situation, Houry describes three other major factors that contribute to depression among Lebanese.

Houry also said anti-depressants are likely the most commonly sold prescription drug at pharmacies.

Samad said several brands of antidepressants are favored by the Lebanese, and highlighted that most don't need a regular prescription.

Marwan, a pharmacist in the Beirut neighborhood of Kantari, explained that Xanax Prozac, Seroxat and Remoron Cypralex are among the most popular antidepressants in Lebanon.

Houry said that lifestyle changes, including an improved diet and increased exercise, can help Lebanese counter their current depressed state, as can seeking professional help.


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