Depression is one of the most common mental illnesses in the world. Among those vulnerable to it today are people with HIV / AIDS and even the social workers and families that care for them. From Washington, VOA reporter William Eagle takes a look at a group in South Africa that?s working to alleviate the problem.
"There is a terrible burnout rate. It?s a soul-destroying job," says Zane Wilson, the founder of the South Africa Depression and Anxiety Group in Johannesburg.
She?s talking about depression among those who provide home-based care for people with HIV / AIDS. Wilson says in South Africa, it?s mostly women.
"We did some work with the world bank a few years ago," said Wilson. "When we went back to do some additional training, it was interesting. We noticed there had been a huge turnover ? hardly any we trained were left. We started to do some research and found that in certain areas of Mpumalanga and Limpopo [Provinces], up to 89 percent of them had themselves got depression."
And no wonder, she said.
The women work in communities that stigmatize both HIV / AIDS and mental health illnesses, including depression ? sometimes referred to as ?black heart? or ?heavy heart? by traditional healers or those who have the disease. Symptoms of depression include loss of appetite, a dramatic change in sleeping habits, withdrawal from others, and in children, sometimes a drop in grades at school.
Health care activists say that up to half of those with HIV / AIDS suffer from depression. The diagnosis often creates stress, which can trigger depression over impending death and changes in some relationships, including marriages.
Adding to the their own stress, the caregivers are often volunteers who practice long hours without the necessary equipment, including gloves and saline solution. Anti-retroviral drugs may not be available, although local clinics may be stocked with anti-depressants.
Wilson says her group goes to hard-to-reach rural areas and holds workshops of between 200 and 400 women. The South African Depression and Anxiety Group reaches about 6,000 care givers a year.
She said, "We work with them and talk to them about what is depression in yourself and in your patient? What is suicidal behavior? What would you be looking for, even in your colleagues? How do you build someone?s self esteem when really they?ve got no hope left, they are disheartened, they?ve just been told they have HIV / AIDS."
Wilson says the workshops have proved amazing because research in South Africa shows that a person with HIV / AIDS is 36 times more likely to attempt suicide. For those, the mental health of the caregiver can be the difference between life and death.