She lived in a small Ugandan village and had lost five of her nine children over the past decade. The spirit, it seemed, the very will to live, had fled her. A neighbor asked if she would be willing to join a local therapy group for depression and, with some persuasion, she agreed. Just over four months later, "the fierce, loving, strong woman she had been" returned, according to an interview with the woman's husband by The New York Times.
The results were published in 2003, in The Journal of the American Medical Association, and they support a growing body of research showing the value of informal discussion groups for treating depression in developing countries.
Depression is often considered a problem of the developed world and treatment a luxury paid for in the developed world. However, depression is fast gaining recognition as a major challenge in developing countries, where daily and persistent privation has led the World Health Organization (WHO) to declare it the disease most responsible for loss of productivity among adults. As of four years ago, the WHO initiated its Mental Health Gap Action Program to help developing countries integrate mental health initiatives into primary care.
Fortunately, ongoing research is uncovering how these programs might be implemented relatively inexpensively—without pharmaceuticals or dependence on psychiatrists and psychologists, all of which are in short supply in developing countries. Instead, local citizens can undergo condensed training workshops for accreditation as discussion facilitators. The discussions they go on to lead have proven powerful forces in alleviating depression symptoms, often working as effectively as professional courses of treatment.
As an additional benefit, targeting depression can help health workers involved in other public health challenges, like stemming the spread of AIDS or tuberculosis; people who are treated for depression are more likely to adhere to critical drug treatment regimens and less likely to exhibit reckless behavior.