Serious Depression is a critical issue in South Africa, with approximately one in five people affected. The festive season can be particularly stressful for those suffering from a chronic form of the disease. Workloads, social responsibilities and financial burdens all increase at this time of the year. It can be debilitating, especially if there is no support structure in place. This story is part of The Journalist’s Mentorship Programme in the Free State.

It’s a beautiful day, and Thandi Mabotsa can’t stop smiling. She’s at the height of her career, and even feels good about her new hairstyle. There is a glow that her colleagues can’t help noticing. But to reach this place where her body, mind and soul are at peace was like being dragged through a pit of darkness.

Thandi (29) grew up in Bloemfontein, the eldest of three. A friendly girl, she was extremely shy. Music was her solace, and she cherished happy memories of her mother’s cooking. Nothing made Thandi’s heart melt like her favourite dish, beef curry with dumpling. She was smart and never failed a grade at school. Thandi was happy. After high school she enrolled for a Bachelor of Arts degree at the University of the Free State (UFS).

On the day that Thandi graduated in 2006, her proud family was there to support her. She was excited and ready to embark on a new chapter of her life. Everything seemed to be smooth sailing for her and she had a full time job at UFS waiting for her.

She continued to work hard, was awarded a bursary and during her final year, was funded to travel to the USA to participate as a delegate in a youth summit.

Three years later, Thandi gave birth to a baby girl and became a single parent. She was facing the difficulty of juggling work, parenting and studying for her Masters Degree. Life became challenging and things changed. Soon just getting up in the morning was unbearable… up to a point where she realised she needed to seek professional counseling.

“I sat across my psychologist in his consultation room. It was my second visit. He took a long look at me, and then casually, he referred me to a therapist for major depression, writing in my file. I was shocked. ‘That’s ridiculous; I’m not insane,’ I thought. Like an observer in a dream, I drifted from one medical expert to another. I was referred to a psychiatrist and booked in for two weeks at the Bloemcare Clinic. I was horrified to be labelled as depressed”.

“I have never been sick a day in my life. I refuse to be considered ‘weak’. I am a strong woman and mother -capable of handling work and life in general, despite the challenges. How dare they imply that I’m crazy?”

Renowned psychiatrist, Dr Elizabeth Kubler-Ross says that we move through the stages of denial, anger, bargaining and depression before finally reaching acceptance. Thandi’s rage was right on cue.

Thandi’s situation is not unique. According to the UFS Health and Wellness records, depression is one of the top five chronic conditions experienced by staff. Statistics for 2013 show that 10% of staff members on Discovery Health Medical Aid (1 915 in total) and 3,6% on Bestmed Medical Aid (364 in total) have been on chronic medication for major depression.

Thandi says she started to experience recurring nightmares. In many of these dreams, she was trying to save her cousin. She hardly slept or rested.

“I was constantly tired, but scared to sleep. My fatigue then started to affect my work performance and I was no longer as productive. I would miss deadlines and sometimes arrived late. In the evenings, I didn’t even have the strength to play with my child or read her a book. I would cry myself to sleep instead and wake up with swollen eyes. I started to also lose a lot of weight and hardly spent time with my family and close friends. One evening, I was alone at my flat and my daughter was visiting my mother. I started crying again after realising my cousin’s favourite song was playing on the radio. I cried so hard that I literally had to gasp for air. I felt like I was losing breath. I opened my window for some fresh air and tried to breathe as slowly as possible. I eventually managed to get my breathing under control and stopped crying but it was a scary experience. It suddenly hit me that if I didn’t get help, I was going to die in my tears and leave my daughter to be an orphan. I needed help!”.

On 19 September 2011, Thandi checked in at Bloemcare Clinic, still in denial. Her family and close friends were worried for her but they gave her and her daughter the support they needed. On her third day there, during a consultation with a Dr Williams, she experienced a breakthrough.

“He gave me a task of writing a letter to my close cousin who had killed himself. He was found dead hanging from the roof in his bedroom with no letter to explain why he opted for suicide. It was just before Christmas four years ago now. With the letter I had to reflect on my loss and confront my anger towards him. How could he leave without saying goodbye? Who will I confide in? Why did he kill himself and why could he not ask me to help him? I had questions with no answers yet I needed peace of mind. As I continued to write, I sobbed for a while. I then took a pause at some stage and smiled when I remembered how happy he made me feel – the jokes, hugs, support and love.

Holding on to the happy memories with him started to feel less painful. I had wonderful memories of my cousin and I dancing and singing together at concerts. I now had to look forward to creating new ones without him”.

Staying at the Bloemcare Clinic for recovery was the first step in the right direction. After the letter-writing exercise, Thandi’s condition started to improve. She experienced fewer nightmares and was more relaxed. Her doctor prescribed antidepressant medication; she had therapy as well as a good support system, and she was discharged after two weeks. Shortly after, Thandi went back to work.

“Upon my arrival at work, I made a decision to inform my Director of my condition hoping to receive support. I was still on treatment and sometimes experienced fatigue as a side effect because of the drug components. It was therefore important that I set realistic goals with my line manger to keep up with the deadlines and continue to add value to the department given my condition and the demanding work environment. I asked University officials if there were any programmes in place to assist staff members suffering from depression,” says Thandi.

She has explored the support networks at the University and wants to tell others about it.

“Staff members experiencing depression can join a support group for UFS employees. The group meets four times in a year. They can also attend scheduled informative workshops or presentations on depression and on living a holistic healthy life often presented by health professionals”, explains Liesl Wessels, from the Health and Wellness Office at UFS.

Employees believed to be suffering from depression receive their first three consultations for free, paid by the university. At the moment there aren’t any programmes in place to assist line managers within the departments, but the Health and Wellness office may be integrating some of their programmes with the Performance Management Plan.

Recovering from depression is a process, and Thandi Mabotsa is not alone. A significant number of UFS staff members are struggling with depression. According to Mrs Lerato Makhele, counselling psychologist at the Health and Wellness Office at UFS, there is the risk that depression patients could experience recurrent episodes, especially toward the end of the year. This is due to the stress of increased work pressures, lack of exercise and socialising, and other personal reasons.

But Thandi who is looking forward to a holiday at the end of the year with her child and family by the seaside, is optimistic.

“Don’t lose hope. It is important to make use of all the resources available at work and at home. This is a condition anyone can overcome with the right support structures. You just need to constantly reflect and evaluate yourself with the aim of finding the right balance. Take especially good care of yourself during the silliness of the festive season. It can be a lonely and stressful time for sensitive people prone to depression.”