With the wall-to-wall sunshine of December and January fading into grayer days, a little bit of bad attitude seems only natural, but the reality of the city’s mental health situation appears much more serious.
An astonishing 47 percent of Bogotá’s population experiences clinically significant depression, anxiety or excessive stress at some point in life according to the District Health Secretary (SDS). The World Health Organization estimates the global lifetime prevalence of the same afflictions to be roughly half that figure– around 25 percent.
The fact that such a huge portion of the population struggles with potentially debilitating psychological conditions suggests a massive social welfare challenge.
Interpersonal relationship problems tend to be the primary reason reported for seeking treatment for depression or anxiety according to Amanda Muñoz, professor of clinical behavioral psychology at the Universidad Javeriana. Rapidly changing social roles, particularly due to Bogotá’s modernization in recent years, can cause stress as people struggle to adapt.
“In Colombia, we’re in a generational transition. Parents try to raise their kids the way that they were raised, but that doesn’t work anymore. Men are struggling to learn how to behave as we move away from machismo, and personal interactions are becoming more complex,” noted Muñoz. “We’re in a moral crisis– not in terms of good vs. bad, but rather in terms of what’s expected of a person.”
Among the many other potential factors behind the city’s depression epidemic are a tough climate, stressful transportation situation exacerbated by constant construction, high levels of unemployment and underemployment and the large and growing population of internally displaced and at-risk residents.
Of course, living in any urban environment carries certain inherent risks, and the challenges of dealing with a crowded city often become internalized as depression and anxiety.
“Stress is almost always a factor, particularly for people who work long hours and have to commute and have no free time with their families,” said Dr. Jorge Tellez, president of the Colombian Association Against Depression and Panic (ASODEP). “Even worse, without free time there’s no time for personal growth.”
Not surprisingly, Bogotá’s residents are also some of Colombia’s least optimistic. Only 30 percent feel that the city is moving in the right direction according to the most recent annual survey from the Colombian Network of Cities: How We Are Doing. The study also found that Bogotanos have the least pride in their city and report being the most fearful for their personal security compared with residents from Colombia’s other metropolitan centers.
Depression and anxiety are highly treatable conditions, with a number of options ranging from medication to cognitive therapy, but only 1 in 5 affected Bogotanos eventually seeks professional treatment.
“Depression is becoming an increasingly chronic condition because treatment is often inadequate. Public health coverage provides for only very limited treatment and the nature of depression makes it likely that patients won’t seek out help,” explained Tellez.
Stigmatization can also play a major role in failure to seek treatment, a problem Muñoz attributes to the perception of depression as a personal weakness or problem. “People with depression or anxiety shouldn’t think of themselves as ‘being’ a problem, but rather as dealing with the problems that bother them,” said Muñoz.
Unfortunately, untreated depression can have serious consequences. In 2011, 275 Bogotanos committed suicide, approximately one death every 36 hours, in addition to more than 1,600 failed attempts, according to the National Institute of Legal Medicine and Forensic Sciences.
Aside from the risk of suicide, depression can cause or worsen a number of other medical conditions ranging from heart disease to substance abuse, according to Dr. Tellez. The increased prevalence of complications stemming from a treatable condition unnecessarily drives up healthcare costs across the city.
Though clearly a grave problem, the outlook for Bogotanos suffering from depression and anxiety looks a little brighter thanks to aggressive campaigns by the city government to reduce stigmatization and increase treatment options.
Aside from traditional psychological consultation, most universities with psychology programs offer professor-supervised therapy with graduate students for a fraction of the cost of a professional session. ASODEP also hosts free support groups every other week.
Bogotanos will probably always suffer from terrible traffic and bad weather but, thankfully, depression is a lot easier to get rid of than the rain.