Depression in Eswatini

Effects of high depression-related stress on health and personal life

• Physical health

  • Sleep problems (insomnia or oversleeping)
  • Low energy, fatigue, and headaches
  • Appetite and weight changes
  • Muscle tension, pain, and higher risk of illness
  • Potential impact on chronic conditions and immune function

• Mental health and cognition

  • Persistent sadness or hopelessness; increased anxiety
  • Difficulty concentrating, decision-making, and memory
  • Irritability or mood swings
  • Thoughts of self-harm or suicide (seek immediate help if present)

• Relationships and social life

  • Withdrawal from friends and family; reduced social activity
  • Increased conflicts or misunderstandings with loved ones
  • Parenting or caregiving challenges; diminished patience
  • Lower sexual interest or functioning

• Work and daily functioning

  • Reduced motivation, productivity, and task completion
  • More mistakes or accidents; higher absenteeism or presenteeism
  • Strained work relationships and burnout risk

• Long-term risks

  • Worsening physical health problems and chronic disease risk
  • Higher likelihood of developing or worsening mental health disorders
  • Negative spillover into finances, housing, and safety

What to do and where to get help

• Seek professional support

  • Talk to a healthcare provider or counselor about treatment options (therapy, medications if appropriate) and affordable local resources.
  • Consider digital supports like October for group sessions, assessments, and psychoeducational content.

• Build a small support plan

  • Establish regular sleep and meal routines; incorporate light physical activity.
  • Reach out to a trusted friend or family member; set short, manageable goals each day.

• Workplace steps (Eswatini context)

  • Talk to HR or a supervisor about flexible scheduling, workload adjustments, or an Employee Assistance Program if available.
  • Use digital or in-person mental health resources offered by your employer or community; consider starting with a short, confidential group session through October if suitable.

• If there is an immediate risk

  • Contact local emergency services or go to the nearest emergency department. If safe to do so, reach out to a trusted person right away.

• Reduced productivity and attendance: Depression lowers energy, concentration, and motivation, leading to more absenteeism and presenteeism, which reduces overall output.

• Higher health and social costs: Increased use of healthcare services, medications, therapy, and caregiver time; potential rise in disability claims and poorer management of comorbid conditions like HIV/TB.

• Erosion of human capital and slower growth: Impacts skill development, training completion, and staff retention; dampens innovation and long-term economic productivity.

• Strain on public health and safety nets: Greater demand for mental health services and social support; stigma can limit help-seeking and increase indirect costs.

• Mitigation and ROI for Eswatini employers: Implement workplace mental health programs, employee assistance programs (EAPs), and digital tools (e.g., October); train managers to spot signs and reduce stigma; flexible work options; these can improve productivity and reduce costs over time.

• Integrate depression screening and treatment into primary health care. Train nurses and clinicians; establish clear referral pathways.

• Expand the mental health workforce and community-based care. Increase funding; train lay counsellors/CHWs; connect mental health services with HIV programs where relevant.

• Strengthen social protection and economic stability. Implement cash transfers or subsidies, unemployment support, housing assistance; ensure paid leave and job protections.

• Promote mental health literacy and reduce stigma. National campaigns, school-based programs, and involvement of faith and community leaders.

• Leverage digital tools and workplace/school programs. Scale telemedicine, online self-help, and digital group sessions; consider partnerships with platforms like October for assessments and group sessions.

• Psychological safety and leadership
  • Train managers to have private, compassionate check-ins and to protect employee confidentiality; foster a non-judgmental culture that encourages seeking help.
  • Tailor programs to Eswatini contexts (language, cultural norms) and ensure privacy in all discussions.
• Workload management and boundaries
  • Set realistic workloads, avoid chronic overtime, and offer flexible hours or remote options where feasible.
  • Encourage regular breaks and clear expectations to prevent burnout and reduce stress accumulation.
• Access to care and resources
  • Provide or subsidize Employee Assistance Programs, on-site or tele-counseling, and easy referral pathways.
  • Consider digital options like October for group sessions, assessments, and mental health content when appropriate and aligned with employee needs.
• Stigma reduction and education
  • Run periodic mental health awareness and literacy campaigns; promote peer-support groups; ensure confidentiality is clearly communicated.
  • Include leadership buy-in and visible endorsements to normalize help-seeking behavior.
• Structured programs and measurement
  • Implement anonymous mental health screenings, resilience training, and regular pulse surveys to track stress and depression trends.
  • Establish a clear crisis protocol and ensure managers know how to escalate and connect employees to care quickly.