Table 4 Impact of history of depression on reasons for not seeking care during depression

1. Treatment of depression

a) Reluctance:

  - The inefficacy of drugs.

  - The possibility that the physician would prescribe drugs with side effects.

  - Afraid of the duration and complexity of the treatment.

  - Afraid of the side effects of drugs.

  - Afraid to face reality.

b) Psychiatrist better suited than a GP

c) Trust in God:

  - God can heal

  - Prayer can heal

d) Not believing that treatment is necessary:

  - I know why I’m depressed. so if I solve the problem. I’ll feel better

  - I don’t think I’m depressed (enough)

2. Perception of depression

a) Loss of self-worth (poor self-image):

  - Shame of being depressed.

  - Feeling guilty towards society.

  - Depression is a weakness.

  - Lack of virility*.

b) Stigmatization:

  - Afraid of being judged by society.

  - Afraid of being considered crazy.

  - I’m afraid of being categorized by society or my friends and family.

c) Mental health problems are not diseases.

d) Depression is a taboo subject.

e) I have a family history of depression and don’t want to follow suit.

3. Social environment

a) Someone at home to talk to.

b) Afraid to bother those around him/her.

c) Incompatibility with social status:

  - Prohibited because of social status.

  - Prohibited because of role among family and friends.

4. Doctor-patient relationship

a) Not knowing a doctor to talk to

  - No GP to talk to about it.

  - Don’t know who to talk to.

  - Don’t know GP well enough.

b) Neglect on the part of the GP

  - The GP would not listen to the complaint

  - Bad experiences with GP.

c) Not a GP’s role

  - The GP could not look after this problem.

  - Afraid to bother GP.