Abstract
Depression is a normal affective state, and expresses the human need for connection and assistance. One of the difficulties in recognizing pathological depression is that it often arises insidiously, and so goes unrecognized by both the patient and family. A number of risk factors for mental distress and depression have been proposed in the medical literature from Arab countries, including low socio economic status, a large number of children in the home, and lower self-efficacy. Studies have consistently shown a high prevalence of depression and psychosocial distress in the Arab world, the available evidence does not indicate a correspondingly high incidence of suicide. As a society moves towards an individualist model and away from mechanisms that provide close interpersonal contact and intense social support, psychological distress escalates to self-harm behaviors. The clinician should explore the patient’s thoughts of possible self-harm whenever a patient is encountered who seems to be hopeless, or expresses feelings of helplessness.