Healing Body and Mind: Patient's Triumph Over MDR-TB and Depression

Lerato Mpholo, a 24-year-old fuel attendant, was diagnosed with multidrug-resistant tuberculosis (MDR-TB), a condition that seemed to bring her life to a halt. She initially ignored the persistent flu-like symptoms that plagued her for weeks, no matter the medication she took. Eventually, the prolonged illness prompted her to seek help at a local health center. There, she was diagnosed with MDR-TB and referred to Partners In Health (PIH)-supported Botšabelo Hospital for specialized care.

"After being diagnosed with MDR-TB, it felt like the world no longer existed," Mpholo shared, reflecting on the initial stages of her illness.

During the early stages of her treatment, Mpholo stayed at the halfway home for two weeks, where she and her treatment supporter received training on how to take MDR-TB medication. Although her physical health gradually improved, the illness's toll on her mental health became evident. "I couldn't cook, I lost a lot of weight, and everything seemed meaningless," she recalled.

Despite significant advancements in tuberculosis (TB) medications, including shorter and less toxic treatments, the infectious disease remains incredibly taxing on a person's overall well-being. In fact, an estimated 40%-70% of individuals treated for TB are also believed to have a mental health disorder, such as depression or anxiety.

"It's our responsibility as doctors and nurses to screen every MDR-TB patient for depression and anxiety at every visit," said Dr. Mikanda Kunda, medical doctor at PIH Lesotho. He emphasized that the severity of Mpholo's condition, which was nearing extensively drug-resistant tuberculosis , took a significant toll on her mental health.

"Depression in MDR-TB patients often stems from the uncertainty of whether they will recover, especially since many are the main providers for their families. The stigma and social pressures only add to their struggles," Kunda said.

Recognizing the impact that TB had on Mpholo, he referred her to PIH's mental health team for counseling.

'I started smiling again'

For Mpholo, the turning point came when she was introduced to Problem Management Plus (PM+), a five-session program designed by the World Health Organization to treat depression, anxiety, and stress among individuals living in low- and middle- income countries. Since 2016, PM+ has been used across many countries where PIH works, including Rwanda, Peru, Mexico, and Malawi.

Matoka Mokhali, a counselor at PIH Lesotho, led Mpholo through the PM+ program and accompanied her as she began to regain control of her life.

"When I first met her, Lerato was deeply depressed, but her willingness to open up was a positive sign," said Mokhali. Throughout five sessions, Mpholo learned practical skills to manage her emotions, including breathing exercises, problem-solving techniques, and reconnecting with activities she once enjoyed.

"The sessions helped me see that my life wasn't over," Mpholo shared.

To further support a full recovery, PIH Lesotho often involves family and friends in the healing process, creating a network of care that helps patients feel less isolated. "Having my loved ones involved gave me the strength to keep going," Mpholo reflected.

During frequent check-ups, PIH staff closely monitored her progress with a screening tool, known as Patient Health Questionnaire-9, which assesses factors such as mood, social well-being, motivation, cognition, and resilience. As her mental health improved, so did her outlook on life.

"I started smiling again and thinking about the future," she said.

Today, Mpholo encourages others facing similar challenges to seek support and remain hopeful. "If my story can make even one person feel less alone, then it's worth sharing," she said with a smile.

In partnership with the Ministry of Health, PIH Lesotho continues to make mental health care more accessible for people around the country; from the capital city to remote, mountainous villages.