–Ibrahim Suleiman Ph.D
October 10th of every year marks world mental health day, it is a day set aside to raise awareness on global mental health issues and to mobilize support for people with mental health problems. More needs to be done to increase awareness of the reality of mental health issues in Nigeria and all around the world.
Lack of proper awareness and sensitization on mental health issues have allowed the progression of stigma against people suffering from any form of mental health illness. They are often tagged as “lunatics”, “crazy”, “possessed” and many more by society. This leads to a vicious cycle of feeling ashamed, embarrassed, isolated and fearful. All too often, these emotions stop people from sharing their mental health concerns with their loved ones and specialist.
Treatment of “physical” illnesses is given top priority because of their ability to physically incapacitate patients, whereas mental health receives less attention simply because its impact is not as visible as that of “physical” illnesses. However, living a full, productive life depends on more than just what you think of as “physical” health. Mental health matters just as much. Unfortunately, mental illness still comes with stigma in our society.
Mental illnesses include conditions such as anxiety disorder, mood disorders, psychotic disorders, and some eating disorders. It is normal to feel anxious or nervous when someone has a challenging task ahead (e.g work interview, making life-changing decisions etc).
Anxiety disorder goes beyond the regular nervousness and slight fear perceived from time to time. About 15% of Nigerians reportedly have anxiety disorders. Some forms of anxiety disorder include; Panic disorder (regular sudden feeling of aggravated fear or panic attacks characterized by racing heartbeat and often occurs without obvious reason), Obsessive compulsion disorder (OCD: excessive thoughts that leads to abnormally repetitive behaviours e.g repetitive washing of hands for hours due to fear of contamination even without prior physical contact with dirt) and post-traumatic stress disorder (PTSD).
Anxiety disorder is characterized by fear and dread. It is often accompanied by physical signs such as a pounding heart, insomnia (lack of sleep), restlessness, and sweating. Mentally, people with an anxiety disorder may complain of heart palpitations (which resembles heart attack), phobias (e.g fear of crowds, fear of leaving your house etc) and persistent feelings of uneasiness. Sometimes they may have nightmares, repeated flashbacks of traumatic experiences and may have uncontrollable obsessive thoughts. Anxiety disorder happens when anxiety interferes with someone’s normal physiologic activities, when someone consistently overreacts to slight emotional triggers, and when you find it difficult to control your responses to emerging situations.
Another common class of mental health problems is the mood disorder. It primarily affects a person’s emotional state. People with mood disorder experiences long periods of extreme happiness, extreme sadness, or combination of both.
Depending on the situation, a change in mood is considered normal. However, when symptoms persist for several weeks or longer, it may likely be a mood disorder. This condition can cause changes in someone’s behaviour and can affect the ability to deal with routine activities, such as work or school. Two of the most common mood disorders are depression and bipolar disorder.
Grief or sadness is a typical response to traumatic life events, such as the loss of a loved one, job disengagement, or a major illness. However, when the depression continues to be present even when stressful events are over or when there is no apparent cause, such could be diagnosed as depressive disorder. For a person to be diagnosed with clinical depression, symptoms must last for at least two weeks.
Bipolar disorder is characterized by periods of depression and periods of abnormally elevated mood termed mania (in severely elevated mood) or submania (in mildly or moderately elevated mood). At certain times (during mania), such persons may feel abnormally energetic, happy and health impulsive decisions without considering the consequences of such decisions. While the same person may (during depressive periods) sustain poor eye contact with his/her audience, feel let down by life and cry uncontrollably.
Bipolar disorder occurs in about 1% of the global population. It is common among people with a history of childhood abuse, family history and long term stress. People with bipolar disorder have high suicidal tendencies. Bipolar disorder must not be confused with borderline personality disorder, a condition characterized by a longstanding pattern of abrupt swings in moods, relationships, self-image, and behaviour (in contrast to distinct episodes of mania or depression in people with bipolar disorder) usually triggered by conflicts with other people. Those with borderline personality disorder often have chaotic relationships and have difficulty getting along with people. They are more likely to have other mental health problems such as anxiety, addiction and eating disorders.
Eating disorders are mental illnesses characterized by self-induced starvation, overeating or other unhealthy behaviours towards food consumption and body weight. An example of an eating disorder includes anorexia; where the affected person becomes dangerously thin due to consumption of dramatically low amounts of food following irrational fear of weight gain. People with anorexia experience false body image. A situation where they see themselves as abnormally fat despite being dangerously thin. Other eating disorders include bulimia and binge eating disorder, both of which involves an uncontrollable act of overeating until someone becomes painfully full. Sometimes, such people do take laxatives (drugs that cause purging) to facilitate stomach emptying. Thus, allowing them space for more food. Overeating behaviours are adopted as a coping mechanism for boredom and loneliness.
Mental health, like any other health problem, requires treatment. It cannot be willed away just like that. It is not a matter of self-discipline or attitude. Someone needs to seek help, get diagnosed and adhere to a treatment plan designed by a specialist. The conditions can be treated by administering medications or by psychotherapy (e.g cognitive behavioural therapy) or a combination of both medications and psychotherapy. Untreated mental disorders may severe family ties, hamper students’ academic performance, decrease workplace productivity, increase susceptibility to many other “physical” diseases and sometimes death (by suicide or health-related complications).
To douse the widespread social stigma, stereotyping, and prejudice against individuals with mental health disorders, there’s a need to intensify mental health awareness, sensitization and the need for the society to reconsider its stand on mental health. There is a lack of education and awareness about mental health among much Nigerian populace. Interestingly, governments, NGOs and the media have successfully raised positive awareness for diseases such as Poliomyelitis, HIV, typhoid, malaria and COVID-19. Similar successes could be achieved for mental health conditions.