First published on graphiconline.com
Scenario One: They wear tattered clothes and walk barefooted. They have disorganized speech, erratically switching topics. They seem to see, hear and feel things that are not present. They may even think they are being followed when they are not. They are found on the streets, prowling left-overs for food. Some are locked up in abandoned rooms as the family tries to conceal their perceived shame, they become invisible relatives.
Scenario two: Robin Williams the famous actor and comedian died on 11th, August, 2014. He was found by his personal assistant after he failed to respond to knocks on the door. It was, apparently, suicide. The man who made the world happy was himself unhappy; he was battling depression.
Chances are that the mention of mental health evokes imagery of Scenario one against Scenario two. After all, we live in a world of, metaphorically speaking, black or white.
The World Health Organization (WHO) defines health as a ‘’state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’’ Mental health is not only about the absence of mental illness, it is also about balancing the stress from everyday life, productive work and functioning at a level of emotional and behavioral adjustment in order to achieve a psychological resilience. It can affect all people regardless of sex, race or religion. The WHO estimates that 20% of the world’s children and adolescents have mental disorders or problems with the highest percentage of population under the age of 19. It also estimates that in Ghana, 650,000 people suffer from severe mental disorders and a further 2,166, 000 people suffer from a moderate to mild mental disorders.
The causes of mental disorders are complex, mostly unknown and vary depending on disorder and individual. However it is certain that different biological, psychological, and environmental factors influence the development and progression of mental disorders. Biological factors include genetics, prenatal damage, diseases/toxins, chemical imbalances and substance abuse. Events such as emotional stress, poor parenting, neglect, abusive relationships and failure to fulfill social expectations are examples of life experience and environmental factors which can trigger mental disorders. It is thought that the combination of several factors rather than one single factor contributes to the development of mental disorders. While there are over 200 classified forms of mental disorders, five of them are considered to be major according to the Mental Health Association
Anxiety disorders come about when persons are filled with uncontrollable fear and uncertainty. Examples are phobias (‘fears’), post-traumatic stress disorder and obsessive-compulsive disorder (OCD). Symptoms may also include overwhelming feelings of panic and fear, uncontrollable obsessive thoughts, pain, intrusive memories and recurring nightmares. A phobia is an overwhelming, obsessive and unreasonable fear of a situation, an event or an object that in a real sense poses no danger. Although fear is a natural response and might even act as defensive mechanism, it can usually be controlled through logic and reason. Phobias cannot. People with phobias might be underestimated since many go unreported because many sufferers just avoid their phobia triggers.
Mood disorders are psychological conditions associated with elevation and lowering of moods. Clinical or major depression, dysthymia and bipolar disorder are some examples of mood disorders. The thought of and attempt at suicide is a common symptom among these persons. The Mental Health Association reports that about 10 to 15% of patients formerly hospitalized with depression commit suicide. Bipolar disorder is characterized by periods of elevated mood and periods of depression. People with mental disorders may develop other conditions such as alcoholism, ADHD and anxiety disorders. There is currently no cure but medications, psychotherapy or combination of both is used in controlling symptoms.
Schizophrenia/Psychotic disorders are mental disabling disorders that may cause delusions, hallucinations and affect the most basic human attributes such as thoughts, language and sense of awareness. Persons with schizophrenia, however, are not perpetually incoherent or psychotic. Like many other mental disorders, genetics and biological factors, together with pregnancy problems like viral infections, have been implicated as causes. In a recent study of its genetics, 108 specific locations of genes were identified to have some association with schizophrenia. Each of these points will have to be studied to understand its role in the condition.
Dementia is characterized by a disturbance of consciousness and a change in cognition including memory loss and a decline of intellectual and physical functions which develops over a short period. These disorders include Alzheimer’s, vascular dementia, dementia due to medical conditions, (e.g., HIV, Parkinson’s disease, Huntington’s disease, head trauma) and substance-induced dementia. It is important to keep up hobbies and interests when caring for people with dementia.
Eating disorders are characterized by abnormal or disturbed eating habits. The three major eating disorders are Anorexia Nervosa (self-starvation), Bulimia Nervosa (binge eating followed by purging) and Binge Eating Disorders. Personality traits like low self esteem, difficulty in communicating negative emotions, difficulty in dealing with conflicts, a need for attention and problems with identity put a person at a greater risk of developing eating disorders.
Fortunately, where mental disorders are not treatable they are manageable when the right medication is sought combined with an enabling environment. One thing is for certain, persons with mental illness should not be stigmatized and as a country we need to take greater interest in mental health and the care of patients.