Kunle Omo Ijoba sits at a particular spot all day, always, with his dress tattered and hair mashed into an untidy Bob Marley style. Sometimes he would accost strangers claiming they owe him money. The market was his home and he would seldom entertain the traders with his dance moves and sometimes reveal more that they bargain for; with genitals out like a ware in a trade fair.
The picture described above is something most, if not all, Nigerians are familiar with. Mentally disordered people litter the streets and from time to time and we may or may not encounter them. Unfortunately, the description above largely defines our knowledge of mental illness. Our socio-cultural beliefs have entrenched in us several myths and misconceptions that affect our overall reaction to mental illnesses resulting in unfair and unwarranted stigma, discrimination and inappropriate or lack of treatment for sufferers.
The World health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
In a research done by V. O. Lasebikan et.al in a primary health center in Lagos Island, Nigeria, 400 people that consisted of 88 children and young adults below aged 29 years, 55 aged 30 to 39 years, 72 aged 40 to 49 years, 63 aged 50 to 59 years, and 122 who were above 59 years, (226 (56.5%) were females, and 250 (62.5%) were married) were assessed and;
- psychiatric morbidity was significantly highest for respondents below 39 years
- psychiatric morbidity was significantly highest among those who were divorced 72%
The most prevalent clinical syndrome was unexplained somatic complaints (57.5%), followed by depression among half (50.0%) of the respondents, any anxiety disorder (49.3%), primary insomnia (45.3%), and alcohol use disorder (11.3%). Between 2.0 and 7.8% of respondents had disablement in various areas of life, out of which the commonest was in the domain of family relations (7.8%).
To bring about “change”, these misconceptions and myths need to be cleared out and the correct picture painted. The following statements are tailored to iron out negativity and bring to light the facts about the illness before we take a journey on specific mental disorders and how to deal with them.
1. Myth: Mental illness is caused by supernatural forces
Evil spirits, witchcrafts have been for so long been held as the cause mental illness. Due to this perceived causes, religious institutions have been consistently sought for a cure or more appropriately deliverance.
Fact: Like every other illness mental illnesses are medical illnesses. Research shows there are genetic and biological causes for psychiatric disorders, and they can be treated effectively.
2. Myth: Mental illnesses are incurable and lifelong?
Fact: When treated appropriately and early, many people recover fully and have no further episodes of illness. For others, mental illness may recur throughout their lives and require ongoing treatment. This is the same as many physical illnesses, such as diabetes and heart disease. Like these other long-term health conditions, mental illness can be managed so that individuals live life to the fullest. Although some people become disabled as a result of ongoing mental illness, many who experience even very major episodes of illness live full and productive lives.
3. Myth/Misconception: Mental illness is innate?
It is customary for families to sort through genealogy in search of history of mental illness in the family their child is marrying into.
Fact: Vulnerability to some mental illnesses, such as bipolar mood disorder, can run in families. But other people develop mental illness with no family history. Many factors contribute to the onset of a mental illness these include stress, bereavement, relationship breakdown, amongst other life negativities. But then, it can be managed.
4. Misconception: Mental illness only affects bad persons (karma)
The lady who bewitched her friend’s husband, the wicked stepmother, the rich ritualist; which other one? Nollywood’s favourite karma dish is “madness”. I suppose, these pictures are what comes to mind first when you see a psychotic person on the streets.
Fact: Everyone and anyone are vulnerable to mental health problems. Many people feel more comfortable with the notion of having ‘a nervous breakdown’ rather than a mental illness. However, it is pertinent to talk openly about mental illness, as this reduces the stigma through reorientation and helps people to seek help early.
5. Misconception: People with mental illness are usually dangerous
Fact: This is about the greatest misconception that results in great stigmatization. People with mental illness are seldom dangerous; in fact people with the most severe mental illness are rarely dangerous especially when receiving appropriate treatment and support. Some mental illnesses are associated with aggresiveness and impasitivity, however, it is extrememly important such persons get help as they are more likely to harm themselves before others.
The vast majority of people with mental health problems are no more likely to be violent than anyone else. Most people with mental illness are not violent. In fact, people with severe mental illnesses are more likely to be victims of violent crime than the general population. You probably know someone with a mental health problem and don’t even realize it, because many people with mental health problems are highly active and productive members of our communities
6. Misconception: People with mental illness should be isolated from the community
Some communities have a myth that if “a mad man bites you, you’d get infected with the madness too”
Fact: Most people with mental illness recover quickly and do not even need hospital care. Others have short admissions to hospital for treatment. Improvements in treatment over recent decades mean that most people live in their communities, and there is no need for the confinement and isolation that was commonly used in the past. Besides, mental illness is not an infectious disease and cannot be passed from one person to another through coughing or touching.
7. Fact: Stigma is one of the biggest problems for people with mental illness.
One of the greatest obstacles to recovery from mental illness is confronting the negative attitudes from the society. These often mean that people with mental illness face isolation and discrimination just for having an illness. Positive attitudes of family, friends, service providers, employers, and other members of the community toward people with mental illness are critical to ensuring quality of life for people with mental illness and supporting recovery.
8. Myth: Children don’t experience mental health problems
Once, I saw an undressed child stand in front of a moving car without fear ; no emotions at all. The driver parked and shouted “ogbanje”, a melodramatic episode followed thereafter.
Fact: Even very young children may show early warning signs of mental health concerns. These mental health problems are often clinically diagnosed, and can be a product of the interaction of biological, psychological, and social factors. Our culture could not describe the emotionless attributes in some children nor is it able to decipher the hyperactivity of some children, they simply label them as “ogbanje” or “hard/stubborn child”. Majority are unaware of developmental mental health disorders which show first signs before a child turns 5 years old, or even before 14 in adolescent disorders and three quarters of mental health disorders begin before age 24.
9. Myth: Postpartum mental illness “abisinwin”only occurs in cases of spiritual attack or genetic in some families.
Still on the Nollywood matter.
Fact: Mental health problems among women who are pregnant or who have recently given birth are observable in all countries and cultures. “Abisinwin” postpartum mental is not as depicted by our southwestern indigenous movies. Maternity, third day or postpartum blues occur in 80% of women who have recently birthed a child, with characteristic emotional swings from euphoria, tears (often without sadness), restlessness, anxiety, to feeling of unreality and detachment from the new born. However, the persistent presence for at least two weeks of cognitive and affective symptoms maybe suggestive of a serious mood disorder. Postpartum psychosis occurs within 48-72 hours after birth.
10. Misconception: Prevention doesn’t work, it is impossible to prevent mental illnesses.
Fact: Prevention of mental, emotional, and behavioral disorders focuses on addressing known risk factors such as exposure to trauma that can affect the chances that children, youth, and young adults will develop mental health problems. Promoting the social-emotional well-being of children and youth leads to:
- Higher overall productivity
- Better educational outcomes
- Lower crime rates
- Stronger economies
- Lower health care costs
- Improved quality of life
- Increased lifespan
- Improved family life.
Friends and loved ones can make a huge difference. Communal support can be important influences to help someone get the treatment and services they need by:
- Reaching out and letting them know you are available to help
- Helping them access mental health services, first aids are possible
- Learning and sharing the facts about mental health, help correct misconceptions.
- Treating them with respect, they are not different from other ill persons
- Labels are for clothes; not human. Do not use labels like “crazy, mad, Kolo”
Overview of Common Mental Disorders
It is characterized by psychotic episodes with recurring functional periods of disordered thought procecess. Symptoms include; delusions, hallucinations, disturbance of thought, disorganized speech, difficulty in concentration and poor memory.
2. Anxiety Disorders
An anxiety disorder involves an inappropriate response characterized by feelings of apprehension, uncertainty or fear. This disorders can be differentiated into Generalized Anxiety Disorders (GAD), Panic Disorder (PD) amongst others.
3. Personality Disorders
Personality disorders are a combinations of patterns and behaviors that deviates markedly from the expectations of the culture of the individual who exhibits it.
Conclusively, Mental illness like every other illness requires specialists to diagnose and provide care. it is treatable, curable, and does not require advance technology; our perception of it will affect how we get approach it positively.
To stay mentally fit, let’s continue the conversation, share some of the myths and misconceptions you know that was not highlighted, together we change the narrative.
Rukayat Ogunbiyi is a Pharmacist and Public mental health advocate, inclined towards child and adolescent psychiatry. She was trained as an intern at the Federal Neuropsychiatric Hospital, Yaba. She is currently set to resume post graduate studies in Child and Adolescent Mental health at the Center for Child and adolescent mental health in University of Ibadan.