Understanding Mental Health

I n the 70s President Jomo Kenyatta visited Mathare Mental Hospital escorted by many police officers. An old man came to him and told him: “you know I was brought here accompanied by only one police man and you, old man has been brought by all these soldiers, your problem must be big”. President Kenyatta thought the man didn’t recognize him so he introduced himself “I am President Jomo Kenyatta” but before he could get to another word, another patient came and said to him. “Don’t worry old man, you will also be healed! when I was brought here, I told people I was president Julius Nyerere”.
It is said every one of us is mad – only the degree varies.

Mental health (WHO definition) is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

A mental illness is a disease that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines – Job Watene  Psychologist. in some cases, counselling can help lift the problem but in other cases one may need medication.
Mental health in Kenya is frowned upon and people with mental illnesses are stigmatized.  The same way families have family doctors and even spiritual leaders they go to when need arises, is the same way we should have a family psychologist or counsellor.  Sad to note, though, is that some family members are locked up in rooms because the family does not know how to handle them and for some the family is ashamed of them.

According to the World Health Organization (WHO), one out of every 4 people has a mental illness.   In that report, Nairobi recorded the most outpatient visits for mental illness. It was followed by Muranga, Nyeri, Kiambu and Mombasa.   In the western world mental health is more accommodated and the governments take the trouble to put policies in place to address mental health treatment.   There are Kenyan families who have children with mental health and have opted to go abroad so  their children receive the medical attention they need.

Scripture references:

II Timothy 1:7 – God has not given us a spirit of fear …

Luke 8:2 6-32 – Jesus healed the demon-possessed man – the legion

Matthew 8:16-17 – many demon-possessed were healed

Emotional well-being:

Mental health has to do with emotional well-being, meaning the ability to cope with issues of life, having high,[3] self-esteem, ability to  perform and productivity at work, and even longevity of life.  On the other hand, decreased emotional well-being is related to mental illnesses which in turn present or manifest in physically e.g. digestive disorders, sleep disturbances, lack of energy, low self-esteem, being pessimistic, overly critical, being timid, worrisome and also such a person feels the need to assert themselves emotionally. This should not be confused with personality traits.  Matthew 25:-34 – Don’t worry; Phil. 4:P6-7 – Don’t be anxious.  Prov. 4:23 – guard your hearts for from it flow the issues of life

Dr. Marisa Navarro  suggests that no one is safe from suffering this emotional state.  The connection between the mind and the body is so strong that mental and physical states feed into each other in both positive and negative ways. 

1. Anxiety

Anxiety disorders are amongst the most common and sometimes misdiagnosed mental health conditions in Kenya.  There are many disorders under anxiety but the most common symptoms in all include:-  Excessive fear; Panic attacks; Feeling nervous;  Restlessness or tense; Having a sense of impending danger, panic or doom; Having an increased heart rate; Breathing rapidly (hyperventilation; Sweating; Trembling; Feeling weak or tired; Trouble concentrating or thinking about anything other than the present worry; Having trouble sleeping; Experiencing gastrointestinal (GI) problems; Having difficulty controlling worry; Having the urge to avoid things that trigger anxiety

These conditions may be caused by one experiencing or even witnessing life-threatening situations e.g. mugging, burglary, accidents, miscarriages, carjacking.  They could also be substance induced.  Relaxation exercises are key when symptoms manifest.

2. Depression

Depression is yet another common mental health problem, whose symptoms may include:-  difficulty concentrating, remembering details, and making decisions; fatigue and decreased energy; feelings of guilt, worthlessness, and/or helplessness; feelings of hopelessness and/or pessimism; insomnia, early-morning wakefulness, or excessive sleeping; irritability, restlessness; loss of interest in activities or hobbies once pleasurable, including sex; overeating or appetite loss – resulting in weight gain or loss; persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment; persistent sad, anxious, or “empty” feelings and thoughts of suicide and suicide attempts

WHO estimates that about 800,000 people commit suicide every year and that suicide is the second leading cause of death among youth age 15 – 29 globally.  The review of mental health data reveals that the suicide rate for men is three times higher than the rate for women.  This is  because men use more lethal methods compared with women when attempting suicide.  The difference between male and female suicide rates is attributed to the many support systems and relationships women have among themselves and their willingness to seek help from friends and medical experts.

3. Substance Abuse related Problems

Substance-induced mental disorders are mental changes produced by substance use or withdrawal that resemble independent mental disorders such as depression (defined above), psychosis (Psychosis is a condition that affects the way your brain processes information.  It causes one to lose touch with reality.   One may see, hear, or believe things that aren’t real.   Psychosis is a symptom, not an illness A mental or physical illness, substance abuse, or extreme stress or trauma can cause it. Substance abuse can start from occasional use and gradually escalate to dependence). or anxiety (addressed above).  For a mental disorder to be considered substance induced, the substance involved must be known to be capable of causing the disorder.  One is said to be dependent when they rely on the drug of choice to function normally.   Substance abuse can be alcohol, cannabis, cigarettes heroin, cocaine or prescription medications.  Alcoholics Anonymous, Narcotics Anonymous.

4. Chronic Stress

With the numerous challenges we face in life, work and family and personal relationships can be contributors of great levels of stress.  Stress after stress can make it harder to cope with daily life challenges and put you at risk for high blood pressure, diabetes and heart disease for those already at risk.

What is stress? – It is a state of mental or emotional strain or tension resulting from adverse or demanding circumstances.

Terminologies:  Stressor is an event that creates the demands;  Stress Response is a person’s reactions to the demands.

Some life stressors:  Everyday things  e.g. traffic jam; Life changing events e.g. marriage, children; loss of parent; poverty; poor health;  overcrowding; traumatic events – e.g. accidents, rape, war, natural disasters 

What do people do when stressed?  They eat; talk to family; pray/meditate; use drugs and alcohol; take medication; hurt themselves and/or exercise

Psychological Stress Disorders:  Acute Stress Disorder; Post Traumatic Stress Disorder (PTSD);  Common Symptoms:  Recurring memories; Avoidance of activities; Feeling detached from people; Increased anxiety and guilt. 

Common Causes of Stress Disorders:  Combat/war; many soldiers experience psychological symptoms that exist after combat/war Disasters; earthquakes, floods, fires, airplane crashes, serious car accidents; Natural Disasters; Victimization; Rape;  verbal or sexual abuse – 1 in every 6 women in raped at some point during her life; Most rape victims are very young; Only 1/3 of rapes are reported to police; Terrorism; Many individuals who are victims of terrorist activities experience PTSD;  Why do people develop stress disorders? Biology/Genetics; Personality, Childhood experiences, Social support,  Cultural factors 

Besides depressions    and anxiety some of the more common disorders are bipolar disorder, dementia and schizophrenia,

 

5. Common Early Childhood Disorders:  

 

• Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that can case above-normal levels of hyperactive and impulsive behaviors. People with ADHD may also have trouble focusing their attention on a single task or sitting still for long periods of time.  Both adults and children can have ADHD. It’s a diagnosis the American Psychiatric Association (APA) recognizes. 

ADHD symptoms:

A wide range of behaviors are associated with ADHD.   Some of the more common ones include:  having trouble focusing or concentrating on tasks; being forgetful about completing tasks; being easily distracted; having difficulty sitting still; interrupting people while they’re talking.  If you or your child has ADHD, you may have some or all of these symptoms. The symptoms you have depend on the type of ADHD you have.

(KNH – Mental Health Department)

1. Oppositional defiant disorder (ODD)
2. Autism Spectrum Disorder (ASD) is a range of neurodevelopmental disorders mainly characterized by impaired social functioning and communication disturbances. 

Symptoms can include:-  Intense focus on one item, Unresponsiveness, Lack of understanding social cues (like tone of voice or body language), repetitive movements, Self-abusive behavior like head-banging. 

Some symptoms are more severe than others among affected individuals. Other possible symptoms include:- learning to speak relatively late, not playing interactively with other children, avoidance of eye contact, lack of empathy,  and social withdrawal. 

Children with ASD who have not developed sufficient language skills may act out like screaming or crying, to express their needs.  It is important to note that people with ASD may vary widely in their level of functioning, and not all people with ASD will experience all of the symptoms listed:  Early symptoms and signs in babies may vary but can include, lack of eye contact or decreased eye contact, being overly focused on one item, and lack of back-and-forth play; Very young children may show early symptoms like loss of interest in social contact and social withdrawal.

1. anxiety disorder.
2. depression.
3. bipolar disorder.
4. learning disorders.
5. conduct disorders.

Conclusion 

• You need to be self-aware and to pay attention to sudden changes in thoughts and behaviours in your own life and in the lives others.
• If you suspect that you or someone you know has a mental illness seek early treatment. 
• Do not be quiet and fear stigmatization
• Be curious and follow up on any changes in your general health to minimise any chances of relapse.
• Seek help from the right practitioner. It is good to deal with a psychologist/counsellor who can refer you to psychiatrist if need be. Mostly the two work together.
• Get people to pray with you even as you seek help.
• Trust God for healing.