World Mental Health Day 2020 - the world faces more risk than ever before - By DJ Irawo

“What mental health needs is more sunlight, more candor, and more unashamed conversation.” Glenn Close

T he World Mental Health Day is marked on October 10 of every year

It is not a day for celebration but a day for reflecting on the beliefs, causes, symptoms, treatments, preventions and laws surrounding this illness that comes in a variety of ways.

This illness and its awareness have increased drastically as a result of the covid-19 pandemic which has caused a rise in mental health cases all over the world.

Suicide, the ultimate action caused by mental health, is not planned in a day. It is a build of negative locked up emotions over a short or long period of arising from sadness, stress, anxiety, depression and suicidal thoughts before a person eventually commits suicide.

Substance abuse too can cause the brain to malfunction and this makes the abuser to develop symptoms of anxiety and depression.

Now, I shall explain the stages of mental health based on my personal experiences.
Mental health begins with stress. Stress is a feeling of emotional tension. It can come from any event or thought that makes one to feel sad, frustrated, angry or nervous.

Stress is the body’s reaction to a challenge or demand. Stress is short termed but if it is not managed, it will result in anxiety. For example, I was stressed out by combining school with marriage and stressed out by my ex-husband, in-laws, pregnancy, children, commuting to work daily, office politics, etc.

Anxiety is the body’s natural response to stress. It is a feeling of fear or apprehension about what is to come. Examinations, job interviews, making speeches, fear of a divorce, the sickness of my late mother, anxiety about pleasing my ex-husband and his family, etc, made me to feel fearful and nervous. Anxiety is also short termed but if not managed, it will lead to depression.

Depression is a common and serious illness that negatively affects how one feels, thinks and acts. It occurs for a longer period of time. It is a feeling of sadness and loss of interest in activities that were once pleasurable to a person over a long period of time. It is normal to feel sad once in a while but if one is sad most of the time and it affects ones daily life, then that person has clinical depression.

This condition can be treated by consulting a psychiatrist who may recommend the intake of prescribed drugs, exercises, changing of one’s lifestyle and staying away from one’s source of depression.

I shall list and explain the types of depression that I know so that when you or someone that you know has any of the symptoms, you will be able to identify the type of depression that they have and seek help on their behalf;

They are;

Major or Chronic Depression

Persistent Depressive Order

Bipolar Disorder

Seasonal Affective Disorder

Psychotic Depression

Peripartum or Postpartum Depression

Situational Depression

Premenstrual Dysphoric Disorder

Atypical Depression

Briefly, I will explain these types of depression.

MAJOR OR CHRONIC DEPRESSION.

This is also known as a major depressive order. This is the kind of depression that I had after my ex-husband and I separated for the third time when he abducted our children.

Symptoms include;
– Loss of interest in once pleasurable activities: I lost interest in singing, drumming, dancing, chatting on social media, etc. I lost interest in living.

-Weight loss or gain: I lost a lot of weight. I looked like an AIDS patient.

-Trouble getting to sleep or sleeping during the day: I slept during the day and night. I was always sleeping. Then after my divorce, I found it difficult to sleep. I had to take drugs to make me sleep.

-Being tired and without energy: I was very, very weak. I fell down many times whilst walking. I had pains in my eyes from staying awake because I was used to keeping them close in sleep.

-Feeling worthless or guilty: I wondered what my family, friends and the society would think of me. Separating again with the possibility of becoming a divorcee worried me sick.

-Trouble with concentrating and making decisions: Yes, this was me. I lacked focus and forgot things easily. My thoughts were muddled up like electric wires on a PHCN pole.

– Thoughts of suicide: Of course! I tried to kill myself for the second time. I was not sure which method to use but I was certain that I did not want to survive it. At that time, I had not heard of Sniper. So, what if I swallowed rat poison, would I survive it? If I cut my wrists, would I survive it? What if my neighbors found me out and took me to the hospital? A painless and sweet way was not to eat; a hunger strike! I did not cook or eat or clean up. I laid on my couch waiting for death to come.

On the day that I probably would have died, my landlady decided to check up on me. She raised an alarm and I was rushed to the hospital by her husband and my parents were alerted. Faintly, I heard the psychiatrist mention my diagnosis to my parents. I had chronic depression.

The psychiatrists carried out tests on my body, my urine and blood and recommended antidepressants, better nutrition, steady sleep, exercises, staying away from people who caused me sadness, supporting the divorce and pursuing my passions once I got better.

PERSISTENT DEPRESSIVE DISORDER

If you have depression that lasts for two years or longer it is called persistent depressive disorder. This term is used to describe conditions previously known as dysthymia (low grade depression) and chronic major depression.

You may have the following symptoms;

  • Change in your appetite (not eating or overeating)
  • Sleeping too much or too little
  • Lack of energy
  • Low self esteem
  • Trouble concentrating or making decisions.
  • Feeling of hopelessness

You may be treated with psychotherapy, medication or a combination of the two.

BIPOLAR DISORDER

Someone with bipolar disorder which is sometimes referred to as manic depression has mood episodes that range from extremes of high energy with an ‘up’ mood to low ‘depressive’ periods.

When one is in the low phase, one will have the symptoms of major depression. Medication can help bring a patient’s mood swings under control. Whether one is in a high or low period, your doctor many suggest a mood stabilizer.

I had this during my marriage because of the stress that I went through on a daily basis or weekly basis such as; living with a malice keeping husband, stressful in-laws, problematic church members, office politics, etc. Sometimes, I would be extremely excited and energetic and ready to go. I would do all the chores and run my business but sometimes, it would be as if I was just hit by a trailer. I would feel so weak and sad.

During these low moods, I could not think straight. My thoughts at this time were pessimistic and depressive. Drugs recommended by my psychiatrist helped me to remain calm and stable.

SEASONAL AFFECTIVE DISORDER

This is a kind of depression that is seasonal. It could occur during the dry or rainy season. The weather simply affects the mood of a patient. During my teenage years, I was sad on dull and rainy days.

I was also sad during examination periods. I was a brilliant student but I did not like tests and examinations but I kept on writing one professional examination or the other just to satisfy my conscience of securing a good job in the future in a career that I disliked.
I was also sad, weak and irritable during my monthly periods.

PSYCHOTIC DEPRESSION

People with this kind of depression have symptoms of major depression along with psychotic symptoms such as;
Hallucinations – Seeing or hearing things that are not present.
Delusions – False believe.
Paranoia – Wrong belief that someone of some people are set to harm the patient.

POSTPARTUM OR PERIPARTUM DEPRESSION

Women who have major depression in the weeks and months after childbirth may have postpartum depression. Postpartum depression arises from an overwhelming feeling of sadness.

It is situation where a woman who has just put to bed is feeling overwhelmed and burdened by the pain of child birth, a caesarian operation or pain from a stitched vagina, cries of her baby, the stress of caring for a newborn, the presence of too many people in her home (friends and family who have come to help care for mother and child), etc.

She wants to be alone and at the same time, she does not want to be alone. She is at crossroads about what she truly wants.

The new mother has feelings of hopelessness. It feels as if she is trying to crawl out of a dungeon with no hope in sight. She suffers from memory loss and may not be interested in carrying and caring for her child.

After birthing my first son, I was depressed. I was no longer crazy about having a baby anymore. I felt as though the child had messed up my plans and daily routines. I wished that I could reverse the situation and go back to being without a child and probably be single again.

I thank God for my mother who was there to help me take care of my baby.

As I got better, I grew to love my son just like I love his two younger brothers.

You can help a nursing mother cure postpartum depression by taking her to see a psychiatrist and assisting her with caring for her child. You should also assist her with household chores and other things that she needs to get done. Also, ensure that she takes a walk in the evenings, listens to soothing music, exercises and make her feel good about her body. It will help her feel relaxed and recover faster.

When I had it after the birth of each of my three sons and a miscarriage, there were questions going on in my mind like;

Can I take good care of this child?

Will I be a good mother?

Why did I bother to have a child?I am in pains!

My body is not as fine as it used to be.

My perky boobs are sagging with milk!

How will I cope with taking care of this child, doing chores and going to work?

This child will slow me down. I need to work!

Why is my husband demanding for sex when I have barely recovered? I feel like giving him a hot slap so that he can get out of my sight!

For the miscarriage;

Why did I have to go through so much pain just for a miscarriage?

I am the cause of the miscarriage. I had sex too early in pregnancy.

Also, I exhibited the following symptoms;

Anxiety

Stress

Memory loss

Fatigue

Pessimism

Lack of concentration

Mood swings

PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

Depression can occur at the start of a monthly period. These women may encounter the following symptoms;

Mood Swings

Irritability

Anxiety

Trouble with Concentration

Change in sleep patterns

Overwhelming feeling

Fatigue

I still have these symptoms before my monthly menstruation cycle. During this period, I try as much as possible not go out or have a confrontation with anyone because I could go overboard.

SITUATIONAL DEPRESSION

This kind of depression arises from sad situations such as the death of a loved one, breakup of a relationship, separation, divorce, loss of job, bankruptcy, etc.

I was already recovering from the chronic depression when my mother passed. It affected me a lot. I almost slipped back into a chronic depression but I got consoled with the fact that I got the custody of our three sons. I had to remain strong for them.

A patient should consult a psychiatrist for professional help.

Children of violent and divorced parents should be taken for therapy. The same applies to sexually, physically and emotionally abused children and adults in order to set them straight mentally otherwise, history will repeat itself but society will call it a family pattern or family curse.

ATYPICAL DEPRESSION

This is type of depression does not occur all the time. A positive event could easily improve the mood of the patient. Symptoms include;

Increased Appetite
Sleeping more than usual
Feeling of heaviness in the arms and legs
Oversensitive to criticism.

Antidepressants can help cure these types of depression but you will have to consult a psychiatrist before you can use them because in Nigeria, mental health drugs are not sold over the counter without a psychiatrist’s prescription.

BELIEFS ABOUT MENTAL HEALTH AND PEOPLE LIVING WITH THE ILLNESS

Only mad people consult psychiatrists: Everyday people going through depression should consult psychiatrists. Mad people have a long period of untreated depression before it gets to that stage. Do not look down upon or segregate a person who has consulted a psychiatrist before. He or she is not mad.

Mental illness may not totally be eliminated from a patient even after treatment but it can be managed. I still have my moods and I know what to do when I feel helpless. Many times, I listen to soft music or dance or even sleep. When I am feeling lonely, I take a walk and greet people and play with children in the community as I walk along the road.

Mental health is a spiritual problem: Many times mental illness does not arise as a result of black magic. It could arise from substance abuse or stress. When clinical help fails, you may now seek your spiritual help in churches.

There is no life after a mental health diagnosis: People believe that once their poor mental health status becomes public knowledge, it is a death sentence. They believe that they will lose their jobs or will not be eligible to contest in elections. This is not true. One can still live a successful life with mental health.

SOLUTION TO MENTAL HEALTH PROBLEMS

When people tell you their problems, listen to help and not to judge. Do not tell a depressed person to pray or accuse them of lack of prayers as the reason for their depression. If you cannot lend a listening ear without judging them, please, be on your way and let them be.

It is when a depressed person has being clinically treated and he or she is getting better that you can preach to them to pray. Prayers cannot treat depression. A patient needs to consult a psychiatrist. It annoys me how Nigerians have become so overly religious that they cannot see beyond their nose. Everything to a religious Nigerian is witchcraft, “Oh! He must have been bewitched!” Please, if you have any of the symptoms or have experienced any of those mentioned above, kindly consult a professional.

In my next and concluding part of my article, I shall write about suicide and what the law says about those who try to commit suicide.

My Mental Health Affirmation

  • I shall consult a psychiatrist immediately I notice symptoms of depression in me.
  • Consulting a psychiatrist does not mean that I am mad. It does not mean that I cannot achieve all that I set out to achieve in life.
  • I will not be ashamed to consult a psychiatrist to help me get back my mental stability.
  • I will not do things that unnecessarily stress me out.
  • I will not allow anyone or anything to put me under pressure. 
  • I will be anxious for nothing but with prayers and supplications, make my needs known unto God after I have put in my own best.

DJ Irawo is a multimedia entertainer, divorcee and mental health coach. She lives in Lagos with her three sons.

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