‘Inadequate rest can lead to stress, brain damage’

Dr. Oluwaniyi Stephen, a consultant psychiatrist at Federal Neuro-Psychiatrist Hospital, Yaba, Lagos, in this interview with Chioma Ukor speaks on mental disorder, causes and precautions to take to avoid it.

 

What is mental health?

Mental health may be described as a state of being in which an individual is able to realise their potentials and cope with normal stresses of life, as well as function productively and contribute meaningfully to their community – this according to World Health Organisation (WHO). What this implies is that, an individual should be able to face stress, be productive, which will be obvious to anyone, because as humans, they should be able to realise their God-given potentials. Note that all I have said are the positive or optimal mental health.

But if otherwise, in which case an individual cannot contribute meaningfully, positively to his/her community; that means the person is not in the optimal mental health and needs to be checked.

Can the state of not functioning well or contributing meaningfully to the society be likened to insanity?

What people think is that an individual is either mentally healthy or have mental disorder, which they refer to as insanity; but I tell you, “it goes beyond that, it is continuous”. What I mean by continuous is that it is not just two options but many stages in-between. In-between for example could be an individual who is not in the state of optimal mental health and does not have mental disorder or insanity but can’t achieve his/her full potentials.

Another instance of in-between is when an individual may not even have a diagnosable mental disorder but because he’s not in the state of optimal mental health -probably there are issues bothering the mind or he is having sleepless night, not able to function in his place of work, not creative, not productive as expected. So it is not all about insanity. What is important is to strive for every human being because the more people we have in the state of optimal mental health, the better for the society and the individual as well. Without positive mental health, an individual cannot enjoy life optimally and cannot interact with others, “human beings social beings”. So if not on optimal mental health, the individual may have difficulty interacting harmoniously with others because sometimes, quarrel may arise.

What are the causes of mental disorder?

For most cases of mental disorder, there are no single causes but combination of factors called Bio psychosocial causes. When you look at the biological aspect of an individual which is the brain and nervous system, there may be some issues there, likewise the psychological aspect, which is the mental functioning of an individual; and when there is disturbance in those areas, it leads to mental problem or contributes to the onset of the individual’s mental issue, while the social part of it has to do with interaction of an individual with others. So inability to interact and function positively is what is called mental health disorder.

Another cause is Psychosis (which makes an individual to behave strangely or believing that which are not real). Sleep Problem sometimes can cause mental issue. We sometimes do not refer to drug abuse as mental disorder technically but it affects the function of the brain. We should know that there are certain chemicals in the brain called Neurotransmitter (a substance in the body that carries a signal from one nerve cell to another) and when issue arises with some of these chemicals, the individual will have a liability, a deficit to develop mental disorder in this case.

The nature of up-bringing also contributes. If perhaps the parents are abusive and such individual receives series of hard punishments which may inculcate the feeling of low self esteem, and he grows up not having confidence in himself. Note that those things inculcated while growing up will stay throughout his life; and though he may not know or remember but these things exist in the subconscious mind.

How is mental disorder diagnosed?          

Aside the above discussion, our skill on diagnoses is to look at the behaviour and state of mind of that person to assess and know what is going through his mind that others may not see. And sometimes, we carry out laboratory investigation but do not check chemicals because it is not necessary. We only check chemicals during research.

What are the signs and symptoms of mental disorder?

One of them is lack of sleep; an individual should be able to take adequate rest to let the brain rejuvenate in order to function adequately, because stress is one of the causes of mental disorder. Another sign is being afraid unnecessarily. They are also accusing people of attacking them and you cannot convince them otherwise. These people are unduly anxious because they are afraid something bad may happen to them.

Another one is not associating with others. They’re persistently feeling unhappy, as if life is not worth living. They even contemplate killing themselves (suicide), while some also say they hear voices when no one is talking to them.

Can mental disorder be prevented?

Very well! The primary preventive measure is taking adequate rest to allow the brain rejuvenate in order to function effectively. Chronic stress will eventually damage the brain and nervous system, and then expose the brain to developing some of these mental disorders. Also, avoid the use of hard substances because they damage the brain. When people take care of these, they will be able to manage their situation.

The secondary prevention is how quickly an individual can get treatment and get out of the disorder. The problem is that people do not open up and come early for treatment. The longer you wait, the more damage will be done and it becomes more difficult for that individual to get back to the state of normal functioning. While the tertiary prevention, has to do with individuals ability to fit in back to the society after secondary prevention. To get back to state of normal functioning, the individual has to be re-equipped with those things he/she has lost in other to function normal as quickly as possible.

Are there treatments for mental disorder?

You know we are trained to give appropriate treatment to the affected individuals and the treatment may involve medication, psychotherapy or psychosocial intervention, which involves counselling the individual on how to go about life by calling attention to things they have not been paying attention to, and gradually expanding their consciousness as well as modifying the way they see life and their reactions about certain things.

As a therapist, one practical step is to equip that individual with skills which will be his sources of income if he/she has no job, and see how he/she will cope with stress. In a nutshell, medication, counselling or both can help manage mental illness.

Which group of people are more prone to having mental disorder?

Mental disorder affects all ages; it is no respecter of anybody. That is the more reason people should take adequate rest and monitor themselves properly.

Is mental disorder on the increase in Nigeria?

We may answer yes, because before now if we take randomly, one in every five individual has mental illness. About 20 per cent the entire population will have one form of disorder or another like Schizophrenia (a disorder that affects a person’s ability to think, feel and behave clearly).

“Remember, we are passing through a period of Covid-19 pandemic, a situation likely to affect mental health negatively.  Basically, in a country where there is adversity, prevailing, economic hardship, insecurity as the case may be, mental disorder will definitely be on the increase because all those factors are forms of stress.

Do we have enough psychiatrists in Nigeria to match the one in five persons’ scenario?

The fact is we don’t have enough. Presently, we have over 200 psychiatrist doctors but not up to 300. We are trying to produce more psychiatrists but as we do, brain drain keeps occurring. After training health workers, the higher paying Western countries employ them and the training go with them. Imagine a situation where just over 200 psychiatrists are facing 200 million Nigerians.

Should we then conclude that most victims of mental disorder do not have access to treatment?

A lot of persons still do not have access to mental health care the way they should. One of the reasons is insufficient manpower. Would you believe that some persons come from as far back Badagry to Federal Neuro-Psychiatric Hospital, Yaba, for treatment? Therefore, it is pertinent to incorporate mental health care in our Primary Health Care, so they would be capable of treating common mental health problems. I know there are some efforts in Lagos State. Psychiatric hospitals should be available at both public and private health centres.

Is the cost of treating mental illness affordable?  

The cost of NOT treating mental problem is higher than it actual costs. When you take it up early enough, you don’t need to spend money. Nobody prays for sickness but when it comes, you have to treat it.

What is your advice to the general public?             

People should monitor themselves because these are trying periods and stress is common in the environment. People should learn to take life with ease; it is said that “tough times never last but tough people do.” Stop blaming yourself. Just do your best and leave the rest to God.

At all time, have adequate rest; sleep well and avoid hard drugs. Also, be at peace with your neighbour, have good friends, do  good to people so when challenges come your way, you have people rallying around you. And also plan your life appropriately – learn a trade if need be to avoid depending on uncles.

When you start noticing problems, instead of looking for answers where there’s none, go to professionals where the problem will be assessed properly and appropriate intervention will be taken. If they do that, the menace of mental disorder will be minimised because we need as many Nigerians as possible to be in state of Optimal Mental Health.