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| Sunday, 23 November 2003 |
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Features |  |
| News Business Features Editorial
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Mental illness : Getting in touch with another reality by Vimukthi Fernando It is masked. How can you detect the isolation, the mood swings, the
unusual behaviour at an age when they are expected to shut themselves in
their rooms listening to blaring music, to be laughing Yes, it is one illness most of us wish that only the other person suffers from. But, the truth is, it is very much at home. According to WHO data, 25 per cent of the global population (that means one in every four of us) have suffered from a mental disorder at some time of life. However, what's unacceptable for us is when it hits home, invades our closely guarded territory. When it is our own family - parents, siblings, children, spouse or those nearest and dearest such as friends and sometimes colleagues who become victims of an illness we still do not want to talk openly about - mental illness. The causes of mental illness are two fold, says Harishchandra Gambheera Psychiatrist and Secretary of the College of Psychiatrists. It can happen either due to structural change (organic damage) or an imbalance of neuro transmitters (a chemical change). While some suffering from illnesses or disorders are not aware that they are ill and live in a world of their own, out of touch of the real world, others live close to normal lives and are very much in touch with reality. However, they show extreme reactions in one or more specific areas and they are aware of their problematic condition. While some mental conditions develop gradually as responses to the environment a person lives in, others emerge as a result of sudden and extreme situations he or she is unable to cope with. The extreme On an extreme is schizophrenia, labled as 'madness' in the vernacular. It is estimated that in Sri Lanka, there are over 70,000 patients suffering from schizophrenia. A disorder which gradually deteriorates a persons mental as well as physical wellness, it sets on males as young as 16 to 25 years and females between 25 to 40 years. With the potential of lasting a lifetime, it is interesting to note that schizophrenia is controllable with the correct type of treatment. Most important are early detection and treatment according to WHO reports. How can one detect this sickness? There are four major symptoms, says Harishchandra Gambheera. Emotionally, either they are incongruent (not appropriate for the occasion) or they show no emotional response at all. They suffer from delusions and will have false and irrational beliefs. They hallucinate and will see, hear, taste, smell and feel things which are not there in reality. Lastly, there is a global change of behaviour. They stay even for hours, in awkward and uncomfortable positions and the awareness and caring for self gradually disappear. Changing of behaviour with one of more of the symptoms could be taken seriously," he explains. The patients suffering from schizophrenia do not generally believe that they are mentally ill. Since they do not have insight into their illness, it is impossible to bring them in for treatment as well. However, there is hope for with medication seven to thirteen percent get cured, says Harishchandra Gambheera. So, what can the family or friends do, faced with such a situation? "Seek the help of a mental care worker. Show the patient to a doctor somehow, for medical care is very important here," advises Harishchandra Gambheera. Early detection, care and medication are vital in the treatment of mental illness in the same manner as of a physical illness. "It can improve the chances of curing or controlling an illness" says Harishchandra Gambheera. With proper medication and care the relapses could be prevented and the period where they do not get sick could be lengthened. "More than anything else, what they need is understanding and empathy," says Asad (not his real name), who takes care of his son, a 35 year old adult. The familiar Schizophrenia may fall into one extreme. However, more familiar and close to home are the sicknesses we fail to identify as sicknesses. Some behaviours are 'accepted' and some are seen as behaviours one "cannot get rid of." Some of which fall into this category include substance abuse such as alcohol, drugs and so on and behaviours such as phobias. People "do not seem to see their unwanted behaviour as something changeable. And some of them seem to have the subtle feeling that they are born with it. They have to live with it till they die," says Corsini Perera, Clinical Psychologist and President, Sri Lanka National Association of Counsellors. "Sometimes there seems to be some kind of unhealthy rationalisation of such behaviour. Also affecting the condition is the passivity and non-assertiveness," he explains. No one would 'label' a person who refuses to travel by train, afraid of heights, screams at seeing rats, cockroaches, fish and so on. Neither would a student who habitually faints at the school assembly suspected of suffering from a mental illness. However, as the schizophrenics, they also suffer from an imbalance in their response to the outer worlds in selective instances. This kind of response, an irrational fear, repulsive action towards an innocent object is very common in society. Almost all of us suffer from a range of phobias but most of the time live with them, and don't bothered to get rid of the nuisance. Sri Lankan society In the same manner, neither are we concerned about a teenager who stays apart from his siblings, friends and peer group minding his own business be it studies or housework. Nor of a young woman who as a habit refuses to spend time outside her house, without the presence of her mother. Sri Lankan society may even hold these persons with esteem, taking these instances as examples of 'refined behaviour'. However, they are symptoms revealing the inner problems and conflicts. The person's fear to face society and the underlying anxiety. Similarly affecting would be the behaviours of repeated checks on doors and windows sometimes waking a few times from sleep, repeated cleansing of oneself, preoccupation with sicknesses and visits to doctors with various symptoms and preoccupation with ones beauty or prestige and so on. Even though People are still reluctant to seek the services of psychologists or therapists fearing that it would leave them with a bad track record it is important that these are detected and treated, says Corsini Perera. In the changing socio-economic scenario it is vital that people seek the right kind of treatment. "Today mental health services have to be rendered by the well coordinated group of professionals, psychiatrists, psychologists, psychotherapists, psychiatric social workers, even barefoot counsellors at the grassroots level. It is only through such coordinated work that mental health services can bear sustainable results." he explains. Let us hope that all this coordinated work will lead Sri Lankans toward health that is "well balanced coordinated development of all aspects of human life, physical, intellectual, emotional, behavioral and even spiritual" according to the WHO. *********** How you can help * TLC-That's what they lack. That's what they do not get from society. The miracle drug TLC (tender loving care). A little bit of TLC can make a significant change in the lives of patients suffering from mental illness. * Your money, resources and time can help many institutions including the three hospitals for the mentally ill, in Angoda, Mulleriyawa and Hendala. * Your skills and availability to share them with patients will help rehabilitate those who are cured, but still have to stay in institutions for they are cast out from their own homes in re-integration to society. * The drugs necessary for treatment of the mentally ill are extremely expensive, according to the doctors as well as family members. May be a few families or an organisation can take care of one such patient, and provide him or her with the necessary drugs. * They do not have many visitors coming in to see them. May be the youth group, housewives club or any other social group you belong to can include a visit to the hospitals at least once in three months, in your calendar. * The families with mentally ill patients need your support as well. Therefore, if you know of such families in your own community your helping hand and your concerned ear would ease their burden. *********** What could you do for family and friends? : Some helpful hints from those who have gone through the mill * Acceptance is the key, say parents and siblings of mentally ill patients. "You cannot help the person unless you accept that he or she has a problem and that it is a mental problem." * Run to the mental health worker. It could either be a consultant psychiatrist, psychologist or a counsellor or a simple grassroots social worker. But, go to someone who understands your problem and could guide you to get the correct kind of help. * Never forget the medicine. Administer it to him or her like a prayer. Do not miss even one dose. However, an attentive carer will sometimes feel that the dose may be too strong or too weak. Talk with the doctor and get his advice. But, do not under any circumstance stop the medication. * Do not look down on the patient. They are people already suffering. Family and friends do not need to aggravate it but help them come out of it. * Strengthen your resources. At times, you may need more emotional support than the person who suffers from the illness. * Have time for yourself. Taking care of a patient suffering from mental illness is a 24 hour job. And you will not be able to do so, unless and until you are in good health. Your own physical and emotional health is important. Therefore, take time for yourself and take care of yourself. |
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and enjoying one
moment and turning away from all that the next and acting in all sorts of
weird ways as teenagers? This is a question posed by a mother who had to
take care of her son suffering from schizophrenia. Besides, even if you
see some of the signs you do not want to accept, you tend to deny that
your own child is schizophrenic.
