Mental Health in Kenya
I know its offensive that its called it madness May, but in the last month, I have observed incredible effort in spreading awareness on mental health- on Twitter at least. Rightfully so, it was mental health awareness month. This post sums up the debate on mental health, with a focus on how our lifestyle affects our mental health and what we can do about it.
While there has been laudable effort to manage mental health in Kenya, it still remains to be a stigmatized subject in our society, hardly attracting the attention deserved for a scourge of its kind. The hashtags, the interviews and analysts on mental health have worked towards raising awareness on mental health, especially now that the disease is causing problem in the country. However, mental health is an aspect of happiness. When the social, political and financial welfare of a nation is at degrading lows, general happiness decreases and mental health creeps in to cripple the society.
Most debates on mental health cover serious clinical disorders such as schizophrenia, bipolar disorder and depression while ignoring general happiness as a measure of mental health. As it follows, our mental health policy is quite insufficient, as are treatment options, information, and resources. The result is a society that rarely understands mental health, some hiding patients in unreachable places, often solitary confinement with a dose of pills strong enough to zombie them for as long as needed.
For most of the mental health issues, the age of onset is reducing, from the 30’s a decade ago to the early and mid-twenties. As a country, about 60% of our population is below 35, with a quarter of the population in their 20’s. Our government spends less than 1% of its health budget on mental health, although figures show that one-quarter of all patients going to hospitals or clinics complain of mental health issues. Considering the major risk presented by mental health, we need awareness and practical tips to improve our mental health.
Stress and Mental health
To understand how stress affects our mental health, a study on baboons offers insight. In the study, Robert Sapolsky studied baboons over twenty years. Just like humans, they have social strata, with primary sources of stress being psychological rather than physical. Dominant male baboons were often seen to bully those of the lower social strata-leading to less access to food, resting places and sexual partners.
Cortisol, a hormone that controls arousal and mobilization was seen to differ considerably between the two groups. Dominant males had high cortisol levels in emergencies and low levels when resting. Subordinate animals had high cortisol levels most times due to stress, even when resting. As a result, dominant males had high immunity and less Low Density Lipoprotein (Cholesterol) compared to low circulating white blood cells and high cholesterol in lower social group. How does this apply to humans?
Predictability and controllability influence our stress levels. When we have a sense of control over our physical and psychological needs, we are less likely to face stress. When this is lacking though-such as when facing a threatening situation-there is a low feeling of control. As humans, basic stress pushes us to fulfil our needs as Maslow hypothesised. When the needs seem unreachable, we get stressed, which progresses to anxiety, and finally depression. Considering the changes in social stratification, especially bulking up chaos in the twenties, it is explicable why the twenties are the new breeding ground for mental health problems.
According to WHO, of the 300 million in our world who suffer depression, 11 million are in Kenya. Depression is a leading cause of suicide in the country, and on onset, not many people want to cope with the disease, preferring to lock up patients, with prayers and no medication. Women have been shown to be at a higher risk of depression, as have youths between 15-29, who result to suicide. As illustrated above on the effects of extreme stress, the causes of depression-led suicide point to poverty, unemployment, physical illness and substance abuse.
A friend of mine with bipolar describes it as wearing a high-heel shoe on one leg, and a flat one on the other, in reference to the acute mood fluctuations that at times cripple patients. Bipolar disorder is an escalated mood disorder characterized by manic periods followed by major depressive episodes. The manic episodes are pleasurable, and patients feel ‘superman-ish’, some even stopping medication, leading to an even lower low. Bipolar 1 is a more severe form, often encroaching at around 18 and requiring frequent medication and management. Bipolar 2 only leads to high excitement states called hypomania and is often experienced from age 22. Bipolar disorder rarely occurs after 40. Adolescents, especially girls, and the creative community are at highest risk of bipolar, with a risk of genetic and familial inheritance.
Relieving ourselves of stress requires that we build resilience, a positive attitude and a way to let go of life’s pressures. While we may want to be specific-limit ourselves to prayer, exercise, meditation, and other therapies, the ultimate plan depends on you. Know what works for you. The options are wide, so do not limit yourself. Some people prefer meditation for at least 15 minutes, to consciously breathe peacefully. Most religions have a reference to meditation, and science supports its effectiveness in relieving the mind of worry.
Exercise is one of the most important remedies for stress. When we force our bodies to go through physical stress, we relieve the mental pressure accumulating within us. Paradoxical but true. Exercise works in three ways. First, working out reduces the amount of circulating cortisol- you remember the baboon story. Exercise will reduce amounts of cortisol in blood and promote other hormones (endorphins) that improve mood. Second, exercising improves our self-image and self-worth, further yielding more positive hormones in blood. The increased blood flow to the brain and other muscles will-lastly- improve sleep quality. So start today: walk, jog, run, dance, cycle, do yoga, go rock climbing and take up those swimming lessons.
Positive thinking is a skill also relevant in maintaining a stress-free life. While science may fail to prove its effectiveness, positive thinking keeps our spirits high, allowing us to have a better outlook. You will be surprised how effective positive thinking is in improving general happiness and removing limitations we set on ourselves. Laugh as much as is possible in the day, learn to say no when you need to and don’t procrastinate, especially on health.
Whatever we take in to our bodies is as fuel to our brains as it is to the rest of the body. Foods which nourish our blood system with energy, minerals and salts, also contain chemicals that get to the brain. l Although most may not get through the blood-brain barrier, caffeine, alcohol and other drugs may affect the working of the brain. Now, before you toss out your coffee supply, consider reducing intake only to when necessary. Go slow on the liquor and drugs though.
What to do
Learn what causes escalations in your anxiety. Keep an hourly log if you have to. Cultivate happy relationships, so you can talk to whoever you can and do your best to prevent the worry. If it is exceeding, a visit to a psychiatrist or counselor will relieve your worries and help you get back to calm. As parents, it is important that we are aware of the mental health of our children, especially those attending boarding schools. With the recent news of mismanagement, mishandling and abuse in schools, our children and siblings may be exposed to mental illness without our knowledge. Older people, who are at risk of mental disorders such a s Alzheimer’s and memory loss need to be constantly checked for depression, as it is often lost in the claim of old age.
In conclusion, talking about depression will help to spread awareness and nourish our mental health as a country. Our health system should empower local hospitals to detect, treat and refer mental health patients, while providing adequate statistics on the problem. Psycho-social treatment together with anti-depressants and other medication should be made more available in local hospitals. As parents, relatives and friends, offering a supportive net. Further, we need to improve our social-economic situation, to ensure that we can provide for the needs of even the lower, poorer class of society, thus help to bring a sense of control in their lives.