By Dr Ntswaki Setlaba
The topic of mental health is one that has been avoided by many over the years.
Speculation has been the foremost reason for this, as there is no scientific evidence to prove them.
Lack of knowledge or understanding of mental health and mental health related issues have however been the among reasons why the topic is totally avoided.
This has resulted in the stigma attached to mental illness, a stigma that is proving to be an uphill battle.
Over the years mental illness has received many interpretations or explanations.
It has taken me 5 years to learn mental illnesses, and this was just to allow me to recognize and know the basic principles ofthe management of various illnesses. With clinical experience, I’m now learning the core of the disorders and the science of treating the most complicated of cases.
Through this column I intend on shedding some light on these disorders.
I hope your knowledge will expand with every read.
Psychiatric disorders (mental illnesses) can be divided into two major groups; common mental disorders (CMDs) and serious mental disorders (SMDs). Common mental disorders include Depressive and Anxiety disorders and serious mental disorders are Psychotic and bipolar related disorders.
The symptoms of common mental disorders are often concealed by the sufferers as their functioning is usually preserved until the illness has progressed. These patients usually report not feeling like ‘themselves’ or may report an increase in the effort required to perform previously effortless activities.
From afar they may appear tearful, slowed, fatigued and some may seem on edge and irritable. These patients usually describe themselves as ‘stressed’.
An identifiable stressor may or may not be present, which may lead to confusion in the latter case as the patients often do not understand the cause of their distress.
Poor sleep, poor appetite, fatigue and poor concentration are often attributed to the specific stressor. By the time the patients realize that something may be amiss, they would have tried various interventions which they feel might work.
These patients usually present to the Psychiatrist or psychologist following a referral from the general practitioner. They often first present to the doctor with physical symptoms, the cause of which cannot be sought or physical ailments which do not respond to the medication that has been prescribed.
On the other hand, serious mental disorders present with more overt symptoms.
The patients are often unaware of their symptoms and hence cannot conceal them. Their way of thinking is completely distorted, mood is disrupted and their experience of reality is inaccurate. They may see, hear, smell, feel or taste things that are not evident to others.
Their perceived reality is what they know and believe and an attempt at convincing them otherwise may lead to aggression with destruction of property or assault on others. These patients often do not seek medical attention on their own and family experience difficulty in getting them to the hospital.
This is where the South African Police Service (SAPS) is often asked to assist.