SB has been experiencing crawling sensation over his head and sometimes over the abdomen. This has been on for a few months. He recently began to breathe fast. Things get him upset easily. His sleep has not been refreshing. He feels a medical condition explains his complaints. Different doctors had diagnosed him of anxiety disorder. He refuted the diagnosis and the counsel to get evaluated by a psychiatrist. He has since had poor quality of life and is unproductive at work……….
T.O hears voices people in her environment don’t hear. These voices many times discuss about her. In fact, they discuss harming her. Occasionally, she experiences vague body sensation. She admits to being a religious person. Her husband occasionally finds her crying without any cause. She believes her experience is God’s way of warning her about her enemies and the need to always pray. They have consulted many doctors who all made same diagnosis of a psychotic mental disorder. She disagrees with her doctors. If her unpleasant body sensation resolves, she would be fine, she affirms. She is still in search of a lasting solution.
It is a fact that some mental health disorders manifest with complaints which are similar to those caused by other common diseases. Except the physician had a prior notification of the patient, attempt is made, if possible, not to make a diagnosis of mental health disorder at the first visit by the patient. This is the primary training by most doctors.
Mental health disorders (anxiety, depression, schizophrenia, drug abuse, etc) are unique disorders which if not identified and treated promptly, the individual may never be well and productive. In many societies, especially developing countries, these mental health disorders have been stigmatized. The fear of stigma is a reason why most ill individuals refute the diagnosis of a mental health disorder.
The following are facts of possibility of a mental health disorder in an individual:
- Multiple visits to different hospitals on account of same complaints.
- Having to do multiple investigations all yielding results that there is no disease in the body.
- Having to be labelled that one’s complaints are due to ‘spiritual’ problem.
- Having to use same orthodox medications (except those used for mental health disorders) repeatedly without improvement.
Common fears associated with mental health disorders include:
- Concern that mental health disorder is a life-long disease.
- The stigmatization from the public is worrisome.
- Job may be lost if employers become aware.
- Fear of loss of friends when they have knowledge of one’s mental disorder.
Misconceptions about mental health disorders include, but not limited to, the following
- An individual with mental health disorder usually behaves abnormally.
- An individual with mental health disorder looks unkempt.
- An individual with mental health disorder is unlikely to have productive relationship with people.
- An individual with mental health disorder most likely will be hospitalized for prolonged period.
It is essential to note the following about mental health disorders.
- In some instances, these mental health conditions are missed if time doesn’t permit thorough evaluation by the health personnel. At other times the patient is just in denial despite being told the diagnosis.
- Is everyone at risk of a mental disorder? Yes, we all are, if traumas of life are not managed with adequate support from self, family, and community.
- Is the condition a life-long one? Depending on the individual’s response to therapy, medication (if required) and/or counseling would be discontinued after a period of stability as assessed by the doctor (most times, a psychiatrist). This does not excuse the periodic follow-up evaluation even when stable.
- What about stigma? Stigma is whatever the individual perceives it to be. So long as daily living doesn’t interfere with that of others, nobody would ‘stigmatize’ an individual with a mental health disorder.
To attain ideal health status, stable mental health is essential.
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the chief editor of The Family Doctors. He can be contacted via firstname.lastname@example.org