Kimah Semir-nyuiy Terry
Why would a crazy person not be associated with witchcraft? In our society today, Cameroon in particular, a mental disorder is not a common disease that is laid on the open table for discussion. With the evolution in time and what all seems to be happening around us, it is quite okay to talk about it. We are all worried about what to do and what to do next which can in turn lead to depression, though we seem not to notice.
Africa is a continent known to be the council of countries termed the third world countries. Cameroon happens to be one of those countries. Bamenda, a major town in Cameroon, so far is one of the Anglophone regions plagued with the ongoing crisis. The crisis might have come and is thus causing a mental situation that is ignored because we “ought” to be strong. However, the crisis is not the only cause for the discussion of mental disorders as there seems to be more underlining.
In our context, unemployment, poor living conditions, poverty, and discrimination tend to take the lead of our status quo. As such people are under the urge and pressure to do anything that seems best to them to survive. Their past and present growing up in such conditions play a role in causing mental disorders.
People seem to be unaware of the different mental disorders that exist. In the context of Cameroon, many will associate this with witchcraft as the culture plays in. so we believe the only solution is prayers or traditional doctors.
Some people do believe that mental illness is the sickness of the “Whiteman” to the extent that even blacks in the western world neglect mental illness despite their access to healthcare, state of the art facilities. In Cameroon, mental illness is recognized only when someone runs on the streets naked and mad. Be that as it may, environmental, social, and economic factors amongst others can trigger several mental illnesses which we don’t talk about or have someone to talk to because our culture masks mental illness.
However mental illness is becoming a global discussion. Statistics from WHO show that, in 2019, 1 in every 8 people or 970 million people worldwide were living with a mental disorder. In 2020 the number rose significantly by 26% because of COVID 19. More and more people in society and even celebrities who have a lot of influence on the population are now entertaining and engaging in conversations about issues of mental health.
One is considered to be mentally ill when his/her thinking, feeling, behavior, or mood seems to be different from what is expected to be normal. These conditions greatly affect a person’s day-to-day living. There are different mental illnesses and they include clinical depression, anxiety disorder, bipolar disorder, dementia, schizophrenia and obsessive compulsory disorder (OCD), and post-traumatic disorder (PTSD).
People tend to go through a lot of traumatic events and may have temporary difficulty adjusting and coping with the reality of life. As stated by the American Mayo Clinic, Post-Traumatic Stress Disorder (PTSD) is a mental health condition that is triggered by terrifying events either experienced or witnessed. Some traumatic events such as natural disasters, a terrorist act, war/combat, rape, someone being threatened by death, sexual violence, or serious injuries can lead to PTSD.
People with PTSD usually have disturbing thoughts and feelings relating to their experiences. In our context, the ongoing socio-political crisis is a case to note as people who have lost their loved ones brutally can be affected mentally as they try to adjust to reality. However, not only losing a loved one in times of war can lead to PTSD, some people do not know how to talk about the pain they feel thus locking it up in them which starts affecting how they think, their feelings, and their behavior.
Also, other cases considered to be mental illnesses can be when someone has memory loss. Dementia as stated by WHO is a syndrome that when chronic or progressive leads to the deterioration of cognition. That is, it affects the memory of the person, thinking, orientation, comprehension, calculation, and learning capacity. Language and judgment. The consciousness is not affected. Dementia is a result of diseases and injuries that primarily or secondarily affect the brain such as Alzheimer’s disease or stroke.
Statistically, WHO states that 55 million people have dementia worldwide with 60% living in low and middle-income countries. With the increase in older people in nearly every country, the number is expected to rise to 78 million in 2030 and 139 million in 2050. Signs and symptoms vary from person to person depending on the underlying causes, other health conditions, and a person’s cognitive functioning before being ill. There is currently no treatment available to cure dementia. There are anti-dementia medicines and disease-modifying therapies that have been developed to help.
In a society like ours, where a quantifiable number of the population worries about sources of livelihood and standards of living, this can play a role in causing mental illness which can be called anxiety disorders. This is when people get to worry so much because they are uncertain or afraid of what is unknown to them, especially in their daily lives. Experiencing occasional anxiety is a normal part of life as explained by Mayo Clinic. But it becomes a problem when panic attacks become involved which become difficult to control and can even last sometimes for a long time. Symptoms may start in childhood or even teen years and continue into adulthood.
Some examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias, and separation anxiety phobia. It is possible to have more than one anxiety disorder. Some risk factors of anxiety disorder can be trauma, stress due to illness, stress build-up, other mental health disorders, genetics, drugs, and alcohol.
Schizophrenia just like any other mental disorder is not so common. Schizophrenia according to Mayo Clinic is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning and can be disabling. WHO simplifies this topic by saying schizophrenia can affect our daily life, it can cause limited speech, restricted experience and restriction of emotions, inability to experience interest or pleasure, social withdrawal, extreme agitation or slowing of movement, and maintenance of unusual postures.
As reported by WHO, research has not identified one single cause of schizophrenia. It is thought that interaction between genes and a range of environmental factors may cause schizophrenia. Psychosocial factors may also affect and cause schizophrenia, heavy use of cannabis/drugs can be associated with causing mental disorders. This fact was confirmed by Dr. Angwafor when he says that there is no lab test to diagnose schizophrenia but a neurological test can be carried out to help rule out other diseases before finally concluding that someone has schizophrenia. Schizophrenia affects approximately 25 million people or 1 in 300 people (0.32%) worldwide. This rate amongst adults is 1 in 222 people (0.45%)
In the opinion of the United States National Health Services (NHS), schizophrenia is usually diagnosed if a person has experienced 2 or more of the following symptoms like delusions, hallucinations, hearing voices, incoherent speech, or negative symptoms most of the time in one month, also it can be diagnosed if these symptoms have had a significant impact on your ability to work, study or perform daily tasks and lastly if all other possible causes such as recreational drug use or bipolar disorder have been ruled out. A health provider who evaluates the symptoms and the course of a person’s illness over 6 months can help ensure a correct diagnosis of schizophrenia.
Usually, risk factors of schizophrenia will include a family history of mental disorder, male and female who can be older, autoimmune system abnormalities, drug abuse during adolescence and early childhood, and complications during pregnancy or birth. Then there is also the risk of schizophrenia in urban areas among low-income families where income inequality is significant. Statically, the British Medical Bulletin states that schizophrenia is somewhat found higher in men than women with a risk ratio of 1.3:1.4. The United Kingdom National Alliance on mental illness attests to this as it writes that, though schizophrenia can occur at any age, the average age tends to be late teens to early 20s for men and late 20s to early 30s for women. It is quite rare and difficult to diagnose schizophrenia in a person younger than 12 years or older than 40 years.
The signs and symptoms of schizophrenia tend to vary from adults to teenagers. Symptoms of schizophrenia usually fall into three categories which are positive symptoms, negative symptoms, and cognitive symptoms. With positive symptoms, the patients do not see reality the same way other people do. They may also see, hear, smell and taste things others don’t. For negative symptoms, the patients tend to have no interest and have lost the motivation to do most things including seeing friends to doing daily activities, and for cognitive symptoms, the patients have trouble paying attention, concentrating, and remembering things.
So, generally in adults we can have symptoms like hallucinations which involves seeing and hearing things that don’t exist, delusions which are false beliefs that are no based on reality, and disorganized thinking which stems from a disorganized speech where answering questions may be partially or completely unrelated, concentration and memory problems, over excited, grandiosity or catatonic behavior like smiling or laughing for no apparent reason, difficulty in thinking and emotional withdrawal. For teenagers, symptoms include withdrawal from family, a drop in performance at school, trouble sleeping, inability or depressed mood, and lack of motivation.
The lack of mental health awareness is not the only challenge impeding the consciousness of people about it in Cameroon and Africa at large. When people are poor, they get stressed about searching for basic resources for survival. It eventually affects their mental health. In this state of poverty, they find it difficult to talk about the mental difficulties they may face. Generally, healthcare facilities are expensive and also inaccessible to people. People are so poor that even getting limited mental drugs becomes difficult.
Despite the neglect of conversations around mental health on the global stage, efforts are being made in recent times to create awareness. Most African countries with Cameroon as an example spend less than 1% of their budget on mental health. This indicates that mental health is yet to be mainstreamed in the health policy of the country. As such it shows how mental illness is not prioritized in the country. Also, there is a lack of personnel and even mental health facilities. Given the high stigma around this illness, graduates have continued to abscond field of study related to mental health. A comment made by Mental Health Innovation Network indicates that 90% of people with mental illness have no access to treatment, especially in poor and rural areas. With all the neglect in the face of mental illness, it is hopeful that people get aware and there is hope for some changes being made.
1) British Medical Bulletin: Predictors of schizophrenia – review https://academic.oup.com/bmb/article/73-74/1/1/332342 (January 2005) Vol 73-74
2) ELSEVIER: Comprehensive Psychiatry
https://www.sciencedirect.com/science/article/pii/S0010440X21000717 (February 2022) Vol 113
3) Mayo Clinic: Anxiety Disorders – Symptoms and causes https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961 (May 2018).
4) Mayo Clinic: Post-Traumatic Stress Disorder. Symptoms and causes www.mayoclinic.org (July 2018).
5) Mayo Clinic: Schizophrenia – Symptoms and causes
6) National Alliance on Mental Illness (NAMI): What is schizophrenia?
7) National Health Services (NHS): Overview – schizophrenia https://www.nhs.uk/mental-health/conditions/schizophrenia/overview/ (Last review November 2019)
8) Schizophrenia – WHO/World Health Organisation
9) The Borgen Project: 5 Challenges to Mental Health in Africa https://borgenproject.org/mental-health-in-africa/ (July 2020)
10) World Health Organization (WHO): Dementia https://www.who.int/news-room/fact-sheets/detail/dementia (September 2021).