Mental health


By Maimuna Jatta

The growing number of mentally unstable youths walking the streets of The Gambia is ringing an alarm bell of emergency. It has been estimated that 20% of the Gambian population is suffering from mental health issues, that is 1 in every 5 Gambians is suffering from mental illness.

Mental health is the health of our mind. It refers to our cognitive, behavioral, and emotional wellbeing. It is the normality, maturity, and sanity of being able to handle simple day-to-day responsibilities and being able to live in a state of well-being. To date, there has not been any biological test to diagnose mental disorder. This makes mental disorder one of the hardest disorders to diagnose and treat. However, a number of models have been setup to explain the abnormality of mental illness. The main models include biological model, behavioral model, psychodynamic model, and cognitive model.


· Biological model remains powerful in contemporary understanding of abnormal behavior. This model emphasizes on the role of biological factors such as genetics, physiological or biochemical abnormalities as a cause of mental illness. It attempts to treat these abnormalities by way of medically grounded procedures such as psychopharmacology (drug therapy), electroconvulsive therapy (ECT), or psychosurgery (brain surgery).


· Behavioral model over comes the ethical issues raised by the medical model of labelling someone as “ill” or “abnormal”. Instead the model concentrates on behavior and whether it is “adaptive” or “maladaptive”. It points out that provided the behavior is presenting no problem to the person or other people, there is no need to regard the behavior as a mental disorder. Behaviorist highlight that we need not look beyond the behavioral symptoms as the symptoms are the disorder.


· Psychodynamic model is quite the opposite of the behavioral model. It claims that symptoms are merely the tip of the iceberg. It is based on principles that psychological illness come about from repressed emotions and thoughts from experience in the past, and as a result of this repression, alternative behavior replaces what is being repressed. The patient is believed to be cured when they can admit that which is currently being repressed. This model can be successful, especially when the patient feels comfortable to speak freely about issues that are relevant to finding a cure.


· Cognitive model is similar to the behavioral model. The main difference between the two models is that instead of teaching patients to behave differently, the cognitive model teaches patients to think differently. It is hoped that if the patient’s negative feelings and emotions towards something are influenced to change, this will induce external behaviors to change. The main method use for treating patients is the rational emotive therapy (RET), which is based on activating emotional events which can cause a change in thoughts toward the situation. This model as well as the behavioral model has been successful in the treatment of compulsive disorder and phobias.


Causes of Mental Illness
Mental illness can have a wide range of causes. It is usually as a result of complicated combination of more than one factor. One of the main causes of mental illness in The Gambia is drug or substance abuse which leads to Drug Induced Psychosis. Other causes include:
· Childhood abuse, trauma or neglect
· Bereavement (losing someone close to you)
· Severe or long term stress
· Long-term physical health
· Alcohol abuse
· Domestic violence, bullying etc.
· Significant trauma such as military combat, being involved in a serious incident in which you feared for your life, or being the victim of a violent crime.
· Physical causes like head injury or neurological condition such as epilepsy can cause an impact on your behavior and mood.
· Social isolation or loneliness.


Types of Mental Disorders
· Depression is a mental disorder in which the patient has feelings of sadness, loss, anger or frustration interfering with everyday life for weeks or longer.
· Bipolar is a brain disorder that causes unusual shifts in mood, energy, activity level, and ability to carry out day-to-day task.

· Schizophrenia is a mental disorder characterized by abnormal social behavior and failure to understand what is real. Common symptoms include false believe, unclear or confused thinking, hearing voices that others do not hear, reduced social engagement and emotional expression, and a lack of motivation.
· Obsessive compulsive disorder is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensation (obsession), or behavior that makes them feel driven to do something (compulsion) in an effort to reduce the anxiety or discomfort.
· Post-traumatic stress is a type of anxiety disorder which can occur after an extremely emotional trauma. Symptoms may include flashbacks, nightmares, and severe anxiety as well as uncontrollable thoughts about the event.

· Eating disorder is a fatal disorder that causes severe disturbances to a person’s eating behavior. It includes disorders such as anorexia, bulimia, and binge eating disorder. Obsession with food, body weight and shape may signal eating disorder.
· Borderline personality disorder is a condition in which a person has long-term pattern of unstable or turbulent emotions. These inner experiences often result in impulsive action and chaotic relationship with other people.


Symptoms of Mental Disorder
Although every mentally ill patient is unique, here are some symptoms we should all keep an eye on.
1. Physical symptoms which includes sickness and run downs, difficulty sleeping, poor appetite, muscle pain, weight loss, and fatigue.
2. Behavioral symptoms include withdrawal from others, don’t get things done, stops enjoyable activities, have difficulty concentrating, and increased alcohol consumption.
3. Thoughts such as nothing good ever happens to me, life is not worth living, my future looks bleak, I am not worthy, it’s my fault, am a failure etc.
4. Feelings such as overwhelmed, unhappy, irritable, frustration, lacking confidence, and indecisive.


Fortunately, mental disorder is treatable. Patients suffering from mental illness when treated recover well or even completely. However, because there are many different factors contributing to the development of each illness, it can sometimes be difficult to predict how, when, or to what someone extend is going to get better. Treatment of mental disorder involves all the different ways someone can minimize the effects of mental illness and promote recovery. Treatment can involve psychological therapy, medication, and various supports in the community, as well as the patients with mental illness helping themselves. Patients can help themselves by living a healthy life style of eating healthy, getting plenty of sleep, and doing regular physical activities. They can also help themselves by learning skills which deal with their stress and most importantly patients should stay away from hard drugs and alcohol

The prevalence of mental disorder in The Gambia is overwhelming. It is very sad that Gambia’s finest youths, the leaders of tomorrow, are being wasted to mental illness. The main factor contributing to the rise in the number of mental illness among our youths is drug and substance abuse. To tackle this problem requires the collective cooperation of the government, health professionals, NGOs and most importantly the general public.

Taking care of our mental health is as important as taking care of our physical health. Mental health plays a major role in our ability to maintain good physical health. Mental illness such as depression and anxiety affect our ability to participate in healthy behaviors. This can result in problems with physical health.
Mental illness affects both the patient and the people around him/her. It is important that the family and community of the patient remain supportive throughout the patient’s recovery journey.

It can be inferred from the above that the cause and management of mental disorders is as much social as it is medical. The management principle should therefore put emphasis on the role the family members and the community at large have to play in trying to help an individual who has been affected by any mental health disorder. Patience and perseverance on the side of the health care professionals and family members cannot be over emphasized.