Stress can precipitate mental illness–Psychiatrist

Dr. Vincent Udenze is a Consultant Psychiatrist with a sub-specialisation in addiction (substance misuse) psychiatry. He works as the Medical Director of Synapse Services, a Centre for Psychological Medicine providing specialised mental in Abuja, Niger and Lagos States. He is also the president of an International Charity called Reconnect Health Development Initiative. In this LARA ADEJORO, he says there is always an evidence of a diagnosable mental illness. Excerpts

What type of specialised psychiatric services are you involved with in Nigeria?

I am very much aware that the Nigerian Government is unable to provide all the mental health care that is required for the population. Even in developed nations like the United Kingdom where you have a National Health Service, there is still a huge gap filled by private health providers and mental health charities in providing care and support services for some patients and families. I am working with professional colleagues (Psychiatrists, Psychologists, social workers etc) to have relevant mental health sub-specialisations within the community especially in the private health care sector.

What are the early symptoms of mental illness?

It is very difficult to just mention one or two symptoms of mental illness bearing in mind that you got a lot of mental illnesses and they would present differently at the early stages. Presentation at an early age group might be behavioural difficulties, challenging behaviour, struggling at school, unable to concentrate at school, laid back at school, a bit disorderly, getting into trouble at school, getting paranoid, feeling low in mood etc. As they get older, some behavioural difficulties, some mood swing, some may start hearing voices, feeling more paranoid, irritability, some might show cognitive decline. Then as they get older, early signs could be memory loss, difficulty remembering things, forgetting birthdays and things, reading and forgetting what they have read, dropping your car keys and forgetting where you dropped it, etc.

What are the major causes of mental illness?

Primarily, it could be biological, psychological or social. The Biological is about genetic vulnerability. So, if someone is born into a family where both parents have depression, that person is genetically more likely to have depression. It does not mean that they would definitely have depression but means that their genetics make them more vulnerable to developing that illness. Psychological, people who are very negative, who do not think that they are good enough, who are very judgmental of themselves, who have a very negative cognitive style are more likely to develop a depressive illness compared to someone who is very positively motivated and driven. And, social factors are factors like housing, finances, job. So, if you lose your job, break up in your relationships, all these social stressors could trigger a possible mental illness. A lot of the etiological factors are spread across those three main domains.

What is your view about diabolically inflicted mental illness or man induced mental illness?

This is a very difficult and controversial topic. I will respond to this question by saying that there are people out there that believe that some mental illnesses are due to some spiritual factors, and there is some evidence-based on that belief system that it is true. Now the questions are these-How do you differentiate between a mental illness due to bio-psycho-social factors as described earlier and the one that is possibly diabolical? do diabolical etiology actually lead to a diagnosis of mental illness? Does the diabolical factor trigger a proper mental illness? My take on this will probably be that, whether it is diabolically induced or proper core mental illness, there is always an evidence of a diagnosable mental illness. If you believe in diabolically induced mental Illnesses, then treatment will usually involve prayers to address the spiritual treatment and then medical treatment by your clinicians to deal with the diagnosable mental illness, so you need prayers, Psychiatrists, Psychologists, Psychotherapists. While that is not diabolically induced, it is really about treatment by clinicians. What I always say to my patients is that the best form of treatment for those that believe in diabolical treatment is to take the patient to hospital to get treatment for the diagnosable mental illness while you ask family members to go to Church or mosques to say prayers to deal with the diabolical origin as God answers all prayers from any location.

How can every sane person avoid mental illness?

Sanity is an interesting concept. Sometimes we talk about a continuum. We all have our individual peculiarities. To focus on the question, you have to pay more attention to your thinking style, and be more positive. You have to prevent stress because it can precipitate mental illness especially in the vulnerable. Manage yourself well, do exercise.

Do you believe in herbal or traditional solution to mental illness?

Yes. For as long as such centres will be the first place some of our clients will visit, then they are already a part of the treatment pathway. We just need to work collaboratively and give them basic knowledge of how to identify mental illness and the need for them to advice clients to go to mental health hospitals. I also believe that there will be some herbal preparations which will be beneficial in treating mental illnesses but people who have such herbal preparations need to subject it to science so we can get the exact dose for it and understand how it works.

Can one get quality treatment in Nigeria without necessarily abroad?

Yes.  In Nigeria, today, we got some fantastic teaching hospitals with fantastic clinicians. You don’t have to go abroad for treatment. We also have a few good private facilities who have got equipment. If you think of the fact that in Nigeria, we have got machines like the Rapid Transcranial Magnetic Stimulation (RTMS). That is the machine used in treatment of mental illness and addiction that can cost as much as N40 million each existing in Centres in this country. We don’t have to go that far, you just need to know where to go to get help for your particular disorders.

What is your general advise to Nigerians on mental health awareness?

Mental illness is a no-respecter of person, age, sex, social-economic status, religion, etc. Anyone is capable of developing mental illnesses. If you have a suspicion that all is not well with you mentally or that all is not well with someone else around you, the first thing you need to do is to seek help, seek clarity, go see a clinician. It doesn’t have to be a psychiatrist. It could be a family doctor; and that person is able to determine if it is something they can handle or they might refer you to the appropriate mental health clinician to help you have a better understanding of your experience.