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Mental illness: urgent need for social recognition [The Fiji Times, 8 October 1999]

29/03/2012

  There are some illnesses many in our societies don’t want to see or acknowledge.  Mental illness is one of them.

A sad case recently

Not too long ago, a bright young man I knew had a few beers, drove a car too fast, crashed, and died.

Anil (not his real name) had been a patient at St Giles hospital, and his sad, untimely death followed a long and painful struggle with mental illness.

His family and close relatives were devastated at the loss of their loved one.  Worse, they continued to torture themselves: could they have done more, and saved him?

Most relatives only came to know of the illness, when Anil was admitted to St Giles, the “loony bin”, the place to dispose of “mad” men and women.

For fear, embarrassment or shame, mentally ill patients are not frequently visited or acknowledged by relatives and friends, as are other patients at the CWM orLautokaHospitals.

I was asked to counsel him: to no avail

As a friend of the family, I was asked to counsel him.  We went for long walks, we talked many times, for many months.   On the surface, his problems were the same as those for most young men: deep, recurring anxieties about his manhood and sexuality, leading to compulsive behavior.

Most young men, while discovering their sexuality, had similar unwarranted worries:  did girls find them attractive; would they be able to satisfy their partners sexually; did they have gay tendencies, and so on.

Anil would be convinced that he was a normal person.  But hours later, sometimes just minutes later, his anxieties and compulsive behavior would return. The same frustrating discussions would be repeated month after month.

It was as if Anil’s mind was reasoning properly but the conclusions were not being recorded in his mind. As if his RAM memory was working OK, but the final output was not being saved on the hard disk.  Every time he thought about his problems, he started afresh.

It is hard to describe the horror of Anil’s mental torture.   In his worst state, he could not appreciate a beautiful sunny day,  colourful birds, or the fragrance of mahogany flowers.  He could see no value in his creative possibilities.  At his worst moments, he seemed to be in a nightmare, while being wide awake.

A common medical problem: OCD

The medical staff at St Giles diagnosed Anil as having the symptoms of OCD (Obsessive Compulsive Disorder) although uncertain whether the cause was OCD.

OCD symptoms could arise from any number of causes:  chemical imbalances in the body (especially those relating to mental communication processes); stresses in everyday lives, marijuana and other drug use, child abuse, or even genetic disposition.

OCD made people engage in uncontrollable, mostly trivial behaviour: frequent washing of hands or checking of doors and windows, compulsive praying, uncontrollable feelings of anxiety or sexual urges.  In extreme cases, patients could also have the urge to hurt themselves or even commit suicide.

The doctors concluded that Anil’s illness had developed from his adolescent days, when it was not recognised by the family. The problems had worsened during several stress-filled post-coup years inAustralia.   Australian public schools can be harsh on innocent adolescent boys, fresh from their protected, prudish, Hindu upbringing inFiji.

Our media and society make matters worse

And it is so easy for our media-driven social environment to make adolescent boys and girls feel inadequate.

TV, movies, magazines perpetually present images of young heroic men as muscular studs, scoring with every attractive female that comes along.

Unlike real-life women, most heroines have hour-glass figures, massive breasts, bulging muscles, and intelligence to boot.

In a country where 95 percent of the people are dark-skinned, we continue to tolerate a disgraceful advertisement which implies that to be lovely, women must be fair, and they could achieved that by buying a facial cream, “fair and lovely”.   In some of our communities, God help your marriage prospects if you are dark in complexion.

Young men and women are not only expected to fulfil their traditional cultural obligations, but also satisfy their parents’ expectations in school, sports, employment and marriage, in harsh competition with others.  OCD symptoms are worsened in stressful environments.

Rationalisation and electric shocks no help often

Some OCD patients could be helped by sympathetic discussions and rationalisation. But rationalisation did not work well with Anil.

He was an extremely intelligent young man, who was flying through University when his mental illness finally floored him.  Discussions with his doctors became intellectual games.

Anil would accurately analyse himself, explain his symptoms, describe his apparent improvements, and ask the doctor if he (Anil) was only pretending to the improvements because he wanted to be allowed to go home.  Anil had a powerful streak of mental stubbornness, and antagonism to being convinced that his problems were solvable.

The doctors tried a variety of drugs, some well-known and others just coming on the market.  Some symptoms were alleviated but not others, and undesirable side effects took their toll.   Some would leave Anil pitifully zombie-like for hours, while others made him hyper-active.

At some stage, electric shocks were also tried, throwing Anil’s parents and relatives into as much trauma as the patient himself.  There were only minor improvements.

Trauma for family: but support was there

Faced with their relative powerlessness, the parents would weep their hearts out and sink into the dark depths of their own depression.

Family relationships suffered.  It is so natural for parents to blame themselves or hold each other responsible for the undesirable behaviour of their children.

Yet, scientific research is revealing that many mental illnesses have biological causes, not due to upbringing.

But unlike many St Giles patients, Anil continued to have full support from his parents.  They visited him regularly; spent thousands of dollars on expensive drugs not found inFiji.   Before St Giles, they had spent thousands more taking Anil to traditional healers and holy men inFijiandIndia, to no avail.

Anil continued to have full support from a devoted aunt who regularly cooked for him, visited him, and took him home, where he shared in the full family life.

Anil’s young cousins, only of primary and high school age, continued to relate warmly, with little indication of any qualms about having a St Giles patient in their home.  The families bravely took Anil to social functions, ignoring the gossip.

Eventually, there came light at the end of the tunnel, when a new drug brought about dramatic improvements in Anil.  He became so well, that the doctors felt confident enough to let him go home with his parents, for an extended period.

But late one night

But late one night, when his family was asleep, Anil drove off in the family car.

He drank a few bottles of beer somewhere. He drove the car at great speed.

Perhaps he was enjoying the emotions of power and control, that he felt missing in his own personal life.

Somewhere, like his life, the car went out of control, and crashed.

A young life that had held so much promise, ended so futilely.

Anil’s anxieties and suffering ended with his death, but that of his parents, family and relatives, continued.  I doubt if they could have done more.

Mental illness is a big hidden problem

Mentally ill people, like Anil are a much larger proportion of our communities than is acknowledged, and of all races- Fijian, Indian, Chinese, European alike.

Some do get to St Giles where they are treated, like any other sick person suffering from influenza or heart disease.  But many of our families keep their mentally ill hidden out of sight,  through fear of social stigma and shame.

Throughout the world, mental illness has come out into the open, with the development of support groups and organisations which share information for patients, families and medical practitioners alike.

You will be amazed at what comes up if you search the Internet (eg through Yahoo), just using the key word “OCD” or “mental health” (try it).

 

InFiji, there are many dedicated medical staff and lay people who try to help the mentally ill, despite serious budget constraints.

 

Their task would be so much easier, if there was greater warmth, understanding, and sympathetic support from families and communities.

 

We just need to break out of our culture of blindness to the mentally ill.

 

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