The word “packaged madness” was received with a roar of laughter that had a tinge of approval and associative unison – everyone could relate. Off the bat, Dr Maymunah Yusuf Kadiri stole our attention at the 2018 Pride Women Conference.
For her speech, Dr Kadiri opted for a title that suggested everyone is mad (and if you listened hard enough, you would have heard the whispered, “God-forbid” rejection from the attendees).
But, she wasn’t mincing words, her title: “Many Are Mad; Few Are Roaming” is the perfect description of the current mental discourse in our society today.
Also, this month is Mental Health Awareness Month and Dr Kadiri has answered our prodding questions on the issue of Mental Health.
What is mental health?
Dr Kadiri: The term ‘mental health’ is sometimes used to mean an absence of a mental illness. However, the absence of mental illness does not necessarily constitute complete mental health. Someone may not have a mental illness but they may not be satisfied with their life or striving to reach their potential. They may be surviving, but not thriving.
Mental health is our cognitive, behavioural, and emotional wellbeing. It involves how we think, feel, and behave. Mental health can affect daily life, relationships, and even physical health. Mental health also includes a person’s ability to enjoy life to attain a balance between life activities and efforts to achieve psychological resilience.
According to the World Health Organization, mental health is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
What causes mental health disorders?
Dr Kadiri: There is not one particular cause of mental disorders, rather there is a myriad of contributing factors to the onset of a mental illness, evidence through researches show that most mental illnesses are caused by a combination of biological, psychological, and environmental factors.
Biological Factors
Mental illnesses have been linked to abnormal functioning of nerve cell circuits or pathways that connect particular brain regions. Also, defects in or injury to certain areas of the brain have also been linked to some mental illnesses.
Genetics (heredity) is a biological factor in mental illness in that mental illnesses sometimes run in families, suggesting that people who have a family member with a mental illness may be somewhat more likely to develop one themselves. Susceptibility is passed on in families through genes. Although a person might inherit a susceptibility to a mental illness and doesn’t necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors such as stress, abuse, or a traumatic event which can trigger, an illness in a person who has an inherited susceptibility to it.
Prenatal damage: Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth an example is, loss of oxygen to the brain may be a factor in the development of certain conditions, such as autism spectrum disorder.
Substance abuse: Long-term substance abuse, in particular, has been linked to anxiety, depression, paranoia etc.
Psychological Factors
Coping with past or current traumatic experiences such as abuse, poor self-concept, neglect, bereavement or divorce will strongly influence an individual’s mental and emotional state which can, in turn, have an influence on their mental health.
Environmental Factors
Certain environmental stressors can trigger an illness in a person who is susceptible to mental illness. These stressors may include:
- Death or divorce
- A dysfunctional family life
- Feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness
- Changing jobs or schools
- Substance abuse by an individual or family members.
How do you diagnose a person with a mental disorder?
Dr Kadiri: Diagnosis of a mental health disorder can only be given by a mental health professional. To begin, with the mental health professional will gather information from the individual through a detailed interview which includes finding out the individual presenting complaints, symptoms, and their life history. Additional information is sometimes obtained from the person’s family or caregivers and from previous treatment records. A physical examination, lab tests, and psychological assessments will then be conducted to rule out other illnesses.
After the information has been obtained, the professional will begin to determine if the person’s symptoms match up with one or more official diagnoses. Each diagnosis is made up of a list of common signs or symptoms. The professional will compare the symptoms the person is experiencing with the list of symptoms that comprises a specific diagnosis. If the person’s symptoms closely match the ones on the official list for a particular disorder, the diagnosis can then be made. The defining symptoms of each mental illness are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual is used by mental health professionals to diagnose mental conditions. It is not unusual for an individual to have more than one diagnosis at a time.
After diagnosis what are the next steps?
Dr Kadiri: After diagnosis, a treatment plan will be made. The treatment depends on the type of mental illness the individual has, its severity and what works best for the individual. In many cases, a combination of treatments works best.
If the individual has a mild mental illness with well-controlled symptoms, treatment from a mental health professional may be sufficient. However, a team approach is appropriate to make sure all the medical, psychological and social needs are met. This is especially important for severe mental illnesses.
Since there are various types of mental disorders, do most or all of them need professional help to treat?
Dr Kadiri: All mental disorders need mental health professionals to properly manage them.
Can most mental health disorders be successfully treated?
Dr Kadiri: Yes. Most mental health disorders can be treated successfully with a combination of prescription medications and psychotherapy. Many people who have a mental illness, and are 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 degree someone is going to get better. This, therefore, states that, when the individual gets relieved of the symptoms, they might experience a relapse. This is, however, not a common occurrence.
In Nigeria who is more prone to have mental breakdown men or women?
Dr Kadiri: Statistically, women are twice more likely to develop a mental illness than men. With regards to depression, women may be at a higher risk for depression due in part to oestrogen, which may alter the activity of neurotransmitters that contribute to depression. Additionally, males are 4 times more likely to take their lives and make up 79% of all suicides, while women are more prone to having suicidal thoughts.
Mental health issues have become a topic of concern in our contemporary media. Historically Nigerians have held on to the opinion that issues of mental health are un-African, resulting in its dismissal. But, despite our unfazed attitude, the suicide rate in Nigeria has risen at an alarming rate in recent times. Do you think that the current sociopolitical and economic state of our country is partly to blame for the rise in suicide rates or what do you suppose have led to this?
Dr Kadirir: The current socio-political state of Nigeria is indeed traumatizing, however, it is not an actual cause of a mental illness; rather it is a trigger. The dismissal of mental illness due to it being ‘Un-African’, has led to individuals, families and organizations denying the importance of mental wellness and thereby not seeking help when needed, which in turn aggravates symptoms of illnesses till they become damaging. Statistics have shown that Nigeria ranks 30th out of 183 nations with 15.1 suicides per 100,000 population per year. In 2016, a report stated that Ogun and Lagos states had the highest figures of 25 and 12 respectively. This is not an entirely accurate number as most families deny the true cause of death, additionally, for every successful suicide, there are at least 25 attempts
How can Nigerians, young and old, be properly sensitized on mental health disorders?
Dr Kadiri: Both young and old Nigerians can be properly sensitized on mental health disorders in the following ways:
- Mental health professionals should educate individuals about mental illness and mental health. They should teach individuals or communities about the signs and symptoms and where to receive help when they experience such.
- Mental Health First aid should be taught to individuals, communities, organizations and schools, to help with better identification, awareness and management of the initial occurrence of a mental related issue.
- Non-judgemental speaking about mental health issues should be encouraged to facilitate better awareness and reduce the stigmatization and rejection of individuals with mental illness.
Mental health and domestic violence may seem like mutually exclusive terms, but with a condition like post-traumatic stress disorder, the gap quickly blurs out. Can we marry the two together in a cause and effect order using the principle of causation?
Dr Kadiri: Mental illness and domestic violence are in itself both a cause and an effect. This is because domestic violence could lead to the onset of a mental illness such as depression, post-traumatic stress disorder, acute stress disorder, etc. Similarly, an individual who has an already existing mental illness, such depression, social anxiety, low self-esteem, etc. or was a victim of some form of abuse in the earlier parts of his/her life could be more susceptible to being in an abusive relationship that could entail, physical, sexual, emotional and/or psychological abuse. Which are all components of domestic violence. Hence, the principle of causation will not be ideal to explain mental health and domestic violence, rather, it is the principle of interaction.
More Nigerian youths are experiencing depression especially in our current fast-paced world of instant gratification is this your observation and if so what can be done to check it?
Dr Kadiri: The need for instant gratification is inherent in all individuals, from birth. This concept is known as the ‘pleasure principle’. However, it has significantly increased as a result of the popularity of social media which has in some cases triggered depression. Educating individuals about the ultimate ideals of life and ‘unrealness’ of social media can aid in reducing the impact of social media on their mental health.
When it comes to issues of mental health, what advice can you proffer with regards to how an individual can safeguard his mental health if such issues are not genetic in his lineage?
Dr Kadiri: To begin with, an individual that has had a history of mental illness in his or her family is only susceptible to having a mental illness, this doesn’t mean the individual shouldn’t safeguard his or her mental health. Every individual should safeguard their mental health by:
- Engaging in exercise to clear your mind and get your blood flowing. When you exercise you release endorphins in the brain that help to improve your mood. Exercise also helps with sleep and can lead to improving other areas of your physical health as well.
- Take a mental health day when you need it as mental health can affect physical health. To perform at your best, you have to take care of your whole self. Caring for your overall health includes caring for your mental health.
- Ask for help, even when you think what you’re dealing with isn’t “bad enough”. Sometimes we underestimate our emotional needs, we all need help from time to time, and there’s strength in asking for a hand when we need it.
- Take some alone time, go off the grid for a while as it can be challenging to stay calm when things in life feel hectic. Stepping back from the stresses may help you feel relaxed.
- Laugh more; laughter can improve one’s quality of life mentally, emotionally, socially and physically. Laughter reduces stress hormones, lowers blood pressure and improves an individual’s mood.
Dr Maymunah Yusuf Kadiri popularly referred to as “THE CELEBRITY SHRINK,” is a multiple award-winning Mental Health Physician & Advocate. She is the Medical Director and Psychiatrist – In – Chief at Pinnacle Medical Services, Nigeria’s leading and foremost Psychology and Mental health clinic.
The founder of Pinnacle Health Radio, Africans #1 online health radio. Also, the founder of a non for profit organization, “Pinnacle Medicals SPEAKOUT INITIATIVE” which is geared towards creating awareness on psychological and mental health related problems in Nigeria and beyond.As a forerunner in the practice of Mental health, Neurofeedback/Biofeedback therapy and other novel therapy techniques in Nigeria, she continues to be the most sought-after Psychiatrist and Psychotherapist in Nigeria and beyond.
She is a trained and certified Rational-Emotive and Cognitive Behavioural Therapist from Albert Ellis Institute, New York, and Beck’s Institute for Cognitive Behavioural Therapy, Philadephia, USA. Also a certified Trauma Counsellor, sexual and reproductive health expert, and Occupational health and safety Physician.
Dr Maymunah was a speaker at the 2017 and 2018 Pride Women Conference.
To register to attend the 2019 Pride Women Conference please visit
www.prideconference.org