TAKE A CHILL PILL

Anonymous Submission

I was having a rough couple of days. I was irritable. I was moody. I was snapping at everyone. My emotions were raw. 

A few days prior, I’d had a session with a clinical psychologist. I thought it went well. During the session, I almost had a panic attack and I thought after it passed, everything would be ok, or at least it would be heading in that direction. Little did I know that it would bring up raw, strong painful emotions to the surface. This was, by the way, not my first session, or my first therapist. The very first one I saw was a little strange. She wanted to clean the “aura" before I sat down and at that time, it was quite hilarious to me. 

Anyway, this new guy seemed to know what he was talking about. He let me talk, he asked me questions, he asked me why I thought people around me reacted to me the way they did - in hindsight. It clicked then that they may have been having issues of their own, but I took it how I took it and that learned behaviour has continued for the most part of my life. He even gave me homework. He asked me to allow whatever I was blocking to come to the surface. I remember shaking my head ‘no’ and then lightheadedness and voice telling me I’m gonna be OK. For once, I felt validated because I’ve always felt different and believed everyone that said I was a little too emotional and for once, I was told I was ‘sub clinically depressed with suicidal tendencies.’

Fast forward to a day after the session I was just stark raving mad. Everything was annoying me. I was called out on a lot of things - which I thought were valid reactions but apparently, I was acting way out of the ordinary. It was hard enough trying to not swear or say something lest I ‘hurt' someone’s feelings, but then I was asked to take a chill pill. This was funny to me because the person who told me to take a chill pill did not know that I had an actual chill pill that usually helps with my non-imagined anxiety. And so I took my chill pill and of course, it did what a chill pill is supposed to do. 

I’m still mad. My emotions are all over the place. Much like a woman who’d just had a baby - I would know this of course because not only did I have the expected all over the place emotions after my baby was born, I also had post-partum depression. That's not a happy feeling, especially when you do not have someone that understands. To people it’s just you acting up and so, like I always say, you put a lid on it… and then one day, as expected, it goes boom. What happens when you don't have a chill pill?

Prevalence Study Dissemination Session 

Gede Foundation, in partnership with the Institute of Human Virology, Nigeria (IHVN) embarked on a joint research project in 2015 to find out the prevalence of depression, alcohol use, and suicidality among the HIV population in Abuja. The study was conducted in 3 conveniently-sampled sites—Asokoro District Hospital, Garki Hospital Abuja, and the University of Abuja Teaching Hospital in Gwagwalada. A total of 1,187 respondents participated in the study, making it one of the largest studies done in Nigeria among the HIV population so far.

At the dissemination session, Mr. Godwin Etim (Performance Director for Resource Mobilisation and Partnership Management) moderated and served as master of ceremonies. He read the welcome address of John Minto (Managing Director, Gede Foundation). Dr. Ernest Ekong (IHVN Clinical & Medical Services Director, IHVN) presented a background of how depression and alcohol use could affect the two most important aspects of positive health outcomes, i.e., adherence to medication and productivity. People diagnosed with HIV who also experience clinical depression more likely do not seek help or delay help seeking and tend not to adhere to medication, thus negatively affecting health outcomes.

Dr. Cynthia Ticao (Performance Director, Research & Advocacy, Gede Foundation) presented the results of the study. Major depressive episode (MDE) was experienced by 28.2% (n=335) of the participants. Alcohol abuse was reported by 7% (n=35) and 7.8% (n=93) were found to have experienced harmful alcohol use. One hundred and seventy (14.3%) participants thought about committing suicide throughout their lifetime, with 2.9% (n=35) doing so in the 12 months prior to the study. There were 27 participants (2.3%) who attempted suicide at least once in their lifetime.

Attendees at the dissemination session (Dr. Pat Matemilola - HiFass, Dr. Evans Onyekele - Gede Foundation’s Board Chair, Dr. Ernest Ekong - IHVN Director of Clinical Services and Co-Investigator for the project), Ms. Anthonia Ojokojo from the Society for Community Development (SCD), Mr. Samuel Jinadu - Karu Behavioural Unit, Dr. Avese Torbunde - IHVN, Yusuf Abubakar and Egbo Lincoln - Research Assistants) actively participated in the Q&A portion, asking very important questions such as: What next? What direction should organizations working for people living with HIV/AIDs (PLWHAs) follow now that we have evidence of the prevalence of depression, alcohol use, and suicidality among PLWHAs? 

The inclusion of mental health care into the National Strategic Framework on care and support is a big step towards the next impactful step forward. Gede Foundation and IHVN are confident that the study has earned the attention of the national authorities responsible for policies that will affect the lives of millions of PLWHAs in Nigeria.

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Ms. Jeremy Boglosa being presented with an award

Dr. Ticao being presented with an award

Board Chair, Dr. Evans shows Founder's award 

Gede Foundation and IHVN are currently restricted from publishing the study as it is being considered for peer reviewed publication. We can certainly meet with your organization to discuss the results if you missed the dissemination session. Please contact us at info@gedefoundation.org.

 

Mental Health Camps: April Rounds

Written By Zunzika T. Okpo 

Gede Foundation held another round of Mental Health Camps, one on Saturday, April 22nd and the other on Monday, April 24th, 2017 in Mpape and Mararaba, respectively. 

As always, there were new, and older cases that came for follow-up. Perhaps the most satisfying, was a case, that most of our regular readers would be familiar with, of the lady that was chained to a pole in a church for over a year. The lady in question is now doing a lot better and in medical terms, she now ‘stable’ and was able to narrate her story from her own point of view. She claimed that when she was pregnant, 4 years ago, she was diagnosed with high blood pressure. She was overthinking everything as things were not going well for her and her husband.  When it was time for her to have her baby, she was in labour for over a week and throughout this time, she kept hearing voices telling her to leave. She stayed, however, and was able to deliver her baby. After she was discharged, everything went back to normal and she was caring for her newborn. When the baby was a few weeks old, she started getting upset at every little thing. One day, when the baby was 3 months old, she had a fight with her husband, got so angry that she left the house. After she left, she walked for such a long distance that she did not know where she was anymore. All she had with her were the clothes on her back and a handbag containing some money. As she could not find her way home, she ended up sleeping on the streets for sometime. Everything looked confusing to her. She did not know anywhere or anything. She eventually began to beg until she had a moment of lucidity and asked for directions to her house. She had apparently been away home for over a week. She was dirty, disheveled and had her lost her bag, save for the clothes she was wearing. When she eventually got home, her husband asked her to escort him to a church. She obliged. Little did she know that she was going to be chained to a pole for a very long time. That was where she had been from the time her child was 3 months old till he turned 3 this year. Right now, through the BasicNeeds livelihoods support part of the project, she was given money to buy a sewing machine and is back to being a fashion designer. She seems determined to advocate for herself and others, to stay in the support group and to adhere to her medication. 

From the new cases, there was a 56 year old woman who talks to herself and has visual and auditory hallucinations. She has been a patient of a behavioural unit for over 30 years but relapses regularly which renders her unstable. She also tends to wander off. Another lady in her 20s has disorientation, usually sudden and lasts over a week. At the time the Psychiatrist saw her, she presented with poor memory and could not even recall where she was serving her NYSC (National Youth Service Corps). She has a form of epilepsy which is characterised by sudden disorientation instead of a series of seizures. An elderly lady, in her 80s, has had wandering tendencies, poor memory, poor sleep and unresponsive to people for over 30 years. She laughs to herself, and also talks to herself. She was diagnosed with schizophrenia and placed on medication. Interestingly, an 11 year old also presented with the same complaints and has been this way for 2 years. 

A man in his 70s started forgetting things and became very aggressive about 10 years ago. This behaviour continued, coupled with visual hallucinations and wandering tendencies. 

It is encouraging to note that the message is getting across; support groups have been formed for our older users and even the new ones. They can support themselves emotionally, financially, if need be and in any way they see fit. 

Please come back for more updates on our work in the field! 

As The Pendulum Swings: Nkechi's Story

Nkechi at first glance is pure perfection; the definition of beauty and brains. I was unprepared for the story she was about to narrate to me during our Skype talk. 

It started suddenly when I was in college. I was happier than usual, I felt I could do anything. Of course, the fact that parents tell us we can do anything and be anything we want, did not help in this case. Being in the media department, I had so many projects I thought I could do - all at the same time. I wanted to write several scripts, I wanted to do photography, because, obviously, the photographer had no clue what he was doing and that was irritating me (he was a professional). I also wanted to anchor another show apart from my own. Because these things obviously fell through, I went on another spiral. I decided to go for a drink with a few friends. What started innocently (or so I thought) quickly turned sour. I went and tried to play ‘bartender’. The drinks were taking forever and I could do it just as well, right? It was cute at first but after my third try, I was given a warning. I left my friends and told them I wanted to go swimming. They were all tipsy and no one really paid me any mind and so I left. I went to a hotel in Abuja and jumped into the pool. It was at that moment that I felt at one with the water. I loved it. I couldn’t possibly drown could I? I was, after all, the queen of the sea. Did I mention that I cannot swim? It took a while for me to be fished out of the water and taken to the hospital. As I sobered up, I started thinking the people in white coats were out to get me. I had to leave. There was work to be done. I wanted to repaint my apartment that I shared with my then boyfriend. I wanted new furniture, but before that, I needed to stop at a store to buy new clothes because this hospital gown just wouldn’t do. I also needed a phone as my telepathic messages to my boyfriend were not going through. So much for being queen of the sea. Where were my special powers? I had too much work to do. Sleep was a waste and it seemed like that is what they wanted me to do at this place with the weird people in white. I somehow managed to slip out. They hadn’t called anyone as I had lost my phone and now I was wondering aimlessly, not quite sure where I was. Eventually, I got home to find a worried and upset boyfriend. I was excited to tell him about my adventures (those I could recall) but he didn’t find it as exciting. I was apparently telling him about so many things I wanted to do but had so little time. I kept jumping from idea to idea till he just left for work. I stayed home re-arranging everything, literally everything. I tried to make several dishes because I just had to. This went on for a while and eventually, my exhaustion caught up with me.

It seemed like a lightbulb had been turned on in my head and I was watching my life as one would a movie. Had I done these things they said I did? How could I be failing my classes? Who sanctioned tattoos all over my back? One of them was a man’s name with ‘forever’ after the name. I was a big girl but I lost weight. I couldn’t bathe, I couldn’t get out of bed. I probably reeked. I hadn't combed my hair in a long time. I kept telling myself that I was just a waste of space. How could I have allowed myself sink so low? To my family, I was a disgrace. That was the first time I decided it really was not worth it. Everyone’s lives would be far better off without me. I decided my 23rd year was going to be my last and so I slashed my wrists. I bandaged it later on and then tried deeper when I was left alone and once again I landed in the hospital. My mother was wailing, asking me what she had done to deserve such a daughter. My father was seething and you could see the disappointment in his face. After my boyfriend explained what had been going on the past couple of months, the doctor suggested I see a psychiatrist. Upon hearing psychiatrist, he ran faster than Usain Bolt; ran right out of my life. It’s comforting to know my twin brother was by my side for the psychiatrist visits and eventual diagnosis. I’ve since left Nigeria and I try to stay out of the limelight. I am married with kids now and that’s not something you want your kids to be associated with. Perhaps with time, I will tell them about my struggles. I now know when my mania or depression is about to hit and I take my medications regularly, I exercise and eat healthy too. My diagnosis is Bipolar Disorder and I’ve learned that once you accept it and do what is necessary, you will be OK. This is just one of the times I have fallen off the wagon. However, it was the defining moment for me.”

Nkechi now lives in the US with her husband and two kids. Edited by Zunzika T. Okpo with Nkechi’s permission. 

Concealing an Illness – Stigma, Shame or Privacy Right?

Written by Ekaette Udoekong

The disclosure of one’s health status comes with a lot of sensitivity. There are various factors to consider, such as confidentiality and the right to privacy. It is not enough to dwell on good intentions and invade another’s right to privacy. Although informed consent is sought prior to the treatment of some illnesses, situations arise in which some of these ethics are ignored.

In February 2017, a close friend passed away. He was young but ill, very ill. Nobody, not even family members or friends, knew what he was suffering from. At first, he was aggressive when he was asked to seek medical attention and adamantly refused to talk of any sickness even when it was obvious his health was deteriorating. What is the phobia of hospital called? Nosocomephobia! This might not have been Michael’s reason for refusing to seek medical attention. May be it was shame or stigma but Michael was not even diagnosed of any condition because he did not accept that he was sick. Or maybe he had the right not to go to the hospital because it was his life and could deal with it his way!  

There are a number of reasons why people do not disclose their health status. The most popular among them is stigma, pity, anxiety and concerns of family and close friends. Strangely, Michael might have had the right not to disclose his status to anyone but what if he had a communicable disease (depending on form of transmission) that needed him to be isolated and treated, do we, his family and friends not have a right to be disease free? 

I remember telling Michael that he needed the help of a Psychiatrist or a Counsellor. He responded calmly that he was not sick and he definitely did not have a mental health disorder. Months past, family and friends watched Michael go out and come in, gradually losing weight. Later on, he could not even leave his bed and perhaps the time came that he thought was appropriate to seek medical attention - only then did he agree to be taken to a hospital. The Doctor said he was physically sick and was also very depressed because of what he suffered from.  In situations such as these, how could family member manage his refusal to seek medical help? Should rights be considered first when handling health status disclosures or offering care to the sick? For us at Gede, we work to lessen the suffering of individuals/communities that are underserved and stigmatized because of their health conditions, and this calls for action within the civil society organization especially those providing health services,  to integrate elements of mental health to their overall service delivery. This may not have saved Michael but it may help someone else who is in a similar situation.

 

Gede Presents Results of Prevalence Study Project

Yesterday, 19th April 2017, Gede was invited by NACA’s Treatment Care and Support Technical Working Group to share its findings on the recent Prevalence Study Project with People living with HIV-AIDS. Dr Cynthia Ticao presented the study design and key findings from the 3 conditions under the study—depression, alcohol abuse and suicidality.

These results had remained one of the catalysts driving the integration of mental health services into treatment, care and support for PLHIV in Nigeria for more than a year.

The meeting that was attended by representatives from WHO, PEPFAR, CDC, IHVN, NACA, MSH, CRS and others from the Federal Ministry of Health, reorganized the significance of this integration and considered as key in enhancing adherence to HIV treatment. It will be worth mentioning that the 2 important aspects of this advocacy had been achieved, namely: i) mental health in the National Strategic Framework (2017-2022), and, ii) inclusion into the recent Country’s Global Fund Grant application for 2018. 

Maiden Yoga At Gede Foundation

Do you want to destress, relax and rejuvenate? Join us at Gede Foundation, 13 Danube Street, every Friday between 4 and 5pm for only N2000. The instructor, Basant Ram is very experienced and has a desire to impart the benefits of yoga to others. He has pursued a career in Yoga and finished a course as Yoga Master. 

The Foundation held its maiden session on Thursday last week, April 13th. Please see pictures below and join us this week!! Call us on 080-5840-4610 for reservations as places are limited. 

See you April 21st at 4pm!

 

Rising Cases of Suicide and Suicidal Attempt Among Nigerians

By Ekaette Udoekong

In my local community, Ndon Ebom in Akwa Ibom State, young men and women were warned about families with a history of suicide. They were warned that it was passed down from one generation to the next. More often that not, suicides were seen as an oyibo thing, but recently suicides and suicidal tendencies are a common occurrence in Nigeria.

A few weeks ago in Lagos, Nigeria, a young man jumped into the lagoon on 3rd Mainland Bridge. Reports stated that he was a doctor and that this was not the first time someone jumped into the lagoon. There have also being reports from other states in Nigeria about attempted suicide and completed suicides. The big question then is, why are the services of the psychologists and psychiatrists not being utilised? Do the victims or their carers not know where or how to get help? Are they ashamed or afraid of being shunned?

There are a lot of stressors these days, ranging from financial failures, unemployment, inability to pay debts, family pressure, loss of a loved one, insecurities and broken relationships, and allof these could be depressive. In my local community, togetherness used to be a major factor in the prevention of these tendencies. Individuals could speak freely about their frustrations and losses and were consoled and counselled. Gossip was not paid any mind. Today however, individualism, culture mix, the high-homed ‘fences’ have gradually replaced communality and this has arguably increased depressive tendencies and substance/alcohol use.

Mental health has to be taken more seriously and it does not have to start with the government but with the mindset of the individual. Awareness needs to be created in our religious meetings, schools, local/town hall meetings. Mental health awareness has to be integrated into welfare regimes at workplaces, employers of labour should take cognisance of the mental health of their employees and come up with activities that aid relaxation.

Civil society organisations have a major role to play in this regard. At Gede SS (South South), managing stress in the work place programme will be one way to raise awareness. This programme will start soon at the zone. Look out for more information.

 

 

 

World Health Day 2017 - Depression, Lets Talk

On April 6th 2017, Gede Foundation, with the Global Association of Mental Health Awareness, (a Coalition of Civil Society Organisations, Non Governmental Organisations, Community Based Organisations, Clinical Psychologists, Psychiatrists, Faith Based Organisations on Mental Health in Nigeria), held a press conference at Gede Foundation Headquarters. The press conference was organised to raise awareness about mental health conditions with the media with a focus on depression which is the theme for World Health Day 2017.

Mr. Godwin Etim, the Performance Director: Partnership Management and Resource Mobilisation for Gede Foundation, welcomed participants and stressed the role of media in raising awareness about stigmatised and underserved health burdens which include mental health. Mrs. Udoh Margaret, representing the coalition, gave a speech in which she highlighted the rising number of suicide cases in Nigeria and linked it to the extreme case of depression.

Media representation at the press conference included NTA, AIT, CORE TV, NAN, Radio Nigeria, Kiss FM, Love FM, Galaxy TV, Vision FM, Powersteering Online, Aljazeera News Online, Voice of Nigeria, Cool Wazobia Info FM and many more.

During the question and answer session, the media sought clarification on where to get help for those depressed, and how to get help if they, or someone they knew was depressed and if there is a directory for mental health specialists in country.Mr. Godwin Etim informed them that there is, indeed a directory of psychiatrists and there are centres such as Karu Behavioural Unit in the FCT where they can access mental health services. 

Mrs. Udoh made reference to the National Institute of Mental Health and listed some common symptoms of depression some of which were persistent sadness, anxiety, or empty mood, feelings of hopelessness, pessimism, loss of interest or pleasure in hobbies, difficulty concentrating, remembering, and making decisions as well as having difficulty sleeping, amongst others. She insisted that any affected person seek help from a mental health professional immediately and if they are not able to do so on their own, a close friend or relative should seek help for them.

Participants at the press conference were interested in the details shared by Mrs. Zunzika Okpo (Media Officer - Gede Foundation) on the current community based mental health programmes by Gede Foundation. In her presentation she highlighted the dangers that are associated with substance abuse especially among youths in Mararaba and Mpape communities. Upon this revelation, the media were interested in attending some of the activities, including mental health camps that the Foundation conducts. It was agreed that depression plays a major role and can be termed as a silent killer and therefore, the media should play their role in disseminating appropriate information. 

Below are some pictures from the event as well as a video!

PHD

Recently, I have been plagued with a question. Will my exposure to mentally challenged individuals affect me? If so, how? Will it be damaging? Should I be scared or should I be proud of the work that I am doing?

A little background, in my work as a media officer, I have met a lot of people with mental illnesses; some illnesses that are strange to even imagine (dissociative identity disorder). It is a well known fact that talk of mental health is generally a taboo, especially in Africa. The fear of being affected has made me question myself when I see similarities between myself and for instance, someone that battles with depression. It is when thinking about this when I came across an interesting term. PHD. No, not PhD (Doctor of Philosophy) but, People with Hidden Depression.

I listened to a podcast which talked about this phenomenon. In it, I heard of a clinical psychologist who, in her career, had probably seen over a hundred patients with various mental health conditions. Interestingly, the psychologist also needed to see a psychologist after a while because of what she had heard over the years. To the outside world, she was a vibrant, warm, fun loving mother with an amazing job and husband. She was the type to volunteer to coach a volleyball team or the first
parent at a bake sale. She was hands on. She was always there for other people and not allowing others to be there for her. Over the years she had taken to self harm; either cutting herself or burning herself and expertly covering it up. She did everything that a seemingly depressed person is not supposed to do. So when she took a gun and shot herself, nobody understood the reasons behind it.

I’m not a clinical psychologist or a psychiatrist and I cannot be impartial. I cannot remove emotion from it all. Yes, it affects me. Sometimes I cry as I listen to some stories but the resilience of people who, for instance, could have ended it all but decided not to, is quite humbling. Others who face so many “demons” end their lives and I shudder to think what they go through. 

Sometimes I am scared. What if this was my life? Would I be like this? Why her and not me? The truth is I cannot tell your story if you are facing some kind of mental illness. You are the only one that knows exactly what your story is and the only one that can stand boldly and say this is how I feel or think. For instance, in the above example, the clinical psychologist wore a mask. She may had faced some depression and anxiety but hid it well; so well that not even her husband realised it. 

I suppose this is the problem with being highly functional; YOU ARE STILL FUNCTIONING and therefore may not fall under that umbrella that only caters to those who are NOT functioning due to their mental illnesses. It is difficult enough that mental health is one of the underserved and
stigmatised burdens without having to question functionality as well. However, with the work that Gede is doing in conjunction with the government, these issues will be brought to light eventually.

Written by Zunzika Thole-Okpo