In Africa and Nigeria as a whole, awareness and knowledge of Mental Disorder is extremely low making it difficult for such patients to access adequate and prompt medical attention. Furthermore, factors like lack of health facilities, inadequate skilled mental health practitioners, low socioeconomic status and poor health seeking behavior further reduces the number of patients getting proper mental health care.
Mental health as defined by WHO is “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community”. It includes how we feel about ourselves, how we feel about others and how we can meet the demands of life. Mental Disorder on the other hand according to WHO is “the collectively all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood or behavior associated with distress and/or impaired functioning”. In this article, we will look at the 8 common mental disorders affecting Nigerians.
It is the most severe form of functional mental illness affecting most Nigerians and it is also found to be the most common mental disorder worldwide. It is commonly described as a severe, chronic and disabling mental disorder characterized by psychotic episodes with recurring functional periods of disordered thought process. It mainly affects perception and thinking hence giving rise to a spectrum of clinical scenarios. Common symptoms of schizophrenia include; delusions, hallucinations, disturbance of thought, disorganized speech, difficulty in concentration and poor memory.
2. Anxiety Disorders
This is a heterogeneous group of disorders with abnormal fear and stress as the main underlying disorder. Anxiety is said to be abnormal/a mental disorder when symptoms interfere with the individual’s normal productive activities and its harmful effects outweigh its benefits because fear and stress is necessary for human survival. An anxiety disorder involves an excessive or inappropriate state of arousal characterized by feelings of apprehension, uncertainty or fear. This disorders can be differentiated into Generalized Anxiety Disorders (GAD), Panic Disorder (PD), Obsessive Compulsive Disorder (OCD), Phobic Disorders (including social anxiety disorder), Post-traumatic stress disorder (PTSD), Acute stress disorder, with each of them having distinct clinical symptoms.
3. Personality Disorders
Personality disorders are defined by the American Psychiatric Association (APA) as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it.” The beginning of these patterns of behavior can typically be traced back to late adolescence and the beginning of adulthood, and, in rare instances, childhood. This deviation from personality is severe enough to affect the interaction of the patient with his/herself and with the community.
Examples of personality disorder are Paranoid personality disorder (excessive pervasive distrust and suspiciousness of others), Schizoid personality disorder (detachment from social relationships and a restricted range of expression of emotions), Schizotypal personality disorders (acute discomfort with reduced capacity for close relationships). Others are Obsessive-compulsive personality disorder, Antisocial, Histrionic (excessive emotionality and attention seeking), Narcissistic personality disorder (grandiosity in fantasy or behavior with need for admiration, and lack of empathy), Avoidant and Dependent personality disorders.
4. Premenstrual Tension
This is a collection of physical, psychological and emotional symptoms related to a woman’s menstrual cycle and should be severe enough to interfere with some aspects of life. 80% of women have some of these symptoms at one time or another during their menstrual cycle, but only 2-5% meets the criteria for premenstrual tension. These symptoms are different from the discomfort associated with menstruation. It is due to the changing level of sex steroids accompanying ovulation during the menstrual cycle. Common symptoms are irritability, emotional liability, headaches, anxiety, depression, weight gain, breast pain, syncope. and paresthesias.
5. Postpartum Blues
It is a very common mental disorder as it occurs in about 50- 85% of women. Symptoms typically peak at about the 4 – 5 days post-delivery. It may last for a few hours to a few days, resolving spontaneously by 2 weeks after child birth. Symptoms include; mood lability, tearfulness, anxiety, and irritability. Symptoms do not interfere with the woman’s ability to function.
6. Postpartum Depression
Usually occurs within the 1st 2 – 3 weeks post-delivery, but may occur at any point after delivery. Milder depressive symptoms may have occurred during the pregnancy and are usually not observed by the patient, spouse or caregivers. Symptoms are similar to those of depression occurring at other times in a woman’s life. It affects 5 -25% of Nigerian women. Common symptoms include; depressed mood, tearfulness, feelings of guilt, feelings of worthlessness or incompetence, fatigue, sleep disturbance, change in appetite, poor concentration. and suicidal thoughts.
7. Postpartum Psychosis
This is the most severe form of postpartum psychiatric illness affecting Nigerian women after childbirth. It is a Psychiatric emergency that needs urgent treatment by a psychiatrist. It occurs in 1-2% per 1000 Nigerian women after child birth. Its onset is usually with 48-72 hours after delivery. Majority develop symptoms within the 1st 2/52 post-delivery. Onset is usually sudden and it is characterized by severe aggressiveness, loud cry/shouts, suicidal attempts to self and the baby.
8. Sleep Disorders
This is a spectrum of disorders affecting an individual’s sleep. It can affect the quality, depth, pattern and rhythm of sleep. A bad night’s sleep could produce: irritability, low efficiency, and productivity at work, difficulty in school work, health and relationships also suffer. Typically, there is difficulty initiating or maintaining sleep, Narcolepsy which is the irresistible attacks of refreshing sleep occurring daily, accompanied by episodes of brief loss of muscle tone (cataplexy), Sleep-wake schedule disorder and other abnormalities that can occur during sleep.