26th June, 2021
By Doyin Adeyemo
“Depression? Never! I am too young for that”. “Mental disorder? God forbid. It is not my portion”. Myths. False assumptions. Misconceptions.
It is both alarming and surprising the number of myths that surround mental health, especially in this part of the world where we attach spiritual connotation to anything and everything. There are many stereotypes surrounding mental illness that are both harmful and stigmatizing.
One major misconception is that people with mental health challenges are unable to function in society. Every day, people dress up and go about their daily lives, completely undetected to be struggling. From the outside, they look completely normal. However on the inside, there is a battle ongoing.
It is important to note that there is no look to mental illness. A disheveled appearance isn’t a symptom of mental illness. Another misconception among the general public is the belief that individuals with mental illness are dangerous to the society. These misconceptions are not accurate and they contribute to stigmatization.
Mental illness is a general term for a group of illnesses that may impact on a person’s thoughts, perceptions, feelings and behavior. They include: depression, bipolar disorder, schizophrenia and other psychoses, dementia and developmental disorders including autism.
Many mental disorders are sever enough to impair a person’s ability to function. In fact, for many mental health conditions, significant impairment is a diagnostic criterion. In some cases, a mental illness may be less severe, and although a person experiences symptoms, they are still able to function normally, most of the time. This hidden condition is colloquially known as high-functioning mental disorder. Some of which are depression, anxiety, bipolar disorder among others.
High functioning mental illness is the term that has been adopted to describe those living with a mental illness that is almost undetectable. It covers a broad spectrum; they might have a job, be studying, dress well or even have the ‘perfect’ family lifestyle.
Those characterized as high-functioning are less likely to ask for help because they are convinced nothing is wrong, or that their feelings are invalid. These individuals are often discouraged from seeking treatment, as they tend to be told “but you don’t look like you are struggling” by those they discuss their feelings with.
Imagine someone who seems to be living a perfect life. She has a great job, a loving and supportive partner and plenty of fun outside of work. Getting to the office on time is no problem and she is one of the most productive employees at work.
There’s one problem though; she is miserable, unable to derive happiness from much of anything because she lives with high-functioning depression, it is difficult for people to understand how anything could be wrong.
High-functioning mental illness can be characterized by the same diagnostic symptoms as anxiety and depression, but those with it manage their daily life as though nothing is wrong, and some even excel in certain areas.
The diagnosis for high-functioning depression is officially called Persistent Depressive Disorder (PDD). Some experts believe that the term high-functioning depression stems from lack of clarity of Persistent Depressive Disorder or as it is otherwise called, Dysthymia.
As this form of depression may be less intense than others, it allows a person to live a relatively normal life without appearing sick to other people. Common symptoms include: sleeping too much or too little, decreased appetite or overeating, difficulty concentrating, low self-esteem, trouble making decisions and feeling of hopelessness.
There is a lot of controversy surrounding high-functioning depression on whether it is a true medical diagnosis or not, however, the fact remains that it exists. Just because one is typically able to get out of bed and present as “normal” to the world doesn’t mean that one is not suffering.
The stigma surrounding depression and other high functioning mental conditions can make seeking help difficult. These stigma include the belief that only those with severe symptoms, such as inability to function in daily life or with suicidal thoughts require treatment.
People often have a mental picture in their heads about what mental illness looks like, they think it looks like a complete inability to function; if the person is not roaming the streets or in the psychiatric hospital, then he’s totally fine. This stigma can cause those with high-functioning depression to believe they should quietly tolerate their symptoms. However, high-functioning depression is a severe disorder that can be debilitating.
Globally, more than 264 million people of all ages suffer from depression. In Nigeria, one in four people suffer from sort of mental illness. According to WHO, Nigeria has Africa’s highest case load of depression, and ranks 15th in the world in the frequency of suicide.
A Mental Health in Nigeria Survey conducted by Africa Polling Institute (API), in partnership with EpiAfric in 2019, estimates that 20-30% of the Nigerian population are believed to suffer from mental health disorders. For a country filled with people that love life, this figure seems unbelievable but according to the report, “the reason for this high figure has been attributed to economic hardship, negative environmental externalities and the rising cost of decent living in the Country”.
The advent of the COVID-19 pandemic ushered in a surge of depression cases. The socio-economic inequalities resulting from job losses and other barriers including reduction of salaries, shortage of daily necessities, insecurity, separation from families, and loss of loved ones have been reported to worsen depression in Nigeria. With the high poverty rate of the country, and the difficulties faced by Nigerians every day, it is likely that the prevalence of depression among Nigerians will continue to increase.
The abysmal lack of mental health services, ignorance, shortage of qualified personnel, financial difficulties and stigmatization are some of the myriad of challenges usually faced in seeking and utilizing mental health services in Nigeria.
These challenges have long lasting consequences, as depressed patients who are untreated are more vulnerable to suicidal thoughts and suicide. It is more worrisome because due to our culture in Nigeria, those who have high-functioning depression will be hesitant to speak up, some are even completely oblivious of their situation, a great number of them are forced to suffer in silence thereby causing a surge in the number of suicides.
In dealing with the menace of mental illness, it is important to address issues around prejudice and discrimination through sensitization and mobilization particularly through non-governmental organizations. Well-planned public awareness can help to reduce stigma and encourage people to seek help.
More mental health professionals should be properly trained and empowered to provide specialized care for people with mental illness. It is worthy to note that depression sometimes is a result of poverty and economic crises, hence, the Federal Government must make efforts to improve the state of the economy.
People living with mental disorder need significant support and care from those around them, the support of family members, friends, peer groups, colleagues and even religious organizations will definitely go a long way in stemming the tide of depression and other high functioning mental disorders in the country.,
-Adeyemo is of the Ministry of Information and Strategy, Alausa, Ikeja.