Covid-19 brings mental health issues to the fore

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Leading medical doctor and psychiatrist Sacrifice Chirisa says issues of mental health will become central as Zimbabwe battles the coronavirus pandemic.

Leading medical doctor and psychiatrist Sacrifice Chirisa says issues of mental health will become central as Zimbabwe battles the coronavirus pandemic.

Chirisa (SC) told Alpha Media Holdings chairman Trevor Ncube (TN) on the platform In Conversation with Trevor, that the outbreak of the disease — which has killed tens of thousands of people globally since it was first detected in China late last year — was causing a lot of anxiety among Zimbabweans.

He said doctors were getting a lot of calls from people that thought they had the disease when they were not infected because of the anxiety. Below are excerpts from the interview.

TN: You are a medical doctor and a psychiatrist, which is also important during this period when people are in isolation and feeling anxious.

All along you have been saying that you are not happy with how mental health is being dealt with in the country, why is that so?

SC: It has to do with the historical perspective where mental health was not held in high esteem. You look at all the programmes that were being run in the past, they were focused on physical health, but if you look at the definition of health by the World Health Organisation, it says, “health is not just the absence of diseases but has to do with your physical, mental and social wellbeing”.

What companies have done in their wellness programmes is that they have focused on the physical being and have totally forgotten the social and mental, which is the psycho-social being we are advocating for.

Mental health is key in everything we do.

TN: What do you think needs to be done to give mental health the attention it deserves?

SC: Awareness like what you are doing now; interviewing us and talking to us.

As the black population, we have treated mental illness with speculation and misinformation and it has to do with our interpretation of what causes it and everyone wants to hide it because it has to do with spirits, witchcraft, avenging spirits, yet it is a discipline in the medical field.

TN: I think there is a lot of stigmatisation within our societies and communities, is it not so?

SC: So much stigmatisation, it is so high not only is it among the patients, but health professionals too. The day I said to my family I wanted to be a psychiatrist they were all up in arms, saying why can’t you be a gynaecologist, neurologist or physician.

They tried to talk me out of being a psychiatrist.

They said if you treat people that are ill you will also become like one of them. That is the notion that was there and it is still there.

TN: Stigma and superstition too?

SC: In Africa, yes, with superstition that makes it very difficult, especially when we look at our religions, two broad spectrums of our religions.

We have Christianity and their interpretation is that if someone is suffering from psychiatric and mental problems, a demon is attached to them; and if it is from our tradition, it has to do with avenging spirits, winds that have been sent by a relative who does not want them to prosper.

These kinds of interpretations are the ones that make people feel discriminated or hold back and not search for things that can be treated.

TN: We decided to speak to you because of the pressure that people are having under this 21-day lockdown and indeed the worldwide lockdown that everyone is experiencing.

We had gathered that this pressure is bringing about a lot of anxiety, a lot of things that cause tension between families and communities.

What have you experienced, what are your clients saying and what are people coming to you saying in terms of help?

SC: For the past two or three weeks especially when Covid-19 became known that is was in this country, I am receiving calls from hundreds of people who think that they have Covid-19.

Every cough, sneeze and throat irritation is Covid, but it is not true.

What makes it difficult with Covid-19 is that the symptoms that it represents with are also common with other problems.

People with asthma or hay fever who experience shortness of breath will think of Covid-19.

We are receiving many calls from people who think they have it because of the similarity of symptoms, which is causing a lot of health anxiety.

TN: Are those people prepared to go for testing or they would rather come to you?

SC: The reason why they are calling is because they do not want to go for testing.

There is one who I said you should go for testing, but the person then said I am not prepared because I might actually contract it there.

There is fear of medical facilities.

That is why we have seen at most of our testing centres — the numbers might be low because people actually are afraid of going there and also what happened with our first demise case, it was bad publicity, so people are scared.

It is good and comforting to see that a lot of effort has been made by the ministry and government to improve the conditions of Covid-19 hospitals and definitely there is a big change.

TN: When they reach out to you, what is it that they are looking for?

SC: What Covid-19 has done is it has caused a lot of fear. And when you have fear, you enter into a zone of worrying and overthinking.

People’s minds are not resting, they are thinking that they might have it and I might be one of those 20% who are dying, what will happen to my kids, what if I pass it to my family.

You have all these unanswered questions because anxiety has to do with worry about the future and you know you are not in control.

Human beings are naturally pessimistic.

We look at the worst-case scenario and that is what is driving the mind — worry and fear which then brings about anxiety and depression.

We have been receiving updates about Covid-19 these past few months. So we have been fuelling our minds with this information.

TN: There is a name for that condition, you call it hypochondriasis where people feel as if they have a disease, which they actually do not have but are not willing to go out and be tested for that disease.

SC: The typical hypochondriasis is whereby somebody will have a lot of sicknesses or symptoms of diseases that are actually out there but they do not have the disease.

They have sensations in their body that feels like they have the disease, which is then driven by fear.

They then go to one doctor and another and have operations to try and prove the theory that they have this disease.

This whole Covid-19 thing is driving us into that feeling that I might have it right now.

TN: What advice do you give to people sitting at home right now, who feel anxious and stressed because they are consuming this negative news about Covid-19 and they think that they have it?

SC: Given the way this pandemic has hit the world, it is normal for anyone to feel anxious.

If you are not thinking about it then there is something wrong with you.

However, there is an extent of the anxiety, which then stops you from being functional.

You can no longer function, you cannot do what you are expected to do, you cannot concentrate or your mind is now fixed on the Covid-19 and you start to experience shortness of breath and restlessness.

It is no longer a normal expected anxiety, but it is now a condition and disease level of anxiety.

TN: What do you suggest someone in that condition does?

SC: If you realise that you have serious signs and symptoms of anxiety and you know that it is starting to affect the way you feel, you can then say what can I do to help myself.

One of the most important things to do is to stop feeding your mind with negative views and interpretations.

You must lock and cut off the news because that is what is feeding the fear.

If you need information get it from reliable sources, WHO and websites that give information that is true.

The second thing is can I handle this anxiety using psychosocial strategies, relaxation techniques and breathing exercises.

In Zimbabwe we have put up a Facebook page called Sound Mind Zim where we are uploading videos of how people can help themselves, eg, relaxing techniques and breathing exercises since they bring anxiety down.

We are also training doctors and frontline workers on how to treat anxiety medically because there is so much of anxiety out there.

l “In Conversation With Trevor” is a weekly show broadcast on YouTube.com//InConversationWithTrevor. Please get your free YouTube subscription to this channel. The conversations are sponsored by Titan Law.