By Dr. Ifedilichukwu Uzoeghe Uchendu Definition of Health: The World Health Organisation (WHO) defines Health to be the complete physical, mental, social well-being and not merely the absence of disease or infirmity. What is Mental Health? Mental health is the successful performance of mental functions in terms of; Thought, mood and behaviour that results in productive activities, fulfilling relationships with others, ability to adapt to change, ability to cope with adversity. (Sadock & Sadock, 2007) What is Mental Illness/Disorder? Mental Illness/Disorder could be defined as; 1. Illness associated with abnormal psychological or behavioural manifestations in terms of emotions, thoughts, cognition, sensory perceptions, beliefs and behaviour. 2. It could also be defined as a behavioural or psychological syndrome which is accompanied by stress and increased risk of suffering, pain, disability, important loss of freedom and death. It is important to note that society has divergent views of mental illness and its causes. However, the cause of mental illness is universal. The causes of mental disorders could be categorized based on the biopsychosocial model as follows; 1. Biological causes 2. Psychosocial causes 1. Biological Causes; These are things that could affect the brain directly or indirectly. These factors affect the normal functioning of nerve cell pathways that connect particular brain regions. They include: a. Hereditary (Genetics); some mental disorders could be inherited e.g. Schizophrenia, Bipolar disorder, and depression. Experts believe many mental illnesses are linked to abnormalities in many genes rather than just one or a few. Research has also shown that where both parents are suffering from some form of mental illness, the probability of mental illness in the children is quite high. The manifestation of mental disorders in genetically prone people may also be influenced by environmental factors. It is also noteworthy to state that genetics or heredity is just one out of many aetiological factors in relation to mental disorders. It is pertinent to note that there are many people suffering from mental illness who have no family history of mental disorders. b. Psychoactive substances; these are substances that when used by an individual, distorts the normal pattern of brain functions. These substances come in different forms and the mode of usage differs from one substance to the other. Some ways of consumption of these psychoactive substances include; inhalation, oral, Parenteral (Intramuscular or Intravenous) and Sublingual routes. These substances lead to the alteration of the chemical and electrical processes in the brain causing changes in cognitive functions, mood, behaviour, thought and belief of an individual. People who are exposed to these substances go from the stage of experimentation to misuse and might end up being dependent on these substances. Some examples of Psychoactive substances include; Indian hemp (cannabis /igbo/marijuana), Cocaine, Codeine (Benylene codeine), Heroine, Tramadol, LSD, Amphetamines, Shisha, Nicotene, Caffeine, Alcohol, Tobacco, Barbiturates, Morphine, Ketamine, Ecstasy, Evostic glue. c. Prenatal, Antenatal & Postnatal causes; a person could be made vulnerable or predisposed to mental illness right from the womb. Apart from the genetic factor, the environmental condition within the womb or the nutritional and health condition of the mother during pregnancy could play a major role in predisposing the unborn baby to having mental illness later in life. Some of these environmental conditions could be certain deficiencies which could range from trace elements [e.g. zinc, selenium, vitamins (vitamin B family), and folic acid] to certain viral infections in the mother [TORCHES syndrome (Toxoplasmosis, Other agents, Rubella, Cytomegalovirus, Herpes Simplex)] and severe anaemia. The process of delivery and the environment where the delivery is being conducted are also very important. Prolonged labour, use of forceps and unsterilized materials could affect the mental health of the baby. Brain trauma from the delivery process, Asphyxia, Jaundice, Neonatal infections, poorly managed childhood convulsions could also predispose one to mental illness. Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth may be a factor in the development of certain conditions like autism spectrum disorder. d. Infective diseases; certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as pediatric autoimmune neuropsychiatric disorder (PANDA) associated with the Streptococcus bacteria has been linked to the development of obsessive compulsive disorder and other mental illnesses in children. Other infections like HIV/AIDS, Meningitis, Typhoid fever, cerebral malaria, Syphilis could also lead to brain damage and the development of mental illness. e. Injuries to the brain; these injuries could be through road accidents, stroke, fall from heights. f. Exposure to toxins; some toxins such as lead may play a role in the development of mental illnesses. g. Primary or secondary tumors of the brain. h. Medical causes that influences the brain; Encephalopathy from liver disease, renal disease, cerebrovascular disease (CVD). These cause more of acute confusional states (delirium) than chronic mental illness. i. Degenerative diseases; Dementia (Alzheimer’s disease and vascular dementia), Huntington’s chorea, Parkinson’s disease. j. Prolonged sleep deprivation. k. Excessive fasting. 2. Psychosocial causes; These are factors which precipitate mental illness/disorders in people who are predisposed or vulnerable. These factors emanate from the disruption of the psychological and social (environmental) milieu of an individual. Some of these psychosocial causes include; -Loss of loved one -Separation / Divorce -Broken relationships -Marital disharmony -Infertility -Delayed marriage -Failure of exams -financial downturn -Stressful life events -Natural or manmade disasters -Torture -Child abuse -Rape -Wars and insurgencies -Cultural & Religious beliefs It is evident from the above mentioned causative factors that mental disorders are not caused by witches and wizards as many tend to believe, but have scientific basis which when applied in the treatment leads to improvement of the sufferer’s mental state. I believe that the knowledge of these factors will change our mindset toward people suffering from mental disorders and should elicit more empathy rather than stigmatization. Dr. Ifedilichukwu Uzoeghe Uchendu Consultant NeuroPsychiatrist. 08035318234

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