Stress is colour-blind

PRESIDENT Jacob Zuma’s statement that blacks do not suffer from stress is extremely dangerous because it perpetrates the archaic, but still prevalent global myth that mental illnesses are a sign of weakness and it adversely affects the efforts by the World Health Organisation and a number of NGOs to destigmatise the condition.

According to the WHO’s recently released fact sheet, depression is a leading cause of disability and a major contributor to global disease; women are affected more than men and it can lead to suicide.

It is estimated that more than 300 million people suffer from depression globally; close to 800 000 people commit suicide annually.

Worryingly, suicide is the second highest cause of death in 15- to 29-year-olds.

The reasons given by the WHO for the gross under-treatment are a lack of resources and trained health care providers.

Only six weeks is allocated to psychiatry training in a doctor’s five years in medical school. This creates the impression mental illnesses are not serious issues, so doctors won’t pay much attention to learning about them.

Little do they realise that almost half the number of a GP’s patients will have some form of mental illness and most of these will be missed and often misdiagnosed.

Chronic headaches are a common symptom of depression and the only treatment many patients receive is addictive codeine tablets.

Depression alone has about 15 different symptoms and at least five of them need to be present for at least two weeks or more to make the diagnosis.

Patients don’t always mention all the symptoms, especially if the doctor is busy, doesn’t understand mental illness or feels delving into the patient’s mental symptoms might take too much time.

There are a number of GPs with diplomas in mental health doing an outstanding job but they are not recognised or acknowledged by the funders, making this time-consuming but valuable discipline unattractive.

Much can be done at a primarycare level, according to the WHO, but we foolishly refuse to acknowledge it.

In my long span of practice, I have treated several black patients with severe depression, anxiety and panic disorders.

About 60% of people with chronic illnesses suffer from anxiety and depression which, left untreated, worsens the management of the chronic condition.

Conditions like diabetes, hypertension and heart attacks are on the increase among people who have moved from rural areas to cities.

I have treated several black youths for severe post-traumatic stress disorder in an awaiting-trial centre over 10 years.

Their main presenting symptom has been insomnia but on further probing they all had the symptoms of severe PTSD.

Most of these young men fatally shot or stabbed as many as six rivals while under the influence of drugs, typically over a period of about two years. They live with the unrelenting guilt of their crimes.

In the centre, they no longer have access to illegal drugs like Mandrax to blunt their emotions so their past crimes haunt them in their sleep. Almost all are filled with remorse and guilt and they end up breaking down and sobbing uncontrollably when they are in the comfort and privacy of a therapy environment.

Many want to leave the gangs but are afraid of the repercussions. Their tattoos make them permanent targets of rival gangs.

Some youths are forced to leave Cape Town and return to the Transkei for safety reasons. I have known parents who sold their homes and moved far away for the safety of their child and family.

Many township youths face trauma of the worst kind, which has a serious impact.

Children, who witness their mothers being beaten by their drunken or drugged and unfaithful dads, are mugged on their way to school, are raped by close relatives or witness gang fights and brutal murders end up being traumatised and do badly at school.

This is a reason so many are addicted to mood-altering drugs that numb their pain but destroy their lives. Many end up with intractable substance-induced psychosis.

With proper intervention, teaching kids smart “handles” and meditation has yielded positive results.

Mr President, black people of all ages, like people in the rest of the world, suffer from mental illnesses when they are faced with issues like poverty, unemployment, muggings, rape and death.

With the stress our president is being subjected to, I am sure he would benefit from some stresscounselling too.

I sincerely hope the president and the rest of society change their ill-conceived perception that mental illnesses are conditions of the weak to be ignored and frowned upon. Patients with mental illnesses are not weaklings and are in as much need of care and empathy as patients with cancer or Aids.