Wellness & Fitness

See a psychiatrist to get answers on hallucinations

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Mental disorders and poverty are in a complex relationship, each worsening the other’s impact in the life of the sufferer. The psychiatrist recognises poverty as a political problem. PHOTO | BD GRAPHIC

Two years ago, and on the instigation of her friends, my married cousin decided to leave the country to work as a domestic worker in the Middle East. She left three children with her husband who did not approve her going. After one year, and with nothing to show, she was back to Nairobi and has maintained a studious silence of what she went through.

A few weeks ago, she started suffering from hallucinations and we asked the pastor to pray for her. Do you think she needs more attention?

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Just to address the last part of the question first, I do think that your cousin needs more attention, specifically, from a psychiatrist. Just in case you do not know what a psychiatrist is, I will explain.

He/she is a medical doctor, who after registration as a full medical practitioner, then proceeds on further training in the field of mental health.

Many people have wondered why a person has to train as a doctor “if all he does is to treat diseases of the mind”. The answer is simple. Diseases of the mind are caused by many factors, including what lay people consider to be causes unrelated to the mind.

Taking your own example first, let me ask, do you know that hallucinations can be due to such diseases as malaria, cancer, Aids, alcohol withdrawal and many other diseases? It is perhaps for this reason that lay people have the concept of malaria kubwa (big malaria) as a description of malaria which presents as a psychotic illness.

If a psychiatrist is to be able to treat hallucinations, as well as other psychiatric disorders, he must be trained in the practice of medicine to be able to understand the link between the body and the mind.

Did you know, for example, up to 25 per cent of people who suffer from cancer also suffer from a significant depressive illness? Did you also know that more than 30 per cent of people with diabetes also suffer from depression?

Do you know the link between heart disease and depression? It is estimated that 20-30 per cent of all those people who suffer heart attacks are also depressed. It is also known that those who suffer heart attacks and strokes but are not depressed at the time go on to develop depression.

Whatever the cause of your heart attack, chances are that you will get better more quickly if your doctor is able to diagnose and treat you for the depression. It helps in all these cases if the doctor treating the mind is also conversant with how the body functions.

There are many other examples where this is true, including a number of conditions that exclusively affect women. These include, premenstrual dysphonic disorder (PMS as many lay people call it) in which up to five per cent of women are so disabled by their monthly periods that they are unable to work.

Following delivery, one per cent of women are so disabled by post-partum psychosis that they have to be heavily medicated to deal with the hallucinations and delusions that follow child birth.

I could go on but will not. I hope you now understand why one must be a doctor to be a specialist in the treatment of diseases of the mind.

Just for clarity, the idea of seeing a pastor was a good one. There is growing evidence that those who get spiritual guidance in the treatment of any disease do better than those who do not.

We now come to the first part of your question. Why did your cousin go to the Middle East in the first place? Few women would agree to leave young children in one country to go work in another, without compelling reasons.

You might have to establish the true reason for her going. Is it for example, possible that the illness that your cousin now presents with today has its roots to that time?

Poor judgment

Some disorders like schizophrenia have long incubation periods, and it is possible that your cousin developed poor judgment in the context of a slowly developing mental illness. In its full blown presentation, schizophrenia is characterised by hallucinations.

In the alternative, is if possible that your cousin was running away from a bad marriage?

You tell us about her silence. Is this possibly part of a depressive illness. Is she perhaps hallucinating as part of an alcohol induced psychosis. Might she be so depressed that she has been using drugs that could induce psychosis.

Remember, any person can develop a mental disorder (20 per cent of the entire population will develop depression in their lifetime) and her hallucinations might have nothing to do with the Middle East. So, while you might be blaming the Middle East, it might turn out to be an innocent bystander.

So, see a psychiatrist and get him/her to answer your questions.