YOUR HEALTH YOUR RESPONSIBILITY (PART 2)

By

DR UCHE J. ENUMAH,

Ag DM, Field Clinics/Occupational Health

NNPC MEDICAL SERVICES LIMITED (NMSL)

ADOLESCENCE- HEALTH ISSUES

• Unintentional injuries sustained from road traffic accidents are the top most cause of mortality among

            adolescent girls (10–19 years) in high- and middle-in countries.

• Mental health
• Suicide and mental health disorders significantly contributes to the burden of ill-health and mortality in all regions.
• HIV/AIDS
  The rate of HIV infection is high in practically all countries that have widespread HIV epidemics. Adolescent girls are at risk of unsafe and many times unwanted and forced sexual activity that can lead to HIV/AIDS, other STDs, unwanted pregnancy and unsafe abortion.
• Adolescent pregnancy
  Pregnancy-related complications are a leading cause of mortality among adolescent girls in developing countries ,with  unsafe abortion contributing significantly to these deaths.
• Substance use
  The risk of this, compromises their health, especially in later life, just as poor diet and physical inactivity. For instance, there is evidence that tobacco advertising is increasingly targeting young girls and women.

Introduction to Mental Health

• Mental Health vs Mental Health Disorders:
• For all individuals, mental, physical and social health are vital and interwoven strands of life.
• Mental health is crucial to the overall well-being of individuals, societies and countries.
• Indeed, mental health can be defined as a state of well-being enabling individuals to realize their abilities, cope with the normal stresses of life, work productively and fruitfully, and make a contribution to their communities
• Unfortunately, mental health and mental disorders are not accorded the same degree of importance as physical health, rather, they have been largely ignored or neglected.

INTRODUCTION

• Mental Disorder on the other hand, according to WHO is “collectively all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood or behavior associated with distress and/or impaired functioning”

Burden of Mental Disorders

• Earlier this year, a student of Babcock university died from suicide.
• Shortly after, a medical doctor killed his mother,
• Some months back, a medical doctor died from suicide.
• Also, a final year student of LAUTECH died from suicide.
• In an UK health facility, 3 suicide deaths were recorded in one year
• How about strange murder cases occurring amongst family members?
• The big question then is…. Is suicide on the increase or we are just realizing the growing incidence..?
• Recently, Some Mental health experts have raised an alarm over increased cases of mental disorder in Nigeria and have called for adequate facilities and personnel to curb it
• Professor Oye Guruje, a psychiatrist with University of Ibadan, said government should give priority attention to the management of mental disorder because its burden outweighed that of HIV.
• He added that while there were no specific causes of some mental illnesses, some might be hereditary, while some could be due to stress or lifestyle.
• The Deputy Commander, Operations and Intelligence, (NDLEA), said, “most addicts were dealing in illicit drugs like Indian hemp but that they have now shifted to legitimate drugs like cough syrups and analgesics.
• The command has a rehabilitation centre which hosts drug addicts whose cases had not attained the level of madness.
• “when you look around, you will see many lunatics roaming about the street without any care and that is because the state does not have a rehabilitation centre to keep such people.
• According to a recent WHO reports:
• As many as 450 million people suffer from a mental or behavioural disorder
• Nearly 1 million people commit suicide every year.
• Four of the six leading causes of disability are due to neuropsychiatric disorders (depression, alcohol-use disorders, schizophrenia and bipolar disorder).
• Over 60 million Nigerians have one form of mental disorder or the other
• One in four families has at least one member with a mental disorder.
• Patients with comorbid depression are less likely to adhere to medical treatment or recommendations, and are at increased risk of disability and mortality.
• For example, it has been shown that depressed patients are three times more likely not to comply with medical regimens than non-depressed patients
• Mental disorders impose a range of costs on individuals, households, employers and society as a whole.
• As a result, mental health disorders often go unrecognized and untreated — not only damaging an individual's health and career, but also reducing productivity at work.
• Adequate treatment, on the other hand, can alleviate symptoms for the employee and improve job performance.
• But accomplishing these aims requires a shift in attitudes about the nature of mental disorders and the recognition that such a worthwhile achievement takes effort and time.
• Here's a quick guide to the most common mental health problems in the workplace, and how they affect both employees and employers.
• In the workplace, they manifest with Stealth symptoms but have tangible impact
• 3 are most common: Depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD), and anxiety disordsers

Causes/types of Mental Illness

• Depressionis the mental health disorder that has been best studied in the workplace, partly because it is so common in the general population
• (WHO) in its 2017 World Health Day message says 7,079,815 Nigerians suffer from one of the most ignored and misunderstood form of mental disorder in the country – depression.
• Unfortunately, the depressed often suffer the ailment alone without a clear signal of help from either the society or even health providers. And when the depression has reached a certain level where they have concluded no one will ever understand them, the next thing is to commit suicide or harm themselves.
• Sadly people who face depression must be prepared for at least two long journeys.
  • One is to face depression itself, including its symptoms – despondency, lethargy, lack of sleep, an inability to concentrate, weak productive lifestyle – are painful and difficult to manage.
  • The second journey, is in many ways, harder, and often longer, which is to face other people’s misunderstandings of their depression, misunderstandings that are sometimes insulting, confusing, and often unhelpful in getting the symptoms under control

TREATMENT

• Will be more effective and successful when identified early. The golden rule is to recognize the symptoms early enough:
  • Symptoms of mental illness vary in persons depending on the type of illness, cause and circumstances surrounding the illness. A mentally ill person may exhibit one or more of these behaviours which include; 
    • ADHD behaviours include inability to sit still, aimless movement, lack of concentration, attention and focus, inability to finish up a task.
    • Others include severe anxiety (fear of something bad happening or likely to happen),
    • In severe cases: hallucination, paranoia, feeling guilt, delusion, obsession(neurosis) , bed-wetting, schizophrenia, phobia, speaking to a companion that cannot be seen,

• Eating and sleeping disorders, amenorrhea
  • bipolar disorders( mood swings, mixed emotions, crying and laughing at the same time), laughing in situations that are not funny, crying unnecessarily,
  • addiction which could be in terms of sex, drugs, suicidal thinking,
  • extreme cleaning of the surroundings by sweeping many times in a minute,
  • withdrawal from people, low interaction level,
  • lack of concentration, Alzheimer (forgetfulness),  tiredness, violence, anger,
  • lack of control, inability to differentiate between reality and fantasy,
  • high self worth, erratic thinking, physical problems, body aches, weight loss.
• All these behaviours affect daily activities and relationship with others.

COMPLICATIONS

• Untreated mental illness can lead to:
• Risky behaviours such as 
  • committing suicide,
  • harm to self and others,
  • extreme violence,
• loss of job,
• absence from  school,
• family problems such as divorce, separation,
• poverty,
• alienation from peers and friends,
• homelessness, wandering
• and relationship strains.
• General:
  • Harmful behaviours like drinking, drug use, and alcoholism must be avoided.
  • Physical activities like exercise, strolling, and engaging in hobbies reduces depression and anxiety should be adopted.
  • Optimistic rather than pessimistic attitude must be cultivated, decision-making process should be done in good health.
  • Social participation, mingling with friends and family members go a long way to help.
  • Diaries to keep tracks on how the days are spent should be kept. This helps in knowing the health status.
• Specific:
• Marital counselling – think again about family history, victims of broken home
• Imbibe age long virtues – patience, moderation, manage ambition, socialize
• Take Charge of your health:
  • I am who I am today because of the choices I made yesterday....
  • I am born to be REAL, not to be perfect. I'm here to be ME, not to live someone else's life.
  • I'm going to make the REST of my LIFE, the BEST of my LIFE.
  • At this very moment, LIFE is perfect...because,
  • I am in charge of how I feel and TODAY I am choosing HAPPINESS.
• Do not wish it away:
  • First rule is knowing you are going through depression.
    You can practice some self help tips like sleeping, do exercises.
    Learn to say No.
    Collaboration is the new competition. Ask someone to help you.
    Depression is real, but the good news is that it is treatable. Get help don’t delay.

PERIODIC MEDICAL EXAMINATION (PME)

• The goal of screening and evaluation is to prevent the onset of disease or the worsening of an existing disease

OBJECTIVES OF PME

• Evaluate Health Status
• Screen For Risk Factors And Disease
• Examine And Educate
• Physical Examination : Inspection, Auscultation, And Palpation
• Educate :Behavioral Patterns ,Environmental Exposures That Pose Risks For Future Diseases

CHALLENGES

• Ignorance
• Self perception of excellent health state
• Incomplete disclosure / insincerity – fear, confidentiality

What is stress?

Stress - the “nonspecific response of the body to any demands made upon it.”

Stressor – any physical, psychological, or social Condition that initiates the stress response, and can be either positive or negative.

TYPES OF STRESS

EUSTRESS -  “good stress”

• Initiates emotional & psychological growth.
• Generates & initiates action.
• Leads to increase performance and improved health.
• Provides the experience of pleasure, can accompany a:
  • Birth
  • Graduation
  • Purchase of a home
  • Development of a new relationship

DISTRESS - “bad stress”

• Results in negative responses.
• Can interfere with physiological & psychological functioning.
• Long term distress may result in disease or disability.

Homeostasis - the body’s attempt to

maintain a physiological balance.

Stress disrupts the balance.

Symptoms of Imbalance

• Physical:
  • Headaches, upset stomach, sleep disturbances, changes in appetite, muscle tension, fatigue, heart palpitations
• Emotional:
  • Depression, anxiety, irritability, difficulty making decisions, angry outbursts, resentment, feelings of powerlessness
• Personal:
  • Lost time with friends and loved ones, job burnout, isolation – stopping social activities, relationship loss/difficulties, self medicating

FINDING BALANCE STRATEGIES TO IMPROVE BALANCE

FAMILY AND FRIENDS

• Drop off kids with trusted friends / relatives for alone time with spouse or self
• Engage in whole family activities ( e.g. biking, board games , holiday, TV programme,Cinema )
• Use small pockets of time well
• Buy time
• Eating out occasionally (cuts cooking time & fosters bonding )
• Travel time
• Strict adherence to “family time”
• Engage in “non-work “ activities during your leave.
• Cut off unhealthy relationships (time wasters)
• Engage help ( e.g. caring for aged parents)
• Seek advice from others

Strategies To Improve Balance

SELF CARE .

• Understand some things are beyond your control to change
• Prioritize and give attention in order of priority
• Adopt self – care practices (sauna, spa, regular health checks etc)

Understand that

• you’re human, and have limitations, don’t push beyond your ability/capability
• Self esteem - Quit trying to get in the good books of others, at your detriment
• Learn to say no without feeling guilty

CONCLUSION:

Prevention is better than cure.

THANK YOU.