The Sunday Mail
Mertha Mo Nyamande
WHENEVER we talk of mental health — illness or disorder — we mostly associate this with fear and violence.
Today, we will try to demystify the correlation among mental health issues, aggression and, ultimately, violence.
Most of the time, when we talk of mental health issues, we often think of the extreme presentations, when so much that could have been done earlier was deliberately neglected.
We have certain societies that only respond to things when they have broken down, rather than be proactive to prevent things from collapsing in the first place.
In Zimbabwe, 72 percent of adults are said to be mildly or moderately depressed but they ignore the symptoms.
This is because they are not yet broken or the pain is not yet debilitating.
They may only attend to this problem when their depression has caused an accident due to loss of concentration, often hurting or killing others and making that depression worse.
Once it has become worse, this is likely to lead to severe symptoms in the form of psychosis, and suicidal thoughts and behaviours.
The symptoms of depression are often misunderstood and mistaken for laziness, or just being difficult in the case of agitated depression.
Other symptoms include the following: generally feeling low and hopeless; losing interest or pleasure in things one used to enjoy; drastic changes in sleep; drastic changes in appetite; feeling bad about yourself, that you have let yourself or your family down; trouble concentrating on simple things; moving too slowly and being too fidgety.
Such issues lead to poor functioning and people respond differently whenever this happens.
Those affected may withdraw, while others may become aggressive.
The withdrawal and isolation make it easy for others to become easily frustrated and lash out as their way of voicing the frustrations. The aggressive ones may become violent as a way of trying to get others to understand what they are feeling.
With psychosis, most often, there are associations with paranoia and/or delusional thinking, similar to a case when someone has taken intoxicating substances.
When one feels paranoid, they start to think bad of others.
They may think others want to hurt or kill them. They may also think their partner is unfaithful, a situation that prompts them to wish to do something drastic in order to protect themselves.
They may punch someone in what an ordinary person sees as an unprovoked attack. However, the attacker would have perceived the situation differently; they feel justified in defending themselves.
That may sound insane to the “normal” person, right?
Those struggling with mental problems get frustrated whenever they try to explain things to others and often feel misunderstood.
This frustration is seen as aggressive action. Instead of the “sane” ones being patient enough to understand the problem to solve it, they react aggressively, too, again, to try and protect themselves from a mentally challenged person.
So, who really should we worry about?
Whenever we look at the assessment of risk, there are several tools that are used, most of which are standardised and used internationally — talk of the HCR-20.
There are others like the START and STAR risk assessments.
Risk assessment tools usually look at the past to understand how someone has responded in similarly challenging situations. They involve analysing the historic information.
History also looks at who is at risk and what kind of risk is posed.
Are they at risk of harming themselves or others? Have they used weapons or set fires? . . .
This information is coupled with an understanding of any clinical features; whether the person has a known mental health diagnosis and if it is managed well. So, whenever you see a person behaving in odd or bizarre ways, it is essential to get someone who knows them to help assist in managing the risk they may pose.
It is not always helpful to assume that simply because someone is considered mentally ill, they will be aggressive or violent. At times, it is the one who is not mentally ill who responds in violent ways, out of fear.
Mental health problems are more widespread than previously thought, and are not always as extreme.
One in two adults in developing countries has a mental health issue of some sort. Reach out and get the right help.
Mertha Mo Nyamande is a psychotherapist. He can be contacted on: [email protected] or @ www.i-wellbeing.weebly.com
