.Mental health conditions from psychological trauma

Welcome to this week’s “Mental Health Chat Room”, this is a chat room where we discuss the basics of our mental health in order to understand and have a full grasp of the rudiments of mental health and mental well-being.

This is an essential component of our mental health advocacy activities aimed at promoting our wholesome wellness, prevent mental illness, improve our awareness of mental illness, understand that effective, qualitative and modern (technology based) mental health care services are available in Nigeria and globally to enhance quality living, harmonious interpersonal relationships and peaceful coexistence within our communities.

A slippery journey to hell on earth:

The road to hell  is a pattern of substance use behaviour involving  insidious and progressive graduation of the use of substance from experimentation, casual use, habitual use, and finally to addiction.

When we embark on a journey, there will be considerations for certain activities, planning and preparations, setting out and encounters on the journey and finally arriving at the destination.

I would like us to take this trip together, and with these activities on our minds, using the journey to demonstrate the evolution of drug addiction from adolescence to adulthood.

Planning/preparation:

This is one of the factors related to the individual predisposition to addiction; they include genetics, early life experiences and dynamics of life.

Studies have shown that drug addiction is overrepresented in some families more than others (there is a higher risk of drug addiction among individuals who have a family member that has suffered from drug addiction); but the direct link to how such genetic transmission takes place is yet to be known.

Studies have also shown that some mental disorders are over-represented in families and extended families of people that suffered from drug addiction; these conditions include mood disorders (depression and bipolar mood disorder). However, such genetic predisposition alone cannot account for the manifestation of addiction disorder.

Setting out and encounters: This marks the commencement of the journey and heading towards the destination. Here we consider factors related to precipitation of the condition, stressors, and challenges of life. The journey to addiction usually starts with “experimentation”.

Young people either due to curiosity, peer influence or the urge to belong to certain groups may find themselves experimenting with psychoactive substances (drugs). Some may walk away from the drug after experimentation whereas some, due to genetic predisposition, stressors or social pressure (the urge to remain in the group) may graduate into “casual” (situational) drug users.

At this stage, the drug use is becoming regular but the individual uses it only during a particular event, situation, place or in the company of peers. As the regularity of the use of the drug progresses, “habitual”  (more intense) use will set in, at this stage the use of the drug has become intense and individualised, the individual does not need the presence of peers or situation and the individual will rather create the occasion for the use of the drug rather than wait for the occasion to arrive!

There will be evidence of assigning some level of priority to the drug at the expense of other activities and there will be a likelihood of the drug-taking some financial toll on the individual.

Initial stressors, precipitants and challenges may no longer be present or responsible for the continuous use of the drug.

Destination: Habitual use of the drug leads to “drug addiction”, the destination is characterised by a cluster of cognitive, behavioural and physiological symptoms indicating that the individual continues using the drug despite significant drug-related problems.

At this point, there is an underlying change in the brain circuitry; that is to say that the normal functioning of the brain has become altered, which may require a long-term intervention to revert! The individual will manifest a poor sense of judgment (due to impaired control), risky use, social impairment and physiological problems like withdrawal symptoms (which could be potentially fatal). Due to the psychological pain, social embarrassment, physical problems and financial predicaments, the individual often expresses a persistent desire to cut down or regulate or stop drug use: here lies the “hell”. In extreme cases, individuals may experience other complications of drug addiction such as mood or psychotic disorder or suicidal behaviour.

A lot of people who suffer from drug addiction most often do not know or understand that they are ill, while some are in denial. Family members tend to play down and sometimes trivialize drug addiction, especially once it has become clear that it is a disorder of the brain. The stigma of mental illness further fuels denial by the individual and the family and constitutes a major barrier to effective and quality care.

Drug addiction is a treatable mental disorder, the care is conducted by a multidisciplinary team of doctors, clinical psychologists, mental health social workers, occupational therapists and other clinicians as indicated after assessment at a centre designated for drug addiction care.

The care involves a combination of medication, psychotherapy, hospitalisation, support group/self-help and any other form of intervention as indicated after proper assessment.

In conclusion, the road to hell in drug addiction describes the pattern of substance use behaviour characterised by insidious and progressive graduation of the use of substance from experimentation to recreational use, graduating to casual (situational) use; to habitual (more intense) use and finally to addiction.

This journey typically starts in the adolescence period and becomes well established in young adult life. The complex interaction between the individual brain circuitry, genetic predisposition, early life experience, the environment and the drug leads to drug addiction.

A central descriptive characteristic of drug addiction is the desire that is quite strong and most times overpowering (compulsive urge) to use the drug. Denial of drug addiction, stigma and trivialising of the condition are strong determinants of appropriate health-seeking behaviour and they constitute a major barrier to quality and effective treatment of drug addiction.

There is a need for community engagement, drug addiction awareness campaigns and advocacy on preventive strategies for drug addiction (and related disorders) and mental health promotion, mental illness prevention and treatment strategies in general.

I hope today’s conversation will improve our understanding that drug addiction is a treatable mental disorder.

Note:  If you have comments, questions and  contributions, please reach out to us on: +2348037004611 or email us at [email protected]

Readers’ comments

I’m feeling low, uneasy, mentally stressed to my stomach

Dear Prof, I have been down with strange feelings.  Sometimes, I feel uncomfortable. At other times I will feel fine the rest of the day, but out of nowhere, I will feel stressed to the stomach mentally. I’m also uncomfortable and uneasy.

Could these be signs of depression?

Gabriel Adeniyi, Lagos

Prof says, Individuals have days when they  feel down, but those feelings usually pass without having too much impact on our lives.

But if they last beyond a couple of weeks or you feel as though things are getting worse, it could be a sign that you are experiencing depression.

Again, symptoms of depression vary from person to person. Often times, it manifests in the feeling of low, numb, worthless or without hope.

You maybe be sleeping too much or too little, or don’t eat properly, and withdraw from social contact with friends and family.

Some people are even known to have thoughts about self-harming or suicide.

Further, there are lots of reasons why someone might feel depressed, but sometimes there isn’t any obvious reason.

 It can be caused by a difficult life event – losing a job, relationship difficulties, or physical health problems like illness and disability, or low self-esteem.

I need tips to stop drug usage

Dear Prof,

Good day Sir.  Thanks for your numerous and helpful tips on drug usage.  I am a victim of alcohol addiction and it has refused to vanish despite several attempts and trials, even staying out for months but alas the old stories would repeat.

It has even almost sent me out of business but with the help of God I am still struggling in the business that was supposed to be better.

Kindly help me with better tips to flee finally, sir. Thanks and remain blessed.

Anonymous, Lagos

I need advice on drug addiction

Dear Prof,

Thanks indeed Prof. Quite enlightening and educative.

Drug addiction is becoming prevalent now more than ever before and one of the factors responsible for the high rate of criminal activities in our country today.

I need your professional advice for what I can do to stop my drug addiction problem that leads me to have headache constantly.

Thank you sir.

Strictly Igbo precisely

Thank you for your contribution

Dear Prof,

Good morning Sir, thank you very much for your positive contribution, you’re quite right. There is a relationship between drug abuse criminality and other social vices!.

Joseph, Owerri

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