By Antoine B. Craigwell
In November, I attended the second annual Guyana Well-being Conference held at the Arthur Chung Conference Centre and there I presented two workshops, on understanding culture and mental health from a “whole-person” perspective, and looking at mental health signs and symptoms for stress, anxiety, depression and the progression toward suicidal ideation and attempts – intervening to prevent a person descending into a mental health crisis and if in crisis, what to do to get the person help.
Following the conference, over the next three weeks I conducted 12 mental health awareness workshops along the coast, from Georgetown to Parika/Salem, and to Adventure, Black Bush Polder, reaching more than 360 community members. Even though some people had a general understanding of mental health, mental illness and wellness, in large part, many approached their descriptions from a judgmental, stigmatizing and shame perspective. It was important then, to provide information and education about mental health from a cultural view – incorporating Guyanese cultural mixture and dynamics.
We looked at understanding what is a mental illness and how do we know we’re experiencing a mental illness. There was a focus on each workshop attendee, as through self-identification, a person is less judgmental about another. Each participant was asked to think about their mental health, that when considering stress and their emotions, how often in the past 30 days would they say their mental health wasn’t good?
As we prepare for the holidays, we’re aware that our stress levels have increased more than normal – higher costs for food, rent, utilities (electricity, water and a 5-lb cylinder of gas), transportation, gifts, new things for our homes; expectations of us, demands on our time and attention, and we may have deeper unresolved issues, which continue to leak out into and impact our everyday lives, in our thinking, choices/decisions, and behaviors. We are aware that these external factors impact us and in turn, our relationships; we’re likely to experience increases in disagreements, altercations, and violence, and after which, many of us would feel isolated, abandoned, worthless and abused.
When our stress is unaddressed, it leads to anxiety, and which if it remains unresolved, leads to depression, robbing us of opportunities to enjoy the companionship and belonging from being with our family and friends. We know when we’re experiencing stress – sometimes, we may have a head or stomach ache, or feel weak. When we’re feeling anxious, often about issues we have no control over or a memory of a traumatic event/experience, we have sweaty palms, our body shakes, our legs feel weak, our mouth feels dry, our heart beats fast (palpitations), blurry vision (dark eye), vertigo (head swinging), nausea or upset stomach with vomiting or diarrhea (frequent motions), and feel tense – sometimes tightness in our chest (NOTE: if this occurs, as soon as possible go to a hospital to check to see if you’re experiencing a heart attack or a panic attack); and some of us may know when we’re experiencing depression, that is, we don’t want to do or be among others, we’ve lost interest in things we used to like (we used to take pleasure in the holidays, but don’t seem to care anymore), or we feel sadness at the memory of a loved one who died around this time or died during the year.
To help us understand what’s happening, the American Psychiatric Association’s Diagnostic and Statistical Manual, 5th edition listed eight criteria for depression, some of which are raised here, and suggests that if someone experiences two or more of these over two weeks or more, that person should see a mental health professional. These criteria include:
Depressed mood most of the day, nearly every day,
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day,
• Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day,
• A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down),
• Fatigue or loss of energy nearly every day,
• Feelings of worthlessness or excessive or inappropriate guilt nearly every day,
• Diminished ability to think or concentrate, or indecisiveness, nearly every day,
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific suicide plan.
The mental health law passed earlier this year, especially, decriminalizing a suicide attempt, was a significant step in the right direction and we’re glad that emphasis is being placed on community mental health, that is, raising awareness, providing information and education to work against shame, stigma and discrimination, and to ensure that a person struggling with mental illness can know that supporting their families, a community rallies around. While many factors come together when a person takes their life, one of which is the role we, the community, play.
As one of the countries with the highest suicide rates in the world, the government with support from the opposition (mental health isn’t and shouldn’t be politicized) should prioritize increasing the percentage of the national budget to providing comprehensive mental health care.
To help us get through these holidays if you’re feeling stressed:
• STOP what you’re doing and take a few deep breaths – when we take a deep breath our lungs fill with air, the oxygen rushes to our brains and calms us down.
• If you were sitting for a while, GET UP and walk around – restores your circulation and allows you to calm down
• Plan when you’d go to bed – try to get as much as seven hours sleep – when you don’t sleep at night your judgment may be affected, you may be more irritable, and you may behave/feel as if you’re drunk the next day.
• Drink water – keeping yourself hydrated
• Allow yourself time to eat, and remember eating is complex, all your senses come together; focus on eating, taste your food, what you eat affects your thinking and impacts your immune system – you are what you eat.
If you’re feeling anxious
• To take your mind off whatever is making you anxious, try to distract yourself by thinking or doing something different,
• Choose a safe time and go for a walk; or develop an exercise routine (a gym membership is helpful, but not necessary)
• Create a safe space where you can go to meditate, practicing mindfulness, breath awareness – be still; be quiet.
• Try reordering your thoughts, thinking about what you can control, over that which you have no control.
While we don’t always keep our “New Year’s Resolutions”, we can begin to think that just as we would mentally prepare ourselves to see a doctor for a “checkup” when we’re feeling something isn’t right in our bodies, we are encouraged to consider finding and speaking with a mental health professional for our minds, to help us understand and come to terms with aspects of our lives and begin our healing. We’re aware that there aren’t enough mental health professionals in the public health system, and many can’t afford to pay for a professional in private practice. Perhaps, there is need for those in public health to receive more appropriate compensation to enable them, too, to live without stress and still be able to provide for their community members.
Many of us may have serious concerns about confidentiality – there are calls for the government to pass a law to protect a person’s confidentiality; it would be an appropriate amendment to the mental health law. You should be assured that a mental health professional is legally bound to protect/guard whatever you tell them, except, if you intend to harm yourself or someone else, then they’re mandated to report it and immediately get you attention and care.
Antoine B. Craigwell, from Stanleytown, New Amsterdam, is the president and CEO of DBGM, Inc., (www.dbgm.org) a US-based non-profit organization, and is an award-winning journalist, documentarian, and a US National Mental Health First Aid Instructor.