Psychosocial disabilities
25% of people have a mental health problem at some stage in their life. This might range from transient anxiety following an accident to conditions like depression or schizophrenia, which can be recurring, and extremely disabling. The disabilities arising from mental health problems are called psychosocial disabilities, which reflects the challenges that people face as they are often shunned from their communities and face discrimination and abuse as well as finding work and other responsibilities difficult to manage.
At present, about 450 million people worldwide are affected. For various reasons, including lack of available medical care, poor attitudes, war and poverty, conditions that can lead to psychosocial disabilities are more prevalent in low income than in wealthy countries.
At present, about 450 million people worldwide are affected. For various reasons, including lack of available medical care, poor attitudes, war and poverty, conditions that can lead to psychosocial disabilities are more prevalent in low income than in wealthy countries.
Because treatment is only available to very few people (typically less than 10% of people with severe problems in Africa), even though most conditions are very treatable, many people remain untreated for years, leading to much more disability than they would otherwise experience.
Persons with psychosocial disabilities are only now starting to be able to speak for themselves as they have been so stigmatised in many countries. CBM strongly supports the service user community through establishment of self-help groups and networks of stakeholders.
Some examples of such conditions leading to psychosocial disabilities are given below.
Depression
Depression is the most common cause of psychosocial disability, and is characterised by persistent sadness, loss of interest in activity, isolation and decreased energy that affect one’s ability to enjoy a full life.
The symptoms mentioned are not exclusive to depression and can be part of “normal” mood changes. However, when these feelings get so intense and long-lasting that they interfere with one’s ability to think, work, eat, sleep, enjoy being with others, or care for themselves, the person may have depression.
What Causes Depression?
The symptoms mentioned are not exclusive to depression and can be part of “normal” mood changes. However, when these feelings get so intense and long-lasting that they interfere with one’s ability to think, work, eat, sleep, enjoy being with others, or care for themselves, the person may have depression.
What Causes Depression?
- There is no single cause of depression, and there is usually a combination of psychosocial factors (family conflict, losing a loved one), as well as genetic and biological factors such as a family history of depression or use of certain drugs. This can influence the onset of depression, as well as someone’s risk of relapse if they have previously recovered from an episode.
- Life experiences that are known to contribute to the development of depression include: a chaotic, unsafe or dangerous environment, serious loss or trauma in early life, traumatic experiences later in life, and unhealthy social conditions such as poverty or homelessness.
The most effective treatment for depression is a combination of talking therapies (psychotherapy) and/or antidepressant medication.
Milder forms of depression and conditions such as anxiety are often grouped together as ‘common mental disorders’ (CMDs) to distinguish them from ‘severe mental disorders’ such as psychosis and severe depression. CMDs are often less long-term, typically more likely to be caused by social factors, and require more social and psychological treatments as opposed to relying on medication.
Milder forms of depression and conditions such as anxiety are often grouped together as ‘common mental disorders’ (CMDs) to distinguish them from ‘severe mental disorders’ such as psychosis and severe depression. CMDs are often less long-term, typically more likely to be caused by social factors, and require more social and psychological treatments as opposed to relying on medication.
Psychosis
Psychosis is a severe mental condition characterised by loss of contact with reality, typically including delusions (fixed, false ideas that can lead to people being very suspicious or frightened), and hallucinations (seeing or hearing things which are not really there). Other possible symptoms include: disorganised thought processes and/or speech, extreme confusion and excitement, and neglect of personal hygiene.
What causes psychosis?
What causes psychosis?
- Certain drugs like cannabis can induce psychosis.
- Other risk factors include: a family history, extreme emotional or physical stress
- Psychosis is a general term describing a pattern of symptoms. The actual diagnoses that can lead to psychosis include schizophrenia, bipolar disorder (manic depression), psychotic depression, brain tumours, epilepsy, degenerative brain disorders and strokes
- Antipsychotic medicine helps reduce auditory hallucinations and delusions and stabilises thinking patterns and behaviour.
- Social support can help to reintegrate people into society and regain their status. As psychotic illnesses usually start in late teens or early the 20’s, education and early career may be disrupted. Once treatment has stabilised someone, livelihood needs to be addressed.
- A brief period of care in a hospital may be needed to ensure the patient's safety, but with modern treatment, there is no justification for long-term incarceration, which unfortunately is still common in many countries.
- Group or individual therapy can also be useful, particularly to help someone be aware of their problem, reduce risk of prevent relapse, and to cope with disturbing symptoms.
Epilepsy
Epilepsy has an estimated prevalence of 40 to 50 million cases and is the most common brain disorder in the world. It is characterised by repeated seizures; sudden surges of electrical activity in the brain that affect how a person feels or acts for a short time. Seizures can occur as often as several times a day or as seldom as every few months. Secondary impairments are common, ranging from intellectual impairment and personality disorders to burn contractures that may result from people falling into open fires during seizures. These consequences are much more common if people do not have access to medication. Epilepsy patients often experience exclusion and stigmatisation.
What causes epilepsy?
What causes epilepsy?
- Genetic predisposition
- Brain damage resulting accidents
- Infections like meningitis or malaria, parasites, withdrawal from alcohol, other toxic substances, and tumours.
- However, over half of all epilepsy cases have unknown causes.
- Epilepsy therapy is aimed at preventing seizures rather than a permanent cure. Some people are able to stop medication after some time, but many have to take the medication for long periods as the underlying condition remains.
- Additional family support, support for livelihood development and public awareness education helps to strengthen the patient’s position within the community. Children with epilepsy are often removed from school, but with the right treatment and support, they should be in mainstream education.
- Many people with epilepsy can lead seizure-free lives if treated with inexpensive, anti-epileptic medicines.
Post-traumatic stress disorder
Post-Traumatic stress disorder (PTSD) is a psychiatric disorder that occurs as a response to experiencing or witnessing a life-threatening event. The condition is characterised by the persistent re-experiencing of the event (e.g. in nightmares or as flashbacks), resulting in numbness, avoidance, and hyper-arousal. These symptoms can lead to a significant impairment of the patient’s daily life.
Treatment for people with PTSD is mainly through encouraging supportive social networks, encouraging reintegration, and allowing the person to talk about their experiences in their own time. Occasionally they may benefit from medication, and should generally be treated within standard services as their symptoms are on a continuum with conditions like depression and anxiety.
Treatment for people with PTSD is mainly through encouraging supportive social networks, encouraging reintegration, and allowing the person to talk about their experiences in their own time. Occasionally they may benefit from medication, and should generally be treated within standard services as their symptoms are on a continuum with conditions like depression and anxiety.
