‘Taking time off to rest is self-care for mental wellness’

Dr. Matthew Oluwaseun Olawuyi, a consultant family physician and the Chairman of the Society of Family Physicians of Nigeria (Oyo State chapter), in this interview with Sade Oguntola, speaks about why the assessment of mental health is important for all individuals coming to the hospital to ensure the best possible health care outcomes and long-term wellness of individuals, generally.

WHY are family physicians calling attention to the need to build mental resilience in a changing world?

 In the world at large, Nigeria inclusive, there are events that could bring mental stress to people. These include conflicts, wars, harsh economic situations, and natural disasters. When we are concerned about all those events, they bring mental stress. Therefore, as family physicians, we realized that we need to talk about how individuals can improve their mental wellness.

Family physicians are frontline doctors; they are primary care physicians and the first point of contact when patients are seeking health care. Most of the patients with mental illnesses will pass through their family physicians. That’s the reason why, even as family physicians, we need to remind ourselves about it and improve our capacity to identify the signs of mental illnesses very early. Treatments for mental illnesses are better when they are discovered early.

Recognizing the early symptoms of mental illness is essential. That’s the reason why we are sensitizing ourselves and the public to be able to identify the symptoms of mental illnesses on time. No matter how skillful a family physician is, if we don’t look out for the early symptoms of mental illness in all our patients, we will just run through the patients and many of them with signs and symptoms of poor mental health may slip out of our hands.

Mental health is part of primary health care; therefore, treating primary mental health disorders is part of the duty of family physicians. Therefore being more proactive in looking out for symptoms suggestive of mental health conditions and those who are at risk of developing mental conditions, to give them preventive treatment is important.

What are those early signs of mental health issues that they should look out for in individuals they attend to in their clinics?

Common mental health illnesses include depression, anxiety disorders, eating disorders, and post-traumatic stress disorder to mention a few. Therefore, when a patient begins to talk about things that are far away from normal experiences, you begin to suspect that a mental illness is setting in. An individual who used to be lively, who suddenly becomes moody, detached from people and the environment and loses interest in things that usually give them pleasure before, should be suspected to have a mental challenge.

For instance, when an individual keeps complaining to relatives or the physician of excessive tiredness each time he wakes up, has the feeling of being overwhelmed, running away or is having episodes of crying spells without being able to say specifically why he is crying, it is important to think about the individual probably dealing with a mental health issue. Of course, these signs or symptoms may be alongside other medical conditions that the individual was in the hospital to complain about to the health care provider.

Are there things that family physicians can use to measure the mental health status of individuals in the clinic; are there policies to back up assessing a patient’s mental wellness in Nigeria?

We have simple screening tools to assess the mental well-being of patients and that’s part of what we are advocating for now, that our primary care physicians should make use of these tools more. You know, it is what you look out for that you will be able to pick early. We do not want to wait until the condition becomes burdensome. We advocate that every clinician should screen all their patients for mental health disease.

What strategies can individuals adopt to build their mental resilience despite adversity?

 When talking about mental resilience, we’re talking about adaptability. It’s not as if there won’t be things that will stress an individual emotionally or even mentally, but people need to develop methods of adapting. They need to calm down and take things easy no matter what they are going through. They should not see it as if that’s the end of life or as if their condition is the worst. They should think positively when passing through difficult situations. In every disappointment or every unpleasant experience they are passing through, they need to calm down and pick out the positives.

Also, taking time off work and our busy schedule to rest is important. Individuals convert all their time, including their leisure time, to pursuing economic activity. When we live like that, we are not going to develop the ability to cope with mental stressors. Taking time off to rest is part of the means to get distracted from unpleasant experiences.

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How can families therefore support each other’s mental well-being during times of stress, particularly economic stress the world is passing through?

First, families need to look out for one another; they shouldn’t wait until they come to tell stories of how they are feeling or what they are going through to provide support. If they notice any member of their family is exhibiting a behavior that is different from what they know him or her for, they should probe further to try and find out what is causing it and then provide support. It should not be overlooked or assumed as the person’s problem alone. Consider depression, oftentimes, very close people, especially family members; often think the individual when greeted and no longer responds is because the person has become arrogant. They don’t know that the person is becoming moody, is becoming overwhelmed and uninterested in things he enjoys doing previously. These are symptoms suggestive of depression.

What are those signs or pointers that someone may need professional help to build mental resilience?

The starting point is to look out for those who are at risk of developing those mental conditions. For instance, people who are at risk include those passing through an unpleasant life event like the loss of a spouse, child, job, or property. Also, the survivors of natural disasters, wars and terrorist attacks. So, when people are going through life challenges, we need to reach out to them to find out how they are feeling. We also need to look out for changes in the way they behave. Someone who is usually spirited and open but now becomes withdrawn and is even reading negative meanings to what others are doing. Somebody who used to be very cheerful but suddenly is now showing a lack of interest in others or in what is going on around them. When you even greet the person, the person will not respond or respond in an agitated way. Then don’t just assume that the person is now bad and arrogant. If from approaching the person you are still not satisfied with his response or despite trying to let him see the reason for him to change his behavior to what you know him to be before, you need to take that person to see a medical practitioner. You should not just assume that maybe that is how he has decided to be living his life now. There may be something unpleasant going on in his life, and so that’s how to support one another and help one another.

What should therefore be prioritized regarding self-care and mental well-being?

Recently, the number of people coming down with mental illness has been increasing. The reason is not far-fetched; the environment we live in is contributory. The harsh economic situation is making people migrate to other places, and that’s a stress on its own. For instance, we have a heavy migration of healthcare workers. Because of this, there is work pressure on those who stay back, causing burnout and mental stress. As such, everyone needs to prioritize self-care and their mental well-being. They need to calm down. One cannot finish all the work, but to do one’s best and rest when it is time to rest. One cannot cheat nature. Don’t say because of the economic situation you want to be working round the clock so that you can make more money. When you are doing that, you are not prioritising your health.

Of course, part of prioritizing one’s health includes adhering strictly to the doctor’s instructions in case of a chronic illness regardless of economic and mental stressors. Also, giving time out for follow-up clinic schedules and adherence to medications is an important aspect of self-care. Part of the stressor again is the exorbitant cost of medications. So, the temptation is there for people not to want to buy their medications because they have other things for which they want to use money. But we should not yield to that temptation.

Q: Are there other things they need for good mental wellness?

 A: Regular Exercise, quality sleep and good diets are all important to ensure wellness and, of course, mental health. Also, we should not load our system with substances that can be harmful to our bodies. Abstinence from smoking, reduction in alcohol use to the barest minimum, taking time to rest and getting involved in relaxation activities, including quality time out with one’s family and friends, are part of coping strategies for stress. When an individual lives in a family where he feels loved, where he feels cared for and supported, that will make the individual enjoy good mental wellness. Have time to laugh. Have time to gist and watch a good movie. Make sure you have adequate sleep. Those are the things that can help us to cope well.

How do you think family dynamics can shape mental health outcomes?

 What we advocate is that especially in this time when the environment is tense, family members should support one another. They should forgive each other of any offences, be more supportive, and show love, care and concern for each other. They should make it a priority that every member of the family feels loved, irrespective of the tension outside; the individual will be able to cope better with any stressors outside the home. The home should be a haven of peace; a place to relax and be able to cool off tension. Imagine, if the spouse is the nagging type, this will not be possible.

These are the days when family members turn to their phones and social media. That’s part of the drawbacks of social media. When we get home, we should create time for our family members. We must limit the use of phones when we are at home. We need to give priority to open communication with family members; we need to give time to gist together; and to watch TV movies together. These are part of relaxation techniques that can help cope with mental stress.

Q: What should the government prioritize in building mental resilience in the community?

A: This should include the government prioritizing the provision of the basic needs of life. This includes access to quality health care, quality education and the security of lives and property. They should prioritize the welfare of the citizens. These will go a long way in providing good mental wellness. You can imagine you have gone out since morning and you come back home everywhere is dark because there is no electricity. If the weather is hot, you cannot relax well and you’ll be irritable. That person will not be in a good frame of mind. Another thing is that they should look critically into all their policies. Before they bring out any policy, they should look into it through and through and ensure it’s not going to bring unnecessary hardship upon the citizen. So in everything we do, we should look out for the mental well-being of the citizens.