Sunday Times Lifestyle Mental Health (March 5 2023)

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MENTAL HEALTH POST-PANDEMIC

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Over the past two years anxiety and depression disorders have increased

ovid-19 and resultant lockdowns affected people mentally, emotionally and physically. The consequences thereof included feelings of isolation, work stress, frustration at rules and regulations, fear for family and friends, and loss of control.

It’s not surprising there has been an increase in mental health-related issues.

One in six South Africans suffer from anxiety, depression or substance use disorder. Over the past two years anxiety and depression disorders have increased by 36.4% and 38.7% respectively.

Globally, 970-million people have a mental health or substance abuse disorder. A study by the Global Happiness Council (GHC) shows mental illness is the main ailment among working-age people.

“Mental illness has a massive effect on employers as they try to cope with keeping their businesses going, preventing job losses and maintaining a happy and motivated workforce,” says Dr Morgan Mkhatshwa, clinical executive at Bonitas Medical Fund.

He says economic uncertainty, political instability and poor socioeconomic conditions in South Africa have also added to the burden.

To make matters worse, according to the country’s National Mental Health Policy Framework, “up to 80% of South Africans who need mental health support are unable to access it easily”.

Mental illness is defined as “any behavioural or mental pattern that causes

Dr Morgan Mkhatshwa, clinical executive at Bonitas Medical Fund.

Picture: SUPPLIED

significant distress or impairs normal functioning”. It can occur as a one-off, be persistent or recur. The common denominator, says Mkhatshwa, is the condition’s debilitating nature.

Confirming that mental illness is a recognised medical condition, Mkhatshwa says it typically affects the way a person experiences and behaves. “Mental illnesses can affect anyone, regardless of race, religion, income or age. The good news, however, is that it’s a condition that can be managed and successfully treated.”

Anxiety disorders and depression are the most common mental health problems, but others include eating disorders, posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), bipolar disorder and psychotic disorders such as schizophrenia and personality disorders.

Substance abuse, such as drugs and alcohol,

is also classified under mental illness.

Responding to what is rapidly becoming a mental health crisis, medical schemes are stepping up. Bonitas, for example, has a Mental Health Programme (MHP) which is part of the scheme’s Managed Care initiatives.

The primarily education-driven programme aims to improve quality of life and empower people to manage their condition, as well as offer support for Bonitas members.

In addition, Bonitas was the first medical scheme to offer its members Panda. A free-todownload mental health and wellness mobile app, Panda provides scientifically validated assessment tools to enable users to measure their mental wellbeing objectively. A gamified tracking tool allows them to document and monitor their progress in their mental health journey.

The app allows members to engage in interactive, audio-only sessions with peers and mental health experts in the “Bamboo Forest”; learn new skills through assignments and videos to help them live more fulfilled lives; track their mental health progress to measure how they are feeling; receive textbased chat support from an accredited wellness counsellor and book one-on-one virtual consultations with accredited and registered counsellors, social workers, psychologists and other mental health professionals.

“The level of support provided depends on the degree to which the member needs help,” says Mkhatshwa. “This ranges from level one, where there is an easy access point to

Levels of stress have increased. Picture: SUPPLIED

community, information and support, to level 5, where Panda will notify the member to contact emergency services. We know how tough it can be to go through difficult times by yourself. Panda is intended to make it easier for members to find the support and resources they need. Ultimately, it’s about ensuring the right support and resources when the member needs them — all available using their phones.”

Historically, there has been stigma associated to mental health disorders.

However, as the Mental Health Society says: “The social stigma attached to mental illhealth and discrimination exacerbates patients’ conditions. It often prevents people from seeking treatment. And if they do, makes it harder to recover.”

Fortunately, this is changing as more influential people come forward revealing that they have suffered from or have overcome a mental illness. “A more open attitude about mental health will go a long way towards debunking myths, negativity, discrimination and judgment,” says Mkhatshwa.

Pointing out that mental illness cannot be wished away, he says: “Don’t expect somebody with a mental illness to be able to ‘pull themselves together’, because they can’t.

However, with the right support and help, their symptoms will be relieved and the recovery rate is encouraging, with patients able to get back to being happier, more productive members of society.”

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HOW TO RECOGNISE SIGNS OF MENTAL ILLNESS Signs indicating a potential mental illness can vary, but generally include: ● Being frequently sad, down, depressed and gloomy for long periods ● Feeling overwhelmed by problems — excessive fears or worries, or extreme feelings of guilt ● Major changes in eating habits, resulting in weight loss or gain ● Struggling to concentrate and make decisions ● Loss of energy, lack of motivation and sexdrive changes ● Constant stress and anxiety about work, finances, life, friends and family

● Emotionally distant, detachment from reality

(delusions), paranoia or hallucinations ● Frequently tearful, trouble understanding and relating to situations and people ● Difficulty sleeping or sleeping more ● Loss of interest in social activities ● Easily irritated and more aggressive (hostile and violent) than usual ● Having thoughts of death or suicide ● Drug or alcohol abuse may also be a sign of underlying mental illness.

Symptoms of a mental health disorder can also appear as physical problems, such as stomach and back pain, headaches or other unexplained aches and pains.

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LEARN TO LOVE YOURSELF MORE Accept you will make mistakes, listen to your body and put yourself first

Wearables can play an important role in healthcare by measuring indicators such as blood pressure and sleep patterns, and helping people take a more active part in managing their health.

Picture: 123RF.COM

STRESS ‘THE ROOT CAUSE’ OF MENTAL DISORDERS Money, work, relationships, starting a career and life’s pace are among the major causes, but there is help out there

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ental health issues have a variety of sources, including genetic predispositions, but the root cause is stress. In South Africa, major causes are financial concerns, work, the future, personal relationships, family and existing medical conditions.

Financial worries top the list as the biggest cause of stress in men and women, irrespective of age, according to Damian McHugh, executive head of marketing at Momentum Health Solutions. Based on insights from the institution’s mental wellness programme, he says age and gender play an important role in people’s stress levels and what worries them.

Damian McHugh, executive head of marketing at Momentum Health Solutions.

“The incidence of mental health issues appears to be more prevalent among Gen Z in South Africa: the stress of starting a career during a pandemic and lockdown, combined with an ever-faster pace of living and working, have impacted this generation significantly.”

He adds that thinking about the future is a major cause of stress for Gen Z, with almost 49% citing it as a great stressor, compared with only 27% of people aged 55 to 64.

Momentum’s research reveals that women tend to stress more than men. Family life, selfimage and childhood experiences are areas they worry about. The only stressors males are more likely than females to cite are work (38% vs 27%) and misuse/overconsumption of legal stimulants such as caffeine, alcohol or smoking (19% vs 12%).

This, says McHugh, is probably because South African men still tend to suffer from the expectations attached to being the breadwinner.

“Women are increasingly integrating homemaker and career roles into their lives, and in most instances the stress they feel is intertwined, which is why they worry more.”

Men and women, young and old, need to learn how to effectively understand and manage stress and their triggers, he says.

“Identifying and managing stress can help mitigate and alleviate other health conditions, making it critical to treat the root cause rather than the symptoms.”

Identifying stress accurately can be tricky, he concedes. “Stress is often not attributed as the underlying cause of physical conditions such as high blood pressure, stomach issues and ulcers, or dissociative seizures, among others. What this means is that healthcare practitioners and medical schemes need to get better at not only picking up and identifying early indicators, but also helping people to manage their stress better.”

Just as we adopted the need for physical check-ups, so too do we need to make mental check-ups common place, says McHugh.

Expecting perfection puts unrealistic pressure on us, with consequences for mental health, says Margot Brews, head of Health Risk Management Strategy at Momentum Health Solutions.

This obsession makes it hard to accept we are human and make mistakes, contributing to a lack of confidence and self-worth that filters into other parts of our lives, including relationships, she says.

The challenge is to stop this vicious circle and better manage what is essentially a toxic relationship with ourselves to appreciate and love ourselves more.

Brews says there are a few steps to consider.

The first is to acknowledge that a better relationship with yourself starts with the acceptance of fallibility and training your thought patterns for positive change.

“Accept that you are human and that you will get it wrong from time to time. When you get it wrong, forgive yourself and move on.

Thought patterns and cognitive filters are like a muscle; they need to be trained to become developed,” she says.

Second, you are more than your thoughts, so listen to what your body is telling you.

“Many of us get stuck in a cycle of listening to our thoughts, even when they are harmful and self-destructive,” says Brews.

“This is where gut instinct and intuition comes in. Train yourself to listen to what your

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body instinctively knows is best for you and then act on what it is saying.”

Last, the key to self-care is self-love — putting yourself first, says Brews.

“Failing to take care of yourself is a form of self-sabotage. Make self-care a priority and consciously do what you know will restore your equilibrium. This looks different for everyone, but can be as simple as taking a walk, having a relaxing bath, meditating, reading, playing sport or spending quality time with a loved one.”

A few small changes every day will help us learn to love ourselves — and each other — more. “And that can only be a good thing.”

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PROVIDING TOOLS FOR WELLBEING Wearables have already shown they can play an important role in healthcare by measuring indicators such as blood pressure and sleep patterns, and helping people take a more active part in managing their health.

Companies and medical schemes, says McHugh, also need to play their part by creating environments and providing tools and support that promote positive mental wellbeing. Employers too have a role to play by creating a supportive mental health policy, providing mental health tools and support, and fostering an environment that promotes resilience and a healthy work-life balance.

“The tools that employers use for wellness screening should include the measuring of resilience and the capacity to deal with challenges through heart rate variability and other stress factors, as well as wearables and apps geared towards support and guidance, and dedicated wellness days,” he says.

Momentum Health Solutions has implemented a number of these tools and initiatives, aiming to create and develop programmes that address total health issues.

“For us, it’s a process,” says McHugh. “In addition to creating awareness and providing tools for consumers to measure their stress indicators, we also need to provide ‘bitesized’ steps to assist in prevention and recovery, all aimed at driving incremental improvements.”

The link between mental and physical health is undeniable, says McHugh. “We need to continue to normalise talking about it and destigmatise mental health conditions.

Though there is still a long way to go, we are on the right track.”

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Picture: 123RF.COM/JAVIINDY

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