I have always believed that all of us need a sense of our own identity - a feeling that we really know who we are and where we belong. This is the core of our ability to cope with the world. This is the bedrock, you might say, of mental health, and its absence is the genesis of mental disturbance.
There was mental illness and cases of institutionalisation in my family, as there are in virtually all families. My grandmother had what is now called bi-polar disorder. But growing up, I didn’t know that.
I didn’t know that others were also experiencing this, so I felt ashamed and scared and, most importantly, unique. I felt like an outcast in the world. I wanted what I thought was a normal, calm family, but wasn’t really aware as a child that that was what I was longing for.
My father grew up in a Detroit suburb. He was raised by his father, aunts and uncles because his mother, my grandmother, left Detroit without much warning and moved to Florida when my dad was young.
My grandmother would disappear for years at a time as I was growing up. Then, seemingly out of the blue, I would receive newspaper clippings with passages circled, notes attached and sometimes flower petals and glitter. I really didn’t know what to make of these odd gifts.
My parents’ explanations for my grandmother’s behaviour were often vague. They tried to reassure me, but their explanations raised more questions than they answered.
As I got older, I struggled to fit in, to be part of and to join the world. I just knew I wanted something other than what I was feeling. I wanted to feel like I belonged. I wanted to be comfortable. But I didn’t know any of this.
I vaguely understood that my grandmother was not ‘normal’, but I was given little understanding of what normalcy really was. Lacking information, I became convinced as an adolescent that whatever ‘normal’ might be, it wasn’t a word that described me or my family.
At a time when I wanted more than anything to be the same as everyone else - to fit in at school and in my own family - I felt isolated from the rest of the world.
When my grandmother died, I helped my father empty her Palm Beach apartment. This gave me a sense of understanding, a feeling that she was a woman who struggled to be part of the world, and a woman who loved me very much. I no longer needed to feel separate, to feel apart from the world.
All of us, with or without mental illness, are humans together. We all need to be thought of as equal.
I never suffered from bi-polar disorder, but I know many people who have a mental illness. I cannot tell the stories of their struggles because their stories belong to them and are theirs to tell. This is one of the problems of mental illness: we continue to treat it as something very private, something people would make harsh judgments about if they knew.
I can tell my own story, however. I had my bout with emotional problems throughout my teens and 20s, using alcohol and drugs to escape the isolation I felt. That struggle is now 30 years behind me, but, of course, it continues to shape my life.
It is my hope that one day people will receive stories about mental disease in the same way they would listen to the story of a broken arm - without judgment.
Al Jazeera partnered with One in Twenty to explore various narratives on what mental illness means to their contributors. This is one of their stories.
Photo by Ellen Jacob
- Todd Danforth
One man reflects on what his grandfather’s battle with dementia has meant for the entire family.
Although dementia isn’t universally considered a mental illness and there is some debate over whether it should be labelled as such, it does share a lot of the stigma and associated issues with mental illnesses.
Video by Greg Marinovich
One man explains why his fight against his addictions is a lifelong journey.
Monsters are real. Forty-year-old Alejandro Morales has seen them.
Right now, he sees a swearing monster, but he doesn’t pay attention to it. It comes and goes. It holds Alejandro’s gaze, but he tries not to get distracted by it.
He remembers how life used to be, before he was diagnosed with paranoid schizophrenia.
“I used to be a parachutist at the ministry of defence. I worked there for three years. We earned a good wage.”
“Once, after leaving the boot camp, I fainted. I saw skulls everywhere I looked. The next day, I skipped work because I had a headache. I was fired from the unit on that day. Me being there felt like a dream. I couldn’t care less about life [after I was fired].”
Before he was hospitalised, his visions stalked his mother and kept encouraging him to kill his father.
“Once, I took a stick to kill my father,” he remembers. “The police got called and they took the stick away from me.”
He speaks calmly - a result of the antipsychotic medication he’s taking.
The visions look like people, he says - dirty, dishevelled people who crawl up his ankles and stick to his shins.
“You get really itchy,” he explains. “You rub it away with a sponge until you bleed. Then, doctors come and rub you with ointment.”
There are particular sounds that trigger feelings in Alejandro. If he hears a lawnmower in the distance, for example, he feels as if a saw is chopping off his leg. If he thinks of a bee, one appears and he feels as though it is trying to sting him.
But things weren’t always like this.
When the visions first started, he didn’t take it too seriously. Then, they became unbearable.
Since he has been taking his medication, the monsters embody different shapes. Sometimes they multiple.
He beats and curses them.
“They are like a ghost, a person. No, two of them. Like twins. When they show up on my way to the chapel I only have to say ‘get out of my way, f*****g monster, why are you following me, mother f****r?’, and they leave,” he says.
Sometimes they crawl through his hair. He wears a bandage across his head. He says that he wears it to banish the visions that take over his head.
Some of them ask him to remove the bandage. But he says he feels better wearing it. “It’s like my lucky charm, it gives me light.”
And that’s how it all begins. After he discusses his antipsychotic medication doses with the nurses, his mouth goes dry. A couple of minutes later, his eyes seem to bulge out of his head. And then he falls asleep, on a folding bed at the Psychiatric Hospital Samuel Ramirez, on the outskirts of Mexico City.
It is the only way to banish the monsters.
Photo and text by Alejandro Saldivar
One woman shares her story of growing up with a grandmother with bi-polar disorder.
All my life I’ve struggled with mental disorders. Ever since I could remember, I’ve tried to understand what was wrong with me. Why didn’t God love me enough to make me feel ‘normal’?
A series of events in my life have whiplashed me back and forth between happiness and fear.
I’ve seen, heard and experienced things that a ‘normal’ person should never.
It made me angry. I hated my life because of the family it gave me, and I hated that I hated life. I wanted to be happy; I wanted to smile all day long.
But I grew up with an alcoholic stepfather who wouldn’t hesitate to whip us and ‘teach us a lesson’. One moment I was dancing on his feet to a country song, My Maria; the next he was yelling at me in the school gym because I’d missed a shot.
I loved and hated him at the same time.
I never cried, though. That was unacceptable, and he’d give me a reason to cry if I ever did that.
Then, the unthinkable happened, and boy did my world get thrown into a frenzy. My ‘dad’ molested me. I was 10.
I gave up. It was like I turned my humanity switch off. I didn’t care about my life. The way I thought about it was that if he didn’t care what he did or what happened to me, why the hell should I.
I resorted to acting out, skipping school, going in and out of the juvenile detention system, fighting, running away, drinking and smoking pot.
I hated my life, I hated him and I hated myself.
I think I spent almost every day in jail just because I didn’t want to be at home, I didn’t want to see him.
After I finally told someone, an investigation was started and they interviewed me. I was sent to a treatment centre to deal with my problems.
I’d been there for a while when I got word from my mum: my ‘dad’ had killed himself.
My world collapsed. I remember screaming because, in my mind, I’d killed him. I had taken my brothers’ and sisters’ dad away from them. He did it because of me; because I told on him.
I struggled with guilt, shame, hate and love - all at the same time.
I became a cutter; I cut my arms to feel. I wanted to see if my life was real. My emotional pain was way worse than the razor marks or the blood that fell. Nothing would amount to the pain I had to live with. Nothing.
The treatment centre I was at doped me up with so much medication I couldn’t function at all. I either slept through everything or was just dazed.
I would ‘cheek’ my medication, because feeling pain was better than feeling nothing at all. I was numb. I wanted to feel something, because feeling nothing was the worst I’ve had to go through.
After almost four years, I learned not to blame myself. I know there was something wrong with my dad, and that maybe no one ever saw or even cared to help him with it. I forgave him and I forgave myself.
Hate isn’t something that I feel anymore, but depression is something that I will always struggle with - even now as a mother of three beautiful children. I have my mummy moments, but I’ll take my moments over how I felt when I was 12 years old.
My life could have been worse. The outcome would have been way different if my mum never intervened and saw that I needed help. For that I will always thank her. She saw my cries for help. She saw the pain in my eyes. She saved me.
I used to automatically view having a mental illness as a negative thing. But as I got older and more informed and lived with other girls with different types of mental illness, I found ways to cope and to identify my triggers.
Everyone is different and everyone has a story: some were born with it, others had something traumatic happen to them.
In my case, my life has always been a complete roller coaster.
I used to want to be ‘normal’, but I have no idea how that feels, since this is my normal.
Al Jazeera partnered with One in Twenty to explore various narratives on what mental illness means to their contributors. This is one of their stories.
Photo by Samantha Herrald
One woman goes on a journey to understand how the mentally ill are treated in Africa.
In a Mexico City psychiatric hospital, one man describes the monsters that cling to his legs and sometimes urge him to kill his father.
- Alejandro Morales
There was one scar that was my favourite. It was on his shin and shaped like a small sunflower. It marked the spot where, for 26 months, a bullet had remained lodged.
My older brother and I would sit fixated as our father told us the stories behind the scars - remembering the day he’d been severely wounded in a six-hour gunfight with Indian troops at the tail end of the 1971 war between Pakistan and Bangladesh, and the many months he’d spent as a prisoner of war after that.
There was one that looked like a dimple on his left cheek. A piece of shrapnel had hit him in the face, leaving a hole through which food would sometimes fall. The wound had healed, but the scar remained, and I’d often watch it at dinnertime, just in case a speck of food could still make its way out. How I wished that I, too, had a hole through which unwanted food could be disposed.
Then there was his crooked left thumb. A mortar shell had grazed it, snapping a tendon so that it resembled a stout old man struggling to stop his hat from blowing away in the wind. We’d try to wrestle it straight - but it never worked.
He wore his scars like a badge of honour - and in our eyes, he was virtually a superhero.
Of course, what we didn’t know then was that there were many other scars we couldn’t see - far more serious scars, hinting at far more ominous wounds.
Slowly, they started to make themselves known. There were just subtle changes in his behaviour at first. But they gradually grew more noticeable.
Two years later, he was hospitalised - kept in a lock-up with drug addicts and the mentally ill. My mother would visit him there, taking our baby brother but leaving me and my older brother in the car. It wasn’t the type of place she wanted us to see. So we played, oblivious to what was going on behind the hospital walls.
My father was diagnosed with paranoid traits.
There was a stigma attached to mental illness in Pakistan then. There still is. And my mother knew that people wouldn’t understand. She worried that my father would lose the respect of his family and friends. She stopped socialising with people.
It was a year before she told anybody what had gone on. She confided in her father.
But this was just the beginning - hospital visits would become routine, his seizures or ‘episodes’ a normal part of our lives, his epileptic fits frequent.
But there was also joy. Birthdays, anniversaries, random achievements at school were all reasons to celebrate. There would be cake and laughter, and my dad would be at the centre of it all.
As a two-year-old, I hijacked my brother’s fourth birthday party - insisting upon cutting his cake. The celebrations had to be paused until my dad could bring me a cake of my own.
But all of this had changed by the time my eighth birthday approached. My mother was on bedrest ahead of the birth of her fourth child and my father was in and out of hospital.
So I took it upon myself to plan my own birthday party - drawing up the menu and guest list with the help of my brother. We pulled it off, but I realised for the first time that I was losing my dad.
Not long after that, he was diagnosed with schizophrenia.
He was prescribed medication that soothed his nerves. But he wouldn’t always take it as he was supposed to and was reluctant to attend his medical appointments. My parents would argue. I’d pray for them to stop, for my dad to take us for ice cream, for him to remember to accompany me to the party I’d looked forward to all week.
I didn’t realise how difficult it was for him - fighting his illness just to be able to function, fighting to keep his job, fighting family and financial pressures.
I’d wonder at how simple logic seemed to fail him. But when your brain isn’t working as it’s supposed to, there is little sense to be found in even the most accepted of behaviours - taking a shower or changing your clothes.
That’s the problem with mental illness - you can’t see or touch it, and yet it touches us. And, of course, we don’t make the same allowances that we might for those who are physically incapacitated.
I know I didn’t always make allowances for him. I didn’t understand why he couldn’t just pull himself together and stop being so stubborn. I questioned why he had to embarrass me in front of my friends, with his slurred speech and frail demeanour. I couldn’t possibly explain to them that he walked with those funny, shuffling baby steps because he was no longer in control of his movements.
By then, he’d been diagnosed with dementia and alzheimer’s. He didn’t resemble my friends’ forty-something-year-old fathers.
He was a shadow of his former superhero self.
He had, it emerged, thousands of pieces of mortar shell embedded in his brain.
Still, we believed in miracles. We always had hope. Until the day we didn’t.
He had been in a coma for 10 weeks, and we finally had a correct diagnosis for what had been afflicting him - cerebral atrophy, a shrinkage of the brain caused by the shrapnel.
I was sat by his bedside when he stirred and squeezed my hand. And then he died.
An Ahmad family photograph
One woman describes how cutting herself felt better than dealing with the emotional pain or living in a medication-induced daze.
Mental illness is beyond subjective. For me it is personal and it is hard to look beyond that. It’s genetic, and something I think about constantly. I have tried over the past six years to understand what mental illness means to me through photography. The process has been cathartic for both my mother and I.
You Have Nothing to Worry About, the long term project recording my mother, is a complex and difficult body of work that can be broadly defined as documentary photography. Since 2009, I have been making photographs of my mentally ill, substance-abusing mother. Her diagnoses change frequently - from alcoholism to dissociative identity disorder - and my relationship with her has been fraught with animosity for as long as I can remember. I am fully aware that my mother thrives on being the centre of attention and that, at times, our portrait sessions encourage her erratic behaviour. The photographs are simultaneously upsetting and encouraging; honest and theatrical; loving and hateful.
Mental illness has affected my life in ways I don’t even understand because for me mental illness is my mother. It is every fight or mishap and has been my whole life. It’s the reason things have been different for my family but it’s also the thing that over the years has kept us together. It has pushed us to become introspective and patient. For my family and I, mental illness means relaxing in the quicksand and helping someone get out.
Al Jazeera partnered with One in Twenty to explore various narratives on what mental illness means to their contributors. This is one of their stories.
Photo by Melissa Spitz
A daughter recalls how her father’s war wounds ran far deeper than the visible scars.
Depression is insidious because many people suffer from it without realising that it is an illness. This was the case for me. My first episodes occurred during my teens in the late 1970s. At the time, depression was rarely spoken about and it was largely misunderstood. The prevailing view was that sufferers of depression should simply pull themselves together and ‘get over it’. But depression never lends itself to an easy cure. It is a mercurial condition that often worsens when it is downplayed or ignored.
It wasn’t until the 1990s that I began to suspect that I was prone to depression. By then I was deep into my career as a photojournalist, mostly covering conflict and global poverty. I used my hectic schedule as an excuse not to confront my own problems.
Then, in 1994, I was sent to Rwanda to document the unfolding genocide. To this day, there is not a book I have read, a film I have watched or photographs that I have seen that communicate the true depth of the horror experienced by the Rwandan people.
Afterwards, I could no longer pretend that my depression didn’t exist. I had nightmares and bouts of psychological blackness that persisted for years.
Depression treats the mind as a blank canvas. The imprint it leaves is abstract and unique to the person it affects. In me, it manifested itself in feelings of abandonment, despair, melancholy, hopelessness, and mental and physical paralysis.
It is difficult to explain being in an acute state of hopelessness and at the same time feeling that you are paralysed, trapped in a dark place and unable to escape. It is not unlike walking into an ordinary room with a door and windows, only to feel, inexplicably, that there is no way out. This sensation causes further disorientation, anxiety and fear, usually creating an emotional downward spiral.
Depression not only exacts a toll on people who suffer from it. Destructively, my depression spilt over into my personal life, impacting loved ones and friends.
I self-medicated, particularly with alcohol, in an effort to cope. In the short term, drinking made me feel better, but ultimately it only made my state of mind worse.
I was often intolerant, irrational, argumentative and belligerent to the people who loved and cared about me. Nothing any of my friends or family said or did in attempts to help made any difference.
It is often said that when you hit rock bottom there is only one way up. I became desperate to find a way back to the surface.
During a medical check-up in 2008 the doctor warned me that I needed to make some positive changes if I wanted to stay alive. I already knew intuitively that he was right.
By this time, I was more aware that depression was an illness, and I researched it further. Medical studies suggest that there is often no clear cause and no magic cure for the condition. Within this context I realised that, while I might not be able to conquer my depression entirely, there were some relatively simple lifestyle changes that I could put into practice to ‘manage’ it.
These included getting into a routine, setting goals, eating healthily, taking on new activities, getting enough sleep, and avoiding addictive substances. I made these changes and became teetotal seven years ago.
Although it was a challenging process at times, the benefits were immediate. It was as though someone had turned on the dopamine tap in my brain again.
I have maintained this regime and depression has retreated – for the most part. I doubt that I’ll ever be totally free of it. However, I am no longer in denial and I have learned how to live with it. Optimism has replaced despair, productivity has replaced paralysis, and all the rooms I walk into now have windows, and a door that I can walk out of again.
Photo Courtesy of Gerhard Joren
One woman describes photographing her mentally ill, substance-abusing mother, and how that has helped her understand what mental illness means to her.
As a child I was raised in a very difficult environment. My mother was a prostitute and a stripper. From the age of six, I witnessed her having sexual relations with strange men for money.
We moved every three to six months, living in trailer parks, motel rooms, cars, apartments and houses, never knowing what school we were going to or who the new guy was going to be.
I went on the join the US army, where I was deployed to Iraq for 12 months, from 2008 to 2009. I was a lead gunner charged with protecting convoys.
After returning home from combat, my mental health began to deteriorate. I started having flashbacks from both my childhood and my time in the military. I would have gut wrenching nightmares. I would hallucinate while I was driving. In every relationship I had with a woman I would black out and yell at them. I’d degrade them and make them feel small, and have no recollection of doing it.
It wasn’t until 2010, when I attempted to take my own life, that I was diagnosed with Post-Traumatic Stress Disorder (PTSD). It was a result of the traumatic experiences from my childhood and my time in the military.
‘Mental illness’ is society’s way of labelling someone or something they don’t understand. It is all about diagnosis, acronyms and medication. While I do believe that depression is a word that can explain what someone feels, I don’t feel that it is a label.
“Patient A is feeling depressed, so let’s label them as manic depressive”. How about this: “Patient B gets more anxious than the average person, let’s label that anxiety disorder”.
Why? Because their emotions may seem a bit more extreme than the average person?
Don’t get me wrong, I do believe that there are people out there who are mentally ill - rapists, serial killers, mass murderers. That’s the perfect definition of mental illness. But someone who struggles to get out of bed in the morning because they feel sad? That’s not mental illness.
We have become a society that has to label everything. But these labels damage us. When you give someone who already feels down a ‘negative label’, you feed into their ‘mental illness’. You are also giving them a word to hide behind so that they don’t have to try and fix the problem.
Panic attacks, anxiety, depression and mood swings are not a sign of a mentally ill person. They are a sign of being human.
I know many people will find my views controversial, and some may feel as though I’m attacking them. But this is my personal opinion. Think about it: the last word in PTSD is ‘disorder’. It doesn’t make you feel good, does it?
I don’t have a disorder. I have a normal human reaction to the extreme situations I have experienced throughout my life. I am not ill, I’m normal compared to the life that I’ve lived.
Photo Courtesy of Andrew O’Brien
After returning from covering the genocide in Rwanda, photojournalist Jack Picone could no longer pretend that his depression didn’t exist.
One man explains why he rejects the labels of mental illness.
Click on a picture to read the story or scroll down
- Jack Picone
- Melissa Spitz
- Sunniya Ahmad Pirzada
- Andrew O’Brien
- Ellen Jacob
- Samantha Herrald
Children are everywhere in Gaza. In their striped school uniforms and colourful backpacks, they play in the streets and among the rubble of bombed out houses.
They live under siege, and those aged six and over have already experienced three wars in their lifetime.
According to UNICEF, during the last one, 539 children were killed, 54,000 became homeless, 2,956 were injured and 1,500 were orphaned.
Theirs is an almost unimaginable psychological burden - but it is one with which Dr Hasan Zeyada must grapple.
The psychologist works from a non-descript office in Gaza City and manages the Gaza Community Centre’s mental health programme.
Born and raised in Gaza’s Bureig refugee camp, the talented basketball player received a scholarship to al-Najah University in Nablus. He chose to study psychology, but never imagined it as a vocation.
He soon learnt, however, that he had a closer personal connection to his topic than he realised.
Zeyada’s father had been shot in the legs by an Israeli soldier in 1948, as he tried to reach his dead brother in the family’s village. As a child, Zeyada always wondered why his father was so afraid whenever he heard shelling, shooting or explosions. Now he was beginning to get some answers.
The realisation that everybody has a story inspired Zeyada to pursue psychology as a profession.
The 51-year-old talks about the issues facing children in the Strip. “[They] are the most vulnerable group in the Gaza community,” he says.
“They are living in an extremely stressful environment in a chronically traumatised community.”
“The feeling of insecurity is the main issue children are suffering from. At a young age they have critical questions about their future: they ask their parents if they can leave Gaza, some even think they will be able to leave when they finish secondary school. Even more worrisome are the ones that dream to die because paradise will be safer.”
“They are continuously experiencing a threat of losing one of their loved ones, their house, their belongings or their school. Children feel that their parents cannot provide the security they long for, which makes them feel helplessness.”
This is often expressed in nightmares, difficulty sleeping, problems concentrating, hyperactivity, communication issues, violence, stuttering, clinginess and anxiety. There are also somatic problems like headaches, back pain and loss of appetite.
Something as natural as thunder and lightning can lead them to re-live traumatic experiences.
In treating children, Zeyada and his colleagues always look for a community-based approach.
“Family members, most of the time traumatised themselves, teachers of kindergarten and elementary school are getting involved in helping the child to cope in the best way possible with their traumas,” he explains.
“The main risk for children in the future is that they have realised that violence is one of the main ways to face frustration or obstacles in their lives.”
The mental health programme draws primarily on play therapy, drawing and family counselling. A lot can be learnt from the type of toy a child chooses to play with or the colours they use in their artwork, he explains.
The Centre has also begun experimenting with drama therapy, where the children are able, for example, to imagine themselves as animals and to express their feelings in that way.
But besides being a “helper”, as Zeyada describes himself, he is himself a victim and a survivor.
During the last war, he lost six family members: his mother, three brothers, his sister-in-law and a nephew. He needed the help of his colleagues, he says.
And what makes living through a war in Gaza so traumatising, Zeyada explains, is the fact that people simply have no place to flee to.
“In Gaza we are in a big prison. When people were under attack and decided to run out into the street, nobody knew where to go, no one can say that schools, hospitals, mosques are safe places to shelter. They realise the world is not a safe place as there is not one safe place in Gaza.”
Many families would choose to stay together in a single room, believing that if something were to happen, at least it would happen to all of them and that nobody would be left behind to grieve.
“Predicting the future of the children of Gaza is hard,” Zeyada reflects. “Some will be able to cope with their trauma, depending on their age, the type of trauma and their family support.”
“It also depends on the situation: will there be an end to the siege, the Israeli occupation, so that real security can be provided?”
“Sometimes it feels like you are working in a circle, as if through therapy you were preparing people for what will happen in the near future,” he concludes, before adding: “However, hope is something embedded in the Palestinian culture and religion - to be patient and trust in your faith.”
Photo and text by Edmee Van rijn
- Abdirisak Mohamed Warsame,
A mental health project manager says there has been “an explosion” of mental health conditions in Somaliland, but the country is ill-equipped to cope.
I was born in a small town in Leningrad oblast, where two thirds of young people are addicted to either drugs or alcohol, or both.
Drug addiction is a complex problem; its roots can be physical – a genetic predisposition, social – an abusive environment, physiological – a lack of self-confidence, but the defining factor is always spiritual.
Everyone faces the eternal question of the meaning of life and everyone searches for ways to fill this inner emptiness in their own way. Drugs give an instant feeling of purpose, freedom, confidence and inner peace. You don’t yet know what the problem was, but already you’re certain that you’ve found a solution.
Of course, it’s an illusion, but it grips you immediately and holds on tight.
I started taking heroin when I was 13, but it wasn’t until my late teens, when I enrolled into university in St. Petersburg and looked back at the ruined social connection I was leaving behind, that I realised I had a problem.
I tried to break free from my old habits, but I had no other means to fill the emptiness inside, so addiction soon won again.
A big part of what makes this mental illness so strong is the constant self-denial; you see a problem, yet refuse to acknowledge it.
I hit rock bottom when I was 24: my girlfriend left me, friends stopped talking to me and my own family refused to let me into their house. I finally decided to seek professional help.
Over the following years, I tried every available treatment, from traditional medicine to spiritual healing, and while some eased the symptoms, none offered a definitive solution.
Withdrawals were relatively easy to get through, but the hardest part started after the treatment, when the emptiness came back.
Drug addiction is a physiological illness that fundamentally shifts your value system. It gives you an illusion of a higher purpose, so all else fades in comparison. Material goods lose their value beyond the amount of money you can sell them for to buy drugs.
This fixation is all-consuming, so if the newly found purpose of existence requires fighting for or sacrificing good on its altar – be it a stolen mobile phone or money from your mother’s purse – so be it.
Fighting this evil requires a complete paradigm shift that is only possible with the ill person’s full participation in every step on the way to recovery. It is a long journey – lifelong for most of us.
Photo and text by Tina Remiz
- Dr Hasan Zeyada
How one man is helping Gaza’s traumatised children.
Mental Health Project Manager,
Mental health is an abandoned field in Somaliland.
I’ve been working in mental health for nearly 20 years now, first as a social worker on a mental health ward and later as a project manager with the Italian NGO GRT.
I became involved in mental health because it is a neglected field here, but also because there are opportunities for improvements to be made.
That said, it was difficult to get involved in the first place. When I started in 1995, my parents used to ask me “Where are you going?” They would ask if I was going to the ‘jail of the crazy’, which was how the community referred to the mental health facility in Berbera [a port city in Somaliland]. When I said yes, they would say “Why are you going?”
In our society, there is a belief that if you work with the mentally ill, you will also become mentally ill. So that’s why my parents were asking me, “Do you want to become mentally ill also?”…“Why are you working there?”
I believe mental health conditions are medical problems and they need to be solved through medical means and medical attention or care. People need to be treated in medical institutions and with psychosocial support, alongside or following medication.
But in Somaliland there is very little knowledge about mental illness. When I see normal people on the streets of Hargeisa abusing the mentally ill, I feel very sorry and I have to act.
The community has no formal ways to provide for people with mental health problems. The government is struggling with the other health issues that are more treatable; only recently did Somaliland’s ministry of health establish a mental health office.
But there is an explosion of mental illness in this society.
We are a country that has come from war, and I think there are a lot of people affected by the war itself. It ended in 1991, but some people did not find security afterwards. There is a high rate of poverty and widespread unemployment; also many people chew khat.
Attitudes in our society are that we should gather mentally ill people in a structure and keep them there, like in a prison. With limited services on the public side, we are seeing the emergence of private mental health facilities.
They do have to start somewhere, but there is a lack of knowledge about how to run these centres.
Globally, knowledge is increasing each day – there is new knowledge about new drugs, new ways of dealing with people with mental health conditions.
But some of these centres hold people for a long time, without an admission and discharge process. I’m worried that in the near future some will turn into detention facilities.
Chaining is a problem in our locality. A lot of people are chained. This is the first concept that comes into the mind of local people when someone becomes mentally ill – chain them. It has a lot of negative impact of course. The mental wellbeing of the person deteriorates.
I have seen people who have been chained under trees for a long time, and who then stopped talking. When they were brought to us at GRT, we were told that they used to speak Somali, Arabic, English, and even Swahili, and now they’re not speaking.
If a person has been chained for a long time with no one speaking to him, he feels that he has been abandoned and becomes like an animal. It’s just one example but after the provision of medication, one of these people spoke again.
Medical faculties in Somaliland do not train psychiatrists, so we have very few professionals who understand and a limited availability of psychotropic drugs. If we can get the right drugs, and the right doctors who do the right diagnosis, then there can be revolution here against chaining and how mental health problems are addressed.
Zoe Flood travelled to Somaliland with Human Rights Watch to investigate abuses in mental health institutions.
Photo and text by Zoe Flood
“When I got my diagnosis, I felt such a fool”
- Jim Wood
Jim Wood thought PTSD was the sort of thing that happened to war photographers. Then his wife died…
Suffering with a mental illness is one of the most debilitating things I have ever been through.
I was diagnosed with PTSD after my wife died. I was hardly functioning and going through a total meltdown.
When I got my diagnosis, I felt such a fool. I had read lots about war photographers suffering from PTSD, people like Giles Duley being blown up and losing two legs and an arm, people who had been with Tim Hetherington in Syria. That’s a reason to get PTSD I thought, who was I to be diagnosed with it, what had I done here in a rural town in England?
I voiced this opinion to my therapist, whose response was that PTSD is something that happens to ordinary people when out-of-the-ordinary things happen.
The only way to get better was to try and find a way to control the emotions and the thoughts running riot in my mind. It’s all about keeping centred, keeping a focus on what is good in life and pursuing the things that enrich it. For me that’s my children and my work covering political demonstrations, spot news and social issues in the UK, pushing the boundaries of my anxiety to get the shot.
Photo by Jim Wood
- Amy Kalasunas
A clinical counsellor explains why she dislikes the term ‘mental illness’.
My name is Amy Kalasunas. I am a licensed professional clinical counsellor.
When I was in high school everybody came and talked to me, and I liked it. I took a psychology class and it piqued my interest. In college I continued to study, and when I was 20 years old I volunteered at a mental hospital. After my training I advanced to answering calls on a suicide hotline. I wanted to know if I could speak to a stranger and make a difference.
I have a graduation announcement from a highly regarded private school, it was sent to me by a former client. When we met, she was 23, anorexic, working in a topless club by the airport, and using crack cocaine. When she finished therapy, she was sober, a normal weight, working at an insurance company, and paying her way through college. She earned an accounting degree and is now working at a top firm in Chicago. I was incredibly lucky to watch her grow.
I feel like mental illness means stigma. If I had an office where I was wearing a white coat, you had lab work from a nurse, we talked a little bit, and I did some sort of Western medicine procedure, then I don’t think people would mind walking out the door and saying, “I have PTSD,” or “I have a major depressive disorder”. I don’t think people would be ashamed.
I even hate the term mental illness. You hear mental, and that’s a derogatory term in many ways. It doesn’t mean you are cuckoo. Call it a disease, not a mental illness.
Photo and text by Angelo Merendino
- Joanna Spirou
One woman recounts growing up with a schizophrenic father and her own battle with depression.
I grew up in a household with a father who suffered from severe paranoid schizophrenia.
I hated every moment of it. He would scream and yell all day and all night long, and was always trying to make us believe his convoluted, delusional stories.
I was always anxious and feared for my life.
The worst moment was when he locked my mother in their bedroom as he was outside loading his rifle. Luckily, my mother escaped through the window and alerted the police. I was eight years old at the time. I remember feeling petrified.
It was only after I was diagnosed with clinical depression in my late 20s that I decided to break the cycle of fear and turn the negative energy into something quite positive.
My depression led me to go trekking into the wilderness, to start writing a blog and to take photographs along the way. I decided that I would use my illness as a vehicle to succeed in life and that I’d break down the stigma associated with it through meaningful conversations with others and through my blog.
Mental illness is a tough battle, and I work really hard every day to beat it. But there are times when I lose.
We have to remember that all is not lost when we suffer from a mental illness. There is hope for a wonderful, beautiful life. I’m living proof of that.
Photo by Joanna Spirou