PTSD is an anxiety disorder which is caused by a distressing event. It causes people to relive the event through flashbacks, nightmares, unwanted thoughts/images and physical sensations. It can also come with avoidance (desperately trying to avoid anything that might remind them of the event), feeling on edge and self-harm. The important thing to remember is that it is treatable (mainly through therapy and medication) and it can get better.
I have been diagnosed with PTSD since I was 14 years old. I experienced trauma as a child in the form of being sexually abused for 6 years by a family friend. It was horrific and devastating to lose my childhood.
When I was 14, I experienced another traumatic event, and I went on a downwards spiral of abusing drugs and alcohol, self-harming and hearing voices. I was desperate to escape the warzone in my head. This is when I was diagnosed with PTSD.
But in reality, I had been living with it since I was first abused at the age of 6. I got the nightmares, I got the avoidance, I got the pain, and most of all, I got the fear. That’s what PTSD is to me, it's pure fear. Feeling terrified all of the time, the thoughts racing so fast you can’t even breathe. The waking up in the middle of the night saying ‘no stop’ because you don’t know what's real anymore. Getting sweaty palms when someone wants to shake your hand in case, they grab me. The seeing someone who looks like the perpetrator so I literally stand in the middle of the street and pee myself. I’d love to be able to say this is all in the past and it doesn’t affect me anymore, but unfortunately that wouldn’t be the truth.
Every day I wake up feeling scared of the day ahead. Every day I go to work scared that I'll be humiliated by wetting myself on my break. Every time I go on dates, I'm scared because if I get close to someone, they might hurt me. Every time I have sex, I cannot be sober as I know I'll have a panic attack. Every day I go to sleep terrified of nightmares. Every day I live like this. And its hell.
Going through the trauma was hell. But reliving it every day? To me that’s worse.
Luckily there are ways to manage it. One way I help myself is by using grounding techniques, which help me to stay in the here and now. The most useful one for me is the 5,4,3,2,1 technique. You say 5 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell and 1 thing you can taste.
Another way I help myself is by using positive affirmations, I remind myself that I've gotten through my bad days before, and I can do it again. I look in the mirror and I tell myself that I'm worthy, I'm valuable and I am loved. I also go to therapy every week to talk about what happened and learn to process the event and understand how it's affecting me now, so that I can learn how to change it and manage the symptoms of PTSD.
Here is a poem I wrote to my ex (who abused me) recently, to tell them I'm moving on, and I hope that you can too.
Every breath I take
Proves I can live without you
All these feelings of loneliness
Is something I'll get through
I might think I need you
But you are not the sun
You are not essential
To me living on
I’ll get my independence back
One day you won’t cross my mind
You are just one person
You are not mankind
I know that this will hurt
I know that you’ll move on
But I deserve the best in life
So I’m glad that you are gone
A psychosocial disability occurs when a mental illness becomes pervasive and disabling. According to a report of the United Nations High Commissioner for Human Rights (2017), the term has to do with “actual or perceived impairment”- that is that the concept deals not only with the challenges persons with these disabilities face as a consequence of having this type of disability but also the stigma that society sometimes attaches to it. Often misunderstood, it is important to raise awareness about such mental health conditions. This is the purpose of commemorative occasions such as Psychosocial Disability Awareness Month, which takes place in July 2019. For this year’s annual campaign, the South African Federation for Mental Health (SAFMH) has elected to adopt the theme “Psychosocial Disability and Identity.”
According to Booth (2000) disability in a socio-cultural context can be defined as "a barrier to participation of people with impairments or chronic illnesses arising from an interaction of the impairment or illness with discriminatory attitudes, cultures, policies or institutional practices" (Booth, 2000).
According to James (2015), “In psychology, identity is the qualities, beliefs, personality, looks and/or expressions that make a person (self-identity) or group (particular social category or social group).
Identity affects how kind or unkind a person is to themselves, their interactions with other members of society and their actions or inactions regarding aspects such as careers, education and relationships. Disability is something to take into consideration when a person formulates how they view themselves and their consequent behavioural patterns. In terms of how a disability may fit into these perceptions and consequent life choices, Murugami (2009) articulates that a person with a disability need not construct their identity in terms of impairment alone, but rather is capable of doing so independently of their impairment while accepting the reality of the impairment.
Disability is not something by which a person should be bound. However, it is important that a person accepts their disability. This will enable them to manage their disability appropriately. There is much that can be done to manage a psychosocial disability, including eating healthily, exercising, complying with treatments and how a person sees themselves is a determining factor in how they treat themselves. Having a disability should not be seen as an insurmountable challenge and a person should know that they are so much more than the challenges they face.
Unfortunately there exists stigma in society about psychosocial disability. Individuals with these mental health conditions are often seen as unpredictable and dangerous and are thus often excluded socially and in settings such as the workplace. Corrigan and Watson (2002) set out that there are two types of stigma- “public stigma” and “self-stigma.” The former deals with the perceptions and actions of society and the latter with how people internalise the stigma against them and internalise it. These authors cite people with psychosocial disabilities as being “doubly challenged” because they have to deal not only with a disability but also with society’s unfair treatment.
How a person identifies with their disability will determine how and if they share their diagnosis with the people around them. Rohini, Fulginiti, Brekke and Rice (2017) highlight the benefits of disclosure, citing that it promotes good mental health. Disclosure can be important in the workplace as people with psychosocial disabilities sometimes require reasonable accommodation. Disclosure to family and friends can provide a person with valuable support in times of need. Disclosure must be carefully considered, however, because many people are either misinformed or uninformed about psychosocial disability, which could have consequences such as negatively impacting on relationships. It is therefore important that the person disclosing the information have answers and information on hand to address any concerns that the recipient of the information may have.
If a person is confident in their identity in relation to their disability, they will know that there are steps that must be taken to prevent or mitigate symptoms of their mental health condition. Such individuals will make good choices with regard to diet, exercise and limiting drug, alcohol and tobacco use. According to the United Kingdom’s Mental Health Foundation, “people with severe mental health problems…on average tend to die 10 to 25 years earlier than the general population.” Someone who is receptive to their own mental health needs will know to take good care of themselves so as to keep mentally well.
McLelland (2015) defines self-advocacy as follows:
“Self-advocacy is the ability to speak-up for yourself and the things that are important to you. Self-advocacy means you are able to ask for what you need and want and tell people about your thoughts and feelings. Self-advocacy means you know your rights and responsibilities, you speak-up for your rights, and you are able to make choices and decisions that affect your life.”
Self-advocacy is very important for the purposes of identity as it speaks to how empowered a person is. For an individual to take control of their lives and to demand better treatment demonstrates that their disability is not an overriding force in their lives. That they may also be determined to forge a better path for others in the same situation shows that they are not defined by a disability but rather are empowered and in the driver’s seat.
It is especially important to raise awareness surrounding mental health on account of a new initiative that has been launched by United for Global mental Health (UGMH)., The campaign- entitled “Speak Your Mind” will target and hold governments accountable and responsible for providing access and funding for mental health. The vision of the campaign is “mental health for all.” It is a nationally driven, globally united campaign involving civil society from 15 countries- many of the members of which with mental health needs. It gives people with lived experience the megaphone and serves to bring their voices to the fore. It requests from governments that they invest, empower and educate to lead us into a future where mental health is valued.
Speak Your Mind has a South African Country Team, led by the South African Federation for Mental Health (SAFMH) in conjunction with the South African Depression and Anxiety Group (SADAG) and the Regional Psychosocial Support Initiative (REPSSI). This campaign will seek to hold governments around the world accountable for their actions and inactions towards mental health care users and is intended to accelerate the rights of people with mental disabilities coming to fruition. The prescripts aims of this campaign will be drawn into our campaign for Psychosocial Disability Awareness Month. For the 2019 campaign, SAFMH will be engaging in a range of activities. These include the publication of a series of press releases, an opinion piece, infographics and the convening of a dialogue on Identity and Mental Health. It is our hope that our campaign will bring awareness to psychosocial disability and how people with these mental health conditions identify with them and the need to create a climate conducive to them identifying positively and constructively. Psychosocial disability need not be a life sentence. It’s time to #takeyourplace in ensuring that the needs of individuals who have them are met.
Project Leader: Information and Awareness
South African Federation for Mental Health
011 781 1852
072 2577 938
With mental health a prevalent issue among young people, it is important that they are informed about this topic. It came to the attention of SAFMH that there was very little information available to such individuals on this subject in a form that was accessible and user-friendly to them. As a response to this the organisation elected to create an online resource that young people could use to become better informed about mental health matters. The resource is a website called My-Mental Health. It is a repository of fact sheets, infographics and news items surrounding mental health, tailored specifically to the needs of young people. The resource is available at www.MY-MH.org. We urge young people to make use of this source of information and to learn as much as they can about this important issue.
The South African National Council on Alcohol and Drug Dependence (SANCA) Drug Awareness Week takes place from the 24th to the 30th of June. It is an opportunity to look back at the past, examine the present and look to the future in terms of how to effectively address and reduce the impact of substance use disorder.
Substance use disorder is a very serious issue in countries across the world, with approximately 275 million people aged 15-64 years of age having used drugs at least once during 2016 according to the United Nations Office on Drugs and Crime (2016). This source indicates that in this year:
Substance use and mental illness can be closely linked in what is known as a dual-diagnosis. According to SANE Australia (2019), if a person has a mental illness, they may stand a greater chance of using drugs as a form of self-medication to improve their symptoms in the short term. In other cases, illicit substances may trigger the onset of a mental health condition. Certain drugs may trigger what is known as drug-induced psychosis. If someone has a predisposition to a psychotic illness, the use of drugs may cause a first episode in an illness that can last a lifetime. Using these substances may also make symptoms of a mental health condition worse or diminish the effectiveness of treatment. On this basis, SANE advises that people with mental health conditions or those who are vulnerable to mental health conditions stay away from all kinds of illicit drugs.
So what is to be done?
First of all, education is key to ensuring that we root out substance use disorder. People who are vulnerable to this disorder and their families must take the initiative to become informed on this issue and must be vigilant about risks in and around their communities. Knowledge is power and it is only in understanding the ramifications of taking drugs that a person can make the decision to stay away from them. Advocacy and self-advocacy within communities is thus key. Also vital, and linked to the need for education, is the need to dispel and eradicate stigma around substance use. There exist beliefs in society that drug use should be punishable. This does not take into account that substance use disorder can be an illness or a product of an illness. This is a form of discrimination that can be addressed through education.
It would not be fair to place the responsibility for eradicating the use of drugs onto the shoulders of society alone. The state is the primary duty-bearer in social and health-related matters. Government must provide adequate prevention and early intervention services, as well as rehabilitation and adequate psychosocial support to those who require such services. Proper dual-diagnosis interventions must be available to those with co-occurring mental health conditions and substance use problems. It is also important to bear in mind that no state department should “own” substance use and that a multi-sectoral and multi-pronged approach is taken in ensuring that members of communities do not make use of drugs. Such a multi-pronged approach must include the provision of the all-important education to communities so as to ensure that such communities are empowered and can begin to manage the issue at home, at work and at schools.
Speak Your Mind Campaign
Women indeed have the capacity for greatness. Unfortunately they have been and still are a marginalised demographic of the population. This has a negative impact on their overall mental health. International Day of Action for Women's Health takes place annually on the 29th of May 2019. It is an opportunity to think about what we need to change in order to ensure that women are happy and healthy. To this effect, SAFMH has compiled a press release. Read it here:
The 29th of May 2019 is International Day of Action for Women’s Health. This offers an opportunity to look back on the past, examine the present and consider what kind of a future we want for the women of South Africa. In a society that has for millennia been dominated by patriarchy, women’s rights have been ignored and overlooked. From the fact that the right to vote for all women was only first exercised in 1994, to the fact that up until the advent of democracy there were no legal mechanisms providing for equality in the workplace and in other spaces women have been prolifically and systemically discriminated against. The mental health of women is no different.
Mental health is defined by the World Health Organisation (2014) as “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” It is our view that everyone can attain a good state of mental health if only a conducive environment is created for them to do so. Women’s health takes on a different dimension to that of men in the sense that they are more prone to certain mental health conditions such as depression, eating disorders and suicidal ideation in adolescence and depression, anxiety as well as serious bipolar depression as adults than their male counterparts (World Health Organisation 2002).
Traumatic events in a person’s life can trigger or exacerbate a mental health condition. Rape leads to post-traumatic stress disorder, for example (Kilpatrick no date) - something which can become a life-long condition if not adequately treated and managed. Unfortunately, as a country with a culture of violence, particularly against society’s most vulnerable and a lack of psychosocial support, women often fall victim not only to these criminal activities but to the poor mental health that ensues as a result.
This week is National Child Protection Week 2019. During this time we must seek to protect the girl child who often falls victim to violence, abuse, neglect and exploitation. According South African Police Service’s 2017/2018 Crime Statistics (2018) 294 girl children were reported to have been murdered in South Africa, which is wholly unacceptable. Section 28(2) of the Constitution indicates that the best interests of the child are of paramount importance in every matter concerning the child but can this really reflect the values of society when statistics like this exist?
So what is to be done?
First of all, all of society must become educated as to what women are entitled to under our law. Equality is a conrnerstone of our constitutional democracy and the entire body of enabling legislation echoes this. The public must acquire an understanding of the law so as to diminish perceptions that women are not equal to their male counterparts and treat women with dignity and equality in all of their interactions with them.
Second of all, South Africa must properly implement the Convention on the Elimination of all Forms of Discrimination against Women through adequate policy and legislation. Action plans must be developed in terms of how to combat discrimination in the workplace and in other spaces. This will improve the overall mental health of women.
While women need not be treated with kid gloves, history has rendered them vulnerable to abuse, detracting from them being able to live to their fullest potential. This can lead to feelings of hopelessness which are a catalyst for the mental health conditions set out above. Let us root out discriminatory practices and let women live happy and fulfilling lives. It’s time to #takeyourplace in promoting women’s mental health, starting from now.
Project Leader: Information and Awareness
South African Federation for Mental Health
011 781 1852
072 2577 938