Written by Adeoye Oyewole - Nigeria.
One of the major lessons to learn is that life is a great challenge that rattles our emotional, physical and intellectual resources as we adapt to the ecosystem and make the best use of the resources and opportunities around us.
This is a brutal reality that no one can escape from because anywhere you are, life comes calling to make her legitimate demands and certain times many factors such as where we are born, the family and our biological endowments, which serve as basic substrates for our experiences, are totally beyond our control.
The egalitarian theory of psychosomatism clearly links the experience of the mind to the manifestations in the body and invariably physical health. There is ample evidence in clinical situations where states of mind may explain exacerbations or even precipitate certain medical conditions.
For instance, non communicable diseases are not contagious since they cannot be transmitted from one person to another. These conditions are usually long-term, cause death, dysfunction and impair the overall quality of life.
These conditions include cancer, diabetes, cardiovascular diseases, some renal problems and even chronic lung diseases. A World Health Organisation report in 2001 indicated that NCDs account for almost 60 per cent deaths and 46 per cent of the global burden of disease. Based on current trends, by 2020, these diseases are expected to account for over 70 per cent of deaths and 60 per cent of the disease burden.
Non-communicable diseases have been established as a clear threat not only to human health but also to the development and economic growth, claiming about 63 per cent of all deaths. These diseases are currently the world’s main killer.
Eighty per cent of these deaths now occur in low and middle-income countries like Nigeria. Half of those who die are in their productive years and thus the disability imposed and the lives lost are also endangering industry and national development.
In 1900, the average life expectancy was about 47years with very little differences among different countries. The majority of the deaths were due to the rampage of infectious and communicable diseases.
However, at the turn of the first half of the 20th century, the industrialised nations made great advances against infectious diseases with subsequent improvement in the average life expectancy.
By the middle of the 20th century, the non-communicable diseases became a real burden for these developed countries and they were called the diseases of the rich. Developing countries like Nigeria started experiencing the upsurge in the incidence of the NCDs in the last half of the 20th century, attributable to rapid urbanisation and globalisation of unhealthy life styles.
Those of us in the developing countries have the greatest vulnerability with the least capacity to cope. The identified risk factors are heredity, environment and the person’s lifestyle. The most reasonable option to reverse this trend is to mitigate these risk factors especially those that are modifiable.
The most modifiable is the patient’s lifestyle which is responsible for over 50 per cent of all NCDs due to drug use, tobacco use, diet, lack of exercise and poor stress management.
We need to develop an appropriate mental capacity to stem the rise in NCDs that are cutting away the most productive and most successful age group of our population.
This cohort is dominated by folks in midlife with its attendant crises. The lifestyle changes are definitely due to mental health issues in the background. It does not necessarily mean psychosis where one hears voices of unseen individuals but varying degrees and types of mood disorders, anxiety disorders, often complicated by alcoholism and self medication.
Most times we hear of great achievers in the academics, entertainment industry, business and even polities cut down suddenly by death or immobilissed by drug addiction or other medical morbidities.
There is a need for the psychiatric consultation over the matter, to interrogate several issues of their minds so that the root causes of some of these lifestyle changes can be identified and managed.
It could take the form of human capital development training or seminars or exclusive medical consultation.
I know that when these lifestyle changes come up, the patients themselves recognise it but they feel helpless until they have a few complaints and travel out to meet doctors who do not have their longitudinal history or consult those at home who will only prescribe medications rather than engaging the underlying psychological issues that may be feeding the lifestyle.
Such changes arise from marital conflict, corporate politics, job stress, fear of failure, fear of the unknown, gross violations of the conscience, identity crisis or fear of African witch.