₦airaland Forum

Abz:
My answer: I am Abz a Yoruba Nigerian from the Ogun state ethnicity, the Egba tribe
You're who you're no matter what; and there is no reason to attach a negative reference to the word 'tribe', please take that vision of huts residences out of your mind. It is what it is

Interesting. The issue, however, is not so much about who you are 'no matter what', but more about what others call you and the reasons why they call you that. Hence the argument. Some Africans feel like break dancing when they are called 'black'. I don't. Because it does not describe me in any way. But that's another topic. Just like i don't describe the clan i come from in terms of 'tribe'.

So @ Abz, what's wrong in saying that you are an Egba man from the Yoruba peoples of Nigeria, instead of denigrating the proud Egba people with the inelegant cloak of 'tribe'? I won't. But then that's my choice.

Put it this way. Whenever a documentary about 'tribes', is going to be aired on TV, you don't need to be clairvoyant to know that it's not going to be about 'civilised' people. 

Whether people want to accept it or not, there is a lot of social controlling going on out there. The visual and verbal images created whether overtly or subliminally by those who wish to control others, go a long way to shaping the way people think about themselves and how they behave. That is a fact and it's not just another conspiracy theory.

So when you look at it from that perspective, i doubt you'd be extraordinarily enthusiastic about flying the tribe-banners very high!

It's true that everybody comes from some group or the other, but must the group be described with the rather uncomplimentary 'tribe', when talking about 'black' Africans and other such developmentally challenged peoples?

it's the collective noun for 'natives' (whatever that means) and also used to describe a group of monkeys!

http://www.ucgc.org/terms-for-collections.htm

Some people have called it Las Gidi[i]s[/i] (with an 's') because it's a city of gidi-gidi (which i think translates as 'hustling').

lannre:
My suspicion starts when he was checking drugs to be prescribed from a book. Ha ! am weak .

By consulting the book, i would say that the Doctor you met is actually a very safe-and therefore reliable-Doctor!

It is advisable to look up current precription guidelines when prescribing something you are not very familiar with. Most Doctors abroad are actually encouraged to do so! In the UK we get a 6monthly supply of the BNF (British National Formulary) that contains the most recent drugs, how they are prescribed and their side-effects. Trying to cram all that information, as some super-star Doctors do in Nigeria and other developing countries,  is so not modern!

I am not ashamed to say that i consult my BNF regularly, even when i am dealing with highly specialized conditions that i am supposed to be a specialist in!

In your case i am assuming that you suffer from a Gastric/Duodenal Ulcer and your Doctor has carried out tests that suggests you have an associated infection (caused by a germ called Helicobacter pylori). All this information is actually accessible to the general public by simply googling!

The bottom line is that his prescription is in order, but as already stated, you may have experienced side-effects to the Amoxycillin.

@ mgbogo

You can be checking the following link for the kind of jobs that you may be interested in http://unjobs.org/themes/public-health They do pop up now and then.

You can also be checking the websites of the NGO's that you'd want to work with. Try USAIDSjobs and others like that. There's so many out there that you could explore.

Good luck!

JJYOU:
is this guy mad or what?

Mad

@ atilla,
Good to hear that you're finding this thread useful.

It's unfortunate that though mental health problems affects hundreds of millions of people worldwide, causing 'staggering economic and social costs'  (http://www.who.int/mental_health/en/index.html) very little effort is made by government and concerned professionals (inluding myself) to reduce the level of stigma it is associated with.

The majority of people who need to understand that their experiences are common and can be helped with, will not have access to a medium like this, unfortunately. So a lot more needs to be done, in a manner and medium that is easily accesible to the majority. In my world, waiting for the government and 'policy makers' is not good enough, so i am currently exploring the most effective ways to 'get my hands dirty' and do something about it!

But thanks for your kind words.

The immature defence mechanisms:
here the individual resorts to ‘childish’ or immature mechanisms to deal with difficult reality and is most common in people suffering from mood disorders (depression, anxiety, panic etc) and personality disorders.
Examples of these are:
• Acting out-a person uses visible action to express emotional distress. For instance, a person who has been sexually abused may resort to self-destructive behaviour (e.g. self-mutilation, promiscuity) to offer them temporary emotional release from the pain of their thoughts.
• Passive aggression-the expression of aggression indirectly. For instance, somebody who is being bullied by their husband or boss, resorts to sabotaging things within the home or the office, in order to get back at their perceived bully.
• Hypochondriasis-the transformation of emotional difficulties and conflicts into physical pain or ‘illness’.  This is very common in societies, where individuals find it difficult to resolve emotional conflicts in more helpful ways, like talking.
• Projection-this is a very interesting one.  Here the individual shifts their own unacceptable weaknesses to another person in such a way they see those things that they don’t want about themselves in others. A common one is prejudice, where you assume the worst things about someone else, when in actual fact these are things about yourself, which you don’t want to acknowledge.

The pathological defence mechanisms;
here the individual ‘rearranges’ external reality in order to cope with it. In this state of mind the individual will be seen by others as ‘crazy’ or having ‘lost the plot’. Examples of this defence mechanism includes
• Denial-an individual refuses to accept their unpleasant reality even though it’s very clear to everybody else around them),
• Distortion-a person reshapes external reality to suit their way of thinking. A depressed person for instance will only see the negative things about themselves and the world around them, while dismissing positive things in their lives.
• Delusional projection-this is a more intense form of projection (see above), where the individual believes that others are out to harm them, or destroy them. This is described also as paranoia.

The pathological defence mechanisms are associated with biochemical changes in the brain and are very common in severe mood disorders, psychosis (like schizophrenia, mania etc).

To help us understand this a bit better, let’s go back to the vignette about Adam who killed himself, when he was supposed to be getting better. It is known that people who have suffered from a psychosis are at a high risk of killing themselves when they have just come out of hospital or their symptoms are resolving. This is actually a paradox, seeing that one would have thought that a psychotic person would want to get better!

The truth is that psychotic people don’t always want to get better. In my practice I have come across a lot of people, who I can almost empathise with their psychosis.

Let's look at Adam's story again. When Adam arrived the UK to live with his aunt, he came to live in a dysfunctional home, where the aunt started to call him all sorts of derogatory names, which all had something to do with evil spirits, demons, witchcraft etc. The stress of this drove Adam into a place of mental refuge.

The problem for Adam was that before he was sent off to the UK, there were already a lot of cracks in his family.

His mother was never really the woman that his fathers clan wanted him to marry. After she took in with Adam, there were rumours, started by his paternal Aunt (living in the UK, and whom Adam had been sent to live with), that Adam did not belong to his father.So Adam grew up with that dark cloud of doubt hanging over his head. He grew up believing that he was not wanted, and as a result his 'life script' had a lot to do with the need to prove himself to his father and to everybody else. For Adam there was also always an unconscious theme about ‘loss’ and ‘being lost’ in his life’s narrative, which gradually became part of the content of his illness (hence ‘the lost children’ and the need to be saved).

And as long as Adam was ‘ill’ he had a life mission and a sense of importance. Once he became well, the tragic wounds of his childhood and rejection became re-opened and he could not deal with them. So he killed himself.

I see a lot of patients like Adam, who feel comfortable in their ‘madness’. Recently one of my patients who had started to get better on his medication told me how he felt increasingly isolated. When he was very ill, he heard voices of ‘god and of angels’ tell him that he was special. The voices told him what to do and kept him ‘company’. Once the voices went silent, he found himself alone. In his recovery, he could now see himself the way others must see him; a mental patient and a 'nobody'. And this realisation makes him to feel shame and a lot of sadness. This particular patient preferred to have his voices back and to live in oblivion, than to be well in a world where he was an outcast.

I’ll pause here for a while and respond to questions that people may have.

biina:
and to what end is this

To make us see the bigger picture.

@Phantom.
Thanks! It's a pet project of mine, which i've not been very diligent with. It still needs a lot of editing before i can go ahead with the books publishing.

@Phantom,

To the best of my knowledge the ones in the UK are not for Consultants. I understand why you think it's for Consultants given that they specified the specialties they're recruting into. But i'm sure that they're looking for service-grade junior and middle grade Doctors. There's a shortage at that level here at the moment (the Nigerian equivalent of Medical Officers). The jobs should be open to whoever can tick the boxes in the application forms! I know that it will be difficult for somebody in Naija to meet the deadline for submission and interview, but you never know.

The ones in Australia and New Zealand are open to every level and are ongoing.

I came across this today and hope it will be useful to somebody.

http://www.severndeanery.nhs.uk/specialty_recruitment_09/international_recruitment.shtml

Closing Date: 20th May 2009, so hurry and good luck!

I came across this today and hope that it will be useful to somebody out there. UK recruiting Doctors   http://www.severndeanery.nhs.uk/specialty_recruitment_09/international_recruitment.shtml

Closing Date: 20th May 2009, so hurry!


Here's some other useful links for working in Australia and New Zealand

http://www.imrmedical.com/australiasalaries.htm
http://www.imrmedical.com/NZsalaries.htm

Good luck!

Let’s look at this defence mechanism thing a little bit closer.

It can help us to understand ourselves a bit better…

Dr Freud postulated that in the struggle of the mind to cope with the memories of its growing up traumas and the difficulties of everyday interaction with reality, it tries to come up with a story that allows it to maintain its self-image. In some instances, this ‘self-image’ may be seen by an informed observer as self-deception. I’ll come back to that later…

Anna Freud, Sigismund’s daughter, who continued with the work of her father, came up with the concept of ego defence mechanisms, as an unconscious process that allows the mind to enter into a place of inner refuge from the realities it cannot otherwise cope with.

This process is used by both healthy and unhealthy individuals throughout there lives, to balance out the life scripts that they had crafted earlier on in their formative years, which gave them their self-image. (See my post about life scripts a few posts above).

For the purpose of this piece we will divide defence mechanisms into the following 4 groups:

The ‘mature’ defence mechanisms
These are used by emotionally healthy individuals to cope with difficult reality. These defence mechanisms helps the individual to continue to function and come across to others as individuals having a lot of virtues. Examples of these are:
• Sublimation-the unconscious diversion of unacceptable impulses into more socially appropriate behaviour or endeavours. I find this to be quite interesting, because the interpretation here is that some people (not all of course) who do ‘good works’ are actually motivated by an unconscious need to dominate others!
• Humor-the expression of ideas and feelings that give pleasure to others. A lot of famous comedians, use humor to divert from their own solitude and sadness.
• Identification-the modelling of ones behaviour upon that of somebody else, to reduce the pain of loss or separation. A male child who tries to be like the father, who did not want him…

The slightly neurotic defence mechanisms
Here the individual uses mechanisms that allow them to cope in the short-term, but which causes longer term difficulties in their relationships and interactions with the environment. Examples are:
• Displacement-the transfer of emotions from its true object or situation to another source. For example, a man who puts his work before the needs of his family in the last months of his wife’s death blames the doctor for failure to give adequate care, thus avoiding to blame himself…
• Rationalization-the use of a false but acceptable explanation for behaviour that has a less acceptable origin. An example is the use of biblical scriptures (the Hamitic theory, for instance) to justify slavery…
• Reaction Formation-when we adopt the opposite attitude to what we really think or believe. An example is the homophobic crusader who actually, has homosexual urges, or the overzealous fanatic who is excessively prudish about sex, to hide from their own raging horniness!

In my next post we will look at the last 2 groups of defence mechanisms and then explore a bit deeper, what may have been going on in the mind of Adam in our vignette above, before he killed himself…

You're not very likely to get a Psychiatrist in most General Hospital but somebody there may be able to give you relevant information. Some big private hospitals may retain a Psychiatrist or a Physician with experience in Psychiatry.

If by 'National Hospital' you mean the National Hospial in Abuja, their official website (http://www.nationalhospitalabuja.net/) has not included it as one of the services they offer, but you could still go there and get seen by one of their clinicians who may point you in the right direction.

All the best.

@bece,

You are not going crazy. Okay?

It seems to me that you are experiencing a depressive illness that is becoming moderate in it's intensity.

The symptoms you describe, which in psychtalk would be described as emotional lability, fleeting suicidal thoughts, increasing guilt (hence worry about going to jail), suspicions about your husband and so on are all symptoms of Depression. Don't worry about talking to yourself. If it helps you, go right ahead and talk as much as you want. In the process you may actually begin to see that all is NOT gloom and doom. Psychiatrists recognise that talking is actually therapeutic, as it allows you to vent out your pent up emotions. In psychtalk we'd say that talking can be cathartic.

If your husband is accessible psychologically, it would be even better to talk to him about your anxieties and worries. But at the end of the day, what you have described suggests that you'll also need some Professional input.

Oga Seun has kindly advised about LUTH. I suggest you try to get seen by a Psychiatrist. The symptoms you've described suggest that you may need a course of antidepressants in addition to the 'talking' therapy.

If it will be any reassurance, Depression is VERY common. Much more common than people would like to admit. So you are not alone.

It's a pity though that something so common, is so maligned.

All the best

So Mr Arobieke is 47 going on 10, maybe 11, then. He still belongs to the criminal justice system and not mental health.

His 'strange' behaviour is most likely motivated by his subnormal intelligence, and not by a 'mental illness' per se. His intentions might not even be malicious!

The statement by the judge that he is a 'danger to young men and (your) behaviour is both strange and obsessive", was his attempt to pan him off to Psychiatrists. But i am most certain that Psychiatrists have reviewed him and found him not to be suffering from 'a severe and enduring mental illness of a degree and nature', that would warrant hospital admission. And as a result of which he would have been passed back to the criminal justice system to dispose of as they deem fit within the law.

I'm guessing that the criminal justice system would have already tried but still not found enough grounds to lock him up for good, since most of his offences would have time-limited custodial sentences. So he will be with us until someone else on the streets decides that enough is enough and takes the law into their own hands.

That's the way it works here unfortunately.

LadyT:
This is his 72nd crime its clear hes not ok. I guess he needs to rape someone before someone does something.

It is a rather scary situtaion isn't it, to have somebody who l[i]ooks[/i] like him, going about trying to feel peoples muscles! I am most certain that by now he would have already had an assessment of the risks he poses to the public done by a Forensic Psychiatrist, which may include his potential risks of sexual offending-if the latter is deemed clinically appropriate. The fact that he is obsessed with squeezing muscles, don't necessarily mean he is a sex offender.

Like i wrote earlier, his presentation is more suggestive of a man with learning disabilities. I don't know how old he is, but he probably has the mental age of someone aged between 8-12, the age when boys tend to be most preoccupied with the size of each others muscles and like feeling each others biceps to test how strong they are.

Mr Arobieke is most likely to end up getting charged with assault or something along those lines, but because he is already infamous for groping peoples muscles, it is not likely that a lot will come out of it. He certainly won't get locked up for it though. That would be against his human rights to lock him up in a Psychiatric hospital, even if he does offend again and get charged for assault. To start with modern Psychiatry doesn't operate the kind of Asylum's that once gave it a bad name. In the UK that ended 40-50 years ago!

He is most likely to end up under the judicial system again and again, unless he commits a serious crime. If he commits a serious crime, like rape, then he could be sent to a Forensic unit for a period of assessment with a view to getting him treated, but even that wouldn't be for ever, since Learning disabilities are managed, usually in the community, with loads of social packages in place.

And by the way, people with learning disability ihave been found to have a higher rate of being charged with sexual offences. This is probably because they are not smart enough in negotiating their way into getting laid smoothly!

The man is NOT sectionable under the British Mental Health Act of 1985, the act that empowers Psychiatrists and the Law to deprive mentally ill people of their liberty in the UK. The Mental Health Act tries to balance between the safety of the public and the human rights entitlements of the individual by doing a comprehensive assessment of the immediate risks the individual poses to the public and his needs as well.  It's because of this Act that a lot of people who have been diagnosed with mental illness live in the community, irrespective of what their neighbours think!

This man most likely has a learning disability, but even that is not enough to lock him up.  Being an 'olodo' who likes to touch peoples muscles, shouldn't be enough to get oneself locked up for good, should it?

tranxo:
The 'modern' medical system treats depression with anti- depression drugs which provide
temporary relief but have harmful side-effects and do not remove the causes or prevent its
recurrence. The harmful side-effects include gross liver damage, hypersensitivity, insomnia,
hallucinations, a confused state, convulsions, a fall in blood pressure which brings on headaches
and dizziness , blurred vision, difficulty in inhaling and urine retention. .[/b]

Your information is NOT as 'modern' as you may think. Most of what you've written is so 20-30 years ago!

@ Mohawkchic
That's very encouraging. Thanks!

deleted.

And we stand by watching, doing nothing.

Adam was found dead.

He was hanging from his bedroom window on the third floor of the council flat, where he lived in a run down part of South London, just four days after he had been discharged from hospital. What baffled his neighbours the most was that following his discharge from hospital, he’d actually come across as back to his ‘normal’ self, and nobody ever guessed that he would kill himself.

He was just 26 years old and had been so full of promise and hope. But he died instead a wasted man. A wasted life.

It is not clear when Adam first became ill.

His parent’s, who are from Nigeria, and who had resisted attempts to treat him when he first started to behave ‘weirdly’, attribute his problems to a spiritual attack and had been very reluctant to engage with services because they felt that what he suffered from was not a mental illness.

In summary, it is believed that Adam suffered a ‘brain gay’ during his final year exams in a Nigerian secondary school about 10 years ago. His parents became concerned about this and were convinced that Adam was the victim of some manipulations by evil people in his village, who were trying to ruin his life.

Adam's father decided that the  whole family needed to relocate to the UK, which they succesfully did over a period of 4 years. They first sent Adam to stay with his paternal Aunt, who resided somewhere in London, following which the rest of the family gradually made it to the UK, where they now reside.

Adam was 17 years when he first came to the UK.

After he arrived, his Aunt tried to get him into a college in South London to sort out his education from there, but Adam had other plans. He believed that he had a special assignment from God to save the ‘lost children’ whom he could identify by the colour of their socks. Any young man or woman wearing grey stockings needed to be ‘saved’. Adam knew this because a voice told him so.

One day, as he was passing a Turkish kebab shop, he saw his reflection in the window and suddenly realised that he needed to reveal himself to the world. So he started to take off his clothes in public, shouting ‘I am he!’, ‘I am he!’ He was subsequently arrested for public indecency, and by the time the police took him to the station he was described as ‘rambling’….

This story is made up but there are so many Adam’s out there, wandering the streets, misunderstood and vulnerable.

I’ll use the story of Adam to introduce the concept of defence mechanisms. Ordinarily, the vignette about Joe, which I gave at the beginning of this thread would have been sufficient but I think the thought that mental illness is a form of protection from reality, a defence from the onslaught of experiences we cannot deal with, is a very interesting one.

As Shakespeare once wrote;
‘Thou seest, we are not all alone unhappy. This wide and universal theatre presents more woeful pageants than the scene where-in we play…’

In my next post, we'll look a little bit more about how we try to navigate the tragedies of our individual experiences, using the defence mechanisms, one of Dr Freuds contributions to modern Psychology and psychoanalysis….

The statement that 'Nigerians are the happiest people on earth' was made from the perspective that 'only fools are truly happy'.
So, like Real Truth says, we were being insulted, not praised!

The really embarrasing thing, however, is that it passed above the head of so many people, just like they intended it to. This re-inforces their views about us that we are a people who seem to be oblivious of the fact that we are being taken for a ride, by our leaders; by the west; by everybody. No wonder they are always asking us to play drums, dance about-in all the glory of our traditional regalia-whenever dignataries from Abuja or visitors from abroad are around!

Yes. We are indeed the 'happiest people' on earth.

sucessful1:
on serious note why do our doc's have to go abroad 2 work while our pple are dying everyday,when we were young pple go abroad to learn and come back home to use their learned skill to helep we pple,now a days every of we young doctor's are going away.i think god that gave u brain to b a doc want u 2 save ur pple's life,why go abroad while there are sick pple everywhere.i think world health org should discuss this issue and put a stop 2 doc's going abroad to work,if they dont by the yr 2070 the westerners will buy all the doctor's in the third world countries and that will cause a massive catastrophy.there'll b a time all we'll find in 9ja 'll only b pastor and native doctor's,because oyibo man go don buy all our skilled pple.our goverment egba wa.

You can get some of the answers to your thought provoking question here https://www.nairaland.com/nigeria/topic-260875.32.html

Some of the liaison cases referred to 'MD's like myself' who are specialists in Psychiatry are actually not really supposed to be for us at the end of the day. But we still get called out or referred such for our professional opinion now and then. That's the beauty of working in a society were every body is specialised! When i worked in Naija, i managed everything and can't remember ever making a referral to a 'specialist'. But here it's different.

I'm sure that given the litiginous nature of practice where you are, a request for a Liaison Psychiatrists opinion would not be out of order in a case like this, as part of your management plans in a woman who presents with behaviour changes and fleeting psychotic symptoms that persists 3 years after her delivery.

I wish there were more MD's like yourself here in the UK! It would have made our work here a lot more easier!

But let's let it rest. We are not fighting over a patient. The man wants help and i honestly think that my advice offered to the gentleman a few posts earlier is in order. I am assuming that you missed the part where i mentioned the need to have had her screened for metabolic disturbances and also check up her electrolytes as part of the baseline investigations.

You are right the majority of Psychiatric (not psychological) problems are actually organic in origin. They are usually referred to 'MD's like myself' by their primary care physicians.  Is that what you are by any chance?

Having said that, i think that your observations are also in order. Peace.

Sheehan's syndrome is an interesting differential diagnosis for this case, but i am afraid it's way down on the list of differentials! In Sheehan's syndrome i'm sure most of the literature would say that the fluctuating hypomanic symptoms and auditory hallucinations, which this lady presents with would not be among the most prominent symptoms of hypopituitrism you'd find.

In an ideal world, the primary care physician would make the appropriate referral.  In my clinical experience, which includes a lot of Liaison Psychiatric work on Oby/Gyn wards what this lady needs is a Psychiatrist to review her.

@naijaking1, i'm not trying to dis you! In Medicine, you never say 'never'!

Sedatives are addictive.

It's important to deal with the underlying cause of your insomnia (i am assuming you have problems sleeping and that's why you want sedatives).

Most causes of insomnia are stress related. But it may also be due to the use of stimulants (like caffeine or nicotine) before your bed time, or the use of something that has ruined your normal sleep architecture (like alcohol or even some drugs).

1.So the first step would be to deal with the cause.
2.If you're going through a tough time, psychologically, then find someone understanding to talk with.
3.If you're using stimulants, or drugs that may affect your sleeping pattern then you may have to review how you use them.
4.Try exhausting yourself by doing some exercises regularly (but not too close to your bedtime)
5. Try to have a refreshing bath before you go to bed.
6. Try to establish a routine for your bed time and try not to nap during the day.

7. Get into your bed, leave the cares and the worries of the world behind and go to sleep!