When is the mind abnormal?

Adeoye Oyewole

This is one of the most challenging questions about life that medical science has courageously answered, despite the fact that other intellectual pursuits — ranging from theology to philosophy, anthropology and sociology — have varied opinions.

Psychiatry, as a medical discipline, has had the enormous responsibility of determining the normalcy or otherwise of the mind having her basic root in the biological sciences, as she attempts to answer a question with strong sociological flavour. This question is as old as creation, but with more potent relevance in our world today.

It’s amazing how folks invest so much money to travel to the ends of the earth in assuring that important organs that keep vegetative life going are in good condition, but with little regard for finding out whether the mind is functioning well; yet, the mind is the most crucial organ that the human being is blessed with. Men can perform prodigies when they have no limbs, blind or even deaf, but he is completely rattled when the basic functioning of his mind is disturbed.

However, as much as we treat the care of our minds with levity, we paradoxically demonstrate its indispensability in many of our sociological contracts, especially in marriage, where some relationships have been unfairly aborted based on unconfirmed history of mental illness in the family of a potential partner. I am aware of some state governments who compile names of those who have ever had any visit to a psychiatrist as part of those who could be laid off in case of staff rationing.

This mental illness label has been employed in the recent past as a subtle threat for those who commit traffic offence that political office holders commit with impunity. Where a political opponent appears stronger than the incumbent, his budding political career may be shattered once an evidence of a visit to a psychiatrist is established.  Struggles for the royal stool is also not spared in this stigmatisation campaign and the crucial issue is that in the contemporary African tradition, the premise for determining the abnormality of the mind is not only spurious but inconsistent and can be cheaply abused.

The situation could be likened to the ‘witch-hunt’ scenario of the church around the 18th century that saw the inhuman confinement of individuals with sound mind into lunatic asylum. Our belief in the world of the spirit has made the recognition of mental illness very difficult for the public. While some have been mislabelled, a good number of folks with mental illness have been concealed. The critical but vague distinction between faith and delusion has been the breeding ground for mental illness and its indulgence.

Some have even administered congregations through hearing of voices that others cannot hear as they inspire multitudes with paranoid ideas. Beautiful marriages have been destroyed, just as emerging strong careers are sacrificed when treatable mental illnesses are not appropriately referred.

A man, who is described as only ‘angry like his father’ when he brings out a cutlass in an attempt to kill his wife after an argument, is mentally ill. There are many authorities in our religious and socio-cultural milieu who have varied and confusing criteria to determine and even treat mental illness.

Technically, a mind malfunctions when the behaviour it facilitates causes distress to self, to significant others — especially his immediate family members; and such behaviour is an oddity within the particular society. In a very religious country like Nigeria, a good number of clients are brought to the psychiatrist in a situation where their religious activities, either in terms of prayers, fasting or other observances, have caused them or their spouses personal distress.

There are abnormal behavioural patterns peculiar to certain cultures, but which are no less mental illnesses in that they incapacitate folks from fulfilling their roles to self and society irrespective of our socio-cultural rationalisations.  A high index of pragmatic suspicion is crucial, based on the criteria set out, so that we can have a sane society.

We cannot continue to employ our cultural and inconsistent religious criteria to diagnose mental illness. This becomes very necessary because mental illness can be properly managed and such patients can live a successful life thereafter. It is now certain that the voices that the mentally ill complain of are not from the spirits, since they disappear when drugs are administered. Psychiatric consultation is not meant only for the mentally ill, but also for those who have distressful experiences such as disturbances in sleep, altered appetite for food and sex, crawling sensations in the head, undue irritability and even nightmares which have occurred over time. The unbridled desire by our leaders to amass wealth for self aggrandizement at the expense of service to others may be a subtle manifestation of mental illness.