Zimbabwe: Mental Health Problems Need Quick Reaction

(file photo).

On the first day of a new year as we were planning how to celebrate, my cousin Emily's smouldering wick snuffed out as she took her own life after a long battle with depression.

Emily had lived a life with a carefully constructed mask. I was shattered, I still am.

She was my inspiration, a brave pioneer who had shown me how to push boundaries and shatter glass ceilings.

I had admired her from childhood and dreamed of being just like her.

She expanded my imagination about what could be possible for herself, for all women and for little girls like me.

She made it real, she brought possibilities within my reach. I aimed higher because of her, I pushed further because of her, I dreamt bigger because of her.

How I wished I had told her this before that fateful day. I wish I had told her as clearly and as articulately as I am able to tell myself all this now. She was loved, she was admired, she was desperately needed and she needed to hear that.

We often become so articulate in describing how a person has impacted us after they are no longer there.

Such clarity in expressing our emotions in death, yet fumbling to do so in life.

Perhaps it is our masks that prevent us from being vulnerable enough to open up and share what we truly feel while people yet live.

I wish I could have saved her, with my words of affirmation, with my time, with my skills as a therapist. Or is that some sort of "god" complex in me?

But, think of the irony of it all, I was fighting battles as a mental health advocate, fighting for access to quality care for people with mental health problems, fighting for my own patients to recover to heal to live decent productive lives in spite of their challenges, then I get robbed, plundered, in my own camp.

The sheer irony of it, I dreamt and planned and strategised for our nation to get better mental healthcare, worked hard, fought hard but in all that failed to save someone so dear to me. There goes that "god" complex again.

King Solomon the Wise declares . . . Love is as strong as death. Love truly is passionate, all-encompassing at times, daring, even ferocious. Yet with loving deeply comes great risk, risk of disappointment, risk of loss. We grieve only because we have loved, the deeper the grief, we realise just how much we had loved.

I have grieved over Emily and I have come to realise just how much I loved her.

Suicide robbed me, robbed our family and we were thrown unexpectedly into a complex form of grief.

Families of those who have taken their own lives are often called suicide survivors just illustrating the challenges this loss can have.

Mourning after a death from self-harm in many parts of the world is difficult. Those left behind are often stigmatised and not permitted to mourn as they would wish, as they need to, sometimes denied the normal cultural processes that we all need to heal after a death.

Grief is difficult even in the most normal of circumstances but with suicide we are left with so many unanswered questions.

We doubt ourselves, we question ourselves, our role in the tragedy, we muse over what we could have done differently, what we could have said differently.

We question the validity of our grief, should we be mourning over someone who chose to die, we battle with feelings of heart wrenching loss yet also deal with the judgement of others, those nasty whispers and rumours of "what really happened here?"

How do you grieve such a loss? So many unanswered questions.

Our family is one of almost a million who have to face life after a family member dies by suicide every year worldwide.

Most of those who die this way are young people making that loss also a loss of dreams and aspirations never achieved; futures never attained, destinies never fulfilled.

It's a loss that robs not only families of loved ones but communities and nations of such potential. Yet it is a wholly preventable cause of death associated with depression in over 90 percent of cases.

That is what makes the loss even more heart breaking.

Depression is treatable. It is described as a pervasive chronic sadness with loss of motivation and feeling drained (loss of energy), caused by a complex combination of biological, psychological and psychosocial factors but still . . . treatable.

A treatable condition that has cost so many young lives with Emily among the growing number.

Mental health needs to come out of the shadows, we need to change the narrative about our challenges and bring to light what has been deemed shameful.

Our masks are killing us.

Changing Narratives

"Depression is a treatable disorder" is often one of the many statements in my repertoire of "psychoeducation" with patients with a new diagnosis of depression battling to make sense of what is happening to them.

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That statement often is one that helps to change the narrative, from "I am just weak" or "I have been bewitched" to "I have a treatable mental health condition' and "there is a way out of this."

We tell ourselves statements, stories and narratives all the time.

We need these stories to figure out what is going on and what to do.

In a crisis, we often reach back to our past and find a story or narrative of how we have reacted to something the past or how others in our family or community have dealt with similar issues and then we replay often the script.

However, some events can severely influence our internal narrative, our beliefs, our story of this is how the world works and this is what I can do. In losing Emily, my narrative was severely shaken.

Depression is a treatable illness, there is a way out of this that easily rattled out of my mouth became a slower statement as I battled by own grief and chewed over those words.

I had been running on my own script, aiming at being a compassionate, caring therapist, ambitious about the great change I could bring to the mental health sphere, fighting to make mental health care accessible to all.

I was at the same time juggling many balls, wife, mother, sister, daughter, friend, therapist , advocate . . . all round super woman . . . It took a dropped ball to wake me up.

In all by busyness I realise I had missed some tell-tale signs that often accompany suicide.

I could have done something. I could have called her one more time. She had actually been reaching out to me in preceding months; I could have actively engaged her treatment team to save Emily but alas I did not.

Richard Tedesch and Lauren Calhaun in the 90s studied the transformative effects of traumatic events.

They claimed that loss and trauma can change us for the better. We can learn to make sense of what seems senseless.

Pain and trauma can help us get a clearer understanding of ourselves, our relationships, the world we live in and what really matters in life.

They called it, Post Traumatic Growth and they described trauma survivors gaining an appreciation of life, appreciation of relationships, personal strength, seeing new possibilities in the trauma, and spiritual growth.

Losing Emily has made me question myself, my motivations, my understanding of my purpose in this life.

I have realised . . . I am not a superwoman, I never was and probably will never be. I drop balls this believe me, was truly a revelation.

I am not God, I could not "save" Emily and cannot "save" anyone in and of myself. I, however, can be a conduit of life to my family, my community, my patients.

I am made in God's image and I have been given areas of influence and dominion where I can change things for the better, where I can bring life and hope.

Since Emily died, I have made a hit list . . . I call it my coffee date list and I have put on it people who, thank God are still yet living who have been brought into my life and impacted me in some way.

I want to have at least one more coffee date with them in case the worst happens but hopefully also to spark a more intentional relationship with each person on that list through that gesture.

Death highlights life. Through loss we are reminded of the need to live intentionally, with purpose, especially with each other.

Life is precious and it is fragile and we can appreciate each day more as we realise this.

What is the purpose of life? Death has a way of drawing out these existential questions in us.

Death woke me up from my script of superwoman with boundary pushing, glass ceiling shattering ambitions. My view of life has been challenged indeed.

Is life about our accomplishments, successes, achievements, letters after our names, titles and honours?

Is life about family, caring, nurturing and providing, building strong homes?

Is life about community, about defending the disadvantaged, making a more equitable world, leaving the world better than when we came?

Is life about fulfilling one's destiny, completing the mission, the task for which you were created? What really matters?

I propose that it is a complex combination of all of the above but to remember that above all our relationships are the only real thing of value in our lives.

Losing Emily has changed me, it has reminded me of what is truly important in life to love deeply despite the risks that love brings, to live with intentionality and fulfil the purposes for which I was created but in that to hold preciously the people in my life, to leave nothing unsaid to them, nothing undone for them at the end of my days.

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