According to the 2022 ‘Mental State of the World’ report South Africa was ranked lowest when it comes to mental wellbeing, hence, our people’s mental health is poor. This will likely not come as a big surprise, given that we are also the country with the highest HIV prevalence and a country where TB infection remains rampant. Whereas we know that both HIV and TB are linked to the development of mental health problems, the impact of the daily and consistent adversity South African’s experience and its impact on mental well-being should also not be underestimated. But do we really have a choice but to push on and to somehow make it work? Unemployment, job insecurity, the electricity crisis, fuel costs, basic food costs, exorbitant crime, gender-based violence, these daily threats continuously chisel away at our resilience shell. Other than a country that is recognised as taking first prize for its disease burden and crime statistics, why is it that our nations resilience is not recognised in the same manner. Maybe, because much like mental health, resilience cannot be measured with a blood test like HIV and TB can. But I would like to argue that South Africans are some of the most resilient people and, whereas we will likely not get ranked for this, our resilience can teach us something with regards to our mental health, and that is the notion of ‘one day at a time’.
The American Psychological Association (APA) states that resilience in the face of adversity can bring about both personal growth and the ability to overcome tough times. I think as South Africans we have all become very good at that. But also, I feel that the context within which adversity is experienced is important because the statement of the APA may also appear to suggest that unless you do grow as a person (whatever that really means) and overcome the adversity, you have failed. In the South African context, ‘overcoming tough times’ does not really seem to be an option as the so-called tough times, never appear to stop, or are simply replaced by another. ‘Overcoming’, which I believe the APA understands as mentally getting through a difficult time, does not translate to the majority of South African contexts, where basic survival, such as food and shelter, are prioritised. But isn’t it exactly in this context, where individual’s need to dig deeper to literally survive and where mental health support is ever so critical? Much like the basic human right to electricity and education, mental health should not be regarded as a luxury or considered only secondary to basic needs. Because what about those individuals who are struggling with their mental health? Who are struggling with keeping the lights on (barring Eskom) and food on the table because they are fighting an inner battle and cannot access the support that will help them sleigh this demon. Mental health is complex, and it is really a bit of an oversimplified term because it really includes a vast array of disorders and levels of severity. What adds to its complexity is that it cannot be visualised, or at least not in the same way as, for example, a broken arm is understood. How did the statement “It’s only in your head” ever come to be an acceptable or helpful solution. Well, what’s inside my head is very real and what I am experiencing is completely real, so how is it not real? Why does it matter “where” it originates from? Mental health or illness for that matter, remains too abstract and too intangible to those who have not experience it. Maybe if the intensity and impact of mental health challenges could be conceptualised less abstract and more akin to that of a heart attack? No one seems to have trouble to understand the seriousness of a heart attack. Is it because the risk of death is more immanent? So, does that mean that quality of life is less important than quantity of life? OK, that got very philosophical, which was not the point. It is, however, true that the experience of many mental disorders can be very physical. Just ask someone who has anxiety and how this affects their heart rate, their sleep cycles, their ability to focus, paralyzes them, not literally, but from any action. Similarly, depression, which is still so frequently described and associated or described as with feelings of sadness, entails so much more. It really is a depression of the whole bodily system, affecting more than your mood, but also your digestion, your sleep, and more. And then there are the brain chemicals – did you know that clinical depression is often caused by an imbalance of the chemicals in your brain (so it’s physical in a way after all) and you are “not at fault”?
Mental health is complex, and although advocacy has been ramped up in the last few years and there has been a movement towards amplifying messages such as ‘you are not alone’, and ‘normalise mental health’, we have a long way to go. Let’s for a moment consider that one way or another, each one of us is likely to face adversity in life. But even if not, it does not mean you will not or should not experience mental health challenges. The nature and extent of what you experience can vary but what you are experiencing is real to you and, therefore, serious and deserves to be addressed. Although South Africans’ have proven their resilience over and over again, it is time that we acknowledge that it is exhausting and that it is ok and completely normal to feel that way. Recognizing, not accepting (that is step 2), is critical for your mental health journey. I specifically call it a journey, because it does take some time, and your approach may change, just as much as your needs may change too. And that is all normal and ok too. And when I say “normal”, what I really mean is, that there are others who feel that way too.
This post came about to mark world mental health day, and so I encourage you to practice some self-care in the next while. Following here are some ideas or questions to get you thinking. Hopefully, at least one can help shift your inner monologue. Some of them you may have heard many times before but maybe this time they will resonate with you, others might trigger some new perspectives, so, why not just give them a read.
- Identify your mental/emotional capacity and learn to set boundaries – this can be in the context of work, with your friends, and your family.
- Try not to take on too much. Embrace JOMO (the joy of missing out) rather than FOMO (the fear of missing out).
- One day at a time. Tomorrow is another day. Only because you did not succeed this time, does not mean you won’t succeed next time.
- You are not alone – this meaning is two-fold – find/ask for support so that you do not go through what you are experiencing alone but also, if you are feeling it, someone else is probably feeling it too, so you are not alone. It’s not just you.
- Take time to reflect – this can be difficult, especially when feeling overwhelmed or anxious. Identify situations that make you feel worse so that you can avoid them where possible. And just as important, try to identify situations that make you feel good and do more of that. I know, easier said than done but if you have not tried it before how will you know that it will not work?
- Remind yourself of a time where you previously overcame adversity or a difficult situation.
- Don’t wait for the light to turn red! This means, before you start spiralling into a deep hole, try and stop and ask for help at orange. Make the changes when the light is green.
- And remember, only because someone else cannot see the pain or understand what you are feeling, it does not mean they are not real or that you are weak for feeling a certain way. Despite adversity, we are more than the circumstances around us, and there are many reasons, including medical ones, which can influence your mental health.