Dr. Maymunah Yusuf Kadiri popularly referred to as The celebrity shrink, is a multiple award-winning Mental Health Physician, Advocathe and the Medical Director and Psychiatrist – In – Chief at Pinnacle Medical Services.

She has an impressive CV that space would not permit me to reel out. But when she stood in front of the camera for this shoot, she was so natural and posed like a pro that I almost thought she lost her calling.

The Goldman Sachs scholar, Vital Voices Fellow, an Ashoka change maker, a global thought leader, she is the creator of the most innovative mental health app in Africa, HOW BODI.

To her credit, she is the producer of the ward winning movies, Pepper soup (focused on drug abuse) and Little Drops of Happy (focused on depression, postpartum depression and suicide).

Ahead of World Mental Health Day next Thursday, and in the light of 20% of Nigerians suffering from emotional and mental health conditions, including suicide, Allure sought out Dr. Maymunah Kadiri, to shed light on this disturbing health conditions. What this mother of three, trained and certified Rational, Emotive and Cognitive Behavioural Therapist, and most-sought -after Psychiatrist and Psychotherapist told us is quite enlightening and enriching.

Enjoy it.

The words suicide and depression have suddenly entered our lexicon. Why is that so?
Suicide and depression have existed for a while. The reason they seem to be new in our lexicon is because of the stigma associated with them in the past. Also, the increased awareness and information being shared across the globe, have only made it seem like it has recently appeared. Now, people are more open with their struggles and their subsequent diagnosis.

What are the near and remote causes of depression?
The cause of depression is hotly debated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much. It’s often said that depression results from a chemical imbalance, but that figure of speech doesn’t capture how complex the disease is.
There are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It’s believed that several of these forces interact to bring on depression. There is cause to believe that certain individuals are therefore biologically predisposed to depression.
The environment in which one interacts with can cause depression. High levels of poverty, unemployment, stress etc have been linked to cases of depression. The most vulnerable therefore are those who are biologically predisposed and exist in stressful societies.

What are the early signs?
Sadness is one of the most commonly misunderstood early signs and symptoms of depression Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation. Loss of interest in daily activities, hobbies, pastimes, social activities, or sex. Loss of ability to feel joy and pleasure. Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month. Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping. Anger or irritability. Feeling agitated, restless, or even violent. Loss of energy,
Feeling fatigued and physically drained, self-loathing, and engaging in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports are all signs of depression.

What first step should family and friends take to help someone suffering from depression or any kind of mental health?
Support them to get help. You can’t force anyone to get help if they don’t want it. So reassure your loved one that it’s okay to ask for help. Be open about depression. Many people find it hard to open up and speak about how they’re feeling. Then, keep in touch. It might be hard for your loved one to have the energy to keep up contact. Even just a text message or email to let them know that you’re thinking of them can make a big difference to how they feel. Don’t be critical. If you’ve not experienced depression yourself, it can be hard to understand why your friend or family member can’t just ‘snap out of it’. Try not to blame them or put too much pressure on them to get better straight away. Keep a balance. If someone is struggling, you might feel like you should take care of everything for them.
It is also important to encourage them to do things for themselves. Everyone will need different support, so talk to your friend or family member about what they might find useful to have your help with. Take care of yourself. Your mental health is important too, and looking after someone else could put a strain on your wellbeing.

A lot of people are still shy from seeking professional help for fear of stigma. How can we improve this situation?
It is very important that we continue to raise more awareness on mental health issues. Going to see a therapist should be just as easyas going to see a dentist. In addition, if we also begin to see psychological/psychiatric help as preventive rather than remedial, it will help shape our perception of seeking help. Hence, we must normalize seeking help for mental health issues in the same way we do for physical health in fact, primary health care centers can also be encouraged to take on milder cases. Likewise, increased public health knowledge on issues that can influence the onset of mental disorders.

Based on your day to day experience with patients, would you say depression is on the rise? Or is it being exaggerated by the media? What is rate of suicide in Nigeria?
As the MD/CEO of Pinnacle Medical Services, I can tell you that 8 out of 10 of our clients/patients are women, and about 90% have depression. So, depression is on the rise and more among women.
According to the World Health Organization, WHO, there are 322 million people living with depression in the world. In the WHO suicide ranking, Nigeria, with 15.1 suicides per 100,000 population per year, is ranked the 30th most suicide-prone out of 183 nations in the world. Nigeria also rates 10th in Africa.

Lagos State has passed The mental health bill. What is holding the bill from being passed into law at the national level?
It is rather unfortunate that Nigeria that claims to be the giant of Africa is yet to have a mental health law. Ghana, about 5 years ago, passed their mental health law. We have a situation that is peculiar in Nigeria. We’ve had 8th legislative sessions so far in this new democratic dispensation that we’ve been asking to pass this bill into law; but this has not yielded anything. As a matter of fact, the last session, the 8th assembly, the bill was almost passed. We were assured by senators then, but what did we get? You and I saw in a day where over 30 bills were passed, but the mental health bill was not passed. We hope the bill is passed during this 9th legislative era.

What are the benefits of this mental health bill if passed into law?
Mental illness is assumed to be caused by evil spirits, attacks from the enemies, mother in-laws, and even sin. Because of this, people with mental health conditions are stigmatized.
The bill will ensure that anyone with mental health condition is not discriminated from gaining employment, from voting and that they can take up public office jobs once certified stable. It will also ensure that they can marry, and that there are subsidy on drugs used by the mentally ill. Do you know our patients go as far as the Republic of Benin to access free medications?
It will ensure more facilities in each Geo-political zones, protects the rights of persons with mental disorders, ensure equal access to treatment and care, and set standards for psychiatric practice in Nigeria.
The fact that there is a law, means that individuals can be arrested, charged and prosecuted if these rules are flouted, like tying up and beating a person with mental illness.

How affordable is the treatment of mental disorders?
Treatment options range from affordable at the public health facilities such as the neuropsychiatric and/or state hospitals to slightly more expensive in private settings. However, much more can be done to offset the price of treatment, if mental health care is handled with utmost concern. The lack of National Health Insurance means that although treatment might be relatively affordable, people who do not have a source of income or live below a certain standard may still be unable to access care.

How many psychiatrist do we have in Nigeria and do we have the required WHO number of doctors to tackle the surge in Nigeria?
In Nigeria so far, we have less than 300 psychiatrists. Out of these, we have less than 200 that are practicing. In summary, we have one Psychiatrist to one million Nigerians. So we have a real problem on our hands and we must arise.

Why are we having a surge in drug related mental disorder and why are more children coming down with the disorder?
Several factors may be at play here. Foremost, is the issue of economic breakdown which can be seen from the reported high levels of poverty that we are currently experiencing. The frustration that this creates on the average person, ultimately means they are pursuing dangerous habits such as drug use. The lack of awareness of its side effects also contributes immensely to this behavior. Another factor to consider is the social breakdown which encompasses poor social support at community level implies that we are unable to adequately listen to the issues that youths face despite being a vulnerable population.
Inadvertently, youths are also more prone to peer pressure. The need to define themselves, that is build an identity and to also belong, is at its peak at this stage of their psychosocial development. If one person indulges in drug use, the propensity for the people surrounding this one individual immediately increases. Finally, there is increased access to the drugs or substances that can be used.

What solutions would you proffer?
I would suggest that we continue to sensitize the young ones on the danger of drug abuse. The long term effects of drug dependence and ultimately addiction is incomparable to whatever short term highs they crave. We can also encourage people to engage is positive pleasurable activities such as sports, volunteer work etc. Through this medium, they will be meaningfully engaged.
We encourage parents to monitor their teens as well, consistently check up on them with love and support, rather than anger and punishment. In addition, drug dispensation should be monitored and there should be a consistent crackdown on suppliers of these dangerous substances hence the government must push for security measures in this regard. Also, the need to support evidence based substance abuse prevention through capacity building, professionalization of drug demand reduction, the introduction of substance addiction as a course of study in our schools. Most importantly, substance abuse prevention measures should focus on communities, and it should be community driven

What activity or activities do you have for the World mental health day?
As an organization, Pinnacle Medical Services in conjunction with our NGO, Pinnacle Medicals SPEAKOUT Initiative, we have activities lined up for the whole month. From speaking on radio and television stations, to talking to students in some secondary schools; having sessions with parents during PTA meetings, a walk for suicide prevention in coalition with other NGOs, to a mental wellness virtual summit which has 30 speakers from 21st-25th October. We would round off with a one-day intensive training on mental health first aid for suicide prevention. The month is packed with activities and we are excited about the collaboration and support we have received so far.

What are your general tips for staying mentally healthy?
One of the best methods of mental health recovery, is to maintain an environment prone to mental health and mental illness recovery. Staying mentally healthy is a way of life, not something you do when things start to go wrong. Connect with others, do what you enjoy, share your interests, help out by volunteering for a cause or issue that you care about. Take care of yourself by eating right and exercising.
Also, challenge yourself by learning, manage stress, rest and refresh by getting enough sleep, then live in the present and ask for help when needed to overcome the bumpy journey of life.

Words By – Jemi Ekunkunbor