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Dr TW Ngwenya Changamire


This week on the Digital Sunday Express – the current affairs topic on this page is mental health disorders – our emotional, psychological and social wellbeing and how mental disorders affect how we think, how we feel and how we act.

Mental disorders affect children, adolescents and adults.

Certain mental disorders are more common in a particular age group when compared to the other age groups. This is determined by their biological, social and psychological exposures that are age specific.

When an individual is exposed to stress and does not have adequate coping mechanisms their mental health is now at risk. Remember mental disorders do not result from a single stress factor. Multiple factors come into play.

Common factors include; family history of mental illness, traumatic life events like sexual abuse, child abuse, violence, cultural, environmental and political environments that place a lot of stress on individuals, chronic medical conditions like cancer and diabetes, use of substances like alcohol, marijuana and illicit drugs, and feelings of inadequacy, fearfulness, lack of self-worth or loneliness and a lack of social support system.

Mental disorders come and go, they may present over a short period of time or longer and some are permanent. Many people shy away from mental health evaluation for fear of being diagnosed with permanent mental disorder and being labelled as a Mental Health Care User.

A common myth is that once a person has been diagnosed with a mental disorder it means they will have the mental disorder for life.

Another myth is that people suffering from mental disorders are all psychotic. It is important to mention that some mental disorders are likely going to be long term diagnoses but some are short term and some are periodic. Not all mental disorders are psychotic conditions, the following disorders are the most common conditions.




Common mental disorders are grouped into:

Anxiety disorders
Post-traumatic stress disorders
Mood disorders
Substance use disorders
Psychotic disorders
Developmental disorders including autism
This list only indicates common disorders!

Anxiety disorders

Anxiety disorder is characterised by an exaggerated or non-appropriate response to a stimulus. The person fails to control the response and they also develop physical signs of anxiety-like sweating, palpitations and difficulty breathing. Anxiety disorders include panic disorders, phobias and generalized anxiety disorders. Treatment includes psychotherapy and if need be anti-anxiety or antidepressant medication is prescribed.




Post-traumatic stress disorders

This condition occurs after a traumatic life event like the death of a friend or family member, sexual assault, physical assault or natural disaster. Again psychotherapy is crucial.

Mood disorders

Mood disorders include Depression and Bipolar disorders. Depression is a very common mental disorder. Globally more women are affected compared to men. Depression if left untreated may lead to suicide. It is important to recognise the symptoms and seek intervention early.



Depression may present as difficulty in sleeping, tiredness, loss of appetite, loss of interest in the things previously enjoyed, feelings of worthlessness, poor concentration ability which may affect productivity at work or at school and failure to cope in activities of daily living.

Treatment of depression will include addressing the psychosocial factors and may also require treatment with medication that we refer to as antidepressants. Mild to moderate depression is often treated by psychotherapy by psychologists with success. Moderate to Severe depression requires adding medication.

Medication is not the first line of treatment for mild to moderate depression.

Antidepressants are also not advised for use in children and adolescents so in this group psychologists play a huge role in treatment of depression.

Bipolar disorder is a condition where an individual experiences the extreme end of being happy which is referred to as Mania and they also experience depression.

These two extremes are separated by a period of normal mood. Manic episode presents as elevated or irritable mood, reckless high-risk behaviour, inability to sleeping, hyperactive, talkative, high self-esteem. Depressive symptoms have been discussed. Bipolar disorder is treated with medication known as mood stabilisers. Mood stabilisers treat and prevent relapse. Adherence is encouraged to prevent episodes of relapse and psychosocial therapy also remains an important part of therapy.




Substance use disorder

This occurs when a person’s use of alcohol or drug (prescription or illicit) leads to health issues or problems at work, school or home. Disorders include intoxication, withdrawal and substance-induced mental disorder.

Criteria used for diagnosis of substance abuse include taking the substance in excess of what was initially desired, attempting to cut down, spending a lot time getting, using or recovering from drug use, experiencing cravings, failing to be productive at work, school or home because of substance use, withdrawal symptoms, needing more each time to get the desired effect, continuing to use even when you know its damaging to your health and relationships. Psychotherapy is a mainstay of substance abuse treatment for many people.

Psychotic disorders

Schizophrenia falls under this group. Schizophrenia is a mental disorder where an individual loses their sense of perception. It commonly affects men and presents early on in life from the age of 20.

Psychotic disorders distort the way of thinking, emotion, perception, behaviour and even sense of self. People suffering from psychosis present with hallucinations (seeing, feeling, hearing things that are actually not there), they become delusional (fixed false belief or false suspicions).

Individuals suffering from psychosis are often misunderstood and experience stigma and discrimination which reduces access to health. Schizophrenia is treated with medication. With adequate medication and psychosocial support affected people can live a productive life.




Dementia is a gradual progressive deterioration in baseline cognitive function. There is no treatment to alter its course but there is a treatment to control the symptoms. Dementia affects language abilities, memory, thinking and as it progresses it affects emotions and social behaviour. Dementia commonly is age-related but may also be caused by Alzheimer’s disease or strokes.

Developmental disorders

These disorders present in the infancy of early in childhood and continue into adulthood. They are marked by intellectual disability. Developmental disorders include conditions like autism, communication problems, narrow range of interest and impaired social behaviour. Children with autism have different abilities and needs which can change over time.

Children with autism may also suffer from anxiety, epilepsy, depression or attention deficit hyperactivity disorder (ADHD)
Get routine medical screening, pay attention to the signs discussed, get help and take good care of yourself.


Contact All In 4 Health – Dr TW Ngwenya Changamire – for General Medical Consultation, Health Screening, Medical Check-up, Health Education and Promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619











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