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Wednesday, 08 March 2023 11:38

Mental Illness is the most neglected health problem in the developing world.

By Myrna Sachs, head of Alexforbes Health Management Solutions.

Mental health is a complex issue, one which many of us take for granted during times when all is going well in our lives. But anything can affect our mental wellbeing, including changes in one's financial or social circumstances, traumatic experiences, losing a loved one, biological factors and underlying medical conditions.

We take a closer look at some of the causes of mental health issues, and how they should be addressed:


We all experience loneliness differently, which should not be confused with being alone (not having people around us). Loneliness refers to an unmet desire to have a sense of belonging and connection with our social contacts. Some lonely people have a lot of people around them but feel empty and unfulfilled by all these people.

Loneliness is a deep sense of uneasiness and discomfort about feeling alone and can occur after a loss of a loved one, if you’re going through a distressing period such as financial problems, a chronic illness or not being able to adjust to a new environment or circumstance.

Each one of these experiences feel different to the people going through them but the common part is the subjective feeling of sadness and disconnectedness.

Deep loneliness can also lead to:

  • anxiety as well as other depressive disorders
  • eating disorders
  • feelings of insecurity and even worthlessness
  • lack of energy
  • struggling with sleep
  • withdrawing from engaging with others

These effects impact decision-making, concentration, ability to solve problems and lead to self-doubt. As these effects deepen, depressive and anxiety disorders are likely.


Losing a loved one can be traumatic. Although we all experience loss differently, some people struggle to come to terms with it, which affects their mental wellness.There are stages to grieving that have been well described by Elizabeth Kubler Ross: denial, anger, bargaining, depression and acceptance. These can occur over a short period but for many people, they take a few months. When grieving becomes prolonged (more than six months) or the emotions are severe, this is called complicated grief.

This kind of grieving very often leads to depressive disorder and is marked by:

  • neglecting normal daily responsibilities
  • no motivation to interact with others
  • detachment from family members
  • intense emotions of anger or pain even after ample time has passed

If these signs go unattended, there is a greater risk of self-harm such as suicide or turning to alcohol and substance abuse in order to cope.


Stress refers to the body’s response to a change in mental, physical or psychological strain. A stress response occurs when you perceive the strain placed on you as bigger or more than you are able to manage.

There are three steps to a stress process, starting with the trigger. This can be workload, family issues or even physical demands. Should you perceive this stimulus to be more than you think you can cope with or handle, your brain responds to this trigger by activating different mechanisms to help you to cope. In the immediate phase, the body releases adrenalin which increases your heart rate and your blood pressure, making it almost impossible to eat or sleep since the nervous system is alert.

This kind of response however can only be sustained for a short period of time. Should the stress trigger persist, the body replaces adrenalin with cortisol which maintains the state of hyper-alertness. However, cortisol has side effects such as weight gain, high blood pressure, irritability, headaches and gut problems.

In the longer term there is a high likelihood of developing anxiety and depressive disorder. The third and final step of the stress process is the outcome. The release of adrenalin will result in your ability to run fast or work faster, or stay up all night in preparation for a project submission, but in the longer term the outcome can be mental illness, diabetes and other non- desirable consequences.

How do you identify that you have continual stress?


  • feel overwhelmed
  • restless
  • have mood swings
  • struggle to focus
  • opt out of social engagements with friends
  • have a sense of hopelessness
  • lose confidence in your abilities

Stress is by far the most commonly occurring of the mental illness causes. Often, we are not even aware that we are stressed and require regular routines to help us with relaxation in order to be able to listen when our bodies are tense. There are tools to help with adapting:

  • Daily mindfulness – consciously choosing to be fully present in each moment of your day or activity that is causing you stress. This way you are alert to the thoughts that go on in your mind and your emotions, and can, with no judgement, work through why you feel the way that you do. Interrogating your thoughts and opening yourself up to feel your emotions as they arise, has been shown to lessen the stress response due to its calming You can train yourself to manage your breathing and to encourage yourself with positive thoughts as you go through the day with awareness of the negative emotions that may arise from your triggers.
  • Frequent quiet time, meditation or self-care – meditation has the same effect as mindfulness in calming your thoughts and allowing you to eliminate the flurry of emotions and anxiety.
  • Destress activities – getting enough sleep, getting up from your desk and taking a walk when you feel overwhelmed, eating your lunch with others and away from your desk in order to interrupt your thoughts of hopelessness, closing your eyes and sitting back with your hands on your lap and counting to ten slowly in between deep breaths, can help in distressing your

Putting the above into practice will create an awareness of your body’s stress response. You will need to respond appropriately in order to normalise this response, and curb the risk of mental illness and other medical issues. This might mean having a conversation with your line manager about reshuffling or sharing your workload, calling your workplace Employee Assistance Programme helpline to speak to someone and open up about your unhappiness.

What can you do?

Mental health exists on a spectrum where you feel confident and happy with your mental state, to feeling out of control and completely unable to live a meaningful life. For each of the possible causes of mental health mentioned above, we may feel like we are coping and winning the battle on some days, while other days may drag us down. Healing and coping is a journey which we must travel daily and with intentionality.

Practice the following when you are not coping:

  1. Acknowledge how you feel - Ignoring your emotions or not allowing yourself time to recognise that “I am not okay” has led to manageable conditions getting worse. Practice mindfulness on a daily basis. It allows you to be aware of how you feel.
  2. Find someone to speak to - Stay away from using alcohol and illicit substances to cope. If you are already struggling with dependence or an addictive substance, seek professional help. Speaking to a friend or loved one is always the first and easiest step. Where you need professional help, do not hesitate to reach out and receive that guidance.
  3. Be bold – Ask for help. Most importantly, be open to receiving help when it is offered to you. People around us often offer to help but due to our discomfort and perhaps avoidance, we do not welcome assistance despite knowing we need it.

Alexforbes Health Management Solutions understands the importance of mental wellness and the impact it has on our overall well-being. We are dedicated to improving mental health and wellbeing, and aim to provide a supportive environment to help individuals, couples and families cope with their mental health issues.