Mental Health

Noetic Minders Health Services Brain and Art Initiative organised the Sip and Paint Wellness Break A program designed to promote mental health wellness through creative expressions, stress reduction, and social connection. The event provides a relaxing and artistic outlet, one that supports emotional wellbeing and resilience, and allows participants to unwind, connect, and explore creative self care. The maiden edition saw a rich gathering of people who embraced the importance of wellness and mental through music, creative arts (painting, drumming circles, and dancing) in an idyllic and luxuriant setting.P.S – Did I mention that the food was so amazingly sumptuous that the suggestions were that it should have been a “Munch & Paint” and the the Jazz was ethereal.

Enjoy a healthy 2024 as we “no gree”for harmful mental health practice. It is important to state that I do not equate “no gree for anybody” with aggression/irritability or anger in all instances. However, I think it is important that in resisting people riding us roughshod and demanding better conditions, we should be mindful of boundaries, people’s idiosyncrasies, and our mental and physical health as well as that of others. Perhaps we can re-channel the “no gree for anybody” and adopt the “no gree for unhealthy mental health” mantra. A few days ago, the air was filled with cheer: Resounding with echoes of “happy new year” and the characteristic exchange of pleasantries to usher in the new year. Goals were set. New year resolutions were made and perhaps broken almost immediately too. And not a few people had high aspirations for a better year. If I am to go by what I have seen and heard, health and wellbeing appear to be strong considerations for the new year. In prepping for a better and healthier 2024, a substantial number of people have cited mental health as topping their priority lists and plan to be deliberate about safeguarding their mental health. In no small measure, the increasing attention given to mental health, albeit inappropriately, is welcome. Afterall, we cannot aim for a healthier society without healthy mental states. However, I cannot help but muse over the new mantra “no gree for anybody” and its many variations that allegedly came into public space towards the twilight of the preceding year as a slogan for 2024 among Nigerian youths — but which now appears to have been adopted across age groups. It can be described as upholding one’s rights, defending one’s turf, or being more decisive. Certain people have argued that the mantra speaks to a positive move for a better country by its youths’ resisting acquiescence, which is presumed to be part of the sundry problems that have plagued Nigeria, insisting that it is high time to demand for improved conditions. In other words, the desire for change for a better Nigeria. Anyway, like every ideology there are bound to be outliers who will distort the underlying good intentions and there is the possibility of it being misrepresented or understood. Little wonder the spokesperson of the Nigeria Police Force described it as a nidus for rebellion and expressed concerns about the trending mantra and its revolutionary tendencies. Although, such innuendoes can be unsettling and appear as threatened infringement of one’s human rights, it is appropriate to remind the citizenry to act within the confines of the law. Contrary to the seemingly austere warning from the Nigeria Police Force, the endorsement of the mantra with regards to security issues by the representative of the Nigeria Defence Headquarters was a more charitable action. Now, the question is: What is the relationship between the “no gree for anybody” mantra and the angst of a psychiatrist? Or simply put, what has this mantra got to do with mental health? As a psychiatrist, I prefer to interpret the “no gree for anybody” mantra as one that motivates individuals to be more assertive, confident, and resilient. One that spurs individuals to aspire for actualisation and these seem to be the case in some situations. Intriguingly, information from social media suggests that some individuals in their pursuit of wider social media visibility and “likes” use this “no gree for anybody” mantra to showcase aggression, bullying, intimidation, and egomania. Quite disconcerting is the interpretation and display of “no gree for anyone” as aggression, irritability, or anger in its subtle or profound forms. Usually, there exists a bidirectional relationship between the subject and the target. Anger can be a normal reaction to untoward events, information, thoughts, and/or actions directed at a person or thing. It can be a positive and valuable emotion, if properly harnessed. Certain others who perceive forms of disenfranchisement have adopted the mantra as an opportunity to project distress emotions, such as aggression or unusual anger. Although, these actions can be argued to be part of the process of evolution from subservience to boldness, a phase of change from learned helplessness to emancipation in a population that has been largely marginalised, I have concerns about the significance of these on the mental health of all involved. Quite disconcerting is the interpretation and display of “no gree for anyone” as aggression, irritability, or anger in its subtle or profound forms. Usually, there exists a bidirectional relationship between the subject and the target. Anger can be a normal reaction to untoward events, information, thoughts, and/or actions directed at a person or thing. It can be a positive and valuable emotion, if properly harnessed. Conversely, it can be a symptom of ill-health, or reaction to the threat or experience of an illness, its course, management, or the outcome of the illness. Studies have linked mental health conditions such as depression, anxiety, self-harm, and some physical health conditions such as elevated blood pressure, headaches, and migraines with anger. Biological, psychological, socioeconomic factors including the changing climate have been identified as causes of aggression/anger. Unsurprisingly, current conditions in Nigeria present a good medium for varying levels of aggression vis-à-vis health concerns. Therefore, in asserting our posture, we should be mindful of our actions and words, how we use them and who we use them on. Targets of hostile actions such as bullying, intimidation or aggression may experience mental health conditions such as anxiety, post-traumatic stress disorders (PTSD), depression and in some cases, have recourse to suicide. A great number of Nigerians are experiencing forms of emotional distress. Some people are like the Indian rubber ball that bounces back while some are at their wits’ end. Some people may see the “no gree for anybody” as a call to claim their rights and some for better governance, while for the person on the receiving end, whose struggle you may never know, it may just be the last straw that will crush his/her resolve

Appropriate resources and regular training on proper dissemination of information on mental health should be offered to journalists, media enthusiasts, script writers and content creators, taking into consideration the sensitivities of people with lived experiences and their caregivers. Media establishments, the entertainment industry, health care providers and regulatory bodies are indispensable to mental health information. Appropriate resources and regular training on proper dissemination of information on mental health should be offered to journalists, media enthusiasts, script writers and content creators, taking into consideration the sensitivities of people with lived experiences and their caregivers. I had put off writing in the media for a while. At some point, concerned persons had reached out to ask if I had also “japa-ed” (a Yoruba word that has become an euphemism for emigration). I must admit that to jump ship has been a tempting recourse in the past triennium, considering that one is constantly confronted by the ills of our society: the insecurity, worsening inflation, a decrepit health sector, successive draconian decisions, and the policies of Nigerian lawmakers which continue to fuel widespread system collapse. Nevertheless, I am aware that there are numerous doctors in Nigeria who still hang on to the tendrils of hope for a better tomorrow and have put “checking out” or “japa-ing” on hold. Recently, on my way to work, these themes ran violently into each other. I was tuned into a radio programme, where I had to endure the ordeal of listening to some “expert” from a different field from mental health lecture listeners on mental disorders and treatments. The horror I experienced listening to this individual, who felt qualified enough to brazenly misinform the public, was profound. It did not help that the call-ins during the programme spurred further misinformation. What was remarkable though was the confidence and eloquence of the “expert’s” delivery. It was almost incidental that he was also endangering uninformed listeners. I shuddered and cringed through the broadcast. But I could not phone in. The phone lines to the studio were ringing off the hook, and bear in mind that I was driving. I also reckoned that taking up arms against a speaker on radio would not have been the best approach and may have further fuelled animosity and misconceptions about mental health professionals. Again, it would have been unimaginable to insinuate that the speaker, who was highly recommended by a popular radio presenter, was spewing misinformation and worsening the stigmatisation of people living with mental disorders. As I listened, I pondered the increasing number of these “neo-psychiatrists” who appear suave, voguish, and knowledgeable. Traits that interestingly appeal to unsuspecting individuals, yet predispose them to exploitation. It was instructive how these traits are rarely found amongst qualified specialists who aim to ensure optimal health and are less bothered about how their appearances or speech patterns come across. On the flip side, there are the lower classes, barely able to afford transportation costs for the next hospital visit, who struggle to procure medications and often skip doses so that purchases last longer. Several of this latter cohort will with gusto seize upon the offer of a purportedly cheaper alternative for an ailment that they still struggle to accept is not wholly supernatural. A little dose of misinformation by these snake oil vendors may be all they need to revert to “questionable unorthodox” care. Afterall, the nostrum on offer is similar to cultural practices and beliefs they can easily relate with. Professionals cannot continue to adopt the practices of old to tackle the challenges of the new. It is no longer tenable to stay within the confines of treatment facilities and allow charlatans to take over the mental health space, misinform people and in the wake of this, have qualified professionals left to deal with the complications of their ill-guided actions. I am not saying that unorthodox care is all bad. But in several instances, people with mental disorders have been exploited by quacks under the guise of cheaper care. There are reported cases of the administration on unsuspecting persons of unregulated doses of antipsychotics and psychoactive drugs included in herbal concoctions. Some of the recipients of these interventions have been physically and sexually abused, culminating in worsened states and complications that warrant medical interventions. A number of these incidents present as would be storylines off Nollywood movies, but the damage they lead to are as real as their occurrence in our clinics. A slight drift to Nollywood: an institution that for too long has stigmatised people with mental disorders and lags in its portrayal of mental disorders – depicting them as ailments without treatment and without hope of returning to normal functioning. But again, aren’t some Hollywood movies guilty of this too? I did not get to muse for long though, as I had arrived at my destination and was jolted back to my reality. The reality of most doctors who have stayed back in Nigeria. A long waiting line of people who require medical consultation, mentees to be trained, and other administrative matters to be addressed. Any issue I had with the radio programme was repressed and archived for a later date. However, this time around, rather than stay in the archives, the experience reignited the need to contribute to the dissemination of accurate information on mental health and appropriate treatment channels. Enough of wishing things were done differently, whispering, or exclaiming at what has and had not been done. I have long realised that while wishes may work in fairy tales, they do not work in today’s world. The time for one to play one’s part in realising the desired change in basic assumptions is here. Professionals cannot continue to adopt the practices of old to tackle the challenges of the new. It is no longer tenable to stay within the confines of treatment facilities and allow charlatans to take over the mental health space, misinform people and in the wake of this, have qualified professionals left to deal with the complications of

Consultant Psychiatrist and a Fellow of the West African College of Physicians, Dr. Margaret Uddin-Ojeahere, says digital technology has helped in the management of mental health practice and helped to create awareness about improving how people accept mental health conditions. But there is still much more that technology and awareness creation can do to manage the entire spectrum of mental healthcare including emotional well-being, cognitive functioning, social connections, and overall psychological resilience. The challenges of tech on mental health are on the rise as digital enablement becomes a way of life for millions of people. For instance, ‘infobesity,’ an overload of information and systematic inability to filter info-consumption online in order to maintain mental balance is increasingly becoming a norm of digital existence. Uddin-Ojeahere, a mental health advocate, works at the Jos University Teaching Hospital (JUTH). She shared insights with Tracy Yekaghe of IT Edge News.Africa. Could you share your own perspective on the impact of technology on mental health? Looking at it broadly, technology in our present day and age is something we have to embrace. Increasingly, our world revolves around technology making it impossible to exclude the demands of our daily living from this reality. Nevertheless, it can have both adverse and positive effects on one’s mental health. It is no longer news that increasing engagement on the different social media platforms and prolonged screen time can lead to negative consequences on people’s mental health in diverse ways such as sleep disturbances, exposure to cyber bullying, viewing people’s glamorous lives on certain apps, especially considering the fact that most people share admirable events or parts of their lives and rarely post the negatives. These can result in feelings of inadequacies, low self-esteem and rejection to mention a few and may lead to mental health conditions such as anxiety, depression, addictions, substance use disorders, and suicide at the extreme. There is also the risk of “infobesity which has a lot to do with excessive consumption and overload of information in today’s digital age that can lead to the mental breakdown of that individual particularly if the person has traits of being easily overwhelmed and anxious. So it is important that people are deliberate in filtering and regulating what they consume or are exposed to. On the flip side, technology has helped mental health practice in advocacy, creating awareness about mental health conditions, improving how people accept mental health conditions. Before now, mental conditions were considered a punishment for misdemeanours, curses from gods or having supernatural aetiology. Not forgetting, how stigmatized people with mental health conditions were in our society and in some instances ostracized. But with advancing technology, there is a paradigm shift and better acceptance. Technology has also improved the delivery of mental health care from screening, identifying, diagnosing, and management of people with mental health conditions. One area which technology is playing a vital role is tele psychiatry which is increasingly being accepted as an important means of delivering mental health care especially during and in the aftermath of COVID19. It has helped in the treatment of hard to reach patients and has yielded good results. There are other useful apps that can help users de-stress and some that can guide users to appropriate helplines/centres. In addition, technology has aided the dissemination of information, monitoring and evaluation, training, education and research in the field of mental health. Do you have a word of caution as regards technology and its impact on mental health? There are a number of things that we can use technology for. But in my opinion, I think an important word of caution is that of moderation and regulation, especially in the development and usage of apps and technological devices. It is important to have in mind the consequences (on mental health and other spheres of life) during the creation process so we do not develop what would eventually destroy us. There is also the risk of “infobesity which has a lot to do with excessive consumption and overload of information in today’s digital age that can lead to the mental breakdown of that individual. Could you share some recommendations in line with how the negative impact of technology can be reduced to the barest minimum? I think it is for us to be informed and educated about these things. Let’s know more about it. An example is cutting down on screen time for instance; not everyone might be aware that blue light from their electronic devices can affect their sleep to the extent of disturbing their sleep cycle and may lead to sleep disorders or forms of mental health conditions. Hence, there is a need for awareness to help more people stay guided on best usage practices. We also need to understand and be informed about the age limits attached to the usage of certain gadgets which would require the need for supervision and promotion of usage by critical stakeholders such as parents, schools and others where applicable. What would be your counsel to those who mostly leverage technology for necessities or gainful activities such as work and businesses? I must state that technology is indeed necessary and something we need to embrace, we cannot throw away the baby and the bathwater. No! It is something that is beneficial for our daily livelihood. However, we just need to understand our weaknesses and our strengths so we are aware of those times we might need to either pause or have some timeout or step back in order to maintain or improve not just our mental health but our overall health and wellbeing. Tele psychiatry … is increasingly being accepted as an important means of delivering mental health care especially during and in the aftermath of COVID19. It has helped in the treatment of hard to reach patients and has yielded good results. Would you encourage the usage of latest technological tools to drastically reduce human efforts used to get work done for the sake of sustaining mental health? Absolutely! I am not against technology as it has made life very

Several risk factors associated with poor mental health following protests were identified among youths. …if we are to avoid a mental health crisis in the country, then the time to act is now. It is necessary for mental health practitioners in Nigeria to be vigilant to the psychological aftermath of collective actions, particularly as some symptoms may be covert and manifest long after the event. Researchers should engage in more studies to determine the magnitude of protests and riots on the mental health of people. “Where ignorance is bliss tis folly to be wise” – Thomas Gray Collective actions, be it in the form of riots or peaceful protests, have long been a part of human history. Increasingly, much of the world is witnessing large scale protests and riots against systems of leadership, with the aim of achieving specific goals occurring in their different parts. Ultimately, such actions can either lead to a definite alteration in the existing system of governance or stimulate a domino-like effect, which may lead to the loss of lives and properties. Nigeria presents a good example, with a history of collective actions predating the country’s independence. One’s mind easily flashes to the Aba Riot by women in the Eastern Region of colonial Nigeria between 1929 and 1930. A historical event which has been described as one of the earliest protests documented in Nigeria.  Some scholars have argued that the women’s riot signaled the emergence of the feminist movement in Nigeria. Others posit that it was a cultural protest resulting from the defects in their government at the time. While this remains debatable, what is commonly known about the women’s riot was the collective efforts to oppose socioeconomic, and political injustice by the existing leadership. Several other protests and riots are intertwined in Nigeria’s history and aimed at changing extant systems, unfavourable policies, and living conditions. One protest that Nigerians will not forget in a hurry is #EndSARS, which occurred at a time when Nigerians were only beginning to bounce back from the turmoil of the COVID-19 pandemic and its adverse consequences. The #EndSARS street protest commenced on October 8, 2020 and was spearheaded by Nigerian celebrities, activists, and other young professionals. It held across several states in Nigeria and gathered support internationally. Demonstrators comprised mostly Nigerian youths who discounted perceived social class, ethnic and religious divisions to protest the perennial police brutality, and unrestrained activities of the special anti-robbery squad (SARS) – a unit of the Nigeria Police Force composed to handle violent crimes. The protest raised the awareness of the terror and psychological distress that Nigerians face as a result of the SARS unit and called for its dissolution and reform of the police force. Certainly, there’s no gainsaying the diverse adverse effects that protests and riots have on the emotional and psychological state of individuals. Unfortunately, the focus of attention has revolved around the economic import, and physical and social components of health. Although this appeared as the main theme for the protest, several other issues were brought to the fore. Common grievances were police brutality, the deteriorating health and educational sectors of the country, the worsening socioeconomic state of Nigeria, increasing corruption, and bad governance. The protest represented different things to different people, but to a large proportion of Nigerians, it kindled the hope for the desired change, regardless of whether they were on the streets protesting or not. However, the hope for favourable change was short-lived, as some other groups of youths saw opportunities in the street protest to unleash mayhem, loot and vandalise properties. This was further compounded by the involvement of the military and the use of ammunition on unarmed protesters on the twelfth day of the protest at the Lekki toll gate, referred to as the ground zero of the “#EndSARS” protests. This left a trail of wanton vandalisation, and carnage across states in Nigeria in its wake. The knotty question then is why I have decided to write on the #EndSARS protest several months after its occurrence. After all, it is presumed that the worst is over and Nigerians are “back to business as usual”. However, the sequence of events and the obvious disregard by certain significant authorities for the psychological consequences of such actions on Nigerians  piqued my interest. Certainly, there’s no gainsaying the diverse adverse effects that protests and riots have on the emotional and psychological state of individuals. Unfortunately, the focus of attention has revolved around the economic import, and physical and social components of health. Nonetheless, if we are to attain the appearance of a balanced society, then strategies that support mental health must be adopted. It will be quixotic to expect people who witnessed traumatic events, such as gruesome killings and mayhem, to remain mentally unscathed. However, there is usually an interplay of factors following a traumatic event before psychological conditions manifest. A few include the personality of the individual, the nature and duration of the traumatic event, existing support systems, underlying health conditions and the presence of other stressful events or previous exposure to traumatic events. … it is likely that the aftermath of the #EndSARS protest had differing effects on the mental health of people, generally, regardless of whether they were directly or indirectly witnessed. The increase in distress calls to organisations which provided psychosocial support during the days to weeks following the shooting and carnage suggested this. One event that has and is still taking a toll on people’s mental state is the COVID-19 pandemic. It has heightened mental health conditions and depression has been reported to increase by six to ten times amongst Nigerians. Existing evidence shows that protests and riots, whether violent or otherwise, may adversely affect mental health. The unbridled dissemination of the gruesome images of the mayhem and carnage on social media platforms ensured people across the country and beyond were indirectly exposed. Therefore, it is likely that the aftermath of the #EndSARS protest had differing effects on the mental health of people, generally, regardless of whether they were directly or indirectly witnessed. The increase in distress calls to organisations which provided psychosocial support during the days to weeks following the shooting and carnage suggested this. Similarly, several risk factors associated with poor mental health following protests were identified among Nigerian youths who accessed available helplines.  Consequently, if we are to avoid a mental health crisis in the country, then the time to act is now. It is necessary for mental health practitioners in Nigeria to be vigilant to the psychological aftermath of collective actions, particularly as some symptoms may be covert and manifest long after the event. Researchers should engage in more studies to determine the magnitude of protests and riots on the mental health of people. More importantly, though, is the implementation of concerted actions at addressing the mental health consequences, rather than the usual “talk” and barrage of paperwork. Therefore, it becomes pertinent to establish structures for rapid assessments, psychological first aid, and appropriate referrals following protests. This will require commitment and funding for the provision of available, yet effective treatment, adequately equipped facilities, and motivated manpower. An all-hands-on deck approach should be adopted, right from the individual seeking change on the street to the highest level of government expected to provide a certain minimum degree of good governance to its citizenry. Possibly, what the people need may just be better governance and then the frequency of collective actions will drastically reduce. Perhaps, the time is yet. In the interim, we continue to carry on with “it’s business as usual”. Margaret Uddin-Ojeahere, is a psychiatrist and Fellow of the West African College of Physicians. Also Published on Premium Times Newspaper – https://www.premiumtimesng.com/opinion/450514-mental-health-protests-and-social-upheavals-in-nigeria-by-margaret-uddin-ojeahere.html?tztc=1

It is important to emphasise that seeing a psychiatrist does not necessarily mean that one is “mad”. At times people need help to cope with the challenges they face, whether at work, in their academic pursuits or otherwise, which may threaten their mental health. The question, “Who needs a psychiatrist?”, is becoming more pertinent than ever before in the history of man. Not only because the different turmoil across diverse parts of the world have led to an increasing number of individuals with one form of mental illness or the other. But, also, because of the misconception by a considerable number of people that “psychiatrists” attend to only “mad” people. The erroneous impression most people have of mental illness is that of a disheveled, matted-haired, tattered-clothed individual who goes around hoarding rubbish and talking to invisible beings. This is as far from the truth as it can be. Truth is, mental illness bears the face of your neighbour, a colleague at work or a member of your church or mosque. However, a lot of people find this simple fact hard to process. While I cannot fault them for this, considering the longstanding stigma and its attendant psychosocial consequences that have been associated with mental illness, I am also mindful that people give their own explanations to what confounds them. Unfortunately, in Nigeria, dare I say worldwide, mental illness has continued to be shrouded in a great deal of mystery, leading to different reactions in which general perception has oscillated between the extremes of fear, ridicule, revulsion and ignorance, on one hand, and fascination, voyeuristic curiosity and normalisation on the other hand. It is therefore not surprising that several misconceptions surround mental illness and the role of the “psychiatrist.” The mere mention of a “psychiatrist” sends cold shivers down the spine of most people. “Why a psychiatrist?” “Isn’t that a doctor who treats ‘mad’ or ‘insane’ people?” “Is my case that bad?” “After all, I am educated. I have a good job. I don’t need to hear about a psychiatrist”. And the list of excuses goes on and on. …there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation. Health, if the World Health Organisation (WHO) is to be believed, is a “state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity”. Is there “health” without “mental health”? Not if “mental health” is understood as a “state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make contribution to her or his community”. WHO, the author of that last quote, also estimates that more than 450 million people worldwide suffer a form of mental illness. In the U.S., the National Alliance on Mental Illness reports that one in five people will experience a form of mental illness every year and for one in 25 persons, it will be severe and persistent. Our Federal Ministry of Health recently put the number of Nigerians suffering from one form of mental illness or the other at about 20 per cent to 30 per cent of the population. What this therefore means is that there exists a huge burden of mental illness, and a dire need for psychiatrists around the world. Yet, Nigeria has about 250 qualified psychiatrists to a population of 40-60 million people with mental illness. Even more bothersome, of late, has been the massive exodus from the country of doctors in different areas of specialisation. Needless to say that a number of these psychiatrists are leaving the country for perceived greener pastures. Can we blame them for not being patriotic or for wanting to “check out”? No! In a country with little or no job prospects for newly qualified specialists in various medical fields, little wonder this exodus continues. Evidently, not every doctor desires farming nor tailoring, as suggested by the Minister of Health in one of his interviews. Beyond her other hobbies, though, a psychiatrist is a qualified medical doctor specialising in the study, prevention, diagnosis and treatment of mental disorders. The psychiatrist is trained to evaluate patients, determine whether a person’s symptoms are the result of an underlying medical condition, which may result in the manifestation of a psychiatric disorder from a solely psychiatric condition, as seen in some cases of schizophrenia or the combination of a medical and a mental disorder. The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders… Psychiatrists are licensed to prescribe appropriate medications, as well as to engage in psychotherapy to alleviate these mental disorders. They usually work with other mental health workers, including psychologists, nurses, social workers, vocational therapists, speech therapists etc., and in liaison with other non-psychiatric physicians. Psychiatrist also engage in intersectoral collaboration with the public, private sectors and civil societies to ensure the best care possible for people with mental illness. The sense, therefore, that psychiatrists treat only ‘mad’ or ‘insane’ people is a distortion of the fact that the public perception of mental illness revolves around psychotic behaviours. Yet, a significant number of people worldwide (Nigerians inclusive) experience less profound forms of psychiatric illnesses such as anger problems, sleep disorders, anxiety and trauma-related disorders. The reality, then, is that not all people seen by a psychiatrist have obvious forms of mental illness. Part of our uniqueness as human beings are our idiosyncrasies and foibles. Most people will have a mental health challenge from time to time, usually