Sunday December 16, 2018

Sierra Leone Grapples with Mental Health Impact of Ebola

Mental health is a much wider problem in Sierra Leone. An estimated 240,000 people in the country suffer from depression.

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Health workers carry the body of a suspected Ebola victim for burial at a cemetery in Freetown, Sierra Leone, Dec. 21, 2014.
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With the recent Ebola crisis, officials in Sierra Leone have seen a rise in mental health concerns. Mustapha Kallon’s problems are typical. He survived Ebola but lost many family members during the epidemic.

“Whenever I think of my parents, I feel depressed,” he said.

Kallon said he turned to alcohol to cope with his grief. He was still receiving care in the Ebola treatment unit when his parents died from the virus. He didn’t get to say goodbye and doesn’t even know where they are buried.

Ebola survivor Mustapha Kallon says that "when I am among my colleague survivors, we explain to ourselves what we go through, and that helps us to forget about the past and face the future," April 6, 2017 (N. DeVries/VOA)
Ebola survivor Mustapha Kallon says that “when I am among my colleague survivors, we explain to ourselves what we go through, and that helps us to forget about the past and face the future,” April 6, 2017 (N. DeVries/VOA)

Sometimes Kallon goes with fellow Ebola survivors when they visit the graves of their loved ones.

‘I always cry’

“I feel like dying … I always cry when I am there,” he said. “I always feel pity, because I can’t find their graves.”

The corpses of people infected with Ebola can be very contagious. During the epidemic, burying the dead quickly and safely was so important to stopping transmission that proper records were not kept and some graves were left unmarked.

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From 2014 to 2016, the regional Ebola epidemic killed just over 11,000 people. Nearly all of them were in West Africa, with about 4,000 in Sierra Leone.

Mustapha Kallon stands with fellow survivor Brima Bockarie in Freetown, Sierra Leone, April 6, 2017. Kallon said that had he not reached out to others, he might not have been able to get through his depression. (N. DeVries/VOA)
Mustapha Kallon stands with fellow survivor Brima Bockarie in Freetown, Sierra Leone, April 6, 2017. Kallon said that had he not reached out to others, he might not have been able to get through his depression. (N. DeVries/VOA)

Those who survived the virus have faced stigma. Kallon was shunned by his community. It was only through support from the Sierra Leone Association of Ebola Survivors that he started to heal.

“When I am among my colleague survivors, we explain to ourselves what we go through, and that helps us to forget about the past and face the future,” he said.

Many of the Ebola survivors in Sierra Leone are going through similar struggles, said Dr. Stephen Sevalie, one of the country’s only psychiatrists.

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“Our data has not been analyzed yet, but I can tell you that mental health symptoms are quite high among Ebola survivors,” he said.

Scientists are studying a host of symptoms now known collectively as the post-Ebola syndrome. Symptoms include loss of eyesight, joint pain, and fatigue, as well as mental health issues like depression and anxiety.

Mental health, however, is a much wider problem in Sierra Leone. An estimated 240,000 people in the country suffer from depression.

Help within communities

Florence Baingana, who heads the mental health team with the World Health Organization in Sierra Leone, said that as a result of the Ebola epidemic, the Ministry of Health, with the support of the WHO, has trained 60 community health officers.

“So we are trying to get services down to as many people as possible,” she said. “We are training health workers in psychological first aid so they can recognize and do some listening and be helping.”

Dr. Stephen Sevalie, one of Sierra Leone's only psychiatrists, says mental health problems "are quite high among Ebola survivors." He's pictured at a military hospital Freetown, April 6, 2017. (N. DeVries/VOA)
Dr. Stephen Sevalie, one of Sierra Leone’s only psychiatrists, says mental health problems “are quite high among Ebola survivors.” He’s pictured at a military hospital Freetown

Baingana added that it’s not just Ebola survivors who have been suffering from the epidemic. Health care workers, burial workers and others involved in response efforts have also reported mental health concerns.

Nadia Nana Yilla, who volunteered in communities to help raise awareness about Ebola, said hearing people’s painful stories took a toll at times.

“I cried endlessly,” she said. “For me, that’s my way of dealing with depression. I just isolate and seclude and cry it out … so sometimes if you cry, it really helps. If you can’t cry it out, you have to find someone to talk to.”

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And that is the message on this World Health Day, April 7: People need to talk to someone if they are feeling depressed.

Kallon said that had he not reached out to others, he might not have been able to get through his depression. And although it’s still hard at times, having that support around him helps, he said. VOA

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Meditation Helps Veterans Well With PTSD: Study

Meditation could be more acceptable to veterans who might associate mental health treatment with weakness.

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Veterans, PTSD, Afghan. Taliban
A U.S soldier patrols at night in Khost province, Afghanistan, seen through night vision equipment. About 400,000 veterans had a PTSD diagnosis in 2013, according to the Veterans Affairs health system. VOA

Meditation worked as well as traditional therapy for military veterans with post-traumatic stress disorder in a small experiment sponsored by the Department of Defense.

One method preferred by the Department of Veterans Affairs is exposure therapy, but it doesn’t work for everyone and many can’t handle what it requires: purposely recalling traumatic events and confronting emotions.

Meditation could be a better choice for some, the researchers said.

Exposure therapy unpopular

The experiment tested meditation against exposure therapy, which involves working with a therapist and gradually letting go of fears triggered by painful memories.

PTSD
There’s growing interest in meditation in the United States.

Many vets won’t try exposure therapy or drop out because it’s too difficult, said Thomas Rutledge, the study’s senior author and a Veterans Affairs psychologist in San Diego.

Evidence for meditation “allows us to put more options on the table” with confidence they work, Rutledge said.

The study was published Thursday in the journal Lancet Psychiatry.

Follow-up study needed

About 400,000 veterans had a PTSD diagnosis in 2013, according to the VA health system. The VA already is using meditation, yoga and similar approaches to supplement traditional therapy with PTSD, said Paula Schnurr, executive director of the VA’s National Center for PTSD.

While the three-month study adds to evidence supporting these lifestyle practices, Schnurr said, more research is needed to learn how long meditation’s benefits last.

Stress, meditation, PTSD
Meditation can boost emotional intelligence, cut stress at workplace. Pixabay

“There’s no follow-up in this study,” Schnurr noted, and one therapist did 80 percent of the exposure therapy so the findings hinge largely on one therapist’s skills.

Researchers measured symptoms in about 200 San Diego area veterans randomly assigned to one of three groups. Some learned to meditate. Others got exposure therapy. The third group attended classes where they learned about nutrition and exercise.

All sessions were once a week for 90 minutes.

After three months, 61 percent of the meditation group improved on a standard PTSD assessment, compared to 42 percent of those who got exposure therapy and 32 percent of those who went to classes. When researchers accounted for other factors, meditation was better than the classes and equally effective as exposure therapy.

The researchers defined success as at least a 10-point improvement in scores on a standard symptoms test, given to participants by people who did not know which kind of treatment they’d received. The test measures symptoms such as flashbacks, nightmares and insomnia.

 

CyclingStress, meditation, PTSD
Cycling, walking in nature may improve your mental health. Pixabay

 

PTSD also can be treated with medications or other types of talk therapy. Many of the participants were taking prescribed medicine for PTSD.

Most of the vets were men with combat-related trauma, so it’s not clear whether meditation would be equally effective in women or with other types of trauma.

More interest, styles

There’s growing interest in meditation in the United States. A government survey last year found 14 percent of adults said they had recently meditated, up from 4 percent from a similar survey five years earlier.

There are many styles of meditation. The type taught to vets in the study was transcendental meditation, or TM, which involves thinking of a mantra or sound to settle the mind.

TM was developed by Maharishi Mahesh Yogi, a guru to the Beatles in the late 1960s. Some of the study authors are affiliated with a university in Fairfield, Iowa, founded by Maharishi. Their role was to oversee the meditation training.

Also Read: 2 War-Stricken Towns in Somalia Finally Receive Health Care: UN

Rutledge, who was the principal researcher, said he does not practice meditation himself.

Meditation could be more acceptable to veterans who might associate mental health treatment with weakness, Rutledge said.

“It’s probably less threatening,” he said. “It may be easier to talk to veterans about participating in something like meditation.” (VOA)