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It’s okay not to be okay

15 October 2020 | Story Angie Vorster | Photo Supplied

Angela Vorster_web read more — Angie Vorster is a Clinical Psychologist in the School of Clinical Medicine, University of the Free State

As a mental healthcare provider, I approach the end of every year with some trepidation. As soon as the August winds start to blow in Bloemfontein, we tend to see a distinct increase in our community’s psychological distress. The year 2020 has not spared us this increased burden of suffering.

This year has presented humanity with extreme challenges and our university community has felt this to our core. The latest research indicates that the South African population has been affected by the pandemic in various ways and on various levels but none less severe than our psychological health. One in three South Africans will present with a psychological disorder during our lifetime (and this was prior to the Covid-19 outbreak); and the effects of the pandemic have caused a significant rise in depression, anxiety and trauma symptoms among South Africans.

In mourning

We are experiencing exceptionally high levels of financial stress due to the impact of the disease and lockdown on our economy. We have endured months of social distancing, fears surrounding our own health and the well-being of our loved ones, our financial safety, managing our children’s home-schooling, adapting to distance-learning and concerns about the academic year being salvaged. We have had to experience loss after loss. We mourn loved ones, colleagues and acquaintances that have become ill or passed away due to the pandemic. We have mourned the loss of our normal lives. The hugs, handshakes, casually touching someone’s arm, the shows, sporting events, weddings, graduations and braais we took as for granted. We grieve for a time before sanitising and masks and avoiding contact with our fellow humans was the daily norm. We miss our offices and tearoom banter. We miss being with our students. Amid all of these losses we know that our rates of gender-based violence, suicide and substance abuse have increased. When people are forced to spend time with others in confined spaces amid increasing financial, health and social stressors, frustration and fear may lead to damaging reactions and dysfunctional coping mechanisms.

World Mental Health Awareness Day on 10 October could not have arrived at a better time. This year the World Health Organisation is encouraging investment into mental healthcare across the globe. While this is an essential step in increasing access to mental healthcare services, it is also only one aspect in the use of psychological treatment resources. One of our most important barriers to providing mental healthcare often lies within us. Mental illness remains one of the most stigmatised conditions in society; even though each one of us will be affected by our own, or our loved ones’ mental-health problems at some point during our lives. Some of the common problematic and erroneous beliefs society holds about people who struggle with mental illness is that they are somehow deviant, dangerous, weak or even faking it. Unfortunately, our healthcare workers are not immune to such prejudicial attitudes and neither are their patients. Self-stigmatisation occurs when we internalise these discriminatory generalisations and fail to access mental health care because we believe that we should be stronger, or just pull ourselves together or worry about the impact of receiving a psychiatric diagnosis on our career or our relationships.

Silence is one of the most insidious barriers

We fear being judged by our healthcare providers, our employers, colleagues, family and friends. This culminates in a situation where we lead lives of quiet desperation – numbing our distress with distractions and substances and perhaps even work. The silence surrounding mental health is one of the most insidious barriers to accessing treatment – because you cannot be helped if nobody knows you are suffering. This is the tragedy of suicide, which more frequently than we wish to believe, is the final symptom of depression and severe psychological illness. I have had to assist more patients than I care to recall to work through the trauma and grief of losing a loved one to suicide. Perhaps one of the most tragic aspects of this is that almost all would sit in utter shock recalling how their loved one had seemed fine. How this came out of the blue. How he or she had never told anyone how difficult life had become for them. How hard it was to get out of bed each morning. How much energy it took to go through the motions of a normal day. How ultimately they were so ill that they believed that they were a burden to their family and friends. How they could see no hope of relief from their pain other than to end their lives. And nobody knew. They were silent in their suffering because of fear of stigma, judgement, rejection or being viewed as a burden.

The surprising gift of the pandemic

Mental illness does not discriminate against anyone. It affects professors, students, support staff and the greater university community equally. Nobody is spared these struggles. This is what we all share, the human experience of life's seasons which we cannot do alone. When we need the help of more than our resilience, support structure and exercise routine. This is where the pandemic has brought some unexpected gifts. Prior to March of this year, it was very unusual for psychologists to provide online or telephonic therapy. In fact, many medical aids were uncomfortable covering teletherapy. Once we had no other alternative; however, we all had to adapt. Suddenly I no longer only saw patients who were able to attend sessions at my office. Now I could assist students and doctors who were in lockdown across the country. I could refer patients to the appropriate therapist, irrespective of where they were. Patients no longer had to negotiate the uncomfortable experience of waiting in a psychologist's waiting room or being seen leaving an office looking upset or need to take time off work to attend a session. Now patients can access their psychotherapist from the containment and confidentiality of their own space, and we in turn, are more freely available as we are not bound to a specific venue.

Receiving psychological treatment is becoming as normal a part of well-being as going for a run, or eating healthily or spending time with our social support system. And this is what is going to save lives. The more we normalise the use of psychological services, the less stigma and silencing we will be subjected to.

We survived a pandemic

As a clinical psychologist I proudly tell my students, colleagues and patients that I have my own psychotherapist without whom I would not be the therapist, colleague, friend and mom I am. There is no shame in owning our vulnerability and reaching out for assistance in order to make meaningful and even enjoyable the few journeys around the sun that we have left. So this October of 2020 should be the month when we start the conversation about our mental health. And by doing, so we permit those around us to do the same. We have survived a pandemic that changed the world and our daily lives. It's okay not to be okay.

Opinion article by Angie Vorster, Clinical Psychologist in the School of Clinical Medicine, University of the Free State

News Archive

Kovsie student and reigning Miss Lesotho en route to Miss World 2015

2015-11-03

Relebohile Kobeli - the beauty queen of Lesotho

Relebohile Kobeli was crowned Miss Lesotho 2015 earlier this year, and is now en route to Miss World International 2015 in China to represent the mountainous Kingdom. The beauty pageant, which takes place between November and December, will see contestants from over 150 countries contending for the title.

The nineteen-year-old second-year Geography and Environmental Management student at the University of the Free State (UFS) also won Miss Lesotho in 2014. She holds other titles, such as Miss Outeniqua 2014, and First Princess Face of Lesotho 2013.

What would it mean to be the first from Lesotho to sit on the Miss World throne?

I believe that it would be a turning point for pageantry in Lesotho. We are one of the few countries that do not fully recognise pageants, and the value they add to the tourism industry. Winning the throne would be putting into practice the theory that we, as beauty queens in Lesotho, always practice what we preach.

Since beginning this Miss World contest, in what way have you reached out to your community through the Beauty with a Purpose project?

My Beauty with a Purpose project focuses mainly on introducing and helping start up sustainable projects in communities. I wanted to move away from giving people donations to giving them the skills to ensure their long-term livelihood.

What skill sets do you possess that are essential to succeeding as an international first queen?

I am a very creative individual who thinks on her feet. That is important for me because, when you are far away from home, should things go wrong, there's no room for panic. I am sociable and human-centered, I relate to different people, regardless of cultural differences, and, as an international queen, it is important to be appreciative of others’ way of life, regardless of how different it is are from your own.

Rolene Strauss, the current Miss World, stated her ambition to capitalise on promoting forgiveness, hope, and unity during her tenure. What are you hoping to achieve, given the chance as her successor?

I would definitely speak about self-reliance among young women and the youth at large. I come from a country where not everyone is lucky enough to get a job. In such cases, young men and women fall into crime, young women become victims of sexual abuse or prostitution, and, although one may argue that that is self-reliance, is it sustainable? Is it not escaping one fire to jump into another? It is important for me to represent every girl who has ever had a dream. I am spreading the message of possibilities when the world is yelling "Impossible!"

What has been the highlight of your term as Miss Lesotho?

My greatest highlight was finding myself through service to others. I discovered that the more I invest in myself, the more of me I can give and share.

The Miss Lesotho 2016 competition is around the corner, what words of wisdom would you like to share with hopefuls?

Pageantry is not all about pretty dresses and tiaras. It is hard work. Always be humble, and remember that, whatever the outcome, it is your life's journey. You are destined for greatness. Don't deny yourself that privilege.

In your experience, what is the Kovsie feeling referred to in the maxim “Only a Kovsie knows the feeling”?

It is the desire to want to be great, the motivation to live to my full potential.

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