No Health Without Mental Health

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  Working at a teaching hospital has made me realize that I’m not alone in being affected by chronic fatigue in Zimbabwe. I sit in front of a computer for long hours, often with little or no rest during the day or exercise. Deadlines make it even harder to schedule much-needed breaks from work.
  Last March, after running a one-week workshop, I was burned out. My exhaustion turned into anxiety. I started developing headaches and fatigue. I feared how my thinking and emotional state would be affected. In my culture, most individuals experiencing chronic fatigue attribute their symptoms to“thinking too much,” or to a supernatural cause or social stressors.
  But working in a hospital environment made it easy for me to approach doctors about my problem. The doctors who diagnosed me with chronic fatigue explained that it’s common in Zimbabwe. Many people working in the capital, harare, come to the hospital with symptoms related to anxiety, depression and panic.
  My hospital visits for chronic fatigue forced me to ask more questions. I found out that, among adults, up to 40 percent of chronic fatigue sufferers still experience symptoms a year after consulting hospital physicians. In one month, it’s estimated that depressive and anxiety disorders affect 15.7 percent of women in urban areas.
  A study by Dr. Melaine Abas, a visiting lecturer at the Department of Psychiatry at the university of Zimbabwe, indicates that unlike men whose chronic fatigue is work- and money-related, for women the culprits are marital or other relationship crises, deaths, and infertility or unwanted pregnancy.
  In Zimbabwe, few consult mental health professionals. Primary care physicians are usually seen first, but patients move on to traditional healthcare providers as their fatigue becomes chronic. Their perceptions of the illness and financial costs are key in this decision-making process. Their healthcare providers typically prescribe vague treatments for the condition, such as painkillers, vitamins or hypnotics.
  The symptoms of chronic fatigue may be fairly universal. According to Abas, similar findings in other developing countries suggest a vicious cycle of poverty, depression, illness, disability, increased health costs, inadequate care and further impoverishment as key causes of chronic fatigue. She notes that preventive strategies for chronic fatigue should include policies aimed at increasing gender and sex equality, eliminating poverty and strengthening social support networks for all working people, both blue and white collar.
  For myself, I’ve decided to run and play to avoid chronic fatigue. Swimming is especially relaxing.
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