KUALA LUMPUR – The figures are out: one in every three Malaysians has a mental problem.
This is based on the results of a recent study by the Health Ministry, which revealed that the number of cases has doubled since a decade ago.
It is set to become the worst disease to afflict Malaysians by 2020, second only to heart disease.
A bigger concern is that mental disorders would not only be the diagnosis of those with depression and schizophrenia but addicts of stimulant drugs like Methamphetamine as well.
Drug abuse and mental problems are very closely related.
Many who suffer from depression are prone to taking drugs and alcohol to self-medicate.
Those who abuse drugs would also inevitably find themselves with mental disorders, particularly depression due to the instability of their lives and the lack of family and community support, said the Director of the University of Malaya Centre for Addiction Sciences (UMCAS), Dr Rusdi Abdul Rashid.
“For the best results, any course of treatment should address both ailments. You cannot just treat one of it,” he told Bernama in an interview.
The usage of stimulant drugs, particularly shabu (methamphetamine), stimulates the release of dopamine that the user would start exhibiting symptoms of schizophrenia.
These include paranoia, insomnia, loss of appetite, loss of focus and interest, hearing voices and hallucinations. This causes them to act irrationally and eventually spiral out of control.
“They are like this due to the influence of drugs. The symptoms stop when they stop taking the drugs.
“However, there are cases when the symptoms of schizophrenia would continue even after they have stopped taking the drugs. This is because they already had the mental disorder,” he said.
DRUGS TRIGGERING SCHIZOPHRENIA
Dr Rusdi said in someone with the genetic predisposition for schizophrenia, drug abuse would hasten their process of becoming afflicted with it.
Patients could suffer from delusions due to their inability to differentiate between their imaginary world and reality, due to their schizophrenia.
Men would typically show symptoms earlier at between 18 and 35 years old, while women tend to be diagnosed between the ages of 25 and 35 years old, he said.
“So a man that starts taking drugs at the age of 18 who would have experienced the onset of schizophrenia at 25, might experience it earlier due to the drug abuse.
“This would place a much earlier burden on the family. If the patient was still in university at that age, he might not have been able to finish his studies. If he was working, he would have to quit his job because of the mental illness,” Dr Rusdi said.
He said that schizophrenia could also be inherited because many of the patients had a family history of the illness.
Schizophrenia has to be treated in its early stages with antipsychotics and counselling so that patients could safely resume their daily routines.
Those who sought early treatment had higher chances of returning to their normal lives.
However, many patients only sought treatment at the later stages of their illness, making it more difficult to treat, he said.
“The social stigma towards those with mental disorders are still high and this has deterred many from seeking treatment in the early stages of their illness.
“Only when things spiral out of control, such as after they’ve harmed themselves or others, or even killed someone, do they come for treatment,” he said.
Dr Rusdi said schizophrenics needed long term medication just like people with chronic diseases like diabetes and hypertension.
IMPROVE EARLY DETECTION
Early detection of symptoms of schizophrenia and proper medication can help patients recover and resume the life they had before the illness.
Doctors at primary hospitals (government or private) can become gatekeepers in the detection and treatment of such patients in the early stages, said Dr Rusdi.
Patients usually saw primary care physicians for diagnosis and treatment, he said. If any of the patients were found with symptoms of mental disturbances such as depression lasting longer than two weeks, loss of appetite and poor sleep, primary care doctors could treat the early stages of it without referring the case to psychiatrists.
“If a patient was found to be suffering from serious mental issues such as suicide, harming himself or others, then the primary care doctor can refer to patient to a psychiatrist,” he said.
This would better help with the diagnosis of schizophrenia as there are only around 300 psychiatrists in Malaysia for its population of over 30 million people.
“That is why there are so many mental illness cases that go undiagnosed until a complication arises.
“By then it would have been too late and it’s a pity because the patient could have been treated in the early stages with medication and counselling,” he said.
Dr Rusdi said UMCAS, the Malaysian Psychiatrist Association and the Islamic Doctors Association recently organised a conference of Mental Health and Addiction.
Some 150 doctors attended the conference which was held for the first time for the purpose of strengthening primary care in hospitals for the early detection of mental illnesses.
TREATING SYNTHETIC DRUG ADDICTION
Addiction to opiods like heroin can be treated with methadone. However, there has yet to be such form of treatment for addiction to synthetic drugs like shabu.
At the moment, the only form of treatment to such patients was counselling, he said.
UMCAS was working towards finding the right form of medication for synthetic drug addiction since the research started two years ago.
“There has yet to be a drug invented to treat the addiction of stimulant drugs like shabu. Universiti Malaya is working on it and we hope we’ll achieve success,” said Dr Rusdi.
In the study, the medication Aripiprazole used to treat patients with schizophrenia was tested on those with addiction to stimulant drugs.
A total of 120 patients were tested in the study. However, there were some diffulties as the patients were using multiple kinds of drugs.
“It would be best if the patients were only on one type of drug like shabu. Otherwise, it would hard to gauge its effectiveness,” he said.
The tests have so far shown positive results as it reduced some of the addiction and attraction of the stimulant drug.
It also reduced some of the negative effects of drug abuse such as hallucinations and illusions.
“When they no longer get the high off the drug, they would quit it. This would help reduce the number of addicts to the drug,” he said.
The demand and abuse of stimulant drugs is on the rise, not only among men and women too, particularly among sex workers.
“In the east coast, children as young as 10 are taking psychotropic pills. The women were more interested in “ice” or “crystal” (forms of Methamphetamines)as they believed it would help with weight loss through the reduction of appetite.
“The high demand for the drug is worrying and we are worried not only about the rise in drug addicts in the country, but the number of people afflicted with mental disorders as well.” – BERNAMA