Although the perspective regarding mental health and substance addiction is slowly shifting, there is still a significant lack of support available when it comes to confronting these issues.
While public resources are available for patients suffering from mental health issues or substance use disorder, demand exceeds supply, and many people still dismiss the mental health needs of others.
The stigma surrounding addiction and mental health affects people’s willingness to seek support in any form.
Reaching out to friends and family members can pose social consequences among crowds that reinforce negative stigmas regarding addiction and mental health discourse.
Because of this, we need to help others understand why addiction is classified as a chronic brain disease, and how stigmatising mental health discourse perpetuates self-destructive tendencies among South African communities.
One of the first steps towards overcoming addiction, not just as an individual but as a community, is by encouraging the understanding of mental illnesses and diseases.
Addiction and Mental Health Issues in South Africa: A Growing Epidemic
Substance use disorder, or addiction, goes hand in hand with mental health issues and forms a mutually destructive relationship.
While some cases show that mental health issues such as anxiety, depression, and more can lead to drug or alcohol addiction, there are also many examples of substance addiction leading to the development of mental health issues.
This is particularly evident in South Africa, where lower-income communities experience higher rates of addiction (particularly alcoholism) and mental health issues.
When considering economic disparity, social issues, infrastructural problems, and more, it’s unsurprising that the country is facing an uphill battle.
The State of Mental Health in South Africa
A study from 2022 suggests that 1 in 4 people in South Africa are suffering from depression or anxiety, and that 1 in 3 will suffer from mental health disorders in their lifetime.
As the evidence shows, South Africa faces a myriad of battles on the mental health front.
Some of the most common causes of mental health issues in South Africa can be attributed to:
- Social problems: Social problems such as crime, antisocial behaviour, and racism are extremely prevalent in South Africa. These can cause a great deal of stress and lead to the development of neurological issues such as anxiety disorder, depression, PTSD, and more.
- Economic issues: Economic issues such as financial and housing insecurity can exacerbate mental health problems, leading to issues such as anxiety or depression among those who are in a constant state of worry and stress.
- Geographical boundaries: South Africans who live in rural areas may face more challenges when it comes to accessing health or medical facilities. This can lead to physical and mental conditions deteriorating as they fail to receive adequate care.
Substance Addiction in South Africa
South Africa has some of the highest rates of alcohol consumption in the world.
People are exposed to alcohol at very young ages in South Africa, suggesting that 12% of teenagers reportedly engage in drinking before the age of 13, and rates of alcohol drinkers among high schoolers reach as high as 69% in some studies.
Here are some of the causes of substance addiction:
- Pre-existing mental health issues: Pre-existing mental health issues, such as depression or anxiety,y may lead to developing coping mechanisms in the form of drug and alcohol consumption. The short-term dopamine release experienced by psychoactive substances, and diminished inhibition, can temporarily relieve the person of these symptoms and instead experience euphoria.
- Socioeconomic issues: If someone is facing financial or occupational insecurity, they may turn towards substances to relieve them of any external stress.
- Prenatal alcohol exposure: Some people are more vulnerable to developing substance addiction, particularly in low-income communities. Fetal Alcohol Spectrum Disorder (FASD) is a condition where the baby develops a substance dependence because its mother engages in drug or alcohol consumption throughout pregnancy.
- Culture: If a culture enables binge drinking or drug use, it will naturally expose people to the effects of addiction. Young people anywhere in the world are subject to peer pressure and respond to social rewards to a high degree. In this case, the social reward comes from fraternising and establishing yourself among others by engaging in binge drinking and drug culture. Many people who are sober or don’t engage in drug and alcohol consumption may experience some form of social isolation, especially among the younger demographic.
- Accessibility: Some studies show a strong correlation between the number of sources of availability and how much people engage in alcohol consumption. If a person has much greater access to drugs or alcohol, they’re more likely to consume them frequently.
Cultural and Social Stigma Around Mental Illness and Addiction
Here are some of the most common cultural and social stigmas surrounding addiction and mental health issues, and why they exist.
Mental Illness as a Sign of Weakness or Madness
Many people believe mental health issues and even discussing mental health issues to be a sign of weakness.
Often, this is rooted in not only a lack of education but also the high expectations of masculinity and how men must be strong in a patriarchal community.
Due to this pervasive but incredibly toxic mindset, people suffering from mental health issues are reluctant to seek professional support or even support from close family and friends.
Whether someone worries that their friends will see them as “weak” or another thinks it will reflect poorly on their image as a parent, stigmas prevent people from taking the necessary steps towards recovery because of the social ramifications.
Addiction as a choice
The misconception that addiction is a lifestyle choice isn’t uncommon at all. Although substance addiction is categorised as a chronic brain disease, some people still attribute the disease to someone’s lack of discipline.
Addictive substances affect people differently, with some people being at much higher risk at developing a form of dependence.
Genetic, physical, psychological, and environmental factors play a significant role in someone’s vulnerability to substance addiction.
When someone is suffering from addiction, they can experience physical and psychological withdrawal symptoms, which aren’t only discomforting but can be fatal.
Common withdrawal symptoms include headaches, depression, vomiting, diarrhoea, hallucinations, and even seizures.
Consequences of Stigmatising Addiction & Mental Health Issues
The consequences of stigmatising addiction and mental health issues are various and counter-intuitive to the local community:
- Delayed or avoided treatment: The stigmas surrounding mental health issues may mean that someone is too afraid to seek emotional or professional help. Instead of recovering, their condition will worsen, and their health will deteriorate.
- Worsened condition and suicide ideation: The person’s condition will continue to worsen until they are either coerced to seek treatment at an addiction detox treatment centre, or consider suicide as an alternative relief from their struggles
- Overdosing and death: When an addicted person relapses, they will often consume similar quantities of drugs or alcohol to what they’re used to. However, their bodies may not be able to handle such quantities following a period of withdrawal, leaving them at greater risk of overdosing or even death.
- Emotional and economic strain: The economic and social burden of addiction can wreak havoc on communities. Not only are public health facilities struggling to cope with surging demands, but friends and family members will suffer dramatically due to their loved one’s ill health.
How to Break the Stigma: Steps Toward Change
Here are some of the ways we can break the stigma and support our loved ones and community members suffering from mental health issues and substance addiction:
- Non-judgmental support: Each case of addiction or mental health issue is different, and we should encourage sympathy. Even if we aren’t able to offer licensed or professional guidance or we don’t have any direct experience with these conditions, being non-judgmental can encourage them to be more open and seek support.
- Offer resources: There is a wealth of resources which can be of use to those suffering from addiction or mental health conditions, particularly those of South African Depression and Anxiety Group (SADAG), the South African National Council on Alcoholism and Drug Dependence (SANCA), and SAFMH. Support groups such as Alcoholics Anonymous, Narcotics Anonymous and SMART Recovery are fellowship groups that also offer synchronised meetings with other people struggling with addiction.
- Attend a support group: Support groups such as AA and NA allow you to attend support sessions with an addicted loved one. This can offer a tremendous amount of support, especially in the first few sessions when your addicted loved one isn’t entirely comfortable attending by themself.
- Reach out to professionals: Reaching out to professionals, whether those working at a drug and alcohol rehab, licensed therapists, or South African-based mental health helplines, can help you understand more of how you can support your loved one. Not only will you discover new and helpful resources, but you can learn about managing relapse triggers and introducing healthy coping mechanisms to your loved one.
- The SAFER Initiative: WHO’s SAFER initiative promotes a set of interventions which can reduce alcohol consumption and the harm it causes in South African communities. Although it is difficult to enforce these rules as individuals, abiding by and encouraging SAFER initiatives can greatly reduce the adverse effects of alcohol.
