Dear Counsellor:

My niece has schizophrenia and is non-compliant with her medication. When she is well, all is good, but when she is sick, she acts strangely, gets aggressive and wanders the streets.

- Catherine

Dear Catherine:

Mental illness is a condition in which many patients lack insight into their problems and feel that all is well with them. They are non-compliant with office visits and medication and feel their relatives are trying to harm them. Therefore, lack of understanding is part of the illness.

Depending on where your niece lives, you can take her to the nearest doctor or health centre for treatment. The Ministry of Health in Jamaica has a nursing service in which mental health officers visit homes of some patients to administer injections on a monthly basis. These injections keep the patients well and functioning. It is important to establish a link with these nurses in your community and get your niece treated.

Some patients need to receive medication long-term so that they are able to function. It is good that you have taken an interest in your niece. The system is able to help families who are supportive of their relatives who are mentally ill.

Dear Counsellor:

I am a working young woman and find that I get stressed quite easily. In the mornings, I have difficulty walking and I have to push myself throughout the day. What do you think is wrong with me?

- Mona

Dear Mona:

Stress is a routine part of life but the symptoms you described suggest that there may be medical causes of your symptoms. You may have anaemia, hypothyroidism, depression or an autoimmune condition.

You will need to see your general doctor to get a physical examination. Certain blood investigations will need to be done. Anaemia is common in menstruating females and so we should investigate for this.

Depression is a common cause of fatigue in individuals. Depression usually occurs in people who have experienced losses in their life. It is good to keep a journal to identify all the losses you have experienced. Sometimes individuals become depressed at the anniversary of the events as we recall the events.

Speak with a psychiatrist to deal with the depression. Talk therapy may be all that is needed but you may need antidepressants. Depression is treatable and should be taken seriously as it can affect your functioning at home, work, church and community.