It is quite unfortunate that as Nigerians, we don’t prioritize mental health or acknowledge mental illness. Here mental illness is an enigma, we only acknowledge the worst forms of mental illness like Schizophrenia or dementia, illnesses that manifest as a complete regression into violence or childhood like cognition. This invisibility continues to hurt millions of Nigerians, especially those affected by Post-traumatic stress disorder (PTSD).
PTSD refers to a mental health condition triggered by a terrifying event — either experiencing it or witnessing it. While people across ages are prone to the disorder, people especially predisposed to PTSD include those who have experienced traumatic events involving actual or threatened death, serious injury or childhood physical abuse. Other catalysts for PTSD include combat exposure, stressful experiences or having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders, medical or family history mental health problems such as anxiety and depression, temperament, etc. Triggers can include physical assault or torture, sexual violation, substance misuse, excessive drinking or drug use, as well as being threatened with a weapon or being at the scene of a terrorist attack.
PTSD is hard to diagnose, especially in Nigeria because on the whole, Nigerians are constantly exposed to trauma and have normalized a lot of the reactions we exhibit to said trauma. Research has shown that the symptoms of PTSD may not appear until years after the event and can vary over time or vary from person to person. The disorder can increase one’s risk of other mental health problems, such as depression and anxiety, issues with drugs or alcohol use, eating disorders.
Common symptoms may also include flashbacks, nightmare fears and severe anxiety, as well as uncontrollable thoughts about the event, hopelessness about the future, self-destructive behaviour, such as drinking too much or driving too fast, irritability, angry outbursts or aggression as well as suicidal thoughts.
The disorder really came into the spotlight during the first and second World Wars and gained even more depth and complexity during the late 1970’s and 1980’s during the Vietnam war. Before the wars, the symptoms of PTSD were known as ‘Soldier’s Heart’ or ‘Nostalgia’, and considered a moral failing or a weakness on the part of the soldier. Soldiers were forced to repress these fears or hide them from their superiors for fear of hazing. After soldiers began to commit suicide at the end of the War, psychology (then just a budding social science) turned its gaze on the condition. Their research deduced that the large numbers of men and women who were succumbing to the symptoms of PTSD were doing so because of the scale of the war and the futility of the fighting. Weaponry had become much more sophisticated, this innovation spurred by the war and the subsequent Nuclear War arms race, and as such soldiers didn’t have time to evolve to accept this change. The British psychologist, Charles Myers would eventually use the term ‘Shell Shock’ to describe the widespread symptoms field doctors noticed in soldier patients. But it would take another half century before proper diagnosis would become common place.
In ‘The Traumatic Neuroses of War, Abram Kardiner outlines what would become the basis for understanding modern-day PTSD. “He believed that many of the symptoms observed in combat veterans of the First World War… can be understood as resulting form chronic arousal of the autonomic nervous system,” Herman wrote. “He also interpreted the irritability and explosively aggressive behaviour of traumatized men as disorganized fragments of a shattered ‘fight or flight’ response to overwhelming danger.”
Kardiner may have been ahead of his time in defining what was then called traumatic war neurosis, but his work did help redefine the character of those affected by these symptoms.
“It was recognized for the first time that any man could break down under fire and that psychiatric casualties could be predicted in direct proportion to the severity of combat exposure,” Herman wrote.
P.S.: This whole parts in bold above with the link was lifted from the site, please edit as fit.
“Is this death? Is this how people die?”
“They ordered everyone to come out to the town square. Col. Ibrahim Taiwo said it was time to dance around town and join our brethren, and he warned that everyone should come along. The people did as they were told, thinking they were being invited to a victory party. They didn’t realise it was a ruse to coax all the men out of hiding. Suddenly, the celebratory atmosphere evaporated. Taiwo’s troops began separating the men from the women.
“They were honest with us. They told us they were going to kill us. They took us to the mounted machine guns. Then it dawned on us that it was true.
“I was standing with my older brother at the edge of the crowd. He was holding my hand. He had always taken care of me. We shared the same bed. He was the first to be dragged away by the soldiers. He let go of my hand and pushed me into the crowd. He was shot in the back. I could see the blood gushing from his back. He was the first victim of the massacre. Then all hell let loose.”
“I lost count of time,” he said. “To this day, I live with the smell of the blood of my brethren that night. Even the heavens wept for the victims of this holocaust. Finally, the bullets stopped.
“For 50 years I’ve lived with this burden…for 50 years I’ve lived with the pains. I want to forget…”
(Dr Ifeanyi Uraih recaps the Asaba massacre in Tampa 2009 to Elizabeth Bird and Fraser Ottanelli)
There is pain and anger, fear and horror wrapped in the psyche of the Igbo, a direct consequence of witnessing violent prolonged war. First the retaliatory pogrom that saw thousands and thousands of their kinsmen slaughtered, men with their limbs amputated, pregnant women with their stomach ripped open, women with their breasts hacked off, and dumped in 911 lorries and transported to Onitsha – an action which compelled Dim Odimegwu Ojukwu to declare a separation of the Igbo from the country of their birth in 1967. Thereafter, millions of Igbo men and women lost their lives through hunger and machine gun fire in an unprecedented “black on black genocide”, the first of its kind. Not to mention the millions of Naira and properties of the Igbo people in Rivers, Lagos and other major cities appropriated by the Federal Government.
It’s a history the Igbo can hardly forget, lurking in the background of their consciousness, spurring them to ensure they have built a (palatial) home or two in the village regardless of how many houses they have in different cities in the nation. The Civil War and its consequences continue to manifest to this day, most notably the mass exodus of Igbo people to touch base in their hometowns during National holidays. This state of affairs has been further exacerbated by the silence of the Nigerian government. Although the Nigerian government had a white paper on the Asaba genocide in 1969, it was carpeted and never published. Economically, the Igbo may have recovered their capital, thanks to their enterprising spirit but politically, Igbos have remained on the fringes of civic engagement, suspicious of government, in general, leading to a revival of pro-Biafra sentiments among the younger millennials. Psychologically, the Igbo have simply been unable to move on. Save for Chinua Achebe’s ‘There Was A Country, Okocha’s Blood on the Niger’, and a ‘Remembrance’ here and there, the older Igbo people hardly speak of the civil war, afraid even to utter the name ‘Biafra’.
Physiologically, a connection has been found between the war and the health of the Igbo people. Sampling a cross-section of women aged 15 to 49 and men aged 15 to 59 of “war ethnicity” – from Adoni, Adun, Annang, Efik, Ekoi, and Ibibio – who were exposed to the civil war as adults, children or in utero, this study examined the impact of the Biafran war on adult human capital (height, body mass index (BMI), and education). The results? War-exposed men marry later, have their first child later and overall, have fewer children. Women, on the other hand, experienced some growth stunt, exhibited a higher BMI and were likely to be overweight. As for childbirth, it was found that women who lived through the war recorded a higher mortality rate even though they married earlier.
Other studies – and stories– have revealed that Igbo combatants and non-combatants in the civil war suffer astounding levels of PTSD. And this cycle is being reinforced in parts of the country ravaged by Boko Haram.
History continues to prove that sometimes the greatest disasters start small. What began as an idea of growth and knowledge quickly turned to a source of violence. This, unfortunately, is the ordeal people living in Northeastern Nigeria have to deal with.
Jihadist group, Boko Haram is a terrorist sect that has its roots planted deep in deceit. Initially formed in 2002, Boko Haram presented itself as a nonviolent group, looking to purify Islam in West Africa. Its initial ideologies were ingrained in promoting Shari’a law via information.in After their original leader was violently murdered by the Nigerian government for purported ‘treason’, his death transformed the group from peaceful to militant. Since then the group has orchestrated a violent uprising, starting off with mild attacks, ultimately leading to bold ones. The world began paying attention to the terrorist group after its August 26, 2011, suicide bomb attack on the United Nations office in Abuja killed 21 persons.
In 2009, founder of the group; Mohammed Yusuf, was killed by the police in an extrajudicial manner and his deputy, Abubakar Shekau, took over reins of the sect.
Boko Haram has been responsible for tens of thousands of death, recording over six thousand deaths in 2014 alone. The group also managed to displace millions of homes in the northern part of the country, causing many to flee their homeland and live as refugees in neighbouring countries. This, unfortunately, did not deter the terrorist organisation, as they spread their tentacles to the villages in Chad and Cameroun, where frightened Nigerians had gone to seek refuge.
This group engages in political violence, mass slaughter, kidnapping and even suicide bombing. In 2015, they were named, the most dangerous terrorist group in the world. Their operation base is in Borno and they previously held sway in the Sambisa Forest before they were dislodged by the military.
With all the violence, one can only wonder, what it is, this terrorist group aims to achieve. Boko Haram is a group that has rejected western education and have promised to fight it viciously. Their aim is to forcefully implement Shari’a law, replacing every religion with Islam and every book with a Qur’an. They seek to make Nigeria an Islamic state.
In 2002, Yusuf embarked on a mission to create an Islamic state. He founded the terrorist group in his home state of Borno. There he began recruiting those that shared the same ideology, which mostly comprised of people neglected by the government. He played on their frustration with government, somehow linking the poverty rate to religion. Yusuf’s activities were reported to the Nigerian government, warning that his ideologies, teachings and the group’s militant characteristics could pose a national threat, but these all fell on deaf ears enabling him to continue his mission legally. Fast forward seven years later and the group’s violent activities exponentially increased. With Yusuf gone and Shekau in charge, the group was able to operate as violently as it wished. They started with small village raids and escalated to national level terrorist attacks. And currently, this violent growth has proved to be something the government can no longer handle.
If one thought the attack on the UN building was daring, the group shocked the world when on April 14, 2014, it abducted 276 schoolgirls from Government Secondary School, Chibok, Borno.
It was later reported that some of the girls showed courage and managed to escape. A few of the girls have been able to speak on the horrible experience, while others choose to remain anonymous, their identities protected by the United States Witness protection programme. This unwillingness to speak could be as a result of fear, and PTSD. For those that were able to share their experience, they described instances of rape and abuse. They stated that some of the girls were married off to members of the terrorist group and forced to accept their religion. Amongst this, they described instances of physical and mental abuse, which is the source of the mental abnormality they are now faced with.
Unfortunately, this is the story for many children living in Borno. Many have witnessed horrors no one should, some of them have had their loved ones killed right before them, and some of them have escaped near death, traumatic situations. What they find hard to escape now is the mental scars they have endured from these interactions. It is a wonder how they would ever be able to live normal lives after going through such experiences.
Besides the civil population who have been displaced and killed in their thousands, the Nigerian military has borne the brunt of the Boko Haram war. Soldiers and officers have been killed in their hundreds and thousands. Military men have laid down their lives at the war front battling the terrorist sect. Military formations have been sacked, barracks have been outrun leading to the deaths of many officers and men.
It is rather disheartening that these heroes were allowed to die needlessly while those saddled with the responsibility of arming them with the needed weapons and equipment to enable them to prosecute the war diverted the funds. The former National Security Adviser, Colonel Sambo Dasuki (rtd.) who is currently in detention reportedly used $2.1bn meant for arms to fund the campaign of his boss and former president, Goodluck Jonathan. Nigeria’s Minister for Information and Culture, Alhaji Lai Mohammed alleged that in one day Dasuki made a $1.2bn transaction, which he is yet to account for.
The problem with the Boko Haram is not limited to funds diversion, Nigeria’s former Chief of Defence Staff, Air Chief Marshall, Alex Badeh while speaking during his valedictory ceremony accused fifth columnists in the military of working against and making the operations against Boko Haram unsuccessful.
“The activities of fifth columnists in the military and other security agencies who leaked operational plans and other sensitive military information to the terrorist, combined to make the fight against the insurgents particularly difficult,” he said. “The activities of these unpatriotic members of the military not only blunted the effectiveness of the fight but also led to the needless deaths of numerous officers and men who unwittingly fell into ambushes prepared by terrorists who had advance warnings of the approach of such troops.”
This divulging of vital intelligence to the enemy not only led to the death of troops it has also made others lose faith in the military hierarchy who have been accused of not meeting the needs of the men at the war front. On May 14, 2014, some soldiers fired shots at the General Officer Commanding, 7 Division of Nigerian Army, Maj. Gen. Ahmed Mohammed, in Maiduguri. Reports say the soldiers carried out the action after some of their colleagues were ambushed by Boko Haram terrorists. This was heightened after some soldiers had refused to proceed to the battlefront because of a lack of weapons; while others complained of not being paid or properly fed.
What is more worrisome, is that in 2018 there are still reports that soldiers beg for food and sleep in classrooms. These conditions are enough to make anyone develop mental health challenges.
It is commonplace to have a fight-or-flight response when someone experiences a life-threatening event. This is what exactly protects the body in times of danger. The stress responses cause heart rate acceleration, rise in blood pressure and body temperature, not forgetting spike levels in energy and attention. Due to the fact that security forces – focus on military men – almost regularly experience traumatic and hazardous situations and events, they are more exposed to PTSD; and suffer higher rates of the disorder.
Symptoms of PTSD may not start right away; they may appear several years after the actual traumatic event. When symptoms last a month or longer and interfere with work production and interpersonal relationships, PTSD can be diagnosed. Mood swings, uncharacteristic aggression, irritability, restlessness, tension, and edginess, which often accompany PTSD, can make people feel disconnected from themselves and the world around them, causing alienation from family and friends. Social isolation and difficulties connecting with people are common, especially in the war veteran population. Appetite problems, sleep deprivation, depression, and suicidal thoughts and actions are additional side effects of PTSD as is drug and alcohol misuse.
There are two primary types of treatment for PTSD — psychotherapy and medications. Commonly, drugs will be offered for PTSD symptoms, as they can provide temporary relief from difficult emotions and a break from troubling thoughts.
However, drug abuse can only compound the potential side effects, severity, and duration of PTSD side effects, as they only serve as a temporary solution to the problem. In fact, drugs and alcohol can make PTSD worse, interfere with treatment protocols, and cause additional problems. The most common and effective types of psychotherapy used to treat PTSD include exposure therapies (such as trauma-focused cognitive behavioural therapy or cognitive processing therapy) and reprocessing therapy known as eye movement desensitisation and reprocessing (EMDR).
But, there are no universally accepted treatment for any single person – it varies according to individual and symptoms.
As for totally solving the problem, there’s nothing more to do than ensure that the root cause is annihilated. Which translates to making sure that individuals – in this case, military men – go through less or no traumatic eventualities.