The Ultimate Lebanese Medical Taboo: Mental Health, Not Demons. Psychiatry, Not Exorcisms

“Tell me I have cancer please,” she said as I stood next to her in the Emergency Room. “Tell me I have cancer,” she repeated again as if repetition would make it true. “I have cancer, yes I do. But I’m not insane.”

1 out of 5 Lebanese will have a mental disorder during their lifetime. This is in sync with international averages, which is interesting given the proficient history that serves as precipitating factors galore that we’ve had. But be sure of this: we all know someone who has or will have a mental disorder.

50 is the approximate number of registered and licensed psychiatrists that could potentially treat these patients. 50 for slightly less than one million. We have incredible shortage and yet it doesn’t show to everyone. Why? Because we simply don’t talk about mental health.

0 is the number of local insurance companies that cover for psychiatry. People don’t care enough about the issue in order to pressure them to make it included with their healthcare bundle. It will never happen, they’d say. It only happens to other people, just like every other serious illness I suppose.

A patient my age thought she was living inside a snake on Mars. That was where she was when she presented for hospitalization with bruises all over her body.
Her family denied knowledge of those bruises at first. But they were too systematic to be coincidental. She had bruises over here wrists, torso and legs. Her parents still didn’t budge.
The patient in question was living on Mars for a few months now. She wasn’t brought in earlier because her family thought she was possessed. A religious man had tried to perform an exorcism. We live in a country where it’s more acceptable to say demons are inside a family member than to say he was admitted at a hospital and is on a few meds.

That patient wasn’t the first nor the only one I saw who had attempted many exorcisms at the hand of religious figures before finally deciding that what was wrong wasn’t, in fact, spiritual as much as it was simply biological and chemical. It’s always that way: demons, not disease. Exorcisms, not medicine.

Wasn’t it at the times of our great-great-to the power ten-grandfathers that illnesses were associated with evil spirit?
That seems to still be the case today in Lebanon, and many other countries around the world, when it comes to mental health. The way we view mental health is also that of a taboo whereby we try to hide from it, shut it away as something not to be talked about. Even the suicide of Amina Ismail, sensational as it was, didn’t turn in the media into a discussion about mental health. It was a discussion about her private life. We have it among family members but instead of looking at those family members as sick people, akin to any person with any chronic illness, we look at them as burdens who got themselves into the mess they are in. My family is no exception to the statistics. And I’ve seen both ends of the spectrum: the cancer patient is seen as the sick one. The mentally ill patient is seen as the spoiled one.

The extent that mental health is a taboo in this country is best manifested when you observe the way people act around the possibility of a mental disorder diagnosis. Some of them exchange their names with numbers as identifiers. You can name me thirteen if you want to. Others would panic when psychiatric people are called in for a consult. “I’m not crazy, get out of my room.” Few are the people who are open about the idea of possibly going to the psychiatric ward. Even fewer are those who actually present voluntarily. The least of all people are those who are open about any possible mental disorder they might have and who actually view such disorders the way they view any other illness. You should also see the reaction that doctors who are specializing in psychiatry get every time they tell people of their plans.

Then there are the diseases which have been ridiculed by people to the extent that few seem to actually see them as illnesses anymore. Schizophrenia becomes split or multiple personalities just because Hollywood says so. Substance abuse becomes an issue that doesn’t concern us because we have willpower. “Tu deprimes today?” becomes the reference for depression.

I have a friend who was diagnosed a while back depression. Treatment has greatly improved his entire lifestyle and approach. And I’ve been thinking lately how lucky my friend was to be surrounded by people who viewed his diagnosis and treatment as a true medical case, not him being a wuss. If his case had been the latter, he’d have probably never improved and he would have never known that there is a better view of life than that of a person who was always sad, who had decreased interests, decreased appetite, guilt, suicidal thoughts.

“Madness is like gravity, all it takes is a little push,” the famous saying goes. Except “madness” is nothing like gravity and it takes more than just a push to get there. It’s a collection of genetics, biological predispositions and psychological stressors – sort of like any other disease, really. A mark of the development of a society is the way they view mental health. Lebanese tell their friends who are truly depressed to suck it up. They’d rather seek out exorcisms and justify diseases with demons than with simple facts. A person who develops substance abuse is weak-minded, his abuse never seen as an actual disorder. That patient who wished she had cancer has been “living with a demon” in her house for 6 years. She had brought in a priest every month. She still doesn’t know nor does she accept that the problem is probably with her and it could have been fixed 6 years ago. I guess some people would rather find solace in demons and live in Mars in the process because society thinks a Martian habitat is better for people like them than to acknowledge the simple and yet vitally important fact that it’s mental health, not demons. It’s psychiatry, not exorcisms and voodoo.

2 thoughts on “The Ultimate Lebanese Medical Taboo: Mental Health, Not Demons. Psychiatry, Not Exorcisms

  1. 100% right. I moved to Lebanon in 2010. I was first diagnosed with General Anxiety Disorder, Social anxiety disorder and a strong tendency towards depression in 2000 after a personal tragedy. When I was abroad, I had no problems at work telling my boss I had my shrink appointment at 4PM. In Lebanon that has been impossible. In fact I was going to my Psychiatrist yesterday and on the way to the clinic, I noticed a friend who asked me what I was doing here (at the hospital). I simply replied I had a stomach bug and was getting a check up.

    The worst part is the insurance companies. Last year I was diagnosed with Cubital Tunnel Syndrome, (your funny Bone in the elbow starts hurting and causes numbness in your hand) it was compressed and needed surgery to decompress the nerve. I was Refused admittance by the insurance company saying it was a psychiatry related issue. HOW do they even relate?

    It’s sad that I don’t have anyone to speak to about my anxiety and depression, I try and tell my close friends, and one or two people at work. But imagine IF everyone knew? TABOO


  2. Pingback: Fekko El 3e2de | A Separate State of Mind | A Lebanese Blog

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