Getting serious about going crazy

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Patients undergo a physical therapy session at the National Psychiatric Hospital No.1 in Hanoi. Photo courtesy of Tuoi Tre

He had never consumed alcohol or smoked, even in that one instance in 2010 when he smashed up the furniture in the house.

Now a 22-year-old first-year college student, the young man, identified only as T.D.A., is under treatment for schizotypical personality disorder, a mental illness characterized by someone's having discomfort with close relationships, as well as eccentricities in their everyday behavior and paranoid ideas.

His mother took him to Ho Chi Minh City Forensic Psychiatric Examination Center last month as he kept having the delusion that some people were following him and talking badly of him behind his back.

Doctors said the condition cannot be cured completely with normal medical procedures; and that the mother needs to play a crucial role at home in helping him get over his fear and withdrawal.

Mental clinics in the country say they are receiving more patients with "clean sheets", those who have no history of drug use or game addiction or genetic disorder. Their mental problems, which vary greatly, seem to be induced by study and job pressure; or major shocks, according to a Tuoi Tre report.

T.D.A.'s mother L.Y.B, who is 62 years old, said he started hating people, especially his only sister, after his father died in 2009 following seven months of sickness.

The sister took over the family's breadwinner role, but A. kept accusing her of "doing evil, unacceptable things," though he could never specify them.

He only had a few friends at class, and then no one at all after he lost focus and the mother agreed to let him drop out.

He returned last year and has been good at learning Japanese. He is planning to apply for a tourism course in Japan and become a chef.

L.Y.B, a retired teacher, said she believes that her son experienced a mental crisis after losing his father who was a big support, and who took care of him most of the time, including driving him to and from school until he passed away.

Doctor Dinh Dang Hoe of the Hong Ngoc General Hospital in Hanoi said parents' rearing methods largely decide the risk of mental health problems in their children.

"Some parents these days are too busy working and don't have time for their children.

"On the opposite side, some care too much and do everything, making their children incapable of standing on their own and feeling like the center of the universe. Both ways cause the children to easily suffer stress later."

Hoe said in the Tuoi Tre report that stress is a common problem and it only needs something small to push the person further into depression, loss of energy and enthusiasm, and incapable of social communication.

Doctor Ho Tong Tien with the Pham Ngoc Thach University of Medicine in Ho Chi Minh City said many people get stuck with mental problems at very young ages.

One of Tien's recent patients was an 18-year-old student from an English class at a high school for gifted students in the city.

She had obsessive compulsive disorder, also known as OCD, characterized by uncontrollable, unwanted thoughts and repetitive behaviors one feels compelled to perform.

She came to his clinic with emotional problems. She had special feelings for a female teacher and would feel jealous when not receiving the same attention back. She also liked another girl in her class, though she is sexually attracted to boys.

Tien said the pressure of studies could have caused the disorder in the girl, who is a good and hard-working student with one major wish a chance to study in the US.

Her condition stabilized after three months of treatment and she has gone on to realize her dream, the doctor said.

He also said that a person's chance of having mental health problems will be reduced if they benefit from good healthcare, education and a "fair and tolerant" environment.

Crisis triggers

Doctors say the economic crisis of the past years has seen many businesspeople approach them or brought to them for help and treatment.

La Duc Cuong, director of the National Psychiatric Hospital No.1 in Hanoi, said one of their patients was the head of a local export company that was on the verge of bankruptcy.

The man was busy and focused on saving his company; and it took sometime before he realized his abnormal behaviors easily getting angry with his staff, including one time when he beat a guard with a chair in front of many people over a trivial issue. 

His family brought him to the hospital when the situation worsened. He constantly felt someone was trying to kill him, and he started beating his wife and children for minor reasons.

Mental health can be proportional to the quality of material life people enjoy or lack, according to a study by the University of Social Sciences and Humanities in Ho Chi Minh City.

Le Minh Cong, a psychology lecturer at the school, said his group looked at more than 840 factory workers in the city earlier this year and found a high number to be victims of mental health disorders, with females far outnumbering male victims, and most of the sufferers aged between 25 and 35.

Depression topped the list, affecting 18.8 percent of the workers, followed by anxiety disorder, which affected 3.57 percent.

The workers had small incomes that hardly covered their basic needs, let alone entertainment demands.

Most had tense relationships with their bosses, and at the end of the day, they had to rented accommodations that were neither spacious nor clean, the study found. 

Doctors said mentally sick persons usually do not accept their problems, and their family members need to notice the symptoms and seek help in time, before the problem gets out of hand. 

They should make use of any chance to take the person to the doctor. For instance, if the sufferer has some other problem like a headache or stomachache, they should take him/her to the hospital and see a psychiatrist, or invite a psychiatrist over in disguise of a normal visitor.

But doctors also admitted a lack of facilities and medical staff. Not all cities and provinces have mental hospitals or clinics, and there is very little public knowledge about mental illnesses, including how to recognize and respond to mental problems. 

Doctor Nguyen Hoai Nam with the Ho Chi Minh City Health Department said Vietnam's mental sickbeds can provide for an average of 0.19 among 1,000 people, according to 2010 figures, while the World Health Organization's standard is 0.5-1.5 out of 1,000.

Official figures also show that 22 to 25 percent of Vietnam's population has mental health problems. They say more than 88,000 people with mental problems had not been hospitalized in this year's first quarter, including 10,000 epilepsy and bi-polar patients.

A patient with the National Psychiatric Hospital No.1 last year stabbed his wife and two children to death shortly after he was taken home from the hospital. 

Cuong, director of Hanoi's National Psychiatric Hospital No.1, said for some reason, the man's wife had let his condition worsen.

He said during the morning visit, doctors had advised her to leave him at the hospital, but the couple discussed it among themselves and decided it was not necessary yet.

"People said he had been a sweet husband and loving father."

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