Essential Grace Magazine June 2022
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Vol. 2 Issue 11
June 2022
In this Issue … Monthly Theme Men’s Health Awareness Month 2022 Infant Mental Health Awareness 2022 Feature Interview Interview with Mr Kumwembe Mental Health Paternal Post-Partum Depression Health and Wellness What is an Andrologist? Father-child Relationships Resources
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Dear Reader, Welcome to the June edition of Essential Grace! This month we celebrate two themes that are recognized the world over in the month of June. The theme for Men’s Mental Health month this year is creating safe spaces for men and boys. In our issue this month we look at encouraging men and boys to have regular check-ups or COF’s in order to know what is happening in their bodies. An interview with Muthi Nhlema (page 12) helps to illustrate how this can look like in practice. June also commemorates infant mental health week. Most of us cannot imagine infants having mental health challenges, which is probably why most of us do not know the signs and symptoms of poor mental health or early warning signs in children. Our feature interview is with Mr Geoffrey Kumwembe (page 27), a clinical psychiatrist working with the Ministry of Health in Zomba, Malawi. Should you have any interests or concerns after reading through the content in this issue, he would be one of the right people to get in touch with. Sometimes it is not that we don’t want to access help for poor mental health or mental illness, we may just not know where to start. There are many things going on around the world, and right here in our own country that can cause anxiety, stress, fear, and even depression in people. Times are hard for our planet. Should you find yourself feeling low and not able to cope, do not hesitate to reach out and speak to a mental health professional. All comments, questions, and feedback is welcome. Let us know through our social media pages or directly to the editor through essentialgrace@zoho.com Enjoy the read! Julie Soko (Managing Editor) 3|Es s en ti al Gr a ce Mag azi ne
June 2022
Julie Soko
Mtendere Kishindo
Thandi De Jong
Naomi Msusa
Managing Editor
Sub - Editor
Editorial Assistant
Editorial Art and Design
Essential Grace is a free online publication that is focused of promoting mental health and wellness in Malawi and around the world.
Follow and subscribe to the magazine at www.issuu.com/essentialgrace follow, like, and share on our social media platforms; @EssentialGraceMagazine @essentialgracemagazine.mw 0995 147 290 Comments and feedback on any of our content can be addressed to essentialgrace@zoho.com
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Did you know … Most of our editorial content is contributed by our readers. We welcome your ideas, articles, questions, images, and feedback. Submit your content to the editor at essentialgrace@zoho.com
Special thanks to this month’s contributors: Muthi Nhlema – interview by Steveria Kadangwe Erin Valentine (online source) Geoffrey Kumwembe Roshin Ebrahim
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Monthly Theme
International Men's Health Week is
celebrated every year around the world in the middle of June. It is an important opportunity to highlight the importance of
men's health, and to promote and support the health and wellbeing of men and boys in our communities. Our theme for Men's Health Week 2022 is
getting regular health checks focusing on knowing how you are doing physically, mentally and emotionally. Regular check-ups are good for early treatment and maintenance of adverse conditions. 6|Es s en ti al Gr a ce Mag azi ne
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Dear men, your car gets serviced each year in order to get a Certificate of Fitness. Everyone makes sure to keep their vehicle in good condition in order to pass.
What about your body? Giving yourself a regular check-up to gauge your fitness doesn’t require a mechanic, and is hardly complicated. Should you find anything worrying as you carry out your self-test, get in touch with a medical professional right away. So how do you perform a COF on yourself? Phase 1: Check your engine To check your heart, you can start by checking your pulse. Place the finger of one hand on the thumb side of the tendons running through the opposite wrist. You should be able to feel the radial artery pumping. Count the beats over four 15 second periods and add them up. This is your resting pulse – a good guide to the heart’s efficiency.
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Then, check your recovery rate. Step on and off a step for three minutes (average a step every three seconds) and rest for 30 seconds before taking your pulse again. This is your pulse after exercise. The table below shows you what sort of results you should be getting for your age: Very Fit
Average
Unfit
Age
Resting
After exercise
Resting
After exercise
Resting
After exercise
Teens/20s
59 or less
75 or less
60-85
76-101
86+
102+
30s
63 or less
79 or less
64-85
80-103
86+
104+
40s
65 or less
81 or less
66-89
82-105
90+
106+
50s+
67 or less
83 or less
68-89
84-107
90+
108+
If you’re in or close to the unfit range, you need to think about whether you’re taking enough exercise. If you’re older, very overweight or have an existing health problem, check with your GP before starting an exercise program. Phase 2: Are you overloaded? The simplest guide to whether you’re carrying too much weight is your waist measurement. This gives you a fair idea of your risk regardless of height. Measure around your belly at the widest point - usually around your belly button: over 37 inches, you’re probably overweight and at increased risk of heart disease, diabetes and cancer over 40 inches, you could be obese and at serious risk of the conditions mentioned - talk to a doctor or health professional
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Phase 3: Look out for dashboard 'warning lights' Check yourself all over for: moles changing shape, unexplained lumps, unexplained shortness of breath/breathing difficulties, unexplained pain (especially in the chest), swelling or itching, a cough that won’t go away, blood where it shouldn’t be (in saliva when you spit or in your stools), changes in bowel habits (such as blood in stools, diarrhoea or constipation for no reason, a feeling of bloating or of not having fully emptied your bowels or pain in your stomach or back passage If you have any of these talk to your doctor. Phase 4: Wobbly gear stick? Erection problems are common. You can't always get an erection when you want one. What we’re talking about here are regular problems getting an erection or keeping one. It’s not only your sex life that may be threatened. Erection problems can be an early warning sign of a number of serious health problems including heart disease, diabetes, high blood pressure and depression. They could also be sign of high cholesterol or low testosterone. Again, don’t hesitate to talk to your Doctor should you find anything worrying. Phase 5: Check the water Is there any change in how often you pee or how easy it is? Do you get up more often at night? Peeing more often, especially at night, and less easily with a weaker flow can be signs of prostate enlargement. Prostate enlargement is not necessarily a sign of cancer but it needs to be checked. A selfprostate exam is possible though
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difficult, why not get a professional one done for your own peace of mind. Peeing more often, especially at night, along with being overweight, tired and having sores to heal more slowly may all be signs of diabetes. Get your blood sugar tested. Phase 6: Day-to-day performance How are you feeling? Are you motoring along smoothly? Your mental and emotional health are very important. As a man, you need to be vigilant and ensure that you are keeping track of what is happening within you. Be self-aware, be honest, and be responsible for your health and wellbeing. Should you need help, reach out to a profession for a chat, help is always available for you out there. Phase 7: Check your pressure You can have your blood pressure taken by the doctor or you can buy a hometester and monitor you blood pressure at home. Blood pressure is given as two figures. The first is when the heart is contracting (systolic), the second when it is resting (diastolic). 120/70 would be fine for a young man. Once the systolic starts getting up towards 140 and/or the diastolic to 90, you need to monitor your BP more often. Of course, any stress can raise your BP temporarily but if you’re getting regular readings of 140/90 or more, see your doctor. Lastly … You might want to monitor your testicles for any changes. Testicular cancer is the most common cancer in men aged 20-35 but if caught in time it can be effectively treated and deaths are rare.
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Doing a self-exam to check your testicle health is simple and should be done on a regular basis. Try following the tips below.
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Muthi Nhlema Muthi Nhlema is the Founder and Team Leader for BASEflow, a social enterprise in the water supply and resources management sector. He is also an award winning author. https://www.linkedin.com/in/muthi-nhlema-829834156 12 | E s s e n t i a l G r a c e M a g a z i n e
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What made you start going for regular checks? I go for regular health check-ups for two reasons. First of all, the most practical reason is that I noticed people in my life, age mates and some older than me were getting all sorts of non-communicable diseases such as diabetes, high blood pressure and even cancers. The growing trend is what triggered me and got my attention. All these noncommunicable diseases can be dealt with by early detection and preventative checks. I decided to start going for regular check-ups as a kind of early warning system for myself. In addition, people in my family have a predisposition to some of these diseases like diabetes and high blood pressure. I realised that I have a genetic predisposition and so it is only wise to keep a regular eye on my health. My grandmother only found out two weeks before she died that she had cancer. She went to the doctor for another problem only to find out that she had cancer and that had she been going for regular check-ups, the cancer might have been found and treated early. She would have had a chance. The second reason I go for regular medical check-ups is a philosophical one. I like to be in control of my body. For me, my body is a vessel, and it is under my command within reason. I find it very terrifying prospect that my existence on earth is being dictated by this vessel that should be under my control. Going for regular checks gives me recommendations on how I can adjust my life to minimise markers of ill health like obesity and other health issues. I realise that I will get old and will eventually succumb to age and frailty but while I can, I do my best to keep control of the body and stay as healthy as I can How often do you go? I go twice a year for check-ups in January and in June. I normally apply for annual leave and take a day off to go for medical checks. I take a book or an audio book and tell the medical personnel not to rush anything and do all the necessary checks. I do this because I know some of the tests take time. What checks do you do? Blood checks - haemoglobin, white blood cell count, chemical compositions in blood glucose, HIV and other blood related checks. I also have urine, stool, blood pressure, weight and radiology. I haven’t yet gone for a prostate exam but a friend of mine recently encouraged me to go. On my next check, I am intending to include it. 13 | E s s e n t i a l G r a c e M a g a z i n e
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My results in January showed that I was healthy but my potassium levels were low (maybe because I don’t like eating bananas) so I started eating more oranges, sweet potatoes, beetroot and spinach, which also are sources of potassium. All in all, I am healthy, and I am looking forward to what the next results will bring out. A lot of people say that knowing what is wrong with you will make you die earlier, especially if you are a man. What do you say to that? That is true because men are not always emotionally resilient. Women are groomed from when they are children to manage resources and manage homes and family often with minimum resources. Most men are not. The result is that some men struggle to cope with bad news such as receiving health diagnosis of cancer or HIV. In addition, most men are not very good at following instructions in relation to medical care, while most women are. Many men must be forced to take medication correctly, if at all. Even if they are told to stop drinking, for example, they do not follow because many men like to be in control and do whatever they want. They only do it when there is no choice and it is too late. What would you teach your son about men’s health? Our parents did not teach us anything about puberty, looking after our own bodies and the like, which used to be prevalent in our varied in cultures in the past. I want to be the first person he talks to when he reaches puberty. I have been teaching him how to clean his body and normalising things like sex, erections, and the like. I want to be the first person he talks to when he has a girlfriend and that I can teach him about waiting to have sex until he is older and the physical and emotional consequences that come with it, not to mention risks of pregnancy and sexually transmitted infections. I am also concerned about teaching not just about his physical health but also about mental health. Most of us grew up without even recognising mental health as something that was a priority and it was dismissed as a non-issue. Yet, we were experiencing a mental health crisis. Most times we are told to just snap out of it and be happy because the parents were providing for us. As someone who has experienced anxiety, I found out that there were a lot of people who were also struggling. Now we are recognising that depression is a disease that can debilitate your life and needs dealing with. The attitudes are now changing. I know my son was born in 14 | E s s e n t i a l G r a c e M a g a z i n e
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privilege like I was and does not need to struggle for physical things, but he may struggle with mental challenges. My father is a well-respected man in the community, and I struggled with whether I will live up to his standard because I was born in privilege. I therefore need to teach him that he is not abnormal and how to deal with things by giving him challenges for example exercise, life skills like cooking, making a fire and surviving in adverse circumstances which teaches him resilience and how to cope with the challenges of life. Any final words? You have one life, live it well. Part of that is making sure that you are physically and mentally healthy. Interview by Steveria Kadangwe
As much as it is wise to keep an eye on your mental, emotional and psychological health, make sure you know what is happening with your physical health as well in order to avoid some nasty surprises later on. Get your regular tests and medical check-ups at your nearest medical center.
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Men need to get regular medical check-ups to avoid risking their lives in some serious and life threatening health problems later in life. Men who are obese and overweight have to be extra vigilant in managing their health. They need to visit doctors frequently and get tests which will help them become aware of some conditions they might be living with or are at risk of developing.
Disorders like osteoarthritis, high blood pressure, and diabetes are some conditions that can develop due to obesity. These conditions can complicate life for men, leading some to have personal and financial problems. Their work-life, relationships, and mental health can be affected Being overweight may make people anxious and socially awkward. Overlooking your health as a man can lead to unpleasant consequences even within
your intimate relationship. This is especially the case with men having erectile dysfunction, obesity, poor mental health or undiagnosed mental illness, and other chronic illness. Married couples need to ensure that they are two steps ahead when it comes to knowing and maintaining their health. Most conditions can be managed and even cured when identified early. Wives and husbands should be intentional in the way they check up on each other and on themselves.
Some problems that men experience may not be due to stress and anxiety, but from poor health and undiagnosed, therefore untreated health conditions. It is never too late to start; make the effort to get your physical, mental, emotional, and spiritual health back into your hands. It is your sole responsibility. Avoid things that you know are harmful and toxic to your wellbeing. Alcohol, drugs, unprotected sex, and crime are examples of such, they are never worth indulging in and may lead to illness and early death. Go to your nearest medical facility to find out more about getting regular testing for any medical check-ups. It will do you good to know how your body is doing in order to live a healthy and productive life.
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There’s nothing more important than the health of our babies Thalia Picture quotes.com
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Infant Mental Health Awareness Week will take place from the 13th – 19th June 2022 on the theme of ‘Understanding Early Trauma’.
What is Infant Mental Health Awareness Week? Infant Mental Health Awareness Week provides an annual opportunity to discuss the importance of babies’ mental health as well as some of the issues that affect it. Why Understanding Early Trauma? The experiences we have in the earliest years of our lives impact the development of our brains. Experiencing trauma, such as exposure to domestic abuse, in the earliest years can have a significant impact on brain development, potentially leaving serious and lasting consequences that can create difficulties for the child into their adult years. This is not inevitable. Secure relationships
with parents and carers can reduce stress caused by trauma and limit the long term impact it has on the baby’s development. Specialist support can help to strengthen these relationships and reduce the harms to babies. IMHAW - Parent-Infant Foundation (parentinfantfoundation.org.uk)
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Research has shown that individuals suffering from mental health issues may have exhibited specific symptoms and signs as far back as infancy. In fact, there are currently specialists geared to help with infant mental health wellness from ages zero to three.
And while mental health issues can be difficult to diagnose in babies who can’t yet talk about their thoughts and feelings, infants are capable of feeling anxiety, stress and even depression. Many specific behaviors, environmental factors as well as family history can increase the risk of babies facing mental health challenges in the future. When a parent knows and understands that their baby is at high risk for developing mental illness, this is half the battle in helping them. Ensuring they are healthy, having them assessed, and seeking out appropriate counselling and/or psychotherapy are the next steps. When it comes to dealing with mental illness, the earlier the intervention and treatment, the better the prognosis. Which is why it’s imperative for parents to be aware of possible warning signs and to follow through by seeking the advice of experts in the field. While no one can predict the future, there are many things a parent can do in order to help give their baby the best possible start in life. And knowing what to look for in terms of mental illness signs and symptoms is one such way.
The following are a few examples of mental health challenges that infants may face.
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Attachment Building attachments or bonds to parents and other loved ones is a normal phase of babyhood. These attachments provide baby with a sense of security and help them to develop self-confidence as well as coping skills for the future. Attachments are formed when a baby is consistently soothed, comforted and cared for - when their needs are met and they feel safe, protected and loved.
Forming a healthy and strong attachment is the first step in an infant learning to love and trust others while also developing awareness for other people’s feelings and needs. It paves the road for creating and maintaining healthy relationships for the rest of their lives. Attachments may be disrupted or not formed at all due to a baby being neglected or abused, moving from one caregiver to another, being separated from their parents or when a parent is emotionally distant (possibly due to depression or illness). Attachment issues can haunt a person into their adult lives, resulting in many mental health challenges. Early symptoms of an attachment disorder are sometimes similar to a diagnosis of autism or ADHD and can include: the baby being difficult to comfort, appearing withdrawn, having an aversion to touch and not smiling or making eye contact.
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Eye Contact Where a newborn is concerned, eye contact is an important milestone behavior. It nudges the bonding process along by establishing an emotional connection between infant and caregiver. It also happens to be one of the earliest forms of human communication and lays the foundation for developing long-lasting relationships with others.
If a baby does not make eye contact and appears to avoid it altogether, this can sometimes signify a larger problem. Lack of eye contact can be an early warning sign of autism or mental health issue such as anxiety, depression, even schizophrenia. Either way, it won’t hurt to have baby thoroughly assessed by a professional - even if it turns out to be nothing. When it comes to possible mental health concerns, both infants and parents will benefit from early identification and intervention. Getting in to see specialists can be a long and exhausting process so it makes sense to get the ball rolling as soon as a possible problem presents itself.
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Being Over-Responsive Babies are built to automatically respond where their needs, natural instincts and reflexes are concerned. They are hungry so they cry; they get picked up and the crying stops; a person speaks and the baby looks at them. The way and to what level a baby responds to other people, to external stimuli, even to their own requirements is extremely telling to professionals. Some babies are overly responsive - these infants may be referred to as intense, high maintenance, even demanding. For whatever reason, these babies aren’t as lowkey as some others. While these may just be passing sensitivities or even permanent personality traits, in some instances they can be signs of mental health challenges to come. Signs that a baby is overly responsive include:
Constant and voracious feeding
Extremely poor sleep habits Inability to self-soothe
Urgent crying
Constantly tensed muscles
Forceful reactions when unhappy
For parents who recognize many of these character traits in their own baby, feel free to discuss concerns further with a healthcare provider.
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Exposure to Violent Conflict When a baby experiences violent conflict and abuse (even indirectly), this can negatively impact crucial stages of brain development. Feelings of insecurity, fear and stress can damage the hippocampus, disrupting the normal process of brain development. This damage can lead to increased risks of suffering from depression, addiction and even PTSD in the future. Parents need to be aware that their negative actions and behavior - even when not directed at their children, can still cause as much damage as if they were. Babies and children crave and require routine and consistency in their lives. If their household is chaotic and distressing to them, this can damage them for life.
Research has proven that experiencing high levels of stress at a young age, affects a person’s ability to cope with (even normal levels of) stress in the future. Basically, undergoing stress early on will weaken a person’s ability to handle it in later life.
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Under-responsive An under-responsive baby may be cause for some worry. Hyposensitive to sensory input, they may have trouble noticing touch, temperature extremes and may not be as aware when they are wet or dirty. These babies won’t necessarily fuss when they are tired, hungry or need changing. They may seem floppy, lowenergy, even lost in their own world.
If baby is presenting as under-responsive, it’s important to have them assessed by a professional. Most likely a physical exam will be conducted followed by an interview of their primary caregivers to find out more about family background, medical history and milestone development. Unfortunately, there are no specific tests that can be performed for a definitive diagnosis - this can only be reached by a combination of observation, interviews and presenting symptoms. Under-responsiveness can be a symptom of a Sensory Processing Disorder. It can also be indicative of Reactive Attachment Disorder where a baby either didn’t form bonds or the bond formation was interrupted at a crucial point in time.
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Infant Mental Health: Where Wellbeing Begins Understanding infant mental health
expression and management of
means understating ourselves, how
emotions, the ability to form healthy
we became the people we are today
relationships, and importantly
based on our early relationships,
learning to explore the environment
and most importantly how we can
in a healthy and curious manner.
help the next generation grow with a strong sense of wellbeing. Wellbeing is defined as the experience of health, happiness, and prosperity.
Although infants and young children can, and do, experience mental health difficulties, the primary focus of the infant mental health field is not on diagnosing mental illness,
It includes having good physical and
but on understanding and
mental health, life satisfaction, a
promoting mental wellbeing in very
sense of meaning, and ability to
young people. Infants experience
manage stress. The roots of
very strong feelings and are affected
wellbeing grow in infancy. When
greatly by their caregiver’s
infant mental health is understood,
responsiveness and understanding
cared for, and supported, we see
of their needs.
children grow into strong, resilient, and flexible adults. Yes, even in the first few weeks and months of life we are beginning to develop a sense of wellbeing and babies have mental health needs.
Infants and young children cannot manage their feelings on their own, they cannot guide their development on their own - they need loving caregivers who are wise and kind to help them. They need
Infant mental health specifically
caregivers to understand them, to
refers to a young child’s social and
soothe them, and to make sense of
emotional development from birth
their world in order to lay the
to age five years. It includes the
foundation for their understanding
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their internal and the external world.
childhood development, mental
Infants and young children
health and wellbeing.
understand their world through others - how others act, react, and interact with them. Simple and everyday interactions provide young children with a strong foundation through activities like: holding, talking, comforting, caretaking, soothing, and generally loving. Although simple, these acts are powerful. The field of infant mental health is young, but no longer an infant itself.
This is done practically by taking the time to talk and listen to parents about their young child’s internal emotional world, promoting age and culturally appropriate developmental play, assessing a young child’s social and emotional skills and support system, and holding the child in mind as both an individual and an interconnected member of their family and community.
From pioneers who understood and promoted the importance of attachment and parent-child relationships such as John Bowlby and Anna Freud, to founders of this field Selma Fraiberg and René Spitz, and modern day advocates such as Alicia Lieberman, the field is multidisciplinary, with a child and family focus. Every practitioner who comes in contact with young children and their parents has the ability to positively impact infant mental health by being part of the movement of prioritizing early
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Erin Valentine, PsyD Clinical Psychologist Sidra Medicine Instructor of Psychology in Clinical Psychiatry Weill Cornell Medicine-Qatar Printed here on July 20, 2020 June 2022
Feature Interview
My name is Geoffrey Kumwembe, I come from Domasi, Zomba Malawi. Currently, I work for Ministry of Health (based at the Zomba Mental Hospital) as a Clinical Officer with a BSc in Clinical Medicine. Before joining the health field, I worked as a teacher in primary school. Then I was sent to community day secondary school where I also had an experience in teaching. I happen to be a pastor in the Malawi Assemblies of God church, a field which helps me to
the patient poses a danger to
serve clients comfortably and to
themselves or the community, they
value them more as my Heavenly
are admitted for further monitoring.
Father requires me to.
I usually refer those patients who
What inspired me to work in mental health was the realisation that there are very few clinicians in the field. This is where my passion was born for mental health work. My regular roles and duties as a clinical officer include taking mental health history, conducting mental assessments to rule out medical illnesses. I make diagnosis and manage each patient accordingly. If
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have medical problems to the Central Hospital. If there is need for outpatient treatment, then they can go home and receive care from there. Where there is a need for counselling, I do provide counselling to them. Some patients do not need to be admitted for further treatment but can be seen as outpatients. To these, I will give a date for them to come back and be reviewed. If there June 2022
is no improvement or change on
well in this life. They should be able
their review date, we set some more
to accept themselves because many
time for them to keep coming back
people have challenges when it
for review until they are stable.
comes to accepting themselves.
Once the patient is admitted into the ward, I check on them daily to manage their treatment accordingly.
Some people believe that they are not actually capable of doing anything.
This helps to point out those with
Such negative beliefs can lead to a
medical problems so that they get
very poor quality of life. People need
managed to avoid unnecessary
to have positive self-esteem, a
complications and deaths.
positive evaluation of themselves
I check on those who are showing signs of improvement while in the hospital so that they get discharged in time. If there is no improvement, then we review the diagnosis right there in the ward and manage the patient accordingly. When I hear the word mental health, usually, what comes into my mind is a holistic view, taking into account the total person. I believe that the absence of good mental health leads to poor quality of a person’s life. My personal opinion is that mental health is a good state of mind. I believe that a person has to be mentally stable in order to perform 28 | E s s e n t i a l G r a c e M a g a z i n e
and their life, as well as of their past. Having a sense of purpose and meaning that will result in positive relationships with others. Being able to control themselves and to balance up whatever is good and bad in their lives. All these factors and more are what come to my mind when I hear the term mental health. My personal experience with mental illness while working in the mental health field has not been easy, it can actually be hazardous. I remember one incident which left me with a back bone injury, which still gives me pain till today. It is not an easy profession for any mental health
June 2022
personnel. But, such is the field that
much we can do. I have also found
we love and we do our best to
that men are usually affected by
achieve the goals that we have set
family problems, financial issues,
out for us.
misunderstandings within the family,
When a mentally ill client recovers, I
among many other challenges.
feel very good about it. The
Although it is a challenge working in
progress of each client has a big
this field, love and patience are a
impact on my attitude. For example,
must. If you don’t have these
I sometimes work with cases where
qualities towards your work, you will
a couple may be facing challenges
not succeed in your service. If you
and are in need of intervention.
cannot sacrifice your time, energy,
When I work with such couples and
and whatever else is required of you,
give them the counselling they
you will struggle so much to be
need, I am encouraged when they
impactful in the field of mental
reconcile and resolve their
health.
problems.
Lessons learnt that I can share with
In my experience, men and boys are
others out there are that the
being increasingly impacted by
communities and society at large
substance abuse. This problem has
need to understand mental health
been getting worse and something
challenges in people so that they
really needs to be done about it
can be assisted. They need to be
especially at community level.
loved and understood in order for
I believe that problems arising from
them to be rehabilitated.
substance abuse cannot be dealt
An example is of the tendency of
with solely by mental health
some communities to
professionals but within the
misunderstand elderly people when
environment in which addicts live.
they behave in certain ways as a
Otherwise this problem becomes a
result of mental illness. These elderly
burden on us when there is only so
are often labelled as witches. Some
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of them live alone in the villages,
My advice to readers about mental
and because they feel vulnerable to
health especially when it comes to
being attacked or robbed, they may
building safe spaces for men and
lock their doors when they go out in
boys is to address the issues around
the night to use the bathroom.
substance abuse. Drugs and alcohol
Some may get confused and not be
must be avoided at all cost.
able to find their way back to their
Remember that most quarrels
house, maybe because it’s too dark,
happen when the mind is not sober,
they don’t recognise their way back. Sometimes they may be suffering from symptoms of mental illness related to aging such as dementia.
Forgiveness is also another area where men struggle, forgiveness towards others and towards ourselves.
They may wonder from
so lets us promote sobriety. Many males are affected by substance abuse, which then affects marriages, families, jobs, and may lead to them suffering from mental illness. Let us make sure to promote communication within
house to house trying to find their
marriages in order to improve
home, and people may respond by
mental health for all members in the
beating them and even killing them
family. Poor or absent
because they assume the person is
communication can lead to so many
practicing witchcraft.
adverse results in society through
Should you find an elderly person behaving this way the best approach is to refer them to a mental health professional in order for them to get help. This is my appeal to the public, please do not rush to harm the
broken homes, vulnerable and delinquent youth who are growing up without the love and care of a family unit. May we promote love and unity in families in order to avoid such outcomes.
elderly, let’s stop this habit as a
I would also say let us work hard
society.
towards financial security as part of
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promoting better mental health. Laziness should be avoided, rather lets us plan better for our finances, our families, and our goals so that we have a sense of direction for our lives. This will ensure that we are not living with stress and anxiety related problems that can lead to poor mental health. For the men, may we learn to accept
and can leave us isolated. Forgiveness is also another area where men struggle, forgiveness towards others and towards ourselves as well. Forgiving will allow us to let go of negative perceptions and open up when we have challenges. Men do not need to face problems alone, but they do need to allow others to help them.
when we are wrong or make mistakes. As men sometimes it is difficult to be honest with ourselves and others when we make mistakes. This affects us more than it does others around us as it destroys
Should you want to get in touch with Mr Kumwembe, please send a request to the editor at essentialgrace@zoho.com
relationships
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Mental Health
Did you know that men can also be affected by post-partum depression?
Very little is known about this condition, therefore, very little is done about it and many men suffer in silence. Read more to learn and start looking for solutions to help those in this plight 32 | E s s e n t i a l G r a c e M a g a z i n e
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Postpartum Depression in Men Many people may wonder whether or not men can suffer from postpartum depression. In reality, men are susceptible to postpartum mood disorders after the birth of their child. Unfortunately, there is not much awareness surrounding postpartum depression in men because it is not as common as PPD in women. The condition often goes undiagnosed and untreated. Approximately 25% of new fathers will suffer from symptoms of postpartum depression. However, only about 10% of cases are recorded. The condition in men is referred to as paternal postpartum depression (PPPD) or paternal postnatal depression (PPND). If you suspect you or your loved one is suffering from paternal postpartum depression, educate yourself on the symptoms and treatment options available for new fathers. This can help prevent men from suffering in silence. Risk Factors of PPD in Men Men who suffer from paternal postpartum depression may not understand how it developed. Similar to postpartum depression in women, there are many potential risk factors that contribute to PPD in new fathers. The risk factors of paternal postpartum depression include: A continual lack of sleep
Changes in hormones
High-stress lifestyle, including career and family
Relationship tension with spouse
Poor relationship with in-laws
Lack of support from his own parents
Being part of a non-standard family (i.e., unmarried men or stepfathers)
Financial stress
History of depression
Feeling excluded from the bond between mother and child
One of the biggest risk factors for paternal postpartum depression is the development of postpartum depression in the mother. Half of all men who have a spouse suffering from postpartum depression will be depressed as well.
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Symptoms of PPD in Men The first step in seeking treatment and getting help for paternal postpartum depression is knowing the broad range of symptoms that can affect new fathers. It is also important to know the difference between paternal postpartum depression symptoms and “Daddy Blues” symptoms. “Daddy Blues” is very common in new fathers. Fathers often feel stressed, overwhelmed or tired. However, symptoms go away within a few days once the father is able to take time for himself, exercise or visit friends. Paternal postpartum depression symptoms are much more severe and long-lasting. They do not go away just by getting out of the house.
Common symptoms of paternal postpartum depression include:
Withdrawing socially
Trying to focus more on work or other distractions
Consistently low energy and fatigue
Feeling unmotivated
Changes in sleep, weight and appetite
Alcohol and substance abuse
Headaches and stomach aches
Feeling easily stressed or frustrated
Violent or aggressive behaviour
Impulsive and risky behaviour
Anger and irritability
These symptoms may occur in men at any point during the first year after the birth of their child.
Diagnosis for Men Men often have a difficult time discussing their postpartum depression symptoms. This is more common if their partner, the mother, is also suffering from PPD. In these cases, many men hide their feelings in an attempt to reduce the burden of their spouse’s condition. Men may also feel ashamed of and confused by their postpartum symptoms. Therefore, they are reluctant to seek medical help. 34 | E s s e n t i a l G r a c e M a g a z i n e
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Treatment for Men Men with paternal postpartum depression must be equally proactive in seeking help. Men should know that what they are experiencing is normal. There is no shame in feeling depression or anxiety after the birth of a child. It is a huge lifestyle change that brings extreme emotional shifts.
Like women, men have access to PPD medications like antidepressants. Men should also explore the option of counselling, therapy or support from other mental health professionals. There are many postpartum depression support groups available that cater specifically to men. These groups provide a safe space for men to talk about their concerns and feel understood by others with similar experiences. Men can also participate in family-oriented support groups, such as postpartum support groups for couples, to help learn healthy coping and relationship skills. Self-Help for Postpartum Depression in Men Self-help practices are excellent ways to reduce stress and depression symptoms.
Examples of self-help practices include: regular exercise, healthy eating, getting enough sleep, meditating, journaling, and practicing yoga. Men should also strive for open communication about their feelings so that they do not become closed off and worsen their condition. Paternal postpartum depression can be a serious and severe condition, but it is treatable. Seeking professional help is often not enough. Implementing self-care practices helps ensure that men going the extra mile to recover from their depression. Like women, men deserve recovery for their own personal health and the health of their family.
Written by Jenna Carberg
Postpartum Depression in Men - New Fathers and Postpartum Depression
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Health and Wellness
Who is an Andrologist And andrologist is a medical doctor specializing in men’s health, especially relating to their reproductive system and urological complications specific to males such as their reproductive organs, genitals, and genitourinary system, including kidneys and adrenal glands. What does an andrologist do? They look after male reproductive issues and anomalies in genital organs, teste, the prostate gland, and also the genitourinary system that includes the urinary tract, urinary bladder, kidneys, adrenal glands, and urethra. How often should you see an andrologist? You should see an andrologist in case of the following disease specific to the male reproductive system: Male infertility. This is a condition where the person in unable to conceive. Infertility can result from low sperm count, blockages that prevent the delivery of sperms, injuries to genitals, damage to sperms due to certain radiation exposure.
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Erectile Dysfunctional. Erection occurs when blood flows into the blood vessels of the penis. Insufficient blood flow to the penis can result from psychological problems, such as performance anxiety, stress, nervous system disorder or hormonal imbalance. Premature Ejaculation. The exact cause of premature ejaculation is not known. It’s thought to be caused due to psychological factors that include depression, anxiety, history of sexual repression, relationship problems, etc. It’s also associated with an imbalance of serotonin levels in your brain. Lower amounts of serotonin levels shorten the ejaculation time and vice versa. Whatever the cause, you need to consult your doctor for the correct diagnosis and treatment. Phimosis and paraphimosis. It’s a condition observed most often in children. Phimosis is a condition wherein the foreskin cannot be pulled back. Paraphimosis is a condition where the foreskin does not retract back over the head of the penis. Peyronie’s Disease. It’s a condition where there is a significant curving of the penis resulting in either painful erections or that may interfere with sexual functioning. It’s thought that Peyronies disease is caused as result of repeated injury to the penis. Benign Prostatic Heperlasia (BPH). It’s a condition wherein the prostate gland enlarges. It’s a form of a non-cancerous tumour obstructing the proper flow of urine. Testicular Cancer. It’s a serious health condition that could lead to other health complications of death. How to choose an andrologist Choosing the right male specialist doctor is one of the most important and personal decisions you would ever make. Here are some crucial tips to help you choose the right andrologist.
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Research. There are many andrologists out there, decide on the one that you would be comfortable with. Someone with a good reputation, a good track record, and communication skills. Sexual and reproductive health issues are often very sensitive topics, which means that andrologists must usually have a strong bedside manner in order to find success and retain patients’ trust.
Check for licensing and credentials of the andrologist, as well as their years of experience.
Consider the communication style of the andrologist , choose a doctor you will get along with and that you will be able to communicate with efficiently. Medical professionals within this specialty often struggle to find a balance between scientific honesty and compassion, and must usually be able to communicate well both with patients and their families. Many of the conditions that these professionals treat are long-lasting, and most treatments require trust as much as medical precision to be successful. Source: https://www.mfine.co/doctor/dr-nikit-mahale-general-physician-bangalore
If you would like to access the services of an andrologist, find out more from a hospital near you.
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FATHER – CHILD RELATIONSHIPS By Roshin Ebrahim
It seems that the role of a father has almost always remained under the rug and the role of the mother has always taken the limelight! Anyone can be a father but being a dad takes a lifetime of adjustment, compassion, commitment, patience and love. The role that has always been in the dark has a large impact on a child and helps shape them into the adult they become. Fathers, like mothers are also a pillar in the development of a child’s development and emotional wellbeing. What expectations do children have of their fathers? Children look up to their fathers to make the rules and enforce them in the house. They look up to their fathers for security. More than making the mother proud the child strives to make their father proud of them because a mother has always kept a softer approach to the child than the father. When a child has an involved father and Do you know how to keep your cool in
is successful in knowing that their father is
traffic? Are you a great driver? Do you
proud of them, it promotes their inner
know how to change the light bulbs? If so,
growth and strength. Affectionate and
it’s likely your father has taught you some
supportive fathers greatly affect a child’s
of these skills; have you thanked him for
cognitive and social development and
it? 39 | E s s e n t i a l G r a c e M a g a z i n e
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instill in them a sense of wellbeing and self
the girls model their relationships with
– confidence.
others based on their father’s character.
Building blocks of relationships with others In most cultures, we get to see the mother handling how the child is brought up in a homely environment and the father is supposed to teach the child how to grow outside of the comfort zone and build relationships with people in the outside world. Most of the fathers fail to understand that a child needs more than paying for their expenses and education. They need your attention and affection in order to feel secure enough to take on the world. The way a father treats his child influences what they look for in other people. It helps them absorb the reactions, behaviors and actions from people based on what they get at home. Friends, lovers and spouses will all be chosen based on how the child perceived the meaning of the relationship with his or her father. The patterns that the father will set for the child will be ones the child will use to relate with other people. Father and Daughter relationship Most girls must be familiar with the phrases “I look for my dad in my husband”, “I want a husband like my dad”, “Girls first love is their dad” or “Girls are always more loved by their dads”. All these phrases make sense now but never did when Carl Jung proposed the Electra Complex theory. However, this is because 40 | E s s e n t i a l G r a c e M a g a z i n e
Young girls depend on their fathers for security and emotional support. For a daughter the first relationships she shares with a male is her father and he is supposed to show her what a good relationship with a man should be like. He should be responsible to show her what a healthy relationship between two partners should be like and how a man is supposed to treat her. If a father is loving and gentle, his daughter will look for those qualities when she is choosing her partner or friends. If a father is strong and valiant, she will relate closely to that. Most girls who have fathers who are aggressive and not affectionate tend to have a “thing” for bad boys because they don’t know what it’s like to have a good man in their life. Father and Son relationship Unlike girls, boys tend to seek approval from their fathers and model themselves after their fathers’ character. As human beings we grow up by social modelling – imitating the behavior of those around us. If the father is caring and treats people with respect, the boy will grow up pretty much in the same way and if the father is negligent and absent, young boys look to other male figures to set rules for how to behave, to survive or end up being absent in their own relationships. In most cultures, the boys are taught to be superior and be June 2022
the breadwinners of the family, hence they
they feel if they let it out, they will face a
tend to be chauvinist in their relationships
lot of anger, rejection and sadness.
and become aggressive with their wives and children. Trauma and relationships Over the years, when men come for therapy, the issues regarding their career or relationships have been rooted back to the lack of relationship with their fathers. Some children feel that their father isn’t always available for them as they work too hard to provide food on the table or are always stressed out with their role of being the breadwinner. Because of this unavailability most boys suffer with uncertainties about their masculinity,
What is possible between a father and son? What can men do with the array of untapped emotions that shield them from knowing themselves? Adult men can’t pretend away old unresolved wounds because the hurts eventually resurface in other areas of their lives. The unexpressed hurt and anger often transfers onto their intimate relationships, parenting, challenges at work, and problems with authority. If this wound does get tackled in therapy, it encounters an array of painful childhood memories, disappointments, rage and grief at the loss of what they
because their fathers never share anything
never had with their own fathers.
about themselves or how they tackled
Most children have unpleasant memories
problems in life, or how they became the men that they are. So, the boys are left to do it all on their own. Making it difficult to ascertain their masculinity. Most of the time, the fathers are unaware of the way they make the child feel through their words and judgements, or how they hurt them. The fathers that express hostility towards their child makes the child saddled with a general load of fear, weakness and self-contempt as an adult. In most therapy sessions, men have been damaged because of their repressed longing as they are love starved for their
of abuse from their childhood which is labeled as discipline by the fathers. If the father remains negligent, the child eventually comes to terms that they don’t need to please the father anymore as they have tried their best but got nothing in return. In such relationships, when the child sees their father, they get a build-up of tense emotions and the feeling of not being perfect. Some children can move on whereas some carry it with them for life and later continue the cycle of neglect and abuse to their own children and in their own lives.
fathers. They, however, deny it because
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Tips for better father daughter relationships Love and respect her Mom
All the while your daughter/s loves you being their father, they consider their mother as their ultimate role model. Aside from taking care of your wife, showing your daughter that you love and respect their mom will certainly help your daughter to even love and respect you more. If your daughter sees that you belittle their mom, you are only causing a big gap between you and your daughter. Take note of this quote by Theodore Hesburgh: “The most important thing a father can do for his children is to love their mother.” Make and keep your promises
Whenever you make a promise to your daughter like taking her to school the next day, buying her favorite toy, or just about anything you promise, always make sure that you know how to keep them. If you mess up and didn’t do what your promise, then expect you’ll be in a big trouble. Sure enough it’s very easy to make a promise, but most of the time it’s not easy to keep them. That shouldn’t be the case with your daughter because the best way you can build trust with her and become trustworthy is by making and definitely keeping your promises. Learn to listen a lot to what your daughter says
Because of your busy schedule at work or other activities, you probably don’t spend enough time talking to your daughter. That’s why whenever you are home or have the chance, give some time for chit chats with your princess. Asking her how her day was at school, or what she had for snacks and lunch will let her know you do care about her. If you’re not that aware, your daughter loves to talk about almost anything and you should eagerly listen to what she’s saying by staying focused. If you are able to talk everyday sharing stories with each other including simple secrets, then you two can build trust from each other. Just remember not to violate the trust or it can ruin your relationship and hurt each other’s feelings. Read more of this article for more tips here. 42 | E s s e n t i a l G r a c e M a g a z i n e
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Resources 43 | E s s e n t i a l G r a c e M a g a z i n e
June 2022
For more details on the book please contact: Pam Kudiwa (ABC TV) +277 217 888 40
Blessings Nyasulu
+265 993 507 270
@chawalall +265 993 285 092 chawala.banda@pm.me
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June 2022
In confidence, without obligation No long waiting lists for appointments Individuals, couples, and relationships
Need an Appointment? Call +265 0995 147 290 Let’s talk! 45 | E s s e n t i a l G r a c e M a g a z i n e
June 2022
By now, we hope you are aware that you can
Chitipa District Hospital
access mental health care from all the Central
Karonga District Hospital
Hospitals in the country. Here is something to take note of, before you can get to the Central Hospitals, you need to first visit your local District Hospital in order to be assisted. This applies to mental health care as well. Once you have been assessed, the medical staff (a psychiatric nurse or clinician) will then determine whether you need to be referred to
Mzimba District Hospital Nkhata Bay District Hospital
Rumphi District Hospital Dedza District Hospital Dowa District Hospital
Kasungu District Hospital Mchinji District Hospital Nkhokota District Hospital
the Central Hospital, which also provides
Ntcheu District Hospital
comprehensive care for mental health challenges.
Ntchisi District Hospital
Please take note of the list of District Hospitals
Salima District Hospital
available in Malawi.
Balaka District Hospital Chikwawa District Hospital
Chiradzulu District Hospital Machinga District Hospital Mangochi District Hospital Would you like to advertise your mental health services with Essential Grace Magazine?
Get in touch with us for your free offer of mental health related advertising be it for counselling services, support groups, books, upcoming events, and wellness services (e.g. Fitness, massage therapy)
46 | E s s e n t i a l G r a c e M a g a z i n e
Mulanje District Hospital Mwanza District Hospital Nsanje District Hospital Phalombe District Hospital Thyolo District Hospital
Zomba District Hospital
June 2022
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