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Why are Egyptian parents silent on their children’s mental illness?

Egyptian parents are considered to be very caring to their children; devoting their entire life to make sure they have a good life with a prosperous future. However, while they will rush to the doctors if their child's finger is scrached, they will turn a blind eye if they notice any symptom of mental or psychological disorder due to the societal fears and stigma that come with mental illness. 

"No way! My child is not insane," Mohamed Hamouda, the psychiatrist and the owner of the Center of Children neuropsychology and psychology told Egypt Independent trying to explain parent's misconception about psychological disorder.The Egyptians do not have the culture of the psychiatrist, and they are super-creative in finding physical justification for any psychological disorder. For instance, if the child is violent they say he is naughty, if he is unsocial, his parents label him as the silent type.

In December 2015 a report released by the Egyptian Foundation for Advancement of the Childhood Condition (EFACC) said that at least 44 children committed suicide in Egypt in 2015 for various reasons, and one of them being "psychological". Despite the increase in the number of children who suffer from psychological disorders according to International statistics, the Egyptian society still stigmatizes mental illness. Hamouda pointed out that the most prominant cases of child mental illness in Egypt are attention-deficit-hyperactivity disorder (ADHD), oppositional defiant disorder and Behavior disorder.

"Recently there are bigger media awareness campaigns about children's psychological disorders and mental illness, however the percentage of those with mental disorders is unprecedently high," Hamouda said. He attributed the increase in cases to parent's disregard, "When parents notice early behavioral changes in their kids they never visit a doctor fearing the stigma which worsens the child's case."

He said that there are three different kinds of stigmas; the first one is the fear of the disorder itself, another one is the stigma of the psychiatrist who is traditionally perceived as “insane”, and the third stigma is of the psychological medication and the belief that patients would become addicts.“You cannot become addicted to medication. It’s similar to the antibiotic, if you stop taking it, the symptoms will regress. Patients after taking couple of pills and feel better, they don’t take it anymore so the symptoms of the illness will show again,” He said.

If your child is mentally sick what shall you do?

Egypt Independent asked mothers about what they would do if they discovered that their child is mentally or psychologically ill. The majority said that they might see a doctor, but they would not give their children the medication; while some believed they would handle the problem by themselves because of their distrust with psychiatrists; and a few said that they may visit the doctor but would never admit it to anyone. 

Mona Mohamed said that she will visit the psychiatrist only if he needs behavioral therapy, but she will not give her child any medication until she makes sure that it will help him.  She has no problems instructing him herself without a doctor's consent.

Following Mona's perception, another mother, Yasmin Zaki (25) said, “I will visit the psychiatrist but it will be the last option, because doctors exaggerate," she said. Zaki explained that before visiting a doctor she will make sure that her child really has a problem by paying attention to his behavior and using search engines such as Google to search for symptoms in order to evaluate whether or not she will be able to manage the illness.  “I have a good educational experience with my nephews I can know if he has a problem,” she said. However, if it is clear that Zaki's child is sick she will resort to seeing a doctor.

Another mother, Esraa Al-Desouki, explained that she will attempt to handle her child's problem herself.  However, if his case does not improve, she will see a doctor and will not tell anyone. 

“My cousin’s son was suffering with a psychological disorder and that was clear, we were begging her to visit a psychiatrist but she refused claiming that her son is normal and has no illness, but after a long while she recognized the problem, and visited a doctor,” said Hanaa Safwat.

In contrast to the previous mothers who said they will only see a doctor as a last resort, Doha Abdel Samiea said that if she noticed that her child has a problems she will visit a psychiatrist because his psychological health is very important, adding that “people who may shame my child will not help me if his case worsened,” she said.
 

A mother whose child is autistic said that "the community refuses us, we preferred to keep ourselves in our home because my son is mentally ill, when anyone knows that my he is an autism patient, they prevent their children to play with him sometimes they criticize me if he involuntarily did any inappropriate act".

Parents are the reason

The EFACC report stated that three cases of child suicide were a direct result of the their fear of being punished after making mistakes. Though the underlying cause behind child mental illnesses is debatable, psychiatrists commonly refer to bad parenting as a key reason and parents are often unjustifiably blamed for their children's psychological disorder. Hamouda believes that the parent’s attitude toward their children is the underlying cause of their mental and psychological health, “the children's minds are a blank canvas and their parents’ treatment and the way they are educated build up their personalities and attitude,” he added.

Unfortunately most parents in Egypt rely mainly on positive verbal communication that is contrary to their disappointing body language that the child can easily reconize, “for instance you can give your child approval, but your face does not say that,” he said. 

On one hand, Hamouda urged the parents to be moderate neither to over-coddle their children nor deprive them of any physical object or emotional feeling. He explained that if parents over-coddled their child they would discover a stubborn violent person with uncompromisable demands that may lead to severe psychological disorders including the oppositional defiant disorder, while if the child was deprived physically or emotionally he might be a patient with an obsessive-compulsive disorder.

While Hatem Zaher, a psychiatrist and the head of Nour Zyada for Child Psychiatry said that parents become every child's role model, thus many children believe that everything done by their parents is the “ideal” way. “I remember a child who sliced his arteries after a fight with his friend because he was watching his dad (who had psychological disorders) hurting his own body whenever he got angry,” Zaher said.

On the other hand, Zaher explained that sometimes family frustration from work concerning anything may lead to something called “displaced aggression”, in which parents cannot express their anger toward the source of the problem, such as their boss. As a result, they take their frustrations out on someone weaker and often behave very aggressively toward that person or people.

“We can find many parents who have problems in their lives who are very violent with their children, whether through unjustified verbal abuse or through systematic aggression, which may cause the child to prefer 'death',” Zaher explained. Following Zaher, Hamouda said that sometimes the parents are the individuals who are in need of a psychiatrist' help. For instance many parents with generalized anxiety disorder may cause their children to start stuttering.

Genetics                                                               

According to the largest genome-wide study the people with disorders including autism, ADHD, bipolar disorder, major depression and schizophrenia were more likely to have suspect genetic variation at the same four chromosomal sites.These variations account for 17-28 percent of mental illness risk.           

Moreover Hamouda said that genetics play a big role in children's mental health, as if the parent’s genes carried the illness and it will be inherited to the offspring. “Sometimes parents claim that they were suffering mental illness during their childhood but they handled it without any medication and now they are good, but in reality these parents are not good, as the mental illness doubtlessly affected their personality,” Hamouda said.

Technology

Nowadays technology has a huge impact on families and their relationships with one another causing traditional values to disintegrate. If you dropped by a family gathering you will find everyone on their smart device with no conversation, no spoken words, just the sound of texting. Children no longer play games outside, no hide and seek, no hopscotch, only virtual games. A recent study published in Pediatrics found that children, who spent more than two hours a day in front of a screen, either playing video games or watching TV, were 1.6 to 2.1 times more likely to have attention problems.

Hamouda attributed the increase in the number of mentally ill children in Egypt to the overconsumption of technology in their lives that have badly influenced their mental and psychological health.

According to Zaher the cartoons that children watch on screen play a dangerous role that influences childrens' beliefs, especially when they see their beloved superheroes jumping from a 12-meter high building without getting hurt. “One of my patients, a kid, threw himself out of the second floor window because he was imitating these superheroes. He had to go to the hospital with multiple injuries,” Zaher said. Zaher stressed the family’s role in explaining to children that these cartoons are not real.
 

Never ignore your child's mental disorder

Ignorance to mental illness and psychological disorder may lead to severe implications on the child's health and the illness might be chronic and would take a long time to recover. “Families never go to a psychiatrist. Only when the situation is getting worse and when the patient starts thinking about suicide they might consider seeing a psychiatrist,” Hamouda said.

“Living with a permanent disability can also be a factor for children to commit suicide. A boy was pushed to suicide after suffering from an undisclosed disability for a long period of time,” Zaher said.

Hamouda advised any parent to visit a psyciatrist if they notice either a functional or a social disorder in their children. “Functional disorder includes the decreasing level in school and uncommon behavior, while social disorder includes changes in their relationship with their parents, friends and society,” he said.

 

 

 

 

 

 

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