Disregarded Health

Part I

gayane
My worst fears will come true if I don’t do anything about it! Fear, endless fear that is stronger than my sensibility.  

I was 12 when I began to notice odd patterns in my behavior. Every time I had a thought that frightened me, I immediately felt compelled to touch certain objects, repeat specific words in my head, or stare in a particular direction until I’d find peace. My anxiety and fears intensified as I grew older and my daily “rituals” started to exhaust me. I couldn’t find any logical explanation for my fears but being well aware that my behavior was not “normal”, I worried people would think I had gone insane. So I said nothing.

Contrary to when I had problems with my physical health and my parents would go into a frenzy to nurse me back to health, whenever they noticed my odd behavior, they would scold me and tell me to stop. They never tried to understand what was behind my strange gestures or extreme perfectionism.

I eventually began to study literature on mental disorders and finally found the symptoms that described my condition perfectly. I found out I had Obsessive Compulsive Disorder (OCD) when I was 20. I was terrified to learn I had a mental disorder, and incredibly relieved to learn that my problem had a name, that I wasn’t the only one with the condition.

According to Aram Hovsepyan, a psychiatrist, about 3% of the world’s population has OCD and about 8-10% of people have various types of anxiety disorders. Hovsepyan has estimated that there should be around 200,000 people with anxiety disorders in Armenia. “But only a very small number of people are aware of the issue,” says Hovsepyan.

t
Tried being like you, I failed - feeling guilty.  They don’t like me, will recognize me walking on the street. A glance - hatred. “Live lightly,” “You are Down,” “Go get treatment,” “Enough, change the subject,” “Enough of your self pittyfulness.” My throat hurts.  

 

T., who is 17, has problems with Generalized Anxiety Disorder (GAD). Even most inconsequential things seem to be a big deal to her. When facing difficult situations, she gets extremely nervous and this translates into physical discomfort. "My throat begins to ache, and I constantly cough, suffocating."

Classmates who have noticed T.'s odd behavior complicate her mental state even more. T. has been called "down," told to "take it easy" or "to go get treatment." This rude attitude lead T. to believe that her peers hate her. This makes meeting new people even harder; her subconscious tells her that they would likely hate her too.

Not counting on any support from her parents, T. is constantly seeking ways to get rid of the troubling thoughts on her own.  In the past, to suppress her problems T. resorted to cigarettes and alcohol. She has since substituted smoking and drinking with art, in particular, painting, and she doesn’t plan to go to a psychologist or psychiatrist. T. is not the only one who prefers to either overcome her problem herself or just ignore it. 

According to Khachatur Gasparyan, a candidate of psychological sciences, official statistics show that the number of people who seek psychological services in the Republic of Armenia does not exceed the 1% of the country's population. Gasparyan believes this number is a result of the social stigma that likely starts with the family, distrust in the field of psychology and lack of mental health awareness. 

g

G. is 20 years old. She has Panic Disorder. After tense conversations and unpleasant memories, G. finds it difficult to breathe, her heart rate increases, she feels pain in different parts of her body and her limbs get numb. "I can’t lie down because it makes me feel like I'm dying. Maybe people think I'm making a big deal out of nothing. They do not understand what it is like to feel as if any minute now, you might explode from pain."

G. believes her family will accuse her of being egoistic if she opens up to them. "The problem is serious and the ‘what are you talking about?’ attitude makes it even worse,” says G. Despite this, she learned to ask for help from close friends. And knowing first hand how difficult it is to go through panic attacks on her own, she urges people not to be ashamed and seek help. G. is now saving up for treatment with a private psychotherapist rather than going to a state-financed clinic. 

According to Aram Hovsepyan, the problem of psychiatric and psychological services provided by the state is that there are not enough specialists. "It turns out there are only two clinical psychiatrists for every 40,000 patients. In such conditions, it is impossible to dedicate sufficient time to each patient, and as a result, the treatment isn’t complete.” 

k
Fear. 

K. is 21 years old.  The symptoms of her OCD started manifesting when she was five years old. Her compulsions included counting, washing hands and making the sign of the cross. The condition became more aggravated during her teenage years. When K. was 14, she was sure she was "abnormal" because someone had put a curse on her. Later she was afraid that her oddities were the result of a mental defect. At the age of 20, K. began to study literature on mental disorders. Like myself, she eventually came across OCD.

Her daily rituals had taken over her life and K. had to leave her university studies and take care of her health. Now K. continues her treatment with medication and sees positive changes. However, getting help was not an easy process, she had to change several therapists. "My first psychologist, was not familiar with OCD and told me that I pretended to have a mental disorder to escape my problems," said K. 

According to Khachatur Gasparyan, there is no oversight provisioned by law when it comes to the licensing of mental health professional or the treatment of mental disorders in Armenia. Individuals can provide various psychological and psychiatric services without any accreditation or state regulation. According to Aram Hovsepyan only psychiatrists should deal with the treatment of mental disorders. "A psychologist can only guide the patient," said Hovsepyan. According to him, people should not trust those who can’t clearly diagnose the patient’s problem after the first visit and those who prescribe several medications simultaneously. 

According to the experts, pediatric psychiatry remains one of the most challenging issues in Armenia. Although there is some progress, social stigma, lack of awareness, and public distrust continue to hinder the development of the field and the improvement of people’s mental health remains a distant last to the already disregarded issues of physical health.

It took me eight years to find out what was happening to me. When I shared the news with my family, they didn’t take my words seriously at first but after piecing together my behavior and the symptoms, they acknowledged the problem and its seriousness. Still, they don’t encourage me to talk about it; they worry the feedback will be negative. I, on the contrary, feel confident about sharing my story and have come to realize that a lot of people around me are dealing with similar problems, yet they are afraid to speak up because they fear judgment.

Images by Gayane Ghazaryan.  

This project is funded in part by a grant from the United States Department of State 


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