Obsessions that get out of hand

Fifteen per cent of the Maltese people suffer from mental health problems at some point in their life, however, only a small fraction seek help. On World Mental Health Day, Claudia Calleja speaks to a woman who was courageous enough to fight the stigma and speak up about her story to help others.

Six-year-old Shirley Ann Muscat was convinced that if she did not wash her hands constantly she would contract some deadly bacteria, so she would scrub her fingers till her skin cracked and bled. At night she would regimentally go round the house to check that all doors and windows were locked before settling into bed her mind still very active, harbouring dark, obsessive thoughts.

The stigma stopped me from asking for help

The noise in her mind was a constant distraction, including during lessons at school. She was a withdrawn child struggling to look “normal”.

“I had to pretend I was OK. I was not happy. I thought I was crazy and wanted to hide it,” recalled Ms Muscat, now 40 years old.

Things have changed and Ms Muscat no longer hides her disorder but proudly speaks about it to help others and break the stigma.

Sitting in the board room of the Richmond Foundation, which works with people with mental health problems, she traced the lifelong journey that led her to realise she suffers from obsessive-compulsive disorder and learn to live with it.

Known as OCD, it is an anxiety disorder in which people have unwanted and repeated thoughts or obsessions that make them feel driven to do something (compulsions).

As a child, Ms Muscat was not lucky enough to know the disorder existed. “I always remember myself with obsessions. Sometimes I’d get fixations about contamination and spend almost all my time and energy thinking about germs. Then, I’d get another fixation on something else and forget the previous one.

“During my First Holy Communion I was given a pair of earrings and spent the whole time obsessively checking they were still on my ears,” she recalled.

As she grew up, her thoughts become more complex and her obsessions more disturbing. She started thinking a lot about death, which made her fear she was dangerous to others. “When I’d see a knife, for example, I’d think that whoever wants to kill someone only needed to use the knife. The fact that this passed through my mind terrified me.

“I thought I was completely crazy and not that I had an illness that could be controlled. So I felt I could not tell anyone. The stigma stopped me from asking for help,” she admitted.

She grew up and got married and still managed to keep her thoughts to herself, even hiding them from her husband. The couple had two children and Ms Muscat found it difficult to cope with being a mother and dealing with her obsessions.

One afternoon, about 12 years ago, she saw a psychiatrist talk about OCD on a television programme and recognised herself in his words. She immediately made an appointment with him. He diagnosed her with OCD and put her on medication.

For a long time, the pills did not have the desired effect because she felt depressed. She changed psychiatrist but still expected better results, especially as she was spending lots of money on doctors’ visits and pills. One day, while leafing through a magazine, she came across an article about a spiritual healer and decided to give it a go. She decided to stop her pills – a big mistake, in hindsight.

“I became manic and detached from reality. One fine day, I walked out of the house and spent the day roaming around Malta on buses and taxis giving handsome tips,” she said. A friend of hers took her back home and, the following morning, she decided not to send the children to school. Her husband was upset and took them himself.

I love myself how I am right now. I’m just a human being after all

She locked herself in the bathroom and refused to open when her husband returned. He called their doctor and the police and, when she eventually opened, she was taken to Mount Carmel Hospital.

“I did not want to go and I started screaming and had to be handled by a group of people. I had this supernatural strength and they gave me an injection to calm me down,” she recalled. She spent a week in hospital and started taking her pills again. With the support of her husband, she returned home but still felt depressed and tired.

Then, in 2003, she decided to attend a self-help group at the Richmond Foundation and met people like her. She realised she was not alone and started regaining self confidence.

She now volunteers at the foundation and runs her own self-help group for people with OCD. She was recently appointed a board member, completed a make-up course and has a part-time job.

“I still suffer from OCD and always will but I learnt to live with it... I have my limits... I don’t drive and don’t wake up and clean the whole house in the morning. I’m not that type of super woman. But I do other things. I enjoy living my life and I try to help others. I love myself how I am right now. I’m just a human being after all.”

Facts and figures

• Almost eight per cent of Maltese reported suffering from chronic anxiety, according to the European Health Interview Survey released last year.

• About 6.6 per cent said they suffered from chronic depression at some point in their lives.

• Only 2.5 per cent of people went to a psychologist or a psychotherapist.

• Five per cent took medicines for depression and another five per cent took them for anxiety.

• About four per cent of the population take sleeping pills

Need for research

Mental health is a problem in all EU member states and is estimated to affect about 50 million people. Every nine minutes, someone commits suicide, amounting to 54,000 every year.

The Richmond Foundation is calling for more research in resilience and trauma management in Malta.

Trauma is a common experience that can take place due to many reasons including life losses, abuse, stress or harassment at the workplace, robberies and wars.

Many people who experience trauma may be at risk of developing post traumatic stress disorder.

Symptoms include ­flash­-backs, nightmares and de­tachment from other people. Anxiety, depression and ­suicidal tendencies are also associated with trauma. Recovery is possible when the person finds the right treatment and professional help.

The Parliamentary Secretary for Community Care, Mario Galea, encouraged anyone experiencing mental health problems to seek help.

The Richmond Foundation pointed out that Malta needed more expertise in this field as traumas and traumatic events were widespread. Research on this issue is essential.

The foundation will be holding an International Healing Event for Bereavement After Suicide on November 19 in collaboration with the American Found­ation for Suicide Prevention.

For more information visit www.richmond.org.mt or call on 2148 2336.