Mental Health Matters is published five times a year with the objective of bringing information and support to South Africa’s GP’s in their role as first line care givers and identifiers of mental health issues.


By Z Wilson


Welcome to the first edition of Mental Health Matters for 2017. We are looking forward to a year of inspiration, education, awareness as well as Mental Wellness. The MHM team held two very positive meetings with GPs last year who gave us some interesting suggestions and topics for the publication – so watch out for some exciting changes to this year’s magazine.

Q: What are some of the beliefs clinicians may
have regarding the treatment and
management of depression?

A: One of the significant issues I don’t think clinicians fully appreciate is how limited the literature on the efficacy of antidepressants is regarding the generalizability of that literature to their clinical practice. The studies that are done by pharmaceutical companies use rather restrictive inclusion and exclusion criteria, such that most of the patients who are seen in routine clinical practice would not have qualified for a typical industry-funded antidepressant efficacy study. This is the situation we’re in right now; clinicians have the belief, understandably, that medications are effective for the patients to whom they are prescribing, but, in fact, we really don’t know if that is the case.

By M Zimmerman

Humans are inherently social beings. We typically value social relationships
and tend to thrive and report greater levels of well-being when we experience a sense of belonging. In clinical practice, we often see the numerous emotional costs of prolonged avoidance of specific or general social interaction. It is also well known that social support typically forms an integral part of recovery from illness.

By B Drake

Manic depression and bipolar affective disorder are synonymous with each other and are the names given to bipolar disorder, a chronic illness where the highs of mania alternate after weeks or months with the lows of depression. This is bipolar I which is the classic bipolar disorder found in 2 per cent of the population and has a strong genetic basis. It is generally associated with significant personal and societal costs. Emil Kracpelin, eminent German psychiatrist (1856-1926) studied the natural course of bipolar disorder and found it to have intervals where the patient was stable, functional and free of symptoms. He very importantly distinguished this from schizophrenia which was more psychotic based and had a poorer outcome with no return to normal or baseline functioning.

By D James

There has been a great deal written in recent years on Emotional Intelligence. This is not just a fad but a vitally important, previously neglected area of
understanding. Children (and adults) who do not understand themselves, others and their social context have more difficulty coping with life’s demands.

By A Decaires-Wagner

We are all too aware of the high stress levels in the world in which we live today – from financial stress to poverty; from high school costs to constraints in the current education system; child abuse, domestic conflict, family dysfunction and violence; from divorce to single parent and child headed households; alcohol and drug abuse; chronic physical and mental illness; the ravages of ongoing HIV; fear regarding safety in our homes and on our streets; crime; demonstrations and violence in our communities and our universities, as well as xenophobic violence. We live these every day and experience them through the media. Pre-occupied by our own inability to cope in our own daily lives, we rarely ask the crucial question – “Where are the children?”

By H Clark

Although anger is a natural, normal human emotion it can be difficult to manage. It varies from mild irritation to highly charged rage, and there may be elements of defensiveness and revenge or even violence present. Many people tend to avoid it, withdraw or lash out when it shows up and this leads to problems.

By K van Zyl

According to the World Health Organisation (WHO), depression as an illness is now the leading cause of disability worldwide with an estimated 350 million people affected. It is therefore crucial that clinicians be able to correctly recognise this condition.

By E Pak

Global statistics of suicide risk are chilling. According to the WHO, a suicide occurs every 40 seconds and an attempt is made every 3 seconds. South African statistics illustrate the progressive surge in the prevalence of suicide. In South Africa, which has the 8th highest suicide rate in the world, there are approximately 8 000 suicides a year – 23 a day. An alarming trend is seen in the degree of suicidality and associated behaviours amongst youth – children and adolescents. The suicide rate for children aged 10 – 14 has more than doubled in the last 15 years and 9.5% of teen deaths are due to suicide. Keeping track of attempted suicides helps practitioners to estimate the amount of risk an individual has.

By G Eccles, M Makoni


The diagnosis of schizophrenia is a clinical one, made through the observation of characteristic signs and symptoms and the exclusion of other causes for these (Box 1). It often takes a period of time to be certain of the diagnosis as the various manifestations evolve with the course of the illness.

By L Robertson

Addiction can be defined as a continuing and progressive brain disorder characterised by the physical and psychological compulsion to engage in an activity. The concept of addiction includes not only the consumption of illicit drugs, prescription medications, alcohol and cigarettes (known as substance dependence) but also to activities or behaviours, such as gambling, internet gaming, pornography or sex (known as behavioural addiction). Over time, the addiction becomes uncontrollable and interferes with the individual’s functioning in their work and their interpersonal relationships. In essence, addiction encompasses “four elements: loss of control, compulsion, continued use in spite of adverse consequence[s] and craving[s]” (ACCSA, 2017).

By K Clark, MJ Theron

I was raised by a single mother, who was diagnosed with bipolar depression, which later developed into schizophrenia. I was still young when my mother started showing the symptoms of bipolar. I was eight years old. I did not know what this was, let alone not knowing whether she was sick. I just started seeing my mother changing. She became very moody and sensitive. Sometimes she would be very friendly and in a split second very irritated.

By Y Dlepu

Zane Wilson Founder SADAG

  • Neil Amoore,
  • Psychologist, Johannesburg
  • Kevin Bolon,
  • Psychologist, Johannesburg
  • Dr Jan Chabalala,
  • Psychiatrist, Johannesburg
  • Dr Lori Eddy,
  • Psychologist, Johannesburg
  • Lee-Ann Hartman,
  • Psychologist, Johannesburg
  • Dr Frans Korb,
  • Psychiatrist/Psychologist, Johannesburg
  • Professor Crick Lund,
  • Psychiatrist, Cape Town
  • Dr Rykie Liebenberg,
  • Psychiatrist, Johannesburg
  • Dr Colinda Linde,
  • Psychologist, Johannesburg
  • Zamo Mbele,
  • Psychologist, Johannesburg
  • Nkini Phasha,
  • SADAG Director, Johannesburg
  • David Rosenstein,
  • Psychologist, Cape Town
  • Professor Dan Stein,
  • Psychiatrist, Cape Town
  • Professor Bernard van Rensburg,
  • Johannesburg
  • Dr Sheldon Zilesnick,
  • Psychiatrist, Johannesburg