Poverty, family conflict, substance abuse and the fear of being judged are among the pressures affecting mental health, with many people continuing to struggle in silence rather than seek help.
As South Africa observes Mental Health Awareness Month this October, Chatsworth psychologist Dr Guru Kistnasamy is calling on families and communities to recognise the warning signs of emotional distress and address the social conditions that can contribute to it.
Drawing on his experience in education, counselling and community welfare, Dr Kistnasamy warned that mental health is shaped not only by individual circumstances but also by the environments in which people live.
“Being raised in a nurturing, emotionally supportive family promotes factors such as self-esteem, care, empathy, and confidence. However, when homes become environments of constant conflict, neglect or abuse, the emotional consequences can extend well beyond childhood. Children develop insecurity and anxiety when they witness parents arguing,” said Dr Kistnasamy.
Children exposed to conflict may withdraw or display disruptive behaviour at school, while the effects can continue into adulthood and influence their relationships.
Beyond the home, social media can add to the pressure. Unrealistic portrayals of happiness, beauty, success and wealth can leave people feeling inadequate, while cyberbullying, online scams and excessive screen time may contribute to emotional distress. Dr Kistnasamy also raised concerns about online gambling and substance abuse, particularly among young people.
He highlighted the dangers of experimenting with cannabis-laced food products and mixtures such as “lean”, a recreational drug made by combining cough syrup containing codeine and promethazine with soft drinks and sometimes sweets, producing sedative effects that can impair coordination and pose serious health risks.
These substances can have serious psychological effects, including impaired concentration, anxiety, paranoia, hallucinations and psychotic symptoms. Addiction can also place further financial and emotional strain on families.
Despite these challenges, stigma, fear of judgement, embarrassment, financial constraints and the belief that people should cope on their own can prevent them from seeking professional help.
Dr Kistnasamy cautioned that warning signs are not always recognised. Emotional withdrawal may be mistaken for antisocial behaviour, irritability for disrespect and persistent exhaustion for laziness.
Other signs include changes in sleeping patterns, loss of interest in previously enjoyed activities, difficulty concentrating, unexplained anger, persistent sadness and significant changes in appetite or weight. Recurring thoughts of death or suicide require immediate attention.
Physical symptoms such as chest tightness, rapid breathing, a racing heartbeat and muscle tension may also accompany anxiety, although they can have other medical causes. Persistent changes should not be ignored.
Dr Kistnasamy encouraged people to maintain healthy relationships, get sufficient sleep, exercise regularly, practise mindfulness and make time for hobbies. Gratitude, community volunteering and supportive social connections can also help reduce isolation and strengthen emotional resilience.
However, he stressed that positive thinking and healthy habits cannot resolve every mental health difficulty, and professional treatment remains important for those experiencing persistent or overwhelming symptoms.
From homes affected by conflict to young people navigating social media pressures and substance abuse, mental health challenges demand greater understanding and support.
Families and communities must learn to recognise distress, respond with compassion and encourage those struggling to seek professional help. Creating a society where people feel heard and supported must be a year-round commitment, not one limited to Mental Health Awareness Month.
“Families must create environments where difficult conversations can take place without ridicule or judgement, while communities have a role in challenging the stigma that surrounds mental illness. Caring for mental health requires more than encouraging people to think positively.
It demands families willing to listen, communities prepared to challenge stigma and a society that recognises the psychological consequences of poverty, violence and neglect,” said Dr Kistnasamy.
