Nigeria is no stranger to political tension: elections are often accompanied by uncertainty, anxiety, and stress.

However, the 2023 general elections, in addition to the cash crunch across the country, may significantly impact the mental health of the citizens.

The country has been grappling with economic challenges for several years, with high inflation, rising unemployment, and increased poverty rates.

Recall that since December last year, the cash crunch occasioned by the Naira redesign policy of the Central Bank of Nigeria, CBN, has continued to take a toll on the masses, inflicting more pain on the poverty-stricken Nigerians.

The cash crunch peaked amidst a report by the Nigerian Bureau of Statistics, NBS, that 133 million Nigerians were multidimensionally poor.

The report blamed the country’s rising poverty on poor access to education, living standards, health, employment and security.

Nigerian Bureau of Statistics, NBS, in the early November of 2022, disclosed that 133 million Nigerians were multi-dimensionally poor, saying that the figure represents 63 per cent of the country’s population.

Following the CBN’s direction on Monday that the old N500 and N1,000 notes remained legal tender until December 31, many commercial banks’ gates were full before 8:00 am on Tuesday, with customers optimistic that their sufferings would end.

Mrs John Grace, a bank customer in Kaduna State, lamented she had stood at the First Bank gate since 6:00 am and was sure of going home with money.

Another customer, Mr Jusmana Moses, who banks with United Bank for Africa, said his bank would not have any excuses to give.

“It’s either they give me new notes or old currency,” he said.

With the anxieties generated by the February 25 Presidential and National Assembly elections yet to decline, the Gubernatorial/State House of Assemblies elections are scheduled for March 18.

Amidst the moribund economy, experts have warned that stress caused by anxiety related to economic uncertainties and elections could increase the risk of developing depression and other mental health illnesses.

A Consultant Psychiatrist at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki and Public Relations Officer of the Association of Psychiatrists in Nigeria, Dr Okwudili Obayi, in an interview that the country is in a period of transition, warned that the harsh economic realities and electoral activities would affect people’s mental health state and behaviour generally.

Obayi noted that things get worse because anxieties are high, and people find it challenging to get what to eat, leading to depression and other concerns.

The health expert also advised individuals with mental health challenges to seek medical attention and help from a psychiatric facility.

“We are in a transition period, and a period of transition affects human beings in different ways, coupled with economic realities and hardships. Indeed, the Naira redesign worsened the economic hardships, which led to cash scarcity. So all these will affect people’s mental health and behaviour generally.

”If we take the two jointly, as I said, the transition can affect people’s mental health in many ways. One is a period of campaigning for the politicians. It is a period of increased stress because of campaigns and all it takes; it is a time of stress for politicians. It is a period of increased activities involving night activities, keeping awake longer than before watching television; if you like what they say, you spend a lot of time; if you don’t like it, you get angry with that.

”The other angle has to do with the period after the election. If you like the result, you can be excited; if you don’t, you can be disturbed. One’s predisposition to excitement or anger can affect one’s mental health.

“If you are angry with the result, yes, anything can happen. People will look at the money they have invested; people will look at the hope they expected; people will look at the expectations; all these will affect them. Even those who did not vote but were expecting a good government can feel their hopes are dashed if they don’t like the outcome of the result.

”Now, in all these, you also remember that people with other responsibilities no longer attend to them as before. People leave their other work to go for campaigns, listen to people, vote and invest, in one way or the other, their time and energy in the electioneering process. All these affect the human mind, which is why it worsens when you bring it to the issue of the economy already in shambles.

“It gets worse because anxieties are high, it gets high because things are getting more challenging, and people are finding it difficult to get what to eat, which will lead to depression and other concerns.

“People have money but can’t have access to cash, leading to the inability to attend to basic needs. It is affecting both the traders and the buyers. It is also affecting the average person in different ways. So that is a very major issue,” he said.

While noting that mental illnesses would lead to an increase in violent behaviour, depression and anxiety, Obayi called on people who get overworked or involved in politics to get access to a health facility for evaluation.

He also explained that adjustment disorder, a situation in which people find it difficult to adjust to the current reality, would become common months after the elections.

”Now in all these, going for campaigns, campaigning for people, going to vote and staying long for results, being a thug for political candidates, and staying awake at night for one thing or the other will affect behaviour.

“All these will affect people, especially those vulnerable to developmental illness. Then those who are not vulnerable or those who have had mental illness before but may have recovered can increase the reemergence of the illness.

“Of course, we don’t have the figure, but basically, mental illnesses will increase things like violent behaviour, depression and anxiety. What we call adjustment disorder will increase, and that one will not come now; it will come many months after the election.

”By adjustment disorder, we mean that people will find it difficult to adjust to the current situation. People are finding it difficult to adjust to the Naira scarcity situation.

“After the election, those who invested a lot, who failed, will find it more difficult to adjust because in every position, a very good number of people contested, and at the end of the day, only one person will emerge. So those who spent money, those who borrowed money, and those who invested either as contestants themselves or sponsoring contestants will find it difficult to adjust to the current reality months after the elections, and they will develop what we call adjustment disorder.

“Generally, the transition on its own is an issue that can affect the mental state of everybody in one way or the other,” the health expert said.

He added, ”Prevention is better than cure when it comes to mental illness. All the mental disorders that develop are not new; they have existed before. In this case, we are saying that economic hardship or electioneering is the major risk cause or predisposing factor. So, prevention is better than cure.

“Sometimes, there are things that we cannot prevent. The management strategy is that people who get overworked or involved in politics should get access to a health facility for evaluation. That is the first step; they should not wait for symptoms to manifest. When symptoms like poor sleep, restlessness, unnecessary easy irritability, and getting angry more than one is used to, when one notices it, one should not wait until it becomes full-blown.

”On the other hand, if somebody starts just experiencing from nowhere thoughts that he is the one that won an election when there are no facts or he has lost when he has no evidence to support either way, one should seek medical attention. Again, when one starts thinking that life is worthless, whether it is due to economic hardship or the outcome of an election, one should also seek medical attention.

”In a full-blown state of mental illness, there is a need to seek medical attention and help from a psychiatric facility.

“The Government should be sincere, and when they have good intentions or policies, they should communicate to the people and keep to whatever they have decided. A situation government says one thing and does another makes the citizenry lose confidence or hope in the government.”

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