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A Soul-Stealing Belief

During my psychiatry clerkship, I encountered a patient with his first primary psychotic episode. He was an African-American immigrant, and his story hit many of my buttons. I connected with him as his journey brought back memories, and I was moved to read up on various studies surrounding his case. I found an article that hypothesized that immigrants from underdeveloped countries had a higher chance of mental illness due to “dysregulated immunoregulation.”

According to this theory, immigrants who move from environments with high pathogen burdens to cleaner environments may experience a dysregulated immune system, leading to an increased risk of developing mental illness. The theory suggests that the immune system plays a crucial role in regulating brain function and mental health. When the immune system is dysregulated, it can cause inflammation in the brain, leading to various mental health conditions, including depression, anxiety, and psychosis.

This theory has significant implications for mental health care providers, particularly those working with immigrant populations. It highlights the need for culturally sensitive care that considers the unique challenges and vulnerabilities patients from underdeveloped countries face.

This encounter led me wonder if our coping strategies and resilience are shaped by the environments we grow up in, or if we are all inherently doomed from birth.

Growing up in my community, mental health was not a topic that was widely discussed or understood. It was often stigmatized or dismissed as a personal failing. Growing up, I was surrounded by people who believed that mental illness was caused by witchcraft or the stealing of one’s soul. This belief system persists in many countries, with religion, rather than psychiatry, as the preferred mode of treatment.

All these experiences have helped me appreciate the complexities of mental illness and the importance of treating patients as individuals with unique cultural backgrounds and experiences. Health care providers play a vital role in shaping patients’ lives, and it’s important that we approach patients with empathy, understanding and an open mind.

Chiamaka Okrorie
Lebanon, New Hampshire


1 thought on “A Soul-Stealing Belief”

  1. This raises a lot of questions for both researchers, clinicians, and those outside the medical field. I was teaching at a university and had a Vietnamese student who wanted to go to student health services, yet felt too ashamed to ask for help. She didn’t want her parents to find out she was seeing a therapist. Since I’m half-Chinese, I could relate, with my own family having the same attitude. Additionally, there is the science of epigenetics, the molecular biology of intergenerational trauma, how genetic information is changed; for example, the shortening of telomeres as a result of PTSD. As you say, this “dysregulated immune system” is both personal, cultural, environmental, and really complicated! Thanks for making us aware to bring an open and compassionate mind to people in need.

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