Brain chemistry, medication and mental health

Internalised stigma increases mental health risk, pharmacist warns

Tuesday, 21 October 2025: No one is in control of all the complex biological, psychological, social and environmental factors and life circumstances that together determine our state of mental health. As South Africa marks Mental Health Awareness Month, a pharmacist unpacks how the chemicals in our brains affect how we feel, and how treatment can help reduce troubling symptoms and restore emotional balance.

“Mental health disorders can affect a person’s mood, thoughts and behaviour. These may include disorders such as anxiety or panic disorders, where a person may experience overwhelming fear, worry and avoidance that interferes with their daily life, as well as depression, bipolar disorder, and dementia, among others,” says pharmacist Patrick Kodibona of Medipost Pharmacy, South Africa’s original national courier pharmacy.

“Conditions such as major depressive disorder, which is characterised by feelings of sadness, hopelessness and disinterest in things you previously enjoyed, or bipolar disorder, where the person experiences extreme mood swings from emotional highs or mania to the lows of depression, not only affect quality of life, they can also place sufferers’ lives in real danger,” Kodibona says.

Mental health conditions vary in severity and duration. “There are acute mental health conditions for example stress, as well as periodic conditions, such as bipolar disorder, which recurs in episodes, as well as long-lasting and progressive conditions such as Alzheimer’s disease. Like many other health conditions, mental health disorders can often be treated, prevented from becoming more severe or managed to give the person the best possible quality of life,” he explains.

The human cost of stigma

“Unfortunately, misunderstanding of these kinds of conditions is still quite widespread, and this creates fear or silence about mental health conditions, which is what we refer to as stigma. Negative attitudes, stereotyping and discrimination against people with mental health conditions make people reluctant to support others or speak up when they are struggling themselves. In extreme cases, this may even lead to suicide if the person does not find help in time.

“Internalised stigma, that is, when the person themselves holds negative stereotypes about mental health, can lead people to avoid or delay seeking treatment, which may result in the worsening of symptoms making them feel more isolated. This underlines the importance of mental health awareness to break incorrect ideas that allow stigma to thrive.”

Kodibona says that understanding and treatment of psychiatric conditions have advanced considerably over recent decades. “Professional talk therapies, counselling and, where needed, medication specific to each individual depending on their diagnosis, comorbidities and other relevant factors, aim to manage symptoms, thoughts, feelings and behaviours that can be disruptive to the person’s life, ability to work and relationships.”

He points out that the duration of therapy may depend on various factors, such as the type and severity of the condition, the treatment itself (as specific mental health medicines may be associated with withdrawal or have a limited recommended prescription period), and individual factors, such as the person’s co-existing conditions.

“Medication prescribed for treatment of mental health conditions, also known as psychotropic drugs, helps by altering brain chemicals called neurotransmitters to ease and reduce condition-associated symptoms such as mood fluctuations, depression, anxiety, hallucinations, and so forth. Examples of types of psychotropic medications include antidepressants, antipsychotics, anxiolytics, stimulants and mood stabilisers, and they can make an enormous difference to people’s outlook and lives when used appropriately as prescribed by a psychiatrist or doctor.”

Pharmacist’s notes: Getting the best out of treatment

“When starting psychotropic medication, it is important to adhere to treatment exactly as prescribed and report any undesirable effects experienced to your treating healthcare provider. The decision to continue or discontinue should be a shared decision between patient and healthcare provider, guided by evidence, effectiveness, side effects and individual-specific conditions,” Kodibona says.

“It may take a few weeks to start feeling the benefit of the treatment, so be patient and keep taking your medicine if you don’t notice a positive difference immediately. When a person feels better, it is essential to continue with treatment as prescribed. Risks of not adhering to treatment or abrupt withdrawal from psychotropic medicines may include relapse of your mental health progress, worsening of the condition and potentially experiencing withdrawal symptoms, among others.”

 It is also important to note that various dietary and lifestyle factors may affect treatment with psychotropic medication. For instance, certain foods or drinks, and habits, can affect medication absorption, effectiveness, and side effects, or worsen symptoms of the illness.

“Consuming alcohol, for instance, can greatly increase the depressive effects of some medications. It can also sometimes worsen the original mental health condition that the person is receiving treatment for,” he warns.

“Eating foods with high fat content may affect the absorption of some medications and ultimately the effectiveness of the treatment, so it is worth keeping this in mind and discussing any questions with your healthcare provider or pharmacy team.”

Kodibona emphasises that simple lifestyle habits are an essential part of any treatment plan. “Getting enough regular sleep is essential for good mental health, and should be a priority for everyone’s physical and mental wellbeing. Lack of exercise may contribute to fatigue and mood swings, while exercising releases endorphins, which are your natural feel-good hormones,” he says.

“No one chooses depression, post-traumatic stress disorder or any form of physical or mental health condition, and at Medipost Pharmacy, we do everything possible to help reduce the burden that comes with treatment acquisition through traditional methods.”

South Africa’s first national courier pharmacy provides consistent delivery of medication to the right patient, at the right place, at the right price and at the right time. “We help meet treatment goals by improving adherence to treatment, ensuring product safety and integrity, and providing clinical support – all while protecting the privacy of patients with its confidential medication delivery service and collection points.

Individuals and families registered with Medipost Pharmacy have direct telephonic access to the pharmacy team to discuss any questions relating to prescribed or self-care medication in all official South African languages. Visit www.medipost.co.za, https://shop.medipost.co.za/, download the Medipost app or say hi on WhatsApp 012 426 4655 to register and learn more.

“Our team further assists with therapy reviews to optimise treatment, and we engage with prescribers, medical aids, and caregivers as needed, on behalf of the patient to ensure proactive disease management and the best chance of adherence with free delivery to any address throughout South Africa,” Kodibona adds.

“There is so much hope today for managing mental health conditions effectively when patients are supported to keep to their treatment plan and understand the fundamentals of their condition. First, we need to address the stigma that needlessly keeps too many people silently suffering without reaching for professional support for their mental health.”

Ends

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