Ahmed, 22, was busy working at a restaurant in the Iraqi capital, Baghdad, when he started to speak of the horrifying images he saw of people getting killed when he closed his eyes.
When he tried to explain the pictures to his family, they first shrugged it off as tiredness and overwork. But when the images started changing Ahmed's personality, they decided to take him to the community religious leader.
The sheikh gave Ahmed a pair of shoes he said would cure him, Ahmed's brother Kassem Abdallah, 24, told IRIN. Gradually his health deteriorated, he started slurring his words and making no sense when he talked. The family then took him to another sheikh, who told them that Ahmed was suffering from schizophrenia and needed to go to hospital for the correct treatment.
Ahmed's situation is not uncommon, said Dr Hashim Zainy, director of what he says is the only mental illness teaching hospital in Iraq. The hospital in Baghdad has 74 in-patient beds and a couple of other outpatient clinics in other areas of the city.
The hospital, which appears well-staffed and equipped, is virtually the only one for the estimated 25 million people in Iraq. It is helped by various NGOs and private donors, Zainy said, including the UN World Health Organization (WHO) in the past and the Japanese-based Peace Winds NGO.
In former president Saddam Hussein's Iraq, mental illness was considered an abnormality which Saddam said couldn't happen to people who were faithful Muslims. Families continue to believe that it can be cured by religious leaders, even though many mental illnesses, including schizophrenia, are caused by chemical imbalances in the brain. "Psychiatry was neglected by the previous regime," Zainy told IRIN. "They believed psychiatric patients should be sent to religious healers."
Although there are no exact statistics for Iraq at the moment, schizophrenia is typically found in one percent of the population, which would be 250,000 people in Iraq, Zainy said. Depression could affect as much as 10 percent of the population, or 2.5 million people. The Ministry of Health, which oversees all health care in Iraq, does not have current statistics on mental health patients.
"In our outpatient clinics, we sometimes treat 120 people per day," the doctor explained. "But we have no psycho-social services in Iraq and no social workers working in this way."
Military hospitals used to treat soldiers with mental illness, including Iraqis held as prisoners of war in Iran. But virtually all of those hospitals are now closed. An asylum in Baghdad houses an estimated 1,200 people, but many of them left when US-led troops came into Iraq a year ago, Zainy pointed out. Many of the estimated 80,000 former prisoners kept in jails around the country and released by Saddam Hussein last spring also had mental disorders, he said.
Mohanned, 37, another patient diagnosed as having an acute mental disorder at the teaching hospital, said he used to be scared to visit the doctors, but he now feels they are acting more professionally than they did under the previous regime.
Mohanned started suffering flashbacks and delusions after his vehicle was bombed, killing everyone but him, as he and other soldiers were travelling back to Iraq from Kuwait following the 1991 Gulf war a decade ago, his father said. Mohanned recently tried to set the family car on fire, pouring kerosene onto it, but was prevented from lighting it. When he was locked in his room by the family as punishment, Mohanned tried to set the room on fire with a kerosene lamp.
"The medication here tranquilises me and makes me feel better," Mohanned told IRIN with a smile on his face. "They are helping me overcome my situation, so I can be a normal person in society," he added. In addition to helping such patients at the hospital, Zainy said he and the other doctors are seeing many adults and children in post-war Iraq suffering from post traumatic stress disorder. For example, many of the children at a primary school near the International Committee for the Red Cross (ICRC) in Baghdad have been too scared to leave their homes since a bomb hit ICRC offices in October, he said.
"We might not know for months or years the impact of all of the things that have happened here," Zainy said. "It's a very wide subject and very hard to tell what's happening."
Psychiatrists in Iraq also want to do a study on chronic stress disorder. Many people currently lack initiative, they cannot plan well, they lack the ability to plan for the future or feel pleasure, all symptoms of the syndrome, Zainy said. The uncertain political situation has led to tension in people's everyday lives, he said.
"We are more free, but our situation now is not better," Zainy said of the current instability in the country, which includes almost daily car bombs,shootings and other random acts of violence. "Even when many good things happen to people, the trend is to think of the bad things. And we were spoon-fed by the former regime."
In addition, the population outside of Baghdad is thought to suffer more mental illness per capita than most people around the world, Zainy said, following three devastating wars and social problems. Many live in remote areas and don't come to Baghdad to get treated, he said. "There is fear and stigma and ignorance," Zainy said. "Who knows how many patients are out there?"
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions