MENTAL HEALTH AWARENESS
How much do we know and accept for real?
Awareness and seeking of treatment for physical illnesses like diabetes, blood pressure, arthritis, asthma, etc. is high in the population. However, the same unfortunately cannot be said about mental health awareness and illnesses (like depression, anxiety, other stress-related or mood disorders, psychosis, and substance abuse). Such conditions are not only an ignored health aspect but also associated with myths and stigmas.
1 in 4 people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, making mental disorders a leading cause of ill-health and disability worldwide. In India, 10-14% suffer from mental health problems, with more than 50 million people suffering from depression and anxiety disorders.
The myths and stigmas
Health surveys have revealed that 50-60% of people have inadequate mental health awareness, and have fixed, adverse opinions of people diagnosed with mental health disorders. People have reservations about mixing with them in society and working with them. Most people don’t accept that mental health conditions are real problems like physical illnesses and dismiss them off as mere attitudinal or behavioral problems of ‘difficult’ people.
Often, mental health problems and disorders get clubbed as a single entity in a person’s mind, but there are many defined types of mental illnesses, treated differently, and specifically. Sensitivity and understanding of mental illnesses can help in prevention as well as early diagnosis and treatment, which can greatly enhance productivity, individual performance, and the happiness of a family.
It is also important to understand that many people go through periods of low or affected mental health, depression, anxiety and stress. However, they may not have a mental health disorder, even though they may require or seek medical help, and benefit from treatment. Mental health disorders are those that fit defined criteria of consistent and significant symptoms and abnormalities in emotions and behavior, that have been present over a certain period of time, are uncontrollable, and significantly impact personal, social and occupational functioning.
TYPES OF MENTAL HEALTH DISORDERS
There are several categories of mental health disorders that broadly fit into the following groups –
These are disorders in which insight and perception of reality are lost. It is characterized by delusions, hallucinations, and disorganized speech and behavior.
In these disorders, insight and perception of reality are maintained. These include:
Mood disorders mainly include depression and bipolar disorder.
Stress and trauma-induced disorders include post-traumatic stress disorder (PTSD), acute stress disorder, and adjustment disorder.
Anxiety-related conditions include generalized anxiety disorders (GAD), social and specific phobias, and panic. Other mental health disorders like obsessive-compulsive disorder (OCD), eating disorders (anorexia, bulimia, binge-eating, etc.) and somatic symptom disorders, though classified separately, are also elaborated under anxiety-related disorders as their causal basis is linked to anxiety.
These fall in between the realm of psychosis and mental health disorders of mood, stress and anxiety (earlier called neurosis).
These are placed in 3 clusters. A prior understanding of temperament and personality types and traits also helps analyze many mental health conditions, and customize psychotherapy.
This is a unique category that deals with disorders of sleep, dreams, and the subconscious mind.
Substance abuse (uncontrollable intake of intoxicating substances: alcohol, tobacco, and other narcotic or recreational drugs) is a recognized category of mental disorders, more common in men, with an alarming 25% population prevalence. Substance abuse is also associated with mental illnesses like psychosis, mood and anxiety disorders. It is important to rule out or diagnose and manage substance abuse while diagnosing and treating any mental health disorder.
MANIFESTATIONS AND SIGNS
Mental illnesses can manifest in multiple ways like aggression, violence, recklessness, inappropriate behavior, change in sleep and eating patterns, anxiety, depression or moodiness, decreased focus and work productivity, social withdrawal, and relationship problems.
Just as someone can have many physical disorders together like diabetes, high BP, or high cholesterol, the same can happen with mental disorders. So sometimes anxiety-depression can co-exist or the patient may present manic and depressive states together in bipolar disorder. Some may become substance abusers because of depression, may present a mood disorder with psychotic symptoms (schizoaffective disorder), or become obsessive-compulsive due to an underlying anxiety disorder. The COVID pandemic has also adversely impacted mental health due to the suffering induced by the disease itself (post-COVID stress disorder, similar to PTSD), and the loss of normal socio-cultural and economic aspects of life.
WHAT CAUSES MENTAL HEALTH DISORDERS?
There are many factors that play a role, and usually, a combination and interaction of these factors lead to mental health conditions:
Biological factors: genetic predisposition and family history
Development, functioning and interaction of certain parts of the brain: The amygdala and anterior cingulate gyrus (parts of the limbic system that regulates and processes emotion, and controls behavior), hippocampus (controls learning and memory), and the prefrontal and frontal cortex (controls thoughts, cognition, planning, motivation and actions).
Neurotransmitters (neurochemicals or neurohormones): These are chemicals that can have excitatory or calming effects, and regulate mood, as well as pleasure and motivation. These include serotonin and noradrenaline (decreased in depression), GABA (decreased in anxiety), glutamate (increased in anxiety), and dopamine (increased in schizophrenia). Medicines given in various mental health conditions act by modifying levels of these neurochemicals.
Hormones: Cortisol and adrenaline increase has been implicated in stress and anxiety disorders. Other hormones that can affect moods include thyroid hormones and estrogen in women.
Personality and temperament predisposition: Certain personality types like neuroticism and introversion, are associated with a greater risk of mental health conditions. A person’s temperament developed in childhood can also affect perceptions, interpretations, outlook and response to situations, people and events.
Social and Environmental factors: Adverse and unpleasant experiences, exposure to stressors, and traumatic events play a very important role. Many mental health conditions can be traced to such underlying causes, especially in childhood. Social and cultural practices prevalent in a region can also play a role. The degree of support and protection from family, as well as key people part of one’s life, coupled with one’s own learning, education and positive reinforcement can determine resilience and coping ability during stress and adversity.
Lifestyle factors: Reducing stress of daily living and having support systems play a crucial role, especially in the case of women. Other important factors are the amount and quality of sleep and the effects of circadian rhythm. The gut-brain connection is also seen to have a role, and a person’s diet especially if high on processed items, sugar, caffeine, and trans/saturated fat can lower mental health, as opposed to a positive impact with natural items like fresh fruits, vegetables, pulses, and curd. Adequate physical activity and exercise, breathing and mindfulness techniques, relaxing and engaging hobbies, family bonding, and social interaction, are all beneficial factors for better mental health.
Substance abuse: There is a vicious cycle-like relationship between mental health conditions and substance abuse (alcohol, narcotics, recreational drugs, sedatives or stimulant drugs) as each can be both the cause and effect of the other. Substance abuse is now classified as a separate category of mental health disorders.
Physical health: This too is a cause-and-effect factor, as often underlying chronic physical conditions may lead to mental health disorders like depression and anxiety, while many chronic conditions are linked to and exaggerated by mental health disorders. A medical examination and diagnosis of underlying or associated physical conditions is therefore as important.
Learn, understand, accept, then help ones in need……
Most people with mental health illnesses have normal intelligence and are as capable, competent, and talented as any other person. There should be no undue fear, reservation, or hesitation in mixing, interacting, and working with anyone undergoing or in need of treatment for any mental illness.
In fact, with mental health awareness of the types and presentations of mental illnesses, one can help oneself or a known one to seek help for diagnosis and treatment. This can greatly help in regaining health as well as productivity and normalcy in life, just as would happen after treating a physical illness.
For any query, additional information or to discuss any case, write to firstname.lastname@example.org, and be assured of a response soon.