Mental Health Awareness – How much do we know and accept for real?
Awareness and seeking treatment of 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, bipolar disorder, schizophrenia). These are not only an ignored health aspect but also associated with myths and stigmas.
One in four 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 an estimated 56 million people suffering from depression and 38 million from 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 illnesses. People have reservations about mixing with them in society and working with them. Most people don’t accept that mental illnesses are real problems like physical illnesses and dismiss them off as mere attitudinal or behavioral problems of ‘difficult’ people.
Often, mental health problems get clubbed as a single entity in a person’s mind, but there are 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.
TYPES OF MENTAL ILLNESSES
The table below gives a quick anytime reference for Mental Health Awareness.
Vulnerability and Patterns…
The 40-60 years age group shows a high vulnerability to mental health disorders, however, anxiety-depression may be seen even in younger age-groups.
Schizophrenia affects both genders equally, however, Bipolar disorders affect men more while Depressive and Stress-related disorders affect females more. In addition, mental illness as a result of Substance Abuse (uncontrollable intake of intoxicating substances like alcohol, tobacco, and other narcotic drugs) is a recognized category of mental disorders, more common in men, with an alarming 25% population prevalence.
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, or become Obsessive-Compulsive due to an underlying Anxiety disorder.
Psychiatrists can also identify personality disorders with or without the above mental illnesses as shown in the table below. Every human being shows aspects of many of these personality types based on circumstance and situation. However, in some people, one of these particular types of human behavior or response is exaggerated and dominantly present in the majority of the situations, as compared to normally seen in people. Understanding personality and behavioural types is also an important aspect of mental health awareness.
WHAT CAUSES MENTAL HEALTH DISORDERS?
The cause of mental disorders is the imbalance of certain chemicals in the brain and nerves (neuro-chemicals or neurotransmitters).
Some chemicals have a calming effect, while some have an exciting effect, so an imbalance towards the excitatory chemical can lead to anxiety. There are chemicals that control mood and prevent depression, and a fall in these can lead to a depressed state, while a rise can lead to a manic state.
Some of the chemicals mentioned include Serotonin, Noradrenaline (decreased in Depression), GABA (decreased in Anxiety), Glutamate (increased in Anxiety), and Dopamine (decreased in Parkinson’s, increased in Schizophrenia). Medicines given in various mental health conditions act by modifying levels of these neuro-chemicals.
Mental Health conditions require a holistic and multidimensional approach-
- Behavioural therapy
- Medical therapy
- Nutritious Diet
- Lifestyle modification – Sleep and Physical activity
- Stress management
- Support Groups, Helplines and Community Awareness Programmes.
Medical therapy with appropriate drugs is now available which treat most mental disorders. Usually, medicines are given along with or after a trial of counselling or behavioural therapy which involves listening, discussing, and advising suitable lifestyle and behavioral modifications to the patient. Many mental illnesses in their initial or milder stages and personality disorders can be managed effectively by counseling, support programs, and lifestyle modification alone. Many physical illnesses may be associated with underlying mental illness which when not addressed, gives the patient incomplete relief from his physical symptoms. This is often seen with chronic pains and digestive complaints.
Poor mental health may be linked with poor diet regardless of gender, age, education, marital status, and income level. Increased consumption of sugar and high amounts of processed grains and fats in the diet has been linked with depression, bipolar disorders, and overall poor mental health. The vitamins in the diet which have been linked to optimal mental health are Vitamin D, Vitamin C, Folic acid, and Vitamin B12. While among the minerals, Iron, Zinc, and Magnesium have shown benefits to mental health. It is also important to test for levels of Iron, Vitamin D, and B12 if suffering from low moods, fatigue, and stress. In addition, including Omega 3 fatty acid foods like fish, or flaxseed, and walnuts in the diet can also add benefit.
A diet rich in vegetables, fruits, nuts, yogurt, whole grains, and legumes, with a reduction in processed/packaged foods is recommended for holistic physical and mental health. In addition, good water intake of at least 8-10 glasses of water (2 to 2.5 liters/day), timely meals, and not skipping meals is important for mental health.
Lack of adequate sleep and deterioration in mental health often have a mutual relationship forming a vicious cycle. Therefore improving duration and quality of sleep is an important component of managing mental health conditions. Regular physical exercise has a mood-elevating role and is protective against mental health disorders. Stress management programs are regularly conducted in institutions to maintain mental health. Relaxation techniques like stretches, breathing exercises, yoga, and sports are known to improve mental health. Indulging in hobbies like music, dance, reading, gardening, and crafts are also helpful for mental health.
Reaching out to Support groups and Helplines is recommended and can save situations and even lives.
Learn, understand, accept, then help ones in need……
Most people with mental health illness 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, 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.
Some useful reading –
For any query, additional information or to discuss any case, write to firstname.lastname@example.org, and be assured of a response soon.
TLLLF 2018 NATIONAL SURVEY REPORT: Mental Health Perception;
NIMH Clinical symptomatology and management;
International Journal of Food Sciences and Nutrition 16 Feb 2019