Definition of Mental Health:
According to the World Health Organization, mental health is "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community".
What causes mental health to break down?
Mental health is influenced by a number of considerations, which may be permanent feature of someone’s life or a response to a transient situation. Conditions such as the following can lead to a breakdown in mental health:
· Stress particularly if it is prolonged
· Social isolation and loneliness
· Physical illness and prolonged pain
· Poverty, debt and the associated social disadvantage and discrimination
· Childhood experiences such a abuse, trauma or neglect
· Adult experiences of trauma, either acute or chronic
· Genetic or family history of conditions such as depression, anxiety, bipolar disorder and schizophrenia.
· Substance abuse which may be both a cause and consequence of mental illness
The most common kinds of mental illness which may affect an individual at any time of the life span include:
· Depression – a persistent feeling of sadness or low mood accompanied by by behavioral changes such as social withdrawal, alterations in sleeping and eating patterns, and a loss of interest in activities which were previously a source of joy or satisfaction
· Anxiety, including Panic Disorder – an overwhelming reaction of fear or stress either occurring spontaneously without an apparent trigger or in response to a normally unchallenging situation.
· Bipolar Disorder – in which the individual may rotate between feelings of great sadness and depression alternating with periods of elation and even dangerous and unpredictable behavior
· Obsessive Compulsive Disorder – the need to control feelings of anxiety by ritual behaviors such as counting, cleaning or tidying/arranging items in a particular way
· Post traumatic stress disorder (PTSD) – may occur after a single traumatic incident but be made worse by ongoing exposure to fear-inducing situations. The symptoms may include nightmares, flashbacks, avoidance of any situation which may feel similar to the original trauma.
This list is obviously not at all exhaustive but highlights the kind of mental illnesses which are most commonly encountered by mental health practitioners in their practices. Psychotic disorders (where the connection with reality becomes fragile or is lost) is complex and needs highly specialised diagnosis and management. And substance abuse, which may be both a response to stress (self medication) and as symptom of an underlying mental illness, presents a huge challenge to the mental health services both in and of itself as as part of what is called a dual diagnosis, requires specialised care. Eating disorders including anorexia and bulimia are conditions which also require management by highly trained specialists
Who treats mental illness?
The term “therapist” is commonly used as an umbrella term for the professionals working in the mental health field. But there are two professions most commonly associated with managing mental illness. Psychiatrists are medical doctors who have done additional and extensive specialised training in mental health and who prescribe the medication which may be required to treat the illness. And Psychologists who have academic and practical training in research or evidence-based “talking” practices or therapy which may be used as a stand-along treatment or to supplement medication.
However, depending on the circumstances, the needs of a particular patient and the resources available, other health professionals such as social workers, occupational therapist and registered counselors and even dieticians all have an important part to play in both treating mental illness and maintaining mental health.
Diagnosis and treatment:
Knowing where, when and how to get help can be overwhelming. Not least of all because of the pervasive stigma attached to admitting to any kind of mental health challenge. With access to the internet many people attempt to avoid seeking professional help and self diagnose and treat, sometimes with disastrous consequences.
Any suspicion that there is deterioration in mental health should be followed by a visit to a clinic or general practitioner as a very basic first step. A proper assessment can be made and referral to an appropriate mental health specialist.
Medication is not always required and the research indicates that the relief provided by therapy on it’s own is often sufficient to alleviate the symptoms and mediate the underlying cause. However, a competent and responsible psychologist or counselor would be able to assess the point at which medication may be required and refer to the appropriate specialist. Outcomes based research indicates that the combination of the two – therapy and medication - has the best possible outcome.
Where are we now? The intersection of several pandemics.
Even prior to the covid-19 pandemic there have been discussions about the global mental health crisis alongside the “pandemic of loneliness”. The number of single-person households has increased to up to 26 per cent of the general population in certain first world countries.
While the focus has been on the physical morbidity and mortality of the covid-19 pandemic, it has also intersected with and had a monumentally negative impact on the these mental health issues in the world population. Apart from the vulnerable – people with pre-existing mental health challenges, the socially isolated and lonely, the economically disadvantaged etc.– who have been disproportionately impacted by covid and the isolating lockdowns, other groups including all health care workers, especially the frontline and mental healthcare workers have been affected. Hospitals, clinics, private practitioners and healthcare funders have been overwhelmed by the avalanche of patients requiring mental health care. Many of whom may never have experienced mental health symptoms prior to the advent of covid.
However, the positive spin-off of the highlighting of these crises, is that many governments are allocating greater resources to funding mental healthcare services both in the private and public sector. Inroads are potentially being made to de-stigmatize mental health conditions – especially depression and anxiety which have become almost ubiquitous since the first lockdown – which will hopefully translate into better access to help and a greater willingness to acknowledge the need for assistance for mental healthcare support and assistance.
If you or your family are struggling with any of the conditions discussed above, please get help urgently from:
· Your general practitioner
· Your local clinic
· A mental healthcare specialist – a psychiatrist, psychologist or counselor
· Online support groups