Basic Information About Mental Health for Indians

Mental Health Definition

Mental health is defined by the World Health Organization as 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 fully; and 
  • Is able to make a contribution to his or her community. 

Healthy Mind

A healthy person has a healthy mind and is able to: 

  • Think clearly; 
  • Solve problems in life; 
  • Work productively; 
  • Enjoy good relationship with other people; 
  • Feel spiritually at ease; and 
  • Make a contribution to the community. 

Importance of Mental Health

Mental health is vital for individuals, families and communities, and is more than just the absence of mental disorder. To be a healthy person we need to have both mental and physical health, and these are related to each other. Mental health provides individuals with the energy for active living, achieving goals and interacting with people in a fair and respectful way.

Mental Disorder

What is Mental Disorder

Mental disorders can affect both men and women, and can affect people from different age groups including the young and the elderly. 

Mental disorders are common – about one in five adults experience a mental disorder at some stage in their life. 

Most people suffering from a mental disorder look the same as everyone else. It’s not always possible to tell that someone is experiencing a mental disorder just by looking at the person. 

Mental disorder include a variety of different conditions ranging from more common problems such as excessive fear and worry (anxiety) or usually sad mood (depression), to more severe behavioral problems that can involve suspiciousness, violence, agitation and other unusual behaviors (psychosis). 

Mental Disorers And Other Conditions

Mental disorders are more than just the experience of stress. Although stressful life events often contribute to the development of mental disorders, stress itself is not considered to be a mental disorder. 

While seizures, epilepsy, and intellectual disability (Mental retardation) are all conditions that affect the brain, these are not actually classified as mental disorders. 

A mental disorder can be a brief episode or it may be a long-tearm persistent condition. 

When a family member has a mental disorder, that family is often socially and economically disadvantaged. 

Communities often have many false beliefs about mental disorders, including what they are, what causes them, and how to respond to a person experiencing a mental disorder. 

Consequently, many people with mental disorders experience stigma and discrimination that resut in:

  • Delays in seeking appropriate help for the problem 
  • Distress for the affected person and their family 
  • On going social and economic exclusion for the affected person and their family 

Reality With Mental Disorders

There are effective and affordable treatments for most mental disorders. 

Appropriate treatment can help improve the quality of life for most people experiencing mental disorders and their families.

Factors Affecting Mental Health

Most mental disorders are caused by a combination of factors including:

  • stressful life events 
  • biological factors 
  • individual factors e.g. poor self-esteem, negative thinking 
  • adverse life experiences during childhood e.g. abuse, neglect, death of parents or other traumatic experiences. 

Some people may be more vulnerable to mental disorders than others but may not develop an illness until they are exposed to stressful life events. 

Contribution of Individual Factors In Mental Disorders

Biological factors can include genetics, brain injury, and chemical imbalance in the brain. 

Sometimes people experiencing chronic medical problems such as heart, kidney and liver failure, and diabetes may develop mental health problems such as depression, as living with a chronic illness can be  very stressful. 

Stressful life events can contribute to the development of mental disorders e.g. family conflicts, unemployment, death of a loved one, money problems, infertility and violence. A lot of stress may also contribute to an imbalance of chemicals in the brain. 

Difficulties in childhood such as sexual or physical violence, emotional neglect, or early death of parent can sometimes lead to a mental disorder later in life. 

Unhealthy behaviors such as drug and alcohol abuse can lead to the development of a mental disorder as well as being the result of a mental disorder.

Poverty and Mental Disorders

Poverty can place a person at risk of mental disorders because of the stresses associated with low levels of education, poor housing and low income. Mental disorders are also more difficult to cope with in condition of poverty.

Symptoms of Mental Disorders

You can not always tell just by looking at a person whether or not they have a mental disorder. The symptoms of mental disorders can be physical or psychological.

Physical symptoms

Are those that involve the physical functioning of the body e.g. aches and pains, weakness, tiredness, sleep disturbance, and increased or decreased appetite. 

Psychological symptoms

Are those that involve the mental functioning of the body. 

  • Feeling symptoms– are those that involve our emotions or feelings e.g. sadness, fear and worry.
  • Thinking symptoms – are those that affect the way a person thinks e.g. problems in understanding, concentrating, memory, and judgment (decision making). Thinking about ending your life (suicide) or thinking that someone else is going to harm you are examples of thinking symptoms.
  • Behavioral symptoms– are those that affect the way people act or what they do. Behaviors are what we actually see others doing e.g. being aggressive, increased or decreased talking, withdrawal from family and friends, self-harm e.g. cutting the skin, and attempting suicide. 
  • Imagining symptoms – are those that involve the person perceiving or experiencing things that are not actually real (although they seem very real to the person experiencing them). For example, the person may be hearing voices or seeing things that are not actually present. 

Some of the symptoms associated with mental disorders, such as feeling of sadness and worrying a lot, affect everybody from time to time. These symptoms only become a mental disorder when they are excessive and prevent the person from leading a normal life. Other symptoms such as hearing voices are nearly always a symptoms of mental disorder.

The different types of symptoms are closely related to each other for example, hearing voices saying that others are going to harm you can lead to aggression due to fear. Experiencing the symptoms of mental disorders does not mean the individual is weak or lazy, possessed by supernatural forces, or losing his/her mind.

Types of Mental Disorders

  • Common Mental Disorders: which include symptoms that we all experience from time to time, for example, feeling of fear, worry or sadness. 
  • Severe Mental Disorders: which are often difficult for the general community to understand, for example, hearing voices or expressing strange or unusual beliefs. 

Mental Health in India

People with common mental disorders usually experience physical, emotional, thinking and behavior symptoms, but not imaging symptoms. Some people may get treatment for physical problems associated with there illness (like poor sleep or appetite) but neglect the cause of these physical problems such as underlying depression or anxiety. People with common mental disorders are often not treated because it is more difficult for family members and health workers to recognize that they are suffering from a mental disorder. 

The main common mental disorders are:

  1. Unusually sad mood that does not go away – this is called depression 
  2. Excessive fear, nervousness and worry – this is called anxiety
  3. Excessive use of alcohol or other substances – this is sometimes called substance abuse

(1) Usually sad mood that does not go away (depression) is a mental disorder when the symptoms last for at least two weeks and they affect the person’s ability to carry out his/her work or have satisfying personal relationships. Everyone can feel sad when bad things happen, occasional sadness is not depression. The symptoms of depression include unusually sad mood, and all or some of the following:  

  • loss of interest and enjoyment in activities. 
  • Tiredness and lack of energy 
  • loss of self confidence 
  • feeling of hopelessness and helplessness 
  • wishing they were dead 
  • difficulties in concentrating 
  • sleeping problems 
  • loss of interest in food and loss of weight 
  • experiencing a range of physical complaints that have no apparent medical cause e.g. weakness, aches and pains 

Not every person who is depressed has all these symptoms, and the severity of depression is different for different people. Events that contribute to the development of an unusually sad mood include:  

  • Distressing events that the person can not do anything to control like the death of a loved one or the breakdown of a relationship. 
  • Stressful events such as ongoing family conflict. 
  • Chronic medical conditions like diabetes or stroke. 
  • Sometimes women can become depressed after they give birth. 

(2) Excessive fear, nervousness and worry (anxiety) is a mental disorder that is more severe and longer lasting than everyday worries. It interferes with a person’s ability to carry out his/her work or having satisfying personal relationships. Symptoms include unrealistic or excessive fear and worry, and one all of the following: 

  • Irritability 
  • Worrying about things a lot 
  • Feeling that something terrible is gong to happen 
  • Feeling scared (butterflies in the stomach) 
  • Avoiding certain situations e.g. social events 
  • Disturbed sleep 
  • Muscle tension 
  • Restlessness 
  • Physical symptoms like rapid heart beat, dizziness and trembling 

There are many types of anxiety disorders ranging from mild uneasiness to panic attacks:  

  • Generalized Anxiety Disorder – when the person worries excessively about things, and experiences multiple physical and psychological symptoms that occur nearly every day for at least six months. 
  • Panic Disorder – when the person experiences a sudden and severe anxiety attack. They feel intense fear or terror that is inappropriate for the setting. The symptoms are often physical and include dizziness, shaking, sweating, a feeling of choking, rapid breathing, and rapid heart beat.   
  • Phobias – when a person feels very scared in particular situations e.g. when in closed spaces, crowded places like markets, or near lizards etc. The person generally avoids the fearful situation. 
  • Obsessive-Compulsive Disorder (OCD) – a condition where the person has repeated thoughts (obsessions) or does things repeatedly (compulsions) and is unable to stop the behavior or the thoughts e.g. hand washing to the point where the skin is damaged. 

(3) Excessive use of alcohol and other drugs (substance abuse):  This is one of the most common mental disorders. Using alcohol or drugs does not mean that a person has a mental disorder, but it does become a disorder when the alcohol or drug use harms the person’s physical, mental or social health. Excessive use can result in:

  • Dependence on alcohol or drugs which makes it difficult for people to stop using the alcohol or drugs. 
  • Problems at work, school or home or legal problems due to use of alcohol or drugs. 
  • Damage to physical or mental health secondary to the use of alcohol or drugs. 

  People with alcohol and drug problems often have other underlying mental health problems and use alcohol or drugs as a type of self medication for feelings of excessive worry or sadness. 

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