Dr. T.R.John, Consultant in Psychiatry, Aster Medcity.
Posted on Wednesday, February 15, 2017
Good mental health is the most important requirement for living life to the fullest and having an optimal life experience. Good mental health is not merely absence of mental illness.
The signs of good mental health are
From the above it is obvious that good mental health is essential for all human endeavoursespecially in establishing and maintaining healthy relationships, making good choices in life, being successful in work, handle the ups and downs of life and maintaining physical health and well being. Job stress occurs when the job requirements do not match the abilities, resources or interests of the individual. On the immediate level job stress increases work related accidents and injuries. There’s reduction in productivity and output, increase in error rates, poor decision making and poor planning and control of work, longer working hours with diminishing productivity, poor time management etc. The individuals show increase in overall sickness absence, depression, constant anxiety. Motivation reduces and commitment to work decreases ultimately ending up in burnout. There will be poor relationships with clients, increasing conflicts with colleagues and increasing disciplinary problems. Various physical illnesses like high BP, heart disease, back ache, recurrent infections, and headaches can occur or worsen. In fact any illness and recovery from it can be adversely affected by stress.
Having a mental illness is like having any other illness like say Diabetes Mellitus. While diet Counseling has a role in management of Diabetes, it should not be the only treatment in serious diabetes. Major psychiatric illnesses like schizophrenia, mania, depressive disorders, anxiety disorders and drug abuse should be referred to a psychiatrist. Counseling should be reserved for what is called problems of living- relationship disorders, role transitional difficulties, role disputes etc. it can also be used as a supportive therapy along with medication. No endocrinologist will treat diabetes without diet control /counseling. Mentally ill persons need to be treated with respect and dignity. They are not different. Treat them as far as possible as you treat any one in similar situation with reasonable consideration for any specific deficit he has shown. After all when interacting with a man whose leg is broken you don’t expect him to walk with you. Over protection and over criticism are equally bad. Don’t go by the stereotype. Don’t be scared of violence. Brute majority of violence in this world is done by sane men.
Mental illnesses are considered to be much more common in children than we usually think it to be. The commonest mental illnesses in children are anxiety diseases, depression, eating disorders and attention deficit hyperactivity disorder. Common signs of mental diseases in children are change in eating and sleeping habits, school refusal/ reluctance, excessive vague physical complaints, increased crying or irritability, decreasing academic performance, increased secretiveness, excessive need for money, social withdrawal, loss of interest in friends or activities that they used to enjoy, increased worrying and increased defiance and disobedience. Age of onset varies for different mental illness and sex. Over all it is estimated that age of onset for more than half of mental illnesses are in adolescence. However the commonest time they come for treatment is between 20-50 years. That is the time required for most of the people to understand that some of their mental experiences are either not present in others or are way far more than in an average person. That’s also the time when the relatives run out of benign ‘logical’ explanations for alterations in the patient’s behavior .
WHO estimates that that out of the ten top causes of disability producing illnesses five are mental illnesses. By 2020 depression will top that list. The causes are innumerable and will vary depending on whom you are reading. Food technologists will attribute it to processed food and genetic ally engineered food and so on. The main causes as per me are the increasingurbanization that has resulted in breakup of real world relationships. This has been aggravated by rise of virtual relationships that only leaves you a sense of emptiness. Second is the loss of a core guiding philosophy in life you may call it spirituality or whatever, an anchor when the sea of life gets rough and thirdly the skillful encouragement of materialistic possessions and the needless wants it creates. Nothing is enough because there is something more desirable available. These three can be considered as the three major driving forces for an increasing mental distress in this world. This pushes vulnerable people into frank mental diseases, just like eating fried food regularly will cause heart attack in a vulnerable man.
Social Media are becoming Mental Health villains!. From a communicating tool it was originally envisaged as, social media has grown into virtual lives and virtual world, something like an avatar in movie avatar. Hence it is invariable that you will experience depression when you return to reality. Many studies including those done by Dr Era and colleagues from Mumbai has shown increasing depression and anxiety as internet use especially social media use increases. It causes drain in productivity, distracts us from real life activities, makes us lose our social skills leading to social phobias, and as everyone puts up their best in the social media makes us feel inadequate and inferior, makes us physically inactive which too interferes with mental health and renders us incapable of being alone or reflective always waiting for the next ping of the new message. Social media will be the next big trigger for mental illnesses. We are seeing infidelity ideas and paranoid illnesses based on whatsapp and facebook . Mental illnesses rarely kills!! The notable exception being suicide. What it kills is relationship. One of the early signs of mental illness is strain in relations. Work place and family relations being the most intimate and longest they are the first to feel the strain of illness.
There is no life problem that can invariably result in mental illness. Appearance of a mental illness is based on interaction between genetic vulnerability, your child hood experiences, your resilience, supportive psychosocial factors and finally the problem itself. That is why of two children growing up in the same deprived circumstances one turns out to be a criminal and other a police officer. That is why being fired from job is considered as an opportunity for growth by one person and end of the world by the second.
There are many tips for good Mental Health. In fact everyone has suggestions that they sincerely believe in. Mine are as follows
a. Take control of our own life. We have to face our problems and only we can solve it , of course with some help from others
b. Keep a positive attitude. Think you will win, and then you will. There are others to say no to you. Don’t say it yourself
c. Have a close friend with whom you can open up better. Not a social media virtual friend definitely. Ideally it should be same sex friend as it will reduce later complications
d. Identify what relaxes you- music, aroma, pictures, and meditation. Practice it regularly. Use it when you feel tense
e. Eat nutritious, balanced food. Dieting is not eating food
f. Love yourself. Understand that human being is a basket. He has both good andbad qualities. Don’t grieve for what you don’t have. Encourage the good ones while trying to control the bad ones. Understand that you cannot remove the bad qualities totally
g. Trust yourself. Once you develop basic skills of introspection you will be able to tune into your intuitions. Listen to what it says. But don’t fool yourself
h. Exercise regularly. The one who walks 3.5 kms in 30 minutes at least five days a week is unlikely to require a psychiatrist.
i.Take breaks. When going gets tough. Take a break, relax, revaluate the options and then start going again
j. Ask for help. We are scared to ask for help. But the truth is that an average man is willing to help. Asking for help includes seeking help from a psychiatrist.
Kerala’s mind set is changing. The easy money from expatriates and now the skyrocketing land values has put money into the hands of an average malayali. Hence easy money has become the norm and the hard earned money is looked at askance. The rise of service industry and unnecessary trade unionism are just but two effects of it. Believing in equality he refuses to do any job that the other man will not do and one who does is ridiculed. Catching up with neighbor drives them into debt and to solve that into the ultimate holy grail of easy money the lottery or other scams. When reality becomes too difficult to endure he tries to escape into alcohol. This increases failure and finally causes a psychiatric breakdown. For all his education, there is still reluctance to report to a psychiatrist even for clear- cut mental illness, destroying self and loved ones in the process. First signs of mental illness are different for different illnesses and for different people. Some of the general signs are
a. Change in behavior- especially if it is very different from usual behavior
b. Disturbed sleep
c. Change in appetite
d. Social withdrawal
e. Increased anxiety, fearfulness
f. Increased emotional sensitivity, especially crying
g. Easy Irritability and angry outbursts
h. Negative outlook toward life, pessimism
i. In children reappearance of bed wetting, increasing clinging behavior, schoolrefusal, drop in academic performance etc.
If you think that you or someone dear to you are suffering Illhealth, please contact a psychiatrist at the earliest.
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