Safeguarding our mental health

Dr Anjali Mehta

Defining what really constitutes good mental health is difficult although the meaning is instinctively understood  . It is a state of mind that enables an individual to function efficiently in society. Understanding the complexities of the mind needs a heightened degree of awareness. Mental illness that does not fit into a well-recognised syndrome often goes undiagnosed. Sometimes, the sufferer does not recognise his own affliction though it may be apparent to others.

In the past, mental illnesses were not well documented. People recognised “eccentricities’ in their friends and relatives but were fairly accepting of these and the “eccentric” party usually found at least some support within the ranks of the family. Actually a really thin line separates normal from what lies just beyond it. For example, a person who washes his hands three times daily is deemed hygeinic, but handwashing twenty times daily would possibly come in the realm of obsessive compulsive. The grey area is with handwashing 6-8 times a day. In such a case, must we start to worry that something may be brewing in the brain? Caregivers are often  in a dilemma about how much to let the natural personality develop and what and how much to curb in the child’s behaviour.Many of us are on one side or the other of the active child versus Attention Deficit Hyperactive Disorder debate. There are no easy answers.

Why are we more vulnerable than ever to mental problems ?

The faster pace of life nowadays gives us less time to heal naturally from traumatic events . With families becoming increasingly nuclear and people less tolerant, social isolation makes people more prone to mental illness. People spend an increasing amount of time on their computers but it can’t compare with the warmth of a direct human interaction . The life span of humans has increased and there is a larger population of elderly people. Also, diseases like cancer and AIDS  took the lives of their patients with great impunity earlier but now there are many survivors. However, chronic illnesses cause significant morbidity  and this leads to greater prevalence of sickness related depression. In today’s strife torn world, many children are growing up seeing war and bloodshed all around. This plays havoc with their mental health in the years to come. Also, soldiers who are increasingly being sent on peace keeping missions around the world are prone to post- traumatic stress disorders.

We are susceptible to mental stress at almost every stage of our lives. Right since birth. Psychiatrists have ascertained that  emotional coping mechanisms are formed in the first few years of life. In the school years, shy , affable children are the ones who are the most easly bullied and can be left with long lasting emotional scars. Often the bully himself is riddled with deep insecurities which makes him/her behave thus. Teenage has its quota of confusion, succumbing to peer pressure and experimenting with drugs and alcohol. As adults, the three big areas which may prove challenging are marriage, work and chronic illness. Old age brings loneliness and vulnerability .

Why is mental disease more difficult to diagnose and treat

A mild mental health problem is rather difficult to pick up . It is not very clear where “mood” or “personality” ends and where mental health disorders begin, even for a trained psychologist. A physical disease causes a lump, pain, discoloration or other visible and often quantifiable symptoms. How does one describe a heartache ? And how would a layperson know when natural sorrow has ended and given way to depression? These illnesses therefore simmer under the surface for a longer period than physical ones.

Making a diagnosis is not easy for a psychiatrist . The patient may not want to reveal everything in their history if they feel ashamed of something or they want to impress a psychologist they have developed a rapport with . From another perspective , for a psychologist to deal with confused, irrational ,slow patients usually requires good listening skills and the fortitude of a saint. Drawing out information on the status of the mind is clearly not an easy task.

Assuming the diagnosis is made; cures are not easy. Individual sessions with the doctor are lenghthy and the course of therapy spills into weeks and months, requiring large investments of time and not many patients or even doctors possess the staying power . Cures are not easily attainable : we all know that removing a lump surgically is far easier than changing the way a person thinks.The results are not clearly identfiable though improvement can be ascertained. Relapses occur often.

Mental health, including hospitalisation is not covered by insurance and the cost has to be borne by the patient in totality.

The drugs used in psychiatry often have side effects that may impair a person’s ability to function as they can lead to drowsiness or a dullness of affect.  A patient may have to take these for long periods.

How we can safeguard our mental health

At an individual level

Being proactive :  If we have troublesome physical symptoms such as headache or toothache, we are likely to promptly consult a doctor, but how many of us would consult a psychiatrist that routinely ? Acknowledging that all is not well your mind is fraught with unpleasant social implications . We should learn to pay more attention to our minds also. In fact, a mental health check up should form an integral part of the routine annual health check up offered by hospitals .

Being alert :  A high index of suspicion should be maintained for changes in behaviour or uncontrollable behaviour. For example , sudden onset of mood swings in a person may be attributed by the family to his/her alcohol consumption or lack of professional success whereas it may be a result of a hormonal disorder or a  brain tumour. Likewise, a person’s uncontrolled eating may be attributed to his lack of will-power whereas it may be a hypothalamic disorder.

Mental exercises/meditation:   A sound mind is our most prized possesion, to be guarded well. The buddhists are known to indulge in mental exercises to make their minds strong. Yoga and meditation are effective and healthy ways to lessen stress. We must build in a mental health routine into our daily life just as we build in physical exercise.

At a group level

Mind lifeguards : School consellors or work counsellors, being trained people can pick up subtle mental disease in the group they are in charge of and provide good advice and treatment. They also build in general stress releiving games and activities into the daily routine as a preventive health measure.

Promoting mental health and peace at a social level.

Spiritual groups and other initiatives.  Concious promoting of mental peace is being done by several organisations including  Art of living , Brahmakumaris, Buddhist monks and such like . In a novel development, the Indian army decided to train its army priests to be counsellors .The priests could recognise early signs of depression in those who they came across during daily prayers and also counsel the concerned soldier or officer.

The arts and culture : We know that even the simplest minds do not fail to appreciate the beauty of music and music therapy is much in vogue for several mental disorders. Movies can be used to create awareness amongst people about mental disease and induce more sensitivity in people. Many acclaimed movies on various mental disorders have made a big impact on audiences. A few such are: “A Beautiful Mind” , “ Taare Zameen Par” “ The Prince of Tides” and on a lighter note, the incredibly funny “Analyse This”

To summarise, as far as mental health is concerned,even if we understand it only intuitively we must guard it zealously !