Understanding Mental Health

What is mental health?

Mental health refers to our emotional and psychological wellbeing. This includes our emotions, thoughts and behaviour. Imagine if you were a car and you need fuel to run…. mental health is like your fuel. If our mental health is satisfactory or optimum, life and ongoing stresses seems relatively manageable.

Our mental health is influenced or affected by a variety of factors. Life events and genetics are the obvious ones, but are not the only influencers. Our predisposition, such as how we have internalized childhood experiences, poor self-esteem or concept of self, and/or a negative internal thought processes can increase the likelihood of having poor mental health.

If an individual has such a predisposition and encounters stressful life events or any loss, they are more prone to coping negatively and developing mental illness.

Mental health issues, however, exist along a continuum and can range from mild and occasional distress, to severe and debilitating conditions. You do not need to have a mental illness or disorder to have poor mental health. If your mental health causes difficulties in your day to day functioning, work responsibilities, interpersonal relations or affects your state of mind, you can seek professional help. You don’t need to have depression to go to therapy. You don’t need to have panic attacks to seek help for the low levels of anxiety you are experiencing. If there is anything that interferes or prevents you from being your best self, YOU CAN SEEK HELP.

How common or pervasive are mental health problems?

How common or pervasive are mental health problems?

• Hundreds of millions of people worldwide are affected by mental, behavioural, neurological and substance use disorders. For example, estimates made by WHO in 2002 showed that 154 million people globally suffer from depression

• One in four patients visiting a health service has at least one mental, neurological or behavioural disorder but most of these disorders are neither diagnosed nor treated.

• Mental illnesses affect and are affected by chronic conditions such as cancer, heart and cardiovascular diseases, diabetes and HIV/AIDS. Untreated, they bring about unhealthy behaviour, non-compliance with prescribed medical regimens, diminished immune functioning, and poor prognosis

• Worldwide about 877,000 people die by suicide every year. Furthermore, for each suicide, there are more than 20 suicide attempts. Suicides and suicide attempts have a ripple effect that impacts on families, friends, colleagues, communities and societies

• Barriers to effective treatment of mental illness include lack of recognition of the seriousness of mental illness and lack of understanding about the benefits of services. Policy makers, insurance companies, health and labour policies, and the public at large – all discriminate between physical and mental problems.

• Most middle and low-income countries devote less than 1% of their health expenditure to mental health. Consequently, mental health policies, legislation, community care facilities, and treatments for people with mental illness are not given the priority they deserve.

What is therapy? How is it different from talking to a friend? What can I expect in a therapy session?

Therapy (also called psychotherapy or talk therapy or counselling) is a form of treatment aimed at relieving emotional distress and mental health problems. This treatment is provided by qualified professionals (psychologists and counsellors) and is typically conducted over meetings with the ‘clients’ or person facing distress.

Therapy is different from talking about our feeling to a friend, or family member or someone supportive. While this is helpful (and having someone listen to us is a valuable support), it only provides short term relief. A therapist or a counsellor is trained to help us identify the root causes of our distress and use therapeutic tools to address them. They are equipped with the ability to facilitate healing that allows an individual to move past their suffering. While the process primarily involves talking, the therapist using a theoretical framework and establishes a therapeutic relationship which becomes the vessel for change.

While there are different approaches to therapy, the therapist in a session will actively listen, help you explore using open ended questions, make observations showing existing patterns causing difficulties, and support you in changing these by equipping you with tools and strategies to heal. This process brings the unconscious to the conscious mind.

Often there is unconscious resistance here, because these patterns may be deep rooted from childhood, or have built defenses around them. This is why therapy is a slow process. By staying with all these discussions, and reflecting on them you are working towards ‘rewiring’ your brain.

Our human mind isn’t like a fan switch - switch on and the fan moves. Similarly, telling someone to ‘not think negatively’ or ‘stop feeling sad’ doesn’t make their problems go away. Therapy takes time. The shifts in our mind are gradual. And the healing is long term.

What is psychiatric medication?

Psychiatric medication is taken to exert an effect on the chemical makeup of the brain and nervous system. At times when mental health difficulties are severe, therapy alone may not be sufficient. In cases of depression, anxiety and other mood disorders, there are low serotonin and norepinephrine levels in the brain. These low levels contribute toward the low mood or anxiety experienced. Hence, medicines are required to increase these levels and stabilize mood. Just like when our Vitamin D levels are low and we need supplements, our brain needs the same support.

The four main categories of medications used to treat mental health disorders are antidepressants, anti-anxiety medications, antipsychotic medications, and mood-stabilizing medications. Medication can be prescribed by a licensed psychiatrist (not a psychologist or a counsellor). The psychiatrist will recommend medications when they feel your body requires them. Many people have apprehensions about taking medications for mental health concerns. One of the biggest fears is that they will become addicted to the medication. If you are prescribed medication, discuss these concerns with your psychiatrist. The psychiatrist will usually help you with dosage control and monitoring.