In general, mental health comprises emotional, psychological and social well-being. It’s all about how we think, feel, and act in life, which profound impacts our overall well being – physical, emotional, and psychological. Taking care of mental health is vital as it affects every aspect of our life – relationships with friends and family to our performance at the workplace or college. A number of mental health conditions, including anxiety, depression, bipolar disorder, substance use disorder and more can adversely affect our mental wellbeing. Though they have wide variations in terms of their severity, they do have a negative impact on our lives.
On the obverse side, our mental health is also affected by the situations we face in life. Managing mental health during COVID-19 has become even a bigger challenge given the severe restrictions on economic and social activities globally. For professionals managing mental health during COVID-19, there has been a record rise in the number of mentally sick people. With the clubbing together of fear and anxiety about COVID-19, emotional distress resulting from illness, bereavement, unemployment, income loss, and loneliness due to social isolation — all of them interact and create or worsen mental health problems on a global scale.
Being a life coach, I get to talk to many people having such problems. Such problems contribute to the issues which people bring to a life coach. The life coach needs to work on such issues to realize the most from the consultation process. As a daughter of a severely depressed mother and a depressive patient myself, I can well understand the personal distress, dysfunction and the social costs of being part of such a household. My mother had developed severe depression when I was a young school-going kid. She kept lying in bed all day long, hardly moving out of it. Though I wasn’t alive to its real nature then, I could still make out that not all was well with her. And at a point in time, her condition worsened to the extent that she had to be administered electro-convulsive therapy to give her some relief. When later, my husband committed suicide, leaving behind two teenage daughters and me, a 60-crore debt, hundreds of court cases to fight, and a fledgling textile plant to manage, I too believed I would slip into depression, given my harrowing circumstances and my genetically inherited tendencies. But fortunately, I was able to collect the pieces of life with my determination and positive attitude to rebuild my life. So much so that I underwent training to become a qualified life coach to help others like me to improve their lives. My own story is a message to the readers of the immense value of hope, optimism and determination to come out of life’s adversities.
The Cost of Mental Illness
With the COVID-19 pandemic, the issues of mental health have come to the forefront. The pandemic has drastically changed our lives – the way we live, work and enjoy – and has brought in its wake a lot of worries, insecurity, and fears. Virtually none has been left unaffected by COVID-19 and this is why it’s doubly important to be conscious of our mental health needs and make mental wellbeing a top priority.
Unfortunately, despite the huge medical advances, the concept of mental health as part of holistic well-being doesn’t evoke the interest it deserves in the developing world. The indifference is understandable in that such countries are still struggling with the more mundane poverty, hunger, unemployment and given the situation, any talk of mental health is greeted with indifference. Mental health care will get open acceptance only if there are concerted efforts by governments, awareness campaigns and improved economic well-being.
From anxiety, depression to substance addiction to dementia to schizophrenia, almost 100 crore people i.e. about 12.5% of the global populace suffers from one or the mental disorder. Just to get a handle on the overall economic, social and psychological costs of mental illness, consider the loss of productivity happening due to two most common disorders – anxiety and depression. They both cost the global economy about US $ 10000 crore annually. Overall, poor mental health is estimated to cost the global economy US $ 25000 crore by way of poor health and loss of productivity, besides causing personal distress to crores of people.
In India, almost all those availing of mental health services pay their bills out-of-pocket. Therefore, the economic case for investment in mental health is quite strong: it has been calculated that every $ 1 invested in treatment for depression and anxiety results in a $ 4 return in terms of better health and productivity. Thus, mental health awareness is the crying need of the hour in larger social and economic interest.
The Meaning of Mental Health
From my experience, I can tell you that we need to get a strong handle on “mental health” first before we proceed. Contrary to common perception, mental health is NOT just “the absence of mental disorders or disabilities.” Rather, it is a positive state of well-being in which an individual realizes his/her abilities, can cope with normal stresses, works productively, and makes a contribution to the community. In other words, it implies overall cognitive, behavioral, and emotional well-being of a person.
What Good Mental Health Does
Better Quality of Life
As any good mental health coach will tell you, mental well-being brings better quality of life and thereby makes room for greater participation in community building e.g. volunteering, taking up local causes, fundraising etc. A mentally healthy person is also more likely to take to new hobbies, forge new acquaintances, and travel more.
Mental health coaches opine that good mental health makes challenges easier to overcome. Whereas some people take recourse to alcohol / drugs, withdrawal or fighting as coping mechanisms to manage relationship problems, financial worries, job challenges and other problems, a mentally healthy person adopts healthier coping mechanisms.
Mental health has a strongly link with self-perception as it can play a big role in building self-esteem. Self-confidence is a good indicator of a healthy mind. A mentally healthy person focuses on the good in themselves and is fired by the ambition of leading a healthy, happy life.
Good mental health enables us to have quality time, affection and support of our friends and family. Besides, since there is no emotional distress, it is easy to support the people you love and care for in their times of need. Obviously, one cannot expect an unhealthy person to support another unhealthy person!
All mental disorders, without exception, affect our productivity negatively since we are unable to work to our full potential. A mentally healthy person works more efficiently and produces good quality work.
What Causes Mental Illnesses
By now, we know that mental health affects all aspects of our life, relationships, work and overall health. Conditions like stress, depression, and anxiety can all affect mental health, thereby disrupting a person’s daily living. Many psychological disorders are rooted in biological factors as well.
Globally, mental disorders are a major cause of physical and mental distress, poor relationships, loss of productivity, absenteeism, reduced performance and suicides. Sadly, as of now, we do not much idea about the exact causes of many of these disorders. But current medical research makes it amply clear that most such problems arise from an interaction of biological, psychological, and environmental factors. One’s mental health is shaped by social and financial circumstances, biological factors, and lifestyle choices. Therefore, good mental health is contingent on keeping the delicate balance of various factors and elements of life and the world at large.
- Biological Factors
Many common mental disorders like depression, schizophrenia and bipolar disorder have been linked to abnormal functioning of circuits in the brain. These circuits interact with each other by an exchange of neurotransmitters (serotonin, dopamine etc.). For example, a biological tendency towards lesser production of feel-good hormones has been found to be among the major causes of depression, Thus, a common approach to treating such diseases is tweaking the balance of these chemicals with medications or psychotherapy to make the brain circuits work more efficiently. Besides, defects/injuries to some areas of the brain are also responsible for memory loss, loss of speech etc..
Several mental disorders run in families as they are rooted in the way the genes behave. Most such mental illnesses are caused by many genes working together rather than one or a few of them. Exactly how they interact with the environment is quite unique for every person. That’s why making targeted drugs for these diseases is often a big challenge for researchers. Revolutionizing mental health care would require more of such genome sequencing so that researchers can develop more targeted drugs for such disorders.
This phenomenon can also explain why some people carrying genes for a certain mental illness don’t always develop it as it is a result of multiple genes interacting among themselves and other triggers like stress, abuse, or trauma. It’s quite akin to the way diabetes develops i.e. one may be born with the genes for it, but whether one actually develops diabetes later is a function of environmental factors too like body weight, physical exercise, diet, stress etc.
Some infections are linked to brain damage and mental illnesses or their deterioration. For example, the pediatric autoimmune neuropsychiatric disorder (PANDAS) attributed to Streptococcus bacteria leads to an obsessive-compulsive disorder among children.
- Brain defects/injuries
Certain defects/ injuries in some areas of the brain can result in mental illnesses e.g. damage to the hippocampus, which results in amnesia or loss of memory. Brain defects/ injuries are also counted among the causes of depression.
- Pre-natal damage
Traumas occurring at the time of delivery like the shortage of oxygen can disrupt and arrest early brain development in a fetus, which may, trigger certain conditions like autism.
- Substance abuse
Long-term substance abuse is linked to problems like anxiety, depression, and paranoia.
- Other factors
- Health problems
Health problems like cancer, diabetes, and chronic pain can lead to stress, depression, and anxiety. Likewise, poor nutrition and exposure to toxins like mercury (Minamata disease) and lead (poor intellectual functioning) in early age may cause mental illnesses.
- Psychological Factors
- Emotional, physical, sexual abuse in childhood or teenage
- Loss of a parent / primary caretaker
- Emotional neglect
- Poor ability to relate to others
- Environmental Factors
- A loved one’s death or parents’ divorce / separation
- Broken families, dysfunctional family life
- Inadequacy, poor self-esteem, anxiety, anger, or loneliness
- Change of job / school
- Socio-cultural expectations e.g. associating beauty with a lean body can be a contributing factor in triggering eating disorders e.g. bulimia, anorexia nervosa etc.
- Alcohol / drug/ substance abuse by self/ parents
Common Symptoms of Mental Illness
There are no physical test/scans, which can reliably detect a mental illness. However, there are some common symptoms that we can look for as possible signs of a mental disorder:
- Social withdrawal from family, friends and colleagues
- Avoidance of favourite activities/ hobbies
- Excessive/ under-sleeping
- Over/under- eating
- Ideas of hopelessness
- Poor energy levels
- Use of alcohol, nicotine
- Having negative emotions, feelings of worthlessness
- Problems performing daily tasks
- Suicidal tendencies
- Having delusions
- Excessive Confusion, anger, guilt or worry
- Frequent mood swings
- Fights with family, friends
- “Hearing” voices with no identifiable source
Most Common Mental Disorders
The most common mental illness types are:
- Anxiety disorders
- Mood disorders
- Schizophrenia and allied disorders
- Anxiety disorders
The most common mental illnesses. Anxiety-related disorders involve disproportionate worrying which tends to disrupt everyday life. Fear or anxiety in the presence of certain objects or situations is a common experience. Patients with such problems avoid exposure to situations, which trigger anxiety.
Generalized Anxiety Disorder (GAD)
Patients suffering from Generalized Anxiety Disorder (GAD) experience excessive anxiety in everyday life situations like doing routine chores or meeting people. They can also experience other symptoms like restlessness, fatigue, muscular tension and disruptions in sleep.
Panic disorder patients suffer from regular panic attacks involving a feeling of sudden terror or an imminent disaster and death.
A phobia is an irrational, excessive fear of certain objects, scenarios, or animals e.g. a fear of spiders or heights.
A k a social anxiety, social phobia is the fear of being subject to the others’ judgment. As a result, such people tend to reduce their social exposure.
A fear of open places like a marketplace.
Obsessive-compulsive disorder (OCD)
People having Obsessive-compulsive disorder (OCD) suffer from obsessions and compulsions i.e. persistent, stressful thoughts and an urge to perform repetitive acts like hand washing or locking a door repeatedly, bathing again and again. Unless they do so, they experience a feeling of anxiety and unrest and that’s how, it tends to become a habitual action, causing significant disruption in daily life.
Post-Traumatic Stress Disorder (PTSD)
A Post-Traumatic Stress Disorder (PTSD) results from someone experiencing a very stressful or traumatic event, for example, riots, genocide, fire, earthquake, floods, war, ethnic conflict, acts of terrorism etc..
A k a affective disorders or depressive disorders. Patients with such problems have significant mood changes, generally involving either mania – a state of high energy and elation, or a down-in-the-dumps depression. A few examples of mood disorders are:
Consistently low mood and loss of interest in favourite activities and prolonged sadness.
Bipolar disorder patients experience unusual changes in their mood, energy and activity level. The ‘highs’ bring a manic phase, while the depressive periods tends to bring a low mood.
Seasonal Affective Disorder (SAD)
A reduced amount of daylight triggers it during the fall, winter, and early spring months. It’s quite common among people living in countries located far away from the equator.
Schizophrenia and related disorders
Mental health professionals are still unsure of whether schizophrenia is a single disorder or a group of related disorders. Typically, schizophrenia appears between 16 and 30 years, with the affected person exhibiting significant thought disruptions. The individual experiences a fragmentation of thoughts, with there being no filter to check them and finds it hard to process information efficiently.
Schizophrenia has been seen to be usually marked by delusions, thought disruptions, and hallucinations, social withdrawal, lack of motivation and a flat (indifferent) mood.
Various methods are available for managing mental health problems. Of course, the treatment plan in each case has to be tailored to each individual and what works for one may not work for the other one. Most often, a combination of various proves to be most effective in terms of results.
Types of Treatment
Talk therapy takes a psychological approach to treating mental illnesses. Some such therapies are the cognitive behaviour therapy, exposure therapy, and dialectical behavior therapy. Typically, psychologists and psychotherapists employ psychotherapy to relieve the symptoms of patients suffering from mental disorders. Psychotherapy is based on the concept of helping people understand the root causes of their problems and enabling them to develop healthy thought patterns with therapy.
Most often, people suffering from anxiety or depression benefit from relaxation techniques like progressive muscular relaxation, deep breathing, meditation, and mindfulness.
One of the major factors behind the current revolution in mental health care has been the emergence of medicines.
A psychiatrist may, in many cases, prescribe tranquilizers, antidepressants, antipsychotics and other drugs to relieve the symptoms of such diseases. Although these medicines cannot cure mental disorders, they can relieve the symptoms and help the patients function effectively in daily life.
Some medicines work by boosting the bodily absorption of happy hormones like serotonin from the brain. On the other hand, others boost the overall levels of these chemicals or prevent their degradation or destruction.
A major factor contributing in the overall healing process is the willingness and readiness of the patient to change their lifestyle to facilitate wellness. Such changes may involve modification in the patterns of physical activity, sleeping habits, socialization, meditation, relaxation etc.
Risk Factors in Poor Mental Health
Mental health, an important part of overall well-being, determines how effectively we can work psychologically, emotionally, and socially to lead a productive and happy life, which enables us to contribute meaningfully to society.
One just needs to have a look at the millions of broken homes, poor productivity, loss of man-hours, absenteeism, personal distress, rising divorces and suicides to understand how much havoc bad mental health can wreak. Thus, in the light of the role it plays in all aspects of our life, it’s vitally important to improve our psychological wellness using appropriate measures.
However, various circumstances may affect our ability to handle the curveballs of life. Some of them are
A child witness to physical assault, sexual violence, emotional abuse or neglect during early years can develop severe mental and emotional distress in later life. In fact, loving relationships and good mental health in early years are the touching stones of happy, well-adjusted personalities. Such early abuse can worsen the risk of getting depression, anxiety, post-traumatic stress disorder and personality problems in adulthood. Such abused children may eventually develop problems related to substance abuse, besides others.
Our environment is a contributor to our mental well-being as adverse circumstances can affect our psychological wellness. For instance, facing extreme weather conditions or air pollution or natural disasters can increase the likelihood of developing post-traumatic stress disorder (PTSD).
Our biological makeup also affects our well-being. As discussed earlier, many such disorders run in families and may be transmitted to the next generation e.g. autism, attention deficit hyperactivity disorder (ADHD), bipolar disorder, depression, and schizophrenia.
Our lifestyle also affects our mental health e.g. smoking, poor diet, alcoholism and substance use, and risky sexual behavior may cause psychological damage by giving rise to or worsening various psychological problems.
Looking after Your Mental Well-Being
Various campaigns launched on mental health awareness emphasize the value of preventive steps in keeping good mental health. Maintaining your mental health is vital to getting the most out of life. Here are my Top Ten Tips, which won’t cost you much money or time.
Embrace yourself as you are
Accepting and loving yourself i.e. self-acceptance is the key to good mental health. You can’t be someone else. Remember, no one is perfect and trying to improve oneself is a sensible thing to do. But alongside, learn to love yourself, with problems and all. If you can’t love yourself, no one else will!
Talk to friends and family about your feelings, which can help you stay in good mental health and deal with tough times. You may not get a solution but often, just talking about a problem makes you feel immensely better.
Eat, sleep well
The brain needs many nutrients to keep itself in good shape and work the way other organs do. Taking a nutritious, balanced diet is crucial for physical and mental health. Likewise, have enough, quality sleep to keep good mental health.
- Get going
Regular physical exercise boosts your self-esteem and helps you focus, sleep, and feel better by releasing feel-good chemicals. It keeps the brain and other vital organs in good form and improves mental health.
- Drink sensibly
Having a few drinks to alter one’s mood or deal with a fear or loneliness is commonplace but it has temporary effects. As the effects wear off, you begin to feel worse due to the way alcohol works on the brain and the body. Search for better ways to deal with such feelings and try to develop more effective coping strategies.
- Keep in touch
Though there is nothing to beat catching up with someone face to face, that may not be always possible. So, give a call, drop a note, or chat online instead to keep the communication open. It’s better for your mental health!
Admit it- you aren’t a superhuman nor is anyone else. It’s normal to feel tired or overwhelmed sometimes when things don’t work as per expectations. Seek help from family or friends, who may offer practical help or at least patient listening. Having a support network in the family and close friends can be a greatly aid in the recovery from a mental illness.
- Take a break
Take a break from work. A change of scene or place can work wonders for mental health. It may be a 5-minute pause from your chores, a 30-minute lunch break or a weekend getaway. But it can also be a longer break i.e. a vacation. In most cases, it is enough to de-stress you.
- Enjoy hobbies
Try to do what you love to do. Have some fun and enjoy yourself to beat stress. Do something you’re good at e.g. music, painting, cooking, stitching, carpentry etc. to feel good about yourself and boost your self-esteem.
Try to change your thought processes to make them more realistic and work on personal relationships contributing to poor mental health.