<%-- Page Title--%> Health <%-- End Page Title--%>

<%-- Volume Number --%> Vol 1 Num 114 <%-- End Volume Number --%>

July 18, 2003

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What is Mental Illness all about?

Dr. Sanjay Chugh


Most people believe that mental disorders are rare and “happen to someone else." In fact, mental disorders are extremely common and widespread. All societies have struggled with the impact of mental illness, and rejection and avoidance of mentally disabled people are common. Public attitudes to mental health problems surface in many different ways. They are apparent in the language people use to describe mental illness and in their reactions to those experiencing mental distress. For many, mental illness is a taboo subject. This can prevent people from seeking help when faced with a mental health problem. Negative attitudes are evident in the care, secrecy and discretion people would exercise to visit a psychiatrist.

One of the commonest reflections of this diffidence and ignorance is the use of the term 'Nervous Breakdown.' It is a popular term, though not a clinical one that is often used to describe a mental disorder that a person experiences. It is used for a number of reasons, such as to hide a diagnosis, to avoid the stigma of a diagnosis, not understanding the reasons for certain loss of function (such as not seeing a doctor, but having symptoms) and not accepting a diagnosis among others.
So what are mental health and mental illness all about?
Mental health is not just the absence of mental disorder. Rather, it is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
Mental illnesses affect the functioning and thinking processes of the individual, greatly diminishing his or her social role and productivity in the community. In addition, because mental illnesses are disabling and last for many years, they take a tremendous toll on the emotional and socio-economic capabilities of relatives who care for the patient, especially when the health system is unable to offer treatment and support at an early stage.
Mental health problems have the potential to affect anyone regardless of that person's age, sex, socio economic status, educational background and so on. The prevalence and incidence of such problems remains virtually the same in all countries all over the world. However, in countries like India and Bangladesh, the infrastructure available to treat these tens of millions of patients is woefully inadequate. This becomes worse because of the stigma and a large number of misconceptions associated with mental health related issues.
Several recent surveys indicate that stigma and prejudice against people with mental health problems are reduced when the general public is better informed.
There are more than 200 classified forms of mental illness. Before we take a quick overview of some such glaring problems, we need to understand what the warning signals for mental illness are. It is important to understand that these disorders can now be diagnosed reliably and as accurately as the most common physical disorders. Some can be prevented and all can be successfully managed and treated provided treatment is sought in good time from qualified personnel.

Causes of Mental Illness
Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many individuals learn to cope or recover from a mental illness or emotional disorder.

Warning Signs and Symptoms
The following are signs that might warrant a visit to a mental health professional.
In adults:
Confused thinking
Prolonged depression, sadness or irritability
Feelings of extreme highs and lows
Excessive fears, worries and anxieties
Social withdrawal
Dramatic changes in eating or sleeping habits
Strong feelings of anger
Delusions or hallucinations
Growing inability to cope with daily problems and activities
Suicidal thoughts
Denial of obvious problems
Numerous unexplained physical ailments
Substance abuse
In older children and
Substance abuse
Inability to cope with problems and daily activities
Change in sleeping and/or eating habits
Excessive complaints of physical ailments
Defiance of authority, truancy, theft, and/or vandalism
Intense fear of weight gain
Prolonged negative mood, often accompanied by poor appetite or thoughts of death
Frequent outbursts of anger
In younger children:
Changes in school performance
Poor grades despite adequate and consistent effort
Excessive worry or anxiety (i.e. refusing to go to bed or school)
Persistent nightmares
Persistent disobedience or aggression
Frequent temper tantrums
Drug / Alcohol Addiction
For the last few years, Bangladesh is in the grip of the most severe and vicious problem imaginable, which is the problem of drug dependence or addiction. People from all walks of life, of both sexes, both young and old, have been affected. The lack of proper, scientific treatment has made it very difficult for the individual to get out of the clutches of drugs.
There are a number of disorders resulting from the use of psychoactive substances including opioids such as heroin, codeine (present in Phensidyl) and pethidine, alcohol, cannabinoids such as marijuana, sedatives and hypnotics, stimulants such as YABA, amphetamines and cocaine, hallucinogens and tobacco. The conditions include acute intoxication, harmful use, dependence and psychotic disorders. Tobacco, heroin and alcohol are the substances which are abused most widely across the globe and which pose the most serious public health consequences.
( to be continued…)
The writer is Chief Consultant, Neuropsychiatrist, Prottoy Medical Clinic Ltd. Dhaka.


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