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

<%-- Volume Number --%> Vol 1 Num 116 <%-- End Volume Number --%>

August 01, 2003

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What is Mental Illness all about?

Dr. Sanjay Chugh


(Continued from last week)

Depression / Mood Disorders
Depression is the commonest mental disorder characterised by sadness, loss of interest in activities and by decreased energy. Depression is differentiated from normal mood changes by the extent of its severity, the symptoms and the duration of the disorder. Suicide remains one of the common and often unavoidable outcomes of depression. If depressive episodes alternate with exaggerated happiness, elation or irritability the problem is then known as Bipolar Disorder.
The first-line of treatment for most people with mood disorders consists of antidepressant medication, psychotherapy or a combination of both.

Anxiety Disorders
Everyone feels anxious or uneasy from time to time. Your first day on a new job, planning for a long trip, going to the dentist....your palms sweat, you feel shaky, your heart pounds. Some anxiety helps to keep you focused on the job at hand. However, when your anxiety is so serious that it interferes with your work, leads you to avoid certain situations or keeps you from enjoying life, you may be suffering from a form of the most common type of mental disorder, an anxiety disorder.
Anxiety disorders are not just a case of "nerves." You can't overcome an anxiety disorder just through willpower, nor can the symptoms be ignored or wished away. These disorders cause you to feel anxious most of the time, making some everyday situations so uncomfortable that you may avoid them entirely. Or, you may experience occasional instances of anxiety that are so terrifying and intense that you may be immobilised with fear.
Anxiety disorders are of different kinds, such as Phobias, Obsessive Compulsive Disorder, Panic Disorder, Generalised Anxiety Disorder, Post Traumatic Stress Disorder and Agoraphobia.
Although these conditions can be very frightening and disabling, they are also very treatable. It is important to recognise the symptoms and seek help. As with the mood disorders, the first-line of treatment for most people with anxiety disorders consists of antidepressant medication, psychotherapy or a combination of both.

Schizophrenia is a severe disorder that typically begins in late adolescence or early adulthood. It is characterised by profound disruptions in thinking, feeling, language, perception and the sense of self. It often includes psychotic experiences such as hallucinations or delusions and can impair functioning through the loss of capability to earn one's own livelihood or the disruption of studies.

The treatment of schizophrenia
has three main components:
Medication to relieve symptoms and prevent relapse;
Education and psychosocial interventions to help patients and families cope
Rehabilitation to help patients reintegrate into the community.
With modern drug advances and care, a majority of the sufferers can expect a full recovery.
Disorders of Childhood and Adolescence
Mental and behavioural disorders are common during childhood and adolescence. An estimated 10-20% of children have one or more mental or behavioural problems. Many disorders commonly found amongst adults, such as depression can begin during childhood. There are two broad categories of problems specific to childhood and adolescence:
Disorders of psychological development e.g. dyslexia or autism
Behavioural and emotional disorders e.g. attention deficit / hyperactivity disorders (ADHD) or conduct disorders
The treatment of these disorders requires a continuum of care over time linking settings such as families, schools, hospitals and out-patient facilities. Treatments include both individual and group psychological support such as psychotherapy or counselling. Use of medication to treat ADHD or hyperkinetic disorders is now common as are behavioural techniques for anxiety disorders.

Dementia is a degenerative brain syndrome characterised by a progressive decline in memory, thinking, comprehension, calculation, language, learning capacity and judgment. It is important, however, to differentiate the symptoms of dementia from normal age-related decline in cognitive functions which is more gradual and leads to much milder disability.
An estimated 37 million people worldwide live with dementia with Alzheimer's disease causing the majority of cases. About 5% of men and 6% of women over 60 years of age are affected with Alzheimer's. With the ageing of populations, this figure is projected to increase rapidly over the next 20 years.

There is currently no cure for Alzheimer's disease. However, medications are effective in mild to moderate cases to slow the progression of disease. Computerised software Brain Function Retraining packages are also being increasingly used now to help the patient overcome the deficits caused by the degenerative process. The goals of care are:

To maintain the functioning of the individual
To reduce disability due to lost mental functions
To reorganise routines so as to maximise use of the retained functions
Minimise symptoms such as depression, agitation, suspiciousness;
Provide support to families.

How the Family ShouldCope
Accept your feelings. Despite the different symptoms and types of mental illnesses, many families who have a loved one with mental illness, share similar experiences. You may find yourself denying the warning signs, worrying what other people will think because of the stigma, or wondering what caused your loved one to become ill. Accept that these feelings are normal and common among families going through similar situations. Find out all you can about your loved one's illness by reading and talking with mental health professionals. Share what you have learned with others.
Handling unusual behavior. The outward signs of a mental illness are often behavioral. Individuals may be extremely quiet or withdrawn. Conversely, he or she may burst into tears or have outbursts of anger. Even after treatment has started, individuals with a mental illness can exhibit anti-social behaviors. When in public, these behaviors can be disruptive and difficult to accept. Family members need to visit a mental health professional to discuss these behaviors and develop a strategy for coping.
Establishing a support network. Whenever possible, seek support from friends and other family members. If you feel you cannot discuss your situation with friends or other family members, the best people to contact for support would be other people who you know are experiencing the same type of problems. They can listen and offer valuable advice.
Seeking counseling. Therapy can be beneficial for both the individual with mental illness and other family members. A mental health professional can suggest ways to cope and better understand your loved one's illness. When looking for a psychiatrist or a therapist, you might need to be patient and talk to a few professionals so you can choose the person that is right for you and your family. It may take time until you are comfortable, but in the long run you will be glad you sought help.
Taking time out. It is common for the person with the mental illness to become the focus of family life. When this happens, other members of the family may feel ignored or resentful. Some may find it difficult to pursue their own interests. If you are the caregiver, you need some time for yourself. Schedule time away to prevent becoming frustrated or angry. If you schedule time for yourself, it will help you to keep things in perspective and you may have more patience and compassion for coping or helping your loved one. Only when you are physically and emotionally healthy can you help others.
It is important to remember that there is hope for recovery and that with treatment many people with mental illness return to a productive and fulfilling life.
Most families are not prepared to cope with learning their loved one has a mental illness. It can be physically and emotionally trying, and can make us feel vulnerable to the opinions and judgments of others. If you think you or someone you know may have a mental or emotional problem, it is important to remember there is hope and help. And the sooner this help is sought, the better the outcome would be.




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