Mental Wellbeing and Types of Mental Health Disorders

What does being healthy (in psychiatric terms) come down to? Healthiness, as defined by the World Health Organization (WHO), involves a state of substantial physical, mental and psychological stability. Not merely the absence of illnesses for example.” Primarily, one must aim to feel as connected as possible and strive for a holistically peaceful existence.

But what do we mean by mental health? Our mental health has a massive impact on our quality of life, whilst a lot of the time internal and external factors at play. Those factors include high stress levels, anxiety, self-esteem and personal relationships, all of which give us a proper insight into our own mental health.

How does one define mental illness?

As regards to mental health, a wide range of over 200 disorders are applicable, not excluding depression, anxiety disorders, schizophrenia, eating disorders and addictions. Regrettably, mental health concerns mean recurrent stress, which is detrimental when it comes to one’s ability to function efficiently and in accordance with normality. Hence, it is imperative that our society understands that mental illnesses are more than just a temporary phase. Not just that, similar to other medical conditions, mental illnesses are totally indiscriminate.

Yet, it is important to remember that mental illnesses are very much treatable and although there are distinct variances and stages of mental illnesses, one can seek help by means of therapy and treatment. Learning effective strategies for dealing with mental illnesses and seeking help when it is required are positive moves towards acceptance and addressing stigmas appropriately. Just as is the case with other sicknesses, the body and the brain begin to feel the effects and that is the reason why such disorders are so threatening.

References:

[1] https://www.triadmentalhealth.org/what-is-mental-illness/

Causes

One of the most common misconceptions include blaming the individual for being ‘insane’ or in some way being at fault for having a mental illness. However, over the years, research debunked this claim and whilst new research is produced regularly, it can be concluded that mental illness is actually caused by a combination of biological, psychological or environmental factors. For the sake of a more in-depth clarification, we will look at all three of those factors individually.

Getting to the bottom of mental illnesses

Mental illnesses are a product of an imbalance of neurotransmitters (chemicals that connect nerve cells in the brain). An imbalance of these chemicals prevent the brain from functioning adequately. Other dangers to watch out for include poor nutrition, infections, brain injuries, traumas and a lack of oxygen in the brain during birth/ at the time of fetal brain development.

A person’s dispositional susceptibility to mental illnesses is another key factor (researchers maintain that genetic dispositions such as mental illnesses are passed down from generation to generation). Yet, that does not necessarily mean that environmental stressors and/or psychological traumas are inapplicable for example.

Trauma

Psychological traumas and losses are amongst the traumatic experiences that inevitably hamper our overall mental health. Overwhelming feelings of distress and other stressful experiences are likely to result in lapses. Violence, verbal and sexual assault, irreplaceable/ unbearable losses (parents or loved ones) tend to be just as worrying and detrimental.

Social and environmental factors

Social and environmental factors effectively relate to a person’s surroundings or any other events (unforeseeable or not) that have the potential to bring about undue stress. Stressful situations emerge as a result of a plethora of environmental factors, including the following: From financial troubles, the loss of loved ones, divorces, dysfunctional family life to troubled childhoods, a change of schools, no support system and substance abuse. All of these hindrances trigger mental health difficulties if things gets out of hand, whilst those amongst us with a dispositional susceptibility are more at threat. Unlike biological factors that are rooted in our psyche, duress due to our environment is treatable by way of psychotherapy and counseling.

Other challenging circumstances such as miscarriages, domestic violence, forced marriages and giving birth, combined with societal pressures and peer pressure are more examples of environmental factors that give rise to mental instability, if one’s circumstances are allowed to deteriorate.

Stigmas and harmful labeling

Stigmas are accompanied by lot of disgrace and the end result is often complete alienation by that individual’s community. Unfortunately, when one receives a diagnosis, a great deal of stigma come with it, especially in a religiously conservative society such as Pakistan. To make things worse, the sufferers face shunning by their own family and friends.

Take a bad fall, followed by a leg fracture as an example. Being too ashamed to go to the doctor seems ridiculous. Taking medication or going to a physiotherapist to treat your leg would be the answer. In fact, many individuals might even show off their casts. Due to a lack of awareness, societal pressures and various additional factors, we tend to ignore mental health and forget the importance of healing.

Let’s take cancer as another example - Cancer is an autoimmune disorder. Cells begin to destroy themselves when someone has cancer, yet there is no such stigma attached to that illness and therapy is part of the expectations for recovery. Just as there is a scientific reason behind someone suffering from cancer, there is a scientific reason behind mental illnesses also. For example, someone with depression will have lower serotonin levels and that ought to be sufficiently explanatory (Just like other illnesses medication is prescribed to treat this imbalance). Despite that, there is a vast difference between how society reacts towards a psychical ailment and how they react towards a psychological/psychiatric condition.

So what happens when individuals going through mental health issues face societal stigmas?

Firstly mental health illnesses are not a choice, nor a figment of that person’s imagination. By holding such beliefs, we downplay the importance of seeking help.
Self-blame is consistently prevalent
Withdrawal. People start to become less open towards trusted advisors, at a time when confiding in someone can be of great help.

Pakistan, a developing nation, which has been resilient through the nation’s troubles is home to a population of people with high stress levels. Yet, it should be noted that more than 60% of the people with a mental health conditions do not seek help, out of the fear of being labeled (stigmatization). An experience that is just as tough as the illness itself. Meanwhile, the scope of psychology and psychotherapy has grown immensely over the years and fortunately we have increase in individuals that are starting to accept their mental health problems.

Are there any foreseeable barriers with regard to our mental health services?

Several barriers exist that seem to be responsible for lackluster mental health services. In Pakistan, it can be said that some of the most significant barriers are the strong beliefs rooted in the Pakistani culture and the lack of trained professionals that provide quality services. Before attempting to remove those barriers, we must address the effectiveness of our services properly.

So what exactly do these barriers include? Let us try to understand some of these barriers in the context of Pakistan:

A lack of self-compassion

Your self-esteem is certainly not at an all-time high during bouts of mental illness. Also stigmas and self-pity tend to further worsen the situation. What may seem like a few thoughtless words on the part of friends or family can have a lasting impact on you. In many cases, it is common to hear statements such as the following: “I mean, we all have problems!” “Stop being dramatic”. “Everyone goes through this”. “Why is this a such a big deal for you?” Or “we don’t talk about such things”.

NB: Even so, it is important to communicate again and again as a sufferer (for one’s own sake).

Family, society and culture

In Pakistan, some of the most obvious obstructions seem to be cultural barriers. Concepts like social bonds, social approval, conformity and financial dependency on males are particularly emphasized in this part of the world, unlike in the Western World. Thus, a strong reliance on medical/pharmacological intervention has become more prevalent amongst the population in Pakistan, leading to the deprioritizing of psychotherapy/CBT/Counselling.

Ignorance

As discussed, psychotherapy has a certain reputation and too often the consensus regards that particular form therapy as less meaningful, in contrast to pharmacological treatments. This is largely due to a lack of sophistication and a reluctancy to acknowledge the benefits of psychotherapy. Therefore, ignorance is a major barrier.

Discrimination towards sufferers

Research has shown that the majority of people with mental illnesses want to work and are fully capable of being productive members of the workforce in our society. [2]. Having said that, a whopping 50% [3] of employers claim that they would be reluctant to hire an individual with a history of mental illnesses. Such a fact is extremely worrying, due to the fact that those with a mental illnesses, just like everyone else also require an income to sustain their modus vivendi. But also for many individuals, the structure and productivity of a work day can be therapeutic and that actually facilitates their process of recovery. Not surprisingly, many individuals who are employed report feeling less favored by colleagues if information about their mental illnesses happen to be revealed, even as more stable individuals than those who have never received treatment previously. It should also be noted that not all people who stigmatize are doing so on purpose, even whilst thoughtless words and outdated attitudes perpetuate harmful stereotypes.

A lack of trust in others

Another facet of societal stigmas is a loss of trust. As a consequence, sufferers are not open about their struggles. This is unfortunate, because when family and friends are supportive, that cohesion can be a great source of hope and strength. Being isolated is a reality that can be altered with a proper support system in place, thus also motivating sufferers to seek assistance in the first place.

Nazar (evil eye) or Saya (possession)

Muslims in Pakistan have an unshakeable belief in “Nazar (evil eye) and Saya (possession)”, whilst these beliefs are ingrained in the culture. Hence why turning to mental health professionals is not always part of the list of preferred solutions. Even before approaching a mental health professional, too many Pakistanis prefer to seek guidance from their religious leaders (primarily), due to such local norms and values.

Human resources, competence and centralization

The shortage of human resources in Pakistan, competent psychiatrists and psychotherapists is concerning. The few mental health facilities and competent professionals that are present in Pakistan tend to be centralized and situated in major cities such as Karachi, meaning that rural areas are largely neglected. This along with ignorance on the part of policy makers when it comes to public health funds amount to noticeable gaps in services and training. All such problems are reflected in current psycho-therapeutic practices in Pakistan where western-based therapies are in demand (religious and cultural tendencies push people further away from sorely needed assistance).

Types of mental health disorders:

Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or panic, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the person’s response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias.
Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, bipolar disorder, and cyclothymic disorder.
Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations — the experience of images or sounds that are not real, such as hearing voices — and delusions, which are false fixed beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder.
Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa, and binge eating disorder are the most common eating disorders.
Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.
Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the person’s patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person’s normal functioning. Examples include antisocial personality disorder, obsessive-compulsive personality disorder, histrionic personality disorder, schizoid personality disorder, and paranoid personality disorder.
Obsessive-compulsive disorder (OCD): People with OCD are plagued by constant thoughts or fears that cause them to perform certain rituals or routines. The disturbing thoughts are called obsessions, and the rituals are called compulsions. An example is a person with an unreasonable fear of germs who constantly washes their hands.

Post-traumatic stress disorder (PTSD): PTSD is a condition that can develop following a traumatic and/or terrifying event, such as a sexual or physical assault, the unexpected death of a loved one, or a natural disaster. People with PTSD often have lasting and frightening thoughts and memories of the event, and tend to be emotionally numb.

References:

[1] Scott, S., Quinn, S. (2014). One in five young people struggle with mental illness but few seek help: report – ABC News (Australian Broadcasting Corporation). Retrieved from

http://www.abc.net.au/news/2014-06-18/young-people-with-mental-illness-do-not-seek-help/5530748

[2] Scott, E. (2017). New research reveals people with mental illness are facing a “locked door” when it comes to getting a job. Retrieved, from

http://metro.co.uk/2017/07/27/new-research-reveals-people-with-mental-illness-are-facing-a-locked-door-when-it-comes-to-getting-a-job-6808819/

[3] Maki, D. R., &Tarvydas, V. M. (2011). The Professional Practice of Rehabilitation Counseling. Springer Publishing Company. Retrieved from

https://books.google.com.pk