According to Medilexicon's medical dictionary, mental health is "emotional, behavioral, and social maturity or normality; the absence of a mental or behavioral disorder; a state of psychological well-being in which one has achieved a satisfactory integration of one's instinctual drives acceptable to both oneself and one's social milieu; an appropriate balance of love, work, and leisure pursuits".
According to WHO (World Health Organization), mental health is "a state of well-being in which the individual realizes 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". WHO stresses that mental health "is not just the absence of mental disorder".
WHO explains that especially in low- and middle-income countries, mental health services are very underfunded - both human and financial. Most resources are channeled into treating and caring for mentally ill patients, rather than on any integrated mental health system. Countries should integrate mental health into primary health care (general practice), provide mental health care in general hospitals, and improve community-based mental health services, rather than just providing care in large psychiatric hospitals.
Mental health problems (disorders) can affect anyoneExperts say we all have the potential for suffering from mental health problems, no matter how old we are, whether we are male or female, rich or poor, or ethnic group we belong to. In the UK over one quarter of a million people are admitted into psychiatric hospitals each year, and more than 4,000 people kill themselves. They come from all walks of life.
According to the NIMH (National Institute of Mental Health, USA) mental disorders are "common in the USA and internationally". Approximately 57.7 million Americans suffer from a mental disorder in a given year, that is approximately 26.2% of adults. However, the main burden of illness is concentrated in about 1 in 17 people (6%) who suffer from a serious mental illness. Approximately half of all people who suffer from a mental disorder probably suffer from another mental disorder at the same time, experts say.
In the UK, Canada, the USA and much of the developed world, mental disorders are the leading cause of disability among people aged 15 to 44.
Mental disorders may affect job prospects more than physical disability or illnessPeople's employment prospects may be more badly affected by mental illness than physical illness or disability, Australian researchers reported in October 2012.
They explained that the main obstacle to employing people with existing or past mental disorders is simply ignorance - or a lack of understanding. This is unfortunate, because mental illness is not linked to poorer job performance.
People with a mental illness are able to work, and to do their jobs well, the researchers stressed. On many occasions, an individual with a mental disorder may be the best person for a job.
It is estimated that about one in every five adults has some kind of mental illness or disorder. This means that employers with five or more staff most likely have personnel with some kind of mental illness, many of whom are in positions of responsibility and trust.
What are - mental illness, mental disorders and mental health problems?Mental illness is a term that is used to refer to a wide range of mental disorders that can be diagnosed by a health care professional. In this article, mental illness, mental disorders and mental health problems have the same meaning.
What are the most common mental illnesses?The most common forms of mental illnesses are:
- Anxiety disorders - the most common group of mental illnesses. The sufferer has a severe fear or anxiety which is linked to certain objects or situations. Most people with an anxiety disorder will try to avoid exposure to whatever triggers their anxiety. Examples of anxiety disorders include:
- Panic disorder - the person experiences sudden paralyzing terror or imminent disaster.
- Phobias - these may include simple phobias - disproportionate fear of objects, social phobias - fear of being subject to the judgment of others, and agoraphobia - dread of situations where getting away or breaking free may be difficult. We really do not know how many phobias people may experience globally - there could be hundreds and hundreds of them.
(OCD) Obsessive-compulsive disorder - the person has obsessions and compulsions. In other words, constant stressful thoughts (obsessions), and a powerful urge to perform repetitive acts, such as hand washing (compulsion).
- PSTD (Post-traumatic stress disorder) - this can occur after somebody has been through a traumatic event - something horrible and scary that the person sees or that happens to them. During this type of event the person thinks that his/her life or other people's lives are in danger. The sufferer may feel afraid or feel that he/she has no control over what is happening.
- Mood disorders - these are also known as affective disorders or depressive disorders. Patients with these illnesses share disturbances or mood changes, generally involving either mania (elation) or depression. Experts say that approximately 80% of patients with depressive disorder improve significantly with treatment. Examples of mood disorders include:
- Major depression - the sufferer is not longer interested in and does not enjoy activities and events that he/she previously got pleasure from. There are extreme or prolonged periods of sadness.
- Bipolar disorder - also known as manic-depressive illness, or manic depression. The sufferer oscillates from episodes of euphoria (mania) and depression (despair).
- Dysthymia - mild chronic depression. Chronic in medicine means continuous and long-term. The patient has a chronic feeling of ill being and/or lack of interest in activities he/she once enjoyed - but to a lesser extent than in major depression.
- SAD (seasonal affective disorder) - a type of major depression. However, this one is triggered by lack of daylight. People get it in countries far from the equator during late autumn, winter, and early spring.
- Schizophrenia disorders Whether or not schizophrenia is a single disorder or a group of related illnesses has yet to be fully determined. It is a highly complex illness, with some generalizations which exist in virtually all patients diagnosed with schizophrenia disorders. Most sufferers experience onset of schizophrenia between 15 and 25 years of age. The sufferer has thoughts that appear fragmented; he/she also finds it hard to process information. Schizophrenia can have negative or positive symptoms. Positive symptoms include delusions, thought disorders and hallucinations. Negative symptoms include withdrawal, lack of motivation and a flat or inappropriate mood. (See the article "What is schizophrenia")
What are the most common serious mental disorders (illnesses)?Most major (serious) mental illnesses tend to have symptoms that come and go, with periods in between when the person can lead a relatively normal life (episodic illness). The most common serious mental disorders are:
- Schizophrenia (See the article "What is schizophrenia")
- Bipolar disorder (see article "What is bipolar disorder")
- Depression (see article "What is depression")
Treatments and strategies for mental health problemsThere are various ways people with mental health problems might receive treatment. It is important to know that what works for one person may not work for another; this is especially the case with mental health. Some strategies or treatment are more successful when combined with others. The patient himself/herself with a chronic (long-term) mental disorder may draw on different options at different stages in his/her life. The majority of experts say that the well informed patient is probably the best judge of what treatment suits him/her better. It is crucial that healthcare professionals be aware of this.
There are a lot people with mental health problems may do to improve their mental health. Alterations in lifestyle, which may include a better diet, lower alcohol and illegal drug consumption, exercise and getting enough sleep can make enormous differences to a mental health patient's mental health. Let's have a closer look and some of these strategies:
Diet and mental health
Scientists, psychiatrists, and other health care professionals know that the brain is made up in large part of essential fatty acids, water and other nutrients. It is an accepted fact that food affects how people feel, think and behave. Most experts accept that dietary interventions could have an impact on a number of the mental health challenges society faces today. So, why is it that governments and public health authorities in developed economies invest so little in developing this knowledge?
The evidence is growing and becoming more compelling that diet can play a significant role in the care and treatment of people with mental health problems, including depression, ADHD (attention deficit hyperactivity disorder) to name but a few. If experts are talking about an integrated approach which recognizes the interplay of biological, psychological, social and environmental factors - with diet in the middle of it as being key - and challenging the growing burden of mental health problems in developed nations, surely individuals can speed things up and do something about their diet themselves and improve their mental health.
It is estimated that in the UK people eat 4 kilograms of food additives each year. We are not sure what effect decades of such consumption may have on the brain. We don't know for one simple reason - governments are reluctant to fund, conduct or publish rigorously controlled large scale studies which look at the effect of additives on human mental health.
Changing farming practices have introduced higher levels of different types of fat into our diet. For example, chickens reach their ideal weight for slaughter twice as quickly today compared to three decades ago - this has changed the nutritional profile of meat, according to a report by the Mental Health Foundation (UK). Three decades ago a typical chicken carcass used to be 2% fat - today they are a whopping 22%. The omega-3 fatty acid content in chicken meat has dropped while the omega-6 fatty acids have risen. The same is happening to farmed fish.
The function of fats and amino acids in our brains:
Our brains' dry weight consists of approximately 60% fat. Our brain cell membranes are directly affected by the fats we eat. Saturated fats make our brain cell membranes less flexible. Saturated fats are those that harden at room temperature. 20% of the fat that exists in our brain is made up of essential fatty acids omega-3 and omega-6. The word essential here means we cannot make it ourselves, so we have to consume it in order to get it.
Fatty acids perform crucial functions in the structuring of neurons (brain cells), making sure that optimal communication is maintained within the brain. Nutritionists say omega-3 and omega-6 essential fatty acids should be consumed in equal amounts. If we consume unequal amounts there is a higher chance of having problems with depression, concentration and memory. It is crucial omega-3 intake is kept up. While one study shows a link between omega-3 intake and mental skills, others show there are benefits for cardiovascular problems, diabetes, ADHD, and a host of other problems:
Fish and omega-3 linked to mental skills.
Experts recommend that infant formula should include DHA omega-3 and AA omega-6 to guarantee correct eye and brain development.
The diet of Typical North Americans is deficient in omega-3 fatty acids and may pose a risk to infant development.
Trans-fat, which has appeared in growing quantities into much of the food we eat over the last few decades, assumes the same position as essential fatty acids in the brain. In other words, the proper vital nutrients are not able to assume their right position for the brain to function effectively. Trans-fats are commonly found in cakes, biscuits, shortbread, some pastries and many ready meals.
Neurotransmitters, such as serotonin, are made from amino acids which we often have to get by eating it. If you want to feed your brain with good stuff eat less intensively farmed chicken and meat, and go for organic chicken and non-farmed oily fish, such as tuna, sardines, trout, or salmon.
The Mental Health Foundation has a booklet "Healthy eating and depression", for anyone who wishes to protect their mental health through healthy eating.
A study found that eating a Mediterranean diet appears to be associated with less risk of mild cognitive impairment - a stage between normal aging and dementia or of transitioning from mild cognitive impairment into Alzheimer's disease.
An Australian study found that a high quality breakfast, with foods from at least three different healthy food groups, was linked with better mental health in 14 year old boys and girls. The researchers found that for every extra food group eaten at breakfast, the associated mental health score improved.
Exercise and mental health
An interesting animal study found that physical and mental exercises help improve schizophrenia symptoms.
A Harvard University study found that exercise may help people with depression by enhancing body image, providing social support from exercise groups, a distraction for every day worries, heightened self-confidence from meeting a goal, and altered circulation of the neurotransmitters serotonin, norepinephrine, and the endorphins.
Even a very small amount of additional exercise has been seen to have an important impact on mental health. A Scottish study involving 20,000 people found that performing as little as twenty minutes of any physical activity, including housework, per week is enough to boost mental health.
Exercise can boost an exercise-related gene in the brain that works as a powerful anti-depressant, scientists at the Yale School of Medicine found. They then compared the brain activity of sedentary mice to those who were given running wheels. The researchers observed that the mice with wheels within one week were running more than six miles each night. Four independent array analyses of the mice turned up 33 hippocampal exercise-regulated genes-27 of which had never been identified before.
The UK's National Institute for Clinical Excellence (NICE) issued guidelines for health professionals on how to encourage older people to engage in more physical activity as a way to boost their mental health; one suggestion is for GPs to encourage their older patients to join local walking schemes and tell them how walking benefits mental wellbeing.
Another study, carried out in the United Kingdom found that regular intense physical exercise is linked with lower rates of depression and anxiety in men up to five years later.
Sadly, the Mental Health Foundation found that very few UK patients are offered the choice of exercise therapy for mild to moderate depression. Apparently, only 5% of GPs (general practitioners, primary care physicians) use it as one of their most regular treatment responses, compared to 92% who use antidepressants as one of their most popular treatment responses. In 2006 only 42% of UK GPs reported having access to exercise referral schemes, despite the overwhelming evidence of its benefits for patients. Even among GPs who do have access to exercise referral schemes, only 15% use them very frequently or frequently for patients with mild or moderate depression. Unfortunately, apart from a couple of exceptions, much of the rest of the world's health care professionals seem to ignore exercise as a vital treatment for mental illness.
If you have a mental disorder, remember that you can do the exercise yourself. You do not need to wait for your doctor to "prescribe" it for you. Perhaps you should initially check whether you are in acceptable physical health to do exercise. If you are not, insist that your doctor help you devise an exercise plan that suits you. The benefits may surprise you.
Alcohol is a common form of "self-medication" for people with mental health problems
There is evidence that very moderate alcohol consumption may aid mental health in some cases. However, the evidence is overwhelming that excessive alcohol has a very bad impact on people's mental health. Whatever your attitude is to alcohol, remember that alcohol will not resolve your mental health problems, and will most likely make them worse if you are not very, very careful.
Drinking to deal with difficult feelings or symptoms is referred to by some mental health professionals as self medication. It is important to know that excessive drinking is a likely medium to long term consequence of this type of self medication. Most studies clearly prove that consuming high amounts expose people to significant risks of higher levels of mental health problems. People who suffer from more severe mental health problems are more likely to have alcohol problems too, compared to other people. Experts say this does not necessarily mean that alcohol causes severe mental illness. Perhaps it is more linked to 'self-medication'.
A report in 2008 said that urgent action is needed to prevent a 'silent epidemic' of alcohol-related dementia in the UK.
A statistical modeling study suggests that problems with alcohol abuse may lead to an increased risk of depression, as opposed to the reverse model in which individuals with depression self-medicate with alcohol. In other words, alcohol increases depression risk - it is not the other way round.
A study found a clear link between binge drinking and depression. It seems the link is stronger for women. However, the relationship between alcohol use and depression when depression is measured as recent feeling of depressions or unhappiness, is the same for both sexes.
Scientists at the University of North Carolina School of medicine found that stopping drinking - including at moderate levels - may lead to health problems including depression and a reduced capacity of the brain to produce new neurons, a process called neurogenesis.
Video games help elderly people stay happy and enjoy better emotional health. Researchers from North Carolina State University found that seniors who play video games tend to have higher levels of emotional well-being compared to their counterparts who do not play. They reported their findings in Computers in Human Behavior.
Past research has suggested that women with polycystic ovary syndrome are at greater risk for mental health problems, such as anxiety and depression. Now, a new study suggests this may be down to hormonal imbalances before birth that affect the brain.