Introduction
Mental disorders, also called mental illness, are conditions that affect our thinking, feeling, mood, and behavior and are generally characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships with others. These conditions may be occasional or long-lasting, which are called chronic.
Mental disorders affect a significant number of children and adolescents worldwide.
Types of mental disorders?
There are many different types of mental disorders. Some common ones include
• Anxiety disorders like panic disorder, obsessive-compulsive disorder, and phobias
• Bipolar disorder, depression, and other mood disorders
• Eating disorders
• Personality disorders
• Post-traumatic stress disorder
• Psychotic disorders like schizophrenia
Facts on gender disparities and mental health
Despite being common, mental illness is underdiagnosed by doctors. Less than half of those who meet diagnostic criteria for psychological disorders are identified by doctors. Patients, too, appear reluctant to seek professional help.
Gender bias occurs in the treatment of psychological disorders. Doctors are more likely to diagnose depression in women than men, even when they have similar scores on standardized measures of depression or present with identical symptoms.
Men are more likely than women to disclose problems with alcohol use to their health care provider. The female gender is a significant predictor of being prescribed mood altering psychotropic drugs. Women are reluctant to disclose a history of violent victimization unless physicians ask about it directly.
Depression, anxiety, psychological distress, sexual violence, domestic violence, and escalating rates of substance use affect women more than men across different countries and settings.
Pressures created by their multiple roles, gender discrimination, and associated factors of poverty, hunger, malnutrition, overwork, domestic violence, and sexual abuse combine to account for women's poor mental health.
History
Throughout history, there have been three general theories of the etiology of mental illness: supernatural, somatogenic, and psychogenic.
Supernatural theories attribute mental illness to possession by evil or demonic spirits, gods' displeasure, eclipses, planetary gravitation, curses, and sin. Somatogenic theories identify disturbances in physical functioning resulting from either illness, genetic inheritance, or brain damage or imbalance. Psychogenic theories focus on traumatic or stressful experiences, maladaptive learned associations and cognitions, or distorted perceptions.
Age at onset of mental disorders worldwide: a large-scale meta-analysis of 192 epidemiological studies.
The line indicates the median age at onset (a single index that summarizes the age distribution) of mental disorders. Y-axis shows the age, and X-axis has the disorders existing globally. Each bar indicates the 25th and 75th percentiles of that particular disorder.
India statistics
Of all the non-fatal disease burden in India, Mental disorders are among the leading causes. A systematic understanding of their prevalence, disease burden, and risk factors is not readily available for each state of India.
Mental disorders were the second leading cause of disease burden in terms of years lived with disability. It has been recognized as one of the priority areas in health policies worldwide and included in the Sustainable Development Goals. In this report, we describe the prevalence and disease burden of each mental disorder for India from 1990 to 2017.
Recognizing the importance of mental disorders in reducing the total disease burden, India launched its first National Mental Health Policy in 2014 and a revised Mental Healthcare Act in 2017 to provide equitable, affordable, and universal access to mental health care.
Prevalence of current depressive disorder among adults (>18 years) in India by age and gender.
Global burden of mental disorders
A 2017 study estimates that 792 million people lived with a mental health disorder. This is slightly more than one in ten people globally (10.7%).
Global burden of MDD. Women suffer more from MDD than men, both globally and in all European regions.
Causes of mental disorders
Multiple factors can contribute to mental illness, such as
• Disturbed family history or genetic predisposition
• Disturbed childhood life experiences such as stress or a history of abuse
• Biological factors such as chemical imbalances in the brain
• Traumatic brain injury
• Exposure to viruses or toxic chemicals during pregnancy
• Use of alcohol or recreational drugs
• Underlying medical severe conditions like cancer
• Lack of friends and feeling lonely or isolated
Who is at risk from mental disorders?
The risk of developing mental health and mental disorders depends on managing one's thoughts, emotions, behaviors, and interactions with others.
However, social, cultural, economic, political, and environmental factors such as national policies, social protection, standards of living, working conditions, and community support also play an essential role. Stress, genetics, nutrition, perinatal infections, and exposure to environmental hazards also contribute to mental disorders.
Medical students have been believed to experience greater incidences of depression than others. Depression affects almost one-third of medical students globally, but treatment rates are relatively low. The current findings suggest that medical schools and health authorities should offer early detection and prevention programs and interventions for depression amongst medical students before graduation.
How are mental disorders diagnosed?
• Medical history
• A physical exam
• An underlying medical condition that could be causing symptoms
• Lab tests like thyroid function, alcohol screening etc
• A psychological evaluation where a doctor asks questions about thinking, feelings, and behaviors.
Impact of COVID on mental health
Due to COVID, many countries imposed measures to restrict movement to reduce the number of people infected with COVID-19. People are making considerable changes to their daily routines. Working from home, unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues are challenging to deal with for people with mental health conditions.
We should look after our mental health and help others who may need extra support and care by advising tips like having a routine, maintaining personal hygiene, healthy meals, exercising regularly, following our passion, and allocating fixed working hours.
Management of mental disorders
Promotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. Treatment depends on the type of mental illness and its severity. In many cases, a combination of treatments works best.
1) Medications
Antidepressants to treat depression, anxiety and sometimes other conditions. They can help improve sadness, hopelessness, lack of energy, difficulty concentrating and lack of interest in activities.
Anti-anxiety medications are used to treat anxiety disorders, such as generalized anxiety disorder or panic disorder. They may also help reduce agitation and insomnia.
Mood-stabilizing medications are most commonly used to treat bipolar disorders, involving alternating episodes of mania and depression. Sometimes mood stabilizers are used with antidepressants to treat depression.
Antipsychotic medications are typically used to treat psychotic disorders, such as schizophrenia. Antipsychotic drugs may also be used to treat bipolar disorders or used with antidepressants to treat depression.
2) Psychotherapy
This is also called talk therapy, which involves talking about your condition and related issues with a mental health professional. During psychotherapy, you learn about your situation and your moods, feelings, thoughts and behavior. With the insights and knowledge you gain, you can learn coping and stress management skills.
3) Brain-stimulation treatments
These treatments are used for depression and other mental health disorders and when other therapies fail to perform. These include electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation and vagus nerve stimulation.
4) Hospital and residential treatment programs
This includes 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a temporary supportive place to live. Another option may be intensive outpatient treatment. This is recommended when the patient can't care for himself properly or is in immediate danger of harming himself or someone else.
5) Substance misuse treatment
Problems with substance use commonly occur along with mental illness and interfere with treatment and worsening it more. This is advised when the patient is unable to control drugs or alcohol use on their own.
Conclusion
Mental disorders are a widespread concern worldwide. More than one in three people in most countries report sufficient criteria for at least one at some point in their life.
Mental health literacy is the beliefs and knowledge about mental health issues and their remedies. Attitudes and beliefs of lay individuals about mental illness are shaped by personal knowledge, knowing and interacting with someone living with mental illness, and cultural stereotypes.
Learning to accept your condition and recognize what you need to do to treat it, seeking support, and helping educate others can make a big difference.
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