• Shruti GOCHHWAL

Mental Health Disorders

We’re all capable of executing unusual behaviours and thinking unusual thoughts from time to time. That is normal. However, in some people, such behaviours and thoughts are more frequent than others. Such people are often diagnosed with a mental disorder.

The disorders which affect the cognitive, emotional and behavioural wellbeing of a person are known as mental health disorders. Apart from behaviours and thoughts, mental disorders can also affect one’s perception and relationships.

The most common mental health disorders are:

  1. Anxiety Disorders

  2. OCD

  3. PTSD

  4. Panic Disorder

  5. Social Anxiety Disorder

  6. ADHD

  7. Personality disorders

  8. PTSD

  9. Schizophrenia

All of the above mention disorders are manageable. Let’s briefly discuss how these disorders affect a person before discussing their management.

Anxiety Disorders

The most common anxiety disorder is Generalized anxiety disorder. You may have noticed how some people around you worry more and get tensed easily. These people may be suffering from chronic anxiety, also known as generalised anxiety disorder or GAD.

Causes of GAD:

  1. It may be hereditary

  2. It may be a consequence of a having been in a highly stressful situation recently such as a divorce or the passing of a loved one.

  3. Childhood trauma

  4. Substance abuse of excessive smoking and/or coffee drinking.

Other anxiety disorders include obsessive-compulsive disorder (OCD), Post-traumatic stress disorder (PTSD), Panic disorder and social anxiety disorder.

OCD

Uncontrollable, obsessive thoughts and/or repetitive behaviours. These behaviours often include cleaning rituals and arranging things in a particular manner. Think of someone who cleans their room 5 times a day or has to make sure that labels of the bottles kept in their fridge are facing outwards.

PTSD

PTSD is what a person goes through after coming out of a highly stressful situation. Soldiers of war often suffer from this. Other examples of people who suffer from PTSD include people who were assaulted, threatened for their life or witnessed someone else being assaulted.

Panic Disorder

If someone has repeated episodes of experiencing unusually high degrees of fear, they may have panic disorder. To make matters worse, the said fear may be accompanied by physical symptoms including chest pain, an elevated heartbeat, breathlessness, or stomach cramps.

Social Anxiety Disorder

As we all know, some people do better in social situations than others. But some of us get so overwhelmed when we even the most everyday social situations that it’s no less than a disorder. In the most extreme cases, one cannot even take to or other people or eat food in their presence.

Anxiety Attacks

A sudden overwhelming occurrence of symptoms of anxiety is known as an anxiety attack. It is usually triggered by an external fear. An anxiety attack is an extension of existing anxiety disorders.

Symptoms of Anxiety Disorders

  1. Fear

  2. Uncontrollable worrying

  3. Numbness in body parts

  4. Chills

  5. Breathing difficulty

  6. Sweating

Treatment of Anxiety Disorders

  1. Cognitive Behavioural Therapy

It is a form of psycho-social intervention which focusses on changing the attitude and behaviour of the individual.

  1. Antianxiety Drugs

Diazepam, Alprazolam, and buspirone are the most commonly used drugs. Some other antidepressant drugs are also prescribed for anxiety disorders.

ADHD

ADHD stands for Attention deficit hyperactivity disorder. It is more common and problematic among children. This is especially true because the symptoms of ADHD vary and can be hard to recognize. Children and Adults with ADHD have trouble focusing and can execute behaviours that affect their relationships with other people. Also, they may experience more emotional turmoil and physical fatigue than others.

Symptoms of ADHD in Adults

  1. Lack of Motivation and Focus

  2. Restlessness

  3. Poor Time management and organisational skills

  4. Poor self-worth

  5. Proclivity for substance abuse

  6. Poor personal relationships

Symptoms of ADHD in kids

  1. Not finishing tasks regularly

  2. Finding it hard to remain quiet

  3. Speaking out of line

  4. Frequent temper tantrums

  5. Lack of focus and leaving tasks unfinished

ADHD Rating Scale

An ADHD rating scale is a system in which the patients are scored using specially designed questionnaires. ADHD rating scales are helpful for the doctor to understand the severity of the condition. The questions focus on behavioural aspects of the patient but can vary depending upon the caregiver. They are also used to measure treatment responses. Some common ADHD rating scales are:

  1. Swanson Nolan and Pelham (SNAP)

  2. The diagnostic Interview for ADHD in Adults

  3. Clinical Global Impression of Improvement

  4. Brown Attention-Deficit Disorder Scale

ADHD Treatment

The treatment for ADHD involves two kinds of medications. These medications cannot cure ADHD but these can help in managing the disease.

  1. Central Nervous System Stimulants

Amphetamines, Dextroamphetamine, and methylphenidates are used. These drugs increase the amount of dopamine and norepinephrine in the brain.

  1. Non-stimulant Drugs

The mechanism of action of these drugs is not known. However, they have shown positive outcomes. Clonidine and Guanfacine are the most used drugs.

Depression

Depression is a mood disorder. It is very common and something that everyone goes through to a certain degree at some point in their life. To put it in simple words, depression is the unshakable and relentless feeling of a sense of loss, sadness or loneliness. Unfortunately, some studies suggest that India is the most depressed country in the world.

Symptoms of Depression

  1. Irritability

  2. Worthlessness

  3. Suicidal thoughts

  4. Alterations in sleep pattern

  5. Changes in weight

  6. Fatigue and loss of energy

  7. Mood Swings

Treatment of Depression

The treatment of depression involves pharmacological intervention as well as non-pharmacological intervention.

Pharmacological intervention includes the following medications:

  1. Tri Cyclic Antidepressant: Amitriptyline, Imipramine

  2. Selective Serotonin Reuptake Inhibitors: Citalopram, Paroxetine

  3. Selective Serotonin and Norepinephrine Inhibitor: Duloxetine, Tramadol

  4. Monoamine Oxidase Inhibitor: Isocarboxazid, Phenelzine

Non-Pharmacological intervention focusses on activities which can help the patient psychologically.

  1. Placebo Effect

This refers to a treatment in which medication which is given to the patient does not have any pharmacological activity. The purpose is to make the patient believe that he has been given medication.

  1. Lifestyle Changes

Physical activity and improving sleeping patterns have been shown promising results.

  1. Stress Management Activities

Stress Management activities are those which can reduce the stress of an individual. These activities can vary from person to person and have a wide range to choose from. These include psychotherapy, deep breathing, visualisation techniques.

Credits: Pexels Caption: Meditation can be very helpful in reducing stress.

Bipolar Disorder

It is a condition in which extreme shifts in moods are observed. The sufferer can feel depression, mania and hypomania. It is a common condition. The famous Bollywood singer Honey Singh suffers from bipolar disorder.

It is mainly characterized by severe mood swings which range from a depressive state to a manic one.

There are 3 major types:

  1. Type 1 Bipolar Disorder

In this disorder at least 1 manic episode is observed in the patient. The manic episode can also be followed by a depressive or hypomanic episode.

  1. Type 2 Bipolar Disorder

The patents who suffer from this disorder have depressive episodes that have a minimum duration of two weeks which are followed by hypomanic episodes which last for a comparatively shorter duration.

  1. Cyclothymia

Patients suffering from cyclothymia have shorter episodes of hypomania and depression as compared to other bipolar disorders. They are less severe and usually last for a few days.

Treatment of Bipolar Disorder

The treatment of bipolar disorder involves a combination of drugs. These medications have serious side effects and should be used carefully.

  1. Antipsychotic Drugs: Aripiprazole, Asenapine

Mood Stabilising Drugs: Lithium Carbonate, Valproic Acid

Credits: Pexels Caption: Bipolar disorder is characterized with severe depressive episodes.

Schizophrenia

A serious mental disorder in which a person’s ability to think, feel and behave is severely diminished. Lifelong treatment is required to manage this disease. In most cases, patients require constant supervision and care.

The cause of schizophrenia is not known. Although, it is widely believed that genetic factors play a role.

The symptoms of schizophrenia vary among individuals, but the most prevalent symptoms are:

  1. Delusions

  2. Disorganized Speech

  3. Impaired Thinking Ability,

  4. Abnormal Motor Behaviour

  5. Lack of Ability to Function

There is no cure for Schizophrenia now, but certain drugs and therapies can help in managing the diseases. The following drugs and therapies are used:

  1. Electroconvulsive Therapy

  2. Psychological Therapy

  3. Cognitive Behaviour Therapy

  4. Psychotherapy

  5. Antipsychotic Drugs

Personality Disorders

These are serious mental health disorders in which the behaviour and thinking of an individual are deemed unhealthy and inflexible. Personality disorders vary from mild to severe.

The most common time for personality disorders to emerge is between the ages of 12-19. However, they can emerge at other ages as well.

Types of Personality Disorders

Personality Disorders are classified into 3 categories:

  1. Cluster A: Eccentric and Suspicious

These involve behaviour which seems suspicious or eccentric to others. The following are Cluster A personality disorders:

  1. Schizoid Personality Disorder

  2. Paranoid Personality Disorder

  3. Schizotypal Personality Disorder

  4. Cluster B Emotional and Impulsive

The patients show erratic and emotional behaviour. Some cluster B personality disorders are:

  1. Antisocial Personality Disorder

  2. Histrionic Personality Disorder

  3. Borderline Personality Disorder

  4. Narcissistic Personality Disorder

  5. Cluster C: Fear and Anxiety

In these disorders, fear and anxiety persist among individuals. Cluster C includes:

  1. Avoidant Personality Disorder

  2. Obsessive-compulsive Personality Disorder

  3. Dependent Personality Disorder

Treatment of Personality Disorders

There are no specific drugs which are indicated to be used for personality disorders. However, drugs which are used in other mental disorders have been helpful in personality disorders as well.

Mental Health Act and Raising Awareness

The Mental Health Act of 2017 was brought passed to protect individuals suffering from mental health disorders. It recognized various mental health disorders and ensured that the constitutional rights of the patients are protected.

Its main objective is to ensure that no form of cruel or inhuman activities is done to mental health patients in health care facilities.

Most people in India are unaware of mental health disorders. This lack of awareness results in people not identifying the need for treatment and often stigmatising mental health disorders.

Credits: Pexels Caption: We need to raise awareness regarding mental health.

Takeaway

Mental health disorders are serious medical conditions that require treatment. If you feel any symptoms of these disorders you should consult a doctor.

Mental health disorders impair the mental ability of an individual which can result in various harmful activities. Raising awareness and destigmatising mental health disorders would be beneficial for those who are suffering from it/

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