jitters
01-10-2007, 11:17 AM
Some information and Facts about Anxiety and Depression in the U.K.
It is estimated that approximately 450 million people worldwide have a mental health problem.
- World Health Organisation (2001)
Roughly one in six adults in Great Britain have had a mental disorder (such as anxiety and depression), while one in seven had considered
suicide at some point in their lives. One in 200 had a psychotic disorder such as psychosis and schizophrenia.
The most common mental disorders were: mixed anxiety and depression (7 per cent for men, 11 per cent for women), anxiety (4 per cent for men, 5 per cent for women) and depression (2 per cent for men, 3 per cent for women). All neurotic disorders were more common in women than men, except for panic disorder which was equally common in both sexes.
What Are the Different Kinds of Anxiety Disorders?
• Panic Disorder—Repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.
• Obsessive-Compulsive Disorder—Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
• Post-Traumatic Stress Disorder—Persistent symptoms that occur after experiencing or witnessing a traumatic event such as rape or other criminal assault, war, child abuse, natural or human-caused disasters, or crashes. Nightmares, flashbacks, numbing of emotions, depression, and feeling angry, irritable or distracted and being easily startled are common. Family members of victims can also develop this disorder.
• Phobias—Two major types of phobias are social phobia and specific phobia. People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities. People with specific phobia experience extreme, disabling, and irrational fear of something that poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily.
• Generalized Anxiety Disorder—Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
1 in 4 British adults experience at least one diagnosable mental health problem in any one year, and one in six experiences this at any given time. Women are more likely to have been treated for a mental health problem than men (29% compared to 17%). Women are twice as likely to experience anxiety as men. Of people with phobias or OCD, about 60% are female. This could be because, when asked, women are more likely to report symptoms of common mental health problems. However it is obvious when we look at the suicide rate that the numbers are much more evenly spread British men being three times as likely as British women to die by suicide.
In 2004, more than 5,500 people in the UK died by suicide. Suicide remains the most common cause of death in men under the age of 35. The suicide rate among people over 65 has fallen by 24% in recent years, but is still high compared to the population overall Men are more likely than women to have an alcohol or drug problem. 67% of British people who consume alcohol at ‘hazardous’ levels, and 80% of those dependent on alcohol are male. Almost three quarters of people dependent on cannabis and 69% of those dependent on other illegal drugs are male.
Prevalence of mental health problems among children increase as they reach adolescence. Disorders affect 10.4% of boys aged 5-10, rising to 12.8% of boys aged 11-15, and 5.9% of girls aged 5-10, rising to 9.65% of girls aged 11-15. About 10% of children have a mental health problem at any one time with one in twenty suffering over the course of any given year. This trend continues with depression affecting 1 in 5 older people living in the community and 2 in 5 living in care homes.
Mental illness therefore is very common. About one in four people in Britain have this diagnosis, people with a mental illness can experience problems in the way they think, feel or behave. This can significantly affect their relationships, their work, and their quality of life. Having a mental illness is difficult, not only for the person concerned, but also for their family and friends.
Mental illnesses are some of the least understood conditions in society. Because of this, many people face prejudice and discrimination in their everyday lives. However, unlike the images often found in books, on television and in films, most people can lead productive and fulfilling lives with appropriate treatment and support. For some people, drugs and other medical treatments are helpful, but for others they are not.
Medical treatment may only be a part of what helps recovery, and not necessarily the main part. It’s important to remember that having a mental illness is not someone’s fault, it’s not a sign of weakness, and it’s not something to be ashamed of. Seeing someone’s problems solely as an illness that requires medical treatment is far too narrow a view. It discourages people from thinking about the many different influences on someone’s life, on their thoughts, feelings and behaviour, which can cause mental distress. It may also prevent people from exploring the various non-medical treatment options that are available. For these reasons, some people prefer to talk about mental or emotional distress, rather than mental illness.
Psychiatrists have classified mental distress into different categories, or diagnoses. Making a diagnosis helps a doctor to assess what treatment is needed and to predict what is likely to happen. It can also be a relief to a distressed person to be able to put a name to what is wrong. But there are limits to diagnosis. Each person’s experience of mental distress is unique and it can be misread, especially if there are cultural, social or religious differences between doctor and patient.
Different doctors may give one person completely different diagnoses. Simply focusing on the symptoms can mean that not enough attention is paid to the person as a whole, and to their situation. Their experience may hold a meaning for them, which no medical diagnosis can do justice to.
If a diagnosis becomes a label, it can be very damaging. For example, instead of being seen as a parent, writer, mechanic or student who has schizophrenia, a person may be seen as ‘a schizophrenic’, as though this diagnosis summed them up. It’s important to remember that a diagnosis does not have to determine the whole course of life, and may come to be a relatively minor part of an individual’s identity or history.
It’s possible to recover completely from mental distress and many do. Sometimes, people even emerge from the experience feeling stronger and wiser. Others get over the worst, but remain vulnerable, and relapse from time to time. Some don’t recover, and will continue to receive treatment in the long term. Psychiatrists aren’t able to predict, accurately, what each individual outcome will be.
Recovery is possible with all types of mental distress but, unfortunately, people are sometimes told that they won’t recover. Such statements can become self-fulfilling because they add to existing feelings of hopelessness. It’s important never to give up, whatever you are told.
What forms can mental distress take?
Mental distress takes many forms. The terms used to diagnose them are sometimes words that are in everyday use, for example, ‘depression’ or ‘anxiety’. This can make them seem easier to understand, but their familiarity can mean underestimating just how severe and incapacitating these conditions may be. Some of the most commonly diagnosed forms of mental distress are described below.
Depression
Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep, appetite and self-esteem, and interfere with daily activities. It may even affect your physical health. This may set off a vicious circle, because the worse you feel, the more depressed you are likely to get. Depression often goes hand in hand with anxiety. (See Understanding depression. Details of this and other publications mentioned here can be found under Further reading.)
Anxiety
Anxiety can mean constant and unrealistic worry about any aspect of daily life. You may feel restless and have problems sleeping. You may also suffer from physical symptoms. Your heart may beat faster, your stomach may be upset, your muscles may tense up and you may feel shaky. Anxiety also feeds on itself. Someone who is highly anxious may develop other related problems, such as panic attacks, a phobia or obsessive-compulsive disorder. (See Mind’s booklet, Understanding anxiety.)
Panic attacks
These are sudden, unexpected bouts of intense terror. You may find it hard to breath, and feel your heart beating hard in your chest. You may have a choking sensation and a pain in the chest, begin to tremble or feel faint. It’s easy to mistake these for the signs of a heart attack, or other serious problem. Panic attacks can occur at any time, and this is what distinguishes them from a natural response to real danger.
Having one panic attack doesn’t necessarily mean you will have another one. But, sometimes, the experience is so frightening that people become afraid of having another. This fear may actually trigger another attack when a similar situation arises. (See Mind's booklet How to cope with panic attacks.)
Obsessive-compulsive disorder
Someone with an obsessive-compulsive disorder feels they have no control over certain thoughts or ideas that are highly disturbing to them, but which seem to force themselves into consciousness. These thoughts, or obsessions, create unbearable anxiety, which can only be relieved by performing a particular ritual to neutralise them. This could be something like repeatedly opening and closing a door, washing your hands, or counting. (See Mind's booklet Understanding obsessive-compulsive disorder.)
Phobias
A phobia is an unreasonable fear of a particular situation or object. It may cause major disruption to life because it imposes such restrictions on the way people live. Agoraphobia can cause such paralysing fear that a person may remain isolated in their own home, afraid to go out. Other common phobias include fear of animals, heights, flying and enclosed spaces. (See Mind's booklet, Understanding phobias.)
Manic depression (Bipolar disorder)
Manic depression is a mood disorder. During manic episodes, people tend to be hyperactive, uninhibited, reckless, full of grandiose schemes and scattered ideas. At other times, they may go through long periods of being very depressed. Not everyone experiences both these extremes. (See Mind's booklet, Understanding manic depression.)
What are the causes of mental distress?
There are many opinions about what causes mental distress. It’s part of a wider debate about what makes people the way they are, whether their personality is shaped by the life experiences they have gone through, or whether it’s determined by their genetic make-up, inherited from their parents. It’s possible that some people are more vulnerable to mental health problems, which could be triggered by stressful or traumatic events. The following are some of the possible causes of mental distress. It may be due to any one of these factors, or to a combination of them.
Difficult family background
Growing up feeling uncared-for, scared of a parent, or having been sexually abused can make people highly insecure and more vulnerable to mental distress. But being much too overprotected as a child can also put you at risk.
Hidden feelings
You may have been discouraged from expressing your feelings from a very early age. As a child, you may even have been punished for getting angry, crying or laughing too loudly. Feelings that are held back, and which are not expressed, affect your physical and mental health.
Stressful life events
These may be traumatic events, such as the death of someone close, or longer-term struggles, such as being the victim of some form of harassment or oppression.
Biochemistry
Your body chemistry can affect your mind. For example, if you are frightened, it triggers the body’s ‘fight or flight’ response to produce a hormone called adrenalin. If physical activity doesn’t use up all the adrenalin, the body remains tense and the mind stays over-active.
Genes
You inherit physical characteristics from your parents and can pass them on in the same way. It’s possible that your genetic make-up can also affect your personality. There are genes that cause physical illnesses, so there may be genes that predispose a person towards mental illness. There is some scientific evidence to support the idea that one person may be more likely than another to develop a particular problem, such as manic depression or schizophrenia.
What are the different treatments?
Users of health services are increasingly being consulted about treatments and conditions in NHS facilities and the decisions made about how health services are run and what they provide. Above all, they want to have more say in their own treatment. This means being properly informed about the undesirable effects of drugs, for example. It also means being offered choice: residential crisis centres as alternatives to hospital; talking treatments as an alternative or complement to drugs (as recommended by the National Institute for Health and Clinical Excellence – see Useful organisations). They want to be seen as individuals, not simply as passive cases.
Medication
By far the most common type of treatment is prescription medication, given by a GP or psychiatrist. Depending on the diagnosis, there are a variety of drugs commonly used. Different types of medication can be used to help someone calm down, or to help them sleep (minor tranquillisers), to lift depression (antidepressants), or control disturbing thoughts (antipsychotics). The great advantage of drugs is that they can help people to keep going. Millions go to work each day, or look after their children, while taking them. Without drugs they might have lost their jobs or been separated from their families.
However, these drugs don’t ‘cure’ mental distress. Medication can relieve the symptoms of mental distress, but the underlying problems often remain. Drugs can also have side effects that may make people feel worse rather than better. They need to be used with caution. Taking minor tranquillisers can be seriously addictive, while antipsychotics in high doses can cause permanent damage to the central nervous system. (See Mind’s Making sense series of booklets)
Talking treatments
Talking treatments, sometimes in combination with medication, can be very successful in helping people deal with mental distress. Professionally qualified therapists and counsellors are specially trained to help people to a better understanding of themselves, and to overcome difficulties in their lives. There is a wide variety of talking treatments, and they may be available on the NHS (through GP surgeries or hospitals) or privately.
GPs often employ counsellors, who are trained to listen, and who may see you once or twice a week. They can help you deal with specific issues, such as bereavement, or to find strategies for managing your life better. Longer-term psychotherapy, individual or in groups, helps you understand the origins of your problems in the past and to bring about change in the present. There can be considerable overlap between counselling and psychotherapy.
Psychotherapists can offer up to four sessions per week. Some work with a sliding scale of fees. Your GP can also refer you to a psychologist who can provide cognitive behaviour therapy. This is a short-term treatment, usually one session per week. It can help you to identify and change unhelpful patterns of thinking and behaving. (See Useful organisations and Further reading.)
Electroconvulsive therapy (ECT)
ECT is a controversial medical treatment for mental illness. It involves passing an electric current through the brain, under anaesthesia, to produce a seizure similar to a fit, with the aim of relieving severe depression. ECT can cause unwanted side effects in some people, including drowsiness, confusion, memory loss, headaches and nausea.
How can I improve my mental health?
Relaxation
This is a skill everyone should acquire. There are many books and audio tapes on relaxation techniques available, and classes are organised by adult education institutes. Yoga, meditation, massage and aromatherapy can all help with relaxation. There is an increased interest in complementary and alternative medicine as a way of tackling mental distress. Practitioners of this kind of medicine take a ‘holistic’ approach, looking at the whole person, not just their symptoms. Many people appreciate being able to take a more active part in their treatment. (See Further reading.)
Physical activity
Physical activity can boost both your physical and mental wellbeing. It can change your whole outlook on life, helping you to deal with negative emotions, alleviating anxiety or depression, and boosting self-esteem. It may even help prevent mental health problems from arising in the first place. (See The Mind guide to physical activity.)
Learning to assert yourself
If you have been taken advantage of, or mistreated in some way, you may find it hard to stand up for yourself. Although it may feel easier just to keep quiet, anger can build up inside, causing tension and anxiety. Assertiveness training classes can improve your ability to handle such situations.
Setting goals
This involves thinking about ways to improve your life. You need to ask yourself, ‘Where would I like to be in ten years time?’, ‘What small changes can I begin to make now?’. It’s possible to make positive changes in life, however daunting.
Expressing feelings
Expressing feelings openly, by getting angry, crying or shouting, helps you recover from hurtful experiences. Repressing feelings and emotions can cause stress and lead to tension and anxiety.
Facing up to problems
When things are going wrong for you, it’s tempting to ignore the problem and hope it will go away. It may not. Usually, the quicker you start dealing with a problem, the easier it is to solve.
Finding someone to talk to
Most of the advice given here is easier to follow if there is someone you can talk to openly and honestly. It could be a friend, a counsellor or a psychotherapist. Or it could be someone in a similar situation, who you might meet through a self-help or support group, or a local befriending group.
There are many ways of trying to understand mental distress. This booklet has concentrated on views that are currently held in the West. In other countries and cultures, where religion is more important, attitudes may be very different. It would be reassuring to have more agreed facts about mental distress, but since this isn’t possible, individuals need to think for themselves, reflecting on their own experiences, listening to others and staying open-minded. There is no disputing the fact that millions of people lead impoverished lives because of mental distress, and that society needs to find better ways of preventing it and helping people to help themselves.
Telling people is a very personal decision. Mental illness is all around us; in fact, if you entered a room of 40 people, it's likely about eight people in the room would have a mental illness serious enough to require professional help. The silence helps maintain the ignorance about mental illness. But that doesn't mean that it is beneficial for you to open up indiscriminately about your mental health. As an advocate I could say that it would be wonderful if everybody came out. But it is a very subjective decision and you have to consider the consequences.
Disclosure doesn't have to be all or nothing. Weigh the risks and benefits involved with telling certain people. Not everyone in the world needs to know if you struggle with diabetes or hypertension or some other illness. The same is true for mental illness. You're in charge, and should think about what the payoff is if you share information about your mental health.
Everyone is an individual and will deal with mental illness in their own ways. However, I hope that the following information arms you with the power to tackle ignorance, prejudice and fear.
• Some people experience their illness only once and fully recover. For others, it recurs throughout their lives.
• Most mental illnesses can be effectively treated.
• 'Mental illness' is a general term that refers to a group of illnesses, in the same way that heart disease refers to a group of illnesses affecting the heart.
• Episodes of a mental illness can come and go in periods through people’s lives
•
Though we know that many mental illnesses are caused by a physical dysfunction of the brain, we do not know exactly what triggers this.
• Stress may trigger some mental illnesses or may prolong episodes.
• Stress can also result when a person develops a mental illness.
More facts to think about:
• 1 in 4 people will experience some kind of mental health problem in the course of a year.
• 1 in 6 people will have depression at some point in their life. Depression is most common in people aged 25-44 years.
• 1 in 10 people are likely to have a 'disabling anxiety disorder' at some stage in their life. For manic depression and schizophrenia this figure is 1 in 100.
• 20 per cent of women and 14 per cent of men in England have some form of mental illness.
• 18 per cent of women have a 'neurotic disorder' such as anxiety, depression, phobias and panic attacks, compared with 11 per cent of men.
• Men are three times more likely than women to have alcohol dependence and twice as likely to be dependent on drugs.
• 15 per cent of pre-school children will have mild mental health problems and 7 per cent will have severe mental health problems.
• 6 per cent of boys and 16 per cent of girls aged 16-19 are thought to have some form of mental health problem.
Sources: Surveys of Psychiatric Morbidity among Adults in Great Britain, Office for National Statistics
Better or worse: a longitudinal study of the mental health of adults living in private households in Great Britain, Office for National Statistics, Mind UK
Hope this is useful
Duncan[/b]
It is estimated that approximately 450 million people worldwide have a mental health problem.
- World Health Organisation (2001)
Roughly one in six adults in Great Britain have had a mental disorder (such as anxiety and depression), while one in seven had considered
suicide at some point in their lives. One in 200 had a psychotic disorder such as psychosis and schizophrenia.
The most common mental disorders were: mixed anxiety and depression (7 per cent for men, 11 per cent for women), anxiety (4 per cent for men, 5 per cent for women) and depression (2 per cent for men, 3 per cent for women). All neurotic disorders were more common in women than men, except for panic disorder which was equally common in both sexes.
What Are the Different Kinds of Anxiety Disorders?
• Panic Disorder—Repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.
• Obsessive-Compulsive Disorder—Repeated, unwanted thoughts or compulsive behaviors that seem impossible to stop or control.
• Post-Traumatic Stress Disorder—Persistent symptoms that occur after experiencing or witnessing a traumatic event such as rape or other criminal assault, war, child abuse, natural or human-caused disasters, or crashes. Nightmares, flashbacks, numbing of emotions, depression, and feeling angry, irritable or distracted and being easily startled are common. Family members of victims can also develop this disorder.
• Phobias—Two major types of phobias are social phobia and specific phobia. People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment, or humiliation in social situations, which leads to avoidance of many potentially pleasurable and meaningful activities. People with specific phobia experience extreme, disabling, and irrational fear of something that poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives unnecessarily.
• Generalized Anxiety Disorder—Constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.
1 in 4 British adults experience at least one diagnosable mental health problem in any one year, and one in six experiences this at any given time. Women are more likely to have been treated for a mental health problem than men (29% compared to 17%). Women are twice as likely to experience anxiety as men. Of people with phobias or OCD, about 60% are female. This could be because, when asked, women are more likely to report symptoms of common mental health problems. However it is obvious when we look at the suicide rate that the numbers are much more evenly spread British men being three times as likely as British women to die by suicide.
In 2004, more than 5,500 people in the UK died by suicide. Suicide remains the most common cause of death in men under the age of 35. The suicide rate among people over 65 has fallen by 24% in recent years, but is still high compared to the population overall Men are more likely than women to have an alcohol or drug problem. 67% of British people who consume alcohol at ‘hazardous’ levels, and 80% of those dependent on alcohol are male. Almost three quarters of people dependent on cannabis and 69% of those dependent on other illegal drugs are male.
Prevalence of mental health problems among children increase as they reach adolescence. Disorders affect 10.4% of boys aged 5-10, rising to 12.8% of boys aged 11-15, and 5.9% of girls aged 5-10, rising to 9.65% of girls aged 11-15. About 10% of children have a mental health problem at any one time with one in twenty suffering over the course of any given year. This trend continues with depression affecting 1 in 5 older people living in the community and 2 in 5 living in care homes.
Mental illness therefore is very common. About one in four people in Britain have this diagnosis, people with a mental illness can experience problems in the way they think, feel or behave. This can significantly affect their relationships, their work, and their quality of life. Having a mental illness is difficult, not only for the person concerned, but also for their family and friends.
Mental illnesses are some of the least understood conditions in society. Because of this, many people face prejudice and discrimination in their everyday lives. However, unlike the images often found in books, on television and in films, most people can lead productive and fulfilling lives with appropriate treatment and support. For some people, drugs and other medical treatments are helpful, but for others they are not.
Medical treatment may only be a part of what helps recovery, and not necessarily the main part. It’s important to remember that having a mental illness is not someone’s fault, it’s not a sign of weakness, and it’s not something to be ashamed of. Seeing someone’s problems solely as an illness that requires medical treatment is far too narrow a view. It discourages people from thinking about the many different influences on someone’s life, on their thoughts, feelings and behaviour, which can cause mental distress. It may also prevent people from exploring the various non-medical treatment options that are available. For these reasons, some people prefer to talk about mental or emotional distress, rather than mental illness.
Psychiatrists have classified mental distress into different categories, or diagnoses. Making a diagnosis helps a doctor to assess what treatment is needed and to predict what is likely to happen. It can also be a relief to a distressed person to be able to put a name to what is wrong. But there are limits to diagnosis. Each person’s experience of mental distress is unique and it can be misread, especially if there are cultural, social or religious differences between doctor and patient.
Different doctors may give one person completely different diagnoses. Simply focusing on the symptoms can mean that not enough attention is paid to the person as a whole, and to their situation. Their experience may hold a meaning for them, which no medical diagnosis can do justice to.
If a diagnosis becomes a label, it can be very damaging. For example, instead of being seen as a parent, writer, mechanic or student who has schizophrenia, a person may be seen as ‘a schizophrenic’, as though this diagnosis summed them up. It’s important to remember that a diagnosis does not have to determine the whole course of life, and may come to be a relatively minor part of an individual’s identity or history.
It’s possible to recover completely from mental distress and many do. Sometimes, people even emerge from the experience feeling stronger and wiser. Others get over the worst, but remain vulnerable, and relapse from time to time. Some don’t recover, and will continue to receive treatment in the long term. Psychiatrists aren’t able to predict, accurately, what each individual outcome will be.
Recovery is possible with all types of mental distress but, unfortunately, people are sometimes told that they won’t recover. Such statements can become self-fulfilling because they add to existing feelings of hopelessness. It’s important never to give up, whatever you are told.
What forms can mental distress take?
Mental distress takes many forms. The terms used to diagnose them are sometimes words that are in everyday use, for example, ‘depression’ or ‘anxiety’. This can make them seem easier to understand, but their familiarity can mean underestimating just how severe and incapacitating these conditions may be. Some of the most commonly diagnosed forms of mental distress are described below.
Depression
Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep, appetite and self-esteem, and interfere with daily activities. It may even affect your physical health. This may set off a vicious circle, because the worse you feel, the more depressed you are likely to get. Depression often goes hand in hand with anxiety. (See Understanding depression. Details of this and other publications mentioned here can be found under Further reading.)
Anxiety
Anxiety can mean constant and unrealistic worry about any aspect of daily life. You may feel restless and have problems sleeping. You may also suffer from physical symptoms. Your heart may beat faster, your stomach may be upset, your muscles may tense up and you may feel shaky. Anxiety also feeds on itself. Someone who is highly anxious may develop other related problems, such as panic attacks, a phobia or obsessive-compulsive disorder. (See Mind’s booklet, Understanding anxiety.)
Panic attacks
These are sudden, unexpected bouts of intense terror. You may find it hard to breath, and feel your heart beating hard in your chest. You may have a choking sensation and a pain in the chest, begin to tremble or feel faint. It’s easy to mistake these for the signs of a heart attack, or other serious problem. Panic attacks can occur at any time, and this is what distinguishes them from a natural response to real danger.
Having one panic attack doesn’t necessarily mean you will have another one. But, sometimes, the experience is so frightening that people become afraid of having another. This fear may actually trigger another attack when a similar situation arises. (See Mind's booklet How to cope with panic attacks.)
Obsessive-compulsive disorder
Someone with an obsessive-compulsive disorder feels they have no control over certain thoughts or ideas that are highly disturbing to them, but which seem to force themselves into consciousness. These thoughts, or obsessions, create unbearable anxiety, which can only be relieved by performing a particular ritual to neutralise them. This could be something like repeatedly opening and closing a door, washing your hands, or counting. (See Mind's booklet Understanding obsessive-compulsive disorder.)
Phobias
A phobia is an unreasonable fear of a particular situation or object. It may cause major disruption to life because it imposes such restrictions on the way people live. Agoraphobia can cause such paralysing fear that a person may remain isolated in their own home, afraid to go out. Other common phobias include fear of animals, heights, flying and enclosed spaces. (See Mind's booklet, Understanding phobias.)
Manic depression (Bipolar disorder)
Manic depression is a mood disorder. During manic episodes, people tend to be hyperactive, uninhibited, reckless, full of grandiose schemes and scattered ideas. At other times, they may go through long periods of being very depressed. Not everyone experiences both these extremes. (See Mind's booklet, Understanding manic depression.)
What are the causes of mental distress?
There are many opinions about what causes mental distress. It’s part of a wider debate about what makes people the way they are, whether their personality is shaped by the life experiences they have gone through, or whether it’s determined by their genetic make-up, inherited from their parents. It’s possible that some people are more vulnerable to mental health problems, which could be triggered by stressful or traumatic events. The following are some of the possible causes of mental distress. It may be due to any one of these factors, or to a combination of them.
Difficult family background
Growing up feeling uncared-for, scared of a parent, or having been sexually abused can make people highly insecure and more vulnerable to mental distress. But being much too overprotected as a child can also put you at risk.
Hidden feelings
You may have been discouraged from expressing your feelings from a very early age. As a child, you may even have been punished for getting angry, crying or laughing too loudly. Feelings that are held back, and which are not expressed, affect your physical and mental health.
Stressful life events
These may be traumatic events, such as the death of someone close, or longer-term struggles, such as being the victim of some form of harassment or oppression.
Biochemistry
Your body chemistry can affect your mind. For example, if you are frightened, it triggers the body’s ‘fight or flight’ response to produce a hormone called adrenalin. If physical activity doesn’t use up all the adrenalin, the body remains tense and the mind stays over-active.
Genes
You inherit physical characteristics from your parents and can pass them on in the same way. It’s possible that your genetic make-up can also affect your personality. There are genes that cause physical illnesses, so there may be genes that predispose a person towards mental illness. There is some scientific evidence to support the idea that one person may be more likely than another to develop a particular problem, such as manic depression or schizophrenia.
What are the different treatments?
Users of health services are increasingly being consulted about treatments and conditions in NHS facilities and the decisions made about how health services are run and what they provide. Above all, they want to have more say in their own treatment. This means being properly informed about the undesirable effects of drugs, for example. It also means being offered choice: residential crisis centres as alternatives to hospital; talking treatments as an alternative or complement to drugs (as recommended by the National Institute for Health and Clinical Excellence – see Useful organisations). They want to be seen as individuals, not simply as passive cases.
Medication
By far the most common type of treatment is prescription medication, given by a GP or psychiatrist. Depending on the diagnosis, there are a variety of drugs commonly used. Different types of medication can be used to help someone calm down, or to help them sleep (minor tranquillisers), to lift depression (antidepressants), or control disturbing thoughts (antipsychotics). The great advantage of drugs is that they can help people to keep going. Millions go to work each day, or look after their children, while taking them. Without drugs they might have lost their jobs or been separated from their families.
However, these drugs don’t ‘cure’ mental distress. Medication can relieve the symptoms of mental distress, but the underlying problems often remain. Drugs can also have side effects that may make people feel worse rather than better. They need to be used with caution. Taking minor tranquillisers can be seriously addictive, while antipsychotics in high doses can cause permanent damage to the central nervous system. (See Mind’s Making sense series of booklets)
Talking treatments
Talking treatments, sometimes in combination with medication, can be very successful in helping people deal with mental distress. Professionally qualified therapists and counsellors are specially trained to help people to a better understanding of themselves, and to overcome difficulties in their lives. There is a wide variety of talking treatments, and they may be available on the NHS (through GP surgeries or hospitals) or privately.
GPs often employ counsellors, who are trained to listen, and who may see you once or twice a week. They can help you deal with specific issues, such as bereavement, or to find strategies for managing your life better. Longer-term psychotherapy, individual or in groups, helps you understand the origins of your problems in the past and to bring about change in the present. There can be considerable overlap between counselling and psychotherapy.
Psychotherapists can offer up to four sessions per week. Some work with a sliding scale of fees. Your GP can also refer you to a psychologist who can provide cognitive behaviour therapy. This is a short-term treatment, usually one session per week. It can help you to identify and change unhelpful patterns of thinking and behaving. (See Useful organisations and Further reading.)
Electroconvulsive therapy (ECT)
ECT is a controversial medical treatment for mental illness. It involves passing an electric current through the brain, under anaesthesia, to produce a seizure similar to a fit, with the aim of relieving severe depression. ECT can cause unwanted side effects in some people, including drowsiness, confusion, memory loss, headaches and nausea.
How can I improve my mental health?
Relaxation
This is a skill everyone should acquire. There are many books and audio tapes on relaxation techniques available, and classes are organised by adult education institutes. Yoga, meditation, massage and aromatherapy can all help with relaxation. There is an increased interest in complementary and alternative medicine as a way of tackling mental distress. Practitioners of this kind of medicine take a ‘holistic’ approach, looking at the whole person, not just their symptoms. Many people appreciate being able to take a more active part in their treatment. (See Further reading.)
Physical activity
Physical activity can boost both your physical and mental wellbeing. It can change your whole outlook on life, helping you to deal with negative emotions, alleviating anxiety or depression, and boosting self-esteem. It may even help prevent mental health problems from arising in the first place. (See The Mind guide to physical activity.)
Learning to assert yourself
If you have been taken advantage of, or mistreated in some way, you may find it hard to stand up for yourself. Although it may feel easier just to keep quiet, anger can build up inside, causing tension and anxiety. Assertiveness training classes can improve your ability to handle such situations.
Setting goals
This involves thinking about ways to improve your life. You need to ask yourself, ‘Where would I like to be in ten years time?’, ‘What small changes can I begin to make now?’. It’s possible to make positive changes in life, however daunting.
Expressing feelings
Expressing feelings openly, by getting angry, crying or shouting, helps you recover from hurtful experiences. Repressing feelings and emotions can cause stress and lead to tension and anxiety.
Facing up to problems
When things are going wrong for you, it’s tempting to ignore the problem and hope it will go away. It may not. Usually, the quicker you start dealing with a problem, the easier it is to solve.
Finding someone to talk to
Most of the advice given here is easier to follow if there is someone you can talk to openly and honestly. It could be a friend, a counsellor or a psychotherapist. Or it could be someone in a similar situation, who you might meet through a self-help or support group, or a local befriending group.
There are many ways of trying to understand mental distress. This booklet has concentrated on views that are currently held in the West. In other countries and cultures, where religion is more important, attitudes may be very different. It would be reassuring to have more agreed facts about mental distress, but since this isn’t possible, individuals need to think for themselves, reflecting on their own experiences, listening to others and staying open-minded. There is no disputing the fact that millions of people lead impoverished lives because of mental distress, and that society needs to find better ways of preventing it and helping people to help themselves.
Telling people is a very personal decision. Mental illness is all around us; in fact, if you entered a room of 40 people, it's likely about eight people in the room would have a mental illness serious enough to require professional help. The silence helps maintain the ignorance about mental illness. But that doesn't mean that it is beneficial for you to open up indiscriminately about your mental health. As an advocate I could say that it would be wonderful if everybody came out. But it is a very subjective decision and you have to consider the consequences.
Disclosure doesn't have to be all or nothing. Weigh the risks and benefits involved with telling certain people. Not everyone in the world needs to know if you struggle with diabetes or hypertension or some other illness. The same is true for mental illness. You're in charge, and should think about what the payoff is if you share information about your mental health.
Everyone is an individual and will deal with mental illness in their own ways. However, I hope that the following information arms you with the power to tackle ignorance, prejudice and fear.
• Some people experience their illness only once and fully recover. For others, it recurs throughout their lives.
• Most mental illnesses can be effectively treated.
• 'Mental illness' is a general term that refers to a group of illnesses, in the same way that heart disease refers to a group of illnesses affecting the heart.
• Episodes of a mental illness can come and go in periods through people’s lives
•
Though we know that many mental illnesses are caused by a physical dysfunction of the brain, we do not know exactly what triggers this.
• Stress may trigger some mental illnesses or may prolong episodes.
• Stress can also result when a person develops a mental illness.
More facts to think about:
• 1 in 4 people will experience some kind of mental health problem in the course of a year.
• 1 in 6 people will have depression at some point in their life. Depression is most common in people aged 25-44 years.
• 1 in 10 people are likely to have a 'disabling anxiety disorder' at some stage in their life. For manic depression and schizophrenia this figure is 1 in 100.
• 20 per cent of women and 14 per cent of men in England have some form of mental illness.
• 18 per cent of women have a 'neurotic disorder' such as anxiety, depression, phobias and panic attacks, compared with 11 per cent of men.
• Men are three times more likely than women to have alcohol dependence and twice as likely to be dependent on drugs.
• 15 per cent of pre-school children will have mild mental health problems and 7 per cent will have severe mental health problems.
• 6 per cent of boys and 16 per cent of girls aged 16-19 are thought to have some form of mental health problem.
Sources: Surveys of Psychiatric Morbidity among Adults in Great Britain, Office for National Statistics
Better or worse: a longitudinal study of the mental health of adults living in private households in Great Britain, Office for National Statistics, Mind UK
Hope this is useful
Duncan[/b]