The Covid-19 pandemic has created a global crisis for mental health, fuelling short- and long-term stresses and undermining the mental health of millions. Many mental health conditions can be effectively treated at relatively low cost, yet the gap between people needing care and those with access to care remains substantial.
To understand the scenario of mental health in the valley, Rising Kashmir’s Senior Health Correspondent Mansoor Peer talks to three psychiatrists of psychiatry department GMC Srinagar which includes its HOD Dr Muhammad Maqbool Dar, Consultant Psychiatry Dr Deeba Nazir and Registrar Psychiatry Dr Aliya Khanam about mental ailments, efforts to protect and improve mental health and way forward.
What is mental health?
Mental Health is a state of complete emotional, psychological and social well-being and just not the absence of any mental illness or infirmity. Mental health is all about wellness rather than illness. It’s a state of wellbeing in which an individual realises his or her own abilities, can actualise his or her potential, can work productively, can cope with stresses of life and live harmoniously in community.
How important is mental health? How to protect and improve mental health?
Mental health is of utmost importance for an individual as it governs wellbeing, helps in social development and in actualising ones potential.
It can be improved by maintaining a healthy lifestyle (i.e. taking nutritious diet, adequate sleep and exercise). For maintenance of a good mental health, it is important to give validation to ones emotions and feelings. Feeling sad or restless during any crisis should be normalised.
However, it is imperative to adopt healthy and positive coping strategies like venting out to family and friends about stressful experiences, resorting to meditation, exercises and also by practicing kindness and empathy.
What are the general symptoms of mental health disorders?
Different psychiatric disorders present with different symptoms like depression presents as depressed mood, easyfatiguability, decreased pleasure, disturbed eating and sleeping patterns, problem concentrating and at times suicidal ideations.Like wise patient of mania present as excessive talking, increased energy, decrease need for sleeping, increased self-esteem etc. Patient with psychotic disorders have symptoms as muttering or smiling to self, inappropriate behaviour, decrease self-care etc.
How should people deal with anxiety?
Anxiety can be a normal response of an individual to stressful experiences. If anxiety is excessive and causes a socio-occupational dysfunction to patient, then seek help from a mental health professional. A healthy lifestyle, good diet, regular sleep, exercise, meditation and relaxation techniques may help to reduce anxiety. It is important to identify the ‘triggers’ and avoid anxiety provoking substances like caffeine, alcohol and nicotine.
What is the role of stress in mental health issues?
Stress of any kind, be it adverse life experiences/traumatic experiences can act as a precipitating factor for mental illnesses. Mood disorders are often preceded by a stressful event. Stress can exacerbate or worsen a pre-existing mental health condition.
What’s depression and how a person is s involved in this ailment?
Depression is a mood disorder characterized by persistent sad mood which is either reported by the individual himself or by the observation of others, decreased interest in previously pleasurable activities, feelings of hopelessness, worthlessness, guilt feelings and changes in sleep and appetite.
This condition arises from a complex interplay of biological and psychosocial stressors (bio-psychosocial model) that include a genetic predisposition in the form of family history and adverse life events like death of a close one, relationship issues, divorce or separation, financial stresses etc.
Is domestic violence a cause of mental issues in Kashmir?
Mental health issues arise because of a complex interplay of biological and psychosocial factors. Domestic violence is a stressful experience and can be a contributory factor to the genesis of mental health illness. It can lead to acute stress reaction/ disorder, major depressive episode, adjustment disorder and even post-traumatic stress disorder.
Given the figures of previous years, why mental health issues are on rise in Kashmir?
Due to increased awareness about mental health issues and de- stigmatisation of mental health illnesses in the current age, a huge recognition is given to mental health which has lead to rise of these issues in Kashmir. Increased prevalence of substance use disorders in Kashmir has also contributed to it.
There is still a stigma associated with going to mental hospitals for treatment? How can we encourage people to come out?
We can encourage people to seek mental health services by creating awareness regarding mental health and illness. Mental illnesses are treatable and people should be encouraged to seek treatment. Furthermore, de-stigmatising approaches should be employed by community leaders, religious heads to create awareness and to reduce stigma around mental illnesses.
Many people face sleep problems and some take sleeping tablets. What should such people do to improve sleep?
A lot of people have sleep issues/ disorders. Maintaining sleep hygiene is the key to it i.e going to bed at the same time each night and get up at the same time each morning. Making sure that your bedroom is quiet, dark, relaxing, and at a comfortable temperature.
Remove electronic devices, such as TVs, computers and smart phones from the bedroom and using bedroom for only sleeping. Proper exercise and avoiding caffeine in evening and if sleep hygiene is not working consult a psychiatrist.
What is Obsessive Compulsive Disorder (OCD)?
OCD presents as cleanliness concerns, recurrent instructive thoughts, images or actions, checking behaviours etc. So each disorder has its own spectrum of symptoms. Whenever you feel that there is a change in emotion or behaviour of a person, never shy away from consulting a psychiatrist.
Talking about the symptom patterns, contamination, pathological doubt, intrusive thoughts, need for symmetry, religious obsessions, compulsive hoarding and many others fall into the spectrum. These behaviours are time consuming, distressing, and can cause disturbance in social and occupational domains. It is treatable, both with psychotherapy and pharmacotherapy.
Please define Seasonal Affective Disorder (SAD) in Kashmir perspective?
Patients with a seasonal pattern to their mood disorders tend to experience depressive symptoms during a particular season, mostly in winters. Circadian rhythm dysfunction is said to be an etiological factor. Light therapy has been seen to plan a role in management of the same.
What is bipolar disorder?
Bipolar disorder is a mood disorders in which the symptoms of both polarities that is depression or mania/ hypomania are present.
What are the activities that women can do at home to distress themselves?
Women can do a lot of activities at home, like meditation, cooking their favourite foods, listening to music and can have get together (kitty parties) so that they can maintain their social circle. Nature-based outdoor activities for half an hour to an hour for 8-12 weeks are effective for improving mental health. Gardening, green exercise and nature-based therapy are found to improve mental health in adults, even for those with pre-existing concerns.
The COVID-19 pandemic has created a global crisis for mental health, fuelling short and long-term stresses and undermining the mental health of millions. What should people do?
Covid-19 pandemic has been a stressor for the world. It was about physical distancing and not social distancing. It has given a financial strain to many people globally, so it’s the need of others to help the one in need. Follow proper protocol so that health deterioration won’t add much financial burden. Be calm with your family and spend quality time with them.
What facilities are available for mental health treatment in Kashmir hospitals?
For mental health services, general OPDs and IPDs are running 24/7, child psychiatry and de-addiction units are working separately. Psychological assessment and counselling is being done. Online suicide helpline prevention initiative “Zindagi” is already established. The NHM is recruiting counselors and doctors for The Tele Manas Initiative.
How can we ensure mental health & well-being becomes a priority for all?
Insight building regarding mental health issues among common people. Providing information to people about various factors leading to mental health problems can we ensure mental health & well-being.
What should common people do in daily lives to stay mentally fit?
Healthy diet and active lifestyle (exercise, extracurricular activities, avoiding illicit drugs) are key to good mental health.