Today – 10th October – is World Mental Health Day – a day designated by the World Health Organization (WHO) to raise awareness of mental health issues. This year the theme is mental health and older adults.
Thankfully, mental health issues are becoming better understood, and suffering from mental health problems no longer attracts quite the stigma and discrimination that it once did. However, there is still quite a way to go, as recent events which saw major UK supermarkets selling offensive ‘mental health patient’ and ‘psycho ward’ fancy dress outfits demonstrated. Thankfully, there was a very quick public response to this, during which real ‘mental health patients’ posted photos of themselves on social media sites saying ‘this is what a mental health patient looks like’. The supermarkets quickly withdrew the offending articles and at least one made a donation to a mental health charity. But this just shows that there remains a lack of awareness and even a fear of what having a mental health problem really means.
Every year, one in four people will suffer from a mental health problem (source Mind) and almost half of that number will be diagnosed with a mental health disorder. Mental health disorders cross all boundaries of age, gender, socio-economic class, race, sexuality and religion. Mental health problems can affect not only the sufferer, but can also impact on families, loved ones, friends, colleagues and carers. When I began my career as a counsellor and started working for a mental health charity, I had a steep learning curve to climb. Despite my training, my awareness of mental health disorders and problems was pretty limited. So it’s no surprise that general levels of public awareness are poor. There are, however, some great resources for learning about different mental health problems. I can highly recommend the Mind (www.mind.org.uk) and Time to Change (http://www.time-to-change.org.uk/) websites for general information and for more detailed information NICE publishes patient information leaflets about different mental health disorders, which are available to download online.
Depression is the most common mental health problem in the UK and each year approx. 6% of adults will experience a depressive episode; up to 15% of those over 65 suffer from depressive symptoms. Over the course of their lifetime, approx. 15% of the population will experience depression first hand (source NHS). Even if not diagnosed with depression, around two thirds of British adults will experience, at some time in their life, depressed mood of sufficient severity to interfere with their normal life. In addition, many people who suffer from the symptoms of depression will never seek help or go to their doctor. Those with physical health problems are more likely to suffer from depression. There are some predisposing factors for depression, including abuse and neglect in childhood, being bullied or loss of a parent when young; severe negative life events, chronic difficulties and/or poor social support networks may precipitate depression. Most people suffering from depression also suffer from anxiety.
Anxiety disorders are also extremely common, with or without depression. These include general anxiety disorder, social phobias, panic disorders, obsessive compulsive disorders, health anxiety and others. In fact, anxiety is a normal human reaction and is a survival mechanism, but it becomes a problem when its effects cause difficulties in someone’s everyday life. Anxiety sufferers experience high levels of fear, stress and apprehension which affect their functioning; they may have difficulty doing routine things like going out, speaking to other people, or being in busy places. Very often the effects can be physical, causing pains, skin problems, raised heart rate, nausea, diarrhoea and many other symptoms. If anxiety symptoms last for longer than a few weeks, an anxiety disorder may be diagnosed. Anxiety tends to cause a vicious cycle, where the effects and symptoms make the sufferer more anxious and so the problem is exacerbated.
Although both depression and anxiety can be treated with medication, and medical advice should always be sought, many people also find it very helpful to undergo talking therapy, such as counselling. For example, both depression and anxiety can respond well to therapy that includes behavioural components, where the sufferer learns to understand which behaviours will help and which will worsen their problems. If the problems have developed due to life events, therapy can often help the sufferer to cope better and to understand their feelings and responses, which in turn can help to alleviate their symptoms. Those suffering from more complex mental health problems, including psychoses and personality disorders, can also respond well to therapy, but must always seek medical help first and the role of medication is very important.
On World Mental Health Day, I will be seeing clients, some of whom are coping with severe mental illness. I never fail to be impressed and inspired by their determination and capacity to overcome their problems, to live a ‘normal’ life. But when I first started working with people suffering from mental health problems I had very little idea what to expect, I admit that I was nervous about meeting people diagnosed with illnesses that had complicated and scary names. Although I had known people (including friends and colleagues) who had suffered from anxiety or depression, I’d had very little contact with people with more serious mental health illnesses – or so I thought. I remember reading the notes for the first client I had with several serious mental health diagnoses before I met her; I felt overwhelmed and was quite anxious about what she would be like. But as soon as I met her, I forgot the notes, I even forgot her diagnoses, and realised that she was simply a human being, like anyone, trying to deal with what life had thrown at her. Most of the clients I work with do not wish to be defined by their diagnoses which they see as ‘labels’. They are people who want help to deal with a health problem that they want to overcome. I work with them as I would work with anyone – helping them to get back in touch with their strengths and find their own ways to solve their problems, or to cope. Having information about mental health disorders is helpful, as awareness helps to dispel misunderstanding and discrimination usually stems from a lack of understanding; however, in my work with mental health sufferers, it can be just as helpful for me to be ‘unknowing’ about my client’s problems – and to let them tell me what it means to them, how it affects them. Talking is good.
The mental health charities Mind and Rethink Mental Illness have jointly launched the Time to Change campaign. The campaign urges us to talk about mental health – to start conversations, to share our experiences, to raise awareness and to put an end to ignorance and discrimination. None of us know if we will become one of the ‘one in four’. Many of us have been one of the ‘one in four’. It’s time to talk about it.