WORLD Mental Health Day will be celebrated on Monday, October 10 by the World Health Organisation (WHO) with the tagline: “Make mental health and wellbeing for all a global priority.”
However, the challenge in making mental health a global priority is how to merge the time consuming mental assessment with a routine medical check-up at the primary care physician level.
Oftentimes the mental wellbeing of man, woman or child goes unnoticed since a mental health check is only done after friends, family and colleagues coerced a visit to the primary care physician having made their layman’s observations. In very rare cases the affected person directly seek out a psychiatrist, mostly because of self-denial or unawareness of his or her mental status. Usually, patients are accompanied by a relative.
The family doctor has the choice to handle some situations, consult a clinical psychologist if one is available, or refer challenging cases to a psychiatrist in both public and private systems. Referrals from pediatricians and gynecologists are also encouraged to improve otherwise lost possibilities. You must, therefore, ask for these services in order to give it priority.
A diagnosis is made only after ruling out any medical issues hence a physical examination and a thyroid function test are done. The patient’s history, including a genetic history and personal disclosure on relationship status such as martial, occupational and family, is recorded before proceeding on the mental health screening. Basic questionnaires online are available for easy access but are not a substitute for a doctor’s interview. These results must be forwarded to a mental health professional for evaluations and medical interpretation.
Patient confidentiality is key for building trust and following-up on treatment.
These mental health conditions are not monitored by routine biochemistry labs like cholesterol, kidney and liver function tests. Neither is there a visual measuring apparatus like the sphygmomanometer or the glucometer so you cannot self-assess your progress based on readings from a machine.
Mental illnesses have signs which vary in severity from mild and occasional episodes of mood disorders to life threatening scenarios, which can result in the tragic loss of a life by one who once enjoyed perfect physiologic health with optimally functioning organs.
Red flags for the mentally unhealthy are excessive worrying or fear, extreme sadness, significant personality changes, changes in eating habits and sleeping patterns, dramatic mood swings, frustration, irritability, anger, fatigue and or lack of energy, confused thinking, inability to concentrate, feelings of guilt or worthlessness and withdrawal from routine activities, relationships, work, school and life.
The alarm bells should most definitely go off if someone mentions suicidal ideation in the most casual by the way comment. This shows that this option is being considered and assistance should be rendered.
In Guyana mental illness should definitely be a high priority since it is visible in substance related disorders which have become culturally acceptable habits such as smoking, alcoholism, coffee addiction and binging. Since it is taboo to seek out professional help, many persons self-medicate with cigarettes, alcohol, coffee and food as a mechanism to address their inner feelings. Sometimes referred pains or unrelated ailments such as digestive problems without any etiology are indicators for mental illness.
A 2018 Pan American Health Organisation (PAHO) study in Guyana showed that more men suffer from self-harm and suicide, alcohol use disorders, depressive and headache disorders than women. From a Department of Public Information release in August 2022 it was estimated that 15 to 20 per cent of the Guyanese population suffer from mental illness from about 150 categories of disorders.
Hence, vigorous national moves were launched in collaboration with PAHO to formulate new strategies to address mental health, which includes enhancing accessibility to trained and certified resources. So the number of psychiatrists in country has been increased from two to 14 and there is a plan to incorporate mental health into the primary healthcare, using telemedicine for remote locations.
The common mental health disorders are:
* Bipolar disorder such as depression, manic –depressive and mania (mood disorders)
* Anxiety disorders (phobia, panic)
* Obsessive-compulsive (hoarding, hair pulling)
* Neurodevelopment disorder (attention deficit hyperactivity disorder- ADHD, autism and learning disorders)
* Eating disorder (binging, anorexic)
* Substance-related and addictive disorder (abuse of alcohol, tobacco, caffeine, gambling)
* Trauma and Stressor related (post-traumatic stress disorder-PTSD and acute stress disorder)
Other mental health disorders are:
* Dissociative Disorder (dissociative identity, dissociative amnesia)
* Neurocognitive disorder (Alzheimer, delirium and traumatic brain injury)
* Personality disorder (anti-social personality and narcissism)
* Paraphillic disorders (sexual sadism disorder, pedophilic disorder)
In mild circumstances, a general practitioner may give medication; in more complex cases, they may properly send patients to a psychiatrist; or they may collaborate with a psychologist to do talk therapy. Treatment options include talk therapy (psychotherapy) with or without medication, medication only, yoga, meditation, and case management in addition to complementary and alternative therapies, self-help groups, and peer support. The electroconvulsive treatment is another option.
It is very important to set up your support network. Apart from the handful of available experts in field, the psychiatrists and psychologists, other members of the treatment and care group can provide support such as the nurse, pharmacist and social worker.
Medications can be a game changer for those who are challenged to live a normal productive life which is not fixable with just talk therapy, exercise and meditation. The key is accurate diagnosis and dosing regimens to rectify the chemical imbalances in the brain. Always ask about what side effects to anticipate and follow up immediately if experiencing any unbearable side effects so as not to discontinue treatment. Knowing what to do if you miss a dose or when and how to stop the medication, are questions to ask.
Some of the non-medication contributions to mental wellness are eating foods to support a healthy gut such as reducing processed and sugary foods, eliminating food intolerances, using a high fiber diet, fruits, vegetables and other whole foods. Exercise and physical activities you enjoy should be regularly scheduled.
Quality and length of sleep and sleep hygiene (scheduled bedtime, non-use of electronics just before bedtime, activating dark mode and rest and relaxation) are key to getting mentally healthy. Social connectivity with friends and family enhances your emotional and physical well-being.
Developing a routine of healthy habits and setting work boundaries are gradual life changing processes to regain your power. Meditation or mindfulness along with positive affirmations are two self-disciplinary activities that will add to your mental strength.
For further discussion, contact the pharmacist of Medicine Express Pharmacy located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.