Understanding Mental Health: Defining mental illness

“A MENTAL illness is just like any other illness,” said Dr. Laureen Conanan, chief of Southern Philippines Medical Center’s Institute of Psychology and Behavioral Medicine (SPMC-IPBM), and that mental illness can also take various forms just like the physical illness. Like physical illness, too, it can be cured.

“Most people misunderstand mental illness. Some even make jokes about people being crazy even if we know we shouldn’t make fun of them. It should not be feared also. There is no fear only if we learn more and understand about them,” Conanan said.

Conanan defines the mental illness as a psychological state of a person who has emotional or behavioral problems; a serious health condition enough to require psychiatric intervention. Just like other diseases, mental illness is severe in some cases and mild in others, she added.

“We have all had some exposure to mental illness, and it will turn out bad kung hindi natin aalagaan ang ating sarili,” Conanan said.

Conanan said there is “NO” single cause of mental illness, only an interplay between medical (biological), traditional (social and cultural) and psychological factors, which means the grounds are either on stress; complicated family background; brain diseases; heredity or genes; abuse of alcoholic drink; and medical.

Based on the “Mental Health Care Delivery: Linking the hospital to the community,” offered by Conanan, the common types of mental illness are depression; anxiety; alcohol & drugs; schizophrenia; retardation; dementia; attention deficit hyperactivity disorder (ADHD); autism; and obsessive-compulsive disorder.

Here are some explanations:

ANXIETY: People with anxiety disorders respond to certain situations with fear and dread. It also shows physical signs of anxiety or nervousness, such as suffocation, rapid heartbeat, and sweating. The anxiety is diagnosed if the person’s response is not appropriate to a situation.

“Anxiety disorder include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias. It has thoughts of impending death and going mad,” Conanan said.

DEPRESSION: It is also called affective disorder. This includes persistent feelings of sadness, or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. A mood of whether depress, mania, and bipolar disorder. People with poor self-esteem and has suicidal ideas.

“When we say depression, hindi lang sadness or poor appetite yung pag-babasehan natin. Posible ding meron problem sa brain that generates that kind of thinking, feeling, behavior or pagiging out of control. A clinical depression that needs intervention, at malalaman lang natin yan through a CAT scan,” she said.

PSYCHOTIC: It includes distorted awareness and thinking. Most common symptoms of the psychotic are hallucinations--seeing images, hearing sounds that are not real, and delusions which are all false beliefs, despite evidence to the contrary. Schizophrenia is an example of psychotic disorder.

ADDICTION: A person with impulse control disorder is unable to resist urges or impulses to perform acts that could be harmful to themselves or others, such as pyromania (starting fires), kleptomania (stealing), and compulsive gambling are among the examples of impulse control disorder.

“Alcohol and drugs are the common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships,” Conanan added.

PERSONALITY: People with personality disorders have extreme and inflexible personality traits that are distressing to others and/or cause problem in work, school, or social relationships. The person's patterns of thinking and behavior significantly differ from the expectations of society.

“These kinds of persons are rigid such that they interfere with others’ normal functioning. It includes antisocial personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder,” the doctor said.

MENTAL RETARDATION: For young ones, there are delays in achieving milestone like sitting up, walking, and speaking, or having difficulties in school and difficulties in relating to others. For adults -- problems in everyday activities, such as managing money, finding and staying in a job, and more.

Conanan said individuals who have mental illness don’t necessarily look like they are sick especially if the illness is just mild. She added that other individuals may show more clear symptoms such as confusion, disturbance, or withdrawal.

She also said that not all brain diseases are categorized as mental illnesses. She said disorders such as the epilepsy; Parkinson’s disease and multiple sclerosis are considered neurological diseases but not mental illness.

According to The Science Education of Mental Illnesses, as scientists continue to investigate the brains of people who have mental illness, it was learned that such illness is associated with changes in the brain’s structure, chemistry, and psychological function. Mental illness does indeed have a biological basis.

“How would we able to know if a person is mentally ill? There are factors na dapat tingnan like may mga kakaibang pagbabago ba sa mga ikinikilos o pananalita niya compared nung una, ano bang pinagdaanan niya sa buhay, at iba pa. The best way to know is to consult a doctor,” Conanan said.

She said conduct disorder manifests the following: the person lies, is destructive, runs away, stays out late, bullies, initiates fight, is cruel to animals, sets fire, engages into robbery, mugging, or any crimes, uses weapons, harms people even itself, and forces sex.

A problem

Conanan admitted that mental illness is a major public health burden simply because it affects all. She said it should be treated not only by the psychiatrists and psychologists but also with the help of his/her loved ones, adding that aside from medical treatment, the recuperation also depends in the environment.

Emily, 49, a mother of Kit (not his real name) who is mentally ill, said she had a hard time understanding his son, and it is painful for her and his husband to see their son struggle. She added that her Kit has been acting odd for two years already.

“Makaapekto siya in the sense na kailangan namo siya alam-alaman kay naa man gud mga times na kalit ra s’ya magwala ug magyaw-yaw bisan wala siya hilabti. Ikaduha, gastos sa tambal. Dili baya mi arangan ug kahimtang unya iyang tambal nag kantidad ug P60 ang isa--maintain gud na (It affects us in the sense that we have to closely monitor him because there are times when he will break out in anger even though no one angered him. His medication also costs a lot, one tablet costs P60 each and it’s for maintenance),” Emily said.

When asked if she has idea what happened to her son, Emily said their not sure as the change was sudden. But she believes it has to do with his vices.

He was once a plumber and that while there were times when he went without a meal, that did not happen often, and thus the mother is convinced it was his vice and maybe some personal problems he kept to himself.

Kat (not her real name) who also experienced mental illness said she is still taking maintenance medicine until it is deemed that she no longer needs it. He deep depression was triggered by a breakup with her boyfriend almost five years ago.

“It’s complicated. Pero okay nako karon not only because of the medicine I take tungod na pud sa ako family and friends na sobra kaayo ang pag-pangga sa ako (That’s how it is when we are very much in love. It wasn’t just the breakup but the reason. It’s complicated but I’m okay now not only because of the medicine I’m taking but also the support of my family),” Kat said.

Kat’s cousin Ann, 27, said her cousin still needs to take medicine though not all the time, just for her to calm down and relax in times of trouble or difficulties. She added that Kat is now already doing well with her new life.

“Now, the question is, are these people crazy? No. How about unwell? Yes. Is it treatable? It is treatable. Kaya nga meron psychiatrists and psychologists to help people who are experiencing mental illness bring back to their normal lives. Para ka lang may diabetes niyan na kailangan ng medicine,” Conanan said.

The doctor said among the clinical presentations that might suggest mental illness is when the person or relatives complain directly of mental illness, when relatives suspect supernatural causes, when a specific cause of mental illness -- such as alcohol misuse and violence -- is obvious and when the patient history is too raw yet.

Services offered

As the only mental institute in Mindanao, the SPMC-IPBM offers services for its in-patient care are short, medium and long term care; consultation–liaison service; Women and Children Protection Unit (WCPU); forensic psychiatry; psychological testing and counseling; occupational therapy; and social work services.

As to the outpatient, Conanan said the Outpatient Department (OPD) is open Mondays to Fridays from 8 a.m. to 5 p.m. for medical consultation but the registration ends at 3 p.m. She added that doctors would only prescribed medicine to a patient who tested positive for mental illness.

“I would like to make things clear for those families na dinadala nila yung patient dito to undergo rehab or crisis intervention, please don’t leave your family member here for the rest of their lives. Just in case the patient needs regular treatment, it’s not necessary he/she must stay here, di po ganun,” she added.

Conanan said to avoid mental illness -- one must eat regularly; do some exercise; sleep and rest well; do stress management; live a healthy life -- have constant communication with family, friends, or colleagues; maintain a spiritual life; attend legal activities; avoid too much alcohol and other vices; and no to drugs.
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