Mental Health Care

The facts of the mind, the games it can play, and the aces it has up its sleeve can dwarf the most eerie pieces of fiction. When tormented by irrational ideas, we can be driven into doing the unthinkable. Ideas, impulses, and images of senseless and intrusive nature can possess us. Howsoever disturbing, unrealistic or repugnant, it is sometimes impossible to escape them. Such repetitive, unwanted thoughts called obsession, in conjunction with inappropriate or bizarre repetitive acts, termed compulsion, give birth to the obsessive-compulsive disorder.A common disorder, it can put you through hell and fire­ guzzling a lot of time, causing much anxiety and distress, and interfering with your ability to function in various social settings. Preyed upon by this illness, you may well realize the irrationality of your thoughts and acts, and yet be unable to suppress them.

There are moments in our lives when many of us have bizarre, inappropriate thoughts and we may even engage in strange, senseless actions. For example, about to leave for work you turn on the ignition of the car, and suddenly feel compelled to check if you had left the door open, stove burning, or the faucet flowing. Watching a game on the television you find that your team is doing well, and so you remain glued to your seat fearing that any movement on your part could undo your team! You are desperate to see a job through and decide that if you were to reach the spot in ‘x’ number of steps, you would accomplish it, and so you will yourself to take the ‘x’ steps! These are all examples of obsessive-compulsive behaviour, but they should not be regarded as a disorder unless they are persistent and repetitive and oppress life.

Read out more on stress management and alzheimer’s care

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It can happen any time. Your inner self presses the panic button for no rhyme or reason. All of a sudden, an attack of terror and apprehension overwhelms you. Your heart begins to race, your face flushes, and you have trouble breathing. You feel dizzy, queasy, out of control-some people even feel they are going crazy or are about to die.

Every year, millions of people across the world go through an experience like this. Many, fearing the worst, think they’re having a heart attack and rush to an emergency room. Others, though overtaken by fear, try to ignore it. But the story is much the same. Each of them just had a panic attack. Call it panic disorder, if you like. Once dismissed as ‘nerves’ or stress, a panic attack is now recognized as a potentially disabling but treatable condition. Typically, the attack lasts from a few seconds to several hours. Most attacks, however, peak within ten minutes and exit within 20 or 30 minutes, leaving its sufferer sometimes with a vague sense of exhaustion. They may come back any time and the unpredictability regarding their reappearance perturbs the victim with persistent anxiety. Life is laden with fear and one simply does not know what to do. Some people feel so inundated with fear that they stop stepping out of their homes.

The disorder is fairly common. It affects about two per cent people during their lives and twice as many women as men. The attacks typically begin in young adulthood-late teens and early twenties-and can recur throughout life. While some people experience panic attacks frequently, almost daily or every week, others suffer the attack less often. The condition tends to run in families; possibly heredity plays a role. If somebody has a diagnosed panic disorder, up to 18 per cent of his or her first-degree blood relatives may also suffer similarly. Studies done on identical twins also corroborate the genetic factor. If the disorder affects one of a pair of identical twins, the second twin runs a high risk of being similarly affected. But this kind of risk does not affect non-identical twins.

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Liver. Repeated exposure to large amounts of alcohol may cause serious liver damage. In the first stage of liver disease caused by alcohol, fat accumulates in the liver. This stage of the disease is known as fatty liver. Most people do not notice symptoms of fatty liver, although in some people the liver becomes enlarged and tender. Some people with fatty liver develop hepatitis, which inflames and kills liver cells. Hepatitis is marked by jaundice, which gives a yellowish tint to the eyes and skin. Still later, people develop cirrhosis, an irreversible condition in which normal liver tissue is replaced by scar tissue. The scarring prevents blood from travelling freely through the liver, building blood pressure in the veins that run from the intestine to the liver. Consequently, the liver can no longer process toxins efficiently, causing poisons to build up in the blood. The body begins to bloat, the kidneys may also fail and rapidly the condition can become fatal. Many cine stars, writers, poets, artists and commoners die a painful death because of this ill effect.

Pancreas. Chronic intake of alcohol or an alcoholic binge can cause a severe acute or chronic inflammation of the pancreas. The condition is called pancreatitis, and it can have serious and potentially fatal outcome.

Food pipe, stomach and bowel. Acute alcohol intake can severely damage the inner lining of the food pipe and the stomach, and lead to vomiting, bleeding and, sometimes, a tear in the wall. The bowel movement can increase leading to diarrhea.

Increased cancer risk.There is also an increased risk to cancer developing in the oral cavity, gullet, food pipe, stomach, liver and pancreas.

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Schizophrenia appears to be related to a cluster of causes rather than to a single cause. The current thought is that schizophrenia is a biological disease linked to genetic factors and the imbalance of neurotransmitters (chemicals) in the brain. In some people, the illness could also be caused by abnormalities in the prenatal environment or some distinct structural abnormalities in the brain. The role of stressful life-events has also been a subject of intense study as it is suspected that they could also be playing a secondary part in the precipitation of schizophrenia in vulnerable people.

Genetic Factors

It is clear from the studies of twins, family, and adopted children that genes and schizophrenia are intertwined. The risk of the onset of schizophrenia strongly depends on one’s genetic inheritance. Studies of families with the illness have found that a child who has one parent with schizophrenia, has a 10-13 per cent risk of developing the illness, whereas a child whose mother and father both have schizophrenia is at a 46 per cent risk of being similarly affected. The risk does not mitigate even if such children are adopted and raised by healthy parents. In comparison, children in the general population are only at about one per cent risk. It is likely that not one or two, but many different genes interacting with each other and with environmental risk factors result in schizophrenia.

The Dopamine Factor

There is mounting evidence to suggest that schizophrenia could be a result of an imbalance of chemicals in the brain. These chemicals enable brain cells to communicate with each other and are called neurotransmitters. The main culprit seems to be dopamine. Its overactivity in certain parts of the brain is the likely root cause of schizophrenia. The support for this hypothesis comes from several quarters. First, the effectiveness of antipsychotic drugs, which help in schizophrenia, hinges on blocking receptors for dopamine in the brain. Second, dopamine also plays a role in the mechanisms that govern attention and filtering of stimuli, the breakdown of which can lead to the illness. Third, amphetamines, which increase dopamine activity, intensify psychotic symptoms in people with schizophrenia. Despite these findings, scientists are yet to find out what causes the increase, or increased sensitivity of brain cells to dopamine in the first place.

Structural Abnormalities in the Brain

With the help of newer brain imaging techniques, researchers have discovered specific structural abnormalities in people suffering from schizophrenia. They tend to have larger cerebrospinal fluid cavities in the brain, a smaller overall volume of brain tissue and an abnormally low activity in the frontal lobe of the brain, which governs abstract thought, planning, and judgment. These defects may partially explain the abnormal thoughts, perceptions, and behaviour that characterize schizophrenia. However, these changes are not universal and may also be a result rather than the cause of the illness.

Prenatal Environment

Evidence suggests that pregnant mothers, who have poor nutrition or who get exposed to the influenza virus, are more likely to give birth to a child vulnerable to schizophrenia.

Psychosocial Stress

There has been a search for stressors and possible schizophrenic personality traits that may affect the onset and the course of illness. These efforts have largely drawn a blank, except for finding that stressful life circumstances can trigger episodes of schizophrenia in a person biologically predisposed to the disease. Individuals who have effective skills for managing stress may be less susceptible to its negative effects.

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Phobias are thought to be learned, not innate, emotional responses. It is generally held that phobias occur when fear produced by an original threatening situation is transferred to other similar situations, with the original fear often repressed or forgotten. A traumatic childhood experience such as being attacked by an animal, being trapped in a closet, or a near drowning, can produce a specific phobia for the animal, closed spaces, or water. It may also relate to an unpleasant childhood memory of seeing another person suffer. For example, a child who sees a person fall from a height might develop a phobia of heights. The impressionable young mind might also develop a fear modelled on the behaviour of a parent or role model. Likewise, repeated viewing of horror-filled images of a train accident or airplane crash on the television, and repeated warnings from a parent or elder about the dangers of an object can also spur a phobia. The individual may at first try to avoid the object or situation. This response might reduce anxiety in the short term, but it instils deep fear of the object in the inner consciousness and generates phobia.

Social phobias often emerge out of a childhood history of social inhibition or shyness. They may also relate to a stressful or humiliating experience. A poor public performance followed by loss of esteem can cause permanent cracks in the inner self

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Discuss your concerns with a trusted friend or family member. Talking helps relieve stress and put things in perspective; it may also lead to a healthy plan of action.

A positive social support system provides us with emotional sustenance, tangible resources and aid, and information when we are in need. It makes us feel cared about and valued by others and we also have a sense of belonging that can come in handy in moments of despair.

Many large community surveys have linked social support to good health and a superior ability to cope with stress. In general, people with extensive social ties live longer and healthier than those with few close social contacts. Even the perception of social support can help people cope with stress. Studies have found that the promise of availability of social support by itself mitigates the stressors, irrespective of the actual support received in need.

Even a pet at home can help lower the stress. The companionship acts as a balm to your bruised mind. Studies have found that in times of stress, people with pets made fewer visits to the doctor than those without pets.

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