Features — 26 July 2013 — by Dr. Elma Whittaker-Augustine, Clinical Psychologist

I would like to begin our first monthly article on mental health and mental illness by clarifying the difference between the two. Contrary to common belief in Belize, mental health is not the same as mental illness. Mental health, which is inseparable from physical health, is essential to the healthy functioning of individuals, families and a healthy society.

It is important to understand that mental health is not the same as mental illness. Mental Health is interconnected with our physical health and is defined by our:

ABILITY TO ENJOY LIFE

ABILITY TO BOUNCE BACK FROM STRESS, LOSS, CHANGE

ABILITY TO MAINTAIN BALANCE IN OUR LIFE, e.g. balance between work and play, rest and exercise

ABILITY TO BE FLEXIBLE in our thinking and emotions

ABILITY TO RECOGNIZE OUR GIFTS, STRENGHTS, POTENTIAL

ABILITY TO FORM HEALTHY RELATIONSHIPS

SELF ESTEEM, FEELINGS, THOUGHTS, PERCEPTION OF OURSELF, OTHERS, LIFE

On the other hand, Mental Illness is a term used to describe disorders that affect our thoughts, emotions, behaviors and functioning, cause distress and negatively affect our lives and our family. There are many common mental illnesses such as mood disorders, anxiety disorders, psychotic disorders, etc. Mental illness affects adults, children, rich, poor, male, female, all ethnic and racial groups.

I hope the monthly articles in Amandala will serve to: promote knowledge, understanding, eliminate social exclusion, get rid of stigma and discrimination that are barriers to treatment, and promote good mental health for all Belizeans. Our monthly discussions will cover common mental illnesses and ways to enhance and maintain our mental health.

Today I would like to begin our discussion with one of the most common mental illnesses – Clinical Depression.

Clinical Depression

When we respond to rough periods, distressing or upsetting events, for example, the death of someone we love, break up of a relationship, loss of a job, natural or man- made disaster, or abuse, we experience fleeting periods where we feel sad, low or depressed. Everyone becomes depressed at some time in their lives. However, most of us quickly recover from such feelings. When this is the case, the fleeting experience of depression is normal. However, when we become stuck in our depressed feelings (almost every day for two weeks or more), we experience Clinical Depression, a mood disorder which is an emotionally, physically, spiritually painful illness.

Some have described clinical depression as “the great sadness,” or have compared it to wearing a “cloak made of steel” or being surrounded by a dark cloud that follows you wherever you go and prevents you from enjoying a sunny, pleasant day. The experience of clinical depression affects our thoughts, emotions, behaviors, our functioning, and can disable us socially and biologically. Research shows that clinical depression is one of the top causes of disability in the world and contributes to death (due to suicide).

Clinical Depression is characterized by some of the following symptoms:
We cannot enjoy things in life that we once enjoyed and our capacity to experience interest or pleasure is reduced

We experience low mood and feel sad, down, empty, depressed

We do not feel like talking to or being around other people; we prefer to be alone

We feel tired, lack energy and slow down

We do not eat or we overeat, or we lose weight or gain weight

We sleep badly, e.g. wake up early and get little sleep or we sleep too much

Our mind becomes full of negative thoughts: we focus on how bad things are and how hopeless everything is all the time

We feel hopeless, helpless, worthless, bad, guilty, and wish we would die and may even think about hurting ourselves

We experience difficulty concentrating, thinking straight, making decisions

We may cry excessively, or we may display anxious or irritable moods

It should be noted that at times clinical depression in adults can present (be masked by) physical symptoms such as headaches, tightness in the head, rapid heart-beat, chest pains, backaches, indigestion, memory loss, dry mouth.

In infants: failure to grow properly. In toddlers: protracted tantrums. In nursery school child: overly aggressive or withdrawn behavior. In elementary school child: school avoidance. In adolescents: refusal to eat, irritability, restlessness, easily annoyed, boredom, energy, reckless behaviors, sensitivity to rejection and failure, alcohol and substance abuse, runaway behavior, school absence, poor school performance.

Clinical Depression can be mild, moderate or severe. A person can experience a single episode or it may keep occurring, chronic. An episode may last a few weeks, 6 months, 9 months, or years. There are different types of depression: unipolar, bipolar, atypical, postpartum, seasonal (SAD).

Some Causes of Clinical Depression:

Stress from our environment and personal lives

Genetics (runs in some families)

Biochemical abnormalities in the brain, changes in brain chemical

Drug use

Physical illness

Treatment for Clinical Depression:

Antidepressant medication for moderate to severe depression combined with therapy/counseling. Improvement with medication takes 2-4 weeks and is usually prescribed for 6 months to 1 year to reduce relapse.

Supportive therapy (which alone may be sufficient to treat mild depression) which focuses on: cognitive behavior techniques to change negative thoughts, to understand and manage triggers and feelings, make life changes, learn ways to cope, set short term daily and long term goals, learn to appreciate your talents, strengths, skills, good qualities, etc.

What you can do: outline and engage in ways to help yourself: e.g. plan activities that will keep you active and improve your mood such as exercise, change the way you spend your time, e.g. avoid isolation, avoid negative thinking and talking, encourage yourself to eat even if you do not feel like it, talk to someone you trust, get a good night’s sleep, learn to manage and let go of hurt and anger, avoid resentments and grudges, listen to positive, self-soothing, uplifting music, read, pray, use daily positive affirmations, make a daily grateful list, find relaxing outlets, e.g. sports, a funny movie, art, practice deep breathing.

Accept that clinical depression is not your fault, it is not a sign of emotional weakness, and it is not a sign of failure. It is an illness that can be treated. Early recognition and treatment prevent great suffering.

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