Mental Health Day

Mental Health Day — October 10

Dr. Zach

 

1. Most common mental health problems
2. Symptoms of depression
3. Types of anxiety disorders
4. Substance abuse and self-medication for mental illness
5. When is it a disorder?
6. Why don’t people get help?

— stigma

— the system

7. What to do if you or a loved one needs help
8. What treatment is available

 

Institut national de santé publique du Québec: annual prevalence of mental health disorders is 20%

Fewer than 50% of people with mental disorders see a doctor for these problems

Increasing prevalence in children and adolescents.

 

Mental illness in Canada

• In any given year, 1 in 5 people in Canada will personally experience a mental health problem or illness.
• Mental illness affects people of all ages, education, income levels, and cultures.
• Approximately 8% of adults will experience major depression at some time in their lives.
• About 1% of Canadians will experience bipolar disorder (or “manic depression”).

• By age 40, about 50% of the population will have or have had a mental illness.
• Schizophrenia affects 1% of the Canadian population.
• Anxiety disorders affect 5% of the household population, causing mild to severe impairment.
• Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds.
• Suicide is one of the leading causes of death in both men and women from adolescence to middle age.
• The mortality rate due to suicide among men is four times the rate among women.
• Almost one half (49%) of those who feel they have suffered from depression or anxiety have never gone to see a doctor about this problem.
• Stigma or discrimination attached to mental illnesses presents a serious barrier, not only to diagnosis and treatment but also to acceptance in the community.
• Mental illnesses can be treated effectively.

Depression

 

Causes of depression

 

Biological — neurotransmitter imbalance — serotonin, norepinephrine

Psychological — worldview, thoughts

Social — Life events

 

Depression symptoms:

 

Emotional Symptoms

Constant sadness, almost every day

Feeling of worthlessness, of excessive or inappropriate guilt

Dark or suicidal thoughts

Loss of interest or pleasure in favourite activities

Physical Symptoms

Low energy

Aches and pains

Insomnia or its opposite, hypersomnia

Change in weight

 

Behavioural Symptoms

Change in appetite

Impression of restlessness

Difficulty making decisions or focusing

 

Treatment

 

Therapy

Exercise is as good as medication (but it is often hard for depressed people to be motivated to exercise)

Sleep (both a result and a cause of anxiety and mood disorders)

Diet (studies on diet and mood are ongoing)

Medication

 

Anxiety

 

Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying.

These disorders affect how we feel and behave and can cause physical symptoms. Mild anxiety is vague and unsettling, while severe anxiety can seriously affect day-to-day living.

Anxiety disorders affect over 3 million people in Canada. Anxiety and depression are the most common mental illnesses in the country. However, less than 50% of people with the condition receive treatment.

What is anxiety?

Anxiety is a natural human reaction to stressful situations, but becomes a condition when it frequently occurs without a trigger.

The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”

It is important to know the difference between normal feelings of anxiety and an anxiety disorder that requires medical attention.

Anxiety

When faced with potentially harmful or worrying triggers, feelings of anxiety are not only normal but necessary for survival.

Ever since the earliest days of humanity, the approach of predators and incoming danger has set off alarms in the body and allowed an individual to take evasive action. These alarms become noticeable in the form of a raised heartbeat, sweating, and increased sensitivity to surroundings.

A rush of adrenaline in response to danger causes these reactions. This adrenaline boost is known as the ‘fight-or-flight’ response. It prepares humans to physically confront or flee any threats to safety.

For most modern individuals, running from larger animals and imminent danger is a less pressing concern. Anxieties now revolve around work, money, family life, health, and other crucial issues that demand a person’s attention without necessarily requiring the ‘fight-or-flight’ reaction.

That nervous feeling before an important life event or during a difficult situation is a natural echo of the original ‘fight-or-flight’ reaction. It can still be essential to survival – anxiety about being hit by a car when crossing the street, for example, means that a person will instinctively look both ways to avoid danger.

Anxiety disorders occur when a reaction is out of proportion to what might normally be expected in a situation. The APA describes a person with anxiety disorder as “having recurring intrusive thoughts or concerns.”

Types

Anxiety disorders can be classified into six main types. These include:

Generalized anxiety disorder (GAD): This is a chronic disorder involving excessive, long-lasting anxiety and worries about nonspecific life events, objects, and situations. It is the most common anxiety disorder. People with GAD are not always able to identify the cause of their anxiety.

Panic disorder: Brief or sudden attacks of intense terror and apprehension characterize panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties. Panic attacks tend to occur and escalate rapidly and peak after 10 minutes. However, they may last for hours.

Panic disorders usually occur after frightening experiences or prolonged stress but can also occur without a trigger. An individual experiencing a panic attack may misinterpret it as a life-threatening illness. Panic attacks can also lead to drastic changes in behavior to avoid future attacks.

Phobia: This is an irrational fear and avoidance of an object or situation.

Social anxiety disorder: This is a fear of being negatively judged by others in social situations or a fear of public embarrassment.

Obsessive-compulsive disorder (OCD): This is an anxiety disorder characterized by thoughts or actions that are repetitive, distressing, and intrusive. OCD sufferers usually know that their compulsions are unreasonable or irrational, but they serve to alleviate their anxiety.

Post-traumatic stress disorder (PTSD): This is anxiety that results from previous trauma such as military combat, sexual assault, a hostage situation, or a serious accident. PTSD often leads to flashbacks, and the person may make behavioral changes to avoid triggers.

Separation anxiety disorder: This is characterized by high levels of anxiety when separated from a person or place that provides feelings of security or safety. Separation sometimes results in panic symptoms. It is considered a disorder when the response is excessive or inappropriate after separation.

 

Treatment (as for depression)

 

Therapy

Exercise

Sleep (both a result and a cause of anxiety and mood disorders)

Diet (studies on diet and mood are ongoing)

Medication

 

The stigma of mental illness persists

 

Mental health issues exist on a continuum/spectrum.  Everyone experiences anxiety and sadness from time to time.  It is normal and sometimes adaptive (some anxiety before a race or test).

 

When does it become an illness — when it causes Impairment of function

 

There can be Physical manifestations of mental illness — headaches, abdominal pain, nausea, numbness, dizziness, chest pain, shortness of breath

 

It is difficult to get mental health services.  CLSC is the guichet d’access for mental health services but it takes time.  ER for emergencies.

 

Substance abuse is prevalent.  Some of it stems from self-medication

 

How to help someone:

Don’t try to fix your loved one’s problem on your own

Don’t ask them to “snap out of it”

Learn the symptoms of depression

Some helpful things you can say are:

“I’m here for you.”

“I care.”

“I may not understand your pain, but I can offer my support.”

“You are a worthwhile person and you mean a lot to me.”

“Don’t give up. You can get through this.”

Encourage treatment

Take care of yourself