Resources

Mental Health is an individual’s emotional and psychological well being. It is equally important as physical health. However, we often see that because mental health is not ‘visible’, it gets less attention. This also results in a lot of misunderstandings about mental health. In the following section, we attempt to learn the correct facts about mental health. After all, mental health is everyone’s business!

+ What is Depression?

What is Depression?

Depression is one of the commonest mental disorders. Though common, it is a serious disorder that affects the well being of an individual. Depression is a mood disorder but it affects the way an individual thinks, feels and behaves. Approximately, 36% of Indians suffer from depression. it must be noted that depression is the second leading cause of deaths in the world. It is on a rise among the adolescents and younger population. People of all ages are likely to suffer from depression. Women are twice likely as men to suffer from depression. Most often, depression sets in at the age of 25-44 years but people below and above that age are also equally likely to suffer.Depression is caused due to various factors- usually a combination of genetic, biological, environmental, and psychological factors. It is a disorder that runs in families. Factors like traumatic experiences, heavy losses, poor environment and other socio-economic factors play a role in contributing to the development of depression.

Symptoms

  • Seek help if you notice some (5 or more) of these symptoms for over a period of 2-3 weeks:

  • Persistent sad, anxious, mood

  • Feelings of hopelessness

  • Irritability

  • Feelings of guilt, worthlessness, or helplessness

  • Decreased energy or fatigue

  • Thoughts of death or suicide, or suicide attempts

  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

  • Loss of interest or pleasure in hobbies and activities that were once interesting

  • Moving or talking more slowly

  • Feeling restless or having trouble sitting still

  • Appetite and/or weight changes

  • Difficulty concentrating, remembering, or making decisions

  • Difficulty sleeping, early-morning awakening, or oversleeping

  • Continue to learn more about depression

In the presence of these symptoms, one may consult a counselor or a psychotherapist. Medication along with psychotherapy works best for depression.

Tips to take care

  • Small steps to help you or your loved ones along the way.

  • Exercise regularly

  • Eat a healthy and balanced diet

  • Sleep well in the night

  • Follow a hobby

  • Interact with people around you

  • Talk to family and friends about your feelings

  • Don’t bottle up your feelings

  • Meditation and yoga under guidance may help

+ What is Anxiety?

Anxiety disorder is a serious and another common mental disorder. It is characterized by unexpected and repeated episodes of feeling fear and tenseness.

Though feeling anxious at times is completely normal, the disorder is very discomforting for the individual. The feeling of anxiety is manifold as compared to usual anxious feelings and it is repetitive and overwhelming. Anxiety disorders disrupt daily functioning along with personal and social relationships. There are several types of anxiety disorders (social anxiety, GAD, panic attack, panic disorder etc), which will be discussed in later blogs.

On an average, one in four individuals suffer from an anxiety disorder. On an average, the age at which anxiety occurs is 19 years but research shows that it has and it can develop in children as small as 14 years also. The likelihood of adolescents suffering from this disorder is on the rise. Women are more likely to develop anxiety disorders than men.

The cause for anxiety disorders is a combination of genetic, biological, environmental, and psychological factors. It is a disorder that runs in families. Factors like stress creating situations are a major factor of anxiety disorders, especially so when adequate support to deal with stress and anxiety is absent.

Symptoms Seek help if you notice some (5 or more) of these symptoms for over a period of 2-3 weeks:

  • “Racing” heart or heart palpitations
  • Feeling weak, faint, or dizzy
  • Tingling or numbness in the hands and fingers
  • Sense of terror, or impending doom or death
  • Feeling sweaty or having chills
  • Chest pains
  • Muscle tension
  • Breathing difficulties
  • Feeling a loss of control
  • Irritability
  • Fatigue
  • Difficulty to pay attention and concentrate

In the presence of these symptoms, one may consult a counsellor or a psychotherapist. Medication along with psychotherapy works best for anxiety disorders.

Tips to take care Small steps to help you or your loved ones along the way.

  • Eat healthy and a balanced diet
  • Exercise regularly
  • Sleep well in the night
  • Relaxation techniques for breathing under guidance
  • Reduce consumption of caffeine
  • Talk to family and friends about your anxious feelings
  • Let people know that you need support
  • Meditation and yoga under guidance may help

+ What is Epilepsy?

Epilepsy is a neurological problem in which people get unexpected and repeated seizures or fits.It is a chronic disorder that continues for a long term of period. Approximately 50 out of every 100,000 people develop epilepsy each year and about 50 million people have epilepsy globally.

The seizures occur because of a sudden surge of electrical activity in the brain – there is an overload of electrical activity in the brain. Epileptic seizures are often associated with particular triggers or changes in your daily habits or routine.The onset of epilepsy is most common during early childhood and after age 60, but the condition can occur at any age. If someone from the family has epilepsy, then the person is more likely to develop epilepsy.

Symptoms

Seek immediate care if any of these symptoms are present.

  • A convulsion with no temperature (no fever).
  • Short spells of blackout, or confused memory.
  • Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme tiredness.
  • For a short period the person is unresponsive to instructions or questions.
  • The person becomes stiff, suddenly, for no obvious reason
  • The person suddenly falls for no clear reason
  • Sudden bouts of blinking without apparent stimuli
  • Sudden bouts of chewing, without any apparent reason
  • For a short time the person seems dazed, and unable to communicate
  • Repetitive movements that seem inappropriate
  • The person becomes fearful for no apparent reason, he/she may even panic or become angry
  • Peculiar changes in senses, such as smell, touch and sound
  • The arms, legs, or body jerk, in babies these will appear as cluster of rapid jerking movements.
  • If some of these symptoms are present, you must see your general practitioner who will then guide you to see a neurologist. The treatment of epilepsy involves the use of medication (anti-epileptic drugs) or in some severe or untreatable conditions, surgery also helps.

Tips to take care Small steps to help you or your loved ones along the way.

  • Get plenty of sleep each night — set a regular sleep schedule, and stick to it.
  • Learn stress management and relaxation techniques.
  • Avoid drugs and alcohol.
  • Take all of your medications as prescribed by your doctor.
  • Avoid bright, flashing lights and other visual stimuli.
  • Skip TV and computer time whenever possible.
  • Avoid playing video games.
  • Eat a healthy diet.

+ What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a group of neurological and developmental disorders. It begins early in childhood and lasts throughout a person’s life and significantly affects social and communication skills. Usually, parents may identify certain behaviors in toddlers between 18 to 24 months of age.

It is referred to as a “spectrum” because it involves numerous closely related disorders and an entire range of symptoms that may differ in different individuals. While some may be mildly impaired, others can be severely affected. However, in many cases, individuals with ASD may show great strength and excellence in a particular field.

Risk Factors

The exact cause of ASD is unknown. Apart from the listed risk factors, there can be multiple triggers that may co plicate the problem to an another degree like bullying, problems in school, unemployment, over dependency on others, social exclusion and familial stress and ill treatment.

  • Sex: Boys are about four times more likely to develop autism spectrum disorder than girls are.
  • Genetics: Parents who may have a child with ASD are likelier to have another child who may also develop ASD. 20% of children with ASD may also have other genetic conditions like Downs syndrome, fragile X syndrome, tuberous sclerosis and Rett’s syndrome.
  • Older parents are at an increased risk for having children who may develop ASD.

Symptoms

Seek care if any of these symptoms are present. Visit your paediatrician first.

  • No response to their name by 12 months of age
  • Rarely sharing enjoyment of objects or activities by pointing or showing things to others
  • Repeating certain behaviors or having unusual behaviors
  • Flap their hands, rock their body, or spin in circles
  • Get aggressive and upset by minor changes
  • Have unusual reactions to the way things sound, smell, taste, look, or feel
  • Has trouble understanding other people’s feelings or talking about own feelings
  • Has flat or inappropriate facial expressions
  • Avoids or resists physical contact
  • Reverses pronouns (e.g., says “you” instead of “I”)
  • Gives unrelated answers to questions
  • Does not understand jokes, sarcasm, or teasing
  • Has to follow certain routines
  • Has poor eye contact
  • Has difficulty recognizing nonverbal cues, such as interpreting other people’s facial expressions, body postures or tone of voice
  • Has specific food preferences, such as eating only a few foods, or refusing foods with a certain texture
  • Difficulty or failure to make friends with children the same age

Diagnosing ASD

Diagnosing ASD is a difficult task due to the overlapping of symptoms with other disorders especially in older adults. Usually there is a general screening that looks at any family, physiological and genetic factors which may point towards the disorder.

Post which, additional evaluations involve cognitive level or thinking skills, language abilities, age-appropriate skills, blood tests and hearing tests. A child with ASD may have a team of specialists who will help with diagnosis including child psychologists, child psychiatrists, speech pathologists, developmental pediatricians, pediatric neurologists, audiologists, physical therapists and special education teachers who also help with educational determination.

Tips to take care

Due to the wide range of symptoms, there is no single best and appropriate therapy or treatment optional available for ASD and hence it is best to choose an elective approach towards treating ASD. Behaviour programs mainly focus on social kills, communication and parent interaction. Specially trained professionals will work with both children and parents to facilitate change in challenging behaviors.

There are different forms of therapy used to treat ASD. Some of them include speech and language therapy, music therapy, occupational therapy and neurofeedback. There is no way to prevent ASD but early diagnosis and intervention can go a long way in reducing the intensity of symptoms and improving daily functioning.

ASD is a lifelong condition but with the right treatment programme, symptoms can be considerably managed and controlled. Medication is usually prescribed to help with irritability, aggression, repetitive behaviours, hyperactivity, anxiety and depression.

+ Can High-Functioning Individuals Suffer From Depression?

Sadness is a typical, universal emotion that is expected in situations of loss, change, or difficult life experiences/situations. One must understand the difference between sadness and depression. Where sadness is an emotion that we all experience at some point of time, depression is not an emotion, it is an illness. Depression is a condition that exists without triggers and continues to be there for a period of time, to an extent that it hampers daily functioning. Depression is more than occasional sadness and not everyone will suffer from depression during their lifetime. Depression involves periods of hopelessness, lethargy, emptiness, helplessness, irritability, and problems focusing and concentrating. Depression needs treatment and it is a treatable condition. Depression is the second leading cause of death across the globe, increasing the burden of illness in the bio-psycho-social realms of society. Depression has multivariate faces with a manifestation in more than 10 types depending upon the context, onset and severity of the illness. Nevertheless, the primary symptoms of depression remain to be seen as-

  • Changed patterns of sleep
  • Reduced or increased appetite
  • Lack of feeling of joy and interest in activities that were previously enjoyed
  • Lack of energy; and lethargy
  • Low mood

However, when we speak about high functioning individuals, the depression is manifested and overtly seen quite differently and not that obviously. High functioning individual, as understand colloquially, refers to someone who is performing above what would be expected of them. It is usually used with a context of development. Thus, the term is actually a comparative term and rather subjective (or based on someone’s opinion). It may be simplistically used to have an “all or none” connotation – which would entail the person either being high-functioning or not. Most individuals have a mix of skills and abilities and may be high-functioning in certain areas and not in others. It is also important to understand that sometimes, high functioning is understood in the pathological context where the individual is referred to as a high functioning disordered personality and such an individual is one who is able to conceal his/her dysfunctional behaviour in certain public settings and maintain a positive public or professional profile while exposing their negative traits to family members or close ones.

Though no clear statistics are available to demarcate the prevalence of depression among high functioning individuals, the situation tends to prevail. What is characteristically seen in high functioning individuals with depression is that the inhibited energy and desire for activity/action is directed in an effort to succeed with goals. The drive to accomplish often sustains action and moves high-functioning individuals towards getting things done which makes it appear to be relatively constructive diversion of energy. High-functioning depression is similar to low-level depression and can last around five years in adults or one to two years in children and teens, according to the Harvard School of Public Health. And while it may not leave you devastated and hopeless, high-functioning depression can deteriorate quality of life, dampen the enthusiasm for work and also affect school, family, and even social activities. There are certain signs that we may look for, to identify depression in individuals who are high functioning by action and nature-

Setting higher goals and feelings of dissatisfaction: People with high functioning depression constantly set higher goals for themselves without the appreciation of their achievements. It is difficult for them to accept compliments because they feel they can be better than what they are.

High functioning individuals with depression are usually low on physical energy but have adequate mental energy that is constructively diverted to work.

It is difficult for them to deny work, especially when given by people in position of authority. They are also typically seen as Type A personalities (workaholic, competitive, self-critical).

They fear obligation and guilt. Depression and anxiety may coexist in the individual. Irritability is a lesser known symptom of depression, but it’s seen and individuals may be seen displacing these emotions on loved ones and near ones with no apparent reason. The feeling of guilt lingers. Feeling drained to maintain relationships may drain out the individual who feels the compulsion to keep contributing more to add value or enrich eh relationship, even in instances when not required. Individuals with high functioning depression either sleep too much or too little.

Depression isn’t a recognisable condition in high functioning individuals as they are able to surface their depression with skills. Reduced social interactions and meetings outside work settings. They may be isolative, and this may often translate into distance in relationships with peers and kinship.

Co-occurring medical conditions, like diabetes or cancer, cause stress and strain that can lead to depression. Depression also lowers the immunity, increasing the vulnerability to acquire other diseases or health problems.

Family history is an important marker for vulnerability to depression. Individuals with history of family members suffering from depression are at a higher risk of developing depression

Alcohol or drug dependence, eating disorders or engagement in excessive video game playing may be seen and this may exacerbate symptoms of depression, anxiety and sleep problems, further hindering people’s abilities to cope.

Affluent, educated people are, surprisingly, more likely to have high functioning depression. It is said that it is a paradox of high functioning depression is that these are very often people who are educated and have important jobs.

Keeping the above points in mind, it is necessary to note that not every individual who may have these symptoms is an individual with high functioning depression. It is important to note the context and duration of symptoms. Nevertheless, having identified depression, it must not be let go of, ignored or delayed with intervention. Earlier intervention (and treatment) helps to better manage symptoms and allows the individual to return to healthier functioning sooner. Early intervention also reduced the chances of relapse (the illness recurring) for the individual. Mental health professionals such as psychiatrists, clinical psychologists and psychotherapists (or sometimes, counsellors) are equipped to understand and manage depression. They must be reached out to for help. Usually, a combination treatment of medication and therapy works the best for treating depression. High functioning tendencies of individuals may be managed through therapy.

Publications By The MINDS Foundation

Manual for Caregivers of Bipolar Disorder Affected Individuals

In Partnership with Bipolar India, we have determined that an under-addressed area of Bipolar Disorder is the sheer helplessness expressed by caregivers. Caregivers could be parents, siblings or spouses or even the children of those affected. Awareness about the illness, treatment options and other holistic approaches is scant. So is guidance in the crucial area of caring for those who are not compliant. We felt that a Handbook that builds awareness about the condition, educates them about warning signs to watch out for and prepares them how to cope, could be of great practical value. We hope that this handbook may be widely distributed and helpful for those around the world.


Manual for Caregivers of People Suffering From Depression

Together with Bipolar India, we recognize that caregivers of those with mental illness are often forgotten about. Caregivers could be parents, siblings or spouses or even the children of those affected. As depression continues to rise, so does the impact on caregivers. We felt that a Handbook that builds awareness about the condition, educates caregivers about warning signs to watch out for and prepares them how to cope, could be of great practical value. We hope that this handbook may be widely distributed and helpful for those around the world.