No health without mental wellness

No health without mental wellness - Millions of people from the world over continue to arrive and work in Saudi Arabia and other parts of the Gulf. For some, the salaries are enticing, the benefits competitive, the lifestyle more relaxed, and many may find the location “exotic.” Major cities have some of the best residential buildings or housing compounds, which they hire for themselves and their families. Their children study in international schools that are proliferating by the day. They have the best shopping malls and recreation facilities. However, for anyone coming from any other part of the world, there can be a culture shock that may vary in degrees from person to person.

“Culture shock manifests itself in many ways. For some, it may be anger or frustration, while for others it may be depression and feeling homesick. Children may not be able to understand or easily comprehend how the culture of a new country can impact on what has been familiar or normal to them. They may rebel, become overly aggressive or perhaps retreat into themselves,” says a senior physician at Jeddah’s Dr. Erfan & Bagedo Hospitals.

“If one wishes to seek counseling or mental health assistance in this part of the world, it is difficult, as there are few professionals who are accustomed to interacting and counsel expatriates. Although many Saudi psychiatrists may have been educated and trained in the advanced countries of the West, they will likely practice in accordance with the local cultural practices. As a result, an expatriate may hesitate to approach a psychiatrist for counseling,” an Asian doctor in a major polyclinic says.

Culture shock can itself lead to health problems. Any chronic physical sickness can lead to psychological problems. Such problems are commonly seen among patients suffering from certain chronic diseases or those like cancer that have no cure.

It is against this background that there is an ongoing campaign for promoting mental health among both residents and expatriates. The campaign became more intense with the observance of World Mental Health by hospitals and health care centers across the Kingdom on Oct. 10. This year’s observance of World Mental Health day focused on making the people aware that there can be no health without mental health.

Mental Health refers to a broad array of activities directly or indirectly related to the mental wellbeing component included in the World Health Organization’s definition of health: “A state of complete physical, mental and social wellbeing, and not merely the absence of disease.” It is related to the promotion of wellbeing, the prevention of mental disorders, and the treatment and rehabilitation of people affected by mental disorders.

With proper care, psychosocial assistance and medication, many people can be treated for depression, schizophrenia, and epilepsy, and prevented from suicide, and begin to lead normal lives even where resources are scarce.

Mental, neurological, and substance use disorders are common in all regions of the world, affecting every community and age group across all income countries. While 14 percent of the global burden of disease is attributed to these disorders, most of the people affected do not have access to the treatment they need. About one in five people will have an episode of major depression in their lifetime, says a physician at King Abdul Aziz Hospital.

There is a specific focus on the relationship of mental health with chronic physical illnesses including diabetes, cancer, heart disease, respiratory diseases, and obesity. One in two for people with heart disease suffers from depression. Also the risk of heart disease is double in people with a history of depression. One in four persons with diabetes suffers from depressive symptoms.

Fifty percent of patients with cancer have some form of diagnosable psychiatric disorder at some point during their course of care. For example, depression, anxiety, delirium and distress occur from such problems (pain management, difficulties with family, work related problems, financial issues, worries about children). Twenty percent of patients with asthma suffer from major depression or anxiety (generalized anxiety, panic and phobia).

Obesity and depression share similar symptoms such as sleep problems, sedentary behavior. Depression and anxiety are associated with unhealthy behaviors, such as poor diet, physical inactivity and sedentary lifestyle, tobacco use, and heavy alcohol consumption. Many of these unhealthy behaviors are linked to an increased potential for obesity.

The World Federation of Mental Health (WFMH) sponsors World Mental Health Day each October. Its mission over the past 62 years has been to increase awareness about mental health issues, and its agenda is summarized in what they call the Great Push for unity, visibility, rights and recovery. This year, they specifically dedicated the day to mental health and chronic physical illness, and the need to continue to integrate the care of both.

There is good reason. Worldwide, noncommunicable chronic diseases are the leading causes of death. Dr. Gouden Galae, coordinator of health promotions for the World Health Organization, says that heart disease, diabetes, cancer and lung disease are responsible for 60 percent of deaths worldwide and 80 percent among the world’s poorest people. It is also estimated by 2020 that obesity will be the No. 1 cause of death worldwide.

Prevention and management of these noncommunicable diseases affects both mortality rates and quality of life. The financial burden is enormous — to governments, the health care industry, and families — and sufferers’ ability to cope is affected by these diseases’ emotional impact. Kathryn Powers, director of the US-based Center for Mental Health Service, says: “We know that many individuals with chronic medical conditions have untreated, co-morbid mental illnesses or substance use disorders, and this can complicate the recovery from both conditions.”

Between 25 and 33 percent of people with these chronic medical conditions also struggle with depression. Whenever something happens that we feel we do not have control over, depression — a sense of helplessness — is a possibility. A vicious cycle begins as depression weakens the resolve for coping with physical symptoms. In turn, this creates a greater sense of despair. In fact, depression can triple the risk of nonadherence to medical treatment.

The ultimate key for coping with chronic illness, however, is resilience. Here are some suggestions from medical experts and specialists:

Stay connected with family, friends and support groups. Our wellbeing is tied to who we spend time with. PsychCentral’s online support community has over 160 forums for support. Your local hospital likely has a list of support groups in your town.

Consider psychotherapy. Psychotherapists can provide not only personal therapy for coping, but may also be resources for group and family therapy. And, as the Course in Miracles suggests about the importance of psychotherapy “... only the mind can be healed.” Having a psychotherapist to help in the healing process can aid in the mind-body healing process.

Take care of yourself. Rest, exercise (if your physical limitations allow it), eat a proper diet, and have fun. Don’t let yourself go. A positive outlook is easier to maintain when you are immersed in self-care.

Practice the principles of positive psychology, particularly those associated with acknowledging gratitude, counting your blessings, and resilience.

Maintain your daily routines. They provide a sense of stability when coping with the demands of illness.

Aside from prayer, engage in yoga, meditation or any creative endeavor you are drawn to.

The bottom line is that there is no health without mental health, and there is no development without health and mental health,” emphasizes Dr. Michele Riba, professor of psychiatry, University of Michigan. ( arabnews.com )