Understanding Mental Health

Interview with Dr. Urmila Pillay, Chartered Clinical Psychologist, UK.

Mental health is an important component of health, however, the recognition of mental disorders and awareness about its importance is to some extent very limited. There is a lot of stigma attached to it even today. So how do we recognize if someone we know needs our help? What are the signs? When must one seek help?

This mental health awareness week, we connected with Dr. Urmila Pillay, M.Phil, Ph. D, Chartered Clinical Psychologist with over 20 years of experience and currently practicing in the UK, to get to know more about Mental Health.

Q.How to recognize the warning signs and symptoms of a mental illness?

Dr. Pillay: Mental illness is a broad term and there are various mental disorders that fall under the umbrella of mental illness which again could vary from mild to moderate to severe.  While each disorder will have its own early warning signs, a crude indication that the person might be struggling is a change in their behavior, which is going to cause harm in the long term.

We can look out for behaviors such as no interest in activities they previously enjoyed, not mingling with people as before, preferring to spend time alone than with people, not eating as usual, difficulty in sleeping, weight loss, reduced interest in personal hygiene, getting irritably more quickly than usual, crying spells, turning to drinks and drugs, not able to cope with work and personal responsibilities to list a few.

If you notice such changes, it will be worth exploring this with the person and try to understand what the individual is going through. Ensure that while exploring, you are not being judgmental of the person. Also, these symptoms have to be persistent at least for a couple of weeks for the symptoms to qualify as a mental illness.

Never label anyone as having a mental illness unless you are a professional.

Q.Can mental illness run in the family?

Dr. Pillay: Mental illness in the family only predisposes one to mental illness. Just because someone in the family has mental illness, it doesn’t mean it will be passed on to the next generation. Genetic studies have shown that even among identical twins there is no 100% concordance rate. Having a history of mental illness in the family can make us vulnerable and can genetically predispose us but that does not mean we have/ we will get it.

What happens when there is mental illness in the family is, in addition to the genetic predisposition, there is also the modelling aspect of behavior. Suppose the parent has depression and the way of coping is through alcohol, it is very likely that the child learns this as a coping mechanism, which can trigger as well as maintain depressive episodes. So, there is a combination of his/ her genetic predisposition as well as the modelling that resulted in his/ her becoming depressed.

Q.How to know when to see a therapist?

Dr. Pillay: It is a personal choice when and whether you want to seek professional help. However, knowing the benefits of talking to a professional and having worked in the field for more than 20 years, I would urge all of you to seek professional help if you find yourself struggling to cope and it is affecting your functioning.

If you have a good support network around you and you are able to talk to them without the fear of being judged, then utilize that network in order to ventilate your feelings and for feeling supported but seek professional help for problems that would require more than just feeling supported.

Q.What causes depression? What causes anxiety? – The two most commonly heard mental illnesses.

Dr. Pillay: There is no one cause for depression or anxiety. In psychology, we follow a Bio-psycho-social model which means it is a combination of factors – biological (for example. family history, temperament etc.) social (example. no social support) and Psychological (example. negative thinking, low self-esteem etc.) that leads to any form of mental illness- whether it is anxiety or depression.

Q.What is PTSD and how is it treated?

Dr. Pillay: Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by very stressful, frightening or distressing events. A person experiences PTSD when they have gone through some kind of trauma   such as War trauma, accidents, rape etc.

It is treated through a combination of medication and psychological therapies such as Cognitive behavior therapy, Eye movement Desensitization and Reprocessing (EMDR)

Q.What causes postpartum depression? How to recognize it?

Dr. Pillay: Once again, it is not possible to pin point what exactly is the cause of any mental health condition.  Postpartum depression can occur at any point in the first year after the baby is born. It can be sudden or gradual. Most women go through baby blues for the first two weeks but if symptoms of anxiety, tearfulness etc. last for more than 2 weeks, it is an indication of postpartum depression.

Symptoms to watch out for include persistent feeling of sadness, loss of interest, feelings of hopelessness, helplessness, lack of energy, tearful, not able to focus, anxious about looking after the baby, struggling to bond with the baby, getting irritable easily, frightening thoughts, etc.

Q.How can I tell if someone has a mental health problem?

Dr. Pillay: I answered this in the first question. Let me add that it is very important not to label anyone as having a mental health problem without getting a professional opinion.

Having problems and being stressed is part of everyone’s life and people cope with it in different ways.  Feeling stressed does not mean the individual has a mental health condition.  

However, if symptoms are persistent and has lasted for more than two weeks and it is affecting the individual’s day to day functioning, then it requires the attention of a professional.

Q.How can I speak to/help someone with a mental health problem like depression or anxiety?

Dr. Pillay: Talk to them in an empathetic way,  be non -judgmental, listen to what they have to say, encourage them to seek help from a professional if you feel they are really struggling to cope,  do things to show you care- make their favorite food, or take them for a walk, spend time with them, do things they used to enjoy and provide them with a listening ear. Validate their feelings, encourage them to take up hobbies etc. Do not force them to talk.  Do not dismiss their feelings. Do not ever say ‘There are people going through things bigger than this’.   Do not start labelling what they are going through into a disorder.

Q.Do environmental factors, increase the risk of mental illness?

Dr. Pillay: Yes, our environment plays a crucial role in contributing to one’s mental wellbeing.

Our home environment, work environment all play an important role in our mental health.

It is the responsibility of all family members to make it a pleasant environment where the family could flourish. Domestic violence can have a major impact on children’s emotional wellbeing.  Every day fights and arguments between parents in front of the children, parents complaining to the young children about the other parent, all can have an impact on their wellbeing. It is important that the home is a place where all members, irrespective of whether they are adults or children, should feel safe.

Similarly, the work environment should be devoid of bullying, and harassment. It should be a place where each one is encouraged to do their best and given the required support- emotionally as well as professionally- to grow and develop. A toxic environment can have a negative impact on the individual and in turn, it can affect the organization as a whole.  It is the responsibility of the employees to make it a pleasant environment for themselves and their work colleagues and for the management to ensure a positive environment and work culture and ethics in their organization.

If we talk about the larger environment, that is nature, there have been various studies showing that being with nature contributes immensely to our wellbeing. So, going for walks in a park, gardening, playing in the soil all contributes to our wellbeing. This again highlights the importance of preserving and respecting our environment/ nature.

Q.How to improve one’s mental well-being?

Dr. Pillay: Just like having healthy and nourishing food is important to maintain our physical health, it is important to feed our mind with good thoughts and good deeds.  Benevolence has been shown to play an important role in contributing to our mental wellbeing.  Some of the ways are:

• have a routine
• exercise regularly
• engage in tasks that give you pleasure
• interact with people
• Practice mindfulness regularly
• engage in tasks that gives you a sense of fulfilment.

The above points are just a few of many things one could possibly do to enhance one’s wellbeing. it will be impossible to list all here. However, it is a good start.