Welcome back Readers, This week I would like to discuss mental health. This is a very common area of medicine which is frequently under-recognized, under-diagnosed, and under-treated.
believe that part of what holds us back as a society in addressing mental health issues is a lack of proper resources to address the numerous mental health crises we face as a nation, and across the world. Unfortunately there are not enough mental health practitioners in this country, or indeed anywhere in the world to address the growing demand for mental health services. There are not enough psychiatrists (physicians who specialize in the medical treatment of mental health disorders). There are not enough counselors, psychologists, or social workers, all of whom may provide therapeutic counseling of various types for the non-medical treatment of mental health disorders. There are not enough inpatient psychiatric hospital beds for those patients suffering from severe exacerbations of mental health disorders, such that they need intensive psychiatric care to help get them on the right treatment plan, and stable for outpatient management.
There are also not enough people willing to discuss their mental health challenges with their medical providers, and too many who may feel ashamed to discuss these feelings, which prevents us from helping. I am not a Psychiatrist, or a counselor. I am a General Practitioner, and I think that one contribution I can make to the public wellbeing is my willingness to address these issues both publicly, in forums such as these, and also privately with patients who wish to discuss these issues with me.
Mental health is one of the foundational pillars of a person’s overall health, and my team and I spend a tremendous amount of time and energy addressing these issues at Dundy County’s Quality Healthcare Clinic. Part of my goal with this article is to help remove the stigma and prejudice that comes with discussion of a person’s mental health, and to encourage those who simply “don’t feel right” to discuss this in a meaningful way with your healthcare provider.
Mental health can be very subjective, which makes it difficult to identify and treat disorders of mental health. My best attempt at a simple explanation of what makes a person mentally healthy is their contentment with their current and usual state of mind, having beliefs and patterns of behavior which allow them to interact well with other people, and which do not significantly limit their enjoyment of life or pursuit of their goals. There is a lot to unpack there. I will address specific mental health issues in more detail in future articles, but I’d like to start by briefly discussing the relationship between depression, anxiety and stress.
Depression and anxiety are frequently two sides of the same coin. The common screening questions healthcare professionals ask to screen for these are “In the past two weeks, have you felt down, depressed, or hopeless”, and “In the past two weeks, have you felt nervous, anxious, or on edge”? A certain amount of these feelings is normal in all people, and everyone should be capable of feeling the full range of human emotions. It is normal to feel sad in the middle of misfortune and loss, and it is normal to feel anxious when an unpleasant situation has grown beyond your control.
Not every instance of depression or anxiety needs to be treated, but I find that naming the feeling out loud and recognizing what may be causing it is a great first step to addressing it in a productive way. Many patients who feel depressed also feel some level of anxiety, and vise versa. Frequently I find that one of these feelings is dominant in patients with these complaints, but sometimes it’s hard to figure out what came first (the chicken or the egg question). Both anxiety and depression are exacerbated by stress. Stress that lasts for a long time, or high levels of stress for even a short period of time can be overwhelming and can make symptoms of depression and anxiety worse.
Furthermore, some people have neurochemical imbalances in their brains which predisposes them to feeling this way far more often (or intensely) than other people, even with what most of us would consider to be a “normal” level of stress, if there is such a thing. When I try to help people with their mental health, one of the most important things I do is help them to identify the major sources of stress in their life. Some can be significantly improved with some thought and lifestyle changes.
Other sources of stress cannot be reasonably modified, and so symptomatic treatment may be beneficial to improve that person’s quality of life. Just as stress can worsen depression and anxiety symptoms, having these symptoms can also be extremely overwhelming at times when a person is in the midst of a very stressful situation, especially if that situation is not able to be easily or quickly resolved. This situation describes ‘Adjustment Disorder’, in which a person’s mood symptoms are significantly worse than usual due to a major stressor or major change in their life. This is not usually permanent, but some people in this position may benefit significantly from treatment of their depressive or anxiety symptoms.
Helping to remove the incredibly burdensome weight of depression, or the exhausting hyper-vigilance and restlessness of anxiety, can give some people the tools that they need to really deal with their sources of stress head-on. Believe it or not, treating anxiety, depression, and Adjustment Disorders can improve a person’s ability to resolve the underlying issue, and can significantly unburden them.
There is no magic pill that makes everything better, but there are scientific treatments to address these very common issues and give people the tools they need to help them solve their own problems. Even if no medication is necessary, or even desired, I would encourage everyone to discuss your mental health and level of stress with your trusted healthcare provider. Even though there’s no magic pill or silver bullet, we still care about what’s going on in your life and in your mind, and we are here to help any way we can, even if it’s only to listen.
Thanks for reading. HDanDerbes.MD@gmail.com