Mental health care: World Mental Health Day is commemorated on October 10

Depression, anxiety, thoughts of death, and addictions are among the main mental health problems, which can be adequately treated if detected in the early stages, says Ingrid Vargas Huicochea, an academic from the Department of Psychiatry and Mental Health at the UNAM School of Medicine (FM).

A key point to begin to suspect that emotion or thought could be part of a mental health problem is, on the one hand, dysfunction; that is, that the emotion or behavior is not allowing me to function properly with my family or friends. And, on the other hand, the suffering that emotion causes, which makes us suspect that something is going on.

If that emotion lasted too long, beyond what is expected, if it begins to cause me not to function as would be appropriate from my own parameters and also generates discomfort, then it may be part of a problem. Reflecting on World Mental Health Day, which is celebrated on October 10, Vargas Huicochea explains that in order to make a diagnosis, specialists evaluate the set of manifestations, since a single altered behavior is not enough on its own.

"Depression, which is one of the most frequent and disabling problems, has several manifestations almost every day of a given period, constant for at least two weeks. It includes low mood, sometimes irritability or sadness, anhedonia, which is the difficulty to experience pleasure, sleep disturbances (insomnia or oversleeping), changes in appetite (loss of hunger or overeating), disturbances in concentration and memory, as well as thoughts that one is worth less than others," she explains.

Vargas Huicochea points out that when this condition occurs, "the person shows him/herself to be less capable, less successful or less intelligent". There are feelings of irrational guilt without support, alterations in the level of energy, fatigue without effort, and non-specific physical symptoms such as headaches or body aches and even burning. Sometimes, it is accompanied by the idea of death, which does not necessarily indicate seriousness, it is a passive thought where the person has no intention of harming himself. Or: "I hope I fall asleep and never wake up again", "what am I doing here", "the world would be better off without me".

Depression and anxiety, "first cousins"

When it becomes intentional, and I am planning how to die, that is suicidal thinking, which "speaks of a severe depression, where there may be symptoms outside reality, such as delusions or hallucinations," emphasizes Vargas Huicochea. Although depression and anxiety "are first cousins" and at a cerebral level they are very similar, they have different symptoms and behave in different ways, clarifies the university professor.

Depression tends to be more episodic (it comes and goes), while anxiety is constant and is linked to the individual's personality. "It is established in the personality and suddenly it is exacerbated and that is what we notice as pathology". Anxiety is a group of diseases, the specialist points out. The most recurrent in the consultation are generalized anxiety disorder and panic disorder.

In the first case, in order to make the diagnosis, at least six months must pass with the symptoms, although people often come for treatment after years. It includes constant anxiety (the person is unable to relax, cannot be at peace) and worries that things will go wrong (this is called catastrophic anticipation). In anxiety, there are usually changes in mood, irritability, intolerance, anger, shouting, failures in the cognitive part (especially in concentration and memory), insomnia, and alterations in appetite that make the person eat more.

"It is physical, so many times before going to the psychiatrist the patient has already visited many specialists, especially the gastroenterologist because there is usually gastritis and colitis. With it, people can get used to living this way and they don't notice the alteration," she says. Another anxiety problem is panic disorder, which includes episodes that are intense peaks that strictly last 10 to 15 minutes, but are confused with intense physical or emotional pain.

The chest hurts, some parts of the body fall asleep, something gets stuck in the throat, the pressure rises and the patient experiences it as real and thinks that something negative is going to happen to him/her, the specialist explains. "In addiction problems, each case has to be explored a lot. They are complex problems that need to be broken down by the specialist to detect where they originate," says Vargas Huicochea.

A question of attitude or will

The psychiatrist considers that the lack of information on mental illnesses has caused them to be stigmatized and those who suffer from them to be marginalized. These conditions "do not initially show alarming symptoms such as fever, hives, or tumors. They involve gradual changes in behavior and that makes us think that they are not real diseases, but that it is a question of attitude or willpower," she says.

And she adds: "If we start to make people aware of mental health problems and seek care, the big problem is that services are scarce and saturated, so there must be improvements in infrastructure and patient care, which is a worldwide challenge". For the expert, World Mental Health Day is not a day of celebration, "it is a reminder to reflect on the different challenges in the field of mental health. This year it refers to having access to services, and to opportunities for care and support.

On its website, the World Health Organization's campaign slogan for this year is "Mental health care for all: let's make it happen".

It stresses that the HIV/AIDS pandemic has had an impact on people's mental health. Some groups, such as health care and other frontline workers, students, those living alone, and those with pre-existing mental health conditions have been particularly affected. And care services for mental, neurological, and substance use disorders have been significantly disrupted. However, it notes that during the May 2021 World Health Assembly, the world's governments recognized the need to expand quality mental health services at all levels.

Source: UNAM