How is your emotional balance in the mental health spectrum?

By Dr. Anna Grazia Lecca, Consultant Clinical Psychologist, LifeWorks Holistic Counselling Centre, Dubai

Mental health is an important component of peoples’ overall health, which revolves around the individual emotional well-being. Good mental health hygiene involves a dynamic process that consists of being confident to manage any challenging situation effectively. It in fact empowers individuals to make responsible choices, work productively, helps to realise their full potential, and provides meaningful contributions to the society while living their life at their fullest.

Reasonable levels of stress, low mood, emotional tension triggering fears or anger, are healthy responses to particular events that allow individuals to recognise threats, find appropriate solutions, bridge the gap between discrepancies in opinions, and therefore establish and maintain satisfying social connections.  

This emotional balance is not always experienced among individuals. Unfortunately, sometimes people can feel totally defenceless against the racing thoughts that play in their minds. They may find themselves unable to deal with their uncontrollable fears or prevent escalation of their anger. These feelings can become so overwhelming that coping with day-to-day life, work, leisure, and relationships can be perceived as an over demanding task.

Mental health problems can affect anyone at any age, regardless of their gender, social status, or financial situation. Additionally, they are also interspersed among population cross-culturally.

Within the mental health spectrum, mental health conditions can vary on a continuum ranging from good mental health, to poor mental health, up to a mental illness, which eventually emerge as a mental illness of mild, moderate or severe intensity. Moreover, a large proportion of the people who have a mental health disorder, demonstrate overlapping conditions rather than a single mental illness. Therefore, the main mental health diagnosis often includes additional mental health problems gravitating around the main mental health disorder. This may cause mild to severe disturbances and inabilities or may impair people to cope with life’s ordinary demands and routines.

Over the course of life, from childhood, adolescence and throughout adulthood, mental health problems and illnesses can impact peoples’ life according to the severity of the circumstances. Commonly they may include: Anxiety Disorders, Mood Disorders, Psychotic Disorders, Eating Disorders, Impulse Control and Addiction Disorders, Personality Disorders, Post-traumatic Stress Disorder, Stress Response Syndromes, Dissociative Disorders, and many others.

Research suggests that mental health problems are the result of more than one event: multiple, linking causes such as genetics, biologic, unfavourable experiences during childhood, on-going challenges and major life changes; environment and lifestyle increase the risk of experiencing distress and determine whether someone would develop a mental health condition.

Clinical practice confirms that family history of mental health problems, traumatic life experiences, such as being the victim of a crime, sexual or emotional abuse, harassment, living in a war zone, being bullied, and other kinds of victimisation are highly associated with mental health illnesses.

Mental health problems and emotional imbalances may present under different forms with a combination of different symptoms.

Physical symptoms are usually easy to notice. The predominant recurrent symptoms include having unexplained aches and pain such as: chronic joint pain, limb pain, back pain, gastrointestinal problems, tiredness, sleep disturbances, a rapid heart rate, chest pain, or fast breathing.

These symptoms are so commonly presented in primary care and often are purely related to organic diseases, which eventually are explored with further clinical investigation and pharmacologically treated according to medical protocols. However, unexplained aches and pain usually describe the physical component of a wider constellation of other mental health symptomatology so crucial in mental healthcare. This medicalised practice seems to underestimate the magnitude of cognitive, emotional and behavioural symptoms, which lead to misdiagnose mental health problems. A high percentage of patients with mental health conditions who seek treatment in a primary care setting, in fact, report physical symptoms, which can make mental health problems very difficult to diagnose if not assessing their psychological conditions in terms of cognitive, emotional and behavioural key factors.

Mental health symptoms aren’t only displayed at the physical level but usually represent a combination of different conditions, which address cognitions and thoughts, emotions and feelings, and behavioural set of attitudes that people are more inclined of displaying as dysfunctional. Mental health symptoms, therefore, encompass the way people process thoughts, and the connotation and the intensity at which they experience emotions, which result in determining the pattern of their unhealthy behaviours.

Cognitive symptoms are related to the normal brain function. People may report having trouble concentrating for long, lack of attention and focus, memory difficulties, foggy brain, mental confusion, and other several symptoms, which are associated with the way they think.

People experiencing cognitive symptoms usually adopt negative mind-sets, irrational thoughts, intrusive thoughts, negative beliefs and statements about one self, assumptions against any evidence, memories difficult to control, or flash backs of past experiences.

Among cognitive symptoms that governs individuals’ thinking process, negative self-talk is the most common. It resembles a negative poem they recite in their inner dialogue. They are continuously committed to state to themselves a variety of statements reflecting their negative core belief about the way they conceive themselves, other people and life in general. Some say: “I am not worthy of love”, “I cannot make it”, “I am not good enough”, “I am not important”, “I will end up alone”, “Nobody understands me”, “Nothing matters”, “The worst will happen”, or “Life is a bad place to be”.

Alongside these statements, wishing of being dead, thinking of harming own self or others, are also part of people’s inner dialogue. These cause them to start questioning their values and the sense of their existence. They even ask themselves about their life purpose and the reason for living.

This thinking process may lead individuals to feel a sense of isolation or disconnection from family members, friends and other people and places they care about. Therefore, sets of recurrent negative emotions start to take over. They may experience a variety of different emotions from sadness, mood swings, feeling confused, forgetful, worried, feeling scared, demotivated, helpless, hopeless, angry, or upset. Other emotional symptoms indicating imbalanced mental health conditions include having worrying dreams or feeling numb or disconnected from reality.

Behavioural symptoms

Mental health conditions can also be recognised by means of behavioural symptoms. Often, they are the result of a combination of cognitive and emotional symptoms. All of them are strictly interconnected to each other. Symptoms involving behaviours may include: difficulties in starting usual activities or getting through tasks as before. Peoples’ inability to perform daily tasks may consist of difficulties in taking care of their kids, getting to work or school or not being able to complete standard tasks such taking shower or cooking a meal.

Other typical behavioural symptoms of mental health conditions are changes in eating or sleeping patterns and manifestation of hostile behaviours such as yelling, fighting or frequent temper tantrums causing problems in relationships. In addition, repetitive behaviours, drug misuse, smoking, drinking, social withdrawal, dropping from leisure activities, are also behavioural symptoms of poor mental health condition.

Dealing with mental health symptoms can be physically and emotionally draining, often leaving people feeling vulnerable to the opinions and judgments of others.

Preparedness to cope with mental health problems heavily depends on people’s awareness on the importance of preserving and enhancing mental health. Mental health stigma seems to be still very commonly held in society. It is characterised by the difficulty of externalising a mental health problem, receiving mental healthcare or mental health treatment.

Unfortunately, prejudicial attitudes towards people who have mental health problems dictate a conviction that mental health is a sign of personal weakness. It is a common assumption that mental health conditions can improve with time without any form of specialised support. These perceptions and misconceptions although unintentional or subtle, may most likely lead to reluctance in seeking help or treatment and as consequence may corner people into isolation. Apart from creating self-doubt and shame, this situation exposes individuals to an even weaker situation: it undermines their sense of self-efficacy and their self-esteem by engaging individuals into a tighter spiral of an increased critical self-thoughts and even more severe self-judgment.

The recovery from any mental health illness starts by recognising that mental health diseases are well described and understood among clinicians; that mental health diseases need appropriate clinical attention for a precise evaluation; and that mental health recovery is not an event but a tailored process: a unique journey for each individual that requires time and includes relapses.

More successful treatment for mental health conditions usually consists of multi-disciplinary approach including medication, psychotherapy, lifestyle education, unconventional form of therapy and other forms of support. According to the condition, treatments can be held in outpatient clinics, residential or semi-residential treatment facilities with daytime programmes or in hospitals according to the typology of the mental health problem, its severity and family circumstances.

While treatment with medications is aimed at reducing symptoms such as improving low mood, stabilising mood swing, controlling psychotic symptoms, reduce the symptoms of anxiety or panic attack, lifestyle changes such as reducing alcohol intake, balancing sleeping patterns, eating healthy and practicing regular exercise help substantially in increasing the quality of life, making the mental health condition more manageable.

Psychotherapy plays a central role in identifying how experiences are processed by thinking process and mediated by emotions leading to unhealthy behaviours. In addition, psychotherapy helps individuals to understand how they have related themselves to significant others and how this may have affected them. It also helps to understand people’s concerns that are caused by avoiding or suppressing emotions rather than having their emotional needs met.

Common therapies to treat mental illnesses are Cognitive behavioural therapy, Exposure therapy, Dialectical behaviour therapy, Gestalt therapy and other forms of therapies.

Untreated mental health problems can have serious impacts both in individual’s life and across the community. Awareness about the development of early warning signs, differentiating between different sets of symptoms, and taking proper actions towards them with early mental care interventions, may prevent or delay major mental illness and may reduce the intensity of their severity.

Cultural competence in mental health field needs to be expanded so that individuals with mental health problems are provided with effective and respectful quality of mental healthcare. Promoting wellness, implementing health strategies and planning social campaigns on mental health is imperative in targeting a healthy and prosperous community. The sense of belonging to a community is able to support individuals with mental health problems, has priceless value and it is not a fact of private interest. Mental health belongs to community of which members are psychologically empowered to overcome their mental health conditions, achieving their personal goals and live a fulfilling life.