Are they mood swings or mental illness?

‘Mental health’ refers to a person’s level of cognitive and emotional well-being, or his ability to enjoy life, including work, relationships and leisure activities, with a sense of confidence and satisfaction.

A significant compromise in the level of functioning in some way is ‘mental illness’. Symptoms of mental illness are recognised by people who closely associate with him; however, they are often dismissed as ‘moods’ or a passing phase.

What are the symptoms friends and family should take a person to a doctor for?
• Odd behaviour, example, talking or laughing to himself, excessive tidiness or cleanliness, checking locks, electric switches, etc, several times, uncharacteristic aggressiveness or violence.• Impaired thinking, example, a belief that people are trying to harm him, or intrusive thoughts that cannot be controlled.

• Social withdrawal, ie, keeping to himself and avoiding friends and activities that require interaction with others.• Altered perception, example, hearing voices when alone.

• Mood fluctuations without adequate cause, example, talking and laughing excessively, crying for no reason, severe anxiety, irritability.

• Uncontrollable anxiety lasting months after facing traumatic situations like natural disasters.

• Disturbed sleep, inability to concentrate at school or at work, feeling mentally disturbed in a way he cannot express.

• Drastic changes in food habits like binging or eating unreasonably tiny portions.

• Phobias, ie, fear and consequent avoidance of certain situations like open spaces, closed spaces, crowds, etc.

• Certain diseases of old age, like dementia which present with memory loss, and some childhood problems like attention deficit/hyperactivity disorder, also benefit from medical treatment.

Though alcohol and other kinds of substance abuse may appear to be troubles people bring upon themselves rather than ‘mental illnesses’, they are a result of underlying disturbances in mood, negative thoughts or a lack of control over impulses.

What are the causes?
Obviously, the causes of mental illness vary. Some may be genetic, others reactions to environmental stresses like injuries, infections and major life events.

If you pause to think, you will realise that every time you think a thought there are nerves working busily inside your brain, communicating with each other within nanoseconds via chemicals. These chemicals are called neurotransmitters. When there is an imbalance in these chemicals, mental illness results, ie the brain no longer functions normally. The sufferer is unable to monitor his behaviour and says and does whatever his addled brain directs him to, appearing strange to the people around him.

How do you treat mental illness?
The goal of treatment is to get the brain to function normally again. Medications to set the chemical imbalance right would be the starting point, followed by helping the family and, later, the patient himself, understand the possible reasons for his/her episode of illness. The next step would be to work out strategies to prevent similar episodes in the future. In cases where complete recovery is not possible, it would be necessary to make lifestyle changes to help the patient adapt to his new reality.

Can you prevent mental illness?
Some mental states can be prevented by simple changes in lifestyle or environment: severe stress and despair before school exams can be avoided by planning out a sensible study schedule well before exams; personality disorders may be prevented to a large extent by raising children in a peaceful environment with consistent discipline; some forms of depressive illness may be avoided by taking steps to deal with situations that trigger a low mood.

This is because the brain responds to cues in the environment by some changes at a cellular level, or the chemical level. For instance, it is a known fact that physical exercise releases chemicals called endorphins which are like opium and produce a sense of well-being.

Conclusion
Mental illness is an affliction of one particular organ in the body, viz the brain. If jaundice as a manifestation of liver disease, chest pain as a manifestation of heart disease, deafness as a manifestation of ear dysfunction, etc can be understood, behavioural disturbance as a manifestation of brain dysfunction should be equally comprehensible, leading to suitable steps to alleviate the patient’s suffering.

— Dr Shyamala Vatsa is a consultant psychiatrist