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Sunday, Mar 08, 2020 15:00 [IST]

Last Update: Sunday, Mar 08, 2020 09:23 [IST]




Mental Health Nursing Lecturer

Vinayaka College Of Nursing, Gangtok

Mental illnesses take many forms. Some are mild and only interfere in limited ways with daily life, such as certain phobias (abnormal fears). Other mental health conditions are so severe that a person may need care in a hospital. The burden of mental disorders continues to grow with significant impacts on health and major social, human rights and economic consequences in all countries of the world.


Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviours. Examples of signs and symptoms include:

•Feeling sad or down

•Confused thinking or reduced ability to concentrate

•Excessive fears or worries, or extreme feelings of guilt

•Extreme mood changes of highs and lows

•Withdrawal from friends and activities

•Significant tiredness, low energy or problems sleeping

•Detachment from reality (delusions), paranoia or hallucinations

•Inability to cope with daily problems or stress

•Trouble understanding and relating to situations and to people

•Problems with alcohol or drug use

•Major changes in eating habits

•Sex drive changes

•Excessive anger, hostility or violence

•Suicidal thinking

•Sometimes symptoms of a mental health disorder appear as physical problems, such as stomach pain, back pain, headaches, or other unexplained aches and pains.


It can be challenging to tell the difference between expected behaviours and potential signs of a mental health condition. Each mental health condition has its own symptoms, but common signs of mental illness in adults and adolescents can include the following:

•Excessive worrying or fear

•Feeling excessively sad or low

•Confused thinking or problems concentrating and learning

•Extreme mood changes, including uncontrollable “highs” or feelings of euphoria

•Prolonged or strong feelings of irritability or anger

•Changes in eating habits such as increased hunger or lack of appetite

•Changes in sex drive

•Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)

•Abuse of substances like alcohol or drugs

•An intense fear of weight gain or concern with appearance.

Mental health conditions can also begin to develop in young children.

They include the following:

•Changes in school performance

•Excessive worry or anxiety, for instance fighting to avoid bed or school

•Hyperactive behaviour

•Frequent nightmares

•Frequent disobedience or aggression


Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

•Inherited traits- Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.

•Environmental exposures before birth-  Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.

•Brain chemistry- Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression and other emotional disorders.

Certain factors may increase your risk of developing a mental illness, including:

•Stressful life situations, such as financial problems, a loved one's death or a divorce

•An ongoing (chronic) medical condition, such as diabetes

•Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head

•Traumatic experiences, such as military combat or assault

•Use of alcohol or recreational drugs

•A childhood history of abuse or neglect

•Few friends or few healthy relationships

•A previous mental illness

Mental illness is common. About 1 in 5 adults has a mental illness in any given year. Mental illness can begin at any age, from childhood through later adult years, but most cases begin earlier in life.

The effects of mental illness can be temporary or long lasting.


Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include:

•Unhappiness and decreased enjoyment of life

•Family conflicts

•Relationship difficulties

•Social isolation

•Problems with tobacco, alcohol and other drugs

•Missed work or school, or other problems related to work or school

•Legal and financial problems

•Poverty and homelessness

•Self-harm and harm to others, including suicide or homicide

•Weakened immune system, so your body has a •hard time resisting infections

•Heart disease and other medical conditions.


If you have any signs or symptoms of a mental illness, see your primary care provider or a mental health professional. Most mental illnesses don't improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems.

Mental Disorders are treatable but there's no sure way to prevent this disorders. However, if you have a mental illness, taking steps to control stress, thinking positively and taking to someone whom you believe may  help you to increase your resilience and to boost low self-esteem and also may help to keep your symptom under control. Using following steps may even help you more to control Mental illness to your way. They includes:

?Pay attention to warning signs - work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends to watch for warning signs.

?Get routine medical care- don't neglect check-ups or skip visits to your primary care provider, especially if you aren't feeling well. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication.

?Get help when you need it- Mental health conditions can be harder to treat if you wait until symptoms get bad. Long-term maintenance treatment also may help prevent a relapse of symptoms.

?Take good care of yourself - Sufficient sleep, healthy eating and regular physical activity are important. Try to maintain a regular schedule. Talk to your primary care provider if you have trouble sleeping or if you have questions about diet and physical activity.

•Use your mental mechanism or defense  mechanism - A defense mechanism is a tactic developed by the ego to protect against anxiety and defense mechanisms are thought to safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to cope with. In some instances, defense mechanisms are thought to keep inappropriate or unwanted thoughts and impulses from entering the conscious mind.  Although we may knowingly use these mechanisms, in many cases these defenses work unconsciously to distort reality. For example, if you are faced with a particularly unpleasant task, your mind may choose to forget your responsibility in order to avoid the dreaded assignment. In addition to forgetting, other defense mechanisms include rationalization, denial, repression, projection, rejection, and reaction formation. While all defense mechanisms can be unhealthy, they can also be adaptive and allow us to function normally.

WHO response

WHO’s Mental Health Action Plan 2013-2020, endorsed by the World Health Assembly in 2013, recognizes the essential role of mental health in achieving health for all people. The plan includes 4 major objectives:

           more effective leadership and governance for mental health;

           the provision of comprehensive, integrated mental health and social care services in community-based settings;

           the implementation of strategies for promotion and prevention; and

           strengthened information systems, evidence and research.

WHO's Mental Health Gap Action Programme (mhGAP), launched in 2008, uses evidence-based technical guidance, tools and training packages to expand services in countries, especially in resource-poor settings. It focuses on a prioritized set of conditions, directing capacity building towards non-specialized health-care providers in an integrated approach that promotes mental health at all levels of care.

Health and support

Family involvement in care of people with disorders is very important. Knowing what causes affected people both distress and well-being is an important element of care, as is finding out what environments are most conducive to better learning. Structure to daily routines helps prevent unnecessary stress, with regular times for eating, playing, learning, being with others, and sleeping. Regular follow up by health services of both children and adults with developmental disorders, and their careers, needs to be in place.

The community at large has a role to play in respecting the rights and needs of people with disabilities. Determinants of mental health and mental disorders include not only individual attributes such as the ability to manage one's thoughts, emotions, behaviours and interactions with others, but also social, cultural, economic, political and environmental factors such as national policies, social protection, standards of living, working conditions, and community support. In addition to support from health-care services, people with mental illness require social support and care. They often need help in accessing educational programmes which fit their needs, and in finding employment and housing which enable them to live and be active in their local communities.

And to those who are suffering  inside in silence,  don't let the Mental illness  be the cause of stress in your life, be open about your mental health issues, share it with your close once, love and laugh has the power to overcome even the toughest of challenges you face in your life. Live, laugh, love your life, love people in your life and most importantly love yourself. Be Kind to your mind.


Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi