Breaking the stigma around mental illness
October 9, 2019 | 6:08 PM
by Gautam Viswanathan

Ask any doctor today, and they will tell you that your mental health as as important as your physical health, if not more important. Some people, unfortunately, do not give mental health the consideration, understanding and compassion that it deserves.

That may be because of the stigma surrounding mere discussions revolving around mental health.

After all – and this is completely unfair – people who do have mental health issues often find that their conditions aren’t taken seriously enough. Not by their families and certainly not their peers.

Worse still, seeking out counselling or psychological help to address these issues is often looked down upon and is seen as a sign of weakness, because as a society, we have been led to believe that mental health issues are figments of our imagination and a pathetic, unwanted cry for attention.

A situation that can easily be dealt with if we weren’t so sensitive, one that exists only within our head.

Yes, mental conditions do exist within our head, and need urgent treatment and dedicated attention, despite society’s myopic, short-sighted views towards the same, which often means that people who do see therapists to balance their mental barometers either do so in secret, or telling only their closest and most trustworthy family and friends about their sessions. A lack of attention towards mental issues at the right time can have disastrous consequences.

The recently released ‘Joker’ movie — starring Joaquin Phoenix — actually does a great job in brilliantly showcasing the agony that patients with mental illness have to suffer from on a daily basis.

Joaquin Phoenix’s character, Arthur Fleck, is marginalised by society because he has a mental illness. He struggles to find a job, and when he does, it’s a demeaning one that forces him to dress up as a clown, stand outside a shop and spin an advertising board around, only for some street thugs to steal his sign and then brutally beat him up when he tries to get it back.

As he heads back to his home, which is in a rundown part of Gotham City, where he can barely make ends meet, he bursts into maniacal laughter that is a symptom of his mental condition which is triggered whenever he finds himself in a stressful or helpless situation. Three Wall Street men show just how arrogant they can be by giving him a thrashing, just because he is different.

Aspiring comedian Fleck then bursts into nervous laughter when he bombs on stage. This is picked up by celebrity talk show host Murray Franklin (a love-able Robert de Niro) who uses this to push Arthur – who’s just lost his mother, the same mother who caused him to have mental illnesses because she used to abuse him as a child – over the edge. Arthur’s rationalisation for his descent into becoming the Joker is summed up in one sentence: people just aren’t nice to each other anymore, no one is civil any longer.

While the on-screen and comic book versions of the Joker show him as a man that society pushed into insanity, the actor who so brilliantly portrayed him in The Dark Knight also suffered from chronic depression. Australian actor Heath Ledger – who posthumously won an Oscar for his performance as the Joker – decided he had had enough of continuously fighting these mental battles, and decided to end his life by overdosing on sleeping pills.

That’s the thing with mental illness: when you tell people that you suffer from a mental condition, because you don’t look ill, people assume there’s nothing wrong with you.

Looks, however, can be deceiving, because they cannot see what you are going through every day, and this is precisely what makes developing understanding and compassion towards mental illnesses very important.

Anuya Phule, a clinical psychotherapist at Hatat Polyclinic in Muscat, said the reason people had such a strong disposition against mental illnesses is because of the stigmas associated with it. She said, “When you tell someone that you are going to see a therapist or a counsellor for treatment, a lot of people often see it as a sign of weakness, they believe you are unable to take care of yourself. People sometimes think that counselling is beneath them because to have a mental condition or a mental illness, you are somehow inferior. As a society, we’ve been conditioned to think that way and assume that anyone who has a mental illness is weak.

“Some of the terms we simply associate with mental illness also make it harder to actually go out and seek treatment,” she added. “We often think of people with mental conditions as ‘crazy’ or ‘psycho’ and these can be really demotivating for them, and it really demoralises them when in fact, they know that going to a therapist or a counsellor can be hugely beneficial for them, but because society sees them this way, they are very reluctant to do so, which can actually worsen their mental state.”

As a licensed mental health professional herself, Anuya deals with people of all ages and all walks of life. She says that peoples’ perspectives towards counselling – in the face of changing social attitudes towards the importance of mental health – are hugely influenced by the kind of approach they had towards it when they were growing up, the sort of awareness and education they seek out as part of improving their own knowledge in this matter, and the company that they normally keep.

She was happy to share case studies of some of her patients’ attitudes towards counselling, while of course respecting their privacy and keeping them anonymous, telling T Weekly, “I normally only take clients that are over the age of 18, unless they have parental permission, but I recently took on a client who was about 17, because he told me that no one at home was able to understand the sort of anxiety that he went through. He kept saying ‘I can’t deal with this’, and it is extremely important for someone who suffers from mental anxiety to share how they feel.

“Once you get past the confusion and the uncertainty that is caused by your mental illness, you realise that you want to help yourself, and you get past that uncertainty. That is when your confidence begins to improve, and you realise how good it feels to actually take on and overcome your mental illness. A couple of female clients I had seen told me that their society told them to just immerse themselves in work and keep busy, so that they don’t think about their mental anxiety, but it does not work that way. After all, your mind is extremely important when it comes to living a proper life, and sooner or later, the impact of this mental condition will show.”

What was also interesting was what Anuya said in terms of how some men tended to view counselling. “A lot of men, because they have been societally bred to think that they are strong, that they are men who are not supposed to show any sort of weakness, think that it is beneath them to go for counselling. They sometimes do not want to accept that they have a problem, and that others instead have it. There is a psychological term for this – it is called ‘deflecting’. What happens here is that people are unwilling to accept that they have a problem so they claim that others have it and they don’t.

“When this takes place, they don’t deal with their own problems, but believe that others are projecting their problems onto them as a defence mechanism which enables them to not deal with their own problems,” she added. “They are sometimes afraid of admitting that they have a flaw, and will pretend to know everything, because society has bred men to think that they should not be vulnerable, and not knowing things and admitting that you have an issue might be perceived by some as a sign of weakness.”

“To all those who think that seeing a therapist or finding psychiatric help is a sign of inferiority, I would say that society is changing. There is nothing wrong in seeking out counselling. You go to a doctor for a physical illness, so you can definitely go to one for a mental condition as well. After all, the study of the human mind has been going on for thousands of years.”

While going to a counsellor is of course a highly recommended way to tackle one’s mental problems, simpler things such as taking part in a group activity or exercising is a great way to defuse stress, blow off steam, and interact with a group of like-minded individuals. Vinodhini Krishnamoorthy is a Zumba instructor in Oman, and says that both social interaction and exercise are great ways to help people decompress.

“Exercise releases endorphins in the body and this is essentially the feel-good hormone,” she said. “When you see the positive effects of exercise on your body, and you see yourself getting fitter, then it motivates you to treat yourself in a better manner, and it gives you the confidence to do better. Exercise is not just about losing weight, but the challenges that you overcome when you commit yourself to doing something. What this does is give you focus, and it gives you concentration, so that you are not distracted easily. When you the physical and mental results of exercise, then you will feel much better and it will give you the confidence to tackle any other concerns that you have.”

She added, “Similarly, exercises such as Zumba and other group activities also involve a lot of group participation, and what happens here is that the people encourage each other to do their best so here you have a spirit of togetherness and a group of people who have each other’s back. Over time, a bond develops with these people and you find that you have the same likenesses and the same interests in common with some of the people. I would suggest everyone take up an exercise activity, whether they want to do so alone or as a group, because this really helps you physically and mentally. Even if you work out alone, you will meet other people when you are in the gym or go for a run, for example, and you can share ideas with them.”

Stress plays an important role in our mental well-being. The arrival of technology – which of course does have many benefits – has steadily blurred the lines between our work and personal lives. A text message or email can reach us at any time and any place, which means there are often no set times to decompress and take a break from work.

This of course can have long-term consequences, and if one were to continue giving an excessive amount of priority to work, it won’t be long before your mind has finally had enough. Dr Ali Razak, a family medicine consultant at King’s College Hospital, says that different people react to stress differently. With mental illnesses, there is no one-size-fits-all approach to taking care of people who need help.

“Stress can be quite difficult to define or measure,” said Dr Razak, who is a member of the Royal College of General Practitioners, and of the British College of Aesthetic Medicine.

“Different people handle stress differently. Some people find that they can easily survive a busy lifestyle, and quite well at that, with high levels of stress. On the other hand, some people become tense or anxious and stressed over the slightest change from their daily routines.

Most people fall somewhere in between but there are increased periods where they go through more stress than usual. So, how can one handle these stressful moments?

While recognising that one is suffering from stress is a step in the right direction, it is only the first phase in getting better and overcoming its symptoms. Stress management is an area that deals with the combating of everyday stress.

“The first thing is to make a stress list like keeping a diary over a few weeks, where you register your low levels, the things that trigger stress, and places and people that might aggravate your stress levels.

With this, you might find that a pattern emerges; for instance, you might find that you get stressed when you’re stuck in traffic, or you come home and hear the neighbour’s dog barking, even you might find that a particular person or colleague at work causes your stress levels to increase,” said Dr Razak.

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What are the common signs of stress?

There are several stress signs, which you can also see physically. Some of these signs include:

• Not being able to sleep properly

• Worrying constantly

• Becoming very irritable and impatient of minor issues

• Being unable to make decisions

• Not being able to concentrate due to a lot of things going through your mind

• Not enjoying food

• Feeling tense all the time where you may have a fight or flight response

• Having a dry mouth

• Feeling your heart thumping away or having palpitations

• Feeling sick and having a knot in your stomach

• Having headaches, and muscle tension in your neck and shoulders

Once you’ve identified what the stress triggers are, then it’s time to try and relieve it or avoid in future. You can do this by:

• Just talking to somebody like a close family member or a friend about your stress and triggers.

• Trying some simple relaxation techniques like deep breathing exercises when you’re in a stressful environment can help in stress reduction.

How to: Take a nice deep breath into your lungs and very slowly breath out. If you do this a few times and concentrate fully on your breathing, you might find it is quite relaxing. Some people find that breathing with the abdomen can also be relaxing. To do this, simply sit down and put one hand on your chest and the other one on your abdomen. Aim to breathe quietly by moving your tummy, with your chest moving very little. This encourages you to do it efficiently and might help you avoid over-breathing

• The other technique is to do muscular stretches and tensing. Try twisting your neck from one direction to the other as far as you can without it becoming too uncomfortable and then relax. Additionally, try tensing your shoulders and back muscles as much as you can for several seconds, then relax completely.

• Positive relaxation is another way you can combat stress. You can use this technique by dedicating a timeout in your day to relax. This is because relaxation doesn’t happen by accident; you need to plan for it. This can include simple things like taking a long walk or a nice bath or listening to music. You shouldn’t see this as a waste of time because it is an important part of dealing with the stress of everyday life.

• Meditation and yoga can do a good job of helping you relax as well.

• Exercise is also a very good way to help reduce your stress levels. It is recommended that we exercise at least 30 minutes a day. This can be a brisk walk or going to the gym.

• Last but not list, make sure you avoid smoking and drinking alcohol. People who engage in this think it might be relaxing, but the reality is quite different. You can end up with many health problems, in addition to addiction.

So, the next time you’re in stressful situations, just try practising some of these techniques and see if that helps.

(Courtesy – King’s College Hospital)

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