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F.A.Qs about Mental Illness

Q1: What does it mean to have a mental illness?

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Some of the more common disorders are depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal. When these occur in children under 18, they are referred to as serious emotional disturbances (SEDs). Mental illnesses can affect persons of any age, race, religion, or income.

Here are some important facts about mental illness and recovery:
  • Mental illnesses are biologically based brain disorders. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.
  • Mental disorders fall along a continuum of severity.
  • Mental illnesses usually strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
  • The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.
  • With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.
  • Early identification and treatment is of vital importance. By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.
Source: National Alliance on Mental Illness (NAMI)
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Q2: What are some of the warning signs of mental illness?

Symptoms of mental disorders vary depending on the type and severity of the condition. Some general symptoms that may suggest a mental disorder include:

In adults:
  • Confused thinking
  • Long-lasting sadness or irritability
  • Extreme highs and lows in mood
  • Excessive fear, worrying or anxiety
  • Social withdrawal
  • Dramatic changes in eating or sleeping habits
  • Strong feelings of anger
  • hallucinations (seeing/hearing things that are not really there)
  • Believing in things which are untrue
  • Increasing inability to cope with daily problems and activities
  • Thoughts of suicide
  • Denial of obvious problems
  • Many unexplained physical problems
  • Abuse of drugs and/or alcohol

In older children and pre-teens:
  • Abuse of drugs and/or alcohol
  • Inability to cope with daily problems and activities
  • Changes in sleeping and/or eating habits
  • Excessive complaints of physical problems
  • Defying authority, skipping school, stealing or damaging property
  • Intense fear of gaining weight
  • Long-lasting negative mood, often along with poor appetite and thoughts of death
  • Frequent outbursts of anger

In younger children:
  • Changes in school performance
  • Poor grades despite strong efforts
  • Excessive worrying or anxiety
  • Hyperactivity
  • Persistent nightmares
  • Persistent disobedience and/or aggressive behavior
  • Frequent temper tantrums
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Q3: What are the Causes of Mental Illness?

Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of biological, psychological and environmental factors.

What Biological Factors Are Involved in Mental Illness?
Some mental illnesses have been linked to an abnormal balance of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or are not working properly, messages may not make it through the brain correctly, leading to symptoms of mental illness. In addition, defects in or injury to certain areas of the brain have also been linked to some mental conditions.

Other biological factors that may be involved in the development of mental illness include:
  • Genetics (heredity): Many mental illnesses run in families, suggesting that people who have a family member with a mental illness are more susceptible (have a greater likelihood of being affected) to developing a mental illness. Susceptibility is passed on in families through genes. Experts believe many mental illnesses are linked to abnormalities in many genes, not just one. That is why a person inherits a susceptibility to a mental illness and doesn't necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors such as stress, abuse, or a traumatic event, which can influence, or trigger, an illness in a person who has an inherited susceptibility to it.
  • Infections: Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as pediatric autoimmune neuropsychiatric disorder (PANDA) associated with the Streptococcus bacteria has been linked to the development of obsessive-compulsive disorder and other mental illnesses in children.
  • Brain defects or injury: Defects in or injury to certain areas of the brain have also been linked to some mental illnesses.
  • Prenatal damage: Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth, for example, loss of oxygen to the brain, may be a factor in the development of certain conditions, such as autism.
  • Other factors: Poor nutrition and exposure to toxins, such as lead, may play a role in the development of mental illnesses.

What Psychological Factors Contribute to Mental Illness?
Psychological factors that may contribute to mental illness include:
  • Severe psychological trauma suffered as a child, such as emotional, physical, or sexual abuse
  • An important early loss, such as the loss of a parent
  • Neglect
  • Poor ability to relate to others

What Environmental Factors Contribute to Mental Illness?
Certain stressors can trigger an illness in a person who is susceptible to mental illness. These stressors include:
  • Death or divorce
  • A dysfunctional family life
  • Living in poverty
  • Feelings of inadequacy, low self-esteem, anxiety, anger or loneliness
  • Changing jobs or schools
  • Social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in the development of eating disorders.)
  • Substance abuse by the person or the person's parents
Source: WebMD
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Q4: What are the commonest Mental illnesses?

Anxiety disorders and Depression are the commonest mental illnesses. Some of the others are Schizophrenia, Dementia, Sleep Disorders, Alcohol and other substance use disorders, Personality disorders, Sexual functioning disorders, Autism, ADHD, etc.
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Q5: Why do so many people with mental illness not seek treatment?

There are many reasons why so many people with a mental illness do not seek treatment.
  • One simple reason is that people with a mental illness may not know they have such an illness, and their loved ones might not know either. People may know that something is wrong, be unhappy, and have problems functioning but still not know that they have the symptoms of a mental illness. Mental illnesses are different from physical illnesses since it is parts of the mind, not the body, that aren't functioning properly. This can make it harder to "see" when someone is having problems related to a mental illness.
  • Another important reason people do not seek help is they may not know that effective treatments exist for mental illnesses. People may be more afraid to get help for problems they don't believe are "fixable" than ones for which they believe effective treatments exist.
  • One more reason some people don't get help is they may be afraid of public attitudes about mental illness, such as it being a sign of weakness or someone's fault. Fortunately, as the medical community has learned more about mental illness and how to treat it effectively public attitudes have also changed. Mental illness is no longer viewed as a sign of weakness or something to be embarrassed about. In addition, there are many effective treatments for different mental illnesses.
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Q6: What are a few dos and don'ts for initiating a conversation about mental illness with a loved one?

Speak openly, factually, kindly, and without blame. Think of it in the same way that you would initiate a conversation if you saw your loved one was having a problem with what appeared to be sore muscles or heartburn. You have noticed some problems or symptoms, and you are concerned. You are trying to start a conversation about your concerns in order to find out what's wrong and to bring help and relief, to your loved one.

Do not hesitate to be specific in describing the behaviors in your relative that concern you - just be sure to express yourself in a manner that is simple, truthful, matter-of-fact, and calm. Here is an example: "I've would like to talk with you about something I am concerned about. I've noticed you've been angry very frequently lately. Is there something I can do to help?" You have expressed your concern without blaming your relative, and showed him your desire to help. That is enough for a start. It lets him know you are concerned about him. With this simple step, you have taken the topic out of the closet, and calmly put it on the table, where it may be further discussed openly.
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Q7: What should you do if your loved one refuses to seek professional help or refuses to believe there's a problem?

People with a mental illness are sometimes reluctant to seek professional help. However, it is important not to construe this reluctance as a refusal. There are many ways you can help people overcome their reluctance, and get the help they need. Here are a few strategies. The right strategy of course depends on why your relative doesn't want to see a professional.

Your relative may be reluctant to see a professional because he or she lacks the understanding that mental illnesses are common, are no one's fault, and can be effectively treated. Helping your relative understand that having a mental illness is nothing to be ashamed about, and that effective treatment can often bring rapid relief, may overcome his or her reluctance to seek treatment. These kinds of concerns are especially common in people who have difficulties related to anxiety or depression, although they are common in people with other disorders as well.

Some individuals are reluctant to seek treatment because they lack awareness about their problems, even when these problems may be readily apparent to others, such as family members. These individuals can be most effectively motivated to get professional help by linking the help to something they care about and are invested in changing or improving. For example she may be concerned about not having many friends, not sleeping well at night, losing jobs, or feeling down.
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Q8: If one could get rid of three misconceptions about mental illness what would they be?

  1. That mental illness is someone's fault. Mental illnesses are no one's fault. That means there is no one to blame, neither the person with the illness nor someone else, when someone develops a mental illness.
  2. That mental illness is a sign of weakness. Mental illness is not a sign of personal weakness. In fact, plenty of very strong people have experienced mental illness, so it's not something to be ashamed of or embarrassed about!
  3. That there are no effective treatments for mental illnesses. There are many effective treatments for mental illness, including medications, therapy, and rehabilitation programs.. These treatments allow people to live rewarding and productive lives.

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Q9: What are some of the realistic and unrealistic concerns about psychiatric medications?

The most common reason people don't take psychiatric medications is the same reason they often don't take medications for physical conditions: they forget! Helping people fit taking medications into their daily routines often helps address that problem.

One unrealistic (or inaccurate) concern people have about psychiatric medications is that they are addictive. Almost all psychiatric medications are not addictive-that is, they keep working at the same dosage levels over time, and people do not develop physical dependency on the medications.

One more misconception about psychiatric medications is that people who need them must take them for their lives. While it is true that some people need to take psychiatric medications for their lives, there are many other people who benefit from taking medications for just a short period of time, such as a few weeks or months.

A realistic concern about medications is their side effects. Medications do have different side effects, such as weight gain and sedation. However, figuring out the right dosage and type of medication can often minimize any side effects.
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Q10: What are some of the stresses that family members of someone with mental illness face and how can they keep living their lives in the face of those stresses?

Probably the major stress that some families face is when a member has a long-term mental illness. Most mental illnesses are not long- term if they are treated, but some are, and family members may be involved in helping the person manage his or her affairs, and getting the treatment he or she needs for the mental illness. That responsibility can weigh heavily on family members.

This is why it is so important for the family to stop guessing and take steps to find out what may be going on with their loved one when they first become concerned. Recognizing signs early and helping the person get the right treatment as early in the course of the illness as possible can give their loved one the tools to manage his or her mental illness successfully. This is just like other illnesses, in which the earlier the treatment is started the better the recovery.
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Q11: What is rehabilitation?

To rehabilitate means, to re-establish, to reconstruct, to reinstate, to renew or to regain.
All these terms indicate that rehabilitation is a building activity which attempts to restore a person's physical and mental capacities and improve the quality of his life to a level which is as near as possible to that which existed prior to his illness.
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Q12: Who would need rehabilitation?

Rehab focuses on persons who have experienced severe psychiatric disabilities rather than on individuals who are simply dissatisfied, unhappy or socially disadvantaged. Persons with psychiatric disabilities have diagnosed mental illness that limit their capacity to perform certain tasks and functions ( e.g. interacting with family and friends, interviewing for a job) and then ability to perform in certain roles (e.g. worker, student)
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Q13: What is Psychosocial Rehabilitation?

Psychosocial rehabilitation promotes recovery, full community integration and improved quality of life for persons who have been diagnosed with any mental health condition that seriously impairs their ability to lead meaningful lives. Psychosocial rehabilitation services are collaborative, person directed and individualized. They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning, and social environments of their choice.
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Q14: What are the Psychosocial Rehabilitation techniques made use of in the programme?

  1. Self care/independent living skill training.
  2. Social skill training
  3. Cognitive Retraining
  4. Vocational rehabilitation
  5. Supported education/ employment
  6. Continued care

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Q15: What is the most effective treatment for people with mental illness?

By combining psychosocial treatment with good medication practices, the severity of symptoms and the need for readmission to the hospital will be reduced. Adding psychosocial treatment will increase work and social functioning, improve quality of life, and provide the much needed support to patients and families.
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Q16: What is the aim of social skills training?

Social skills training is offered for several reasons
  1. The source of much stress in anyone's life is interpersonal. Learning learn common skills will help reduce stress and in case of people with mental illness also reduce the risk of relapse.
  2. Some people with mental illness like Schizophrenia have never been good in terms of social relationships, for reasons that are not a direct consequence of the illness, for e.g. some were always awkward or shy, whereas others simply failed to acquire the social skills that are part of normal adolescent development. Alternatively social skills that had been acquired may have been lost due to a lengthy illness.
  3. Some people with Schizophrenia find complex social situations to be overwhelming. By learning social skills which will help to engage in as little or as much social activity becomes useful for them at any point in time.

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Q17: What does the word cognition mean?

Cognition refers to thinking skills, the intellectual skills, that allow you to perceive, acquire, understand and respond to information. This includes skills that allow paying attention, remembering, processing information, solving problems, organizing and reorganizing information, communicating and acting upon information. All these abilities work in a close, interdependent fashion to allow one to function in his/her environment.
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Q18: Are Cognitive and Academic skills the same?

Cognitive skills are different from academic skills in that academic skills include knowledge about different subjects like language, maths and history. Cognitive skills refer to the mental capabilities you need to learn academic subject matter, and more generally to function in daily life. Cognitive skills are the underlying skills that must be in place for one to think, read, understand, remember, plan and organize.
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Q19: How does the mental illness affect cognition : What are the signs to look for?

There are different mental illnesses and they affect cognition differently. Furthermore, not every person is affected in the same way. It is important to understand that a mental illness affects each person somewhat differently. By understanding all the different ways mental illness can affect cognition, it is easier to understand how the person you know is affected.
For example, people who have schizophrenia often experience problems in the following aspects of cognition:
  • Ability to pay attention
  • Ability to remember and recall information
  • Ability to process information quickly
  • Ability to respond to information quickly
  • Ability to think critically, plan, organize and problem solve
  • Ability to initiate speech
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Q20: How do these cognitive problems show up in daily life?

Cognitive impairments may be experienced in different ways:

Attention
Some people report that they have difficulty paying attention when people talk and give directions. Others find it hard to concentrate on what they read, and find that they lose track of the important points, especially when reading longer passages. They may find it hard to focus on one thing when other things are happening at the same time. They may get distracted or conversely, become so involved in one thing that they fail to attend to something else that is happening. Multi-tasking, for example, answering a customer's question while operating the cash register, becomes difficult because they have to divide their attention.

Memory
The ability to remember and recall information, particularly verbal material, is often a problem. Directions may be forgotten, or the ability to recall what has been read or heard may be reduced.
The ability to process and respond to information
Families may notice that response times are slower or that it takes longer to register and understand information. Speech production can also seem slower and even though it may only be half a minute, that can seem like a long time to wait for a communication when you are trying to have a conversation with someone.

Thinking skills
Critical thinking, planning, organisation and problem solving are often referred to by psychologists as the executive function; because those are the skills that help you act upon information in an adaptive way. Take the example of cooking meal. Even if you know how to cook each dish, to actually serve a dinner you have to plan ahead to have all the ingredients, organise and manage your time so each dish is finished at the same time. You also need to be able to adapt your plans if problems arise, like an oven that does not work or an ingredient or type of cooking vessel is missing. People with mental illness may seem less able to think of alternative strategies for dealing with problems that arise, or they may have difficulty coming up with a plan, or find it hard to listen critically to new information and know what is important and what is not.
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Q21: How does work benefit those with mental illness?

Work is a major determinant of mental health and a socially integrating force that is highly valued. No single social activity conveys more of a sense of self worth and social identity than work. To be excluded from work not only creates material deprivation but also erodes self confidence, creating a sense of isolation. For people with a serious mental illness, employment is an important stepping stone to recovery. It is a normalising factor that provides daily structure and routine, a meaningful goal, improves self esteem and self image, it increases finance, hence alleviates poverty, provides opportunities to make friendships and obtain social support, enriches the quality of life and decreases disability.
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Q22: What is the impact of mental illness on education and work?

The onset of mental illness can disrupt educational attainment and work thereafter. For psychotic disorders, this may occur because the typical onset age from 10-30 years, which may coincide with the critical career stages of completing formal education and establishing a career pathway.
Through disrupting education, mental illness can indirectly cause long term unemployment and limit career prospects. Hence mental illness can displace career paths downwards and limit attainment to less skilled jobs, lowering both work status and income expectation.
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Q23: How does the mental illness affect performance at school?

The school years are formative years, when the mind is developing and one's knowledge base and critical thinking skills are broadening. Unfortunately, mental illness often starts before people have finished this educational process. The problem with attention, concentration and thinking can make it very difficult to keep up with school work, and even students who once excelled may become discouraged by the lost time, or their declining grades. When students fall behind in their academics, they may start to view themselves negatively, and prefer to quit rather than keep exposing themselves to more academic failure. They also lose the opportunity to consolidate good study and learning habits, or worse, a poor learning style may be developed.
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Q24: How does mental illness affect the working ability of the individual?

Research has demonstrated that people with mental illness who have difficulty with memory, problem solving, processing speed and attention are more likely to be unemployed and having a lower occupational status. In many ways this is not surprising. Critical thinking has been identified as one of the most important skills that people need to compete in the modern workforce. Yet critical thinking/problem solving is often impaired in people with persistent mental illness. The problems that can arise at work when someone has difficulty paying attention, concentrating and remembering are also obvious. Most jobs are not just rote and repetitive but require people to remember new information or deal with changing demands. This is difficult when cognition is not working well.
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Q25: Can performance at school and work be improved?

Yes, with the right kind of treatment balancing medication with psychosocial rehabilitation techniques in a supportive environment performance at school and work can be improved.
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Q26: Can Cognitive problems be improved?

Yes, through medication and cognitive retraining.
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Q27: What is cognitive retraining?

Cognitive retraining is a therapeutic strategy that seeks to improve or restore a person's skill in the area of paying attention, remembering, organising, reasoning and understanding, problem solving, decision making and higher level cognitive abilities.
The purpose of cognitive retraining is the reduction of cognitive problems associated with the illness, decrease the everyday problems faced by the individuals, thereby improving the quality of lives.
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Q28: Are people with a mental illness in a position to handle relationships?

One of the things that makes personal relationships rewarding is the give and take of support, care and concern. People want others to rely, listen and pay attention to them. When someone with mental illness is not able to attend to or remember what is being said, their friend may feel hurt for not being listened to. At work, colleagues or bosses may think the person does not care or is lazy, when infact; it may be that they are not able to perform cognitively. This can affect relationships.
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After completing my school, I joined the J.J. School of Art and I studied for five years before completing my graduation, after which I started working as a commercial artist in an advertising agency. I later went to Dubai for a year and then I came back to Mumbai. I used to drink alcohol regularly and in 1993, I gave up drinking, which was quite tough, and then joined Alcoholics Anonymous. Slowly I started smoking. That was ruining me and I was slowly losing control over myself. I was even shouting at my mother a lot, which is why I went to rehab. Through God's blessing I was able to overcome the habit, although I still in depression. I then joined COOJ and that made me feel much better. Now at the age of 48, I can say that I am feeling happy after joining COOJ, all the sessions we have and the games make me feel like it's my second home. I was given opportunities to revisit art by making paper bags, cards and painting on gift bags etc. I feel nice to say that I like COOJ as it brings me out of my shell.
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