Mental Health Wellness
Too often we talk about mental health and mental illness in the context of problems. Not often enough do we talk about getting the most out of life, enjoying ourselves, feeling good, helping others, appreciating the beauty around us. We might all be feeling better if more often we talked of wellness or well-being.
Well-being is about being emotionally healthy, feeling able to cope with normal stresses, and living a fulfilled life. It can be affected by things like worries about money, work, home, the people around us and the environment we live in. Well-being is also affected by whether or not we feel in control of our life, and feel involved with people and communities; also by feelings of anxiety and isolation. We are all affected by these things but for those of us who are lucky enough not to be living in desperate poverty, we can have an over-riding sense of wellness.
There is a simple test, developed by the World Health Organization that you can give yourself, to judge your level of wellbeing. Ask yourself which of the following is true for you during the past two weeks, on a scale of 5 to 0; somewhere between all the time (5) and never (0).
- I have felt cheerful and in good spirits.
- I have felt calm and relaxed.
- I have felt active and vigorous
- I woke up feeling fresh and rested
- My daily life has been filled with things that interest me
The closer that you get to five scores of 5, the closer you are to complete well-being.
There are five evidence-based things we can do to improve and maintain our mental wellbeing. They are:
- Get active Do what you can. Enjoy what you do
- Connect with others Talk and listen. Be there. Feel connected
- Keep learning Embrace new experiences. See opportunities
- Take Notice/Be Curious Appreciate the little things. Savour the moment
- Give to others Your time. Your words. Your presence
We can introduce any of these actions into our lives, any time, and we will begin to feel the benefits. Start small, keep trying – and good luck!
Well-being is about being emotionally healthy, feeling able to cope with normal stresses, and living a fulfilled life. It can be affected by things like worries about money, work, home, the people around us and the environment we live in.
Well-being is also affected by whether or not we feel in control of our life, and feel involved with people and communities; also by feelings of anxiety and isolation. We are all affected by these things but for those of us who are lucky enough not to be living in desperate poverty or be otherwise unfortunate, we can have an over-riding sense of wellness.
Improving our well-being is a positive step that may prevent most mental illnesses and help us deal with stress and anxiety. While some mental illnesses are caused by physical or chemical factors, there is no doubt that looking after ourselves will improve our chance of avoiding mental illness or lessen its effects, and there is little doubt it will make us feel better. Even more so if we eat sensibly and have good sleep.
Stress and Anxiety
What is stress?
- Stress is normal
- Stress is your reaction to demands on your body, mind and feelings
- Managed stress can become useful and healthy (viewing events as challenges)
- Unmanaged stress can become unhelpful and unhealthy (viewing events as threats)
What is anxiety?
Stressful and anxious feelings are common responses to a situation. Anxiety is more than just feeling stress or worried. “Normal anxiety” usually goes away once a stressful situation has passed.
Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behaviour like extreme worrying, being fearful and unsure about things like health, money, or family problems. The anxiety might occur even when there seems little or no reason to worry.
If anxiety doesn’t go away after a while, then you might want to seek help from a friend or a professional counsellor (See section – Where to get help).
SIGNS and SYMPTOMS OF STRESS and ANXIETY
Some are to do with how we think (cognitive):
- memory problems
- can’t relax; have a hard time concentrating;
- poor judgement
- constant worrying
- seeing only negatives
- having trouble falling asleep or staying asleep.
Some are to do with our feelings (emotional):
- irritable or short tempered
- unable to relax
- feeling overwhelmed
- sense of loneliness
Some reactions affect us physically:
- feeling tired for no reason;
- headaches; muscle tension and aches
- trembling or twitching; sweating, nausea, dizziness
- feeling out of breath;
- diarrhoea or constipation or frequent urination.
- frequent colds
Some stress affects our behaviour
- eating more or less
- lack of or too much sleep
- wanting to be alone
- neglecting responsibilities
- using cigarettes or alcohol or other drugs to relax
Tips to Reduce Stress & Anxiety
- Focus on your breathing. This takes your mind off stress and calms you.
- Talk to someone you trust about a problem that you feel is too big to manage alone.
- Positive self talk to recognise your strengths.
- Eat healthy and sleep well.
- Make time for fun.
- Read something inspirational or spiritual.
- Creative arts release tension and stimulate the mind
- Daily exercise.
- LAUGH- Tap into your funny bones and just let it out.
- Avoid unnecessary stressful situations.
- Avoid cigarettes and alcohol (and other drugs).
The terms mental illness, mental disorder, psychiatric disorder, psychological illness, and similar labels, all mean much the same. Such terms refer to a group of recognised medical conditions in which the central feature is psychological distress or disability. The following information is a brief summary of the most common and serious illnesses. More information can be found in the Links section
Mental illness is not caused by witchcraft, curses or sin. It is an illness like other NCDs.
We need to be careful not to identify all types of human experience (such as normal sadness or disappointment) mental disorders, and therefore medical conditions. It is only when a person’s ability to function as she or he wants in their daily life, that we might describe them as having a mental illness.
The World Health Organization describes the following conditions as mental illnesses.
In typical depressive episodes, the person experiences, for at least two weeks, depressed mood, loss of interest and enjoyment, and reduced energy leading to lessened activity. Many people with depression also suffer from anxiety symptoms and medically unexplained bodily symptoms. They have difficulties carrying out their usual work, school, domestic or social activities.
The most common signs are hallucinations (hearing voices or seeing things that are not there) and delusions (fixed, false beliefs; excessive and unjustified suspicions may also occur Severe abnormal behaviour, such as agitation, excitement and under-activity or over-activity, may be seen. Disturbance of emotions such as feeling numb or contradictions between how people say they feel and how they look (their facial expressions and body language).
Bipolar disorder is described as episodes in which the person’s mood and activity levels change a lot. Sometimes this disturbance consists of elevated mood and increased energy and activity (mania) and sometimes of depression. Usually, the person is fine between episodes.
Alcohol and Drug Use Disorders
Harmful use of alcohol or other drugs is using the drug to an extent that it causes damage to health. The damage may be physical (eg liver disease or infection), mental (eg depressive episodes) or social (causing family, financial or work problems. There is growing recognition that much domestic violence occurs under the influence of alcohol.
It is called dependence is when the use of the drug takes on a much higher priority than other behaviours that once had greater value. Withdrawal state refers to symptoms that occur when a drug is ceased after daily use for a long time.
Suicide is the act of deliberately killing oneself. It does not always result from mental illness. It is, however, usually the action of a distressed person who cannot find help. Attempted suicide is an act of self-harm with suicidal intent but not resulting in death. Self-harm is intentional self-inflicted poisoning or injury which is not intended to lead to death. (For information about getting help, see section – Where to get help).
Anxiety can become a mental illness if stress is severe enough to interfere with our ability to function; to be able to carry out our normal responsibilities and do the things we want to do.
Convulsive epilepsy is not a mental illness is but is sometimes, mistakenly, thought by people to be so. It is characterised by unprovoked seizures. These are caused by abnormal electrical discharges in the brain. In seizures, there are sudden muscle contractions, causing the person to fall and lie rigidly, This is followed by the muscles alternating between relaxation and rigidity, with or without loss of bowel or bladder control. Epilepsy attracts much stigma.
Dementia is a condition due to deterioration of the brain which affects some older people. Usually there are changes in a person’s mental ability, personality and behaviour. People with dementia commonly experience problems with memory and the skills needed to carry out normal activities. Dementia usually occurs in older people but IS NOT a part of normal ageing.
Family members may notice memory problems, change in personality or behaviour, confusion, wandering or toileting problems. Dementia results in decline in intellectual functioning and usually interferes with activities of daily living, such as washing, dressing, eating, personal hygiene and toilet activities.
This is an umbrella term covering disorders such as intellectual disability, mental retardation and autism. These disorders begin in childhood with impairment or delay in function related to central nervous system maturation. They tend to continue in adulthood and people who are affected are vulnerable to physical illnesses.
All treatment of a mental illness involves educational and supportive elements. Medications are often necessary but are not as effective alone, as they are if people receive education and support at the same time.
It is a myth that most people do not recover from mental illness. Most people do recover.
Are people with mental illness dangerous?
No. Most people with a mental illness are more likely to be frightened than frightening. Only a very small number of people with mental illness have a history of violent offending behaviour. People with mental illness are in fact more likely to be victims of violence themselves. Sadly they also face the daily stigma of violence thanks to popular movies and television shows that have spread an incorrect message.
What makes people experience mental illness?
Like many illnesses it’s difficult to establish the exact cause of mental illnesses. It can be brought on by hormonal imbalances in the body, stress or trauma (either physical or emotional). Some mental illnesses can also be passed on from generation to generation due to both genetics and home environments. Drug and alcohol abuse may play a part and can be a trigger in many illnesses. Usually it is a combination of all these factors.
How can you help people with mental health conditions?
People with mental health problems deserve to be treated with the same dignity and respect as everybody else. Sometimes they may need a little extra support and the simple act of listening can mean a lot. You can also support them to get in touch with services and supports like seeing a doctor or getting counselling.
The Model of Mental Health First-Aid (https://mhfa.com.au/ ) suggests that there are five steps in helping someone:
1 Assess risk of suicide or harm
2 Listen non-judgmentally
3 Give reassurance and information
4 Encourage person to get appropriate professional help
5 Encourage self-help strategies
- Assess risk of suicide or harm
The two most important risk factors to look for are:
Does the person have a plan about how they will kill themselves? Have they got the means to do it?
Has the person attempted to kill themselves in the past? Another factor that may increase the risk that someone will choose suicide as a way to end their suffering is if a significant person in their life has chosen suicide.
Warning signs of suicide
- Expressions of wanting to die, not wanting to go on living, to put an end to their relentless suffering
- Organising their affairs
- Giving away possessions
- Sudden change (better or worse) of appearance or behaviour
- No longer including themselves in plans for the future
- Withdrawing into themselves
If you think someone may be at risk, ask the following question directly: “Are you thinking of killing yourself?” or “Are you planning suicide?” It is a dangerous myth that you should not ask such questions because you might put the idea into a person’s mind. It is a myth because, if a person is feeling so low and distressed and miserable, the idea is already in their mind. The fact that you mention it may show the person that you some understanding of how they are feeling and that you are there to help. The question may encourage the person to talk to you about their problems and their intentions.
Take seriously any communication of distress. If you believe the person is at risk of harming themselves, seek professional help immediately.
- Listen non-judgmentally
- Engage the person in discussing how they are feeling.
- Listen to the person without judging them as weak. These problems are not due to weakness or laziness – the person is trying to cope.
- Don’t be critical of them. Don’t express your frustration at the person for having such symptoms.
- Don’t give superficial advice such as ‘pull yourself together’ or ‘cheer up’.
- Give reassurance and information
Help the person to feel hope and optimism and to realise that they have a real medical condition
- Mental illness is common
- Mental illness is not a weakness or character defect
- effective treatments are available
- appropriate and effective help is available
- mental illness is not laziness—mental illness can make people ‘motivationally challenged’
- mental illness is not a result of some evil done by them or their family or ancestors
- mental illness is an NCD like diabetes or asthma
- mental illness takes a while to develop and sometimes takes a while to resolve, but will get better faster with the right help.
- Encourage person to get appropriate professional help
Where to get help (See bottom of page).
- Encourage self-help strategies
Self-help strategies for depression
There has not been much research on the effectiveness of the many self-help strategies that people use to relieve depression. The ones below have some support from research:
- self-help books based on cognitive behaviour therapy
- St John’s wort (this should not be taken together with antidepressants or other prescribed medication)
- exposure to sunlight early in the morning
- alcohol avoidance for people with drinking problems
- massage therapy
- relaxation therapy
- folic acid and vitamin B12
- yogic breathing
Self-help strategies for anxiety
Anxiety is best overcome by confronting fears rather than avoiding them. The longer and the quicker fears are confronted, the sooner they will get better.
- Practise daily relaxation methods to reduce physical symptoms of tension.
- Reduce caffeine intake to 300 mg or less per day (3 cups).
- Regular exercise (at least 30 minutes, three times per week).
- Partake of leisure time and pleasurable activities.
- Get adequate sleep.
- Practise controlled breathing methods (slow, relaxed breathing) to reduce physical symptoms of anxiety, fear and panic. Avoid breathing too deeply or rapidly (hyperventilation) as this can cause physical symptoms of panic.
- Identify and challenge exaggerated worries and pessimistic thoughts.
- Accept that avoiding feared situations allows the anxiety or fear to grow even stronger.
- Follow a set of specific steps to help overcome fear or phobia.
- Remember that treating yourself is hard work but can be very successful. Panic during self-treatment shows you are beginning to confront your fear.
- Use evidenced-based anxiety websites or self-help books.
- Talk about your anxiety problems with other people at self-help groups.
- Kava is known to relieve anxiety and is relatively safe. (However there have been rare reports of liver damage from kava).
Self-help strategies for psychosis
Many people with a psychotic illness also have depression and/or an anxiety disorder. The self-help strategies recommended for depression and anxiety are also appropriate for people with schizophrenia or bipolar disorder. However, they are not to be used as the main source of treatment. Mental health professionals must be consulted. Support groups for people with psychosis and their families may be very helpful. There is a growing recovery (LINK TO RECOVERY SECTION) movement of consumers which is showing great promise in helping people with psychosis.
Self-help strategies for substance-use disorders
Resources in Fiji are limited. There are a number of booklets available from other countries to assist quitting alcohol or drugs. These are available from the Australian Drug Foundation, the National Drug and Alcohol Research Centre and SANE Australia.
Support groups may be a useful source of mutual support and information but these are also largely unavailable in Fiji. There is a branch of Alcohol Anonymous in Suva
STIGMA, DISCRIMINATION AND MENTAL HEALTH
“The single most important barrier to overcome in the community is the stigma and associated discrimination towards persons suffering from mental and behavioural disorders.” The World Health Organization
What is Stigma?
Almost 75% persons with mental illness report that they have experienced stigma.
Stigma originally meant a physical mark of shame. Now, it’s an invisible mark of disgrace that sets a person apart from others.
When a person is labelled by their illness they are no longer seen as an individual but as part of a stereotyped group. Negative attitudes and beliefs toward this person create prejudice which leads to negative actions and discrimination
The problem with the word ‘stigma’ is that it puts the focus on the person’s difference instead of on the people who are setting them apart. So it’s time to talk about stigma for what it really is: prejudice and discrimination. Prejudice is holding negative attitudes or beliefs about people who are viewed as different. Discrimination is acting on these ideas or beliefs.
Effects of Stigma and Discrimination
Stigma brings experiences and feelings of shame, self-blame, false belief, hopelessness, distress, loneliness, isolation, fear etc.
Stigma worsens a person’s illness and can lead to a reluctance to seek and/or accept necessary help.
Stigma affects families as well, leading to a lack of disclosure and support. In many cultures, the entire family carries their loved one’s stigma because they strongly identify as a group. As a result, family members may not confide in friends or others in their support network.
Discrimination affects all areas of living. It can prevent people from getting or having basic things that most of us take for granted, like:
- Getting hired, promoted or keeping a job
- Finding or keeping a place to live in a safe, accepting community
- Getting proper health care
- Feeling loved, needed and accepted by family and friends
- Contributing to communities and feeling productive
- Going to school
- Immigrating to another country etc.
“Layers” of stigma
Many people don’t experience stigma for a single reason. They may experience discrimination based on many different prejudices, like sexual orientation, gender, culture or physical disability. Discrimination itself can lead to mental health problems. And people who already face discrimination for any reason may be even less able to find help for mental health problems or less able to find services that meet their needs.
Challenging and Fighting Stigma
Use respectful language
Use sensitive language like “a person with schizophrenia” rather than “schizophrenic”. Try to have the courage to correct people who use terms like lialia, leqa, pagli, pagla, crazy, psycho, mad, retard.
Include mental illness in discussions about acceptance of diversity, just as you would discuss cultural diversity, religious beliefs, physical disability, and sexual orientation.
Become an advocate
Create awareness by writing letters to newspapers and lawmakers. Speak out and challenge stereotypes portrayed in the media. Take it upon yourself to inform your community about the truth of mental illness.
Help people be heard
We need to encourage and empower people with experiences of mental health problems to be leaders in any efforts, such as anti-stigma programs and research. Teach others about mental illness.
Teach others about mental illness
Spread understanding that these are illnesses like any other.
Five small ways to make a difference:
- Think about the words to use. Use sensitive language.
- Seek direct contact by volunteering for a mental health organisation, or find personal stories of recovery.
- Encourage and help people with mental illness to tell their stories.
- Think about how to personally support and treat people who are living with a mental health problem.
- Speak up when you see discrimination or when you see a law or policy that unfairly excludes people.
WHERE TO GET HELP
Often problems can be sorted out by talking with someone. If there is no one close to you who cares for you and is a good listener, Empower Pacific has a toll-free helpline for confidential counselling (office hours) 5626
If you or your loved one thinks they might be developing a mental illness, there are places to go for help:
Community Mental Health Teams – in each Division of Fiji. These teams are responsible for coordinating care of all clients of Mental Health Services. After hours, call 3381 399 leave a message, and you will be contacted the next morning.
Sub-divisional Hospitals, Health Centres, General Practitioners and Nursing Stations have professional staff who will assist you.
Stress Management Wards are based in Suva (CWM), Labasa and Lautoka Hospitals. They can provide time and space for people who are experiencing mild or moderate distress and also provide in-patient services for someone who might have to stay in hospital for a while.
St Giles Hospital is for people who are highly distressed or having severe symptoms. St Giles has an inpatient and outpatient service.
Psychiatric Survivors Association of Fiji (PSA) is based at 3 Brown Street Suva and provides support to people who have mental illness. PSA also undertakes outreach throughout Fiji.
Youth Champs 4 Mental Health (http://youthchampsformentalhealth.org/about/ – also on Facebook) offers advocacy and supports young people who are distressed.
Important Phone Numbers
Central/Eastern Community Mental Health Team – 3340 421 ext 33149
Western Community Mental Health Team – 6660 411
Northern Community Mental Health Team – 8812 522
CWM/Suva Stress Management Ward – 3313 444
Lautoka Stress Management Ward – 6660 399
Labasa Stress Management Ward – 8811 444
Empower Pacific toll-free Helpline – 5626
Fiji Alliance for Mental Health – 9293 078
Youth Champs for Mental Health –
Fiji Women’s Crisis Centre – 8665 737 or 9316 307 or 9706 512
Suva 3313 300
Nadi 6707 558
Labasa 8814 609
Ba 6670 466
Raki 6694 012
Lifeline Fiji – 3630 400 or 9402 541
Psychiatric Survivors Association 3319 043 or 9538667
St Giles Hospital 3381 399
For more information about mental health services, please contact us at firstname.lastname@example.org
Links to more information
- http://www.beyondblue.org.au – one for the blokes