Mental health encompasses cognitive, behavioural and emotional well-being. Mental illness, thus, produces changes in emotion, behaviour and cognition. A person suffering from mental illness feels, thinks, behaves and interacts differently with others than a person who is mentally healthy does.
There is no single precipitating cause for mental illness. A number of factors can together be responsible, like genes and family history, life experiences, stress, a history of physical or sexual abuse, traumatic childhood experiences, brain injury, loneliness or isolation, living in a stressful environment. In such conditions a person is more likely to develop a mental illness. Losing a loved one is another major cause. Mentally ill persons constantly put themselves down or expect the worst.
Mental illnesses range from depression to anxiety disorders, schizophrenia, bipolar disorder, autism spectrum disorder, eating disorders, and substance abuse disorders. In Kashmir the bloody conflict that has been going on for the past 30 years has severely affected the mental health of people, both men and women, young and old.
In the past 18 years particularly, there has been an immense increase in psychiatric morbidity in Kashmir. Surveys have revealed that the prevalence of depression is 55.72% and the prevalence is highest (66.67%) in the 15 to 25 years age group, followed by 65.33% in the 26 to 35 years age group. Post traumatic stress disorder (PTSD) is highly prevalent in the general population in Kashmir. Prevalence of depression is much higher in rural areas (84.73%) than in urban ones (15.26%). In rural areas, females suffer depression more than the males. About 67% patients had co-morbid depression.
Mental illness can affect anyone, regardless of caste, creed and religion. However, mental illness in Kashmir is not just a problem in itself; it is also an aspect of Kashmiri society. People here do not talk about mental illness. Though in most societies mental illness is considered as a stigma or mark of shame, in Kashmir there is a peculiar traditionalism with which people keep rejecting the person who is suffering from mental illness. Some parents go to great lengths to deny that their child suffers from anxiety or depression, because if they acknowledge it, they know their child will be treated as an untouchable. Some people assume that a person must be possessed by a foul spirit or demon and such a person is best avoided. Many people do not consult doctors but rather pay repeated visits to some hermits or Malang Babas for exorcising the evil spirit of a Jinn or devil by magic tricks. This is more prevalent in rural life where medical facilities are poor.
People with mental illness are thus challenged doubly. On the one hand they struggle with the illness, and on the other hand they struggle with the society. The fear of society has a devastating effect on not just the individual but the entire family. Families avoid taking a member to a psychiatrist in order to save the entire family from shame. Many patients themselves shy away from medical treatments. Untreated mental illness often results in severe emotional, behavioural and physical problems, all creating suicidal tendencies.
Many people believe that patients of mental illness are violent and dangerous, when in fact the patients are more at risk of being harmed by other people. This unfounded thinking has caused much shame among patients for something that is out of their control. The most devastating part is that the stigma attached to the illness prevents people from seeking the help they need and which is available for them. Removing this stigma is as important as any medical treatment. It needs psychological counselling, now recognised as an effective mode of healing, of not just the patient but of the so-called “normal people”.
There are some possible solutions to this problem of mental health stigma. The first solution is mass awareness about mental health conditions and the need for medical treatment. The second is easy access to help, either in the form of a mental health professional or a specialised institution/ organisation. The third is to encourage parity between physical and mental illness. The fourth is to focus on being honest about the treatment. No one should be afraid to admit to and to discuss their mental health issues.
It’s high time to create a social environment that encourages individuals to talk about mental issues and seek help. We must talk responsibly about it. Language and words matter. Mental illness is something that isn’t in one’s control, so it isn’t something to hide or to be ashamed of. If people are not ashamed of going to a cardiologist or a physician, why should they feel so about going to a psychiatrist? If other parts of our body can suffer, so can our brain.
The writer is a student of Psychology at Women’s College, MA Road, Srinagar. [email protected]