MENTAL HEALTH
According to the World Health Organization (WHO), Health is a state of complete physical, mental and social
well-being, and not merely absence of disease or infirmity.
Normal mental health, much like normal health, is a rather difficult concept to define.
Normality is not an easy concept to define, some of the following traits are more commonly found in ‘normal’
individuals.
1. Reality orientation.
2. Self-awareness and self-knowledge.
3. Self-esteem and self-acceptance.
4. Ability to exercise voluntary control over their behavior.
5. Ability to form affectionate relationships.
6. Pursuance of productive and goal-directive activities.
PSYCHIATRIC DISORDER
The simplest way to conceptualize a psychiatric disorder is a disturbance of
Cognition (i.e. Thought), Conation (i.e. Action), or Affect (i.e. Feeling), or any
disequilibrium between the three domains.
Another way to define a psychiatric disorder or mental disorder is as a clinically
significant psychological or behavioral syndrome that causes
significant(subjective) distress, (objective) disability, or loss of freedom; and
which is not merely a socially deviant behavior or an expected response to a
stressful life event (e.g. loss of a loved one).
A psychiatric disorder should be a manifestation of behavioral, psychological, and/
or biological dysfunction in that person
CLASSIFICATION IN PSYCHIATRY
Although first attempts to classify psychiatric disorders can be traced back to
Ayurveda, Plato (4th
century BC) and Asclepiades (1st century BC), classification in Psychiatry has
certainly evolved ever since.
At present, there are two major classifications in Psychiatry, namely
ICD-11 and DSM- V
ANXIETY DISORDER
Anxiety is a ‘normal’ phenomenon, which is characterized by a state of
apprehension or unease arising out of anticipation of danger. Anxiety is often
differentiated from fear, as fear is an apprehension in response to an external
danger while in anxiety the danger is largely unknown (or internal).
Normal anxiety becomes pathological when it causes significant subjective
distress and/or impairment in functioning of an individual.
Some authors separate anxiety into two types:
1. Trait anxiety: This is a habitual tendency to be anxious in general (a trait) and is
exemplified by
‘I often feel anxious’.
2. State anxiety: This is the anxiety felt at the present, cross-sectional moment
(state) and is exemplified by ‘I feel anxious now’.
GENERALISED ANXIETY DISORDER
This is characterized by an insidious onset in the third decade and a stable, usually
chronic course which may or may not be punctuated by repeated panic attacks.
The symptoms of anxiety should last for at least a period of 6 months for a diagnosis
of generalized anxiety disorder to be made.
The one year prevalence of generalized anxiety disorder in the general population is
about 2.5-8%. It is the commonest psychiatric disorder in the population.
As anxiety is a cardinal feature of almost all psychiatric disorders, it is very important
to exclude other diagnoses.
PANIC DISORDER
This is characterized by discrete episodes of acute anxiety. The onset is usually
in early third decade with often a chronic course. The panic attacks occurred
currently every few days. There may or may not be an underlying generalized
anxiety disorder.
The episode is usually sudden in onset, lasts for a few minutes and is
characterized by very severe anxiety. Classically the symptoms begin
unexpectedly or 'out-of-the-blue’. Usually there is no apparent precipitating
factor, though some patients report exposure to phobic stimuli as a precipitant.
Panic disorder is usually seen about 2-3 times more often in females. Panic
disorder can present either alone or with agoraphobia.
