Shedding light on mental illness

By Ni Dandan Source:Global Times Published: 2014-8-27 18:33:01

The tragic suicide of the Oscar-winning comedian Robin Williams earlier this month has once again drawn the public's attention to depression and related mental illnesses. According to data released by the World Health Organization (WHO) in 2013, more than 350 million people worldwide are affected by depression. Moreover, the organization believes that by 2020 depression will be the second most-common cause of death globally, second only to heart disease.

Unfortunately, the WHO says that less than half of depression sufferers will receive necessary treatment. In some countries, this rate can be as low as 10 percent. The situation is similarly bleak in China, even though depression currently ranks as one of the most prevalent mental health disorders in the country. According to a report by China Comment magazine in May, more than 200,000 Chinese people commit suicide every year as a result of depression.

Of course, residents of Shanghai aren't immune to the scourges of mental illness. Back in 2005, a survey carried out by the mental health division of the Shanghai Municipal Center for Disease Control and Prevention found that 1.6 million of the city's residents were in need of some form of psychological therapy or medication to treat mental illness. In an interview earlier this month with the Global Times, Yin Chenfang, a local psychiatrist who specializes in depression and suicide intervention, said that around 2 million locals are afflicted by various mental illnesses and mood disorders.

But while such disorders now arguably have a larger role than ever before in the lives of ordinary Chinese people, according to Dr Tad Pu, a specialist in the diagnosis and treatment of child and adolescent psychiatric disorders at Parkway Health here in Shanghai, this has done little to dislodge long-held preconceptions.

"Seeing a mental health professional in China carries a huge stigma. Physical illness is fine - one gets the flu and he visits a doctor. But it is not the case with mental illnesses. People feel like losers if they get caught by a mental illness," Pu, who has 27 years of experience in his field, told the Global Times.

Pu took pains to emphasize that mental illnesses like depression are not much different from physical maladies, in that they can often be cured with treatment. They can also be fatal if ignored.

"Don't think that just because there aren't many physical symptoms, a mental illness can't be deadly. Half of the entire population will experience a depressive episode at some point in their life, and around 7 percent of the population will develop depression. Why should we feel embarrassed about this?"

In many cases, Pu explained, signs of depression will emerge in childhood and puberty. For this reason, it is incumbent upon parents to watch for symptoms.

Early detection

Pu said parents should keep an eye out for whether their children are easily agitated. Youngsters troubled by depression, the doctor said, can be set off by almost anything. This means they can become angry or distraught over insignificant episodes either at home or at school.

When it comes to making a diagnosis, professionals will usually look at whether the child's ability to function in day-to-day life is being hindered by their behavior. For example, if a child can't go to school, is unable to form relationships with his or her peers, cannot participate in class or routinely acts out in a violent manner, these could all be symptoms of a mental health disorder.

Discussing some of the cases Pu has seen over the years, he mentioned one involving a teenage girl. "She refused to go to school all of a sudden, refused to study, failed in almost all her subjects and lost interest in doing anything.... In this case, her ability to function was substantially impaired. She even thought of suicide. Given these signs, a clinical psychologist needed to take a look at the girl."

Dr Pu recalled that the girl was referred to a doctor by her teachers. "Some of the city's international schools have teachers and counselors equipped with knowledge of mental health. They know when to raise a red flag."

The doctor suggested that parents sometimes overlook serious symptoms or try to convince themselves that their children are just being naughty. Still, when trouble comes to the surface, parents should think critically about its causes.

"They need to do some analysis. Is there any family crisis going on? Firstly, parents need to control their own tempers. Then they should closely monitor their children, open their eyes and ears to see what is really going on." The doctor recommended that parents first try to figure out whether their child has gotten involved in taking drugs, abusing alcohol or hanging out with the wrong crowd.

Clinical depression in children and adults can stem from a combination of factors, many of them related to genetics and heredity. Children have a higher chance of developing depression if one of their direct relatives had such a problem. The environment can play a role as well, with family abuse being linked to emotional and psychological disturbances later in life. Other risk factors include chronic illnesses or behavioral disorders such as ADHD (attention deficit hyperactivity disorder).

"Depressed children need love and support. We need to be there for them - to be extra patient, careful and close to them. Some kids will even engage in self-harming behaviors like cutting themselves. Parents need to take them to professionals. It's very important," Pu exhorted.

The doctor said that as many as 70 percent of teen depression cases worldwide are left untreated. "This only leads to more adult depression. Many suicides happen in late adolescence and early adulthood because signs of depression weren't recognized or treated properly in their early stages."

Hard to convince

Among adults, symptoms of depression include sleeping problems (either sleeping too much or too little), loss of interest in formerly pleasurable activities, being unable to make decisions, extreme feelings of guilt or worthlessness and sudden dramatic changes in weight. In severe cases, the sufferer may fixate on thoughts of death or suicide.

Sadly, with adult sufferers of depression, Pu said that it is even more difficult to convince them to see a doctor or to follow the advice of a professional.

"Quite a few of my patients shut me off when I mention medication in discussions of treatment options. They say 'no way.'"

The doctor noted that depression often has a biological basis and medications that affect brain chemistry can ease symptoms and promote receptivity to psychotherapy and counseling.

Returning to his previous comparison, Pu argued that "if you're nearsighted, you get prescription glasses. If you have a headache, you take Tylenol. It's the same with medication for depression."

Pu explained that medications are often strongly recommended for persons who engage in self-harm or seriously contemplate suicide.

An estimated 2 million people in Shanghai are afflicted by different mental illnesses. Photo: CFP



 

Posted in: Society, Metro Shanghai

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