A healthy mind just as important as a healthy body

by Dhaneshi YATAWARA

The corner for their colourful thoughts

Nimal believes that the television records our lives - at home, at work as well as at the hospital. “Even aliens know about me. Through all the TV stations, those living beings of the universe are extracting facts about our lives,” he said.

“How do you know aliens are aware of your life?” asked the doctor. “They speak to me through the television,” ‘Nimal’ answered.

“Why do the aliens want to know about you?” the doctor asked. “Because I worship the sun, the moon, trees and mountains. I have to survive as well, isn’t it?” Nimal answered and added that the doctor is clueless about the ‘loka dharma’ (philosophy of the world).

‘Nimal’s’ (not his real name) ideas are bizarre. His speech flows from issue to issue which are totally irrelevant and unrelated to each other. Yet, he strongly insists on others believing him. ‘Nimal’ is one of the patients with severe conditions receiving treatment at the Mental Health Teaching Hospital at Angoda.

‘Nimal’ is a healthy-looking ‘normal’ person in his physical appearance. “A person with perfect physical health may not necessarily be perfect in his/her mental health,” says Doctor Harishchandra Gambhira, Consultant Psychiatrist of the Angoda Mental Hospital. “Mental health is a higher state than the ‘no disease’ state which we, at the moment, are trying to acquire,” said Dr. Gambhira.

A healthy mind is part and parcel of a person leading a healthy life. “We cannot have demarcations between physical and mental health. It is all interconnected,” he explained.

Mental illnesses

Do we properly understand this greater importance of a healthy mind? Have we ever seriously thought about it? “Unfortunately, no,” Dr. Gambhira said. “Until very recently the importance of mental health was not much highlighted across the globe, even in the medical field,” he explained.

At the post-natal ward

In search of a new world for a better life - by a patient

According to him, genetics determine the occurrence of mental illnesses in people and environmental factors do contribute on a secondary level.

As Dr. Gambhira explained, psychiatry deals with the body, like any other illness. “There are millions of neurons in the brain and there are different associations between these neurons,” he said, explaining that our thinking patterns depend on these associations of these nerves.

“In people with mental illnesses, there is a disorganization of these associations. Secondary to that, a chemical change also affects a difference in thinking patterns. These thinking patterns become entirely different from that of a normal person,” he explained.

The thinking pattern is the basis of a person’s behaviour. Thus, in mental illnesses, due to the difference in patients’ thinking patterns, their behaviour differs from a normal person’s in a major way. In most cases, they get delusions. Patients believe in these delusions, just like ‘Nimal’ does. “Some patients of mine believe that teledramas are produced to comment on them. There are some very distressing situations,” Dr. Gambhira added.

According to Dr. Gambhira, this disassociation of the neurons or the chemical changes are determined by genetics or during the intra-uterine life of a person or caused by birth trauma.

According to the Mental Health Directorate of the Ministry of Healthcare and Nutrition, of the ten leading causes of disability worldwide, five are mental disorders. The danger is that many do not recognize that they are ill and even when an illness is detected, mostly at the complicated stage of the illness, many do not seek help because of misconceptions about such disease.

We find three main illnesses related to mental health - schizophrenia, Bipolar disorder and major depression.

Dr. Harishchandra Gambhira

A research done on twins has revealed that schizophrenia does not always affect both twins. In certain cases, only one twin was affected with schizophrenia. “Only 50 per cent of the cases reported both twins suffering from schizophrenia,” Dr. Gambhira added.

According to this medical expert, depression shows different characteristics though it is also caused genetically. “Obviously, genetics and environmental interactions lead to the illness,” the doctor said. Major depression is the leading illness that causes disability in the USA. “Worldwide, including in Sri Lanka, it is rated in the fourth place,” he explained.

Bipolar disorder is a mental illness where two extreme characteristics can be seen in a person during two different stages in life. These two stages may occur one after the other or after a lapse of several years, during which the person may lead a very normal life.

Public awareness

Though one newspaper article is not enough to create awareness among the public on mental illnesses, accepting personal responsibility for taking time to learn about mental illness could make all the difference to you or to someone else you care about. A survey conducted by Dr. Harishchandra Gambhira on tsunami victims in Kirinda, three months after the 2004 tsunami, revealed that 24 per cent of them suffers from some kind of mental illness.

Enjoying their life - leisure time in the evening

Keeping them occupied could be the best treatment

Post-natal disorders are another aspect receiving more recognition today. A separate ward in the Angoda Teaching Hospital treats mothers with these disorders; they are facilitated to care for their babies and have interactions with their families.

“We do not believe in tying up patients and treating them. Such methods do not exist in the world any more. The most important thing is to reintegrate such people in to society,” Dr. Gambhira said, explaining the rehabilitation process that is carried out in the hospital as part of the treatment.

A healthy mind can be conceptualized as a state of well-being in which each individual realizes his/her own abilities, and is able to cope with the normal stresses of life, thus becoming a productive and fruitful person to the society. Mental health is the foundation for the well-being and effective functioning of both an individual and a community.