Patients do not Address Psychiatric Illnesses Adequately (IInd and Concluding Part)

We continue with the interview of the Psychiatrist Dr. Sumit Kumar Gupta.

Family Reaction and Legal Consequences: Unrecognized mental illnesses are a common cause of divorce and domestic violence. Dr. Sumit Says, “I got the first-hand experience of this, during my association with a pilot project in collaboration with Crime against Women (CAW) Cell of Delhi Police. Because of the fear of legal consequences, the affected party is usually not open to acknowledging the symptoms overtly, which hampers treatment-seeking. Equally common is the tendency of the opposite party to take legal advantage of the revealed fact of mental illness and treatment during adversarial legal process rather than showing interest in well being of the affected party.”

Most people and their families are relieved after being communicated about the diagnosis and the explanation of the symptoms. Finding a cause to the distressing experience and the hope of improvement with treatment is in itself relieving. However, a few people are unable to understand that mental illnesses are ‘real illnesses’ until they witness the improvement with treatment.

Medicines Addictive? There is a prevalent myth that medicines used for the treatment of mental illnesses are sedatives or addictive in nature. Dr. Sumit told us, “We, specifically, inquire about and address such believes while prescribing the treatment. However, such beliefs are so ingrained in the society that around 80% of the patients do not continue with their treatment as advised. The modern-day antidepressants do not have any such tendency. Despite this, misinformation is rampant. I was upset after reading an article in a leading national daily covering the menace of addiction, which wrongly used the term antidepressant to describe few sedatives commonly abused. Such unintentional loose use of words by influential people and mass media further reinforces the already prevalent myths about mental illnesses and their treatment. A few patients report back to mental health professionals after discontinuing the treatment and subsequent worsening of the condition based on their knowledge of some serious ‘side effect’ gathered by using a search engine on the internet. It is important to understand that the information provided by such search engines is not filtered by the authenticity of the source or the relevance to the context. Any such concern can be best addressed by discussing it with the treating professional.”

A few Facts about Mental Illnesses that the Society at large should know:

• Expression of a negative emotional state is not a sign of mental weakness and it requires a lot of courage to say “I am feeling sad or depressed”. The person is in need of emotional support and acceptance. Denial of such feelings by statements like “you are not weak and should not say so” does not boost the morale and rather discourages the sufferer to share such feelings and delays help-seeking. A statement like “I am with you” is more helpful in providing emotional comfort and promotes healthy coping.
• Stress is universal and stress alone usually does not result in mental illnesses. After treatment and recovery, most people with mental illnesses can lead a normal life and can assume usual responsibilities. Attempts to reduce stress by not allowing the recovered person to work or not allocating responsibilities or hiding non-pleasurable happenings does not usually help. It only induces dependence on others and decreases the sense of self-reliance and self-esteem. For some mental illnesses requiring long-term continuation of medications to prevent relapse, this becomes all the more relevant.
• There are different types of mental illnesses with their specific treatments. The medicines used for the treatment of mental illnesses are not ‘addictive’. A few mental illnesses are chronic in nature just like diabetes or hypertension and medicines may be prescribed for a long duration to prevent relapse. This should not be confused with ‘addiction’ or ‘dependence’. While discontinuing addictive substance precipitates ‘withdrawal symptoms’ associated with the addictive substance, discontinuing the drugs used for mental illnesses can lead only to the reemergence of signs and symptoms usually associated with the illness and not any new symptom.
• Good intentions alone are not sufficient. Get information from authentic sources like a mental health professional. Do not pay much attention to casual advises of ‘well-wishers’ and clarify with the treating doctor in case of any doubt.