Facts about mental health
In this entry we present the latest estimates of mental health disorder prevalence, disease burden rates, and mortality impacts across a number of disorders.
Mental health disorders are complex and can take many forms. The underlying sources of the data presented in this entry apply specific definitions (which we describe in each relevant section), typically in accordance with WHO's International Classification of Diseases (ICD-10). This broad definition incorporates many forms, including depression, anxiety, bipolar, eating disorders and schizophrenia..
Mental health disorders remain widely under-reported .Even taking into account that mental health disorders are likely underreported, the data presented in this entry demonstrate that mental health disorders are common and have a high prevalence. Improving awareness, recognition, support and treatment for this range of disorders should therefore be an essential focus for global health..
The table below provides a brief summary of the data which follows on mental health and substance use disorders. Clicking on a given disorder will take you to the relevant section for further data and information.
Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:
- Eating or sleeping too much or too little
- Being away from people and unusual activities
- Having low/high or no energy
- Feeling numb or like nothing matters
- Having unexplained aches and pains
- Feeling helpless or hopeless frequently
- Smoking, drinking, or using drugs more than usual
- Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
- Yelling or fighting with family and friends unwontedly
- Experiencing severe mood swings that cause problems in relationships
- Having persistent thoughts and memories you can’t get out of your head
- Hearing voices or believing things that are not true, suspiciousness
- Thinking of harming yourself or others
- Inability to perform daily tasks like taking care of your kids or getting to work or school
Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.
Over the course of your life, if you experience mental health problems, your thinking, mood, and behavior could be affected. Many factors contribute to mental health problems, including:
- Biological factors, such as genes or brain chemistry
- Life experiences, such as trauma or abuse
- Family history of mental health problems
Mental health problems are common and proper guidance and help are available. People with mental health problems can get better and many may recover completely.
Major Psychiatric disorders
Depressive disorders occur with varying severity. The WHO's International Classification of Diseases (ICD-10) define this set of disorders ranging from mild to moderate to severe. The definitions by disaggregating to mild, persistent depression (dysthymia) and major depressive disorder (severe).
All forms of depressive disorder experience some of the following symptoms:
reduced concentration and attention;
reduced self-esteem and self-confidence;
ideas of guilt and unworthiness (even in a mild type of episode);
bleak and pessimistic views of the future;
ideas or acts of self-harm or suicide;
Anxiety disorders arise in a number of forms including phobic, social, obsessive compulsive (OCD), post-traumatic disorder (PTSD), or generalized anxiety disorders.
The symptoms and diagnostic criteria for each subset of anxiety disorders are unique. However, collectively the WHO's International Classification of Diseases (ICD-10) note frequent symptoms of:
- Apprehension (worries about future misfortunes, feeling "on edge", difficulty in concentrating, etc.)
- Motor tension (restless fidgeting, tension headaches, trembling, inability to relax)
- Autonomic overactivity (lightheadedness, sweating, tachycardia or tachypnoea, epigastric discomfort, dizziness, dry mouth, etc.)."
Bipolar disorderBipolar disorder (also termed bipolar affective disorder) is defined by the WHO's International Classification of Diseases (ICD-10) as follows:
"This disorder is characterized by repeated (i.e. at least two) episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (mania or hypomania), and on others of a lowering of mood and decreased energy and activity (depression). Characteristically, recovery is usually complete between episodes, and the incidence in the two sexes is more nearly equal than in other mood disorders. As patients who suffer only from repeated episodes of mania are comparatively rare, and resemble (in their family history, premorbid personality, age of onset, and long-term prognosis) those who also have at least occasional episodes of depression, such patients are classified as bipolar."
Eating disorders are defined as psychiatric conditions defined by patterns of disordered eating. This therefore incorporates a spectrum of disordered eating behaviours. The underlying sources presented here present data only for the disorders of anorexia and bulimia nervosa (as defined below). It is however recognised that a large share of eating disorders fall outwith the definition of either anorexia or bulimia nervosa (these are often termed 'eating disorders not otherwise specified'; EDNOS) — some estimates report at least 60 percent of eating disorders do not meet the standard criteria.
It is therefore expected that the data presented below significantly underestimates the true prevalence of eating disorders, since it concerns only clinically-diagnosed anorexia and bulimia nervosa.
"Anorexia nervosa is a disorder exemplified by deliberate weight loss, and associated with undernutrition of varying severity.
For a definite diagnosis, the ICD note that all the following are required:
(a) Body weight is maintained at least 15% below that expected (either lost or never achieved), or Quetelet's body-mass index4 is 17.5 or less. 4 Quetelet's body-mass index = weight (kg) to be used for age 16 or more - 139 - Prepubertal patients may show failure to make the expected weight gain during the period of growth;
(b) The weight loss is self-induced by avoidance of "fattening foods". One or more of the following may also be present: self-induced vomiting; self-induced purging; excessive exercise; use of appetite suppressants and/or diuretics;
(c) There is body-image distortion in the form of a specific psychopathology whereby a dread of fatness persists as an intrusive, overvalued idea and the patient imposes a low weight threshold on himself or herself;
(d) A widespread endocrine disorder involving the hypothalamic - pituitary - gonadal axis is manifest in women as amenorrhoea and in men as a loss of sexual interest and potency. (An apparent exception is the persistence of vaginal bleeds in anorexic women who are receiving replacement hormonal therapy, most commonly taken as a contraceptive pill.) There may also be elevated levels of growth hormone, raised levels of cortisol, changes in the peripheral metabolism of the thyroid hormone, and abnormalities of insulin secretion;
(e) If onset is prepubertal, the sequence of pubertal events is delayed or even arrested (growth ceases; in girls the breasts do not develop and there is a primary amenorrhoea; in boys the genitals remain juvenile). With recovery, puberty is often completed normally, but the menarche is late."
"Bulimia nervosa is an illness defined by repeated behaviours of overeating, preoccupation with control of body weight, and the adoption of extreme measures to mitigate the impacts of overeating.
For a definite diagnosis, the ICD note that all the following are required:
(a) There is a persistent preoccupation with eating, and an irresistible craving for food; the patient succumbs to episodes of overeating in which large amounts of food are consumed in short periods of time.
(b) The patient attempts to counteract the "fattening" effects of food by one or more of the following: self-induced vomiting; purgative abuse, alternating periods of starvation; use of drugs such as appetite suppressants, thyroid preparations or diuretics. When bulimia occurs in diabetic patients they may choose to neglect their insulin treatment.
(c) The psychopathology consists of a morbid dread of fatness and the patient sets herself or himself a sharply defined weight threshold, well below the premorbid weight that constitutes the optimum or healthy weight in the opinion of the physician. There is often, but not always, a history of an earlier episode of anorexia nervosa, the interval between the two disorders ranging from a few months to several years. This earlier episode may have been fully expressed, or may have assumed a minor cryptic form with a moderate loss of weight and/or a transient phase of amenorrhoea."
In every country women are more likely to experience an eating disorder than men. Eating disorders tend to be more common in young adults aged between 15 and 34 years old.
Schizophrenia is a severe psychiatric disorder. "The normal requirement for a diagnosis of schizophrenia is that a minimum of one very clear symptom (and usually two or more if less clear-cut) belonging to any one of the groups listed as (a) to (d) below, or symptoms from at least two of the groups referred to as (e) to (h), should have been clearly present for most of the time during a period of 1 month or more:
(a) thought echo, thought insertion or withdrawal, and thought broadcasting;
(b) delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions, or sensations; delusional perception;
(c) hallucinatory voices giving a running commentary on the patient's behaviour, or discussing the patient among themselves, or other types of hallucinatory voices coming from some part of the body;
(d) persistent delusions of other kinds that are culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and - 79 - abilities (e.g. being able to control the weather, or being in communication with aliens from another world);
(e) persistent hallucinations in any modality, when accompanied either by fleeting or half-formed delusions without clear affective content, or by persistent over-valued ideas, or when occurring every day for weeks or months on end;
(f) breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech, or neologisms;
(g) catatonic behaviour, such as excitement, posturing, or waxy flexibility, negativism, mutism, and stupor;
(h) "negative" symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance; it must be clear that these are not due to depression or to neuroleptic medication;
(i) a significant and consistent change in the overall quality of some aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal."
Risk factors for mental health
The determinants, onset and severity of mental health disorders are complex – they can rarely be attributed to a single factor. Identifying potential risk factors form an important element of health research, potential prevention and in some cases, appropriate treatment; nonetheless, many risk factors remain only correlates of observed patterns in mental health. They therefore need to be interpreted carefully.
The World Health Organization synthesize the potential contributors to mental health and wellbeing into three categories:
- individual attributes and behaviors: these can be particular genetic factors or personality traits;
- social and economic circumstances;
- Environmental factors.
In the table below we see the WHO’s breakdown of potential adverse and protective factors for mental health within these three categories. These factors often interact, compound or negate one another and should therefore not be considered as individual traits or exposures. For example, particular individual traits may make a given person more vulnerable to mental health disorders with the onset of a particular economic or social scenario — the instance of one does not necessarily result in a mental health disorder, but combined there is a significantly higher vulnerability.
Psychiatric disorders can be effectively treated with one or a combination of the following treatment plans:
- Out- patient and In-patient treatment
If needed our Psychiatrist can refer the patients for other treatments like:
- Electroconvulsive therapy (ECT) and modified ECT
- Transcranial magnetic stimulation (TMS) is a newer therapy
- Transcranial direct current stimulation (tDCS)
- Neurofeedback Therapy
- Brain function therapy (BFT).
- Cognitive training/brain training
Ways to maintain Positive Mental Health includes:
- Realize their full potential
- Cope with the stresses of life
- Work productively
- Make meaningful contributions to their communities
- Getting professional help if you need it
- Connecting with others
- Staying positive
- Getting physically active
- Helping others
- Getting enough sleep
- Developing coping skills
Good mental health is more than just the absence of mental illness. Here are some tips for building good mental health.
Having good relationships with other people is the most important factor contributing to a sense of wellbeing. This can include family, friends, workmates and others in the community. Investing time and energy in your relationships can lead to great benefits for all involved.
Exercise and stay healthy
Exercise has been shown to increase wellbeing as well as reduce symptoms of depression andanxiety. Good physical health is related to better mental health so a healthy diet, avoiding excess alcohol or drugs, getting a good night’s sleep, and regular checkups with the doctor can all help.
Count your blessings. Try keeping a gratitude journal and write down 3 positive things each day. This can lead to increased wellbeing.
Identify and use your strengths
We all have different strengths and weaknesses but finding out what you are really good at and using those talents can increase wellbeing. A strengths questionnaire is available at Authentic Happiness. (It’s free, but you need to register). Using your strengths to help others or contribute to the community creates a sense of meaning and purpose.
Flow is the state of being so highly involved in an enjoyable activity that you lose track of time. This usually happens when the level of challenge is about right for your level of skill. Flow can happen during work, hobbies, creative arts or sports.
Give to others
Making a contribution to the community, however small, increases social wellbeing. Many people feel a sense of contributing through meaningful work, but this could also mean volunteering, helping a neighbour or performing small acts of kindness. Take some time to do the things you really enjoy. Pleasant events can lead to positive emotions that can cancel out negative feelings.
Spirituality or religion
For some people, being involved in spiritual or religious practices can improve wellbeing, help in coping with stress and reduce symptoms of mental illness. This can include belonging to a faith community, meditation, prayer, mindfulness or practices such as yoga and Tai Chi.
Get plenty of sleep
Sleep is really important for our physical and mental health. Sleep helps to regulate the chemicals in our brain that transmit information. These chemicals are important in managing our moods and emotions. If we don’t get enough sleep, we can start to feel depressed or anxious.
The Sleep Foundation provides tips on how to sleep well, and to overcome problems with sleeping.
Eating well isn’t just important for our bodies, but it’s also important for our minds. Certain mineral deficiencies, such as iron and vitamin B12 deficiencies, can give us a low mood. Try to eat a balanced diet. If you find you’re a particularly stressed or anxious person, you should try limiting or cutting out caffeine as this can make you feel jittery and anxious.
Avoid alcohol, smoking and drugs
Drinking and smoking aren’t things which we always associate with withdrawal symptoms, but they can cause some which impact on your mental health. When you’ve had a few drinks you can feel more depressed and anxious the next day, and it can be harder to concentrate. Excessive drinking for prolonged periods can leave you with a thiamine deficiency. Thiamine is important for our brain function and a deficiency can lead to severe memory problems, motor (coordination) problems, confusion and eye problems. If you smoke, between cigarettes your body and brain go into withdrawal which makes you irritable and anxious.
Other drugs will often leave you in withdrawal and can often cause very low moods and anxiety. More severe effects of drugs include paranoia and delusions. There is some research that suggests drug use is related to developing mental disorders like schizophrenia.
Get plenty of sunlight
Sunlight is a great source of vitamin D. Vitamin D is a really important vitamin for our bodies and our brains. It helps our brains to release chemicals which improve our mood, like endorphins and serotonin. Try to go out in the sun when you can, but make sure you keep your skin and eyes safe. 30 minutes to two hours a day of sunlight is ideal. During the winter, some people become depressed because they aren’t getting enough sunlight – this is known as Seasonal Affective Disorder (SAD). Some people find using a special light-therapy lamp helps to alleviate the symptoms.
Stress is often unavoidable, but knowing what triggers your stress and knowing how to cope is key in maintaining good mental health. Try to manage your responsibilities and worries by making a list or a schedule of when you can resolve each issue. Often if you break down your worries and stresses and write them down, you realise that they are manageable. Try to avoid burying your head in the sand, and tackle problems face on. If you find you are having trouble sleeping, or are waking up thinking about all of the things that are stressing you out, write them down and reassure yourself that you can deal with them in the morning.
Do something you enjoy
Try to make time for doing the fun things you enjoy. If you like going for a walk, painting or a specific TV show, try to set aside time to enjoy yourself. If we don’t spend any time doing things we enjoy, we can become irritable and unhappy. Whether you need help to get out and about or not take a look at our Things To Do section, or go to our Events calendar, for ideas and information on what is going on in your area.
Do things for others
Helping others isn’t just good for the people you’re helping; it’s good for you too. Helping someone can help with your self-esteem and make you feel good about your place in the world. Feeling as though you’re part of a community is a really important part of your mental health. You could try volunteering for a local charity, or just being neighbourly.
Ask for help
One of the most important ways to keep yourself mentally healthy is to recognise when you’re not feeling good, and to know when to ask for help. There’s no shame in asking someone for support if you’re feeling low or stressed. Everyone goes through patches where they don’t feel as good as they should. You can try speaking to your friends or family, or if you think your mental health is getting on top of you then you can speak to your DOCTOR.