Compared to severe mental disorders like bipolar illness or schizophrenia, other mental causes of suffering are sometimes far more subtle, and often difficult to recognize, especially in the early stages, for both the patient and the general doctor. These include issues like relationship difficulties; emotional trauma arising from bereavement, abuse, and other traumatic experiences; anxiety; cognitive distortions; self-esteem issues; and many others.
Suppose there is an underlying emotional issue that is bothering you. You do not feel it is a big issue and suppress your feelings about it. Or perhaps it is such a difficult issue that you would rather avoid thinking about it. It festers inside you, affecting your mind first and then your body.
You are feeling exhausted for a month now. You feel your heart race at times. When you wake up, instead of feeling refreshed and looking forward to the day, a feeling of dread or fatigue washes over you. Your sleep quality is also not what it used to be. What do you do?
After you have tried to help yourself with homely remedies, you might decide to show a doctor or get a blood test done to check for anaemia and thyroid problems. We all know that these issues can lead to fatigue.
What happens when the doctor and the blood tests cannot find anything wrong with you? The doctor gives you some vitamin and mineral supplements, asks you to follow a better diet according to your weight, and recommends exercise. You do all that, and still, it does not help. And if the examination and tests detect something, you may get the treatment for that and yet not feel fully better.
It is unlikely that the physician will ask you in detail about what is going on in your life, career or family or relationships. It is unlikely that the physician would be able to correlate that some childhood trauma is manifesting itself in the current ill health you are facing.
Even if the doctor realizes that there is more at play here than just physical illness, their suggesting that you seek the health of a mental health professional may alarm or offend you. For some people, it would probably be more shocking to hear that they need psychological help than to hear that they need a minor surgery. In this post, I discuss why it can be challenging to seek out help for mental health issues.
Delay and Difficulties in Diagnosis
The example outlined above is one of the biggest ways how we fail to get the help we need to feel better. We do not seek and receive mental health care because the problem is often not even identified. Even when we know that something is not well in our feelings, or emotions, or our mind, seeking mental health therapy can be a difficult decision.
Identifying the culprit in this case can be difficult, due to: (1) the lack of personal awareness of the mental aspects of one’s own health problems, and (2) the lack of awareness among general medical doctors regarding the role of mental health issues in giving rise to physical symptoms.
Socio-Cultural Factors
Lack of social awareness:
Many people are not aware how our mind affects our body. In most societies, only psychoses are considered as mental illness, and the less obvious forms of mental distress are not even considered worthy of medical care. Some people may not be aware of mental healthcare, the benefits of therapy, or how to find a therapist. They may not understand the different types of therapy available or how therapy can help them cope with their mental health issues. This lack of awareness can make it difficult for people to seek out the help they need.
Lifestyle diseases have become so common in developed countries and in the middle and upper socio-economic strata of all the countries that some of them have even become glamorous – a validation of the successful, high-stress life one has. On the contrary, mental health problems are still largely a taboo. Slowly, things are changing and even celebrities are opening talking about their own mental health issues to raise awareness and make the discussion about these issues normal.
Stigma:
There is still a significant stigma surrounding mental health and seeking psychotherapy. Many people feel ashamed or embarrassed to admit that they are struggling with their mental health and seek out help. There is still a strong tendency in people to discriminate against mentally ill people. People needing help may worry about being judged or misunderstood by others if they seek therapy. Other people coming to know that a person sought psychotherapy can lead to the loss of job, difficulties in relationships, and other types of social ostracisms. This stigma and prejudice can prevent people from seeking the help they need and keep them trapped in a cycle of suffering.
Personal Beliefs
Beliefs about therapy:
Some people may believe that therapy is only for people with severe mental health issues and that they do not need it because their problems are not "serious enough." Others may believe that they should be able to handle their problems on their own and that seeking therapy is a sign of weakness. These beliefs can prevent people from being open to seek help.
Fear of vulnerability:
Therapy requires people to open up and share their deepest thoughts, feelings, and experiences with a stranger. This can be intimidating and scary for many people. They may worry about being judged or misunderstood, or they may be afraid to confront their own emotions and experiences. This fear can prevent them from seeking therapy.
Shame:
Many people who struggle with mental health issues feel a sense of shame about their struggles. They may feel like they are "broken" or "defective" and that there is something wrong with them. They may equate seeking mental healthcare to being a “loser”, even when their community or family does not have prejudice against mental problems. This personal shame can prevent them from seeking therapy, even when they know it could help them.
Accessibility to Mental Healthcare
Lack of financial and geographic access:
For many people, access to mental health therapy is limited due to financial or geographical barriers. Mental health care can be expensive, and many people cannot afford to pay for therapy out of pocket. In India, there is little support from the government or insurance for the coverage of mental healthcare. Additionally, people who live in towns and rural areas may have limited access to mental health care providers. Even in large cities, the ratio of mental health professionals to the population is dismal. Further, people may not have access to the kind of mental healthcare giver who can help them the best, like a psychiatrist, neuropsychiatrist, psychological counsellor, art therapist, play therapist, movement therapist, etc.
Time constraints:
Many people have busy schedules and may not have the time to commit to regular therapy appointments. It can be difficult to find the time to make and attend therapy appointments, especially for people who have demanding work or family commitments. In contrast to usual physician consultations which last 5 to 20 minutes, psychotherapy sessions tend to last from 1 to 3 hours.
Among all the factors discussed above, awareness is one single factor that can influence all the other factors in direct and indirect ways. We all must do what we can to facilitate dialogue about mental health. We must make ourselves vulnerable first and be ready to talk about our own struggles. In opening up and talking about our mental sufferings, we will not only help others, but we will also take the first step to heal ourselves as well.
Seeking mental health care can be difficult due to stigma, lack of access, financial barriers, and fear of being judged, but once you start the journey of mental health, you will find it an incredibly valuable and rewarding experience. Therapy can help us to better understand and cope with our mental health issues, improve our relationships, and lead happier, more fulfilling lives. If you are struggling with your mental health and are considering seeking therapy, it is important to remember that you are not alone and that there is help available. It may be difficult to take the first step, but it is worth it in the long run. Remember, seeking help is a sign of strength, not weakness.