Immigration and Mental Health

depressed-immigrant

Immigrants, refugees, and asylum seekers are one of the most vulnerable social groups in the U.K. Most of these people are fleeing their home countries because of poverty, civil war, or a ruthless government.  Many of these countries are third world nations in which there are high incidences of disease, crime, torture, and separation from families.  As a consequence, some may have developed mental illness to some degree.  Others may have acquired some mental health issues owing to the stress of adapting to a new culture, system, lifestyle, and social treatment in their adoptive countries.

In the U.S., a high number of Asian American immigrants show depressive symptoms.  This is according to a 30-year old study, one reported by the University of Hawaii in 2011.  These people are stressed by the loss of their support system in their home countries and the pressing need to learn a new language and adapt to a foreign system.  Most of these immigrants may not have had mental health issues to begin with; but, the piling up of all the stressors from moving to a totally different country and society can contribute to the decline of mental health.  Children are particularly vulnerable to immigration stressors.

In the U.K., the African and African Caribbean communities have a high prevalence of depression and anxiety.  Everyday, people in these communities have to live with racism, difficulty in finding employment, bad housing conditions, and other stressors which can make many people, mentally ill.

Among African refugees and asylum seekers, PTSD is the most ubiquitous mental problem.  Mood disorders come second.  Some, being torture survivors, may be experiencing hallucinations, nightmares, panic attacks, sexual issues, acute phobias, and major depression.  These individuals may have difficulties forming relationships and developing trust.

Why Immigration Can Lead to Development of Mental Health Problems

When a person immigrates to another country or place, they face huge changes that they need to cope with:

  1. Upheaval of their social network and the need to re-establish personal, social, and business ties with new people
  2. Adapting from one type of socio-economic system to another
  3. Adapting to a new cultural system

Migrants have to leave the social ties they have built and try to forge new ones in the new host country.  Whatever role or profession they had occupied in their old place may have to drastically change to a lower profession or even a totally different one.  For instance, a respected dentist in her country may come to find herself having to occupy a much lower level position, such as a dental receptionist, in the new place.  The migrant may also have migrated to a place where her certification as a professional dentist holds no value or recognition.  In order to be certified as a dentist in the new country, she may have to study again to get the credentials.  Often, the migrant does not have the necessary financial means to fulfil such requirements.

The immigration process also puts a great strain on the migrant as his citizenship status and his economic status is highly uncertain.  Institutions may question his legality of stay in the country which in turn could impact his employment options, not to mention his options as a person without citizenship privileges.  He may also be vulnerable to situations involving violence, especially if he finds himself in refugee camps or detention centres where resources are meagre and conditions are harsh.  Such environments and the reality of powerlessness can trigger or create chronic depression, anxiety, trauma, and other mental health issues, even in mentally healthy people.

Treating Immigrants

Psychiatric treatment of immigrants needs to be approached from a cultural perspective.  Since most immigrants come from a different cultural background, it is important to understand how a migrant patient communicates.  Sometimes, patients with depression or panic attacks focus on unexplained physical symptoms such as pain, stomach upsets, fatigue, and the like.  When interviewed in a more relaxed social rather than clinical setting, the patient may reveal being burdened by social and situational stressors which they are usually reluctant to talk about as culturally, these may be deemed inappropriate medical topics.  Some cultures also highly stigmatise mental illnesses so that seeking professional attention on the matter is not something individuals may want to acknowledge they need or want to talk about.

Language is another barrier to treating migrants who do not adequately speak the tongue of the host country. In this case, language interpreters and culture brokers can effectively assist and vastly improve diagnosis and treatment by helping to span both cultural and communication gaps.

How Mental Illness Affects a Marriage

marriage-and-mental-illness

One of the heartbreaking sad realities of a marriage in which one partner suffers from mental health issues is a broken relationship leading to divorce.  There is a strong link between divorce and mental illness, the highest ratios belonging to major depression, substance addiction, histrionic personality disorder, antisocial personality disorder, and PTSD (post-traumatic stress disorder).

A partner with a mental health disorder is often debilitated, emotionally, mentally, and even physically.  In many cases, cognitive functioning, social drive, sexual appetite, and social behaviour lie outside the normal limits of acceptance.  These may manifest on decreased or extreme levels, causing chronic stress, anxiety, fear, and frustration on the mentally healthy spouse.

Common Challenges a Marriage Faces with a Mentally Ill Partner

The vow to stay together “for better or for worse” is challenged by the fact that the tenor of the marriage changes as the symptoms of mental illness bring about these conditions:

  1. Loss of a sense of partnership

For the mentally stable partner, there is “no partner to turn to” when situations become   difficult.  The mentally ill partner however may come to depend heavily on the spouse for emotional, social, and even financial support.  Instead of a partner-based relationship, the healthy spouse may find himself or herself alone with the burden of keeping the family together, without help or support from the significant other.

  1. Financial issues

Mental health disorders debilitate and may cause a sick individual to lose his job or source of income.  In this case, it falls on his/her spouse to financially carry the family alone.  This puts a strain on the relationship with the healthy spouse developing resentments and the unhealthy one, being frustrated with himself and further worsening his mental condition.

  1.  Single parenting and taking the role of a caregiver

Not only does the healthy spouse lose a partner when mental illness strikes, he also has to assume the role of a caregiver who has to weather the storm of emotional upheavals mental illnesses bring.  The healthy partner also has to make decisions alone regarding children, if any, and steer the family into the right direction, almost without help from the spouse.  This often leaves the healthy partner feeling alone, trapped with an enormous burden from which there is scant relief.

  1.   Sexual distancing and loss of desire

The chronic burden of caregiving, dependency of partner, and other issues that may crop up can decrease sexual desire of the caregiving partner for the other.  If the mentally ill partner is experiencing major depression, he may lose his sexual appetite as a common repercussion of the malady.  Sexual distancing also erodes emotional closeness between partners which over time contributes to the dissolution of the marriage.

  1.   Social distancing and isolation

When the behaviour of the mentally unhealthy partner starts to become socially unacceptable and embarrassing, such as compulsive habits or lecherous remarks, friends may start withholding invitations and the couple may find themselves isolated from their former social groups.  Even family relations may place some distance from the mentally ill person, and in consequence, isolate the other stable partner as well through no fault of his own.  This could exacerbate the healthy spouse’s feelings of being alone with the burden of caring for a mentally ill patient.

According to John Gottman, psychology professor emeritus and author of over 40 books and academic articles on marriage and parenting, the four horsemen of the apocalypse that destroy marriages and lead to divorce are:  contempt, defensiveness, criticism, and stonewalling.  In relationships where one or both partners are dealing with their mental health issues, these four elements crop up more frequently, making a marriage with a mentally ill partner rather difficult to upkeep.

thinkaboutdivorce

What Can Be Done

There is no one-way-fits-all approach for helping a deteriorating marriage on its feet.  Just as it is with any malady, seeking professional help is paramount when the symptoms are still at their early stages.  In a marriage, early counselling coupled with medical treatment is key.  Sadly, couples who come in for counselling usually have gone years relating dysfunctionally with each other so that one spouse has already seriously been considering divorce.

It is best for both partners to seek counselling or therapy together.  The therapist can mediate between both parties, set a “no blame” environment, help the mentally ill partner acknowledge how his behaviour is affecting the relationship, and reduce relationship distress.  The therapist may also prescribe medication as part of his therapy plan in order to improve the mentally ill spouse’s ability to function and communicate.

There are, however, cases where the severity of mental illness mandates a separation, especially where the mental and physical health of children are involved.  Violent behaviour, for instance, may be one imperative for couples to distance themselves from each other.  Staying in a marriage where one is mentally ill is a case-to-case basis.  For some undergoing couple’s therapy, mental illness can somehow strengthen the relationship bonds; for others, however, sticking it out together just cannot be an option any longer.

The Link Between Intelligence and Mental Health

genius and madness

High I.Q. and Mental Stability

Geniuses and highly creative people with high I.Q.s have always been linked to mental health problems such as depression, bipolar disorder, and schizophrenia.  Often we may picture a brainy computer geek who may be a programming whiz but prone to social awkwardness and withdrawals.  We admire masterpieces and learn of its gifted creators who oscillate between mania and depression.  Indeed, in the pantheon of great achievers, there are a number of personalities such as Beethoven, Virginia Woolf, Ernest Hemingway, Buzz Aldrin, and Jackson Pollock who have struggled with mental health issues during their lifetimes.  Even Aristotle was quoted to have said, “There is no genius without having a touch of madness. “

Some individuals with above average to superior I.Q.s commonly tend to exhibit symptoms from these three mental illnesses:  bipolar disorder, schizophrenia, and obsessive-compulsive disorder.  There are about 20-30 studies that support the “tortured genius syndrome,” the strong link between genius and madness.  One decade-long study on a 700,000 Swedish adolescents turned up surprising evidence, which was published in 2010.  Those teenagers that excelled in intelligence tests were four times more likely to have developed bipolar disorder.  Another study on children gifted with superior I.Q. above 130 showed that 65% of these kids had some sort of major depressive disorder.

Why is genius or superior intelligence linked to mental and emotional instability?  Brilliance instils the ability of being able to construct an inner world to fit their views and preferences.  However, when that worldview clashes with reality, it often leaves the person lost and unable to cope well.  Moreover, highly intelligent people are more sensitive to stimuli than average individuals.  Ellyn Saks, a University of Southern California mental health professor reiterates that “people with psychosis do not filter stimuli as well as others without the disorder, meaning that they’re able to ponder contradictory ideas simultaneously and gain insight into loose associations that the general unconscious brain wouldn’t even consider worthy of sending to consciousness.”

A Swedish study also found that many people diagnosed with schizophrenia or bipolar disorder are or have been in highly creative jobs that demand highly functioning cognitive skills and artistic cleverness in levels not usually employed by the average or normal individuals.  This is why artists seem to be functioning at a perspective so different from non-artistic or creative people.

Highly intelligent individuals have the ability to see novel patterns and innovative connections of things which the average intellect may not discern.  This ability also makes a very creative and smart individual, very vulnerable to feeling strong emotions, hallmarks of bipolar disorder.

It is however not entirely accurate to stereotype intelligent people as mentally unstable individuals.  Not all people with very high I.Q.s are unhealthy, mentally; but, there is a percentage of the gifted population that have developed depression and other major mental disorders because of their intellectual gifts.

As high I.Q. can be factor of developing mental illness, low or below average I.Q. can be contributory element as well.  Studies have also pointed out a direct correlation between low intelligence and depression.

Low I.Q. and Depression

Low I.Q. or a low intelligence quotient means lower than average cognitive abilities and problem-solving skills.  People with a 70-79 intelligence rating (below average I.Q. rating) have been surveyed by the Adult Psychiatric Morbidity Survey in England to be generally less happy than those with average or high I.Q.  People with less than average intellectual abilities often have difficulties catching up in school, getting hired in good paying jobs, earning sufficiently for their families, and earning peer respect and regard.  Because of these inabilities, people with below average I.Q.s tend to have poor relationships, low income, scant employment opportunities, and a lot of personal frustration.  These conditions alone are enough to drive a person into clinical depression.

 

Scientists are still unsure about the precise mechanisms on how intelligence affects mental health.  Perhaps there will come a time in which formulated cures would be available to help people balance their intelligence, high or low, against their propensity to develop mental illness.  Until such time, people need to understand that people with low or high I.Q.s may carry the extra burden of ill mental health and therefore should be treated with more understanding.

Obesity and Its Impact on Mental Health

obesity scale

While the world’s population has been going on a rising trajectory, it has also been growing heavier by the year.  Obesity is now a global health issue.  According to the World Health Organization (WHO), the epidemic is spawned by the pervasive issues of unhealthy diets and low physical activity.  Obesity is expected to be one of the biggest killers by the year 2020.

High body mass indices (BMIs) of 30 or more plague an estimated 300 million people globally at every social class and age group, particularly in the U.S., U.K., Middle East,  Australia, China, and the Pacific Islands.  Much more disturbing is the phenomenon of rising child obesity which has almost tripled within the last three decades.

Notwithstanding the fatal repercussions morbidly excessive weight can have on physical health, obesity takes its toll on mental health as well.

The Relationship between Obesity and Mental Health

Research backs evidence of an intrinsic link between obesity and common mental disorders. Obesity can cause depression, anxiety, and other unhealthy mental conditions just as these mental illnesses can lead to obesity.  According to the March 2011 National Obesity Observatory paper on Obesity and Mental Health, studies point to a two-way correlation between depression and obesity.  “Obese persons had a 55% increased risk of developing depression over time, whereas depressed persons had a 58% increased risk of becoming obese.  Another recent systematic review and meta-analysis found a weak but positive association between obesity and anxiety disorders.”

Generally, an obese person is not a very happy person.  Obesity can trigger many unhealthy psychological conditions:obesity stigma

Depression

A higher incidence rate of depression occurs among morbidly obese individuals, especially those with BMIs of 35 and over.  Studies also reveal that obese children often rate their quality of life lower than children suffering from cancer.  The Swedish Obese Subjects (SOS) study disclosed that very obese individuals often had as much as or higher depression scores than patients who were afflicted with chronic pain.

Western culture places a stigma on weight and as a result, excessively overweight individuals tend to develop self-imposed social isolation, poor self-image, and low self-worth, all major contributory factors to depression.  This has not been without just cause, though.  Society has not been very kind to the excessively overweight.  Fat people have often been ridiculed, ostracised, and stereotyped; hence leading most overweight individuals to adopt even more self destructive behaviours such as binge eating and substance abuse.

There is a silver lining though.  When obese patients begin to take off significant weight, their mental state also begins to improve.

Anxiety and Mood Disorders

A study that involved NESARC data found that obese persons were one and a half times more likely to report a mood disorder or panic attacks that have been plaguing them for the past year or as long as they can remember.  Extremely obese individuals were twice as likely to report the same.  The anxiety phenomenon is stronger in women than in men.

Because of Western culture’s aversion to fat people, obese individuals can develop social anxiety disorder (SAD) just from the sole reason of being extremely overweight.  Such a disorder has served to impair their functioning in their social milieu.

On the obverse, anxiety can breed obesity as well.  Anxiety can trigger compulsive and excessive eating patterns and depress the will to engage in physical activity, two factors which generally lead to obesity over time.

What Can Be Done?

For people with mental health disorders due to obesity, there is good news.  Mental health conditions significantly improve as one reduces his weight.  However, making radical changes to lifestyle eating and movements may backfire if one does not make such changes with a support group or team.

Consider approaching the obesity problem with the help of qualified professionals.  Your GP can draw up a safe, balanced eating plan and exercise regimen while a psychiatrist or psychologist can help you discover the core issue behind overeating and your subsequent weight gain.  These professionals can also help you deal with negativity and low self-esteem.

Depending on the level of obesity, medications for obesity or surgical procedures such as gastric bypass, bariatric surgery, and the like may be prescribed.  However, lifelong lifestyle changes will always be obligatory to complement and maintain obesity treatment.

HIV and AIDS

hiv virus

What is HIV?

HIV or human immunodeficiency virus is a disease that compromises the immune system, gradually leaving the victim defenceless against other diseases.  The virus attacks white blood cells called T-helpers or CD4s and replicates itself inside these.

Different strains of HIV exist and these can coexist in one infected individual.  HIV resides in bodily fluids such as semen, blood, vaginal and anal fluids, and breast milk.  Sweat or urine however are not carriers of the virus and therefore HIV cannot be transmitted through these bodily excretions.

A person can be infected with HIV through:

  • Vaginal and anal sex without condoms –The most common form of transmission from which 95% of cases in the UK in 2013 resulted.
  • Breastfeeding — Infected mothers pass the virus to their babies through breast milk.
  • Injections by contaminated needles or other equipment that pass through skin
  • Unprotected oral sex and sex toy sharing although the risks are very low with 1 in 5,000 chances of transmission

HIV is incurable but people who are diagnosed early on and get good medical treatment can live long lives with the disease.

As of 2014, about 103,700 cases have been diagnosed in the U.K.  About 60% of these cases fall within the age range of 35-54 and the remaining 40% are distributed among the young and senior group.  The highest incidence of HIV in the U.K. is among two groups: gay and bisexual men and black heterosexual men.  Sadly, there are perhaps numerous cases undiagnosed simply because of lack of knowledge.

It is easy to miss the onset of HIV because the early symptoms mimic those of the flu.  Symptoms such as joint pain, fever, sore throat, and body rash appear 2-6 weeks after contraction of the disease.  After this period, the symptoms disappear for years; that is why symptoms can be brushed aside as simply indicators of common influenza.

HIV can be asymptomatic for as long as ten years.  The infected person can actually feel healthy and well during this time period.  This is a major reason why there are numerous individuals who remain undiagnosed.  The asymptomatic period is dangerous because the afflicted person does not know that his immune system is gradually being damaged to the point where the body is left defenceless to all sorts of illnesses.  In the advanced stages of HIV, the patient may experience:

  • Weight losshiv uk stats
  • Recurring infections
  • Extreme fatigue
  • Swollen lymph glands
  • Dangerous and life-threatening diseases
  • Skin disorders such as red or purple blotches, rashes, etc.
  • Night sweats
  • Chronic diarrhoea
  • Sores in the mouth, genitals, and anus

What is AIDS?

AIDS or acquired immune deficiency syndrome is an illness that attacks an HIV patient towards the last stage of the HIV infection when the immune system has been rendered helpless against the onslaught of various illnesses.  AIDS is therefore euphemistically known as advanced HIV infection or late-stage HIV.  Because an AIDS patient has no defence against disease, death can result from infections from other illnesses such as pneumonia, cancer, and tuberculosis.  Even mental illness such as depression and dementia can set in with AIDS.  Any sort of illness can invade the body at the AIDS point because the body has been left wide open to health invaders.

The Psychological Impact of HIV and AIDS

Despite the decreasing numbers fatalities because of adequate treatment and increased public awareness, HIV and AIDS remain highly stigmatised diseases.  An HIV diagnosis on the outset is highly traumatic as it not only means that one is harbouring an incurable and possibly fatal illness but it also means the likely possibility of becoming a social pariah.

The stigma of HIV and AIDS has left many feeling isolated and very lonely.  Fear of rejection from potential partners hound many HIV-positive people and these feelings are of especial concern to infected adolescents growing into adulthood.  Shame and embarrassment are also other factors that positively diagnosed individuals feel as the disease is still socially viewed as proof of immorality.  As a result, HIV patients have higher incidences of depression, anxiety, and suicidal tendencies.

Depression in itself causes physical problems with HIV patients.  Depressed people are less likely to stick to their medical treatments, a phenomenon lessening their chances of being able to live long, normal lives with the disease.

An HIV patient does not need to disclose their condition to just anyone; but he or she must have at least one supportive person they trust to talk to about their situation.  There are also organized HIV-support groups to touch base with other people afflicted with the same condition.  Talking to other HIV-positive people can dampen feelings of isolation and rejection.  In addition, professional support from a psychologist, psychiatrist, or social worker may greatly help your mental and emotional condition.

When an HIV patient’s mental and emotional health is addressed, their adherence to their anti-retroviral treatments, reduction of high risk behaviours, and their social engagements become remarkably improved.  Quality of life for an HIV-positive individual need not be severely compromised as long as he takes care of his physical, mental, and emotional well-being.

Promoting Our Own Mental Health

Sound mental health is as important as good physical health for optimal overall well-being.  Everyone agrees that a strong mental constitution is a vital factor for living potentially to the fullest.  

What Mental Health Means

Wikipedia defines mental health as “the psychological state of someone who is functioning at a satisfactory level of emotional and behavioural adjustment.  From the perspective of positive psychology or holism, mental health may include an individual’s ability to enjoy life, and create a balance between life activities and efforts to achieve psychological resilience.

Mental health is not simply the absence of mental illnesses or disorders.  It encompasses the abilities of an individual to:

  • think, emote, and relate well with others
  • realise their potential
  • be productive in the community
  • cope well with life’s stresses
  • enjoy life
  • be reasonably independent

To put it simply, the famous psychoanalyst Sigmund Freud defined mental health as the ability “to work and to love.”

Managing Sanity

Since every stage in life brings major changes, we need the psychological resiliency to meet the challenges life metes out.  Our mental health is challenged by adversity and also by the response of our own genes and brain chemistry.  Because anyone’s mental health can be risk at some point in life (from trauma, sudden change of fortune, etc.), it is important to be aware of the early warning signs of mental health deterioration.

Early warning signs such as those listed below should prod one to get immediate help:

  • Loss of interest in learning or doing anything
  • Pulling away socially
  • Sleeping too much or hardly sleeping at all
  • Low energy; chronically fatigued or exhausted
  • Feeling lost, helpless, or hopeless
  • Experiencing unexplainable aches and pains
  • Feeling of detachment from self and others; emotional numbness; indifference
  • Severe mood swings
  • Irritable, confused, angry
  • Worried, scared, forgetful, anxious
  • Inability to perform normal tasks
  • Thoughts of self harm or inflicting harm on others
  • Persistent thoughts that play in the mind over and over

Early psychological intervention increases the chances of an individual’s full recovery.  

Strengthening Your Mental Health

As important as it is to strengthen or maintain our physical health, our mental health also needs constant upkeep.   

strengthen mental health

Value Yourself

We may be kind and understanding to others but we usually tend to be hard with ourselves.  Tone down your self-criticism and treat yourself with the same kindness and respect.  Aim for personal growth by allowing yourself new experiences and learning new things.  Becoming an expert in your hobby, learning a new language, or challenging your intellect with puzzles can help you build different facets of yourself, making you a more interesting person.

Valuing yourself like this helps fortify your self esteem which goes a long way to promoting your mental health.

Take Good Care of Your Body

The mind and body are intrinsically connected.  If the body weakens, so does the mind and vice-versa.  In order to bolster chemicals in the brain that are responsible for making us feel good, good habits that promote physical health promote mental health as well:

  • Regular exercise — increases the production of endorphins and serotonin, both “feel good” elements that lower depression and encourages positive perception
  • Enough rest or sleep — sleep deprived individuals are more prone to developing anxiety and depression.  Lack of sleep also significantly decreases one’s cognitive abilities thereby impairing memory, focus, problem solving, and the like.
  • Avoiding vices such as alcohol drinking and cigarette smoking
  • Eating a nutritious, balanced diet — a diet high in sugar, processed food,  or sodium can be detrimental to both physical and mental health over time

Learn Stress Management   Mental-Health

As stress invades life, almost daily for others, one must learn how to deal.  Anger management, work-life balancing, time management, and such must make their way into your skill set so you may manage the degree of stress that comes your way.

In addition, try to find humour in your mistakes.  Laughter can boost your immune system and reduce stress.  

 

Give of Yourself

Helping others and realising you have made a difference, no matter how small, in a person’s life, increases your sense of self-worth which in turn strengthens your mental health.  Positive social connections help improve mood, emotional resilience, and confidence.  The best form of social interaction is one’s giving of himself…time, effort, money, goods, etc….to others.  The act of generosity stimulates the pleasure areas of the brain because it makes us feel relevant, useful, and needed—factors which improve the way we see and feel about ourselves.

Cultivate a Support Group

People who have strong familial or support connections often exhibit good overall health.  Your mental and emotional well-being can be maintained well over time if you have people you can trust, talk to, and be of help as well.  Widen your circle of friends by joining a club, gym, or cause.  Spending time to cultivate positive relationships within the family and among friends is always a wise investment of your time.   

Because your happiness rests on your mental well-being, it is vital that you take steps to safeguard and maintain it.  When you feel you need help, seek it out and get it.  This is not a personal sign of weakness but of strength.  With appropriate treatments and care for mental disorders, you can make a full recovery to live your life to the fullest.