• Anxiety disorders include phobias, panic attacks, obsessive-compulsive disorder and post-traumatic stress disorder.
• Major depression is characterized by dysphoria and an obvious loss of interest and pleasure in usual activities. There could be a significant weight change, secondary to decreased or increased food intake, sleep pattern disturbances, feeling of tiredness, feelings of worthlessness and excessive guilt, diminished ability to concentrate, and recurrent thoughts of death.
• Bipolar illness is characterized by either alternating depression and mania, or rapid cycling of mood, which may appear as irritable depression and dysregulation of affect.
• Children with autism or autistic disorder, have problems in interacting and communicating with others. Autism develops before 36 months of age and is typically diagnosable at 18 months of age.
• Conversion disorder is the loss or alteration of physical functioning without a demonstrable organic illness
• Pseudoseizures
• Hypochondriasis is a preoccupation with the fear of having a serious illness, and somatisation disorder
• Limit sleep disorder is common among children preschool-aged and older. It is characterised by difficulty in falling asleep and bedtime resistance (curtain calls)
• Parasomnias are episodic nocturnal behaviours.
• Habit disorders include tension discharging phenomena, such as head banging, body rocking, thumb sucking, nail biting, hair pulling (trichotilomania), teeth grinding (bruxism), hitting or biting parts of one’s own body, body manipulations, repetitive vocalizations, and air swallowing (aerophagia). Tics which involve the involuntary movement of various muscle groups are also included.

Adolescence

Adolescence can be a turbulent period. It is the age when an individual starts thinking and behaving independently.

Dr Bharat Shah, consultant psychiatrist, Lilavati Hospital says, “An adolescent has to cope with changing sex hormones, change in physical appearance to which he or she can become extremely sensitive; sexual urges flood the mind and an adolescent may not know how to deal with these urges.”

He adds, “There’s the pressure to excel in studies, to choose a career and finally there is peer pressure to cope with. It is because of this or merely incidental that major psychiatric illnesses like schizophrenia and bipolar disorder have their onset during this age.”

Certain young individuals, who are scared of weight gain and refuse to believe that they are underweight, may have life threatening eating disorders. Young people with anorexia nervosa have difficulty in maintaining a healthy minimum body weight. Those with bulimia nervosa feel compelled to binge. Then in order to prevent weight gain, they use measures like vomiting, laxatives, enemas or compulsive exercising to rid their bodies of the food.

Adulthood

Dr Shah says, “Young adulthood has its own set concerns, like being able to form a stable relationship with a person of opposite sex, to be able to get and give love, to succeed in a career and to able to find satisfaction there and be able to make a living out of it. Inability to deal with these leads to anxiety and depression. There is the added risk of developing addiction.”

He continues, “During late adulthood, men face mid- life crisis and women face issues like children going away, reduced physical attractiveness, husband paying more attention to his business, and menopause and its reactions. At this age, there is also a higher incidence of depression in women.”

Geriatric age

With age come new challenges, choices and milestones. There are retirement and post retirement adjustments. At this age, people start questioning self worth and usefulness of existence. Individuals with a good social support system – family and friends, generally make the aging transition without mental health problems.

However in the older adults, especially those above the age fifty, certain disorders are common. They are also the people who may not seek help. The disorders common to this age group include:

• Anxiety disorders like phobias
• Mood disorders like depression
• Severe cognitive impairment like dementia which includes Alzheimer’s disease
• Substance abuse
• Schizophrenia

In people with pre-existing mental problems, the changing equations experienced with age can exacerbate it. The mental health problems at this age can vary from being mildly troublesome, to severely interfering with daily living or even fatal.

The Gender Bias

While several studies suggest that the rate of mental disturbances is almost similar in men and women, certain gender differences play a role in the pattern of the illness.

Menarche to menopause

The gender related risk factors related to common mental disorders in women are gender based violence, the socioeconomic disadvantage (economic as well the social status), and the responsibility of caring for others. Hormones also play an important role.

Men and Mental Health

Throughout the history of mankind the mantle of being macho, the protector and the provider has been thrust on the male of the species. They have to be strong, they have to be brave and they are not allowed to cry.

The pressure of living up to the image takes its toll. There is a feeling of ‘nothing can happen to me’ and a tendency to avoid regular health checks. The process of growing up, the peer pressure, need to excel, get a good job, need to prove themselves sexually, become a provider and protector lead to stress situations and depression when standards are not reached. Substance abuse as a stress buster and even suicide as an option are considered. Some studies suggest that men also undergo a phase now being referred to as male menopause similar to that in women. Probably, once again, related to the life stresses experienced during that period.

For ‘vital aging’ and keeping healthy mentally, at all stages of life, it is suggested to:

Being positive and staying positive is the mantra to a healthy mind.