Cause of mental illness , Its type and How do we counsel to a mental illness patient?

 

Mental illness is the illness of higher mental functioning which includes poor functioning of the thinking, ,memory, judgements, orientation, intelligence and perception. During our life many us undergo through times of "temper loss", "emotional distress", "sadness and fatigue". But they are transient and do not affect our daily routine activities significantly not included on mental illness.

ETIOLOGY OF MENTAL ILLNESS

Biological causes

• Genetic causes
• Neurotransmitter disorder
• Personality
• Neuroendocrine theory( Hormonal, disturbance)
• Lesion on brain
• Physical disease
• Intrauterine infection
• Prolonged labor
• Toxic effect eg. Alcohol/Drugs/Heavy metal

Psychosocial causes

• Stress
• Family background ( stressful society)
• Socio- cultural factor( Isolated family)
• Separate with parent during childhood
• Loss of property or a loved person
• Cognitive theory
• Personality and temperament
• Psychodynamic theory etc.

There are different types of mental illness some psychiatric disorders are sever and some are mild in nature.  Some mental illness can be broadly grouped into.

1. Psychosis( severe type of mental illness)

• Schizophrenia
• Mania
• Bipolar disorder
• Delirium, Dementia etc

2.Neurosis (Minor type of mental illness)

• Anxiety neurosis ( Generalized Anxiety disorder, panic Anxiety disorder, phobic Anxiety disorder)
• Conversion disorder
• Dissociative disorder
• Somatoform disorder( Summarization, Hypochondriasis etc )
• Obessive  Compulsive disorder (OCD)
• Other: Psychosexual disorder ,Psychosomatic disorder)

3.DEPRESSION: 

• Endogenous
• Exogenous
• Alcohol and substances dependence disorder

4.OTHER DISORDER

• Mental retardation
• Childhood behavioral problems
• Epilepsy= General epilepsy, partial epilepsy.
• Personality disorder
• Eating disorder/Sleeping disorder

Counselling to the mentally ill patients:

1. Tell the client that everything he/she tells will be confidential and maintain confidentiality. Encourage the client to talk with minimal interruption
2. Maintain eye to eye contact with the client. Do not look at something else while the client talking. Do not write while the client talks.
3. Interrupt only when necessary, tell the client to be precise when unnecessary details are there.
4. Always ask, open ended questions, for example," tell me more about this", "could you tell me more about that", or " could you give me an example". If you ask closed questions, client will only answer with "yes" or "no" only .
5. Do not be in hurry. Give sufficient time to client to express the problem; if there is a time constrains plan next appointment soon.
6. Have positive regard to the client. Do not be judgmental, remain neutral. Do not argue , defend, justify or tell your feelings.
7. Supportive  silence at the right time may be your most powerful attending behavior.
8. If there is privacy like closing the door or having a curtain and other people are not listening, client feels more comfortable to talk. Good sitting arrangement is also important.
9. Maintain safety measure in case of mentally ill client.
10. Do not leave the client alone so that it may prevent suicidal attempt, accident and other social problems.
11. Avoid stress, irritation and uncomfortable environment from the mentally ill client.
12. Listen to the client and reassure him/her so that client may be realized good interaction and discussion.
13. Be re-assuring and supportive for example ,'I agree that you you have problems, you will find some way to solve it".
14. Teach the patient's family member about the mental illness, patient's condition, safety measure and follow up.
15. Keep the patient always in supervision/ consultation of specialist