Mental Health Essay

Within this essay, I will examine the definition of mental health, as well as it’s connection in our daily lives. I will be discussing a particular mental health problem which is depression under mood disorder. By examining a scenario of a patient who I have looked after who is suffering from this mental problem, and the available treatment options. I am please to focus in this topic that made a real difference to people lives, most especially to the patients who are suffering the kind of mental illness. To understand fully what is mental health, let me first start by giving the definition of health. Health as define by the World Health Organization, â€Å"is a complete state of physical, mental and social wellbeing, not merely the absence of disease or infirmity†(WHO, 1948). By examining the definition, one cannot conclude that anyone who is seemingly healthy to their outer appearances but in fact may be there is a possibility that person may have hidden characteristics which may consider or regard them unhealthy. For instance, a person with normal vital signs, example of this is an individual with normal blood pressure of 120/80mmhg (Uren & Rutherford,2004) ,may be suffering from any degree of anxiety or depression. By assessing the physical health of a person is relatively easy by taking health measurement of the body. Nonetheless, mental and social aspects of health are much more difficult to determine. It needs a careful and complex assessment to conclude that the individual is mentally healthy. Mental health reflects a person approach or ability to adapt and respond to life by communicating emotions, giving and receiving ideas, working alone as well as with others, accepting authority, displaying a sense of humour and coping successfully with emotional conflicts (Shives & Issaacs p.6). Another definition of mental health is a state of wellbeing in which individual realises his or her own abilities, can cope with the normal stresses of life productively and fruitfully, and to be able to make contribution to his or her community (World Health Organization, 2001). It is easy to disregard the intrinsic value of mental health until some unusual circumstances or behaviour is noticed. We live in the world full of challenges such as pressure from work, studies, family issues, financial difficulties, relationship problems and poor physical health. These are only few examples that affects individual to perceive and act accordingly to their surroundings. Mentally healthy people who achieve self-actualization are able to have positive self concepts and relate well to people and their environment, form close  relationships with others, make decisions pertaining to reality rather than fantasy, be optimistic and appreciate and enjoy life (Abraham Maslow, 1970). Problem solving occurs because people are able to make decision pertaining to reality rather than fantasy; they are able to appreciate and enjoy life; optimism prevails as they respond to people, places, and things in daily encounters; they are independent or autonomous in thoughts and action and rely on personal standard of behaviour and values such people are able to face with relative serenity and happiness circumstances that would drive other to self- destructive behaviour, they are creative, using a variety of approaches as they perform tasks or solve problem (cited in Shives, 2002). Mental illness cannot be viewed in isolation from physical functioning; the two are inseparable. Memory and cognition are mental functions, but because they are initiated in the brain, they are also physical function. A change in brain chemistry- a physical occurence, cause, perhaps by something as seemingly benign as stress- can cause changes in mental functions that manifest as anxiety, panic attacks, or depression. Physical and mental are two inseparable components of the complete human experience. In attempting to understand the complexities of mental illness, it is important to understand that physical and mental, that is, body and mind, cannot exist in isolation from one another ( Marie Thompson,2007 p.5) . Although scientist do not know exactly what causes mental illness, like cancer, mental illness can strike anyone and variety of causes. Scientist are certain that genetic vulnerability plays a role in many mental illness, since the risks of becoming ill is greater if you have a close relative who suffers from depression, bipolar illness, schizophrenia, anxiety or alcoholism among others. However, no specific gene has yet been isolated that causes any of this illness (James Hicks, 2005 p.2). Mental illness or mental disorders defined as an illness or syndrome with psychological or behavioural manifestation and /or impairment in functioning as a result of a social, psychological, genetic, physical/chemical, or biological disturbance ( The American Psychiatric Association). Depression is an important global public health problem due to both it’s relatively high lifetime prevalence and the significant disability that it cause. In 2002, depression accounted for 4.5% of the worldwide total burden of disease (in terms of disability- adjusted life year ). It is also responsible for the greatest proportion of burden attributable to non-fatal health outcome, accounting for almost 12% of the total years lived with disability worldwide. Without treatment, depression has the tendency to assume a chronic course, to recur, and to be associated with increasing disability overtime (World Health Statistics ,2007, p. 16). Depression is considered a disorder of mood (sometimes called an affective disorder, 2  signifying the disturbance of â€Å"affect†) in all widely used classification and diagnostic schemes. In general, a mood disorder represents a departure from what we might consider to be a typical mood state experienced by most persons most days of their lives. Depressive disorders are characterized by sad, guilty, remorseful, tired , withdrawn moods and the influence of these moods on a person’s day to day behaviour ( Sam Victor et al., p. 6 ). The term depression is used in variety of ways. In everyday language, it is commonly used to describe feelings of sadness or despondency. These feelings are part of normal emotion and may be the consequence of disappointments or failures. As a medical term, depression can refer to a symptom, syndrome or illness. In its usual clinical context, depression denotes a disorder of mood that is distinct from normality. Disorders involving abnormalities of mood used to be called manic-depressive but are now more often termed affective disorders. This is more accurate because only a minority of sufferers experience episode of both mania and depression (bipolar affective disorder) and most have recurrent episodes of depression only (unipolar depression) (Malhi, p.1). It is imperative to recognise the severity of depression as it can lead to life threatening such as suicide. Therefore ,it is important for health professionals to assess the potential risks for this. As presence of depression can sometimes not obvious to clinicians, some symptoms, when observed in combination with the others can clearly indicate that a person is in depression. Symptoms often associated with depressed states include early morning wakening, a feeling of grinding tiredness, loss of energy, loss of sexual interest in relationship, loss of appetite, feeling â€Å"down† and feeling of bad temper (Alexander et al, 1994). To maintain confidentiality the patient’s name has been changed to a pseudonym, in order to conform to the Nursing and Midwifery Council Code of Conduct (NMC, 2008). I will call my patient Mrs. M is a 35-year-old woman who complained of feeling very low for the last 4 months but always attributes this from being tired from work. She was diagnosed with Sero-posivite Rheumatoid Arthritis five years ago but refused to be treated because she believes her joint pains and inflammation can be cured with only paracetamol . Not until her inflammation was uncontrollable and left some of her joints in hands and feet some deformities. Mrs. M. has a husband and two children who are still very young. She describes that the family relationship is good. She was brought up mostly of her childhood by her grandparents. Mrs. M. worked full-time as a Registered Nurse where she was admitted as a patient. Mrs. M has been in the hospital for some time due to the flare up of her disease and over a week I have looked after her. I can still remember when I first met her, the doctor ordered to give her intravenous steroids infusion. It has to be administered through her peripheral line in her right radial vein by Aseptic Non-Touch Technique (ANTT) (Anonymous, NHS Trust, 2007). This is the protocol to decrease risks of acquiring infection through intravenous lines. To observe how is this being done, I went with my mentor. At first, we greeted her and introduced ourselves. My mentor explained what we were about to do. I observed that Mrs.M. was calm and only answer when we speak to her. It was discussed by her doctor that after having been given steroids , inflammation of her joints will get better and so improve her mobility but she would have some side effects. Mrs. M. knew these will happen which made her felt hopeful but somehow low and upset. As a nurse herself, she was aware the medication would lower her immune system, could experience mood swings, difficulty sleeping at night, increase her appetite in eating and will contribute in gaining weight. I found it interesting as a student nurse to learn how to respond to a particular situation and observe a patient’s treatment can improve his/her disease or condition. Every shift I am working , I made sure I go and see Mrs. M. For me always visible and ready to listen to verbalise her concerns in consistent way will develop a rapport which I learned was very important in a nurse-patient relationship. I can remember there was a day Mrs. M. was feeling so happy and laughing telling me stories about her family in her own family, her favourite hobby making handicrafts and her experience being a nurse. She also told me how her strength differs prior to the diagnosis of her disease. There were times I saw Mrs. M. not interested in doing anything for the day. She was only lying down in bed crying frustrated in trying to get out of bed independently. She was irritated expressing she did not wish anybody to be near her if not her own doctor or assigned staff nurse. It has been reported she never sleeps soundly at night and always seen sitting at the bedside seemed in deep thoughts. The curtain around her bed was remained closed all the time. As her student nurse, I made sure I frequently checked and asked if she was needing any help. Whenever she was ready to speak , I was there for her. During one of my conversation with her , I have learnt that she used to be being independent with her activities of daily living and looking after her family. She rarely asked for other people’s help. Since she suffered from the disease, she had some deformities in different joints of her hands and feet which added to her mobility problems. She had mentioned to me how she felt frustrated when she cannot complete her household chores. Mrs.M. remembered the day told by doctor to commence on anti-depressant tablet because she was diagnosed with mild depression, she was very scared her family and friends to know. She had decided not to take any medication for her depression. After few days of looking after her she is somewhat different from our first meeting. She became more relaxed,expressing her interests in eating her food, more energy when meeting people, good eye contact and happy while  talking. To actively listen to Mrs. M was showing her that I can be always ready to listen and trusted like her family or close friend. Although some patients can be quite adamant to take medications for their depression , there are some that are referred for counselling. GP’s frequently find themselves in the position of providing emotional support, advice and counselling to depressed patients in an effort to give reassurance, warmth and encouragement . Indeed, this is probably the most common and effective treatment for the majority of patients with mild depression. In this situation, active listening is more important than advice-giving; paying attention to non-verbal and hidden messages as well as what the patient is expressing verbally, and feeling emp athy for their predicament. It should be noted that much of this support is provided by ministers of religion, voluntary agency and self-help support groups (Wilkinson, G.etal). According to my research for patient to be emotionally responsive, I found out some interventions that nurse can use independently without doctor’s order. Use a warm, accepting, empathic approach. Be aware of and in control of one’s own feelings and reactions (anger,frustration,sympathy). With depressed patient: Establish rapport through shared time and supportive companionship. Give the patient time to respond. Personalise care as a way of indicating the patients value as a human being. With the manic patient: Give simple, truthful responses. Be alert to possible manipulation. Set constructive limit on negative behaviour. Use a consistent approach by all health-team members. Maintain open communication in sharing of perceptions among team members. Reinforce patient’s self-control and positive aspects of patient’s behaviour (Stuart,G.,1998). Within this assignment, I am going to use (Gibbs, 1988) reflective cycle. I choose to use this cycle because it encourages a clear definition of this project. The analysis of the feelings, the evaluation and the way to make sense of the experience, and pla what needs to be done in the future. It has helped me demonstrate my ability to reflect on my personal experiences in doing this essay and gave the opportunities to explore my personal learning needs. Before I continue my reflective writing ,let me first discuss the importance of reflection. Reflection as defined by ( john, 2000 ) as a window through which a practitioner can view and focus self within the context of their own lives experience in a way that enable them to confront, understand and work towards resolving the contradictions within their practice. Knowing how to reflect is a process for making sense out of all experience (Taylor, 2000 ). For my first assignment, I have to write a reflective project based on what I have learned. We were asked a project focusing on the subject ,â€Å" What is mental health?†. At first, I was struggling to figure out what topic to write about the given subject. I started to collect data from vast resources of books but the more I read, it becomes more difficult to put my ideas into writing. I am getting more frustrated because I was making little progress. My idea was to sit down and write one long essay and then be finished early. Finally, I decided to write about depression. This essay was about a patient I have encountered and looked after who was diagnosed with sero- positive rheumatoid arthritis. When I wrote this assignment, I have to look back and remembered an interesting nursing experience. Writing this kind of essay was difficult and challenging in a way it was emotional and stressful due to time pressure in meeting deadline and juggling placements and family time. I felt more confident now in dealing with my personal issues as well as dealing with my patient’s physical and emotional needs. I think my writing has improve during this time because of all the different resources and help I have use. With regards to my future assignment, it has broaden my knowledge in constructing my essay. Instead of collecting vast materials to read, I will be more selective of materials to read and will more focus on the specific subject given. I will do more planning and thinking around the topic as much as pos sible. The benefit of this approach is that from the start, I can get the sense of the shape my essay will take. To the greater extent, I really enjoyed writing this essay because it is about the professional nursing field which I am pursuing through schooling. I believe that thru studies and placements, I wil develop my capabilities to be a good and proper nurse to help and support every person to be physically, emotionally, socially and mentally healthy. Because of the many things that I have learned and witness from nurses and nursing aids, I feel this reflective essay will help me in my future career. In conclusion, this reflective assignment demonstrates my ability to show and express my feelings concerning different kind of situations and difficulties while I am writing this project. By basing my own reflection using Gibbs reflective cycle, it gives me the chance to explore, to improve my skills and knowledge to have a better foundation for the nursing career I am aiming for. Through critical reflecting, I can learn from my mistakes and highlight my knowledge and expertise. Nurture yourself with good nutrition: Depression can affect appetite. Appetite is typically decrease and you may loose weight. Sometimes, although appetite is still decrease, you tendto eat for comfort and may gain weight. So you will need to be extra mindful of getting the right nourishment. Proper nutrition can influence a person’s mood and energy. Identify troubles, but don’t dwell on them: Try to identify any circumstances that have contributed to your depression. If you know what is the cause and you feel down, why not talk about it with a caring friend. Talking is a way to release the feelings and to receive some understanding. Focus yourself and look on the bright side: Depression affects a person’s thoughts, making everything seem dismal, negative, and hopeless. If depression has cause you negative outlook in life, make an effort to notice the good things life has to offer. Consider your strengths and blessings. Most of all, do not forget to be patient with yourself. Depression takes time to heal.