Garth Rattray

World mental Health Day is observed on October 10 every year. Most people believe that mental health problems only encompass psychosis, bipolar disorders, severe depression, personality disorders and severe neurosis. However, the most common source of mental health problems is stress. It is usually (erroneously) somewhat taken for granted. It's true that some stress is a part of life and that a little of it is beneficial. We need stress to perform difficult jobs. Without some stress, we tend to become nonchalant and listless. We should not aim to get rid of stress, entirely, we should minimise its duration and use it advantageously.

Problems arise when stress is severe and/or sustained. Under those circumstances, it does us no good and can lead to a plethora of psychological and physical problems. Severe, short-term stress initiates the fight or flight response that we need to deal with threatening or dangerous situations. But, prolonged stress causes the release of certain chemicals that inappropriately stimulate our excitatory mechanisms and suppress our immune system. We then become susceptible, not only to anxiety disorders, but also to physical problems affecting the cardiovascular, nervous, endocrine, gastrointes-tinal, integumentary and, as already mentioned, anything dependent on a properly functioning immune system.

Altering the lifestyle

Sustained stress leads to anxiety. Depression and anxiety are now known to be inexorably intertwined - you can't have one without some of the other. People manifest anxiety in different ways. Everyone knows that anxiety (prolonged stress) can elevate the blood pressure, but, it can also elevate the blood glucose and is listed among the precipitative agents in everything from migraines, chronic fatigue syndrome and epilepsy to psoriasis, alopecia and pityriasis rosea. Stress makes some people want to void their urine or empty their bowels and it lowers our defence against viruses and bacteria. Stress makes many people lose their appetites, while others overeat constantly. Some are always tired and sleep too much while others become nervous and sleep very little. Some become irritable and quick to temper while others become withdrawn and distant. Fright and anger are likely to cause a heart attack more than moderate exercise. Stress can be found listed somewhere under just about every disease that I can think of.

Real dilemma

Most people mistakenly assign stress and the other mental-health problems to the domain of medical science. They are seen as the responsibility of health-care professionals - especially primary-care doctors, psychiatrists and psychologists. But, I tell my patients that doctors can talk with them, listen to their problems, teach coping mechanisms, perhaps make a few sugges-tions and write a prescription for an antidepressant and anxiolytic agent but, until the cause of their stress is removed, the underlying problem will remain.

Herein lies the real dilemma - whether or not we feel stressed depends on whether or not we are in control. Unfortunately, most of our problems are beyond our control. We are at the mercy of bad drivers on the roads; our lives depend on the whims of heartless predatory killers with guns; utility bills are rising exponentially; given the real inflation rate, user fees and tax on interest rates, our savings attract little or no interest; lending rates are exorbitant; crassness, corruption and crime are rampant and environmental abuse has awakened Mother Nature's wrath. By and large, we have become a nation of helpless, powerless victims.

The sooner our politicians do something about the stressful social conditions that cause much of our mental and resultant physical health problems, the far better off we will be.