Sometimes it goes beyond stress and pressure into the darker realm of clinical condition. Economic instability, political uncertainty, a thirst for materialism, personal history, the breakneck social competition _ all this, and more, contributes to the increasing number of people suffering from mental health disorders.
According to Dr Kraisit Narukhatphichai, managing director of Manarom Hospital, which specialises in treating mental health, the top five mental health disorders in Thai society are schizophrenia, bipolar disorder, panic disorder, major depressive disorder and psychosomatic disorder.
Dr Kraisit says that since physical and mental health are inter-related, to stem the number of patients falling prey to mental illness, it is important to go back to basics and address the issue of child rearing seriously because emotional development starts from infancy.
It is his opinion that the Thai family unit is currently at its most fragile state. Working round-the-clock to provide a good life for their children only serves to shorten the quality time they could otherwise spend with their children. Understanding the emotional development of a child should be prioritised, said Dr Kraisit.
"While the first 18 years of a child's life pretty much is a period when their personality is developed, it is from infancy up to three years that their feeling of self worth is formed. They begin to develop a self perception of themselves based largely on how they are treated by family members. So parents who are emotionally and financially prepared might have a more positive effect on the child than ones that are not.
"Even though childhood memories fade, the self awareness they develop from both positive or negative experiences becomes a part of their subconscious self. To change what has been instilled in the subconscious from childhood takes time."
While child rearing should be given precedence, Dr Kraisit said it is equally important for people to keep a check on their emotional health.
''Stress can affect any part of our body so a number of physical ailments are found to be related to emotional health. Stress trigger points can originate from a host of external factors, as simple as being in a traffic jam to the more serious issue of dealing with becoming redundant. If a person's self-development is poor, they find it more difficult to cope with stress which others can manage better,'' noted the psychiatrist.
''Going to the psychiatrist is not as big a taboo as it used to be. However, I have found some parents who bring their children for treatment too often do not have enough time to get personally involved. They tell me to deal with the problem as I am the psychiatrist. In my experience, if bonding between parents and children is weak, there is a higher risk for the trigger of a mental disorder.''
For parents to admit that their child has an emotional problem is not easy, he said, but what is harder for them to accept is when it is brought to their attention that the problem actually stems from them. Mental disorders are treatable, however, it is crucial that they are detected early.
Cases are based on interviews with patients and Dr Kraisit. All names have been changed.
Schizophrenia
Once an amiable and sporty 20 year old, Bee stopped attending classes abruptly. His sudden change in behaviour alienated himself from the outside world, leaving him in a state of limbo.
The onset of insomnia, which lasted for four months, became apparent when his parents began hearing sounds emerging from his room at odd hours of the night.
When Bee finally sought medical help, the psychiatrist found that the young man had reached the stage of hallucinations _ he had convinced himself that a catastrophe was about to hit and that it was his mission to protect society from being annihilated.
The doctor diagnosed him as being schizophrenic. Bee was rather fortunate that after six months of combined medication and psychological treatment, he was able to resume classes.
While he is on the road to recovery, he continues to suffer auditory hallucination. Bee is at a stage of his treatment where he can differentiate between reality and fantasy.
What is schizophrenia?
A mental disorder characterised by profound collapse in cognition and emotion, involving the most fundamental human functions: language, thought, perception and sense of self. The array of symptoms, while wide ranging, often includes psychotic manifestations.
Diagnosis of schizophrenia is often focused on a standardised list of outwardly observable symptoms. There are no specific laboratory tests. However, researchers have found patients with schizophrenia to have certain abnormalities in the structure and functioning of the brain.
Causes
End result of a combination of factors including genetic, biochemical, developmental, environmental and some causes which are still not completely understood. There is no known single cause of the disorder.
Few common symptoms
Delusions, hearing voices, auditory hallucinations, disorganised speech and thinking, disorganised unruly behaviour.
Bipolar Disorder
Made redundant at the age of 40, Navin encountered a sudden erratic behavioural change two weeks after his company was liquidated. He was given severance pay of 300,000 baht, which did little to avert a bout of stress made worse by three days of sleepless nights and chain smoking.
With his physical and mental well-being at its lowest, he demonstrated symptoms of lack of inhibition by investing all his severance pay, in a short span of time, into a video rental business, putting a deposit on two new cars (for himself and his wife) and signing a contract for a new house. Other outward symptoms included being over talkative and restless.
Navin's obsessive demeanour took a toll on his wife. When she begged him to seek psychiatric help, he angrily declined at first. It was only when his emotional health went from bad to worse that he agreed to seek medical help.
The diagnosis was bipolar disorder. After a week of medication, Navin began to feel better, but is required to be on medication to help him conduct his daily duties properly.
What is bipolar disorder?
It is a manic-depressive, mood disorder that causes radical emotional changes and mood swings, from manic highs to depressive lows. The majority of bipolar individuals experience alternating episodes of mania (an elevated or euphoric mood or irritable state) and depression. Medication is believed to be the most useful treatment for bipolar disorder. A blend of mood stabilising agents with anti-depressants, anti-psychotics and anti-convulsants may be employed to regulate manic and depressive episodes.
Causes
The source of bipolar disorder has not been clearly defined. Because two-thirds of bipolar patients have a family history of emotional disorders, researchers have searched for a genetic link to the disorder.
Few common symptoms
Manic episodes: euphoria, lack of inhibitions, racing thoughts, insomnia etc. Depressive episodes: low energy levels, feelings of despair, difficulty concentrating, extreme fatigue etc.
Panic Disorder
Sue, 42, was recommended by her cardiologist, who suspected she suffered from a panic disorder condition, to visit a psychiatrist, largely because she showed symptoms of chest pain, feeling that she was suffocating and deep fear of dying and going insane, without any evidence of cardiac abnormalities.
These symptoms usually manifested when she happened to be either walking in the rain, sitting in heavy traffic or travelling by plane. She was eventually diagnosed with panic disorder. Today Sue takes medication and undergoes psychotherapy to lead a productive life.
What is panic disorder?
A condition in which the person with the disorder suffers recurrent panic attacks that are not caused by outside factors, or by a medical condition.
During the attack, the patient may experience sensations such as accelerated or irregular heartbeats, shortness of breath, dizziness, or a fear of losing control.
Patients may suffer repeated panic attacks and experience severe anxiety about having another attack. This disorder is often treated with a combination of cognitive-behavioural therapy and medication.
Causes
Largely biochemical/physiological, genetics is believed to also play a pivotal role in the development of panic disorder. Research has shown that patients with the disorder have difficulty with anger management.
Few common symptoms
Sweating, shaking, shortness of breath, feeling of choking, pain in the chest which makes them feel they're having a heart attack.
Major Depressive Disorder
When May found out that her husband had cheated on her, she began experiencing long term bad mood swings, boredom and feelings of despondency. The emotional roller coaster had made the 40-year-old go days without proper sleep and loss of appetite, which had made her lose a considerable amount of weight, experience frequent headaches and fatigue. May found herself worthless and sometimes experienced suicidal thoughts.
With typical signs of depressive disorder, her psychiatrist prescribed medication, psychotherapy and family therapy. The concoction of treatments have helped her to return to her daily routine, and she is able to function better now that she is able to sleep well.
What is major depressive disorder (MDD)?
A condition characterised by a long-lasting depressed mood or marked loss of interest or pleasure in all or nearly all activities. Children and adolescents with MDD may be irritable instead of sad. For some, the pain and suffering accompanying MDD becomes so intolerable that suicide is viewed as the only option _ MDD patients are reported to have the highest mortality rate of any mental disorder.
Causes
Environmental, biological and intrapsychic (arising, occurring, or situated within the mind).
Few common symptoms
Disturbed mood, loss of interest/pleasure in activities, insomnia, hypersomnia (sleeping much more than normal), psychomotor retardation (slowed thinking, speech, body movements), agitation, sense of worthlessness/unreasonable guilt over minor failings, recurrent thoughts of death/suicide or making a suicide attempt.
Psychosomatic Disorder
Chai began experiencing a series of physical ailments, beginning with headaches followed by painful muscles and limbs and hot flushes. He spent sleepless nights worrying whether these symptoms were due to the inflammation of a nerve.
After a string of physical check-ups came out negative, the 30-year-old was recommended by his physician to consult a psychiatrist.
A session with the psychiatrist confirmed the doctor's assumption: The young man's symptoms were indeed related to anxiety, so the more he worried about his physical condition the more severe the symptoms became. The psychiatrist diagnosed Chai with a physically-related syndrome that is associated with apprehension. To put him on the road to recover, he was treated with anti-anxiety drugs and given information which would equip him with knowledge about the connection between his physical symptoms and his anxiety.
It took Chai two months to stabilise his condition. Today he lives a happier existence.
What is psychosomatic disorder?
Psyche, meaning mind and soma meaning body _ the disorder is defined as an aliment involving both mind and body. Some physical diseases are thought to be particularly prone to get worse due to mental factors such as stress and anxiety. The current mental state can affect how bad a physical disease is at a given time.
The treatment for psychosomatic disorder includes therapeutic measures from the medical and psycho-social fields, many of which are formal guidelines and procedures, mostly achieved through the application of research data and evidence based results.
Causes
This disorder is caused by mental and emotional stress that manifest as physical diseases.
Few common symptoms
Stomach and gastrointestinal functional problems, dizziness, sleeping disorders, muscle aches, tension, headaches, chronic fatigue syndrome, etc.