Behind the smile: The global mental health epidemic

Dr Humera Saeed is a consultant psychiatrist specialising in adult and geriatric mental health. She is the co-founder and director of Compassion Couch Psychiatry and Therapy Clinic, and a graduate of Dow University with specialist training from England.

Mental illness is one of the leading causes of disability worldwide. According to the World Health Organisation (WHO), one in every eight people globally lives with a mental disorder. These conditions encompass a wide range of disturbances affecting an individual's mood, emotional regulation, thinking, cognition, and behaviour. Often, they are accompanied by distress or impairments in daily functioning. Just like physical illnesses, mental illnesses are real, diagnosable, and treatable medical conditions.

The COVID-19 pandemic has had a devastating impact on global mental health. Initial estimates reveal a 26% increase in anxiety disorders and a 28% rise in major depressive disorders in just one year. Despite the availability of effective treatment and prevention strategies, the majority of people living with mental illness do not have access to proper care. Stigma, discrimination, and human rights violations remain significant barriers to recovery.

Some of the most common mental health conditions include depression, anxiety disorders, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and eating disorders. It is normal for people to experience mental health challenges occasionally, but when symptoms persist and begin to interfere with daily life, they may indicate a diagnosable mental illness.

Importantly, mental illness is not a sign of personal weakness or a problem one can simply "snap out of." These are legitimate health conditions that affect how individuals think, feel, relate to others, and manage daily life. With the right support and treatment, recovery is possible.

Recognising the signs and symptoms:

The symptoms of mental illness can vary greatly depending on the specific disorder, the individual, and their environment. However, there are common signs across emotional, cognitive, physical, and functional domains:

• Emotional and behavioural signs may include persistent sadness, hopelessness, excessive worry or guilt, extreme mood swings, withdrawal from social interactions, loss of interest in activities, and substance misuse.

• Cognitive symptoms can involve trouble concentrating, confusion, difficulty understanding or relating to others, delusions (false beliefs), or hallucinations (seeing or hearing things that aren’t there).

• Physical symptoms often present without a clear medical cause. These might include changes in sleep or appetite, chronic fatigue, low energy, stomach or back pain, headaches, and changes in libido.

• Functional impairments can manifest as difficulties at work, school, or in relationships, or an inability to manage daily responsibilities.

Several risk factors contribute to the development of mental illness, such as a family history of mental health issues, chronic stress, traumatic experiences, ongoing medical conditions, substance abuse, and early childhood adversity. Mental illnesses can begin at any age, although most begin early in life.

Understanding the causes and progression:

Mental illness develops due to a complex interplay of biological, psychological, and social factors:

• Biological factors include genetic predispositions, neurochemical imbalances, and hormonal irregularities.

• Psychological influences often involve trauma, abuse, neglect, or intense emotional stress.

• Social contributors include poverty, social isolation, discrimination, and dysfunctional relationships.

Can mental illness be prevented?

While not all mental illnesses are preventable, there are strategies that can reduce the risk or delay onset. Building mental resilience, practicing self-care, and maintaining healthy habits can significantly improve mental well-being.

Key prevention strategies include:

• Recognising early warning signs and seeking timely help

• Developing strong social connections

• Managing stress through mindfulness, exercise, or creative outlets

• Ensuring adequate sleep and nutrition

• Avoiding alcohol and recreational drugs

• Addressing emotional difficulties before they escalate

Early intervention and seeking help:

Early detection and support are essential for effective treatment and recovery. Here’s how individuals can take the first step toward getting help:

• Talk to someone: Confiding in a trusted friend or family member can provide relief and validation.

• See a doctor: General practitioners can rule out physical causes and refer individuals to mental health specialists.

• Consider therapy: Psychotherapies like Cognitive Behavioral Therapy (CBT) offer valuable tools to cope and heal.

• Medication: When necessary, psychiatrists may prescribe medication for conditions such as depression, anxiety, or psychosis.

• Join support groups: Sharing experiences with others who understand can foster hope and reduce feelings of isolation.

Final thoughts:

Mental health is just as critical as physical health. With understanding, compassion, and accessible care, those experiencing mental illness can recover and lead fulfilling lives. Seeking help is a sign of strength—not weakness. Ending the stigma and advocating for mental health awareness is a collective responsibility we all share.