Mental distress

Last updated

Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, affect a person's emotions in a negative way, and affect their relationships with the people around them. [1]

Contents

Certain traumatic life experiences (such as bereavement, stress, lack of sleep, use of drugs, assault, abuse, or accidents such as the death of a loved one [2] [ which? ]) can induce mental distress. Those who are members of vulnerable populations might experience discrimination that places them at increased risk for experiencing mental distress as well. This may be something which resolves without further medical intervention, though people who endure such symptoms longer term are more likely to be diagnosed with mental illness. This definition is not without controversy as some mental health practitioners would use the terms "mental distress" and "mental disorder" interchangeably. [3] Some users of mental health services prefer the term "mental distress" in describing their experience as they feel it better captures that sense of the unique and personal nature of their experience, while also making it easier to relate to, since everyone experiences distress at different times. The term also fits better with the social model of disability.

Differences from mental disorder

Some psychiatrists may use these two terms "mental distress" and "mental disorder" interchangeably. However, it can be argued that there are fundamental variations between mental distress and mental disorder. "Mental distress" has a wider scope than the related term "mental illness", which refers to a specific set of medically defined conditions. A person in mental distress may exhibit some of the broader symptoms described in psychiatry, without actually being 'ill' in a medical sense. [4] People with mental distress may also exhibit temporary symptoms on a daily basis, while patients diagnosed with mental disorder may potentially have to be treated by a psychiatrist.

Types

The following are types of major mental distress: [5]

Symptoms and causes

The symptoms for mental distress include a wide range of physical to mental conditions. [7] Physical symptoms may include sleep disturbance, anorexia (lack of appetite), loss of menstruation for women, headaches, chronic pain, and fatigue. Mental conditions may include difficulty in anger management, compulsive/obsessive behavior, a significant change in social behavior, a diminished sexual desire, and mood swings.

Minor mental distress cases are caused by stress in daily problems, such as forgetting your car keys or being late for an event. However, the major types of mental distress (see section above) can be caused by other important factors. It is important to distinguish between Chemical imbalances in the brain is one of the causes that happen when there is a disequilibrium of chemicals inside the brain's neural pathways, that can lead to irrational decisions and emotional pain. [8] For example, when your brain lacks serotonin, a chemical primary in regulating a brain's functioning, this deficiency of serotonin can lead to depression, appetite changes, aggression, and anxiety. A second cause for mental distress can be exposure to severely distressing experiences, such as life-threatening situations and experiences. A third cause, although in very rare cases, can be inheritance. Some research has shown that very few people may have the genetics for the potential to develop mental distress. However, there are many factors that must be accounted for. Mental distress is not a contagious disease that can be caught like the common cold. Mental distress is a psychological condition. [5]

In the United States

African-Americans

The social disparities associated with mental health in the Black community have remained constant over time. According to the Office of Minority Health, African Americans are 30% more likely than European Americans to report serious psychological distress. Moreover, Black people are more likely to have Major Depressive Disorder, and communicate higher instances of intense symptoms/disability. [9] For this reason, researchers have attempted to examine the sociological causes and systemic inequalities which contribute to these disparities in order to highlight issues for further investigation. [9] [10] [11] [12] [ full citation needed ] [13] [ full citation needed ] Nonetheless, much of the research on the mental well-being of Black people are unable to separate race, culture, socioeconomic status, ethnicity, or behavioural and biological factors. [11] According to Hunter and Schmidt (2010), there are three distinct beliefs embraced by Black people which speak to their socio-cultural experience in the United States: racism, stigma associated with mental illness, and the importance of physical health. [10] African Americans are less likely to report depression due to heavy social stigma within their community and culture. [14] All of these social aspects of mental health can create a lot of distress. Therefore, discrimination within the healthcare community and larger society, attitudes related to mental health, and general physical health contribute largely to the mental well-being of Black people. [10]

There are also disparities with mental health when it comes to Black women. One of the reasons why Black women tend to hesitate when it comes to mental health support and treatment is the aura of the Strong Black Woman schema or S.B.W. According to Watson and Hunter, Various scholars have traced the origins of the S.B.W. race-gender schema to slavery and have suggested that the schema persists because of the struggles that African-American women continue to experience, such as financial hardship, racism, and sexism. [15] Watson and Hunter state that due to the Strong Black Woman schema, Black women have a tendency to handle tough and difficult situations alone.

African-American youth

Comparable to their adult counterparts, Black adolescents experience mental health disparities. The primary reasons for this have been stipulated to be discrimination, inadequate treatment, and underutilization of mental health services, though Black youth have been shown to have higher self-esteem than their white counterparts. [16] [17] [18] [19] [ full citation needed ] [20] [ full citation needed ] Similarly, children of immigrants, or second-generation Americans, often encounter barriers to optimal mental well-being. [16] [21] [22] [23] [24] [ full citation needed ] [25] [ full citation needed ] Discrimination and its effects on mental health are evident in adolescents' ability to achieve in school and overall self-esteem. [16] Researchers are unable to pinpoint exact causes for Black teenagers' underutilization of mental health services. One study attributed this to using alternative methods of support instead of formal treatments. [17] Moreover, Black youth used other means of support, such as peers and spiritual leaders. [17] This demonstrates that Black teens are uncomfortable disclosing personal matters to formal supports. It is difficult to decipher if this is cultural or a youth-related issue, as most teens do not choose to access formal supports for their mental health needs. [26] [ full citation needed ]

Common stigma among immigrants

"Mental health stigma, particularly personal stigma, is important because those who hold stigma beliefs are less willing to obtain the needed treatment (1-9). Often due to stigma, individuals will avoid treatment until the disorder is nearly incapacitating. This avoidance is particularly pronounced in members of ethnic minority groups because they are less likely to seek mental health treatment than those of European Americans [e.g., Ref. (4, 10–12)]. [27] Expressly, Immigrants who hold personal stigma against mental illness are less likely to seek treatment. Its often that immigrants feel stigmatized because they're already undocumented which makes them feel embarrassed, causing them to refrain from treatment. [27]

Demographic and societal factors

There has been a history of disparity and exclusion in regards to the treatment of Black Americans which consists of slavery, imprisonment in the criminal justice system, the inability to vote, marry, attend school, or own property amongst other factors. These factors have attributed to the increase of mental distress in the Black community and due to the lack of resources afforded/known in the community also leads to a lack of resources and treatments available for members of the community to seek and receive some for of help. [28]

LGBTQ+ Community

Those who identify as part of the LGBTQ+ community have a higher risk of experiencing mental distress, most likely as a result of continued discrimination and victimization. Members of this population are often confronted with derogatory and hateful comments (physically and/or through social media). This discrimination has the potential of affecting their feelings of self-worth and confidence, leading to anxiety, depression, and even suicidality. It is for this reason that members of the LGBTQ+ community may experience higher rates of mental distress than their cisgender and heterosexual counterparts. Along with the increased risk of experiencing mental distress, members of this community may refrain from seeking mental health care due to past discrimination by medical professionals. In addition to the lack of knowledge and research with this population, this group is marginalized due to the lack of funding as most of the funds go to campaigns for the younger LGBTQ+ population. [29]

A study published in 2021 found that "LGBTQ+ students experienced more bullying and psychological distress". [30]

Related Research Articles

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.

<span class="mw-page-title-main">Mental health</span> Level of human psychological well-being

Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to World Health Organization (WHO), it is a "state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite, thinking of harming oneself or others, self-isolating, and frequently zoning out.

Mental health in China is a growing issue. Experts have estimated that about 130 million adults living in China are suffering from a mental disorder. The desire to seek treatment is largely hindered by China's strict social norms, as well as religious and cultural beliefs regarding personal reputation and social harmony.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

As defined by the United States Department of Veterans Affairs, military sexual trauma (MST) are experiences of sexual assault, or repeated threatening sexual harassment that occurred while a person was in the United States Armed Forces.

Various topics in medicine relate particularly to the health of lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA) individuals as well as other sexual and gender minorities. According to the US National LGBTQIA+ Health Education Center, these areas include sexual and reproductive health, mental health, substance use disorders, HIV/AIDS, HIV-related cancers, intimate partner violence, issues surrounding marriage and family recognition, breast and cervical cancer, inequities in healthcare and access to care. In medicine, various nomenclature, including variants of the acronym LGBTQIA+, are used as an umbrella term to refer to individuals who are non-heterosexual, non-heteroromantic, or non-cis gendered. Specific groups within this community have their own distinct health concerns, however are often grouped together in research and discussions. This is primarily because these sexual and gender minorities groups share the effects of stigmatization based on their gender identity or expression, and/or sexual orientation or affection orientation. Furthermore, there are subpopulations among LGBTQIA+ groups based on factors such as race, ethnicity, socioeconomic status, geographic location, and age, all of which can impact healthcare outcomes.

Minority stress describes high levels of stress faced by members of stigmatized minority groups. It may be caused by a number of factors, including poor social support and low socioeconomic status; well understood causes of minority stress are interpersonal prejudice and discrimination. Indeed, numerous scientific studies have shown that when minority individuals experience a high degree of prejudice, this can cause stress responses that accrue over time, eventually leading to poor mental and physical health. Minority stress theory summarizes these scientific studies to explain how difficult social situations lead to chronic stress and poor health among minority individuals.

<span class="mw-page-title-main">Transgenerational trauma</span> Psychological trauma

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary modes of transmission are the uterine environment during pregnancy causing epigenetic changes in the developing embryo, and the shared family environment of the infant causing psychological, behavioral and social changes in the individual. The term intergenerational transmission refers to instances whereby the traumatic effects are passed down from the directly traumatized generation [F0] to their offspring [F1], and transgenerational transmission is when the offspring [F1] then pass the effects down to descendants who have not been exposed to the initial traumatic event - at least the grandchildren [F2] of the original sufferer for males, and their great-grandchildren [F3] for females.

Culture defines how people view the world and certain phenomena. Culture also appears to influence the way people experience depression. An individual's experience with depression can vary from country to country. For example, a qualitative study revealed that some countries did not recognize post-natal depression as an illness; rather, it was viewed as a state of unhappiness that did not require any health interventions.

The mental health of Filipino Americans is emotional and cognitive status of Americans of Filipino descent. Filipino-Americans utilize mental health services less than some Asian-American groups.

Mental health inequality refers to the differences in the quality, access, and health care different communities and populations receive for mental health services. Globally, the World Health Organization estimates that 350 million people are affected with depressive disorders. Mental health can be defined as an individual's well-being and/or the absence of clinically defined mental illness. Inequalities that can occur in mental healthcare may include mental health status, access to and quality of care, and mental health outcomes, which may differ across populations of different race, ethnicity, sexual orientation, sex, gender, socioeconomic statuses, education level, and geographic location. Social determinants of health, more specifically the social determinants of mental health, that can influence an individual's susceptibility to developing mental disorders and illnesses include, but are not limited to, economic status, education level, demographics, geographic location and genetics.

Race-based traumatic stress is the traumatic response to stress following a racial encounter. Robert T. Carter's (2007) theory of race-based traumatic stress implies that there are individuals of color who experience racial discrimination as traumatic, and often generate responses similar to post-traumatic stress. Race-based traumatic stress combines theories of stress, trauma and race-based discrimination to describe a particular response to negative racial encounters.

Racial trauma, or race-based traumatic stress, is the cumulative effects of racism on an individual’s mental and physical health. It has been observed in numerous BIPOC communities and people of all ages, including young children. Racial trauma can be experienced vicariously or directly. It has been linked to feelings of anxiety, depression, and suicidal ideation, as well as other physical health issues.

<span class="mw-page-title-main">Mental health during the COVID-19 pandemic</span> Psychological aspect of viral outbreak

The COVID-19 pandemic has impacted the mental health of people across the globe. The pandemic has caused widespread anxiety, depression, and post-traumatic stress disorder symptoms. According to the UN health agency WHO, in the first year of the COVID-19 pandemic, prevalence of common mental health conditions, such as depression and anxiety, went up by more than 25 percent. The pandemic has damaged social relationships, trust in institutions and in other people, has caused changes in work and income, and has imposed a substantial burden of anxiety and worry on the population. Women and young people face the greatest risk of depression and anxiety.

LGBT trauma is the distress an individual experiences due to being a lesbian, gay, bisexual, trans, queer person or from possessing another minoritized sexual or gender identity. This distress can be harmful to the individual and predispose them to trauma- and stressor-related disorders.

<span class="mw-page-title-main">Mental health of Asian Americans</span> Issues and problems for Asian American mental health

Concern about the mental health of Asian Americans has been raised as the Asian population in the United States is rising. According to the US Department of Health and Human Services Office of Minority Health, the leading cause of death among Asian Americans aged 15–24 is suicide. Asian Americans tend to underutilize resources, especially those that are not deemed culturally competent. Studies suggest that Asian American patients tend to ignore the emotional symptoms of mental illness and only report physical ones to doctors, resulting in misdiagnosis.

The social determinants of mental health (SDOMH) are societal problems that disrupt mental health, increase risk of mental illness among certain groups, and worsen outcomes for individuals with mental illnesses. Much like the social determinants of health (SDOH), SDOMH include the non-medical factors that play a role in the likelihood and severity of health outcomes, such as income levels, education attainment, access to housing, and social inclusion. Disparities in mental health outcomes are a result of a multitude of factors and social determinants, including fixed characteristics on an individual level – such as age, gender, race/ethnicity, and sexual orientation – and environmental factors that stem from social and economic inequalities – such as inadequate access to proper food, housing, and transportation, and exposure to pollution.

The psychological impact of discrimination on health refers to the cognitive pathways through which discrimination impacts mental and physical health in members of marginalized, subordinate, and low-status groups. Research on the relation between discrimination and health became a topic of interest in the 1990s, when researchers proposed that persisting racial/ethnic disparities in health outcomes could potentially be explained by racial/ethnic differences in experiences with discrimination. Although the bulk of the research tend to focus on the interactions between interpersonal discrimination and health, researchers studying discrimination and health in the United States have proposed that institutional discrimination and cultural racism also give rise to conditions that contribute to persisting racial and economic health disparities.

<span class="mw-page-title-main">Psychosocial distress</span>

Psychosocial distress refers to the unpleasant emotions or psychological symptoms an individual has when they are overwhelmed, which negatively impacts their quality of life. Psychosocial distress is most commonly used in medical care to refer to the emotional distress experienced by populations of patients and caregivers of patients with complex chronic conditions such as cancer, diabetes, and cardiovascular conditions, which confer heavy symptom burdens that are often overwhelming, due to the disease's association with death. Due to the significant history of psychosocial distress in cancer treatment, and a lack of reliable secondary resources documenting distress in other contexts, psychosocial distress will be mainly discussed in the context of oncology.

People who are LGBT are significantly more likely than those who are not to experience depression, PTSD, and generalized anxiety disorder.

References

  1. Medicine, Institute of; Health, Board on Neuroscience and Behavioral; Terrorism, Committee on Responding to the Psychological Consequences of (2003-08-26). Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy. National Academies Press. ISBN   978-0-309-16792-5.
  2. Katherine M. Keyes; Charissa Pratt; Sandro Galea; Katie A. McLaughlin; Karestan C. Koenen; M. Katherine Shear (August 1, 2015). "The Burden of Loss: Unexpected death of a loved one and psychiatric disorders across the life course in a national study". American Journal of Psychiatry. 171 (8): 864–871. doi: 10.1176/appi.ajp.2014.13081132 . PMC   4119479 .
  3. Goldberg D (December 2000). "Distinguishing mental illness in primary care. Mental illness or mental distress?". BMJ. 321 (7273): 1412, author reply 1413. doi:10.1136/bmj.321.7273.1412. PMC   1119126 . PMID   11187100.
  4. "Mental Distress Changes". Changes.org.uk. Retrieved 2010-06-01.
  5. 1 2 "Mental Distress Information, Symptoms" (PDF). EthnoMed. Harborview Medical Center, Health Sciences Library, University of Washington. August 2003. Archived from the original (PDF) on 2014-06-11. Retrieved 2020-08-24.
  6. Long PW (2019). "Bipolar I Disorder". Internet Mental Health. Archived from the original on 1 March 2020.
  7. Bouchez C (1 January 2006). Chang L (ed.). "Emotional Distress Signs". WebMD.
  8. "Social Anxiety, Chemical Imbalances, and Neural Pathways in the Brain". Social Anxiety Institute.
  9. 1 2 Shim RS, Compton MT, Rust G, Druss BG, Kaslow NJ (October 2009). "Race-ethnicity as a predictor of attitudes toward mental health treatment seeking". Psychiatric Services. 60 (10): 1336–1341. doi:10.1176/ps.2009.60.10.1336. PMC   4905699 . PMID   19797373.
  10. 1 2 3 Hunter LR, Schmidt NB (March 2010). "Anxiety psychopathology in African American adults: literature review and development of an empirically informed sociocultural model". Psychological Bulletin. 136 (2): 211–35. doi:10.1037/a0018133. PMID   20192561.
  11. 1 2 Griffith DM, Neighbors HW, Johnson J (January 2009). "Using national data sets to improve the health and mental health of Black Americans: challenges and opportunities". Cultural Diversity & Ethnic Minority Psychology. 15 (1): 86–95. doi:10.1037/a0013594. PMID   19209983.
  12. Gonzalez et al., 2008
  13. Levin, 2008
  14. Borchard T (15 August 2011). "Black And Depressed: Overcoming The Stigma". The Huffington Post. Retrieved 2016-03-01.
  15. Watson NN, Hunter CD (October 2015). "Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking". Cultural Diversity & Ethnic Minority Psychology. 21 (4): 604–612. doi:10.1037/cdp0000015. PMID   25602466.
  16. 1 2 3 Seaton EK, Caldwell CH, Sellers RM, Jackson JS (September 2008). "The prevalence of perceived discrimination among African American and Caribbean Black youth". Developmental Psychology. 44 (5): 1288–1297. doi:10.1037/a0012747. PMC   2556985 . PMID   18793063.
  17. 1 2 3 Freedenthal S (February 2007). "Racial disparities in mental health service use by adolescents who thought about or attempted suicide". Suicide & Life-threatening Behavior. 37 (1): 22–34. doi:10.1521/suli.2007.37.1.22. PMID   17397277.
  18. Alexandre PK, Younis MZ, Martins SS, Richard P (2010). "Disparities in adequate mental health care for past-year major depressive episodes among white and non-white youth". Journal of Health Care Finance. 36 (3): 57–72. doi:10.7916/D8BK1994. PMID   22329331. S2CID   4669688.
  19. Wu et al., 2010
  20. Hughes, 1989
  21. Rumbaut RG (December 1994). "The crucible within: Ethnic identity, self-esteem, and segmented assimilation among children of immigrants". International Migration Review. 28 (4): 748–794. doi:10.1177/019791839402800407. S2CID   143473035.
  22. Dotterer AM, Lowe K (November 2015). "Perceived discrimination, parenting, and academic adjustment among racial/ethnic minority adolescents". Journal of Applied Developmental Psychology. 41: 71–77. doi:10.1016/j.appdev.2015.08.003.
  23. Bridges AJ, de Arellano MA, Rheingold AA, Danielson CK, Silcott L (March 2010). "Trauma exposure, mental health, and service utilization rates among immigrant and United States-born Hispanic youth: Results from the Hispanic family study". Psychological Trauma: Theory, Research, Practice, and Policy. 2 (1): 40–48. doi:10.1037/a0019021.
  24. Thomas et al., 2009
  25. Nicolas et al., 2009
  26. Silverman et al., 2001
  27. 1 2 DeFreitas SC, Crone T, DeLeon M, Ajayi A (February 2018). "Perceived and Personal Mental Health Stigma in Latino and African American College Students". Frontiers in Public Health. 6: 49. doi: 10.3389/fpubh.2018.00049 . PMC   5834514 . PMID   29536000.
  28. "Black & African American Communities and Mental Health". Mental Health America. Retrieved 19 February 2019.
  29. Hoy-Ellis CP, Ator M, Kerr C, Milford J (2016). "Innovative Approaches Address Aging and Mental Health Needs in LGBTQ Communities". Generations (San Francisco, Calif.). 40 (2): 56–62. PMC   5375170 . PMID   28366982.
  30. Hobaica S, Kwon P, Reiter SR, Aguilar-Bonnette A, Scott WD, Wessel A, Strand PS (December 2021). "Bullying in schools and LGBTQ+ youth mental health: Relations with voting for Trump". Analyses of Social Issues and Public Policy. 21 (1): 960–679. doi:10.1111/asap.12258.

Further reading