Yellow September | A mental health awareness

Mental health is a field surrounded by stigmas. Many in society still find it difficult to accept that mental disorders are illnesses that require attention and treatment like any physical illness. In order to promote awareness about the theme and combat the growing number of suicides that are registered in Brazil every year, Centro de Valorização da Vida (CVV), the Federal Council of Medicine (CFM) and the Brazilian Association of Psychiatry (ABP) have held, since 2015, the Yellow September campaign.

Horiens supports this initiative together with its partner health insurance companies, which offer support for psychological treatment through their referenced networks and other care platforms. The insured members or dependents can, at any time, contact OLÁ Pessoas – (11) 3096-8080 / olapessoas@horiens.com – for questions, or access the direct links of the insurers to learn more. Click on Bradesco or SulAmérica.

Recognizing when you or someone you love is in pain is the first step to initiating appropriate treatment. In an attempt to help in this task, we invited the psychologist and professor Rodrigo Sampaio* to bring some clarifications on this subject that has been gaining more and more notoriety due to the increase of mental health related disorders around the world. Check out the interview below:

• Why is the topic of mental health still very stigmatized in our culture?

Rodrigo Sampaio – There is a very strong mislabeling that associates mental disorders with lunacy. If the idea of mental health, in common sense, is restricted only to a condition of psychic normality, mental disorders, in turn, place the subject in a deterministic position of erasure, of disqualification. This issue is associated with a historical process, which was marked by a radical opposition between reason and irrationality, and maintained for a long time by power relations. On one side, lunacy (irrationality) was disqualified, on the other, an idea of the truthfulness of things and people was attributed to a logic of impeccable reason. In this understanding, lunacy became a mark of social restriction, segregating and confining people in mental institutions, for example. This violent process of attempted banishment of lunacy from social spaces followed its course and, even with the psychiatric reform and the numerous attempts to give new meaning to these misinterpretations of mental disorders, the dehumanizing stigmas still persist.

• Do people who seek psychological care necessarily have a mental disorder?

Rodrigo – There is a lot of statistical data about the profile, predispositions and motivations for seeking psychological assistance. There is a growing number of people with psychiatric diagnoses of depression, specific or generalized anxiety disorders, mood disorders, eating disorders and somatization. However, we can list important situations which do not need, at first, a psychiatric referral, but which are relevant from a psychological point of view, such as learning disabilities and uncivilized behavior (common in childhood and in the school period), conflicts related to affective and emotional interpersonal relationships, academic and professional insecurity. Other complaints that do not necessarily constitute mental disorders are difficulties in dealing with daily situations, uncertainties regarding the future, problems associated with self-esteem, mourning and low tolerance to frustrations.

• Nowadays, what are the symptoms that most bring people to psychologists’ and psychiatrists’ practices?

Rodrigo – Depression is currently the world’s fastest advancing disease and can affect anyone, even someone who appears to be living in relatively healthy circumstances. Signs of depression include: mood swings, anxiety or feelings of “emptiness” or lack of “zest for life”, demotivation to perform daily activities, feelings of persistent hopelessness, pessimism, irritability, sense of guilt, worthlessness or helplessness, loss of interest or pleasure in life, decreased physical energy, limitation in sexual interest, difficulty concentrating, lack of memory or decision-making, difficulty sleeping and unusual tiredness on awakening, thoughts of death or suicide, joint pain, headaches, digestive problems without a clear physical cause and/or that do not relieve even with treatment; and all this for a prolonged period of one or two weeks.

It is important to point out that not everyone who is depressed experiences every symptom. In more severe situations, people can experience many of them. Another important element is to rule out any clinical diagnosis that is related to these signs, which can only be done by health professionals with differential diagnosis. Again, a personalized evaluation is necessary to rule out or confirm any diagnostic hypothesis.

• What causes depression?

Rodrigo – Several factors can act on the development of the disorder. One example is in the driving of certain chemicals in the nervous system, which can contribute to symptoms. In addition, genetic factors, people with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic, as well as environmental factors, such as continued exposure to violence, neglect, abuse, poverty, degrading working conditions, can make some people more vulnerable to depression.

• Talking to friends and people you trust can be effective and even exempt the help of a specialized professional?

Rodrigo – Social, family, affective-sexual relationships, religion, or other social-emotional devices do not replace the personalized intervention of a mental health professional. All these elements are part of a complex set of interventional actions that can help people with psychological illnesses to have a greater well-being and quality of life. Physical activity, healthy eating, social relationships, sleep, prescribed medication and pleasurable activities are auxiliary to the psychotherapeutic process and fundamental for progress in therapeutic management. However, the technical knowledge of the mental health professional is essential to succeed in this goal.

• In practical terms, what is the work of the mental health professional in treating issues such as anxiety, stress, depression and other disorders?

Rodrigo – Depression, as well as anxiety and other mental health disorders are multifactorial and multidetermined, that is, they result from a set of biological, psychological and social interactions that a person experiences throughout their life. Another part of these experiences is the exposure to endogenous or environmental stressors that can be defining factors for psychological intervention in situations of this nature.

It is up to the professional to analyze the context of each person’s life to define the most appropriate intervention strategies. In any case, it is of great relevance to think that the performance in mental health requires the suffering person himself as the protagonist, so that they can exercise their autonomy, also with regard to the conduct of their treatment. It is also up to the professional to promote, in their respective areas, favorable environments for the exercise of this protagonism, offering real conditions for the improvement of the people they assist.

• How to detect if a close person is in psychological distress and what can be done to help them in this situation?

Rodrigo – Two words that can be useful when we talk about helping people in psychological distress: welcoming and referral. Welcoming is an approaching action that implies acknowledging the other, their singularity, their experiences, their suffering, their understanding of themselves and of the world, and their ways of living and feeling. It implies an attitude of respect, of openness to what the other has to say, of their pains and dilemmas, in a process of empathetic listening, without judgements or comparisons. For a person who lives with or detects situations of mental suffering in someone close to them, it is important to listen carefully to what that person has to say, in their own words, based on what they feel and on how they interpret what they feel. So, if you detect any signs of psychological distress in someone close to you, offer a listening ear and seek professional help.

*Rodrigo Sampaio is a clinical psychologist, Master and Researcher in Education at the Universidade do Estado da Bahia – UNEB. He is currently a pedagogical advisor at UniFTC Salvador, also teaching in the areas of Human Development, Psychopathology, and Theories of Personality.