Nice to meet you

Article by Dr. Mark Ritzen

 

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Meeting other people is a very common, and for our mental health important part of our daily life; Meeting others can ensure us to be part of a group, which gives us the feeling of being accepted, protected, integrated. Furthermore, meeting others can help us fulfill some of the intentions or plans we have in life; Here, a meeting gives us the feeling of opportunity. Last but not least, a meeting can help us to develop ourselves in all possible ways : by meeting people we learn about the existence of other values, lifestyles, ideas, convictions, intentions, etc. and might enrich ourselves with this. By learning about other ideas, intentions, believes , we can reflect more profoundly about ourselves, put things in perspective and place ourselves better in the complex and fascinating heterogecity of being human.

The other person we meet presents us a rich diversity of individual characteristics that are the result of his genes (nature), as well as his education and life experiences (nurture).

Some examples of the many characteristics that define a person are his sex, weight, size, personality, temperament, interests, know-how, intentions, social intelligence, strengths, weaknesses, desires and worries, and of course we can define many many more.

When two persons meet, two different worlds of individual characteristics are voluntarily or involuntarily confronted with each-other ; this can be a very enriching, never-ending process of dialoging/ experiencing/ discovering. It can also be a challenge to adapt oneself to avoid greater discomfort.

Fortunately, during most of our meetings we are rather pragmatic ; during a meeting, we reduce the complexity of the other to those dimensions that are important to us in the given specific situation. That might for example be a specific know-how (for example if we consult a lawyer), or a shared interest/ habit (like religion, to reassure us being part of a group).

Knowing all this, we can imagine that meeting others is a very complex event for the brain that is accompanied by differentiated and precise perceptions, priorisations, interpretations, curiosity, expectations, hopes, fears, desires : We try to estimate/ inventorying the other’s individual characteristics, especially those, that are important to us in a given situation; In the meantime we have to reflect about/ look at/ eventually re-define our own characteristics ; furthermore, we have have to estimate the chance to reach our goals with the available/ detected ressources in ourself and in the person we meet. Finally we have to develop or adapt a strategy to reach (if defined already) our goals.

Meeting others is necessary for our mental health ; on the other hand it is a very complex challenge for the brain. Therefor, If the brain is affected by a a psychiatric illness it might have difficulties to manage all the necessary processes in order to have a « good meeting »; as a result, many psychiatric patients don’t feel at ease with other people and tend to isolate themselves, to draw themselves back from society. Meeting others is so important to experience happiness ; Without it, how can we feel ourselves accepted, wanted and integrated ?

Exactly here I think that society (that means everyone) can really help people, suffering from psychiatric problems. By being sensitive, tolerant, inviting and supportive, especially to those who have a risk to loose connection to society ; By doing this, society has an opportunity enrich itself, by rediscovering other values than competition, power and wealth-related successfulness, by reactivating ressources as patience, observation, fascination, compassion, heterogenicity and flexibility.

 

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Dr. Mark Ritzen – Psychiatrist in Luxembourg.

Visit his Medihoo profile HERE

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Participation in society: necessity and risk to experience happiness

Mark_Wand_klein     By Dr. Mark Ritzen


Participation in society is generally regarded as an important condition for experiencing happiness. We develop ourselves in dialogue with those around us, within society. We are embedded in society; in a family, a village, a political system, a religion, a sub culture, a culture, a system of values, ideas, norms,……..

The society in which we are living (and especially our closest social environment) defines what we have to do/ how we have to behave and how we have to look, to be regarded as a successful person.

While growing up in this “social nutritive matrix” , we take decisions, make choices, let us inspire by others, exchange warmth, compassion, love, compete and while doing that we progressively find and develop our identity, our resources, our limits, our “value” in all thinkable ways. Furthermore, we develop dreams how/ who we want to be, who and what we want to have around us,….in resonance with our individual resources (given by nature and nurture) and as a result of inspiration by the surrounding society we define values, targets, goals, visions that are highly attractive to us (ideal-self),…We try to reach up to them all our live; we try to live them every day.

But what if we find out that we cannot reach them? What if there is a too large gap between our ideal-self and our true self. What if we have neglected our individual resources/ambitions/ nature and too much of our ideal-self has been nourished by society defined ideals?

What if our resources have other qualities than those needed to reach our (perhaps more society-defined) goals?

Can we adapt our goals that have been developed over more than a decade and that are in harmony with a specific social environment (for example our parental house)?

Can we accept other goals, which are more in harmony with our individual nature/ resources?

Can we be that strong in the social environment in which we live that we progressively live other values, more in harmony with ourselves but possible in disharmony with the environment?

Are we prepared to pay the price of eventual devaluation if we have to size down or adapt our ambitions within the social environment in which we live?

Can we support a feeling of devaluation until we have discovered that there is a lot of value in the new ambitions, which are more in harmony with our individual nature?

 

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Too large discrepancies between a person’s individual nature/ resources on one hand and his ideal-self on the other or a wide gap between his nature/ resources and the requirements of the society in which he lives can create a very significant and stress-causing tension. This might lead to a feeling of disconnection with society, isolation, stigmatisation and even clinically relevant symptoms like low self esteem, fatigue, sleeplessness, restlessness, irritability, hopelessness, pain, feelings of insufficiency, anger, sadness, anxiety, exhaustion…..

 

Participating in society also means that you will have to deal with a variety of daily to do’s.

The quality, quantity and size of those daily to do’s changes in the course of time and varies between different cultures and sub-cultures.

Being an active member in society, taking initiatives, organizing a complex, rich and varied life, increasing your connections, showing that you exist…..that you live, causes a certain visibility that is often used as a measurement (parameter) for successfulness.

 

But does participating by “doing” / “showing that you live” also result to a feeling that you live?

Do we still take time for being in our daily life? Do we grant ourselves enough space to look, to hear, to feel, to sense,… to experience? Who am I, Where am I standing in my life, where do I want to go to?

Can we really meet people around us in a rich and profound way (“Begegnung”)

Can we really experience the beauty of Nature around us? Do we give ourselves enough space to experience the profound joy of being touched by art?

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In the western world there seems to be an overestimation of the value of doing things. We are so much trained in doing things, so much used “to do” all possible kind of activities that we often tend to forget the importance of the experience of “being”.

The experience of “being” gives us peace, equilibrium, harmony and profundity in our lives. I think that the experience of “being” is one of the most important conditions for experiencing happiness.

While being busy all the time and “doing” things permanently, we might forget too long the importance of “being”. This unconscious neglect of self-care might cause a feeling of loneliness, emptiness, frustration; an incomprehensible profound feeling of unhappiness although we are participating to society in countless ways.

Since the early seventies, clinical psychology and psychiatry rediscovered in a certain way the importance of “being” for experiencing happiness and a large number of therapeutic applications, based on “mindfulness” have been developed.

Mindfulness is the intentional, accepting and non-judgemental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment.

Meanwhile, an impressive number of studies have demonstrated that mindfulness based therapies can be very helpfull in reducing stress, improving the quality of life and in improving certain psychiatric disorders (like anxiety- and depressive disorders) and pain.

In their book: “Mindfulness, a practical guide to finding peace in a frantic world” Professor Mark Williams and Dr Danny Penman explain the importance of giving “being” more space in our lives. Furthermore they propose an eight-week program with several very nice (and easy to learn) exercises

 

http://www.amazon.co.uk/dp/074995308X/ref=as_li_tf_til?tag=drdannypenman-21&camp=1406&creative=6394&linkCode=as1&creativeASIN=074995308X&adid=0C65KDVEXA3E12FA555K&


 

Dr. Mark Ritzen – Psychiatrist

View his profile on Medihoo HERE

Depression a huge global Cloud by Dr. Mark Ritzen

Mark_Wand_klein     By Dr. Mark Ritzen


Depression a huge global problem…

According to an estimation of the World Health Organisation (WHO) worldwide more than 120 million, perhaps even up to 350 million people suffer from clinical depression (1).

At its most severe, depression can lead to suicide and is responsible for 850,000 deaths every year.

Knowing that 60-80% of all depression cases can be effectively treated with brief, structured forms of psychotherapy and antidepressant medications it is very unfortunate that worldwide far less than 25% has access to appropriate care.

(The following info graphic might give a more precise idea about the stats: http://www.healthline.com/health/depression/statistics-infographic)

Some figures……

-Compared to developing countries, lifetime prevalence of depression (10-15%) seems to be higher in high-income lands.

(World Bank criteria for income (2009 gross national income (GNI) per capita): low income is US$995 equivalent or less; middle income is $996–12,195; high income is $12,196 or more)

-Nearly twice as many women (12.0 percent) as men (6.6 percent) are affected by a depressive disorder each year. These figures translate to 12.4 million women and 6.4 million men in the U.S

-4% of adolescents will develop significant symptoms of serious depression each year in the United States. Suicide is the third leading cause of death among children and young adults aged 10 to 24.

-About 50% of all adults experiencing symptoms of depression will not talk to a doctor or seek help for depression. 

-A recent study sponsored by the World Health Organization and the World Bank found unipolar major depression to be the leading cause of disability in the United States.

Although 87% of the world’s governments offer some mental health services at the primary- care level, 30% of them have no relevant programme, and 28% have no budget specifically identified for mental health

-In his article “the cost of depression” Robert L. Leahy, Ph.D.(American Institute for Cognitive Therapy) speaks about the huge economic burden ( about $83 billion each year (lost productivity and increased medical expenses) in the united states alone.
(L
ink: http://www.huffingtonpost.com/robert-leahy-phd/the-cost-of-depression_b_770805.html)

Medihoo Infographic Depression

Medihoo Infographic Depression

Though, before interpreting these figures, it is important to know that many countries cannot provide reliable data.

According to a press release by the WHO in 2001 (“Mental disorders affect one in four people“) only 73% of countries have a formal mental health reporting system, and only 57% have done epidemiologic studies or have data collection systems for documenting mental illness.

Furthermore caused by fear for stigmatisation or ignorance about key symptoms, it is likely that there is a huge number of persons are suffering from depression without having been diagnosed correctly.

Furthermore, the thresholds to determine whether the criteria for clinical depression are present differ from region to region.

The gap between what is urgently needed and what is available to reduce the burden is still very wide. WHO has recognised this and to improve this situation, in 2008 WHO has lanced the “Mental Health Gap Action Programme (mhGAP)”.

The Programme aims to help countries increase services for people with mental, neurological and substance use disorders, through care provided by health workers who are not specialists in mental health.

The programme asserts that with proper care, psychosocial assistance and medication, tens of millions of people with mental disorders, including depression, could begin to lead normal lives – even where resources are scarce.

Ethiopia is one of the first 6 countries chosen to implement the WHO’s mhGAP initiative;


in this video Dr. Tedla W. Giorgis inztoduces a short documentary about the mhGAP programm in his country

Participating health workers can receive structured trainings to assess and manage persons with a psychiatric problem, like depression:

To learn more about mhGAP Intervention Guide, please follow these links: http://www.paho.org/mhgap/en/general_principal.html
http://www.paho.org/mhgap/en/depression.html?reload

Further links:

  1. http://www.who.int/mediacentre/factsheets/fs369/en/
  2. http://www.who.int/mental_health/mhgap/en/
  3. http://www.upliftprogram.com/depression_stats.html
  4. http://www.biomedcentral.com/presscenter/pressreleases/20110722
  5. http://www.who.int/mental_health/mhgap_final_english.pdf
  6. http://www.ph.ucla.edu/epi/faculty/detels/PH150/OTBPH_Chap1_Aug2012.pdf

 

By Dr. Mark Ritzen – Psychiatrist. View his Medihoo profile HERE

Dare to care

Mark_Wand_klein     By Dr. Mark Ritzen


Mental diseases have a huge impact on our quality of live, our ability to experience happiness. Nevertheless, mental illnesses remain often undiagnosed or untreated.

This problem can both be found in rich countries as well as (even more severe) in developing countries.

Besides fear for stigmatization, feelings of shame and guild, or simple a lack of knowledge concerning specific symptoms, this might be caused by a lack of psychiatric health-care, a poor accessibility to health-care or too high treatment costs.

To treat a person’s psychiatric problems, to improve his mental health, means to support him in feeling a respected and participating member of society.

Unfortunately, this turns out to be be more difficult than one might expect.

Highly demanding societies, a very narrow definition of success, an increasing interpersonal competition, as well as a profound individualism have increased the gap between healthy persons and those who suffer from mental problems. Therefor, re- integrating people in a society has become a highly complex job.

Nowadays, treating people with mental diseases has become more and more a matter for highly trained professionals, who normally use to work in specialized facilities (for example psychiatric hospitals) that are, in a certain way ironically, separated from “normal ” society (and thus not very suited to facilitate a reintegration process)

Being a social living being by nature, it is difficult to expect a person to re-experience happiness without an adequate re-integration in society. I think it is crucial to enable a person ( with or without psychiatric problems) to develop themselves while dialoging in a respectful and healthy way, with their surrounding social environment.

Social isolation, stigmatization, marginalisation, and societal individualism might participate to the problem that many persons, suffering from a mental disease remain untreated, lonely and sometimes even forgotten by the society they used to live in.

To facilitate access to support for mental health issues, to improve the situation of social isolation, to re-responsibilize a community for the mental health of its individuals, several very interesting projects (especially for the developing world), have been developed. Examples are the “community therapy” by professor Adalberto Barreto, or the “MANAS” (MANashanti Sudhar Shodh, which means “project to promote mental health”) trial by professor Vikram Patell.

These programs invite people to become guardians of their own health, to help and to support each other. The Community itself activates and uses its power to support mentally troubled participants in their healing process.

Even if those programs partly have been developed to compensate poor accessibility/ poor resources in developing countries, I think they are excellent examples of how an important part of the responsibility to integrate mental ill people can be brought back to where it belongs: Within society; to all people making part of it.

At ted.com I found this interesting video with professor Vikram Patell, who recommends us to “dare to care”:

http://www.ted.com/talks/vikram_patel_mental_health_for_all_by_involving_all?language=en

Other interesting links:

https://www.ashoka.org/fellow/adalberto-barreto

(in french)


 

By Dr. Mark Ritzen – Psychiatrist. View his Medihoo profile HERE