A person may go to work, attend all meetings, share their opinions, participates in activities, care for their family, greet everyone with a smile and appear perfectly fine and still be struggling on the inside.
Perhaps that is one of the most difficult things about mental health. The signs and symptoms are not always obvious and evident. Sometimes, people become so used to carrying their worries so quietly that even those around them may never realise that something is wrong.
Mental health is equally important as physical health. The World Health Organization (WHO) acknowledges mental well-being as an integral part of overall health, in addition to physical and social well-being.
As 10th October approaching, World Mental Health Day reminds us to go beyond what we can see in ourselves and in those around us. It is also a good time to pause and ask : are we really OKAY? Or have we simply become good at saying, “I’m fine” ?
At the same time, Mental health should not be considered synonymous with mental illness. Stress, grief, anxiety and emotional distress are the part of human life.
There are times when life simply feels difficult. But persistent or having severe symptoms can impair normal functioning and require professional support. Seeking help should be viewed as healthcare seeking, just like physical health consultation and not weakness. Mental health deserves the same understanding.
Mental health is shaped by everyday life
It is important to understand that mental well – being of an individual does not depend on any single factor but rather gets influenced by the circumstances in which ones live, learn, work and grow. Poverty, financial insecurity, unemployment, workplace stress, academic pressure, violence, unsafe environment, social isolation, substance use, chronic diseases, displacement, ageing and loneliness can all affect mental health.
This is why Mental health cannot be addressed only inside a psychiatrist’s clinic. Those people who reach or consult a psychiatrist or mental health professional are important, but they may represent the tip of ice-berg. Many others may be experiencing distress without recognising it, talking about it or seeking help, reflects the submerged part of ice-berg, still being considered a part of everyday life.
According to the WHO, about one in seven adolescents aged 10 -19 years experiences a mental disorder globally, accounting for 15% of global burden of disease in this age group. Depression, anxiety and behavioural disorders are among the leading causes of illness and disability among this age group. Suicide is the third leading cause of death among young people aged 15-29 years.
Mental health also matters in adulthood and later life. WHO data from 2023 suggest that around 16% of working age adults were living with the mental disorder.
Depression and anxiety are estimated to account for nearly 12 billion working days lost every year globally, adding up to about US$1 trillion in lost productivity. And this is not something that disappears with retirement or advancing age. WHO estimates that approximately 15% of adults aged 70 years or older live with a mental disorder. Loneliness and being socially isolated are key risk factors for mental health conditions in later life.
These numbers are more than statistics. Behind each number, there is a person who try to manage work, relationships, responsibilities, uncertainty or simply the demands of everyday life
A two-minute check-in with yourself
We often ask people around us, “Are you okay?” , but have we ever thought of asking ourself the same question?
The WHO-5 Well-Being Index is a simple five-item self-report tool that can help you reflect on your mental well-being. It asks us to think about how we have been feeling over the past two weeks. Over the past two weeks:
- I have felt cheerful and in good spirits.
- I have felt calm and relaxed.
- I have felt active and vigorous.
- I woke up feeling fresh and rested.
- My daily life has been filled with things that interest me.
For each statement, choose one response:
- All of the time – 5
- Most of the time – 4
- More than half of the time -3
- Less than half of the time -2
- Some of the time -1
- At no time -0
Add your five scores. The total gives a score between 0 and 25. It can also be converted to a 0-100 scale by multiplying the score by four. A higher score reflects better reported well-being.
Source: World Health Organization (WHO). WHO-5 Well-Being Index. Geneva: World Health Organization, 2024. Licence: CC BY-NC-SA 3.0 IGO.
But there is an important point to remember : this is not a test that can diagnose depression, anxiety or any other mental health condition. Rather, it can be simple opportunity to pause and notice how you have been feeling. If you find that your well-being has been persistently low, you are struggling to cope or your thoughts, emotions or daily functioning have been affected, consider speaking with a qualified mental health professional.
Sometimes, asking ourselves “ How am I really doing?” can be the first step towards seeking the support we need. And if you or someone you know is struggling and needs to talk to, you don’t have to wait until things become unbearable to reach out. Tele-MANAS: 14416 or 1800-89-14416 (24×7) mental health support.
Mental health begins long before the clinic
Mental health does not begin when someone walks into a psychiatrist’s clinic and it does not end when a prescription is written. It begins in our homes, schools, workplaces and communities; the environments in which we live, learn, work and grow.
A healthier society is one where asking for help is not a sign of weakness, but an ordinary part of taking care of our health. A healthier society is not one where everyone is expected to be fine all the time, but one where people can honestly say, “ I am not doing very well” and know that it is okay to ask for help.
Also, the most important question is not whether someone looks fine, but whether we have given them enough of space to tell us how they really are!
Sources: World Health Organization (WHO): Adolescent Mental Health; Mental Health at Work; Mental Health of Older Adults; WHO-5 Well-Being Index.
Author Bio:
Dr. Rukhsar Khan, MBBS, MD (Community Medicine), is a Senior Resident in the Department of Community Medicine at Pt. Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh. She completed her MBBS from Jamia Hamdard, New Delhi.
Her academic and research interests include epidemiology, non-communicable diseases, health systems strengthening, evidence-based public health, health promotion and palliative care. She has experience in implementation research on non-communicable diseases, with particular emphasis on underserved and tribal populations.
