Mental Health is not for Crazy People

There is a fact that stigma is the strongest barrier to reach to mental health support or treatment.

 »» We cannot deny the power of cultural stigma as the biggest barrier to seek mental health care. To be specific, if you have a mental illness; you are a sinner or you are possessed by evil spirits or you have a bad karma. Mental health is a taboo or shame rather than a condition that may be addressed by professionals and that can be healed, alleviated or cleared up.  It is not uncommon that if you have a family member who seems odd, this member is hidden as much as possible as it brings shame to family.

Dr. Ece Tansu, Clinical Psychologist, Al Zahra Hospital Dubai

There is a second fact that people facing with physical health issues are at a higher risk of developing post traumatic stress disorder, depression and/or anxiety compared to the general population (1).

»»Population-based studies have found a 30 % life-time prevalence rate of mood disorders in patients with epilepsy, typically presenting as major depressive disorders (MDD), and less frequently as bipolar disorders or dysthymia

Comorbid anxiety disorders frequently occur together with MDD. Failure to treat MDD can negatively affect several aspects of their life as well as the management of the epilepsy. Often, suicidal ideation is among its symptoms, which need to be addressed without delay to prevent suicidal attempts or a completed suicide. 

We know that the risk of death by suicide in people with epilepsy is 3 times higher than  the general population (2).

          »»Depression is estimated to affect approximately one in four patients with cancer, who are five times more likely to have depression than the general population (3). It  can be observed in any phase of illness, including long-term cancer survivors (4).

          »»Death anxietywhich is partially related to fear of cancer recurrence should also be considered a significant clinical condition, particularly in patients at the end of life, but also in survivors (5).

          »»Due to chronic somatic diseases, we can notice easily that there is a masked depression behind and early detection of this psychological matter prevents complication, increases the effectiveness of treatment and shortens the duration of the treatment (6).

          »»Depression is associated with diabetes. Depression may be a risk factor for diabetes and may be a consequence as well(7).

»»Moreover, increasing evidence suggests that mental health and physical health are linked by neural systems that jointly regulate somatic physiology and high-level cognition which means that our high-level cognition may be sharpened via psychotherapy and may conceptualize events with personal meaning and this, in turns, may allow predictive control over behaviour and peripheral physiology, including autonomic, neuroendocrine and immune function. Disorders of mental and physical health, especially those with high co-occurrence may  benefit to a large extent, from interventions focused on understanding and shaping mindsets and beliefs about the self, illness and treatment (1).

Now comes the third fact: Physicians are the most effective facilitators for people to benefit frommental health services without paying attention to stigma.

    »»When prompted by their trusted doctors, people become ready to describe their psychological stresses and seek for psychological treatment (8).

Evidently,physiciansarethefirst ones who can recognize the mental disorganization in their patients, whoshouldertheresponsability of psychologicalwell-beingbesidesphysicalandwhomay pass on motivationandguidancefor a psychological check-up aiming better quality of life in itseveryaspectsforthem.

Thank you for reading.

References:

(1)Koban, L., Gianaros, P. J., Kober, H., & Wager, T. D. (2021). The self in context: brain systems linking mental and physical health. Nature Reviews Neuroscience, 22(5), 309-322.

(2)Kanner, A. M. (2025). Major depression, anxiety disorder and suicidality in epilepsy: What should neurologists do?. Epilepsy & behavior reports, 30, 100758.

(3)L. Grassi, R. Caruso, M.B. Riba, M. Lloyd-Williams, D. Kissane, G. Rodin, D. McFarland, R. Campos-Ródenas, R. Zachariae, D. Santini, C.I. Ripamonti,

Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline†,

ESMO Open,Volume 8, Issue 2,2023,

(4) Niedzwiedz CL, Knifton L, Robb KA, et al. Depression and anxiety among people living with and beyond cancer: a growing clinical and research priority. BMC Cancer. 2019;19(1):943. 31.

(5) Soleimani MA, Bahrami N, Allen KA, et al. Death anxiety in patients with cancer: a systematic review and meta-analysis. Eur J Oncol Nurs. 2020;48:101803. 28.

(6) Agorastos, A., & Chrousos, G. P. (2022). The neuroendocrinology of stress: the stress-related continuum of chronic disease development. Molecular Psychiatry, 27(1), 502-513.

(7) AbdElmageed, R. M., & Hussein, S. M. M. (2022). Risk of depression and suicide in diabetic patients. Cureus, 14(1).

(8)Kim, W., Yalim, A. C., & Kim, I. (2021). “Mental health is for crazy people”: Perceptions and barriers to mental health service use among refugees from Burma. Community Mental Health Journal, 57(5), 965-972.