Mental Health

Mental Health What does it means “no health without mental health�?

The proportion of Dissability Adjusted Life Years (DALYs) arising from non-communicable disease in 2005 (WHO, 2006) • In 2010, the Mental, neurological and substance use disorder (MNS) become the third leading cause of mortality, disability and dependency (Whiteford et al., 2010).

• In 2030, projected will be raised into 72% in Middle Income Country & 45.1% in Low Income Country (WHO, 2006).

INDONESIA • 6 % atau sekitar 19 juta penduduk Indonesia di atas 15 tahun menderita gangguan mental emosional yang disertai gejala kecemasan dan depresi (Riskesdas, 2013).

Faktor penyebab gangguan kesehatan mental

Sumber : Riset Kesehatan Dasar (2013)

• Gangguan kesehatan mental menyebabkan kerugian ekonomi negara sebesar Rp. 20 triliun (Riset Kesehatan Dasar 2007)

DEFINITION

Mental Health (WHO, 2014)

 Who is responsible to your mental health?

 Could we influence people’s mental health?

Stress  Definition

“ Internal state of individual, an external event or the interaction between a person and his/her environment” (McNamara, 2000.p.4).

 Stress is a natural part of life

Is it always bad?

Does it feels the same for everyone?

“Eustress Vs Distress”

The Mechanism of Stress

Negative Automatic Thought

Understanding Depression

ď “

1. Depresi sebagai Isu Terkini No health without mental health

• Depression is the leading cause of disability worldwide, and is a major contributor to the overall global burden of disease (WHO, 2016)1 • Depression currently (1990) ranked fourth among the 10 leading causes of the global burden of disease, it is predicted that by the year 2020, it will be second leading cause of disability and death2

2. Mental Disorder dan Kita Semua 1 dari setiap 4 orang di dunia mengalami gangguan mental setidaknya sekali dalam fase hidupnya (WHO, 2001)3 • • • • • • • • •

Depression (Unipolar atau Bipolar) Anxiety Panic attack Schizophrenia Eating problems (anorexia, bulimia, dll) Developmental Disorder (ADHD, Autism, dll) Dementia Alzheimer Alcohol and Drug abuse

Di Indonesia…

• Artist • Politician • Athlete • Writer • Single • Married (depresi bukan Cuma tentang cinta dan percintaan) • LPDP Awardee • Human being

3. Depresi dan kesedihan biasa  Kesedihan adalah proses alamiah manusia

saat..  Dapat nilai jelek  Putus pacar  Ditinggal seseorang tersayang (kematian, cerai,

dll)  Clinical Depression is feeling sad when there

is nothing to sad for  Clinical Depression is feeling blue out of

nowhere

3. Depresi dan kesedihan biasa

3. Depresi dan kesedihan biasa

4. Depresi dan Gejala (Simtom) If you have these symptoms4

(consistently) over two weeks or longer, visit your GP

Psychological symptoms

Physical symptoms

Social symptoms

• moving or speaking more slowly than usual

• Self-Withdrawal • having difficulties in your home and family life

•

continuous low mood or sadness

•

feeling hopeless and helpless

•

having low self-esteem

•

feeling tearful

• changes in appetite or weight (decreased or increased)

•

feeling guilt-ridden

• Constipation

•

feeling irritable and intolerant of others

•

having no motivation or interest in things you usually like

• unexplained aches and pains (neck pain, headache)

•

finding it difficult to make decisions

• lack of energy

•

not getting any enjoyment out of life

• low sex drive

•

Having suicidal thoughts and selfharming

• disturbed sleep

5. Depresi dan Jenis-jenisnya Major Depressive Disorder (MDD)

Dysthimia

Clinical Depression / Unipolar Depression

Chronic Depression / Persistent depression

Full blown depression (almost all symptoms at least two weeks)

Half blown depression (at least 2 years)

Bipolar Disorder Manic Depressive

High-functioning depression

Post-natal Depression

Seasonal affective disorder

Baby Blues

Winter blues

6. Depresi dan Penyebabnya

7. Depresi & Genetika 

Genetic5



APOE, DRD4, GNB3, MTHFR, SLC6A3 and SLC6A4

8. Depresi dan Otak •

Brain6

•

Smaller Hippocampus

•

Smaller prefrontal lobe

Hippocampus (memory and emotion)

9. Depresi dan Chemical imbalace Depresi dan mental disorder lain memiliki kaitan dengn sedikitnya neurotransmitter di otak

10. Depresi dan Hormon • Hypothyroidism • Hyperthyroidism

• Hypothyroidism • Hyperthyroidism

11. Depresi dan perempuan Both in high income or low income countries, Female are more likely to suffer from depression6,7,8

1.

Fluctuating hormone levels

2.

Women are more ruminative than men

3.

Women has double job (Office work + the burden of domestic work)

4.

Women are open with their emotion and more likely to seek out for diagnosis of depression

12. Depresi dan Pria Male are less likely to suffer from depression: 1. They don’t want to talk about emotion 2. Talking about emotion is showing their weakness (social construction)

However…………..

In 2014, male suicide accounted for some 76% of all suicides. It is the biggest killer of men under the age of 459

Men are being oppressed by the idea of Masculinity

Male does Vulnerable How male channels their unrecognized emotion?

• Sports (Soccer, Hiking, etc..)

• Arts (Music, painting,…)

• Competition • Hobbies • Jokes • Game (Dota)

• Cigarette • Physical symptoms (neck pain / stiffness, headache) • Anger • Violence • >> Domestic abuse

Gangguan Mental dan Kehidupan Kota  Volunteer………………

Gangguan Mental dan Kehidupan Kota

Gangguan Mental dan Kehidupan Kota Essay 1, 2, 3, 4……….

Penyesalan masa lalu

Project Riset A, B, C…..

Dosen ngeselin, Polisi nilang, temen kantor kurang ajar, boss gak becus

Cicilan rumah, mobil, anak sakit, pindah tempat kerja Whatsapp (17 Group), Line (20 Group), Path, Telegram, Facebook, Instagram, instastories harus diupdate, harus dibales

Gempa di Sumatra, gempa di Jepang, perang di Suriah, dll

Kekhawatiran akan masa depan

Low body image Kurang kurus, Paha kurang panjang Gigi berantakan

Low self esteem Aku gak becus public speaking, Aku gak bisa main musik

Mental Health and 

Permissive (indulgent) parenting style



• Authoritarian (highly demanding) parenting style

• Authoritative (combination) parenting style

10 Parenting

“Anak Anak Belajar dari Kehidupan di Dalam Keluarganya�

Puisi karya Dorothy Law Nolte (1954) Bila seorang anak hidup dalam suasana penuh kritik, Ia belajar untuk menyalahkan.

Bila seorang anak hidup dengan rasa benci, Ia belajar bagaimana berkelahi.

Bila seorang anak hidup dalam ketakutan, Ia belajar untuk gelisah Bila seorang anak hidup dengan rasa malu, Ia belajar merasa bersalah.

Bila seorang anak hidup dalam ejekan, ia belajar untuk tidak percaya diri

Bila seorang anak hidup dengan toleransi, Ia belajar menjadi sabar.

Bila seorang anak hidup dengan semangat, Ia belajar kepercayaan diri.

Bila seorang anak hidup dengan pujian, Ia belajar untuk menghargai.

Bila seorang anak hidup dengan rasa adil, Ia belajar tentang keadilan.

Bila seorang hidup dengan rasa aman, Ia belajar memiliki iman.

Bila seorang anak hidup dengan persetujuan, Ia belajar menyukai dirinya sendiri.

Bila seorang anak hidup dengan penerimaan dan persahabatan, Ia belajar mencari cinta dalam dunia.

Mental Health and Parenting Conditional love (Cinta penuh syarat) • Anak mamah gak boleh marah • Anak papah gak boleh nangis • Jagoan gak boleh nangis • Anak laki gak boleh nangis, kayak perempuan • Sayang gak boleh ngambek, kalo ngambek bukan anak bunda

Anak tidak berdamai dengan emosi • “SAYA GAK MARAH!!”

• Hidup dalam denial • Aggresif • Tidak bisa empati

How to talk to someone with depression (Mental Illness) The “Instant Relief ” Versions: 

Just shake it off.



Get a grip.



Grow up and deal with your problems.

The “Spiritual” Versions:

The “Random acceptance” Versions:

•You need to pray, God is all you need.

•Count your blessings.

•Practice gratitude and enjoy the little things and those you love.

•Read the Bible and your depression will lift.

•Just let yourself go.

•That’s just the way life is.

•Depression is just a disease and you’ll be like that the rest of your life.

The “Compare Yourself ” Versions

The “It’s In Your Head” Versions

•Think of all the people with less than you have •There are people who have no food and are happy •People in other countries have it so much worse, we have no right to be unhappy.

•You think too much and over analyse things.

•There’s no such thing as depression.

•Just get over it.

•Pull yourself up by your bootstraps.

Depression

Your words…

Depression and Stigma

Stigma on Depression‌.?

 Why is stigma matter?

 How early does stigma begin?

 Stigma effect:

- People who experienced the stigma?

- People who deliver the stigma?

How to talk to someone with depression (Mental Illness)  Put away your stigma from your heart, your brain, your eyes, gesture,  Just listen….  Tell him/her that you may not able to help him, but at least you are

wholeheartedly to listen  Being Here and Now when we talk with them

Depression and overcoming it  Obat (anti depressant)  Cognitive Behavior Therapy  Transpersonal Psychology

 Mindfulness Meditation

• Olahraga • Makan sehat (STOP PROCESSED FOOD) • Bermain dengan alam • Jadilah anak kecil kembali (here and now) • Try one-tasking

What to do if you have depression

What to do if you have depression/ you know someone with depression If you……………

If you know someone struggling



Seek out for help



Encourage them to seek help



Don’t afraid of stigma



Don’t judge them



Ask mental health professional



Approach them and make them feel comfort



Use the facility (Uni service, work service, BPJS)



Write down your emotion

What to do if you have depression UK 

Samaritan (116 123)



Child line (0800 1111)



HopeLine UK – 0800 068 4141



NHS



Police 999



Psychological consultation provided by University of Glasgow

Indonesia 

Pijarpsikologi.org



Relieve app (you can download on app store)



www.tanyapsikolog.com

Perasaan bersalah

Pundak kaku (2 tahun)

Sakit kepala (1 tahun) Radang Tenggorokan ( >> 4 Tahun)

Saya bangun tidur dan bertanya “Kenapa saya masih hidup?�

Maag Konstipasi (4 bulan)

Depresi dan saya

Tangan dan kaki berkeringat (12 tahun) Nangis malam hari (7 bulan)

Tidak bisa konsentrasi (4 bulan) Keringat dingin dan badan shaking (4 bulan)

Bunuh Diri

Saya tidak pantas hidup Saya tidak pantas punya teman

Saya benci segala hal tentang diri saya

Saya benci Fisik saya, mental saya yang lemah, hobi saya sampah, saya bego, saya gagal dalam segla hal

Semua orang benci saya Semuanya salah saya

I’m tired

Semoga pesawat ini kecelakaan

Oke, saya masih I’d better to have cancer hidup, saya harus melakukan apa?

I have depression but no one

What’s the point?

Untuk apa saya hidup?

understand

I have an illness but I have to hide it!

I have to educate others so they will understand! I’m Exhausted!!!!!!!!

Depresi dan saya

I have to do good things so everyone knows that I am not weak

Kenapa saya harus kena penyakit gak jelas ini?

Kenapa saya sedih karena hal sepele?

Saya lebih bermanfaat kalo bunuh diri atau tetap

Oke, saya ngecat tembok aja gak bisa, emang lebih panter mati

Saya berguna gak sih?

Saya cengeng, gampang nangis karena hal sepele. Emang dasar lemah, mati aja lu!

Anjir gw relapse lagi!

I just want everyone accept my vulnerability

I should stay alive 1.200 people have been using this website!

But other people will do it

I am tired being good

I need help as well!

But I’m tired!

Now I lost my interest BUT YOU DO SOMETHING ON YOUR OWN. Don’t compare yourself!

Regis, It’s only a part of depression symptom

 I just want to say that:  I am not weak, spoiled, or need of attention. And neither does everyone who

suffer from depression.  We can do something, we can be something. It just we have an illness

How to cope with your stress  1.

LOOK AROUND

Realizing the stressor ( + & -) “what’s make u happy/unhappy, comfortable/uncomfortable, pressure/no pressure?”

3. LOOK AFTER yourself • Emotional focus coping & problem focus coping • If the pressure is too much try to take a break.

• Do one thing at a time to clearing your mind  Regulate your emotion and BREATH (eat, exercise, doing your hobby, meditate, socialize, talk to your trusted person).

2. LOOK INWARDS Familiar with your own reaction “ what do my mental, body, emotion and behavior respond on it?” “ what is my automatic thought towards the stressor?”

Somehow, regulating your emotion could not solve your problem completely.

(Problem focus coping) • Evaluating your automatic thought towards the stress.

• Evaluating the future consequences (Is it rational? irrational?) collecting the evidences.

If irrational replace it slowly with the adaptive thought If rational  deal with it, one step at a time.

• BE NICE TO YOUR SELF. Treat yourself like the way you like other to treat you, with care and respect.

• ACCEPTING your strength and limits, good and bad.

It is SO OKAY to ASK FOR HELP But it is NOT OKAY to TELL OTHER FOR SOLVING YOUR PROBLEM • You can do it and so does people will support you 

You and your life is unique, important, beautiful, worth and contributed to many good things in this world  Keep being alive and happy in the right way  Your physical and mental health is your best investment for your present and future generation 

Thank you for being here and want to learn more about mental health and mental illness