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Mental distress

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Woman portraying the emotion of stress.

Mental distress or psychological distress encompasses the symptoms and experiences of a person's internal life that are commonly held to be troubling, confusing or out of the ordinary. Mental distress can potentially lead to a change of behavior, affect a person's emotions in a negative way, and affect their relationships with the people around them.[1]

Certain traumatic life experiences (such as bereavement, stress, lack of sleep, use of drugs, assault, abuse, or accidents such as the death of a loved one[2][which?]) can induce mental distress. Those who are members of vulnerable populations might experience discrimination that places them at increased risk for experiencing mental distress as well. This may be something which resolves without further medical intervention, though people who endure such symptoms longer term are more likely to be diagnosed with mental illness. This definition is not without controversy as some mental health practitioners would use the terms "mental distress" and "mental disorder" interchangeably.[3] Some users of mental health services prefer the term "mental distress" in describing their experience as they feel it better captures that sense of the unique and personal nature of their experience, while also making it easier to relate to, since everyone experiences distress at different times. The term also fits better with the social model of disability.

Differences from mental disorder

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Some psychiatrists may use these two terms "mental distress" and "mental disorder" interchangeably. However, it can be argued that there are fundamental variations between mental distress and mental disorder. "Mental distress" has a wider scope than the related term "mental illness", which refers to a specific set of medically defined conditions. A person in mental distress may exhibit some of the broader symptoms described in psychiatry, without actually being 'ill' in a medical sense.[4] People with mental distress may also exhibit temporary symptoms on a daily basis, while patients diagnosed with mental disorder may potentially have to be treated by a psychiatrist.

Types

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The following are types of major mental distress:[5]

Symptoms and causes

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The symptoms for mental distress include a wide range of physical to mental conditions.[7] Physical symptoms may include sleep disturbance, anorexia (lack of appetite), loss of menstruation for women, headaches, chronic pain, and fatigue. Mental conditions may include difficulty in anger management, compulsive/obsessive behavior, a significant change in social behavior, a diminished sexual desire, and mood swings.

Minor mental distress cases are caused by stress in daily problems, such as forgetting your car keys or being late for an event. However, the major types of mental distress described can be caused by other important factors. One such cause is chemical imbalances in the brain, which can lead to irrational decisions and emotional pain.[8] For example, when the brain lacks serotonin, a chemical that regulates the brain's functioning, it can lead to depression, appetite changes, aggression, and anxiety. Another cause of mental distress can be exposure to severely distressing life-threatening situations and experiences. A third cause, in very rare cases, can be inheritance. Some research has shown that very few people have the genetics for the potential to develop mental distress. However, there are many factors that must be accounted for. Mental distress is not a contagious disease that can be caught like the common cold. Mental distress is a psychological condition.[5]

In the United States

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African-Americans

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The social disparities associated with mental health in the Black community have remained constant over time. According to the Office of Minority Health, African Americans are 30% more likely than European Americans to report serious psychological distress. Moreover, Black people are more likely to have Major Depressive Disorder, and communicate higher instances of intense symptoms/disability.[9] For this reason, researchers have attempted to examine the sociological causes and systemic inequalities which contribute to these disparities in order to highlight issues for further investigation.[9][10][11][12][full citation needed][13][full citation needed] Nonetheless, much of the research on the mental well-being of Black people are unable to separate race, culture, socioeconomic status, ethnicity, or behavioural and biological factors.[11] According to Hunter and Schmidt (2010), there are three distinct beliefs embraced by Black people which speak to their socio-cultural experience in the United States: racism, stigma associated with mental illness, and the importance of physical health.[10] African Americans are less likely to report depression due to heavy social stigma within their community and culture.[14] These social aspects of mental health can generate distress. Therefore, discrimination within the healthcare community and larger society, attitudes related to mental health, and general physical health contribute to the mental well-being of Black people.[10]

There are also disparities with mental health among Black women. One of the reasons why Black women tend to neglect mental health support and treatment is the aura of the Strong Black Woman schema or S.B.W. According to Watson and Hunter, scholars have traced the origins of the S.B.W. race-gender schema to slavery and have suggested that the schema persist because of the struggles that African-American women continue to experience, such as financial hardship, racism, and sexism.[15] Watson and Hunter state that due to the Strong Black Woman schema, Black women have a tendency to handle tough and difficult situations alone.

African-American youth

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Comparable to their adult counterparts, Black adolescents experience mental health disparities. The primary reasons for this have been stipulated to be discrimination, inadequate treatment, and underutilization of mental health services, though Black youth have been shown to have higher self-esteem than their white counterparts.[16][17][18][19][full citation needed][20][full citation needed] Similarly, children of immigrants, or second-generation Americans, often encounter barriers to optimal mental well-being.[16][21][22][23][24][full citation needed][25][full citation needed] Discrimination and its effects on mental health are evident in adolescents' ability to achieve in school and overall self-esteem.[16] Researchers have been unable to pinpoint exact causes for Black teenagers' underutilization of mental health services. One study attributed it to using alternative methods of support instead of formal treatments.[17] Moreover, Black youth used other means of support such as peers and spiritual leaders.[17] This demonstrates that Black teens are uncomfortable disclosing personal matters to professionals. It is difficult to decipher if this is cultural or a youth-related issue, as most teens do not choose to access formal providers for their mental health needs.[26][full citation needed]

Common stigma among immigrants

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"Mental health stigma, particularly personal stigma, is important because those who hold stigma beliefs are less willing to obtain the needed treatment (1-9). Often due to stigma, individuals will avoid treatment until the disorder is nearly incapacitating. This avoidance is particularly pronounced in members of ethnic minority groups because they are less likely to seek mental health treatment than those of European Americans [e.g., Ref. (4, 10–12)].[27] Expressly, Immigrants who hold personal stigma against mental illness are less likely to seek treatment. Its often that immigrants feel stigmatized because they're already undocumented which makes them feel embarrassed, causing them to refrain from treatment.[27]

Demographic and societal factors

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There has been a history of disparity and exclusion in regards to the treatment of Black Americans which consists of slavery, imprisonment in the criminal justice system, the inability to vote, marry, attend school, or own property amongst other factors. These factors have attributed to the increase of mental distress in the Black community and due to the lack of resources afforded/known in the community also leads to a lack of resources and treatments available for members of the community to seek and receive some for of help.[28]

LGBTQ Community

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Those who identify as part of the LGBTQ community have a higher risk of experiencing mental distress, most likely as a result of continued discrimination and victimization. Members of this population are often confronted with derogatory and hateful comments (physically and/or through social media). This discrimination has the potential of affecting their feelings of self-worth and confidence, leading to anxiety, depression, and even suicidality. It is for this reason that members of the LGBTQ community may experience higher rates of mental distress than their cisgender and heterosexual counterparts. Along with the increased risk of experiencing mental distress, members of this community may refrain from seeking mental health care due to past discrimination by medical professionals. In addition to the lack of knowledge and research with this population, this group is marginalized due to the lack of funding as most of the funds go to campaigns for the younger LGBTQ population.[29]

A study published in 2021 found that "LGBTQ students experienced more bullying and psychological distress".[30]

References

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  1. ^ Medicine, Institute of; Health, Board on Neuroscience and Behavioral; Terrorism, Committee on Responding to the Psychological Consequences of (2003-08-26). Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy. National Academies Press. ISBN 978-0-309-16792-5.
  2. ^ Katherine M. Keyes; Charissa Pratt; Sandro Galea; Katie A. McLaughlin; Karestan C. Koenen; M. Katherine Shear (August 1, 2015). "The Burden of Loss: Unexpected death of a loved one and psychiatric disorders across the life course in a national study". American Journal of Psychiatry. 171 (8): 864–871. doi:10.1176/appi.ajp.2014.13081132. PMC 4119479. PMID 24832609.
  3. ^ Goldberg D (December 2000). "Distinguishing mental illness in primary care. Mental illness or mental distress?". BMJ. 321 (7273): 1412, author reply 1413. doi:10.1136/bmj.321.7273.1412. PMC 1119126. PMID 11187100.
  4. ^ "Mental Distress Changes". Changes.org.uk. Retrieved 2010-06-01.
  5. ^ a b "Mental Distress Information, Symptoms" (PDF). EthnoMed. Harborview Medical Center, Health Sciences Library, University of Washington. August 2003. Archived from the original (PDF) on 2014-06-11. Retrieved 2020-08-24.
  6. ^ Long PW (2019). "Bipolar I Disorder". Internet Mental Health. Archived from the original on 1 March 2020.
  7. ^ Bouchez C (1 January 2006). Chang L (ed.). "Emotional Distress Signs". WebMD.
  8. ^ "Social Anxiety, Chemical Imbalances, and Neural Pathways in the Brain". Social Anxiety Institute.
  9. ^ a b Shim RS, Compton MT, Rust G, Druss BG, Kaslow NJ (October 2009). "Race-ethnicity as a predictor of attitudes toward mental health treatment seeking". Psychiatric Services. 60 (10): 1336–1341. doi:10.1176/ps.2009.60.10.1336. PMC 4905699. PMID 19797373.
  10. ^ a b c Hunter LR, Schmidt NB (March 2010). "Anxiety psychopathology in African American adults: literature review and development of an empirically informed sociocultural model". Psychological Bulletin. 136 (2): 211–35. doi:10.1037/a0018133. PMID 20192561.
  11. ^ a b Griffith DM, Neighbors HW, Johnson J (January 2009). "Using national data sets to improve the health and mental health of Black Americans: challenges and opportunities". Cultural Diversity & Ethnic Minority Psychology. 15 (1): 86–95. doi:10.1037/a0013863. PMID 19209983.
  12. ^ Gonzalez et al., 2008
  13. ^ Levin, 2008
  14. ^ Borchard T (15 August 2011). "Black And Depressed: Overcoming The Stigma". The Huffington Post. Retrieved 2016-03-01.
  15. ^ Watson NN, Hunter CD (October 2015). "Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking". Cultural Diversity & Ethnic Minority Psychology. 21 (4): 604–612. doi:10.1037/cdp0000015. PMID 25602466.
  16. ^ a b c Seaton EK, Caldwell CH, Sellers RM, Jackson JS (September 2008). "The prevalence of perceived discrimination among African American and Caribbean Black youth". Developmental Psychology. 44 (5): 1288–1297. doi:10.1037/a0012747. PMC 2556985. PMID 18793063.
  17. ^ a b c Freedenthal S (February 2007). "Racial disparities in mental health service use by adolescents who thought about or attempted suicide". Suicide & Life-Threatening Behavior. 37 (1): 22–34. doi:10.1521/suli.2007.37.1.22. PMID 17397277.
  18. ^ Alexandre PK, Younis MZ, Martins SS, Richard P (2010). "Disparities in adequate mental health care for past-year major depressive episodes among white and non-white youth". Journal of Health Care Finance. 36 (3): 57–72. doi:10.7916/D8BK1994. PMID 22329331. S2CID 4669688.
  19. ^ Wu et al., 2010
  20. ^ Hughes, 1989
  21. ^ Rumbaut RG (December 1994). "The crucible within: Ethnic identity, self-esteem, and segmented assimilation among children of immigrants". International Migration Review. 28 (4): 748–794. doi:10.1177/019791839402800407. S2CID 143473035.
  22. ^ Dotterer AM, Lowe K (November 2015). "Perceived discrimination, parenting, and academic adjustment among racial/ethnic minority adolescents". Journal of Applied Developmental Psychology. 41: 71–77. doi:10.1016/j.appdev.2015.08.003.
  23. ^ Bridges AJ, de Arellano MA, Rheingold AA, Danielson CK, Silcott L (March 2010). "Trauma exposure, mental health, and service utilization rates among immigrant and United States-born Hispanic youth: Results from the Hispanic family study". Psychological Trauma: Theory, Research, Practice, and Policy. 2 (1): 40–48. doi:10.1037/a0019021.
  24. ^ Thomas et al., 2009
  25. ^ Nicolas et al., 2009
  26. ^ Silverman et al., 2001
  27. ^ a b DeFreitas SC, Crone T, DeLeon M, Ajayi A (February 2018). "Perceived and Personal Mental Health Stigma in Latino and African American College Students". Frontiers in Public Health. 6: 49. doi:10.3389/fpubh.2018.00049. PMC 5834514. PMID 29536000.
  28. ^ "Black & African American Communities and Mental Health". Mental Health America. Retrieved 19 February 2019.
  29. ^ Hoy-Ellis CP, Ator M, Kerr C, Milford J (2016). "Innovative Approaches Address Aging and Mental Health Needs in LGBTQ Communities". Generations (San Francisco, Calif.). 40 (2): 56–62. PMC 5375170. PMID 28366982.
  30. ^ Hobaica S, Kwon P, Reiter SR, Aguilar-Bonnette A, Scott WD, Wessel A, Strand PS (December 2021). "Bullying in schools and LGBTQ youth mental health: Relations with voting for Trump". Analyses of Social Issues and Public Policy. 21 (1): 960–679. doi:10.1111/asap.12258.

Further reading

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