Mind Matters | I’m not okay

I’m a 45-year-old man and a lot of people I know have told me to go see a psychiatrist. But I’m unable to accept that I have any psychological issues. Deep down, I know I do. I get irritated easily, sometimes I get anxiety and panic attacks making me lose control, and there are times when I assume that my family is out to get me even when all they want is for me to get better. But I’m scared of accepting that I might have depression or anxiety, or any other mental health issues. I fear going to the hospital, let alone getting treatment. This has made my family unstable too. They’re always on edge around me, since I have no control over my anger and I have a feeling that they would rather not have me around. It’s understandable. I want to get better but I don’t know where to start. Please help!—GP Answered by Dr Rishav Koirala, psychiatrist, and researcher Mental health issues have been stigmatized in Nepal and that might be one of the factors behind you not wanting to seek help. Many people have refrained from seeking help or accepting the fact that they need therapy. But the truth is seeking psychological help is nothing to be ashamed of. It’s the same as going to the hospital when you have some physical illness. 

People also believe that going to a psychiatrist and getting themselves diagnosed means that they will not get better. That’s not true at all. I suffered from depression a few years back and was under medication. Now, I don’t take any antidepressants and there are some non-pharmacological treatments I follow that help me keep my mental health in check.

The good thing is you are aware that you are suffering from mental health problems, although you are afraid of admitting it. I believe you’re scared of getting properly diagnosed since that will confirm the fact that you are having some mental health problems. But the thing is, they will exist despite you not receiving a proper diagnosis. I have some patients who think that they have depression only when they get a diagnosis from a doctor. But the problem exists with or without the diagnosis.  So isn’t it better to find out what the problem is and get the needed treatment, rather than be in denial? And wouldn’t it be nice to address it in an early stage where treatment will be less intense and medicines can be avoided?  Now, not every mental health problem needs medication. Sometimes it can be treated through non-medical approaches like therapy, exercise, yoga, and meditation. But to know what you need to do exactly, it’s important you visit a psychiatrist or any mental health professional to guide you through it.  Even if you have to take some medication, there are several options. Not everyone needs long term antidepressants and we keep in mind that you don’t suffer from side effects. There are myths regarding medications like drowsiness, weight gain, and having to take those medications for a long time. These are rare cases and if these happen, we address them. What I want you to do right now is look out for symptoms that indicate you need some mental health professional’s assistance.  If you think your current mental health status is hampering your social as well as work life, then that means you need to see a therapist or a psychiatrist. Also, from what you’ve said, you fear going to the hospital. That might be one of the symptoms of anxiety too. The feeling of being diagnosed might have made you more anxious about visiting the hospital.  Based on just the symptoms you have listed, I can’t say that you have a particular mental health issue with certainty, which is why you need to see a professional. They might start with medication, or you might have to go through some non-medical treatment like psychological therapy. But as long as you remain consistent and do as your mental health professional says, everything you’re going through can be treated and will get better.