Армен Мурадян - Male’s Health in the Objective of Stressology – Beyond the Usual

Today we can speak of a new trend in health care, the trend of studying the role of psyche and brain in human health and illness.

In regulations, programs, and in general it has become popular to talk not only about the bodily but also about the mental health. Behind the facade of popular terms, there is no common understanding of “what the mental health is”. Often, the activity of reforms is reduced to the replacement of just a name, for example, “Center for Mental Health” instead of “Psychiatric Hospital”. As a result the accumulated problems of mental health are not solved, but on the contrary become veiled and deeper, not removing stigma, not improving the state of patients with mental problems, moreover not improving their health. The problem of health and illness, norm and pathology is complicated; their boundaries are relative and depend on many factors and reasons. This is the consequence of the complexity of the very object of study – psyche, its characteristics and properties, criteria to be guided to determine “mental health”.

Study of the population of practically healthy people showed that about 50 % of adults had one or more symptoms of mental register manifested in the form of anxiety, irritability, constant strain, alarm, chronic fatigue, asthenia, insomnia, bad mood. The majority of these people did not apply to a specialist: 71 % – did not undertake whatsoever, 1 % – shared their fears with friends or relatives and only 17 % applied to a doctor. Early symptoms are not well pronounced because more frequently they are connected with deadaptation, functional by their nature and do not much worry a person, his environment and doctors. This is the first level of change in mental health, which should be the object of great attention of primary care doctors. Being in the very focus of attention, these states when timely diagnosed and correctly handled, are reversible.

The following characteristics are distinguished in mental health:

• the field of mental health;

• boundaries of mental health;

• quality of human life.

The field of mental health implies the sphere and range of person’s activity in which individual is adapted. It is enlarged or narrowed depending on the society’s requirements, in other words, the field of mental health due to the specificity of psyche and its laws does not have unique determination. Therefore it is important to specify the concept “Mental health” and define its levels. The boundaries of mental health are the “limits” of acceptable behavior in the society. The boundaries of mental health were historically correlated with the ruling basic vision of religion, philosophy, politics. Today the term “ Quality of life ” is widely used. It is characterized by valuation standards adopted by the person for himself. Each person has his own life model that meets his and accepted by the society standards. One is quite satisfied with his domestic needs, interests – to be pleased with life or to consider that he lives full-value life. For the other one it is important to have everything that symbolizes prosperity accepted in the given society. The other seeks to know the world and himself; somebody else lives in the world of illusions. Therefore, the life quality has flexible standards for different people, different societies, different ages and generations. Based on the standards of living before and after illness, personal field of mental health is outlined. Mental health and its disorders can be presented by several levels, definition of which is based on the priority and degree of involvement of brain matter, psyche or personality in the process.

The lower fundamental level – the level of psycho-physiology is determined by peculiarities of the internal cerebral neurophysiological organization of psychic activity. The necessary condition for healthy psyche is safety of the brain as the organ, normal functioning of all blocks (human perception of senses, thinking, memory, emotions, mentality). This level is found in any organic brain diseases (tumors, stroke, atherosclerosis, trauma).

The second level of mental health disorders is the adaptation level . Disorders of this level are the largest and diverse group and make the layer that is to be regarded as true disorders of mental health. Disorders of this level are described as borderline states, anxiety disorders, post-stress disorders, psychosomatic, neurotic. They reflect temporary reduction of human ability to self-actualize, adapt, decrease stress resistance, social competence, purposeful activity. Human character traits are inevitably sharpened and manifested in the activity. The whole “psychic discomfort” is accompanied with somatic troubles (dynamic arterial hypertension, pain syndromes – more often in back, headaches, insomnia, itch, lack of air, vegetovascular dystonia, enteric manifestations, etc.).

The third, highest level is the level of personal mental health, which is determined by the quality of human semantic relations, hierarchy of his sense orientations to the world, himself and his place in it. Personally mentally healthy person is the one who is able to accept the reality as it is (illness, loss); able to overcome traumas of the past, and remembering them able to search for his new true place in the life and in the world. The one, who is able to reassess values, be aware of their unique vital meaning, to overcome himself and external obstacles while realizing new meanings and values.

Personal health is a result of sometimes painful search for new himself. History knows many names of famous persons who had this or that mental illness that did not prevent them to adapt socially, realize their purposes and live full, rich life. Remember Caesar’s, Napoleon’s, Dostoevsky’s epilepsy; Darwin’s psychasthenia; Freud’s and Zoschenko’s depressions. People having certain mental disorders, and even diseases, not to mention bodily problems, somatic diseases, can be personality healthy. Often there are people with certain health problems but in the personality aspect, they prove to be healthier than any other one who, according to WHO definition, has “Absolute health”. The human in his body image is one with spiritual and mental “I”. Therefore violation in any sphere necessarily entails violations in others that are frequently of compensatory or protective nature, e.g. rise of temperature due to infection. In medicine clarification of the primary and secondary role of the factor in cause-and-effect relations is the basis for the adequate therapeutic approach and favorable outcome, hence is the presence of the etiopathogenetic and symptomatic treatment. Often it is difficult to determine the precise feature based on which it is possible to talk about mental illness. So any doctor must have at least minimum knowledge in the field of psychology, its laws, their standard functioning; know regularities of transition states manifested by deadaptation situations, mechanisms of psychological protection. All these issues are successfully solved by a new direction in medicine – stressology. “Mental health” should be understood as the state of person able to correctly (adequately) reflect the outside world, set a goal, plan and fulfill adopted decisions, enjoy lively and adequate emotions, able to overcome conflicts, tension and preserve a certain degree of stress resistance. Mentally healthy person has enough secure instinct of self-preservation of bodily, mental and social “I”.

There are three types of social impacts affecting the state of health.

The first type is historical influence that affects the whole generation. Thus, men whose early childhood fell on the years of the “Great Depression” in the United States throughout their lives showed the difficulties of social adaptation. The whole generation of the former USSR who experienced the “37 thyear” revealed difficulties of adaptation; the males of Armenia whose childhood and youth concurred with crisis years of the end of XX – beginning of XXI century are still experiencing adaptation difficulties.