Aspects of mental health care in a  gynecological setting

Aspects of mental health care in a gynecological setting

Aspects of mental health care in a gynecological setting

Psychological disorders are commonly associated with gynecological conditions, but are frequently undetected and untreated, and may influence the presentation and treatment outcomes of the physical condition. Some of the gynecologic conditions such as menopause, premenstrual syndrome, premenstrual dysphoric disorder, chronic pelvic pain, polycystic ovarian syndrome etc can be associated with an increased risk of psychological symptoms and disorders.

Anxiety and depression are common psychiatric conditions and are associated with significant morbidity. Gynecological conditions, by their nature, are likely to be accompanied by impairments in social, occupational and personal functioning. Greater emphasis should be placed on the mental health aspects of gynecological conditions.

Women present to gynecological clinics with a wide variety of physical conditions, ranging from bothersome premenstrual and menopausal symptoms, to incontinence and pelvic pain. It is well established that depression and anxiety occur more commonly in those with physical illness compared with healthy populations. 

Moreover, many gynecological conditions, by their nature, affect personal and intimate relationships, as well as social and professional roles, thus giving rise to a range of psychological issues, which, may in turn influence the presentation and outcomes of coexisting physical conditions. These relationships are complex, and involve the interplay of hormonal, social, cultural and individual psychological factors.

The gynecological setting provides an important opportunity for the detection and treatment of psychological issues. These can range from transient concerns to more serious symptoms of depression and anxiety, and depressive and anxiety disorders that meet specific diagnostic criteria. Yet, the psychological aspects of conditions presenting in the gynecological setting are somewhat neglected, resulting in relatively few studies that have examined the consequent mental health care needs of women attending gynecological clinics.

 

Psychosomatic Effects Caused by Unmanaged Emotions

Psychosomatic

Did you know that mental or emotional struggles can lead to physical issues? The more stressed or negative your thinking is, the more likely you will develop physical symptoms. This is referred to as psychosomatic. The word psychosomatic comes from two Greek words; psyche, meaning mind, and soma, meaning body. Therefore, a psychosomatic disorder is when emotions or psychological issues cause physical symptoms that typically can’t be explained medically. It can also be referred to as somatic symptom disorder, somatic symptoms, or somatic pain.

The worse a person manages emotions, the more severe the physical symptoms. Some studies state that when a person is anxious, depressed, or stressed, it can lead to increased nerve impulse activity, leading to physical problems. Some examples are when stress or burnout can cause back & neck pain, increased stomach acidity, high blood pressure, and more. 

 

Risk Factors

It is still unclear how psychosomatic symptoms occur physically. However, a few risk factors can increase the likelihood of developing the conditions. These include:

    • Genetics or biological: a person with a family history of an anxiety disorder or chronic & terminal illness can increase the chances of developing psychosomatic disorders
    • Age: symptoms typically are found more in individuals younger than 30
    • Gender: some studies show that women, especially younger, are more prone than men 
  • Personal History: a person with unresolved trauma is more likely to develop symptoms, especially in stressful or triggering situations 
  • Personality disorder: a person with mental or psychological conditions are highly sensitive to the emotional pain that can translate to physical pain 
  • Chaotic lifestyle: a person with a highly chaotic and unpredictable life can experience psychosomatic symptoms

Symptoms

Symptoms can appear as if nowhere and don’t usually leave evidence for medical experts to pinpoint the scientific/medical origin of cause. If you’re experiencing physical symptoms that aren’t related to any medical issue, you might have a psychosomatic disorder. These can include: 

  • Pain in the neck, back, head, or chest
  • Migraine
  • Fatigue
  • Organ issues such as issues with the stomach or breathing 
  • Insomnia 
  • Erectile dysfunction 
  • Eczema or skin rash 
  • Hypertension (high blood pressure)

Treatment

 A healthcare professional will perform multiple tests to rule out any medical conditions. Upon finding no link, s/he will refer a therapist for psychological concerns or causes. Treatment varies depending on the severity of the symptom. If the condition inhibits a person’s quality of life, the counselor could suggest Cognitive Behavioral Therapy (CBT), the most common type to treat psychosomatic disorders.

CBT is a therapeutic technique that helps identify and correct intrusive thoughts, unproven beliefs, and other behaviors that cause psychological burdens. It helps patients understand their thoughts and teaches them ways to problem-solve. CBT is used with meditation or mindful therapy to eliminate self-criticism, overthinking, negative thoughts, and severe mood swings. This can help patients change negative behaviors affecting their emotional and physical health.

It’s important to note that how we react to situations determines our quality of life. We can manage our emotions before they fester and turn into something serious that can seem like they’re out of our control. Practicing mindfulness (the ability to be fully aware of what’s happening in and around us) will help us keep our negative thoughts at bay and prevent us from developing physical symptoms. 

Legal measures on sexual assault

Sexual assault is perhaps the most widespread and socially tolerated of human rights violation, cutting across borders, race, class, ethnicity, and religion.

Following a rape or attempted sexual assault, the survivor is left in a state of crisis. Decisions are hard to make during this time, but the survivor needs to make some decisions which will affect possible prosecution. Survivors have the right to decide whether or not to report the assault to the police. However, if a survivor goes to the hospital, the medical staff are required to report the assault.

For a strong legal case, it is best to report the assault immediately and obtain medical attention for the gathering of evidence.

The survivor may be required to go through additional questioning with the police detective who will be handling the case. Since this is one of the most important phases of the investigation, it will be detailed and thorough. If there are bruises or other signs of attack that were not visible at the hospital, photographs may be taken at the police station. The survivor may also be asked to write out a report. This will include the survivor’s description of the incident and what happened before and after. The place where the incident took place, including the survivor’s home if that was the scene of the crime, may be searched and examined for fingerprints, stains, weapons, and other evidence. Do not touch or remove anything from the scene of the crime until this is done.

Compensation For Victims of Crime

According to Court of Claims of some Western countries, survivors may be eligible for Victim Compensation. To be eligible for compensation monies a crime must meet the following criteria:

  • The crime must have been reported to the police within 72 hours (or be able to show good cause for not doing so)
  • The Victim Compensation Claim Form must be filed within two years of the crime date

The availability of compensation money is limited to the following types of losses:

  • Allowable medical expenses and counseling fees;
  • Work loss as a result of the crime;
  • Any needed services loss (i.e. baby-sitting during court procedures or housekeeping assistance if injuries incapacitate the survivor).

Harassment, Assault, Consent, & Toxic Relationships + Mental Effects

Harassment

Harassment refers to when someone has an unpleasant behavior that can be physical or psychological through inappropriate remarks, sexual comments, or physical advances in different situations. The harasser can be male or female, although a male harasser is more common. The harasser can be a stranger, friend, family member, coworker, supervisor, co-worker, client, or customer. Sexual harassment can happen outside the workplace and work-related, such as in hotels, conference centers, nightclubs, and taxis. Sexual harassment can be verbal, non-verbal, or physical. 

For more info, please click Sexual Harassment – Letena Ethiopia

Mental Effect

Being continuously harassed can have a lasting impact on a person’s mental state, not only in the place of harassment but also in other areas. Some of the psychological struggles a harassed person goes through include: 

  • Depression
  • Self-doubt and blame
  • Low self-esteem
  • Feeling powerless
  • Anxiety
  • Insomnia (inability to sleep) and, nightmares 
  • Post-traumatic stress disorder (PTSD)

In addition to internal mental struggle, a person might also deal with the backlash from coworkers or others through gossip, false perceptions, judgment, disbelief, and more. This is especially the case when the harasser is a beloved or respected figure, and the general public won’t accept the victim’s story. Some victims might feel confused, scared, or lonely, while others feel upset and disappointed in those who support the harasser. If a victim is in this situation, one of the best ways to help themselves is to leave this environment or minimize contact and seek help or comfort, either from a loved one or a licensed therapist. 

Assault

Assault is also referred to as sexual abuse or violence, it occurs when you don’t consent to any type of sexual activity, but the other person isn’t willing to stop. It is any sexual activity or attention from one person that is unwelcome by the other. This includes rape, revealing (naked) themselves to you, or making you see sexual images. Sexual assault is committed by anyone but is usually by someone familiar, like a friend, coworker, partner, relative, etc. Legal definitions of sexual assault differ from country to country so make sure you know the details in your country of residence. Sexual assault can be verbal, visual, or physical.

For more info, please click Sexual Assault – Letena Ethiopia

 

Mental Effects

In some cases, women don’t ever speak up about their experiences for fear of being judged, not believed, shamed, or outcasted. They continue their lives as if nothing happened, but in fact, it’s affecting their mental state in the way they think about the person who assaulted them or anyone who merely resembles them, their views of their surrounding, thoughts on safety, and many more. This can become a severe trauma or mental issue if not properly addressed. In some sexual assault cases, victims might change how they look and act out of fear of not wanting to experience the assault again. Some might even go as far as blaming themselves for the situation, which is false. Victims have a range of mental struggles they go through, such as: 

  • Depression
  • Anxiety
  • Chronis stress
  • PTSD and flashbacks
  • Issues sleeping such as constant nightmares
  • Eating disorders, eating too much or too little
  • Substance abuse
  • Self-harm
  • Shame and guilt
  • Isolation
  • Self-doubt and blame 

There have been multiple reports and evidence that sexual assault isn’t based on how a person dresses. Women have long been taught that dressing a certain way will earn them ‘respect’ or help them avoid being sexually assaulted. Arguments are arising that the attackers are the ones who need to change their way of thinking because it doesn’t matter what a woman is wearing. If the assaulter wants to attack, they will go despite the woman’s clothing. It is up to society to clearly state what’s right and wrong from a young age, avoiding any need for assault. To enforce the laws on assault and punish the attackers. To create a safe environment for women to speak up and more.  

 

Informed Consent

Informed consent is when someone asks for permission to do something or for something to happen with a complete understanding of all the necessary outcomes or risks. This refers to various situations in your life, such as romantic relationships, family relationships, medical care, legal issues, and more. If someone acts in a certain way that the other person has given consent to could lead to legal implications or injuries (for medical consent). Consent is invalid if the giver isn’t informed about all the details and later suffers from the consequences. 

For more info, please click Informed Consent – Letena Ethiopia

 

Mental Effects

When someone violets a person’s boundaries, it causes several emotions that can develop into short and long-term issues such as:

  • Lack of trust
  • Lowered self-esteem
  • Pessimism 
  • Depression
  • Relationship issues
  • Self-doubt

It is essential to understand that the “yes” cannot be coerced. It has to be willingly given without doubts and can be reversible. In addition, the person giving the consent needs to understand fully what they are consenting to. 

 

Toxic Relationships

A toxic relationship is when people don’t communicate healthily, creating a pattern of negativity and resulting in constant conflict. This can include romantic partners, family members, friends, colleagues, or school peers. Toxic relationships don’t always begin so severely. Sometimes, the first few months or weeks can be delightful and exciting, but the toxic traits emerge through time. A toxic person is someone whose actions and words aggravate your life and make you question yourself negatively. 

Most of the time, toxic people are the way they are due to their internal struggles and the type of life they had growing up. They aren’t willing to deal with their traumas, maybe aren’t even aware of it, and therefore project all their pain and anger onto others. Toxic people might not be bad people; they can also be people who didn’t learn to deal with their issues healthily. These traumas develop over time and can lead to mental or personality disorders such as narcissists, compulsive liars, sociopaths, manipulators, victim mentality (constant self-pity and helplessness), and more.

 

Signs of a toxic person include:

Inconsistent: don’t follow through on commitments, and unpredictable

Constant takers: always need something from you that they can’t or won’t reciprocate

Attracted to drama: thrive in adverse or dramatic circumstances, create or worsen conflict

Self-absorption: have an overly elevated sense of self-interest, need to display or explain their greatness, constantly need to receive affirmations

Self-pity: always believing they’re helpless, require assistance from others when they don’t, guilt others into feeling sorry for them

Disrespect: will cross boundaries for as long as they can, will verbally put you down, some cases physical abuse as well

Manipulate: deceitful, constantly lying, twisting the truth (to get pity as well), exaggerating, leaving certain information out, and whatever it takes to get what they want and do not consider the hurt they’re causing others

Substance abuse: turn to alcohol or drugs to avoid difficult situations, which can lead to harming themselves and others 

Toxic relationships give way to disrespect and emotional & physical abuse and can be very draining for those involved and people witnessing it. Unresolved issues in the relationship and personal problems can lead to a dangerous buildup of aggression and rage. It can turn into emotional abuse that can escalate to physical abuse. 

Emotional abuse can manifest in many ways. One common way is when one person has power or control over the other and gives out psychological and verbal abuse. It can include aggressive verbal communication, threats, silent treatment, gaslighting (tricking you into making you question your memory, perception, or judgment), and isolation from others. 

The impacts of a toxic relationship could include:

  • Feeling mentally exhausted 
  • Isolation
  • Stress, depression, and anxiety
  • PTSD
  • Self-harm
  • Sleep and weight changes
  • Poor performance at work or school
  • Poor communication with others
  • Emotional instability
  • Short temper
  • Negative self-talk
  • Low self-confidence and self-worth
  • Developing trust issues
  • Being pessimistic

Dealing with toxic people

When dealing with a toxic person it is essential to understand the following points: 

Identify the actual reality: sometimes people get absorbed in the toxic person’s reality and not realize the manipulation, such as with victim mentality. You must resist the urge to defend yourself if the toxic person blames you for something you know isn’t true. This will only play into their cause and validate or encourage them to continue to loop you into their trap.

Pay attention to facts: being aware of the situation or the person you’re dealing with can save you a lot of struggle, frustration, and confusion. Instead of getting involved in unnecessary drama & arguments, you will be able to separate their or your emotions from facts and allow you to make sound decisions. 

Recognize conditional kindness: sometimes, a toxic person will be very welcoming when they want something and then be the opposite when they don’t get it. For some, this might be confusing and can lead them to blame themselves as if they’ve caused the toxic person before they’re aware of the toxic traits due to a specific action. 

Give straight answers: when confronted by a toxic person, always remember to stick to facts and give straight answers. In addition, focus on the solution, not problems, which is usually what the toxic person tends to concentrate on to deflect blame. 

If you are in a toxic relationship and the person isn’t willing to fix it by admitting faults and contributing solutions, it’s better to end the relationship. You should always check your mental and emotional state to help you understand the healthiness of your relationship. Having someone you trust to help you assess your situation is essential. No relationship is perfect, but it is crucial to know the signs of toxic relationships to avoid the pain and suffering of being in and out of them. Set boundaries and know what you will and won’t deal with. It is essential to care for your mind to be aware of the signs. 

Unstable Parenting and Its Effects on Children’s Growth and Development

Children’s early experiences shape who they really are.  Their early life experiences have an effect on their health and learning abilities.

To develop to their full potential, children need safe and stable housing, adequate and nutritious food, access to medical care, secure relationships with adult caregivers, nurturing and responsive parenting, and high-quality learning opportunities at home, in child care settings, and in school. 

Children thrive in stable and nurturing environments where they have a routine and know what to expect. Although some change in children’s lives is normal and anticipated, sudden and dramatic disruptions can be extremely stressful and affect children’s feeling of security.

Common types of instability

-Economic Instability: a drop in family income from which families may or may not recover from

-Employment Instability

-Family Instability

-Residential Instability

Effects of instability in a child’s development 

 In addition to the social and emotional outcomes, some evidence suggests that children’s language and cognitive development may also be compromised by child care instability. 

Among young infants, certain forms of unstable child care are associated with poorer language development at 15 months of age.

There is less evidence of an impact of child care instability at later ages, and limited research explores instability among older school-age children. These findings highlight the urgency of identifying effective strategies for promoting the stability and continuity of care for young children.

  

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