There is a need for collective collaboration to detect, prevent and treat mental disorders in the country.

This was revealed during the 4th biennial Bhutan counselling conference, “counsellor education, supervision, training and certification” in Thimphu yesterday.

Psychiatrists said that some of the common mental disorders in Bhutan are depression, and anxiety disorders such as phobic, panic, dissociative, obsessive disorder, acute reaction to stress, post-traumatic stress disorder, somatoform disorder, mood disorder, psychosis, alcohol, and substance use disorder.

According to World Health Organisation (WHO), mental health is defined as a state of well-being in which an individual realises his/her own abilities and limits, can cope with the normal stresses of life, can work productively, and is able to make a contribution to the community.

Jigme Dorji Wangchuk National Referral Hospital’s (JDWNRH) senior psychiatrist, Dr Damber K Nirola, said that when people are not able to do those normal things, it would lead to mental illness. “Mental health requires a balance between the body, mind, spirit and the environment in which we live.”

He said people should know the basics about mental health much more than the advanced knowledge on mental illness. “Sometimes mind problems could give rise to physical problems and because many doctors are not sensitive about symptoms of mental illness, they may not be able to give proper diagnosis.”

Dr Nirola said that recurrent changes in thinking, feeling, memory, perceptions and judgment result in abnormalities in talk and behaviour, which can lead to disturbances in daily activities and relationship with others.

Common symptoms of mental illness include changes in bodily function such as sleep pattern, appetite, weight, bowel and bladder functions, sexual desire and activity, changes in mental functions such as appearance, behaviour, speech, emotion (feeling), perception, thinking, and changes in cognitive functioning such as level of consciousness, memory, attention and concentration, orientation to people, place and time, intelligence, and insight and judgement.

Dr Nirola said that seeking medical help, in Bhutanese context, is just going for physical symptoms and not mental symptoms. “You should feel your mental problem like any other illness and discuss it with health officials.”

He said that although there is no exact cause for mental illness, there are theories such as physical and psychological changes in the brain (genetic), environmental factors that can trigger mental illness, childhood experiences, social factors, individual factors, and chronic illness.

A psychiatrist who worked in Bhutan in various capacities, Dr Solveig Kolaas, said that medical professionals, counsellors, teachers, friends, relatives, musicians and artists are all needed to promote better mental health. “Social situation is important as people who live under difficult conditions are more vulnerable to develop mental illness.”

Karma Cheki