Greater Care Needed to Improve Mental Health

Professor Tahmina Akhter

The time after the age of 40 is a very important stage in a person’s life. Maturity, work duties, family commitments, social ties and personal achievements grow in this period. At the same time, many changes can appear in body, mind and social life. Duties at work may grow, children may need more attention, and people must care for elderly parents. Relationships change, money pressure continues, and worry about one’s own health and future also grows.

At this stage we usually pay more attention to physical health. We watch blood pressure, blood sugar, cholesterol and other physical conditions. But we often do not give the same weight to mental wellbeing, though mental health is an inseparable part of overall health. How we work, make decisions, keep relationships, take part in society and face daily challenges all link deeply to mental health. This idea also fits the constitutional view of Bangladesh. Article 15 of the constitution recognises the basic needs of citizens, medical care and social security in illness, disability and old age as the duty of the state.

Likewise, Article 18 names the improvement of public health as one of the state’s main duties. So we must see mental wellbeing not only as a personal matter but also as an important part of public health and social development. The biopsychosocial model helps us understand this in particular. By this model, mental wellbeing in middle age grows from the mutual effect of biological, psychological and social factors. Changes with age, hormone changes, physical illness and sleep problems matter. Stress, emotions, family relations, employment, financial security, social support and taking part in the community matter just as much.

For women, the period of moving into menopause in middle age can be an extra important stage. Along with hormone changes, sleep problems, anxiety, mood swings, lack of focus and changes in memory may appear. Many women describe forgetfulness, tiredness or trouble holding attention. This is often formally called “brain fog”. These changes can also affect anxiety, relationships, social life and working life. But we should neither exaggerate them nor ignore them. Not all women go through the same experience. We should also not see normal changes of middle age as illness by default.

The most important things here are awareness, spotting changes early and getting help in time when needed. Mental wellbeing does not only mean having no depression, anxiety or dementia. It also includes keeping meaningful relationships, being able to decide, adjusting to change, feeling a purpose in life, staying socially active and being able to contribute to family and society. Bangladesh’s Mental Health Act, 2018 also reflects this wide view. This law replaced the colonial era Lunacy Act of 1912.

The Act puts weight on treatment, dignity, rehabilitation, property rights and the overall welfare of people with mental health problems. So it is not enough to see mental health only as a medical issue. It is also closely linked to dignity, rights, inclusion and quality of life. Another key part of healthy ageing is social connection. People do not age alone. Family ties, friendships, community networks, volunteer work and social participation affect our emotional and intellectual wellbeing.

Joining different kinds of organisations widens the circle of social contact. Such groups give people chances for contact, participation, friendship, service, mutual help and a sense of belonging. These can become an important protection for mental wellbeing later in life. Families also need to be sensitive. Suppose a person slowly withdraws, forgets more, or becomes anxious, irritable or lacking in confidence. Criticism often makes the problem worse. In many cases, before treatment, a person needs careful listening, reassurance, respect and an effort to understand.

Many changes in body, mind, social and family life can appear after the age of 40. Some people feel success and satisfaction in their careers at this time. Others face stress, anxiety, depression, changes in memory or worry about the future. But it is not right to think that mental health will go bad once a person passes 40. Many people become more mature, confident, experienced and skilled at controlling emotions at this age.

At this age, stress and anxiety can come from family, the workplace, financial security, children’s future and the duty to care for elderly parents. A working woman may get no time for herself while handling family, job and social duties. So her anxiety, tiredness and irritation may grow. She keeps meeting family, professional and social duties and cannot look at herself at all. She has no time to relax or to understand herself.

Children expect her to do all the household duties. The father goes out to earn money. She must serve her husband, care for elderly parents and in laws and handle relatives. On top of this, she has her professional duties. This unequal gender role is strong in Bangladeshi society. As a result, women’s depression, anxiety, social pressure and tendency toward suicide are double those of men.

There are eight ways to keep mental health good after the age of 40. Walk or do other exercise according to your health and ability. Seven to nine hours of sleep at night helps most adults. Read books, write, learn a language, study or practise a new skill. Keep meaningful contact with family, friends and colleagues. Spend some time every day on rest, prayer or meditation, hobbies or things that bring joy.

Instead of taking all duties alone, take help from others when needed. Break big goals into small steps and check your own progress. If mental problems last long, take help from a psychologist, counsellor or doctor. Professional social workers and clinical social workers also play an important role in mental health at the community level.

Get a professional assessment if low mood, anxiety, sleep problems, loss of interest in work or trouble focusing lasts about two weeks or more. Do the same if these problems disturb daily life. Take new memory problems, or memory problems that keep growing, seriously too. Seek help if you notice odd behaviour or thinking, odd emotions, disruption in work, profession or academic work, gradual withdrawal, or a clear difference from the behaviour of ordinary people.

There are practical ways to protect mental and intellectual wellbeing throughout adult life. Regular physical activity, enough sleep, a balanced diet, mental activity, meaningful social ties and proper care of physical illness all play an important part. Reading, learning new things, exchanging views, storytelling, various games, volunteer work and staying active in community life keep our mind and social identity active. We must also know when to seek professional help for mental wellbeing.

Do not ignore long lasting mental pain, anxiety, loss of interest, serious sleep problems, social withdrawal, big changes in behaviour, or memory and focus problems that affect daily tasks. Not every memory problem is a sign of dementia. Some emotional problems can also affect focus and memory. So a correct assessment is very important.

Author: Vice Chancellor, Rabindra University