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Mental health

We need to differentiate between mental health and mental illness

Over the past decade mental health awareness has exploded and this is absolutely fantastic! Everyone is more aware of their emotions, we’re talking about various illnesses more and people feel ok about saying their not ok. While we still have a long way to go, conversations are now popping up about whether we need to be more nuanced about our language; we’re questioning whether the language people are using now is helpful and indeed safe if it continues. I’ve previously written about this when thinking about normalising mental illness.

Let’s start with the basics!

Mental health is something everyone has, we all have emotions, we all have varying levels of resilience and we all have different coping mechanisms. Emotions occur as a reaction to events that happen around us. Emotions give us information, there is no such thing as a negative emotions; if I’m angry, irritated or frustrated about something, there’s usually a good reason and provided I act rationally around said thing, there’s no reason for said emotion to be seen as unreasonable or irrational.

For example, if I feel sad when someone dies, it tells me that person meant a lot to me; there’s no reason to consider that emotion bad—labelling it in that way has implications of needing to get rid of it but allowing my grief and sadness to be just that, is normal and natural. There’s no need to dwell or to move on until I’m ready but acceptance is key.

Learning to manage our emotions and being resilient to life events using health coping mechanisms are vital to maintaining good mental health. This may involve talking about how we’re feeling, when feeling sad, anxious or angry. Coping mechanisms could involve ensuring we get enough fresh air and exercise as well as a balanced diet (not thinking of foods as good vs bad).

As everyone’s unique, managing our mental health involve self awareness—how much alone time do I need? What does self care look like for me? What outlet do I need for my emotions? Who’s part of my support network?

Mental illness occurs when the brain (just like any other organ), isn’t able to function as it usual would. This means there’s an alterations in the way someone feels, thinks and/or behaves, since the brain manages these functions.

The problem

The difficulty with emotions/feelings and whether they’re used as helpful indicators or they impact us negatively is that this is subjective, we each have unique experiences and it’s no one’s place to judge another person. The difficulty with language is that medical labels also mean normal emotions. For example, when someone feels anxious (about a situations that would be anxiety provoking for most people), “I have anxiety” is now a standard phrase. This is having a number of knock on effects:

  • Those who could be managing a normal emotion think they’re trying to manage an illness/disorder and therefore approach their health with an unhealthy attitude; perhaps they think they need some specialist techniques or even medication when those things that keep us healthy everyday would be helpful.
  • People who have an anxiety disorder are less understood because inaccurate language is used to describe what it’s like to have anxiety as opposed to being anxious. Perhaps they’re therefore expected to manage their disorder without additional support.

This is also the case for depression. Instead of someone saying “I feel sad” or “I feel down” or even “I feel depressed” (all normal emotions); it’s common place for someone to say “I am depressed”. While this is helpful for reducing stigma, it’s not helpful to label a normal emotional reaction as an illness.

The problem amplified

Worryingly “(I’m not qualified but) I can cure your child of their ____________” adverts are popping up on social media fast. The latest company I’ve been discussing with my (qualified) counselling colleagues, claims all her coaches are qualified and talks about tackling anxiety with physiotherapy. She confuses having a degree with being qualified to work with unwell individuals and she talks about a revolutionary technique for tackling normal emotions. I wouldn’t have come straight out of medical school and set up a GP practice but this is what she’s doing. She’s learnt about healthy physiology and she thinks she can apply this across the board. This highlights the confusion.

One of the most important things I was taught at medical school was “know when you don’t know”. Unfortunately with the explosive nature of the mental health industry and the lack of regulation, anyone is now setting up business with limited knowledge because they have no idea what damage they can do.

Child and Adolescent Mental Health Services are over run at the moment. I’m not denying the mental illnesses are on the rise and this is very concerning. But we do also need to be aware that a lot that isn’t mental illness is being labelled mental illness. The stories of children and young people having to be at deaths door before they’ll be seen are horrendous. But how much of this is because too many assessments are being done on people who need basic education on how to cope with everyday life events?

Thinking differently

The Hearing Voices Network is an excellent example of people who’re working against the tide. While many would associate hearing voices and/or seeing visions as experiences that need psychiatric care i.e. “mental illness” there are people who manage their experiences well. They’re self aware and able to function while breaking down stigma and discrimination against people who have these experiences. Having worked extensively with people who hear voices etc, it don’t think I could have heard a more diverse set of experiences. Some were totally devastated by their psychotic symptoms, it was their identity, they were central to their lives and they needed fulltime support, while others (who had extensive symptoms) talked about their experiences in a totally different way.

Balance, accurate information and self awareness are key

So where do we go from here?!

While I wouldn’t want to stop wave of awareness that’s occurring, its important we only ever share accurate information. We must always fact check what we share. For example, a blog like this is an opinion piece and I hope people only ever take it as that. While you may know I have a) a medical degree b) extensive personal experience and c) fact check and extensively research everything I write about, I have not done blind trials on thousands of patients to gather scientific data. Do you know where the information you read/hear has come from? If it’s on social media is it fact or opinion? It may be presented as fact but could be pure opinion.

A lot of mental health awareness is now being delivered by schools and this is fantastic. They’re ideally positioned to positively impact our young people but they’re not health practitioners; we need to remember that they’re focusing on resilience and wellbeing.

As we grow, we all develop self awareness—sometimes this comes from the knocks that happen to us, sometimes we learn from making mistakes. Just moving through life (unless we have our eyes shut) we can’t help but learn and become better versions of ourselves. Asking for help is always a sign of strength. We don’t have to be ill to ask for help.

During my time as a mental health professional, I’ve supported many people struggling to function due to mental illness. I’ve also supported many people grappling with everyday issues as they don’t have the necessary resilience and are using maladaptive coping strategies. Different approaches are needed depending on the underlying causes as well as personal attitude/self-advocacy/personal agency and hopes and additional support.