Mental Health: It Isn’t All In Your Head

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Mental Health: It Isn’t All In Your Head

By Dr. Ben Lexau

When we think of “health,” we typically think of it in terms of the human body, meaning everything from the neck down. In particular, we think about how well or how poorly the body is functioning. When we say one’s health is “good” or “poor,” we’re usually alluding to physical and objectively measured qualities such as body weight, blood pressure, and heart rate.

“Mental health” is the common term used to describe the functioning of the human mind. In this context, the phrase refers to the nature of an individual’s subjective experiences such as thoughts and emotions. Without expounding on philosophical matters involving Descartes and Dualism, suffice it to say that the idea that mind and body are distinct entities is a very old and controversial one. Unfortunately, this has led to the common misconception that mental health problems are uniquely distinct from physical ones. The truth is: at the most fundamental level, our body and mind are inseparable

What causes mental health disorders?

Despite decades of research and studies, our understanding of how the brain truly works is still quite limited. Because of that, the causes of even the most common mental health conditions are not fully understood. However, most conditions are thought to result from a complex interaction of genetic and environmental influences. A person can inherit a certain vulnerability to a mental health disorder.  Whether or not that person develops the disorder will depend on many things, including developmental experiences, the quality of family relationships, social support, economic circumstances, etc.

Mental health disorders are not rare

Approximately 20% of the U.S. population currently lives with a mental health disorder and almost half of the population has suffered from a mental health disorder at some time in their lives. One of the most commonly diagnosed mental health disorders is Major Depressive Disorder. Anxiety disorders such as Phobias, Social Anxiety Disorder, and Generalized Anxiety Disorder are also among the most diagnosed conditions.

In my experience, mental health disorders are rarely clear-cut and straightforward. Diagnosis of mental illness can be difficult because it rests mostly on the subjective report of the affected individual. Individuals with mental health disorders may not be motivated or trusting enough to seek help, and they may not be open and honest about what they are feeling.  Social stigmas and pervasive myths about mental illness make it even more difficult for individuals to seek help.

Diagnosis is also difficult because it rests on judgments about what is “normal” and what is “abnormal.” These standards depend on the social norms of a given culture and the context of one’s environment. Having “visions” or hearing the voice of God may be considered a symptom of severe mental illness in the predominant culture but may be considered more normal among certain cultural groups. Paranoia is often considered a sign of severe mental illness, but some degree of paranoia is more normal and even beneficial for individuals living in unsafe environments (e.g. an abusive family or a violent neighborhood).

How can someone tell if they have a mental health condition vs. just temporarily “feeling low?”

This is a difficult question to answer by oneself and one reason to reach out to others or consult a professional. That said, you might ask yourself how persistent the problem is and how much it impairs your everyday life. Having a low or anxious mood that lasts no more than a day or so is not abnormal or harmful. Having a negative or anxious mood that lasts for days on end, and is accompanied by other problems like difficulty sleeping or concentrating on things, or that makes it difficult to work or get along with others is suggestive of a mental health disorder.

How to talk to someone if you think they’re suffering from a mental health disorder

Using “I” statements is a good way of communicating concerns without provoking a defensive response. Saying “you’re so angry all the time” may not be as effective as “it seems like you get upset more than usual. I’m worried. Is there anything wrong?” Be sure to only ask that last question. If the person you’re talking to feels attacked or judged, they’re less likely to open up. When in doubt: listen, listen, listen.

What to do if you feel like you might be a danger to yourself or someone else

This is an emergency and should be treated as such. Hospital emergency departments are prepared and capable of addressing this kind of emergency.

Emergency mental health services are sometimes available through a given county or city. Nationwide, there is a National Suicide Prevention Lifeline  1-800-273-8255 (273-“TALK).

What to do if you feel like someone might be a danger to themselves or someone else

When in doubt, call 911. If you’re able to remove yourself and anyone else who might be in danger from the situation without agitating the person in crisis, do that first and then call 911.

Treating mental health disorders depends on the person, not the disorder

Generally speaking, for most mental health disorders, some combination of medication and psychotherapy may be the most effective treatment.

I am a therapist by profession, so I am inclined to suggest talk therapy to people with mental health conditions. Talk therapy by itself can be very effective for many disorders. One particular kind of therapy, Cognitive-Behavioral Therapy (an approach that is focused on one’s beliefs, feelings, and actions), has been shown to be especially effective in the treatment of a wide variety of disorders.

Psychiatric medication can also, by itself, or in combination with psychotherapy, be very effective in the treatment of mental health conditions. Unfortunately, some individuals are reluctant to use psychiatric medications. They may be fearful of the stigma of mental illness itself or the perception that using a medication is an indication of personal weakness (as in, “I should be able to handle this myself!”). Generally, the more severe the symptoms, the more important it is to consider the use of medication.

Mental health can be nurtured just like physical health

Our mental health is optimal when we adhere to a healthy lifestyle. Eating nutritious meals, staying active, getting enough sleep, spending quality time with others, and balancing our work life and personal life are all factors that promote mental health.

Why is there still such a stigma around mental health?

The stigma surrounding mental health reflects our ignorance about mental health disorders. We tend to fear the unknown.

The stigma is also persistent because mental health goes to the heart of what we consider to be our individual identity. After all, who are we if we are not what we think and feel? Mental health is aligned with so many of the qualities by which we judge a person. This is especially apparent with more severe mental health problems such as schizophrenia or drug addiction. We might casually refer to an individual as “a schizophrenic” or “an addict” as though the disorder defines the entirety of who that person is. We would not likely use the same kind of label when talking about someone with cancer.

We’re experiencing a mental health crisis in the U.S

The prevalence of suicide in the U.S. is alarming. According to the Centers for Disease Control and Prevention (CDC), in 2018:

  • Suicide was the tenth leading cause of death in the United States, claiming the lives of over 48,000 people.
  • Suicide was the second leading cause of death among individuals between the ages of 10 and 34.
  • There were more than two and a half times as many suicides in the United States as there were homicides.

What is especially alarming is that suicide rates have steadily climbed over the past 20 years. From 1999 through 2018 the total suicide rate in the United States increased by 35% and there is no evidence to suggest the trend will not continue upwards.

At least in the midwestern United States, there is a shortage of psychiatric providers (psychiatrists and other medically trained mental health professionals who prescribe medication for mental illness). Because of this shortage, there can at times be long wait times for a first appointment and treatment can be delayed.

Changing the way we view mental health

People may not think of seeing their family physician or primary care provider for mental health disorders, but these professionals are trained and experienced in treating common mental health problems and they are often more available. A family physician can be an excellent resource for information about mental illnesses and mental health treatment.

Finally, our compassion, our ability to maintain an open mind, and our willingness to listen can be the most effective medicine for mental health problems. Talk to your family. Talk to your friends. Be honest. And be empathetic. We’ve all struggled with mental health to some degree and when we talk about it, we can remove the stigmas while helping each other heal—no prescription necessary.