It’s common knowledge our society isn’t great with mental health. We don’t talk about it enough and invalidate those who are struggling. We often simplify mental health issues as personal weakness while ignoring complex factors which comprise mental well being. By focusing mental health awareness on illness or “weakness,” we are not adhering to scientific research which shows a complicated web of factors comprises mental health.
It’s interesting how many of our mental health “awareness raising” narratives relate to illnesses and chemical imbalances. Awareness raising campaigns often portray mental health as an individual medical problem. However, when we consider this on a societal level, it is hard to justify the idea that nearly everyone develops abnormal brain chemistry. We don’t have a collective wonky wiring making us all depressed or vulnerable to mental health issues.
Our personal challenges might be emotional bruises from our childhood circumstances, for example, poverty, trauma, bullying, instability, or learning difficulties. We may also face more recent challenges such as a lack of fulfilling friendships, stress, alcohol or drug dependency, debt, trauma, or tumultuous relationships. Indeed, some of our challenges might have followed us across the spectrum of life such as factors to include gender, race, sexuality, (dis)ability, emotional sensitivity levels, etc.
We know those of us who face greater life challenges are more likely to be at the sharp end of distress. To me, it’s not as simple as an individual medical problem or failing. The common “illness like any other” narrative simplifies a complex issue, suggesting some people are ill and others are simply not.
This narrative would be necessary, perhaps, if psychiatric diagnoses were reliable and clearly differentiated people with and without mental “illness.” This narrative might also be necessary if conditions of distress were proven biological illnesses, but they’re not. Mental health diagnostic criteria are subjective and culture-bound, there is no clear line between mentally “ill” and mentally “well.”
Depending on which mental health professional one sees, the kinds of questions which are asked, even factors such as one’s age or gender, one could get a very different diagnosis. For example, Borderline Personality Disorder is characteristically feminine. Many people cycle through a range of professional labels before finding one which fits their personal experience – often, a person adopts several diagnoses before finding their best fit.
Also, note how the presence of a “chemical imbalance” or any other biological test for that matter, is not a criterion for a mental health diagnosis. We cannot detect depression, developmental disorders, eating disorders, or “personality disorders” in a blood test, brain scan, or any other biological test. Indeed, science has not proven there is a chemical imbalance for many mental health diagnoses.
According to the British Psychological society, “Our experiences and distress are likely to arise out of a range of factors. The things that have happened to us, including influences on our development before, during and after birth, childhood and educational experiences, our current circumstances and responses, our brains and bodies, and how we make sense of our lives are all important… there is no firm evidence that mental distress is primarily caused by biochemical imbalances, genes, or something going wrong in the brain (with a few exceptions, such as dementia).”
Of course, we know taking medication can help some people feel better. But by promoting an “illness like any other” way of understanding mental health, we are suggesting distress should largely be treated as a physical illness, i.e. with biological treatments. However, medications have the best results when given to people with severe distress and for the shortest time needed, considering long-term medication often has serious side effects.
Many people find the illness narrative useful and validating. For some, it offers answers or proof their distress is valid and should be taken seriously. But, this is up to the individual who should have a choice as to whether or not to accept the medical “illness” metaphor of understanding or to seek alternative understandings about their distress.
This article is an evidence-based suggestion we, as a society, need to be more open to dialogues and alternatives when addressing mental health. We need to consider the full spectrum of understanding mental health and raise awareness of the multiplicity of factors supporting and hindering our well being. Only then can we be truly empowered to take control of our mental health – both as individuals and as a society.