There can sometimes be a chasm between the medical and the psychotherapeutic models of health. In the former, external interventions, such as drugs, are used to relieve and/or cure symptoms. In the latter, the human condition is accepted as fallible, and it is considered normal for the complexities of life to become overwhelming at times.
In psychotherapy the patient has to play a central and active role in their recovery, but within the context of a working and trusting partnership over time. The work involves addressing the whole person, and certain physical symptoms can be seen as clues to begin to understand what might be troubling that person at a deeper level.
In some cases the neuro-chemical levels (eg serotonin) in the brain may need re-adjusting with medication. Drugs can help a person to gain enough mental strength to get to therapy in the first instance and begin to talk about their feelings.
Breaking down some mental health myths
With psychological health issues, the patient has to be able to admit that there is a problem in their life or circumstances, and have a willingness to allow for change. The acceptance that one is vulnerable requires courage. Paradoxically, it is a sign of strength and health.
It is not always helpful to label a person, as if they have taken on a new identity (“the anorexic” or “the alcoholic”); this can also obscure that person’s abilities, strengths and wider interests or ambitions. In some severe cases, it is helpful to say that a person has a mental illness. However, quite often it can be more constructive to view psychological difficulties as a phase during which any of one of us can find the complexities of life overwhelming. Such phases are often vital in helping us learn new and valuable information about ourselves and our lives.
Almost everyone has been in a bad place at some time
Vulnerability is not a weakness but a strength, because it is an important and healthy facet of the human condition
Asking for help is a sign of strength and health
Talking gets you support and treatment
Stigma around mental health
People with mental health conditions are often discriminated against and the stigma will often impede people from asking for help and getting the treatment they need.
Sometimes people are afraid that those with a mental health disorder will be violent or dangerous, but they are far more likely to hurt themselves than others. Stereotypes are often developed in the media by linking violence and criminality with mental illness.
Our society can often portray very limited definitions of health, normality and success, all of which create psychological pressures that can be difficult to navigate. For example:
Material wealth is more valuable than wellbeing and happiness
Women should be thin
Boys shouldn’t cry
Vulnerability is a weakness
Reflection and contemplation is less valuable than productivity
We are encouraged to make more money, spend more and consume more
It is not commonplace to discuss our inner lives
Ignorance, lack of information and lack of understanding all lead to fear and prejudice. It is natural to be afraid of what we don’t know. When we have a psychological difficulty, it would seem that we can easily feel at fault, as if somehow we have caused it to happen willingly; whereas if we get cancer or break a leg we do not feel to blame – it’s something that happens to us.
Very few people ever consciously choose to have a mental health problem, and most people would prefer to overcome it if they could. But the stigma, and some of the values in our culture, make it difficult for people to admit there is a problem, which only makes it worse. It can also be a shock to begin to understand that our unconscious mind (eg. the feelings that we may have had to repress; or the patterns of coping or relating to others which we learned as a child) can have such a powerful affect on our life and behaviour. We are not responsible for what is in our unconscious but finding the courage to be open and really learn about ourselves is the ultimate act of responsibility.
Definition of mental health and illness (taken from the World Health Organisation website)
The WHO defines mental health as “a state of well-being in which the individual realizes his/her abilities, can cope with the normal stresses of life, can work productively and can contribute to their community”. (I would add “can maintain relationships”). It’s about being good enough, rather than being perfect!
Mental disorders are defined in a social and historical context, so perception of them changes over time and across cultures. Over a third of people across the globe report problems at some time in their life that will meet the criteria for a common mental disorder.
July 2013, for BBC Wilshire series on mental health
The following information is taken from the Mind website – http://www.mind.org.uk
Common diagnoses of mental health issues
Depression lowers your mood, and can make you feel hopeless, worthless, unmotivated and exhausted. It can affect sleep, appetite, libido and self-esteem. It can also interfere with daily activities and, sometimes, your physical health. This may set off a vicious cycle, because the worse you feel, the more depressed you are likely to get. Depression can be experienced at different levels e.g. mild or severe, and can be related to certain experiences; for example, postnatal depression occurs after childbirth. Depression is often associated with anxiety.
Anxiety can mean constant and unrealistic worry about any aspect of daily life. It may cause restlessness, sleeping problems and possibly physical symptoms; for example, an increased heart beat, stomach upset, muscle tension or feeling shaky. If you are highly anxious you may also develop related problems, such as panic attacks, a phobia or obsessive compulsive disorder.
Obsessive-compulsive disorder (OCD) has two main parts: obsessions and compulsions. Obsessions are unwelcome thoughts, ideas or urges that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or worrying that you haven’t turned off the oven. Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or washing your hands a set number of times.
A fear becomes a phobia when you have an exaggerated or unrealistic sense of danger about a situation or object. You will often begin to organise your life around avoiding the thing that you fear. The symptoms of phobias are similar to anxiety, and in severe forms you might experience panic attacks.
Bipolar disorder (formerly known as manic depression)
If you have bipolar disorder you will experience swings in mood. During ‘manic’ episodes, you are likely to display overactive excited behaviour. At other times, you may go through long periods of being very depressed. There are different types of bipolar disorder which depend on how often these swings in mood occur and how severe they are.
Schizophrenia is a controversial diagnosis. Symptoms may include confused or jumbled thoughts, hearing voices and seeing and believing things that other people don’t share. If you have these symptoms you might also become confused and withdrawn. There is debate about whether schizophrenia is actually one condition or more a collection of symptoms that are not clearly related.
Generally speaking, personality doesn’t change very much. Yet it does develop as people go through different experiences in life, and as their circumstances change. If you have a personality disorder, you are likely to find it more difficult to change your patterns of thinking, feeling and behaving, and will have a more limited range of emotions, attitudes and behaviours with which to cope with everyday life.
Eating disorders can be characterised by eating too much, or by eating too little. If you have an eating disorder you may deny yourself anything to eat, even when you are very hungry, or you may eat constantly, or binge. The subject of food, and how much you weigh, is likely to be on your mind all the time. Your eating disorder is likely to develop as a result of deeper issues in your life and is possibly a way of disguising emotional pain. Anorexia, bulimia, bingeing and compulsive eating are some of the most common eating disorders.
In addition to the more formal diagnoses above, there are some behaviours and feelings which are strongly associated with mental health problems.
Self-harm is a way of expressing very deep distress. You may not know why you self-harm, but it can be a means of communicating what you can’t put into words, or even into thoughts, and has been described as an ‘inner scream’. After self-harming, you may feel better able to cope with life again, for a while, but the cause of your distress is unlikely to have gone away.
It is common to have suicidal thoughts if you are experiencing mental health problems – especially if you have a diagnosis of depression, borderline personality disorder or schizophrenia. The deeper your depression, the more likely it is that you will consider killing yourself. However, you can help yourself and you can get help from other people. A great many people think about suicide, but the majority do not go on to kill themselves.
These are sudden, unexpected bouts of intense terror. If you experience an attack you may find it hard to breathe, and feel your heart beating hard. You may have a choking sensation, chest pain, begin to tremble or feel faint. It’s easy to mistake these for the signs of a heart attack or other serious medical problem. Panic attacks can occur at any time, and this is what distinguishes them from a natural response to real danger.