How are you today?
We lost the game last night! Didn’t you watch the match last night? We were awful. So depressing!
How are you today?
Do I need a reason? If anything, I need a reason not to be depressed. It is all meaningless to me!
Depression is perhaps one of the most common yet misused mental healthy problems. It is a very good example of how terminological misuse can create confusion and suspicion about mental issues. The mind is a wonderful and a complex origin in our body. It does not just reside in the brain but in the entire body and all physical activities in the body impact on that mind, whether neurological, internal (e.g. blood content), or externally observable (e.g. muscles and bones).
Back to our examples above, there is a need to distinguish between mental health issues that can be classified as illness and mental health issues that can be solved by a good chat to a friend over a cup of coffee. In other words, there is clinical/chronic depression that has clear medically identifiable symptoms and may require the intervention of specialists and then there is depression. This is similar to personalities and personality disorder. There are difficult people with strange habits and attitudes but they are not ill, they do not have disorders, they are just difficult. We may be able to help them with advice, training or even mild talk therapies intervention. But mostly they need to help themselves.Then there are personalities disorder, some are the results of physical-neurological challenges whilst others are the product of years of abuse, bullying, neglect, etc.
Neglect is an important issue that should be addressed in mental health. If we take out the mental health issues associated with physical-neurological challenges, one can claim that all mental health issues are the results of snowballing from a much simpler difficulties. A cup of coffee and a chat with a friend can solve many of our mental worries. Children talk to their imaginary friends, women gossip, men pretend and boost, and we are all fine with our coping mechanisms relying to different degrees on our social networks whether family, colleagues, friends or the society at large, e.g. talking on strangers on public transport. The problems surface when these links are broken or underutilised. Then we need the shrink to practice with the simplest social function humans developed in their great evolution: talking!
Often the severity of the condition specifies if the mental issue is illness or just an issue. We accept that well in physical cases. You may have a headache that you treat with an aspirin and if it persists you would visit the doctor. If your headache leads you to loose control over your physical body, e.g. coma, intervention will be made on your behalf. It does not seem to be the case, however, with mental issues. We may laugh about being depressed if it is just a headache, and if we have healthy social and personal environment it will be resolved as if it did not exist. But then we are slow in facing up to the more sever cases that should be treated as an illness that does not distinguish between healthy and unhealthy, successful and unsuccessful persons. It can attach any person, and patients often suffer for years in silence specially if they are seemingly healthy and successful. Perhaps the problem is in the terminology itself. Whilst we distinguish between cold, flu, fever, etc., we seem to refer to all mental healthy problems as depression, sever depression, chronic depression, post-natal depression, etc. In the end it is depression. Which leads to the simple reaction of “you just have to get over it”! What if the depression is the result of shortage in a particular vitamin or serious changes in sugar levels in the blood? There is no getting over it here, there is a need for a treatment. Another term used often is anxiety. But there is a huge deference between anxiety as a healthy worries and anxiety as an illness paralysing the person. To be more precise, there is a difference between healthy worrying, which is the result of the survival instinct in us, and having a phobia. Once again terminology may lead to misunderstandings and wrongly estimating the impact of a condition. This in my opinion is a contributing factor to the stigma attached to mental health issues. Our lack of understanding of many of these conditions and our lack of expressing these conditions beyond the generic populist terms hinders our ability to understand, treat and participate in mental health research. Of course, the stigma associated with mental health varies in impact from developed countries, where gaining an employment may be difficult, to developing countries where mental illness could mean a death sentence.
So how about we stop talking about mental health issues and start talking about mental illness, psychological illness, and psychological well-being. How about if we classify depression to be a challenge to psychological well-being, which in many cases can be solved by a good holiday, but find a better way to describe chronic depression as an illness due to psychological or physical conditions. Equally, how about extending health and safety terms to include psychological well-being. Of course, for this to be possible, psychological research has to continue adopting a more systematic scientific approach and neurological research has to communicate its outcome better for easier mapping into medical and psychological studies.
Meanwhile, do something you are afraid of, contact a relative you have not spoken to in a while, resolve a difficult situation, or just break of the routine and give yourself few moments of freedom to breathe and think instead of operating on auto-pilot. After all, we go to the gym to maintain a healthy body so why not the mind?
Accept that and be grateful for c’est la vie.