Mental Health in a nutshell (part 1)

Like with everything else – there is more than one definition of mental health. According to the World Health Organization (2018) mental health is more than the absence of mental disorders. It is a state of wellbeing in which individuals realize their abilities, cope with normal stresses of life, work productively and fruitfully, and make contributions to their community. They feel content and fulfilled. In an ideal world, everybody would follow this script. I wish we lived in an ideal world. We – humans - don’t live in an ideal world. There is an enormous amount of challenges each person has to encounter in life and their wellbeing, as a result, is affected. Nothing is written in stone and the only certainty is change.

Mental health could also be described as the balance between emotional, psychological, social, environmental and spiritual states, all interconnected. It is what we think and feel about ourselves and everything else. If the balance is negatively impacted we can talk about ‘negative mental health’ that might lead to all sort of problems and disorders. In order to keep the balance, the status quo of well-being, we need to employ supports to maintain ‘positive mental health’. There isn’t one universal template on how to keep personal balance because we are all different. All humans get triggered in diverse ways, our limits of what we can take vary, so do our responses. Every one of us has a 'norm' that contains our balance. If someone is criticized by their boss – they might see it as feedback and not take it personally. They work harder. Another person might feel attacked and suffer terribly. They are paralyzed by the fear. If the situation repeats, the first person might get a promotion, the other takes sick leave due to stress.

A person’s well-being consists of physical and mental parts, body and mind. Both are vital and inseparable. Both have mighty power to impact each other – if one part is unhealthy, the other part is affected. If I am well – there is a great chance I feel well too. If I want to stay well I need to practice self-care. It consists of certain activities, however the principle is similar to how we look after physical health - it needs attention and nurturing (there is a post about self-care coming up). We have to look after it, exactly the same way we look after our physical health. What do you do when you have the flu?

Somehow, stigma has always followed mental health and only in recent times a conversation about it has begun. Many people, including respectable or famous people, talk about their experiences with bad mental health and recovery without shame, without fear of being judged, opening a new avenue for the rest of us. The reality is that we all have mental health we need to consider, regardless of how aware we are of that or how we feel about it.

Despite mental health promotion and the ongoing national campaigns - like 'the green ribbon' - the stigma attached to mental health problems is still huge. External stigma threats our ‘social’ self and our position in the world. The internal stigma of someone that struggles with mental health problems can turn their life into hell. There is still lots of fear in society. There is lots of shame among sufferers. There is a lot of shame amongst the families of people with mental health problems. The pandemic exposed this – things got turned upside down and shaken. I dare to say all people were affected to a certain degree. Ironically Covid-19 and its aftermath somehow normalized mental health problems and emphasized the need for services and support in normal circumstances, never mind the circumstances of a pandemic. In other words, something very bad brought about something good. My other half, who drives to work every day and listens to the radio during his travel tells me that every day he hears something about promoting mental health awareness. He says this was not the case before.

Positive mental health happens when people feel generally alright. It allows them to manage everyday situations and chores and to look forward to things. It lets them to get on with and interact with others, which might lead to having meaningful relationships equally romantic, familial, professional and platonic. A person is capable to respect themselves and others and maintain healthy boundaries. Good mental health allows us to enjoy and celebrate our successes. Our feelings and emotions don’t torment us. We are able to ask for support, when needed. We are able to offer support to others. We don’t get so anxious that we experience sleepless nights worrying about everything ahead. We aim for progress but not for perfection. We don’t endlessly dwell on past mistakes, instead we learn from them without blaming ourselves. Life goes on. Everybody has a bad day every now and then, or a few bad days. The ability to ‘snap’ ourselves out of feeling sad, overstressed, anxious, or worried is a great skill to have, and the majority of us are able to develop that skill. The problem begins when a few bad days turn into a few bad weeks and a few bad weeks turns into a few bad months or years. It doesn’t happen without an underlying reason, or a trigger, or a cluster of things that go wrong. Something, whatever it is, has potential of destroying our balance, wrecking our norm, ruining our mental health.

Various life situations threaten our mental health. Research proves that stress always contributes to negative mental health, lowers immunity and makes an individual more prone to getting physically and often emotionally ill. People cope with stress in different ways. The same adverse childhood experience might cause a mental health disorder for one person, but could help to develop resilience in another person. The most stressful events of life are: bereavement of someone close, divorce or separation from a loved one(s), financial difficulties, moving houses, prolonged illness, fear of becoming ill (experienced by thousands in recent months), work related stress, troubles with relationships (family, friends, work and other), different levels of trauma, bullying – past and present, abuse – past and present (emotional, physical, sexual), identity issues, coercive control, domestic violence, feelings of low self-esteem and unworthiness, social exclusion, lack of acceptance, isolation, feeling of not fitting in or disconnectedness. Supporting someone with mental health problems or someone terminally ill or impaired can be very stressful. 

Sometimes an individual has no control over what happens. The Social Determinations of Health (Dahlgren and Whitehead, 1991) researched and explained that many things in our life and environment are beyond our control, which has a serious impact on our physical and mental health. Individuals and society as a whole can be affected by things beyond their control for generations. In some places in the world collective mental health is affected. There are ongoing wars, natural disasters, hunger, poverty, danger, and hate: all beyond our control.

Mental health problems begin when mental health is jeopardized by some of the situations listed above and there is no resolution to internal conflict. Or when no emotional/psychological support is offered. When we can’t undo what happened. When the loss is too big to cope with. When we begin to lose hope because we might not be able to bounce back after a disaster. What happens to a person if they experience these situations?

Many books were written about various responses, coping skills and strategies to these situations. Usually we might feel out of balance and disconnected, overburdened with worries, stressed  and brokenhearted, and in the worst case scenario we suffer a mental breakdown that might require hospitalization.

Research links certain behaviors with declining mental health. Isolation can be the first warning sign that a mental health struggle has begun. An individual avoids their family and friends, decline participating in different activities that were a part of their lifestyle before, like going out and socializing. The isolation might lead to withdrawal – a person might be overwhelmed by anxiety or feeling depressed. The person might sleep too much or suffer from insomnia, lose the joy in their life, and have dark thoughts about their future. Unhealthy behaviors and habits may begin and develop further. Those behaviors may include: over/undereating, drinking heavily, smoking, taking illicit drugs, risky behaviors, self-harm and suicidal ideation. A person might not see it as unhealthy because those behaviors can suppress heavy feelings of anxiety and sadness, or the person thinks it doesn’t matter because they believe it is too late. A very dangerous place to be. Some people might develop manic behaviors such as over spending money, gambling, shopping, cleaning; others might develop phobias.
 

Young people might experience mental health difficulties in different ways than mature people e.g. they rebel, undertake risky behaviors, or run away. Men and women may exhibit contrasting behaviors e.g. a ‘traditional’ man will hide ‘in his cave’ and internalize his struggle, whereas a ‘traditional’ woman will talk and cry a lot. If only everything was so black and white… people respond in different ways to their problems or deny that something  is wrong, regardless of gender. This may continue for some time and might resolve itself. It can also continue for a long time and bring unwelcomed consequences. Unfortunately some people might be affected deeper and refuse to go to school/college/work and  other activities like sports or hobbies are abandoned. They lose interest in participating in life. Concentration and memory can be badly impacted. Insomnia or oversleeping can occur. A decrease in standard of physical appearance may be noticed: some people pay no attention to being ‘decently dressed’ or they might drop out of their hygiene routine. There is another extreme, the opposite of isolation: interacting too much with others and not wanting to be on their own even for a short time as a distraction to their problems. Some people might realize they are ‘going down the hill’ and look for support. Others may not realize or deny it because it might mean a change or effort they are not prepared for.

I described some signs and changes that might happen when mental health problems develop for an individual to give an idea for some people who are not familiar with the subject, however there is much more to it. In fact thousands of medical and psychological books have been written on the subject. If something is out of your norm for a while – it might be a sign of negative mental health. Again – mental health is about a state of balance. Each one of us has own personality, physiology and a state of balance: how long we sleep, how much we hang out with others, how much time we spend on our own.  People enjoy drinking, shopping, good spring cleaning and so on. Don’t take me wrong – all is good in moderation, within our balance, allowing us to function healthily, without going overboard.

Something nice to listen to: https://www.youtube.com/watch?v=oEJk3Vjii74