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Mental Health: A Guide to Psychological Challenges and Emotional Wellness

Mental Health
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What is Mental Health?

Mental health refers to the state of your internal psychological and emotional condition.  As with physical health, we can think of health in two different ways; as the absence of any illness that is causing suffering, or as how well is one’s state of overall well-being. 

From the absence-of-illness perspective, the average person might consider themselves “healthy” if they are not sick.  In a society that defines people by their ability to work and produce, the cultural conversation about mental health is very heavily biased towards this definition of health.  If your mood is so low that it impairs your ability to be productive, the most common advice is to take medication that will suppress the symptoms enough that you can function and get back to work, rather than taking time to address the root causes.  It is this perspective of the human primarily as a machine for productivity that gives rise to the stigma we see around mental health.  You are expected to keep functioning, and the threat of social shaming is one mechanism that incentivises you to not fail at this task.  This mode of being is largely responsible for the mental health epidemic we now see.  We’re all encouraged to repress our suffering and soldier on until it is too much and we are suddenly “ill”.

Health is more than the absence of illness.  You can be free from any particular disease or disorder and can still acknowledge that you could be “healthier”.  We know that an athlete with a rounded diet is healthier than someone sedentary who only eats junk food, even if both are free of illness.  Rather than letting society define you as either mentally healthy or mentally ill, we can take the empowering perspective that our mental health is the rich continuum of our everyday wellbeing that we can take control of.

Mental Illness and Disorders

Rather than being seen as an inevitable part of existence that can be navigated in a way that brings about growth, mental anguish is seen by the dominant culture as something to be repressed and ignored until it’s too much to handle.  The point at which one’s mental suffering has become overwhelming is typically the point at which it becomes defined as an illness or disorder. 

The concept of illness can be very helpful to some in helping them make sense of the patterns they are seeing in themselves.  We must always keep a close eye on what is being defined as an illness, however, as the history of psychiatry is replete with “disorders” such as Drapetomania (the “insane” impulse of slaves to escape from slavery) and of non-heteronormative sexulity and gender being treated as a mental illness.  Such definitions of “disorders” are typically used to label people as deviant and to permit their rights being taken away as they are controlled by the state.

Mental Health Statistics

The cultural default of ignoring and suppressing mental suffering has resulted in a mental health epidemic.  According to the World Health Organization (WHO), a quarter of the world’s population will be affected by a mental health issue in their life [1].  Mental health problems rank as the number one cause of disability and illness worldwide.  Each year, 18% of people ages 18 and 54 will suffer from an anxiety disorder while 9.5% of American adults will suffer with a mood disorder.  Approximately 1% of the population is affected by psychotic disorders such as schizophrenia.

Mental Health Problems

There are several commonly recognized mental health conditions.

Anxiety

Stress is a fundamental aspect of being alive, it keeps us vigilant for danger in the present and pushes us to plan for the future.  Understanding one’s relationship to stress is usually at the core of understanding one’s own mental health and wellbeing.  When our stress levels become intolerable, we may experience unpleasant levels of anxiety.  When this anxiety becomes doubled from our current context we may experience Generalized Anxiety Disorder, a state characterized by chronic stress, tension and fear.  Living with anxiety can produce a physiological feedback situation, resulting in panic attacks and the possible diagnosis of panic disorder. 

In other cases anxiety might be linked to a specific context, such as social situations. For social primates like ourselves, it is natural for our stress levels to increase in social situations, producing a state of vigilance that makes sure we concentrate on making a good impression on others.  Against a background of constant stress, this increase in anxiety can go from being a helpful prompt to pay attention, to a disabling inability to interact with others in a social context.  This pattern is usually described as Social Phobia or Social Anxiety Disorder. 

Humans routinely engage in superstitious rituals in order to feel like they have some control over an unknown future, a feeling that can reduce stress associated with the future.  In some people with anxiety, this psychological mechanism is unconsciously used in an attempt to regulate their stress levels.  They may experience obsessive, intrusive thought patterns or may engage compulsively in certain repetitive behaviors, both of which can be understood as attempts to get the background anxiety under control.  This is known as Obsessive-Compulsive Disorder (OCD).

Trauma

While stress is an inevitable part of life for any creature, trauma is a very likely occurrence for most modern humans.  A traumatic experience is one in which you were overwhelmed and lost control.  Traumatic experiences include sexual assault, car crashes, war and even the process of being born.  Because of their vulnerability, trauma during infancy is particularly common and can arise from something as common as having parents who are struggling with mental health issues.  The response to traumatic situations becomes disordered when we don’t return to a baseline feeling of safety after the traumatic experience. 

Survivors of sexual assault may experience the psychological fear and bodily stress reactions of the event itself when hearing the experiences of other survivors, or when in contexts that remind them of the event.  Such a person may find the diagnosis of Post-Traumatic Stress Disorder helpful in trying to find treatment.  When we are overwhelmed for long periods of time, especially in childhood, we may not even realize that we are traumatized and may take our experience to just be the way we are.  This can result in Complex-PTSD (cPTSD), a diagnosis which in many cases can seem indistinguishable from many other disorders such as anxiety or depression.  As a result of this, it appears likely that many mental health disorders are actually magnification of cPTSD, with the roots of the symptoms being found in early childhood stress.

Disordered Eating

Eating is fundamental to our survival and is intimately tied up with our emotional lives.  Much like with OCD, controlling one’s eating can be an attempt to regulate the background level of emotional distress that is present, consciously or unconsciously.  Anorexia nervosa involves under eating, while bulimia nervosa involves periods of binge eating followed by attempts to purge the food from the body.  When this binge eating behaviour is not associated with food restriction at other times of purging following binges, then the behaviour may be classified as Binge Eating Disorder.

Mood Problems

Mood is a vague concept, far less specific than individual feelings or emotions.  We think of mood as varying from positive to negative, with positive mood being characterised by emotional lightness and a likelihood of experiencing pleasure and happiness.  Negative mood on the other hand may be characterized by emotional heaviness, a lack of pleasure and happiness, or disengagement from the world.  Chronic negative mood is typically diagnosed as depression, although this may be a symptom of a deeper issue, such as unresolved trauma.  If periods of negative mood are interspersed with periods of mania, one may be diagnosed with bipolar disorder.

Psychosis

Our brains constantly build a picture of reality around us in order to keep us safe.  When this process breaks down, we can enter a psychotic state.  During a psychotic episode one’s picture of reality becomes decoupled from the ways other people see the world.  You may experience delusional thinking and hallucinations.  By the point a psychotic break has been reached, it is often necessary to resort to symptom management via medication or hospitalization in order to keep the individual safe.

Personality Disorders

Personality disorders are primarily interpersonal, affecting the way one relates to others.  They typically form as a coping mechanism in response to the challenge of living with unresolved trauma.  While many personality disorders exist, they fall into three clusters.  Cluster A involves symptoms that are similar to psychosis, Cluster B disorders typically involve problems with emotional regulation and interpersonal conflict, while Cluster C disorders are characterised by anxiety.  Cluster B disorders include antisocial personality disorder and narcissistic personality disorder, both of which are characterised by a lack of empathy and willingness to do harm to others.  Having someone with a Cluster B disorder in your life can also be the cause of mental health difficulties.

Substance Dependence

More commonly known as addiction, substance use disorders consist of being dependent on the consumption of certain substances.  Addictions to substances typically develop as a way of soothing or gaining temporary relief from emotional pain.

Children’s Mental Health

All of our mental capacities undergo development during childhood.  Sometimes challenges can result in children struggling to meet certain psychological, social and emotional milestones.  What is considered a “disorder” is highly culturally specific but the National Research Council and Institute of Medicine found that between 13 and 20 percent of children living in the US would experience a mental health disorder in a given year [3].  Attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders are particularly common in children.  There are a variety of ways to manage such mental health issues and address their root causes and will most likely involve the parents, healthcare professionals and the child’s school teachers.

Mental Health and Psychedelics

Psychedelic medicine is set to revolutionize modern mental health treatment.  Whereas medications tend to suppress symptoms, psychedelic medicine typically goes to the root cause of the suffering.  MDMA-assisted psychotherapy is currently being trialed for PTSD, and psilocybin is being tested for use against depression, with both on track to be prescribable in coming years.  Through its synergistic combination with psychotherapy, psychedelic-assisted psychotherapy is emerging as the gold standard for treating mental health issues.  While therapy can be immensely helpful, neurological and psychological mechanisms can prevent core issues being fully resolved.  By temporarily disabling these mechanisms, psychedelics make it possible to address the core wound underlying the mental health challenges that are being experienced.

How to Get Help

Whether it is you or someone you know who is suffering from mental health issues, there are ways to get help.

Mental Health Evaluation

Mental health evaluations and assessments are questionnaires that give you an overview of whether you might be suffering with certain mental health issues that fall within the known categories.  Psychology Today, a reputable magazine on psychology and mental health, has a free online test that can be found here.

Types of Treatment

Psychotherapy and counselling are among the most common methods of addressing mental health concerns.  Inpatient clinics also exist where people can go for residential treatment.  If one’s symptoms are severely disturbing one’s life, medication can be a useful tool for suppressing symptoms alongside work to address underlying causes.  In cases where all else has failed or the individual is a danger to themselves or others psychiatric hospitalization can be an option. Twelve-step programs and support groups can also offer help for people in the community.  A variety of complementary treatments are also available, including psychedelic medicine such as ayahuasca, which has been anecdotally found to be powerful in healing trauma and associated mental health issues.

Hotlines

Mental health hotlines can be of use in times of crisis.  It can be appropriate to call 911 if emergency assistance is needed for a potentially life-threatening situation.  Trained crisis workers can be reached 24/7 via The National Suicide Prevention Lifeline 1-800-273-TALK (8255).  A confidential and toll-free conversation via this hotline can provide counselling in a time of crisis and can assist with mental health referrals.

If you or someone you know is suicidal or in emotional distress, contact the National Suicide Prevention Lifeline. Trained crisis workers are available to talk 24 hours a day, 7 days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals.  If you are not currently in crisis but could use assistance in accessing mental health information and support in your area you can contact the SAMHSA Treatment Referral Helpline at 1-877-SAMHSA7 (1-877-726-4727) weekdays between 8am to 8pm EST.

Support Groups

Support groups exist to help those who suffer with mental health difficulties as well people who have someone in their life that is struggling with mental health challenges. A list of support groups can be found online here.

Mental Health Quotes

“In any given moment, we have two options: to step forward into growth or to step back into safety.”

— Abraham Maslow

“What mental health needs is more sunlight, more candor, and more unashamed conversation.”

― Glenn Close

“Take a deep breath to remember you are the child who lived through survival mode and the empowered adult who chose their healing.”

— Dr. Nicole LePera

“Until you make the unconscious conscious, it will direct your life and you will call it fate.”

— Carl Jung

“Depression is your body saying, ‘I don’t want to be this character anymore. I don’t want to hold up this avatar that you’ve created in the world. It’s too much for me.  You should think of the word ‘depressed’ as ‘deep rest.’ Your body needs to be depressed. It needs deep rest from the character you’ve been trying to play.”

– Jim Carey

FAQ

When is mental health awareness month?

Every May since 1949 has been Mental Health Awareness Month in the US.  Its aim is to raise awareness and provide educational resources to the public around mental health issues.

How can I improve my mental health?

When we think of mental health as something primarily psychological we overlook the profound connection between the mind and body.  Treating your body well through exercise and eating a nutritious, well-rounded diet are powerful ways of improving one’s mental health.  Even being dehydrated can raise the body’s stress levels exacerbating mental health issues, making them more difficult to manage.  Therapy is a powerful way to make progress in understanding the root causes of one’s mental health issues.

What are signs of mental illness?

If you are experiencing psychological distress of any kind, it is always worth seeking out support.  Typically signs of mental illness include changes in mood, sleep, appetite, sex drive, social withdrawal, feeling apathetic or disconnected, excessive anxiety, unusual thought patterns or perceptions, difficulty concentrating, dependence on substances, suicidal thinking, impairment of normal function, or multiple physical issues without an easily identifiable cause.

RS Contributing Author: Dr. James Cooke

Dr. James Cooke is a neuroscientist, writer, and speaker, whose work focuses on consciousness, with a particular interest in meditative and psychedelic states. He studied Experimental Psychology and Neuroscience at Oxford University and is passionate about exploring the relationship between science and spirituality, which he does via his writing and his YouTube channel, YouTube.com/DrJamesCooke. He splits his time between London and the mountains of Portugal where he is building a retreat centre, The Surrender Homestead, @TheSurrenderHomestead on Instagram. Find him @DrJamesCooke on Instagram, Twitter and Facebook, or at DrJamesCooke.com.

References

[1] https://www.who.int/whr/2001/media_centre/press_release/en/

[2] https://www.hopkinsmedicine.org/health/wellness-and-prevention/mental-health-disorder-statistics#:~:text=An%20estimated%2026%25%20of%20Americans,substance%20abuse%20and%20anxiety%20disorders.

[3] http://www.ncbi.nlm.nih.gov/books/NBK32776/

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