DISCLAIMER: I am no professional. Just a curious and passionate young mind trying to make sense of things just like the rest of us. I’ve done a fair amount of research to write this piece but much like the point I am trying to make here – I don’t have the answers. This is just how I have interpreted my experience and what I have read and been told by my doctors. More than anything I just hope to inspire others to be more thirsty for knowledge and less judgemental.
Lets get one thing straight.
We know shit all about mental health. So lets stop acting like we know it all.
Don’t get me wrong, we’ve come a long way, and those people who are dedicating their lives to the issue are learning more and more every day. But society (that’s us) need to learn to sit with the uncomfortable truth that there is still so much we don’t understand and so much we are probably still doing wrong. This is by no means a negative thing, it is amazing to be part of an age that is starting to tackle these big, looming issues. But what we need to realize is that it really is only the start.
In my opinion one of our biggest problems is that we are so insistent on giving everything a label, and I am just as guilty of this as anyone else. It’s natural, it makes order of the mess, it validates things that are otherwise too abstract to understand, and it makes communication about the issue more universal and easier to swallow. But it also creates a “us” and “them” attitude, a sort of elite list of requirements to be met in order to acknowledge that someone has a mental health issue. We put these people in their own little pigeon holes, isolating them from the rest of us. Obviously this is damaging to those who are willing to acknowledge their mental health struggles, but I think it’s also incredibly damaging to everyone else too. The reality is nobody is exempt from mental illness, and a diagnosis will look different on everyone. This “us” and “them” attitude that we are fostering is a massive barrier that we really need to get rid of.
I have been lucky enough to be dealing with a team of doctors who are forward thinking enough to acknowledge this. Labels and diagnosis’s have barely been used and when they have I have been assured I am not being pigeon-holed with a particular diagnosis, but rather we are using various disorders to better understand the symptoms I am struggling with. What I have learnt is that there is no one diagnosis for what I am struggling with, but that doesn’t mean it isn’t very real.
If we’re talking about mental health in New Zealand (and most of the western world), much of our categorizing and labeling comes from a measure known as the DSM. This stands for the “Diagnostic and Statistical Manual of Mental Disorders”, and it was first introduced in 1952 by the American Psychiatric Association. Since then it has been revised 5 times, with countless new disorders being added, re-classified, changed and even removed at every opportunity. Up until 1987 homosexuality was even listed as a mental disorder (if this doesn’t show how much influence society has had over our understanding of mental health then I don’t know what will!)
Our understanding of even the most basic and widely accepted mental illnesses has been subject to constant change too, and there’s no reason this won’t continue. Depression has supposedly exploded since the introduction of anti-depressants but in reality it is more our understanding of depression that has grown and lead to the jump in diagnosis’s. When my Grandad battled with depression many years ago nobody would have known to call it that, and visiting the doctor for such a thing would’ve been absurd, he was just “feeling blue.” Another of the most accepted disorders we have today is Generalized Anxiety Disorder, but even this was not identified on the DSM until 1987 and has since gone through multiple changes as new anxiety disorders continue to get introduced. If our understanding of even two of our most basic mental illnesses is still this new and up in the air then imagine how much more we have to learn about things like personality disorders, psychosis’s, gender dysmorphia, or so many issues we have yet to even name or discover.
The latest reboot of the DSM was released in 2013 and is known as the DSM-5. This updated measure introduced a number of new disorders such as, Binge Eating Disorder (similar to Bulimia without the purging), Premenstrual Dysphoric Disorder (a depressive disorder surrounding that oh so wonderful time of the month), or the controversial case of Hypersexual Disorder, which was previously known as sexual addiction in the DSM-3, then later removed from the DSM altogether in 1994.
As the American Psychiatric Association work towards the next update of the DSM they are looking into the possibility of things like Internet Gaming Disorder. That’s an entire new disorder that had the internet never been invented would never have come into existence. So what I’m trying to say here is, society plays a MASSIVE role in mental illness.
I got this wonderful handout last time I was at the community mental health clinic that defined mental health problems as “bio-psycho-social conditions.” Which basically means that our mental health issues have so many factors coming at them from all directions that it is basically impossible to gain a complete concrete understanding that fits for all of us. We are all a result of a unique biology, have brains that are wired completely differently, and are subject to social circumstances that will always be in some way separate to those around us. Add all this together and we are basically left with about 7 billion different definitions of mental health (OK maybe not quite, but you get my point.)
A large reason I didn’t take my own mental health issues seriously for so long was because none of those DSM diagnosis’s quite fit right on me. This made me scared to be labelled with something I didn’t think I had, and also was enough to convince me that whatever struggles I had can’t have been serious enough to be deemed an illness because I didn’t tick all the boxes. In actual fact I was in desperate need of help and found myself tumbling down that cliff towards that ambulance in a pretty bad way (more on that analogy to come).
My own preconceived idea that I needed a label or diagnosis to deserve help was incredibly damaging. The reality of it is that everyone of us is a completely unique being responding to our own worlds in our own unique ways. As a result, no two people are going to have the exact same experience of mental illness (even if they were given the same diagnosis). Therefore, trying to choose from an ever-changing list of illnesses, that some far off organization has deemed legit (for now), is just not helpful.
There is no “us” and “them”, WE are all in this together. Nobody is immune to mental illness just as nobody is immune to physical illness. But what do we do to avoid physical illness? We listen to our bodies and we take care of them. If we’re hungry, we eat. We don’t wait until we are on the brink of starvation to give our body the fuel it needs. It is time we started applying this common sense to our mental health and well-being too.
Yes, some of us are always going to be more vulnerable to mental illness than others. But we all have mental health that we are just as responsible for nurturing as we are our physical health. In this day and age we are using our brains more and our bodies less, so of course we need to care for our minds too. Nobody knows your body better than you just as nobody knows your mind better than you. If something feels wrong don’t go searching for a box to put it in and then disregard it when you can’t find one, and don’t let others do that to you either.
Once we work out that we are all susceptible to mental illness, and do away with this “us” and “them” attitude, then we can start to focus on the much more positive and inclusive idea of mental WELLNESS.