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Thursday, December 20, 2012

What Exactly is Mental Health? (By Anshu Basnyat, LCPC)

     This week I had an epiphany. As I was having a conversation with an educated friend about the Sandy Hook shooting, she asked me if anger was a mental health issue. My immediate reaction was “Of course!” and then I went on a long explanation about how anger is a major mental health concern that can lead to serious, dangerous situations. She then said something along the lines of “But I thought Bipolar, Schizophrenia, Depression, etc.” are mental health.  I stopped in my tracks because I realized in that moment that this is what many people must be thinking when we refer to “mental health.”  The distinct, clinical diagnoses found in the Diagnostic Statistical Manual (DSM), the Bible of mental health disorders must pop into people’s mind whenever talks about mental health arise. 

    I have been a mental health professional for about thirteen years now and was trained in the No. 1 ranked hospital in the United States: The Johns Hopkins Hospital. It hit me that for years  I have been asking the wrong questions, always bewildered why our society does not value mental health. Then, I began to wonder. Did my friend just answer my question of why there is so much stigma attached to mental health? Is it just people's lack of understanding, which go beyond their fear of being labeled “crazy”?  This conversation with my friend inspired me to write this post.

    On a side note, I plead to my family and friends not to use the word “crazy” when referring to people with mental health issues because this is just not true and only perpetuates this vicious cycle of stigmatization. Then, people shy away from getting help until it becomes so severe or never at all. People with mental health issues are regular people who have been strong for too long and now need some support to get them through some hard times, as we are all faced in life. Also, think of mental health in this way. 

     Mental health is in a continuum and involves anything having to do with our social-emotional well-being.  Anywhere from what kind of relationships we form with others to the very mentally ill such as those with schizophrenia and bipolar disorder, which have genetic components.  It is our social-emotional health, and this range is vast and to understand it fully, one has to consider the entire person. It is very individual-specific so making such generalizations as “All people with X condition will do Y behavior” is dangerous territory and again, perpetuates social stigma. Having said that, it may be helpful to think of mental health in these terms.

     Now, close your eyes and imagine a horizontal line with three sections (the left, middle, and the right).  Let me just put a disclaimer out there that is in no way a metaphor for our political system.  This is just the best way I can describe mental health. So, the Left section is the “healthy” part where people sometimes have uncomfortable emotions such as feeling sad, anxious, fear, anger, etc. They may also have some “issues” with people. However, by and large these people tend to have good coping skills to handle such social-emotional difficulties and carry on their normal routines with no major difficulties. 

     The folks in the Middle section have more difficulty than the people in the left in terms of getting what they need to do in their lives such as going to work, school, home life, etc.  They may feel more sadness, anger, fear, sleep is affected, crying more often, turning to other means such as alcohol to feel better, having passing thoughts about suicide or homicide, and/or experiencing other uncomfortable emotions. Their relationships with their loved ones may be changing in a negative way. Grades or work performance may be slipping, but they still manage to get up most mornings and continue on with their routines. However, the quality of their behaviors and relationships with others has changed now even though they are managing.  The reasons (e.g. triggers) for these changes vary from individual to individual and so do the reactions (e.g. coping style).  For instance, losing a job maybe a stressor for some while it may be a blessing to others depending on each person’s situation and mental health.          

     Now, consider the Right section, which is the “unhealthy” part where people are struggling to go on their daily routines such as work, school, and home life. Their social-emotional difficulties are disabling them to the point where they cannot function at all or doing so in destructive ways.  These are people who have the mental health diagnoses, but also those undiagnosed because they are not seeking the support they need (e.g. many people from the Middle section can quickly end up here).  However, please understand that if these folks get the mental health services they need such as counseling or therapy and/or psychotropic medications, then they can very much function as people in the Left or some higher-functioning people in the Middle. Therefore, mental health has to be seen as being on a continuum rather than in discreet compartments.    

    There are many types of mental health professionals who can help. Some include: psychiatrists (medical doctors who can prescribe medicines), psychologists (generally these people have doctoral degrees who can do therapy and psychological testing, but not prescribe medicines), and counselors or therapists who can have educational backgrounds (at least Master's level) in social work, psychology, and/or counseling who can do therapy, but may or may not be able to do psychological testing depending on their training. 

     Life can be beautiful, but it can get quite tough at times. During such times, everyone can use a therapist or counselor to help them. After all, we are all humans and as humans, there is only so much we can take at one time. My belief is that many people want to seek mental health services, but fear that the stigma attached to it will hinder them somehow.  Ironically, I have observed that people who openly talk about “seeing their therapist” seem to be those who are most at peace with themselves and better equipped to navigate Life.

     I sincerely hope this gives a better understanding of what “mental health” is. If not, I would love to hear your feedback!

           Some Signs to Seek Mental Health Support (aka Red Flags):

·         Suicidal talk
·         Homicidal talk
·         Feelings of hopelessness
·         Excessive crying for no apparent reason
·         Changes in sleep patterns
·         Disinterest in activities that were once enjoyable
·         Excessive use of alcohol
·         Drug use and/or abuse
·         Significant drop in school or work performance
·         Engaging in high-risk or dangerous behaviors
·         Extreme irritability
·         Excessive weight changes
·         Persistent negative relationships with others
·         When a loved one expresses concerns about your mental health

Some Free National Hotlines that Can Help:

National Alliance on Mental Illness
Phone: 800.950.NAMI (800.950.6264)
Whom They Help: Individuals, families, professionals  
National Alcohol and Substance Abuse Information Center
Phone: 800.784.6776
Whom They Help: Families, professionals, media, policymakers, concerned individuals

National Suicide Prevention Lifeline
Phone: 800.273.8255
Whom They Help: Families, concerned individuals




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