According to the National Institute of Mental Health, 1 in 5 people live with a mental illness.
When we look at that statistic it becomes easy to set oneself apart; either seeing oneself as ill while others are not, or seeing oneself as entirely free from an illness. When we draw that line, like any line to divide one group from another, it becomes easy to present mental illness in terms of all or nothing; black or white. When we draw a line it becomes easy to judge, pre-judge and stigmatize those who have been labeled as having a mental illness. What far too few people understand is that statistics and definitions tell neither a helpful, nor a whole, story.
A survey released by the American Psychiatric Association (APA) found a significant lack of consumer knowledge and understanding about mental illness. Almost half the public – 44 percent – report knowing only a little or almost nothing at all about mental illnesses. In place of understanding and knowledge are negative stereotypes, misconceptions and outright falsehoods about what the term ‘mental illness’ means and how that definition relates to the realities of day-to-day life.
When organizations like the National Institute on Health (NIH) or the World Health Organization (WHO) publish mental health statistics, they’re referring to a very specific definition of mental Illness. It refers to those individuals who would be diagnosed with symptoms of some mental health issue as defined in the Diagnostic and Statistical Manual of Mental Disorder (DSM), which is compiled by the American Psychiatric Association. Typically, a diagnosis, performed by a mental health professional, psychologist or psychotherapist, is based upon the person’s report of symptoms — including any social or functional problems caused by the symptoms – as well as the health care professional’s observation of the person’s attitudes and behavior.
When defining mental illness, lines must be drawn in the medical community for the purposes of diagnoses and treatment, as well as for insurance reimbursement. And while for a portion of individuals, symptoms of a mental illness are obvious and fairly clear cut, as you move up through the severity of symptoms to those whose social or functional problems are more mild, well managed or well hidden, where to draw that line becomes far less clear.
Severity is a component of assessment and diagnosis, and when making an assessment, it often comes down to whether the functional problems – social interaction, work capability, etc. – are severe enough to warrant treatment. Often, thoughts, feelings and behaviors that are creating problems are manageable and a formal diagnosis is not necessary.
Mental Health is another term that comes into play and is defined as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community. While mental Illness and mental health is not the same thing, they are also not mutually exclusive.
Rather than thinking of there being a line between those who are mentally well and those who are mentally ill, it is more correct to think of our mental health on a continuum with optimal mental health, often referred to as mental well-being or mental wellness at one end, and severe mental illness at the other. Further, mental health and mental illness are not static; like physical illnesses they can change over time depending on many factors. Some factors include a person’s physical wellness, biology, physiology and genetics; environmental factors such as stress and exposure to traumatic events and loss; learned and adopted behaviors, as well as an individual’s own level of resilience to many of these factors.
While 1 in 5 people may be behaving in ways that could be diagnosed as mental illness, a far larger number of people spend their days just barely managing and coping with the pressures and stresses of life, and living with something less than optimal mental health. In some cases the differences are nearly indistinguishable.
Take for example a married couple who are experiencing relationship issues. The complex dance of emotions that come into play when fears of, for example, infidelity are at play can create many of the same emotional and behavioral outcomes as many mental health issues. Rage, jealousy, paranoia, anxiety, panic, sadness and depression, are common in these cases. Emotions, thought patterns and ruminations in cases of marital problems can often lead to changes in eating, drinking, exercise, socialization, and others – all behaviors that are consistent with mental illness. Yet, as a society, we are more accepting of the emotional and behavioral changes that may occur while going through marital problems because we can all relate to it, understand it and accept it as “normal.”
National health organizations say that the lifetime prevalence of mental illness, that is, the likelihood that you could at some point in your lifetime exhibit characteristics of mental illness is 58%; nearly 6 out of 10. As high as that is, national studies of working individuals indicate that over 90% of workers say that the effects of stress, anxiety, and other emotional issues negatively affect their relationships at work, the quality of their work, productivity and overall happiness. Where do we draw the line?
Were we more inclined to talk openly about our feelings of anger, anxiety, esteem or sadness, chances are we’d discover far more people struggling to find true peace and happiness than we might have imagined. And if we came to understand that our mental health is not simply a matter of definitions; a line we draw between well or not, but rather, a constantly changing spectrum of moods and emotions and behaviors that affect us all, we would also discover that we all share much more in common than we might imagine.
To address the stigma and misunderstanding surrounding mental illness we need only look within ourselves and recognize that, when it comes to thinking and emotions, our experiences are far more alike that we may realize. We are all, every day, moving along a continuum of mental health. And while we may, at this moment, be managing our world just fine, things happen all the time that can easily move us to the other side of that line.