There are phrases we use to describe aspects of our lives that I would love to see changed. One of them is the term 'mental health'.
It's great that people's feelings, their emotional health, and the physiology and systems of the brain are now so much more mainstream. It’s great that schools and workplaces are rushing to get their act together and provide students and staff with much needed recognition and support for conditions like anxiety and depression.
But did we have to so comprehensively label it all ‘mental’ health when, like it or not, we are nowhere near eliminating the negative use of the word ‘mental’? A casual search around on the internet quickly yields terms like ‘crazy’ and ‘disorder of the mind’ when you type in the word ‘mental’. For many people, the term ‘mental health’ is too close to the words ‘mentally ill’. I overheard two 14-year-olds talking recently, referring to a friend as 'a bit mental’.
It certainly wasn’t meant as a compliment.
Apart from which, the term ‘mental health’ carries with it an earnest seriousness, sometimes a sense of moral crusade that puts off as many people as it engages. The problems don’t stop there. Although there is much more talk now about ‘mental health’, even the experts can’t decide what it actually means.
According to the BMJ, nearly half of professionals don’t agree with the World Health Organisation definition of mental health, and many prefer a Canadian definition which is:
‘The capacity of all and each of us to think and act in ways that enhance our ability to enjoy life and deal with the challenges we face.’
It’s a nice, human and accessible definition, but you could put forward the same words as a definition for ‘health’ instead of ‘mental health’, and they would work just as well.
What is the difference between mental and physical health anyway?
We already know that thoughts and feelings don't just originate in the brain, whole-body systems such as the digestive and immune are involved in influencing your mood and state of mind. The brain or ‘the mind’ are just as physical as the liver, the heart or the limbs. By separating out mental health as a 'thing' then we are unhelpfully making it something different from physical health.
Why don't we just have ‘health’ and then address those things which might affect or enhance it under one umbrella? To be healthy in relation to our thoughts and feelings, we depend on a body that is moved in healthy ways, on food that nurtures that body, on sleep, on living in an environment that makes the body feel safe, and in having kind, loving nurturing relationships.
Some of us also need, from time to time, help and support to address the results of unhappy experiences, distorted thinking patterns or long term imbalances. But even these interventions address the physical processes within the body's nervous system that governs thought patterns and behaviours. To feel and experience life as we want to, we have to consider what we eat, drink, experience and do. To reduce or eliminate anxiety and depression, for example, we have to keep ourselves in balance in every way.
I often work with young people, especially young girls. They come with anxiety issues and disturbing behaviours which have started to affect school, home and sleep. I soon learned as a therapist trained primarily to deal with thinking patterns and brain states, that it was wise to ask questions first about food.
Why? Because once we had uncovered and addressed the bizarre eating habits these girls had become accustomed to, then often the anxiety and
low mood issues began to fall away.
Eating affects mood and physiology. Obvious you might think, but somehow as people become concerned about anxiety, either their own or other people's, the link between what you eat and how you feel and experience life seems to be downgraded, it's often regarded as peripheral.
Blood sugar is a great influencer of mood. Low blood sugar can trigger anxiety and irritability in the most affable of people. If your 12-year-old daughter skips breakfast and lunch and then whoofs down a bucket load of carbohydrates and fizzy drinks, day after day, don't be surprised if health issues start to arise. Erratic behaviour, anxiety, depression, anger, and hormonal imbalances can all result from the body basically protesting about the abuse, about the lack of what it needs.
In some cases the eating patterns may not even be extreme, if the diet is too narrow, lacking the right amount of fat or protein or nutrients, particularly during puberty and adolescence, then simple adjustments can lead to revolutionary changes in levels of calm and confidence.
So, in these clients, what presented and was labelled as 'mental health' had its origins in a very physical issue. Sometimes the girls had gone through CBT or counselling, or described themselves as 'under mental health services'. One young woman had been receiving mental health support since she was 12. She had been on medication for nine years and still had debilitating anxiety. She'd had counselling and was at her wit's end. She came to see me to find out whether hypnotherapy could help, but in taking a history from her it emerged that she never ate a proper meal, had no idea how to eat a balanced diet and existed on snacks - crisps, biscuits, cakes, chocolate, coke, maybe the odd bread roll and a bite of this or that. Not enough to build a healthy young body capable of taking on challenges.
In my view she wasn't a 'mental health' case, she was a young woman with wellness needs and with a different approach, she would not have spent nine years on antidepressants, seeing herself as a hopelessly anxious person. Within a month of eating a diet of regular meals containing protein with salad and fruits, and water instead of coke, this particular young woman was transformed. With the worst of the anxiety out of the way, she was feeling so much better that we could then work on catching up with the life she had lost through being so anxious. We developed her social skills and opportunities and she made plans for independent life, and coping so much better with study and exams.
This is just one example, I could describe many more women dogged by anxiety and unhappiness whose real problem is obesity and resulting low self-esteem; they inevitably present to me having been given anti-depressants but no dietary help. Professional men who can't sleep who have been signed off sick and are desperate to get back to work once their depression has lifted. Often they also have a prescription for antidepressants but want 'something else' to help them get better. It almost always emerges that they too have what I would call a 'wellness' problem rather than a 'mental health' issue.
They have treated themselves - their bodies- as if they are superhuman. Working day and night, not sleeping, grabbing food on the run, taking on more and more responsibilities, drinking alcohol to escape in the few short moments of leisure they have. They ignore all the niggling issues the body tries first to protest at being neglected, and have crashed.
Maybe they have had a panic attack, or woken up one morning unable to get up they feel so low. The problem is not 'mental' it is physical and it needs physical solutions.
The use of the term 'mental health' allows us to separate the cause from the effect. It allows us to duck the responsibility, the requirements for self-care and to present ourselves as having conditions which can, we think, be treated in isolation.
In my view, we should regard 'mental health' as an outdated term. One that we allow to fade out as we introduce more accurate ways of talking about the way in which the physical and sensory experiences of our bodies, and the way we control the quality of those experiences, affect the way we feel about ourselves and our lives.
By all means let’s talk about emotions, thinking patterns, happiness and unhappiness, types of feelings, confidence, fears, anger, guilt and grief...
But let’s talk about them, and work with them, in terms of our whole ‘being’; we are each of us a ‘being’ composed of complex elements and needs which are endlessly interdependent.
If we need a name for the self-care and the externally provided care that helps us make the most of who we are, and how we are, then the term ‘Well-being’ is positive, aspirational and comprehensive.
Here’s to your well-being, in every way.