What is mental health?
July 18, 2018
People often ask what mental health is. They’re interested to know the main disorders or problems that psychologists work with and if there’s a big difference between people with mental health problems and those without them.
In fact, despite what you may think, there is no clear difference between those two groups of people: there is no unequivocal dividing line indicating the end of mental health and the beginning of psychopathology.
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It is evident that there are people with serious mental health problems: their suffering is so striking and their illnesses have clear consequences on their lives and environments. The disconnection between that person’s sense of self and their outer world is so radical that there is a clear line between health and illness.
However, in less extreme circumstances we consider mental health – like health in general – to not be a binary category (I have it/do not have it) but rather a continuum. One of the extremes of this continuum is optimal mental health (which is never 100%– we are humans, not robots) and on the other end, acute pathology. Let’s examine this more closely.
Mental health as a continuum
To be brief, one extreme could be characterized as a person who feels good about themself and has overall satisfaction with their life. They have an advanced level of maturity so they can maintain healthy relationships, they feel optimism about life and their future, they have reconciled with their past and are connected with their present. When a person has a healthy mind, they have many resources in order to adequately respond to the different curve balls that life throws at them.
At the other extreme is an individual with a severe mental pathology. As mentioned above, at this point there is a serious disconnection between oneself and reality. There are certain somatic and cognitive symptoms that deeply affect the person. Interpersonal relationships tend to be superficial, toxic or nonexistent. There is often extreme seclusion and isolation, physical deterioration, and an inability to integrate into society and manage tasks independently and responsibly. Looking at it from an emotional and motivational level, there is a base of severe unhappiness and apathy. The serious absence of mental health is undoubtedly associated with a high degree of suffering at all levels.
And between the two extremes? The majority of the population lies in the middle of these two extremes, with movement along that scale based on the time of day, the day of the week, the time of year or the stage in their life.
Indeed, mental health or psychological well-being is not stable, although it has a certain stable baseline: both total stability and very pronounced movement along the continuum could be signs of a psychological well-being that is beginning to falter. That’s why we do not always feel the same excitement for life, we do not always have the same high self-esteem, nor do we always feel the same optimism for the future.
What is mental illness?
It is not easy to describe what mental pathology consists of in a few words, although there are hundreds of manuals that explain and develop it in depth. In general, clinical psychologists have at their disposal the DSM, which is a manual for the diagnosis of mental illnesses: they are grouped by categories with specific criteria that determine if a person suffers from a certain disorder.
Therefore, someone may think that they have an obsessive-compulsive disorder and some form of schizophrenia. From the DSM, someone may try to determine whether they are suffering from grief or serious depression. However, officially, only a properly trained psychologist can determine if they are suffering from a mental disorder. This determination is based on whether they meet the criteria established and accepted by the whole profession or if there is no such health problem. It’s possible that someone could be suffering from something but it’s manifesting itself in a way that is indeterminate or not specific, which prevents psychologists from identifying it with a specific diagnostic label.
On the other hand, the general population usually thinks that mental illness is characterized by very rare and strange phenomena, unrelated to the psychological experiences of the healthy population. Actually, this is not the case: if we look closely, much of what happens during a severe mental illness or an episode of mental health failure, are phenomena that all people experience to a certain degree.
For example, sadness is a natural emotion. It fulfills an adaptive function that is useful for our survival and every single (healthy and “unhealthy”) person in the world experiences this feeling. However, taken to the extreme, it turns into the deep despair and melancholy that characterizes depression. In a similar way, a person can be relatively strident, intense or peculiar in their way of communicating without having any problem, although that same behavior -taken to the extreme and accompanied by other symptoms- could suggest a personality disorder, for example of the histrionic type.
Someone can be sitting quietly next to another person and believe that they told them something, when in reality the room was silent the whole time. This is a mild auditory hallucination, this has no importance if it is a one-time occurrence. This phenomenon, taken to the extreme, is what we find in people with a psychotic profile who believe that they hear voices that command them to do things or talk to them.
Over a year or a few months, you can go through periods of increased motivation and joy, stages of amazing bursts of energy and productivity and then, little by little, you begin to feel more flat and downcast, walking around with sadness or fatigue. That is not abnormal. Our mood and our self-esteem fluctuate all the time: even in a person with ideal mental health, they are constantly changing. However this fluctuation is what happens in an extreme way in a person suffering from bipolar disorder.
We could go on and on with multiple examples. The most important thing is to know and understand each other, and to have a deeper sense of self-awareness and what happens to us. Every person is on a path of growth and development in their life and, of course, from time to time we get sick -sometimes seriously- in our emotions, thoughts and behaviors, just like we do with with our physical body. Therefore, pay attention to the signs that tell you that your health is being compromised and see a specialist if you feel that you need support during your recovery. Psychologists are here to help with that, your health is our priority.
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