Why read a post about mental illness?

  • Demographics. Nearly a quarter of the U.S. population will meet criteria for some mental illness this year.  Mental illness touches everyone’s life.
  • Friendships. Maybe you want to support friends who are suffering.  Or you know that increased understanding means a decreased chance of hurting someone you care about.
  • Personal Impact. You want to reduce your own chances of experiencing mental illness or cope better with the situation you are in.
  • Charity.  Perhaps you are someone who wants to “Speak the truth in love.”  The more you know, the better you can reach and relate to someone who struggles with mental health.

Whatever your reason, here are five points that might shift your views on mental illness:

1. Mental illnesses are part of the spectrum of common human experience.

I can’t speak for you, but I know I experience anxiety quite often.  I remember anxiety over speaking in high school or asking someone on a first date.  Now I feel anxiety when others evaluate my work, or when I have to confront someone I care about. I am sure you have worried about some aspect of your life: “Will we have enough to retire?”  “Will the principal judge me if my daughter wears mismatched socks and shoes to school?”  “Is there something wrong with me if I see the dress as white and gold?”   Anxiety and worry are human experiences, but for some they are debilitatingly intense or pervasive.

The criteria for most mental diagnoses are categorical, meaning there is a specific criteria which separates those who fit the diagnosis from those who do not.  However, the reality is much less all or none.  In reality, the threshold for diagnosis is just one point on a continuum of distress and impairment related to some domain of human experience.  Mental illness is our convenient label for those at the most distressed or impaired ends of the continuum of experience.

What does this mean for us?  For me, the phrase that springs to mind is “There, but for the grace of God, go I.”  I have many of the same qualities as the people I counsel.  I have felt sadness, depression, fear, anxiety.  I have trouble changing behaviors I find pleasant but which run counter to my values.  By the grace of God, the good fortune of genetics, the effort of my parents, and some willingness of my own, those negative experiences have been less intense for me.  But that could always change.

I believe that it is actually this commonality of the human experience of emotion that leads some to dismiss anxiety or depressive disorders as a weakness of will.  They have experienced emotions like fear and depressed mood, and did not get stuck.  The attitude could easily be, “Well if you handled it like I did, you would have the same good outcome.”  To me, this ignores many potential differences that place us all at different points on the continuum of mental health. It assumes that everyone has only the liabilities I have, all the advantages I have, and that everyone’s experience of the emotion was the same as mine.  Clearly, this is never the case.

2. Mental illnesses manifest with biological differences.

Those at the high end of that continuum of negative experience, those who fit a diagnosis of mental illness, really experience life differently.  Our scientific instruments have reached a point where we can point to specific neural activity that is reduced or absent in those with mental health diagnoses.  In one sense, we can make a brain-picture of the difference in experience and response to experience as expressed in neural activity.

HealthyvsDepressedBrains

The brains of healthy individuals (left column) released natural opioids during social rejection (colored spots) that may help to reduce negative emotions associated with rejection. In contrast, study participants with depression (right column) did not release nearly as many opioids, which may contribute to a lingering depressed mood following rejection. Credit: University of Michigan

Here is an illustration by way of an example dealing with the experience of rejection. Researchersexamined PET scans of participants while they had simulated experiences of rejection or acceptance by a potential online date. They found marked differences in levels of a common pain and stress-reducing chemical between those with and without diagnoses of depression.  Those with depression produced less of the analgesic molecule when rejected.  Though they had positive responses to acceptance, they were much more short-lived than the response of non-diagnosed participants.

The takeaway: It is not just as simple as “shaking it off” for many of those with a mental illness.  When faced with rejection, those with clinical depression have less neurochemical “pain-killer”.  Their natural healing mechanisms are blunted.  However it has happened, their brains are changed in ways that make healthy behavior harder.  This doesn’t mean that moving on or regaining positive mood is not possible, just that it is a bigger hill to climb.

A metaphor:  When I have the flu, I feel much more physically drained by even the simplest tasks.  If asked, I am physically capable of getting out of bed and cooking eggs for breakfast.  But it would take a huge amount of effort and motivation, I would feel terrible while doing it, and I might burn myself on the pan while cracking eggs cause my hands are shaking that bad.  Afterwards, I would probably spend hours in bed recuperating because I don’t have my normal resources for dealing with the physical stress of a normally easy task.  The mind and body of someone with clinical depression is affected in ways that are just as physically real as having the flu.

3. We know little about why medications work for many mental health problems.

Drugs targeting mental health work by altering the balance of certain chemicals at the synapses between neurons in the brain.  Our knowledge of the brain is rapidly expanding, but the brain is so magnificently complex that we still understand relatively little.

First, we lack a clear roadmap of how, neurologically speaking, many disorders operate.  Neuroscientists still debate which models of depression are most accurate.  Most models of depression actually were developed after a drug appeared that was effective.  The reasoning has often gone like this: “This drug increases serotonin, and many people’s depression improves when they take it.  Therefore, depression must be a deficit in serotonin.” Given that state of affairs, it shouldn’t be shocking that many mental health medications were originally developed to treat other medical conditions.  During testing they were found to have side effects beneficial to mental health, and were then repurposed and refined for mental health treatment.  Without a clear causal pathway, it makes sense that though we know that many medications can be effective, we are less clear about exactly why they are effective.

Take one common example: antidepressants.  They are prescribed to one in ten Americans.  Selective Serotonin Reuptake Inhibitors (SSRI’s) are one of the most common anti-depressants, considered relatively safe and beneficial.  But we do not actually know why the medication works.  For example, we know that the medication prompts higher levels of serotonin at the synapse between neurons within an hour.  But it takes 2-4 weeks for the anti-depressant effects to emerge.  The mechanism for this intended effect is theorized about, but not known.  There is even new evidence that we might have the science completely backwards, and that higher levels of serotonin are worse for depression!

Many people experience some relief from medication, and some I know say they would not be able to manage without it.  My point is not that medication is bad, harmful or should be avoided.  It is just that there is far less understanding about psychiatric medication than one would guess from the huge numbers of people using it.

4. Lifestyle changes can provide a huge benefit.

People with mental illness benefit from the same things that are healthy for everyone.  Healthy diet, exercise, quality time in relationships, religious and spiritual practices, and serving others all tend to have a positive impact on mental health (pdf) . Oftentimes the magnitude of this impact is as great as that of medication or psychotherapy.  Despite this, doctors rarely prescribe diet and exercise changes when people disclose mental health issues.

Turning to religious and spiritual practices can also be a powerful aid in healing.  The sacraments are a source of grace and healing.  Connecting in religious community enables healthy relatedness.  Meditation can be an experience of peace and centeredness.  More and more psychological research has documented this, and books on the topic have proliferated.  Nevertheless, mental illness often makes religious practice more difficult.  Those with a mental illness in church want to receive help through their church, but commonly do not find it offered.

Indeed, the catch is that all these healthy lifestyle changes are often harder to make for someone with a mental illness.  I know how many times I have resolved to exercise more, and it is still a challenge for me.  I also know how little I feel like doing anything when I am really sad or frustrated.  If I mentally put together my natural human tendency to stall and an uncommonly depressed mood, I can have some compassion for just how hard eating right, exercising, or serving others might be.

5. Mental illness has its blessings.

Yep.  Blessings.  In this great, brief article about the blessings of mental illness, the author describes how generosity, spirituality, empathy, an accepting spirit, courage and creativity are often gifts of mental illness.

Indeed, people often grow from the experience of having a mental illness.  When trauma and crisis result in positive changes, this can be labeled “post traumatic growth.” This phenomena has its whole own body of literature, and reflects the ancient wisdom that great good can come from great suffering. Researchers have found that those who endure highly challenging life crises often report:

  • An increased appreciation for life in general
  • More meaningful interpersonal relationships
  • Increased sense of personal strength
  • Changed priorities
  • A richer existential and spiritual life.

As a New York Times article noted, “Paradoxically, many grow even as they suffer. The way we cope with trauma is far more complex than once thought, and the way it molds us is similarly complex. We bend, we break, we repair and rebuild, and often we grow, changing for the better in ways we never would have if we had not suffered.”

In other posts I have talked about the dangers of avoidance, and how our cultural messages often pave the way towards mental health difficulties.  Those who actively battle their illness often emerge with greater awareness of the pitfalls in life and a greater willingness to tolerate suffering.  Engaging in self-reflection or psychotherapy can foster a better understanding of self and more humility and compassion for others.  Achieving something hard yet meaningful, such as recovering from a mental illness, can foster healthy confidence. At the same time it often requires practicing courage and cultivating hope.

Depression and anxiety disorders are real, and are a great example that God often brings good out of even our negative experiences.  After all, our boldest religious symbol is one of intense suffering that yielded amazing grace for all of us.  As a Catholic, it makes sense to me that the suffering of mental illness can also yield manifold blessings.

This article originally appeared on PsychedCatholic and is republished with permission. Photo courtesy of Shutterstock.