“My actual job in life is managing my mental health.” ~ Elizabeth Gilbert
In the 1889 English novel, ‘Three Men in a Boat’, the lead character Jerome decides that he’s suffering from all ailments. He doesn’t just stop at diagnosing himself with cancer, tumors, and other illnesses; he believes that his heart has stopped beating. Rushing to the doctor’s office does him no good as the doctor just rolls his eyes at Jerome’s antics and tells him to go on a trip instead of annoying him. But Jerome believes otherwise; he is a walking medical marvel! In fact, he shouldn’t be inquired about what disease he does have, he should be investigated for the diseases he doesn’t have.
Our dear old Jerome is not to be labelled a fool, however, as this 2 centuries old character is going through the same paranoia that we go through sometimes, when we Google our symptoms and end up fearing for our life. This common cold can be some deadly virus. The stomach ache can be a fatal cancer. Jerome, like us, chanced upon a medical book and misdiagnosed himself as a really ill person. He wanted to get rid of the apparent diseases in his body to feel healthy again.
Being healthy since the past few centuries has been about getting rid of diseases. This approach has brought about massive intervals to deal with public health. We have faced many plagues and epidemics, and dealt with ailments like polio once and for all. This is a big feat to achieve as efficient managing of diseases at a societal level improves the outcome of life for everyone. It ensures that there’s a dignity in growing old; that living well is more important than just living.
Is health, then, just the absence of disease?
Jerome would say yes, but the WHO says no.
The World Health Organization does acknowledge health to be a deficiency of disease, but this isn’t the whole story. This view, which has helped increase life expectancy of nations, is now kind of myopic in nature. Instead, within the Sciences and Social Sciences, there’s a growing interest in examining where the disease is coming from, what is contributing to our health, and what is the true etiology — cause — for it.
If we take a human being and remove all diseases from within this entity (if we can, at all), can we achieve optimum health? The WHO again says no, defining health as a complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Mental Health is an Alive Entity
To be alive means to respond, to be affected, to be receptive to influence and to influence the environment in return. To be alive means to be in a relationship with the world and its elements.
- At one point, mental illness is considered to be too alive. This is a tongue in cheek reference to attributing the bizarre symptoms to supernatural, especially mania, dissociative identity disorder, schizophrenia, talking in different language or voice during psychosis, along with demonstrating peculiar expressions and super — strength.
- The discourse has come a long way from talks of exorcism to a growing focus on individual differences. There’s a saying that no 2 siblings face the same upbringing. Their genes are distinct; the family’s reaction to each child is different, affected by a variety of factors like stress, finances, or divorce.
- The individual differences are a result of micro and macro systems around us, including relationships, family, school, workplace, culture, socio-political climate etc, and ultimately, our mental health is a cumulative effect of these contexts.
- For instance, the literature on attachment states that if our first care takers (parents) are sensitive and responsive to our needs during our infancy years, we feel more secure in exploring the world and learning new things, leading to forming relationships. Similarly, research on touch showed that orphans who were deprived of parental touch in Romania suffered devastating consequences and profound disabilities in their mental functioning. The neglect led to delays in language, physical movements, and executive functioning of thought.
- Moreover, the manifestation of various disorders is also inter-sectioned by individual differences. No two depressed individuals look alike; one may suffer from a lack of sleep and the other may face an inability to concentrate. One may appear to be kempt or neat and the other may struggle to even comb their hair. Therapy targets each case in its individuality while medicine focuses on control of the symptoms. They go hand in hand along with communal support for the best possible outcome.
- Representation of mental illness in pop culture has left something to be desired. OCD is often referred to as a preoccupation with cleanliness when, in reality, that is just a symptom for a few people. OCD is a profound effort to deal with anxiety by unrelated compulsive action, and needs to be approached with more sensitivity. In the same way, dissociative identity disorder is often a result of extreme childhood repressed trauma, but it’s sensationalized in media as something only interesting villains or butt-of-the-joke characters have. This does nothing but stigmatizes the disorder and the individual suffering from it.
- DSM (Diagnostic and Statistical Manual), the bible of the psychological disorders, has its fair share of criticism. The earlier versions held controversial views on homosexuality and gender identity, along with the tendency to put various disorders in boxes. The revised editions are constantly working to correct its past mistakes. Preference of spectrum over labels and de-stigmatizing the queer identity not as an illness are its most recent achievements.
Divergence over Convergence
We have just begun to scratch the surface of what encompasses mental health. The challenge is to be open to a versatility of disciplines and theories while remaining scientific about it. However, in a country like ours, a bigger challenge is making people and communities realize that mental health is a thing.
It’s a thing beyond our religious idols and spiritual ideals. It exists unaffected by the will to live happy, healthy, or successful. It’s not directly caused by being rich or poor (though these do affect the health outcomes). Despite the esoteric definition and lack of a convergent, correct answer, mental health is as real as physical health. It makes up our overall health each day and in every way.