As anyone who has ever suffered from a temporary mental health issue or on-off mental health condition such as anxiety/panic attacks, depression, insomnia, seasonal affective disorder (SAD), grief, feelings of isolation/alienation or even suicidal thoughts – all of which I have suffered with in the course of my life – will tell you, despite the fact such things are very common, they are generally greatly misunderstood.
Quite often, sufferers are surrounded by well-meaning but impatient friends and relatives who expect them to simply ‘snap out of it’ or express annoyance at the sufferer. This is not only harsh, but can be virtually impossible – for example, no amount of well-meaning advice or ‘normal’ self-help remedies for sleeplessness (for example, counting sheep) – will work during periods of mental issue-induced insomnia.
Mental health issues often arise from a combination of various factors, some of which may be entirely externally imposed (such as the Covid crisis, economic crisis or the sudden loss of a loved one), or may in fact be physiological in origin – or example, a lack of sunlight and vitamin D, side-effects from a drug regimen or other dietary/physical health conditions. So, the causes and interlinked symptoms need to be looked at as a whole and treated in a complementary way, which is why, if affected by any of these issues or conditions, your first port of call should always be a visit to your general practitioner (GP).
There will always be some sufferers (frequently men, because of the long-term culture of denying or not owning up to any perceived weakness) who tend to brush off any experience of depression or any other temporary mental or emotional imbalance because of the social stigmas around it. Sadly, this generally has the effect of prolonging or worsening the affliction. This may be because of previous experiences of attempting to share about problems socially or with family, who might have responded unhelpfully – for example, by being too busy, not listening to or hearing the sharer’s words, tones or body language adequately, or even backing off out of fear of being triggered by the sufferer’s problems as a threat to their own wellbeing with any issue that is “too negative”.
Again, this then compounds the sufferer’s problems by adding a feeling of being rejected and/or excluded, making it harder to get help as they might conclude that either no one cares, or can or will help them.
If you or a loved one is facing this issue in the UK, and perhaps your/their suffering has become so bad you/they are despairing or tormented by suicidal thoughts, please call Samaritans on 116 123 or see the numbers on Support Line – both are confidential and the Samaritans phone line is manned 24/7. (Please see other resources listed on the NHS website.)
Another problem with social perceptions of sufferers’ issues is that this may arise out of mistaking a temporary issue or condition for a long-term, chronic mental illness – which it is not, as clarified below. Also, many people appear to be confused about what mental health actually is.
So first, what is mental health – and how is this different from mental health issues or illness?
Mental health vs mental health issues and illness – and the problem of stigmas
As Routledge said: “Currently, mental health is often viewed only as mental health issues, and is seen as a sign that we’re ‘broken’ and need ‘fixing’. It shouldn’t be this way. Mental health issues are an incredibly important part of the mental health conversation, but they aren’t the whole conversation. And working on our mental health shouldn’t be a sign that we need fixing, but about us growing as individuals in the ways and areas that we want to grow [in].”
So, first there is mental health – this concerns our minds as an integral part of our overall make-up as human beings, which comprises our bodies, souls (mind, will/heart and emotions) and spirits. Therefore, proper mental health or mind functioning is intimately related to the health of our bodies, souls and spirits.
As the wise writer of Proverbs said, “As a man [woman] thinketh in his [her] heart, so is he [her]” (Prov 23:7) – in other words, how you think will affect your actions, your health and your entire being/purpose in life – so if your thinking follows a pattern of, say, worry, and you don’t make a conscious (as in, mentally determined) choice to replace that mental pattern with healthier thinking, your temporary mental health issue can lead you to experience further or more lasting effects.
Second, there are mental health issues that occur temporarily when our minds become plagued by unhealthy, out of balance or ‘unsound’ thinking – for example, when we are dominated by a sense of failure, devastated by grief, when an inability to sleep distorts our ability to think clearly or sleep, or when we are temporarily ‘bent out of shape’ by financial or work worries. Or it could be that our minds have been so intently concentrated on something for so long that we eventually burn out, despair, ‘lose the plot’ or the will to live, and struggle to make what would normally be simple decisions.
Third, there are several mental health conditions or disorders that are habitual, on-off or persistent. Most of these have been written about and studied exhaustively so as to confirm their characteristics, providing a wealth of objectively identifiable medical or other assessments.
A very few examples of these (please see the extensive list provided by UK charity Mind) would include children displaying behaviours associated with attention deficit hyperactivity disorder (ADHD); the deep shock from the after-effects of a major trauma such as war, now labelled as post-traumatic stress disorder [PTSD]); or an annual depression caused by reduced amounts of sunlight during winter, referred to as seasonal affective disorder (SAD).
Many of these conditions are categorised as a disability since they can affect a person’s ability to behave or function normally, and may also have physical impacts, as our minds and bodies are intricately linked.
Lastly, there is mental illness – according to the gov.uk website, this is when a long-term (more than 12 months) mental health condition is a permanent, chronic or genetic disability – meaning a person is not able to hold a job or function as normal person in society, and their condition or disorder may not only be a danger to themselves, but to others. Among these, it lists dementia (Alzheimer’s), bipolar disorder (manic-depressive illness), obsessive-compulsive disorder (OCD), schizophrenia and depression. Please note, this more severe level of depression is often accompanied by psychotic elements (hallucinations, delusions or paranoia). Such conditions usually involve treatment with specific drug regimens, being hospitalised or treated in a psychiatric ward for periods of time (or as a permanent ‘solution’).
You may have heard the ‘joke’ version of some of these distinctions in Jerome Lawrence’s quote as: “A neurotic is a man who builds a castle in the air; a psychotic is a man who lives in it; and a psychiatrist is a man who collects the rent.” While we all know someone who we would describe as “neurotic” because they are constantly worried about things – often to an abnormal, seemingly ridiculous or unwarranted degree – a neurotic is someone who has a permanent inclination towards unreality, which is in fact a form of psychosis.
Otherwise, ‘neurosis’ is described as a mild mental illness not caused organically, with symptoms of stress, anxiety, depression, obsessive behaviour or hypochondria. Such conditions do not constitute a disability, as most sufferers are still able to function
normally and hold down a job. I hope this has helped to clarify why, for example, a person who is suffering with depression should be understood and receive compassion and proper care, rather than being stigmatised by their family, friends and work colleagues – or even fellow Christians, as sadly happened to me when I suffered bouts of depression and/or insomnia due to work stresses and burnout (or alternatively, as a freelancer, being out of work for long periods), SAD or occasionally feeling isolated and lonely when freelancing from home for long periods.
Now that most people have been forced to experience some of that sense of isolation through Covid, I trust their capacity for sympathy (“to feel for”) or empathy (“to feel with”) for others has increased. Yet for those of us who have, through other circumstances – such as caring for a terminally ill family member or the social isolation of freelancing and working from home as a normal state of affairs – such mental health impacts have been a regular feature of our existence.
Yet, having learned valuable coping techniques and practices such as explained below, some of us have even flourished during the lockdowns, no doubt aided by the knowledge that others were likewise sharing their circumstances.
The prevalence of mental health issues
When it comes to depression, according to the US National Institute of Mental Health (NIMH), 16.2 million Americans (6.7% of the entire population) had at least one major depressive episode in 2016; the World Health Organization (WHO) estimates 280 million people worldwide suffer from depression, which is also seen as the world’s leading cause of disability.
Note, these statistics were largely done pre-Covid, where many more than that have suffered immensely due to the isolation and pressures of lockdown, including the additional health and financial worries and anxieties this brought. According to the medical journal The Lancet, during the widespread Covid lockdowns, “We estimated an additional 53.2 million (44.8–62.9) cases of major depressive disorder globally (an increase of 27.6% [25.1–30.3]) due to the Covid-19 pandemic, such that the total prevalence was 3152.9 cases (2722.5–3654.5) per 100 000 population.
“We also estimated an additional 76.2 million (64.3–90.6) cases of anxiety disorders globally (an increase of 25·6% [23.2–28]), such that the total prevalence was 4802.4 cases (4108.2–5588.6) per 100,000 population. Altogether, major depressive disorder caused 49.4 million (33.6–68.7) DALYs [disability-adjusted life years] and anxiety disorders caused 44.5 million (30.2–62.5) DALYs globally in 2020.”
To conclude, the main difference between mental health and mental health issues is that while mental health is indeed good and vital to our overall health and wellbeing, if we neglect to care for the health of our whole beings – including our minds – and fail to heed any warning signs or symptoms, our overall mental health can soon become a mental health issue. The good news is that, as with any other physical illness, any temporary mental health issues or longer-term condition can be rectified if caught soon and correctly diagnosed.
In my own experience – particularly as a long-term and very active social dancer / ex-professional salsa, etc dance teacher, which has benefitted me immensely by giving me youth-enhancing energy, but has also left me with numerous physical scars in the forms of feet, knee, hip and other physical injuries – I have unfortunately had to learn the hard way that if I fail to listen to the whispers in my body when I am overdoing it, I will only risk further and potentially more debilitating injuries.
Therefore, I have had to learn how to pace myself, and to be aware of and stop when or if I feel any painful twinge. I only wish, with hindsight, I had been as quick to pace myself with work and other commitments in the same way, instead of overdoing it and ending up being either physically ill or mentally burnt out, both of which have at times left me prone to periods of the ‘black dog’ (a term for depression usually attributed to Winston Churchill).
While the simplest explanation for my own mental health issues was a prolonged lack of rest, there were also other factors that affected me – for one thing, after some 30+ years of living in England, where it gets dark at 3.30pm in winter, I know that particular SAD black dog very well – every autumn, I can feel him lingering outside my door, and hear his howling to be let in. Unsurprisingly, the lack of sunshine also contributes to physical symptoms, largely connected with vitamin D deficiency. [Note: if you like me suffer from SAD, a good aid to combatting this is a specially designed SAD light – a lamp that will help to reproduce the quality of diffuse morning light lost in winter. See here for lamps.]
So, if listening to our bodies is important for protecting our physical health, shouldn’t we also learn to ‘listen to’ what is going on in our minds to protect our mental health? If the ‘solution’ is really that simple, then why do so many people – according to Mind, one in four people experience a mental health issue of some kind each year in England – suffer poor mental health? And how has this become such a problem in our modern-day society, particularly within our work environments?
Let’s take a closer look.
The mind-body-spirit connection vs machines: the brokenness of modern life
The truth is that the mind-body-emotions-spiritual ecosystem that forms the whole strata of our beings as humans is so intimately and dynamically connected that, like the complex network of roots beneath the ground of a tree that are connected underground to all of the other trees in a forest, if there is anything that is unsound, disturbed, unwell or out of balance in one sphere, it will by nature impact the entire structure, ultimately also affecting all the other trees in the forest.
As our minds, emotions, spirits and bodies are an integral part of our make-up, each must all be healthy in order for us to flourish and be whole, and thus be as successful and fulfilled as we are capable of being – the true goal and state of mental health.
One wonders why, if a holistic concept of the mind-body-soul-spirit connection as advocated by Hippocrates was such common knowledge to the ancient Greeks that a concept of the connectedness of the head and body would have been immediately understood by their audience, it is such a foreign concept to us now? Why do we persist in compartmentalising our lives so that we ignore or neglect some parts, only to find ourselves overwhelmed, under-soul-nourished and dangerously out of kilter?
It seems that in our endless quest for achievement, self-fulfilment and success, our lives are increasingly busy and frequently fractured – as per the German word zerrisendheit – ‘torn-to-pieces-hood’. Rather than seeking a whole-istic (holistic) approach to life, we have invented a whole slew of dichotomies and compartmentalisations that unbalance us and disturb our peace, mitigating against any wholeness or connectedness, and ultimately disrupting our mental health. No wonder the health and wellness industry – which emphasises the mind-body-spirit connection – is now worth over $4.5trn!
Although there are various theories about how and why this split occurred historically – and God knows, the worst culprit behind both relentless capitalism and workaholism is undoubtedly the Protestant work ethic and its tendency to make a god (idol) of work – these days we as humans are competing not only with each other, but also with machines.
We are under increasing and effectively dehumanising pressure to validate our worth to our employers by proving that our productivity is justified in economic terms. As a result, all too often we attempt to function like machines, which we are not – and never can be. Yet if even machines and computers need to be repaired and shut down for a time to be able to continue to function properly, so we also need to ‘shut down’, take time out to rest, reflect and recharge.
Some 11–12 years ago, I was working as a chief sub-editor and production manager for a B2B media start-up – a weekly international newspaper for the renewable energy industry, ironically – where, as a result of regularly working 16-hour in-house shifts in the City (an additional two-hour commute each way), I inevitably burned out. I remember once going outside for a cigarette break (I have joked for many years that if I didn’t smoke, I would never get a break) on a particularly frantic press day. When I looked at my smartphone and saw “Switch off’, I took it as a ‘word from God’ or warning I needed to do that.
Sadly, at that time I was so engrossed in resolving the ever-evolving tech issues and issues within my team that I neglected to heed that warning – and indeed had so neglected both my spiritual practices and my physical health that in the end I not only became mentally, emotionally and spiritually burnt out, but also temporarily lost the use of my right arm due to the beginnings of a repetitive strain injury (RSI)-like condition. I then experienced an overwhelming depression for several months, worried I would never be able to work again – or even to do the art and writing that I had long known was my true ‘calling’.
Some months later, my husband and I were travelling in France and could not find accommodation as all the hotels were booked for a conference. Suddenly, we noticed a sign for Taizé – an ecumenical Christian community I had long wished to visit. We ended up staying there for about a week, during which time I joined in several group discussions. At one point, a wonderful Albanian nun said: “We are not machines, and were never meant to work non-stop. God designed us for rest. That is why He created the Sabbath, and blessed it and called it holy – because we cannot truly be holy [or whole] if we do not rest.”
That was when the penny finally dropped that I was indeed trying too hard to function like a machine, and I had to accept I simply could not – and certainly should not – continue in such an unnatural manner.
Practising mindfulness: key to a healthy mind
I mentioned earlier the need to pay attention and learn to our bodies, and the need to do the same thing with our thoughts so that we can keep our minds in a healthy place. Slowing down from our hurried, frantic lives and being still and quiet enough so that we can listen objectively to the conversations in our minds is an essential discipline to ensure we do not get “bent out of shape” with fear or anxiety, burn out and “lose the plot”, or become engulfed in streams of negative or even suicidal thoughts.
One of the best tools to ensure the proper functioning of our minds is the practice of mindfulness. As stated on the Mindful website, “Mindfulness is the basic human ability to be fully present, aware of where we are and what we are doing, and not overly reactive or overwhelmed by what’s going on around us.”
Mindfulness involves tuning out all of the distractions, worries or thoughts that can obsess or plague us from time to time and just focusing on the present. Some people do this by practising meditation, prayer or yoga, for example; others by actively focusing on the rhythms of their breathing. Others concentrate on the immediate physical sensations of a rhythmic or repetitive manual task – say, washing dishes or knitting, or engaging in a creative act such as making art or playing music.
Spending time in nature and listening to your breathing as you walk, simply studying the structure of a tree or leaf, or observing a bird in flight, is also a wonderful way to recover a sense of being fully present and alive to the immediate moment. Such practices of ‘zooming out’ from the world and all its problems and ‘zooming in’ on the present is an excellent way to experience calm, focus and mental clarity – it is similar to the experience of perspective we have when we climb a mountain and can see a whole city spread out below us.
I personally find it helpful to look up at the stars at night and meditate on the massive grandeur of the heavens, to ponder my own / the world’s ultimate insignificance in contrast to the cosmos. In the light of the vastness of space, my own puny problems or whatever else is going on around me or in the world suddenly appear ridiculous. It reminds me that the God who made the heavens is ultimately in control.
When I focus on that, I find it quite liberating to realise the truth of my position as a creature, ultimately created and ordered by the same God (or Intelligent Designer, if you prefer) who made the heavens as well as all the tiny creatures that live in the unseen places in the soil or the depths of the sea.
It is also reassuring to think of Jesus’s words: “Look at the birds of the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? And who of you by worrying can add a single hour to his life?”
So, if I take the time to zoom out from my problems, and just zoom in on my breathing or, say, a single tree or bird in nature, it will help me to gain a perspective and a distance from whatever problems are troubling me and causing me to lose my peace. I can then choose to give those problems to God and experience freedom and clarity by focusing on my current issues one by one or one step at a time, rather than becoming overwhelmed by them all or allowing my thinking to become unhealthily distorted.
- Mental health is part of our entire make-up as a humans and is essential to our wellbeing.
- Mental health issues, conditions or illnesses are not the whole story – positive mental health also includes our growth and development as people.
- Even machines need time out to ‘shut down’ – so take time out to rest, reflect and recharge.
- Listen to your internal conversations to observe any negative patterns, and choose positive ones.
- Above all, learn to practise mindfulness by zooming in on the present moment.