One of the things I’ve wondered about in writing about mental health is how to make clear the distinction between the everyday feelings of sadness, worry, or stress that we all have at times, and diagnosable psychiatric disorders such as depression and anxiety.
As we all get more comfortable talking about our mental health, we begin using the same terms to describe very different states of being, potentially giving too much emphasis, or too little, to a specific experience.
For example, am I feeling sad and depressed today because I’ve lost my job, a feeling I will likely rise above in time? Or, am I experiencing depression with a capital D, a more serious disorder that calls for professional help?
Is one or both appropriately called being depressed? And how can we have a public conversation about depression when we each have different ideas of what it is?
That’s why I read with interest a recent article in The Guardian where author Lucy Foulkes suggests that mental health exists on a spectrum with varying degrees of severity — ones that our current language isn’t adequately able to convey.
“Everything we might think of as a “symptom” of mental disorder – worry, low mood, binge eating, delusions – actually exists on a continuum throughout the population,” Foulkes writes. “For each symptom, we vary in terms of how often we experience it, how severe it is, how easily we can control it, and how much distress it causes.”
Foulkes, the author of ‘Losing Our Minds: What Mental Illness Really Is – and What It Isn’t,’ describes this continuum as a messy area with no clear signposts to show when a person crosses the line into an officially recognized disorder. In fact, she suggests, the line itself isn’t the same for each individual.
“In the terrain of mental health, there is no objective border to cross that delineates the territory of disorder,” she writes.
Because of this, Foulkes argues that we need to rethink the conversation around mental health to one that acknowledges and incorporates this messiness. Using the example of depression, she writes, “When you call all low moods “depression”, the term loses any meaning.”
The solution isn’t to stop talking about mental health but, in my opinion, to dive in deeper — to more often acknowledge the variety of experiences so we can all become more aware of both ends of the spectrum and the many points in the middle.
Like Foulkes, I agree we need to hear more about the difficult experiences of those who have been diagnosed with a disorder. We need to hear more of their stories — the kinds of stories that so often get buried for fear of the person being labeled or dismissed socially and professionally. There are numerous benefits here, not the least of which is to continue lessening the stigma around these challenges.
We also need to be able to recognize and make clear those experiences that can be addressed with help or without it.
As Foulkes says, “We need to promote the idea that a great number of distressing psychological experiences can be managed – sometimes with professional help – without needing to reach for the psychiatric dictionary. This is not meant to be critical but to empower, and reassure: don’t feel you have to take on a psychiatric diagnosis, or consider there’s something medically wrong with you, unless you really do find that framing helpful.”
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