Is it all in our heads? What does mental “illness” really mean.

“Don’t ask whatʼs wrong with me, ask whatʼs happened to me.”

Jacqui Dillion

Mental illness

What if certain mental diseases or illnesses aren’t pathological in their nature but are simply a manifestation of how we react to our environment and certain stimuli?

This is what Dr. Peter Kinderman thinks might be the case.

“The idea that our more distressing emotions are nothing more than the symptoms of physical illnesses, which can then be treated like any other medical disease, is pervasive and seductive. But it is also profoundly flawed, and our present approach to helping people in acute emotional distress is severely hampered by old-fashioned and incorrect ideas about the origins and nature of mental health problems.

We should stop thinking about ‘abnormality’, ‘disorder’ and ‘illness’, and instead offer humane and effective responses to what are understandable and normal psychological reactions. Because this is an approach which celebrates our shared humanity rather than relying on expert treatment of illnesses, I think that the best chance for real change lies in members of the public actively campaigning for better services to promote psychological wellbeing, for choice and for a choice which reflects a more appropriate understanding of our problems.”

Our Turbulent Minds

While I also don’t deny that chemical imbalances, genetics and trauma can contribute to mental illness, like Dr. Kinderman I don’t believe all mental illnesses are caused by a pathology in the brain. A what point does chronic stress become diagnosed as anxiety or depression? And does being labelled as such, change the way healthcare providers treat such a patient or even how the patient views themselves?

“Psychiatrists are full doctors with the ability to issue diagnoses and prescribe medication. But these days, many of them spend much less time than they did in the past practicing psychotherapy, or what we might call “talk therapy.” Instead, they tend to meet with patients briefly and write prescriptions. As a result, “psychiatry” has more or less become shorthand for an industry of medication management.

When, in my early 20s, I asked a new psychiatrist — one of the only mental health providers I could find who would accept my insurance and had openings for new patients — if we could try discussing some of the problems Iʼd been having, she looked at me as though Iʼd proposed a joint mission to Mars. “Ohhhhh,” she said, nodding, as my meaning dawned on her. “You want to see a counselor.””

It’s Not Just a Chemical Imbalance

Dr. Kinderman doesn’t believe that illness is the right metaphor to use, or the right framework of description to use for our distress. He absolutely believes in the reality of the phenomena like depression and anxiety but that the term illness isn’t a right description. Not everything that is bad in life is an illness, when people fall into debt or loose their jobs the consequences can be terrible. However is there an underlying physical pathology which causes these symptoms? Rather, we might have a normal healthy brain simply responding to difficult situations be becoming depressed.

I live in an area that has a high rate of visible homelessness. While I’ve been incredibly fortunate to never have been in that position, I have experienced a brief period of not having a stable home. I can easily see how this external, environmental factor could manifest itself if left unresolved. However it’s not something I would treat with medication or talk therapy, but a societal, political and practical intervention.

I recently attended a lecture on the topic of trauma. One speaker was presenting on some research performed in a Syrian refugee camp where they noticed that some of the children were bed-wetting – clearly a sign of trauma? However, it was discovered that it was due to the toilets being too far from the children’s tents. This is an example of an external factor that could be simply rectified.

Root causes

More people than ever, especially young people, are talking about mental health, which is slowly eroding the stigma associated with it. But rather than simply looking forward to treating the symptoms we need to look in reverse at what causes them. It’s the same as the nature vs. nurture argument, how much is caused by our genetics and how much is caused by our environment?

“The evidence convinces me that variance between us in terms of our neurological processes seems to account for very little in terms of the observable differences between us in our mental health – or indeed human behaviour in general. Most of the variability in peopleʼs problems appears to be explicable in terms of our very different experiences, and how we respond to them, rather than genetic or neurological malfunctions.”

Our Turbulent Minds

“The jury is out on the extent to which mental illness is hard-wired, but black-and-white narratives of psychopathology neglect the tremendous psychological impacts of social and material circumstance: access to the basics of survival; the burdens of intergenerational trauma and insufficient social support systems; the existential gut punch of pervasive injustice.”

It’s Not Just a Chemical Imbalance

Unfortunately we can’t do much about our genetics, nor our upbringing and start in the world; but hopefully, as adults, we do have a modicum of control and efficacy over how we choose to live our lives. Although we have to operate within certain parameters; be it a capitalist society, a workplace culture or a housing association, we are, at least in the Westernised world, allowed a degree of freedom of choice.

I believe we should all campaign for a more equitable, just and compassionate society. I also think there are many things we can do in our own lives and our local communities that are more readily achievable.

Simplicity as a solution

This is where I think simplicity can help. I believe there is a strong causal link between simplicity and wellbeing. By reducing the demands and stressors that external forces such as society, culture and companies can place on us, we can alleviate their detrimental consequences.

Doing so takes a great deal of effort and time in figuring out a) what’s important and b) how to then do what you’ve defined as important in the simplest and most efficient manner.

Of course we can have all the external measures of success in the world and still find ourselves completely miserable at the end of the day. But by fulfilling our basic human needs, we can eliminate them as a potential cause.

As humans we don’t need much to function healthily. We need to remind ourselves that beyond, food, shelter, clean water and warmth, there is little else that will greatly improve our wellbeing as much.

I also make it a daily priority to get at least some light exercise, whether a walk or a jog or a bicycle commute. I maintain a regular yoga practice, try to eat a balanced diet and get enough sleep, read constantly, and work to nurture social connections and build community. All of these, Iʼve learned, I can do to maintain my emotional and psychological well-being, and the key word here is “maintain.” Itʼs about process, not prognosis.

Rather than view my psychological experience as a biologically fated roller coaster, Iʼve come to think of my mental health as a reflection of the complex ebbs and flows of life; accordingly, Iʼve developed tools to better mitigate that which I canʼt control, an agency I once wouldnʼt have imagined possible. I feel, for the first time, like a person who belongs to the world.

It’s Not Just a Chemical Imbalance