Imagine you don’t feel well… Let’s say you have a sore throat. Aches. You’re feeling chilly, yet you’re sweating. You’re exhausted, and you can’t breathe through one nostril…
What would you do?
- Call out sick?
- Ask a friend or coworker to feel your forehead?
- Go the drug store to get some medicine, vitamins, or cough drops?
- Maybe go to the doctor?
If you went to the doctor, and she told you that you had a medical condition, and that medication could clear it up, or at least relieve the symptoms and help you to feel less crummy so that you could get back to work and your normal life, would you go ahead and take the medication?
Now, imagine you have different symptoms. You feel tired and worn down, but you can’t fall asleep at night. You don’t care about your training or exercise regimen, weekend plans with your friends, or your weekly painting class, even though those things used to be your favorites. All of your thoughts about yourself are negative; even something kind of random feels like it’s “all your fault,” and you can’t shake the feeling that you’re “no good.”
What would you do?
- Call out sick?
- Talk to a friend?
- Go to the drugstore to get medicine, or search for remedies online?
- Maybe go to the doctor?
If you went to the doctor, and she told you that you had a mental health condition, and that medication could help clear it up, or at least relieve the symptoms so that you could feel less crummy and get back to work and your normal life, would you go ahead and take the medication?
If you noticed yourself responding to each scenario differently, or even feeling differently about each scenario as you read through it, you’re not alone.
Despite the fact that mental health conditions are widely recognized as medical conditions that have biological and neurological bases, many people minimize the impact of mental health problems, or even disregard their symptoms and consequences, as if mental illness weren’t real, or doesn’t matter.
Quite the contrary – the National Institute of Mental Health (NIMH) reported that in 2015, 43.4 million adults in the US suffered from a mental illness in the past year; that is nearly 18 percent of the population.1
In addition to mental illness directly impacting almost one in five adults in the US, it also indirectly impacts their loved ones, their academic endeavors, and their work. In 2008 the NIMH reported that major mental disorders cost the US at least 193 billion dollars per year, just in lost earnings.2 This means that mental illness has negative consequences on our entire culture and economy, not just the person suffering with the illness.
So what exactly is mental health, and what constitutes diagnosis of a mental illness?
Being mentally healthy means functioning well in daily life, and having an overall sense of wellbeing. Mental health is central to thinking, communicating, learning, relationships, and personal and emotional well being.3 Mentally healthy people still face adversity and have issues like everyone else, but they’re able to manage obstacles that come their way without being brought down by them. Being mentally healthy, “… determine[s] how we handle stress, relate to others, and make choices”.4
Keep in mind that you can be mentally healthy during stressful or sad times; mental health also includes coping skills, resiliency and grit – the ability to bounce back from setbacks and move forward. However, sometimes life stressors can become so intense that they precipitate a mental illness. This can occur both with and without a genetic predisposition to mental illness.
A mental illness is a health condition that includes changes in thinking, emotion, behavior, or a combination of those.3 They cause distress within the individual, as well as problems with social and occupational functioning. Factors that can lead to mental illness include life experiences like trauma, genetic makeup, brain chemistry, and a family history of mental illness.4
Having a few “bad” days, or even a week, does not constitute a mental illness. Many people experience feeling depressed for a day or two, and everyone has experienced anxiety, yet they are still able to function and maintain their relationships. Mental illness, on the other hand, persists for long durations of time and gets in the way of life. The way mental health concerns manifest themselves ranges greatly. Some people experience a change in mood, while others experience disruptions in thinking. Still others may only notice changes in work functioning or their relationships, but cannot identify internal changes. There are a wide variety of mental illnesses defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).5 Among these disorders, anxiety and depressive disorders are most commonly diagnosed.
Longer lasting than having a “depressed day” or two, the hallmark of depressive disorders is that the depressed mood is persistent, lasts for at least two weeks, and can last months, or even years. Signs and symptoms of depressive disorders include irritability, change in appetite, and change in sleeping patterns. People suffering from depression often experience excessive feelings of guilt, worthlessness, and/or hopelessness. While a person having a “bad day” or a “tough week” may cope by engaging in a favorite hobby, or spending time with a good friend, a person suffering from depression has lost interest in the very people and activities that they used to enjoy. As you can imagine, this loss of interest and withdrawal from life only deepens the depression.
Other symptoms of depression are less obvious and include difficulty concentrating and indecisiveness, and vague aches, pains, or headaches that seem to have no cause. The most dangerous symptom of depression is thoughts of suicide – sometimes these thoughts are very vague and without intent. For example, a depressed person might say or think, “things would be better if I never existed” or, “I wish I could disappear forever.” If the depression has become severe, thoughts of suicide may become more clear and include a plan. For example, a depressed individual may articulate a desire to take their own life, a plan by which they could do so, and an intent to carry out their plan.
Depressive disorders are treatable. The recommended treatment for depression is a combination of psychotherapy and medication. Psychotherapy, or talk therapy can help individuals to identify coping strategies, stop and redirect negative and irrational thinking that is caused by and exacerbates depression, and provide support for the client, their partners and family, who often feel confused about how to help, or frustrated by the symptoms.
All of us have experienced anxiety. People with anxiety disorders, on the other hand, deal with persistent anxiety that does not go away, even when anxiety-provoking situations end. Anxiety disorders are the most common mental health problem in the US.6 Individuals with anxiety disorders can often articulate that the anxiety they experience is in excess of the situation, and that the anxiety interferes with relationships, work, and everyday life.
The hallmark of anxiety is avoidance. People with a simple phobia, for example, avoid that which they are afraid of — classic examples include snakes, bridges, and small spaces. People with obsessive-compulsive disorder, a type of anxiety disorder, may avoid “contaminated” or “dirty” places, while individuals with panic disorder may avoid going to crowded places, like the mall, or a concert. Those with social anxiety disorder will avoid people or situations that may make them feel judged, uncomfortable, or awkward.
Other symptoms of anxiety include feeling restless or “keyed up,” irritability, muscle tension, sleep problems, and racing thoughts. Sometimes people who suffer from anxiety also experience stomach pain or even more serious gastrointestinal issues. Panic attacks can also be experienced by people with an anxiety disorder, which can be very disruptive and distressing. A panic attack is typically described as an episode of acute anxiety that feels overwhelming; people describe feeling dread, or intense fear, increased heart rate, racing thoughts, sweaty palms and difficulty breathing.
Anxiety disorders are treatable, and are the most successfully treated mental disorders in the United States. Psychotherapy and medication combined is the most effective way to treat anxiety disorders, although some people benefit from psychotherapy or medication alone. Some medications for anxiety are fast-acting, yet have a potential for developing tolerance and dependence, while other medications take longer to start working, but carry no risk of dependence. Popular therapeutic techniques for anxiety disorders include exposure therapy and cognitive behavioral therapy, but there are a variety of treatments available today.
Anxiety and depression are only two categories of mental disorders. Other categories of mental disorders include eating disorders like anorexia nervosa, thought disorders like schizophrenia, substance use disorders like alcoholism, among others. Although the signs and symptoms of all categories of mental illness are too extensive to review here, there are many ways you can learn more, assess your own symptoms, and reach out for help.
Assessing Your Own Mental Health
How is your own mental health? If you’re not sure, there are three main areas of your life to consider, by asking yourself these questions:
- Am I functioning effectively at work? At school? Can I accomplish my goals, or at least pursue them in a way that feels productive and meaningful?
- How would I describe the quality of my relationships? Are my relationships satisfying, and do they provide me with support?
- Do I enjoy life? Are there specific activities or goals that bring me happiness or feel fulfilling?
The content of your answers can provide a clear picture of your overall mental health.
If you’re wondering whether or not you might be suffering from mental illness, you can consider three main questions:
- Can I function at work? Am I able to work towards my goals?
- Do I do things that bring me enjoyment? Am I able to get pleasure out of life? Or do I feel distressed regularly?
- What is the quality of my relationships? Am I connected to friends and family, or has there been a change? Do I feel a desire to maintain contact with those close to me, or would I prefer to withdraw and stay away from others?
The answers to these questions can provide a general sense of whether or not you may be having mental health concerns. If you feel worried about your mental health based on your answers, you should seek further help.
- You can take a questionnaire and score it to obtain a very basic assessment of anxiety and depressive symptoms:
- You can read about mental disorders and treatments on one of these websites:
- You can call a free, anonymous hotline any time:
- You can make an appointment with a mental health professional, by:
Talk About Mental Health — For Yourself, and Others
Most of us feel comfortable talking about our everyday aches and pains, our colds and allergies, our general health. The stigma around mental health, on the other hand, makes it less acceptable to talk about, and in turn, makes it harder to acknowledge and seek help for. The most important thing you can do for your own mental health, and for the mental health of others, is to talk about it! Celebrities speaking about their own mental health and recent television shows and movies have helped to make the topic less taboo, but there is still a long way to go before culture views mental health as basic a component of overall health as they do lung health or heart health.
If you’re worried about your mental health, talk to a friend or family member. If you’re worried about someone else’s mental health, say something!
It might feel awkward, but here is an example of how you can reach out to someone you care about who may be having a difficult time:
“Hey, I just wanted to check in with you. I noticed you seem bummed the last few times we’ve gotten together, and you didn’t make it to the last three nights out we had with the girls… how are things?”
- Check in. This is a non-judgmental, non-alarming way to express that you want to talk. You’re communicating that you really want to know how your friend is doing, as opposed to just asking, “How are you,” which could easily be interpreted as the greeting, not the question. And as we all know, the answer to the greeting “how are you?” is always, “fine.”
- Observe and describe. Avoid drawing conclusions and asking if your friend is “anxious” or “depressed.” Allow them to name their feelings! What you can do is observe behavior and describe it — without judgment. In this example, you observe your friend’s change in mood, and their absence at recent social events.
- Open-ended questions. Ask to hear about your friend’s life: “What’s new?” “How are you doing these days?” and “Tell me about what’s happening in your life,” are all open ended phrases I use when I’m checking in with someone. If those examples seem cheesy or awkward to you, say something that feels genuine to you.
Take Care of Your Mental Health!
Equally important as brushing your teeth and eating your greens, you must take care of your mental health! Your relationships, hobbies and goals matter — perhaps even more than getting enough goji berries into your smoothie, or hitting 10,000 steps each day on your step-tracking device. Remember that mental health is health! Whether it translates to planning a vacation, scheduling time to laugh and lounge with your besties, or meditating by the sea, make time for the activities that bring you happiness. If you have sick time, take a mental health day when you need it! Irritability and tearfulness when it seems inappropriate or excessive is just as important to respond to as a sore throat or an itchy rash.
Here is a checklist for maintaining mental health:
- Stay connected to others and make time for your relationships.
- Pursue goals and hobbies that bring you happiness and make you feel engaged and productive.
- Maintain a balanced diet, and enjoy your food.
As you may know, exercise can help to manage stress. But, did you know that exercise has been shown to decrease symptoms of depression, anxiety, and attention deficit disorder? Did you know that exercise is an effective stress management tool, and that regular habits of physical activity can promote improved memory attention? Did you know that exercise can improve self-esteem?7
If you’d like to learn more about the myriad of benefits of physical activity, stay tuned! My next article will review these benefits… as if you needed another reason to get strong!
- National Institute of Mental Health. nimh.nih.gov.
- Kessler, RC, et al. The individual-level and societal-level effects of mental disorders on earnings in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry. 65: 703-711.
- American Psychiatric Association. Psychiatry.org.
- S. Department of Health and Human Services. mentalhealth.gov
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. 2013. American Psychiatric Publishing, Washington, DC.
- National Alliance on Mental Illness. nami.org.
- Ratey, J. Spark: The Revolutionary New Science of Exercise and the Brain. 2008. Little Brown and Company.