Mental Illness vs. Mental Health Part. I
By: Rosemary Callahan, MA, CADC CODP-I, CRSS
Many people want to know where mental illnesses “comes from” or how they “get” it. The answer is… 🤷♀️. There is no one on this planet that can definitively say that they know what region of the body or what exact harmful situation is responsible for the development of a mental illness. Not even the smartest, most well-informed mental health professional (I am talking about myself) can do that. BUT! We have some theories and guesses.
For instance, one theory speculates that mental illnesses are part of our biology and may be caused by a chemical imbalance in the brain or that it can run in the family (side note: check my family tree and you will find a shit ton of evidence in favor of this theory). Another guess is that trauma throughout an individual’s life, especially in childhood, increases the risk for developing a mental illness. Another hypothesis is that environmental factors, including experiences in the home and in the larger community can play a factor in development of a mental illness. Finally, most of the time mental health professionals just cannot get a person wrapped up nicely into a box with a little bow on top. In that case, we take little pieces of each theory, mash them together, rename it after ourselves, and do a TED Talk about it.
Regardless of whatever theory a person runs with, most mental health professionals use something called the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose mental illnesses. The DSM-5 is a requirement for many grad school classes, but it is sometimes used as a three inch thick paperweight and could definitely help start a campfire if you became lost in the woods with only the DSM-5. A similar tool that is used is called the International Classification of Diseases, in its 10th edition named ICD-10. The reason why I am bringing it up is because it organizes mental illnesses into categories. Each comes with a code which is used to bill insurance companies and, yes, we usually need to be codified to get treatment, but that is a different blog post.
The National Alliance of Mental Illness (NAMI) reports that 20% of the population experiences a mental illness and about 5% experience serious mental illness. Serious mental illness means that it severely interferes with an individual’s life. A competent and knowledgeable mental health professional may help a person get an accurate diagnosis; however, some people diagnose themselves as they begin to assess themselves and their place in the world.
Before we get into it, take note: if you are ever feeling like hurting yourself reach out to a trusted friend, call the Suicide Hotline at 800–273–8255, or go to your nearest emergency room.
The following is in no way an exhaustive list, but a quick look at some of the more common mental illnesses. Ok, let’s look at a couple of mental illnesses.
First, we have anxiety disorders which includes Social Anxiety Disorder, Generalized Anxiety Disorders, and Panic Disorder. Some of the symptoms of an anxiety disorder could include racing thoughts, excessive worry, restlessness, or heart palpitations. Next, we have mood disorders which include Major Depressive Disorder and Bipolar I and II. Mood disorder symptoms could include a depressed or manic mood, changes in sleeping or eating, impulsivity, and feelings of hopelessness.
Psychotic disorders include Schizophrenia and Schizoaffective Disorder which usually involve (surprise!) psychosis. NAMI defines psychosis as “a disruption to a person’s thoughts and perceptions that make it difficult for them to recognize what is real and what isn’t.” This can mean that a person may hear, see, smell, feels things that are not there (hallucinations) or may experience delusions, which are very rigid and unwavering beliefs despite clear evidence to the contrary. Examples of delusions include believing one is under surveillance, has supernatural powers, or believe that one is a movie star. Schizoaffective Disorder is similar to Schizophrenia, but Schizoaffective Disorder will also have some symptoms of a mood disorder such as depression or mania.
Trauma related disorders have a common element to them, which is trauma (surprise again). The most common trauma related disorder is Post Traumatic Stress Disorder (PTSD). We often see this disorder with veterans of war, but it has so much of a broader reach and I often don’t think people are aware of it. Any traumatic event where an individual thinks they are going to die or be seriously injured or is a witness to these circumstances “counts” as a traumatic event. That means anywhere from being hit by a car to terrorist attacks to going into year two of COVID-19 “counts” as trauma. Some living conditions in this country could also “count” as traumatic. Seeing mass shootings on a regular basis, living in a destitute neighborhood where violence is the norm, or watching a loved one slowly pass away all “count” is traumatic.
Substance Use Disorders are what they say they are and what people used to call drug addiction, chemical dependency, and substance abuse. There is a strong link between substance use disorders and trauma especially trauma in childhood. Eating disorders include anorexia nervosa, bulimia, and binge-eating disorders and are the deadliest of all the mental illnesses because of cardiovascular damage related to the eating disorder, as well as suicide. Eating Disorder Coalition reports that every 62 seconds an individual passes away from an eating disorder. There are 10 different types of personality disorders and according to the American Psychiatry Association, a “personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.”
Again, this list is not the end all and be all, at all. Just a brief look or overview at what we have out there. And things will change. I believe in the coming years, we will be seeing a huge spike in mental health conditions because of the world we are living in. A lot of studies are coming out now about people developing mental illnesses because of the events of the past year. Many are saying there are a lot more instances of anxiety and depression, but we will also be seeing PTSD among many essential frontline workers. Substance use disorders are on the rise as well, as more people are turning to different ways to cope.
So, are you wondering how we fix all this? Just like there are a number of explanations for mental illnesses there are many different treatment philosophies and approaches out there.
A lot of people who are feeling distressed will first try individual therapy. Individual therapy takes place on a weekly basis and the therapist will have a master’s degree or higher in social work or counseling or something similar. At this time, most therapists and clients are meeting on some sort of telehealth platform, but back in the day we went to the therapist’s office. An individual will work with a therapist to help them find ways to cope with what is distressing. That is going to mean something different for every person.
Sometimes coping or processing what is distressful means that a therapist will teach coping skills from a specific intervention, such as cognitive behavioral therapy. Sometimes coping with what is distressing means that a therapist can be a sounding board for an individual or they may help with role playing a situation. And there will be times when you and your therapist will sit in a room while you cry, and you will use every MFer in the book. At least that is my experience… 😬
Residential treatment is available for some mental illnesses, but it can be difficult to find one covered by insurance. We usually hear about 28-day programs for individuals with Substance Use Disorders, but that is not a definite rule. Most of the time, these types of programs follow the 12 Step model or Minnesota Model of addiction recovery. An individual is introduced or re-introduced to Alcoholic Anonymous or Narcotics Anonymous and sometimes other support groups like SMART Recovery are available. Group therapy may help individuals learn specific coping skills. An individual will have a therapist/case manager and doctor to work with. This type of treatment may also include a family therapy or educational program.
It is normal for an individual to experience extraordinarily strong emotions during this time. Alsoooo… its ok to have strong feelings at any point in your life. Many people are scared to cry, I am especially talking to dudes and baby boomers here when I say this, but if we were not supposed to cry at any point in our lives, why do you have the ability to cry? 🤯 It’s ok to let your guard down and accept help. Carol Kurtz once said, “now is the time to be a gracious receiver.” So, sit down, be quiet, and graciously receive some help!
But, when your emotions or state of mind is coming into conflict with how you want to live your life, additional steps can be taken. An individual may have to decide to seek out a psychiatrist who will assist in managing mental illness with medication. Some people who have a mental illness or develop a mental illness will need medications. Some people, myself included, will need medication for the rest of their lives. There is no shame in that and honestly, if you are not packing a little Prozac from the shit show out there, are you even living? I am joking; do you.
For some, managing a mental illness will be a delicate, life long dance. Right now, we have treatments for mental illness, but not a cure. And some people will not be interested in a cure if one becomes available. There is nothing wrong with any of that. What’s important is finding a way to be comfortable living our lives and contributing to something that has personal meaning. Much of that personally meaning comes from improving our mental health while making progress with our mental illness.
Soooooo… stay tuned in kids… We discuss exactly that next time on… Mental Illness vs. Mental Health Part II
Facts about eating disorders: What the research shows [PDF]. (n.d.). Eating Disorder Coalition.
Mental health by the numbers. (n.d.). Retrieved March 25, 2021, from https://www.nami.org/mhstats
Psychosis. (n.d.). Retrieved April 08, 2021, from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Psychosis
What are personality disorders? (n.d.). Retrieved April 08, 2021, from https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
Originally published at http://sarahlewislcsw.wordpress.com on April 9, 2021.
