What is mental illness?
An Engage Aotearoa info pack | Updated May2020
Written by Miriam Larsen-Barr
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A bio-psycho-social response to the world
Mental illness is the popular term used to talk about mental-health problems. Mental-health problems are complex responses to the world that keep us stuck in distressing or unhelpful experiences that stop us from living life the way we want or need to. Mental-health problems are just as serious as physical illnesses but they are not as easy to understand.
Mental-health problems are ‘bio-psycho-social’ conditions. This means they involve our body, mind, and our relationships with others. This is also true for our positive experiences of mental health.
Mental-health problems are not permanent states. We all move between different degrees of wellness and unwellness as our situations, behaviours, physical states and ways of thinking shift. Often part of the problem is that we are doing the same things too often and our experiences get stuck on repeat.
This could happen to anyone. Human beings are complex creatures; our wellness is affected by all of the physical, psychological and social aspects of living in and responding to the world. And the world is not easy.
Mental-health problems are not brain diseases
A brain disease is:
- Parkinson’s disease: when brains stop processing dopamine properly.
- Huntington’s disease: when people have a gene that causes mutations in areas of the brain.
Mental-health problems are quite different from brain diseases. Our brains and bodies are a crucial part of the mental health mix, but they do not operate in isolation. Our environments, the things that happen to us, and our responses to those things are equally important.
Experiencing a brain injury or impairment, a nutritional deficiency or physical illness can all contribute to mental-health problems. And so can the experience of loss, prolonged work stress, trauma, childhood distress, neglect, bullying, family conflict, ostracism, spiritual crises and any number of other accidents, mistakes and acts of nature that impact on the way we see and interact with the world. The things that happen to us affect us.
Mental-health problems can be caused by many different things and there is no single cause that is the same for all people, even if they have the same diagnosis. There is no conclusive evidence that changes in neurotransmitters or genetics cause mental-health problems. Even these rely on cues from our environment to be ‘switched on’. It is most useful to take a holistic view.
Usually there are multiple different factors involved. It is important to pay attention to the whole picture and how the parts fit together. When we do this, we can see that there are many things we can do to get to a better place, step by step.
Our brains are processors
Click the image to enlarge it.
Our brains are constantly making sense of the world for us so we can move through it as safely as possible. Our thoughts, urges, memories, physical responses and moods are the tools our brain uses to guide our actions as quickly as possible. The experiences we describe as mental-health problems can be understood as extensions of these completely normal survival processes that our brains have evolved to keep us alive. What is happening in our brains often tells us more about what is happening around us, what that means to us and how we are coping with it than it tells us about the health of our brain. Everything we do results in some kind of activity in the brain. All the different parts of our experiences are connected so they both affect and are affected by each other in a continuous cycle.
Some situations, behaviours and ways of thinking hold us in the same emotional states for a long time and sensitise those pathways in our brains so they become automatic. Repetition also strengthens those pathways. It is difficult to change these automatic patterns because they have usually seemed to help us survive and they shape how we make sense of our reality, but nonetheless it is possible and actually most people do recover.
Our brains are equipped with an amazing set of tools that allow us to reflect, pause, self-regulate, imagine a different future, plan, and choose our next response. The human brain has a remarkable ability to keep adapting and learning across our lives. Even when neurological processes are impaired, we can find ways to compensate and cope as best as we can. It is always possible to start building new response pathways for ourselves. This could come from making changes to our actions, way of thinking, or our situations – often the people around us can make useful changes too.
What does a diagnosis mean?
A diagnosis is a label that describes a cluster of troubling or unwanted experiences that often occur together in the population. If you have received a diagnosis and it is correct, it means you experience a collection of behaviours, thinking styles and feelings that persistently disrupt your ability to live well – and that other people experience similar things too.
These experiences may be described as symptoms like hearing voices, low mood, delusions, paranoia, elevated mood, anxiety, panic attacks, insomnia, irritability, suicidal thoughts, dissociation and more. The diagnosis is based on the combination of symptoms and the pattern they follow across time and different areas of life.
Every diagnosis is different and people experience them in their own way. In each case there are situations and ways of relating to them that help set up the unwanted experiences and keep them going. Many people who experience mental-health problems have been through trauma in their lives, but this isn’t true for everyone. A diagnosis doesn’t say anything about what might be causing the problem; an individualised assessment and formulation is needed to know the cause. Diagnostic labels just describe what the symptoms are. Every person is dealing with their own set of puzzle pieces. No matter what the mental-health problem is, we are ALL people responding to our worlds.
Around half of the population will go through a mental-health problem in their lifetimes. So it is a normal thing to face as part of being human in this world. A mental-health problem is nothing to be ashamed of. A diagnosis is not a sign of weakness; it is a sign that we are struggling in our response to something and could do with some help.
How do I recover?
Recovery is a process of growth as we find our way towards improved wellbeing and we each get to define what that means for us. It helps to start with the basics; make a commitment to nurture yourself for a while. Get yourself to a safe place with safe people if you need to. Spend the next couple of weeks making sure you’ve got all the rest, movement and nutrients you need to be resilient to stress. Thirty minutes of exercise a day has been proven to help improve mood, concentration, and sleep.
It helps to link in with our communities. People who have social support networks and resources (and use them) tend to have better mental health than people who do not. We are social beings; in the Stone Age days of our evolution, survival depended upon our ability to be part of a group and we are still ‘wired’ that way. So it helps to get connected.
Some people find that medications can be helpful for a while; they can help to lessen the intensity of some experiences so it is easier to work on the thoughts and behaviours. They can bring their own set of adverse effects to manage as well as withdrawal symptoms when they are stopped and it is important to talk about these things with your prescriber so you know what to do. Many people recover using non-medical approaches like psychotherapy, peer support, online learning, nutrition and exercise.
It’s important to give yourself time. As you become more skilled at understanding your experiences, testing out new responses, meeting your needs, and connecting with what matters to you, things will start to shift. The people around us can make a big difference to this process. And there are many supports to help you find a path through.
Who can help?
There are heaps of people out there who can help.
Your GP is a good person to talk to. They can help you with referrals to supports and screening for physical health issues that could be contributing to your difficulties. Some GP services have funded talking therapy available on site.
Every District Health Board (DHB) in NZ has specialist mental-health services for different ages, cultural groups, and people with complex needs. Every DHB has an after-hours urgent team available to help at times of crisis.
Many psychologists, psychotherapists, counsellors, occupational therapists and family therapists also offer private services. Some people may be eligible for funding to help pay for this from WINZ or ACC.
Community support services provide a range of different options including employment advice, emergency housing, respite stays, group activities, supported accomodation, and support workers. There are several peer support services and networks where you can connect with others who have been there. You’ll find services set up specifically to support people facing addictions and people who have experienced family violence or other forms of trauma.
There are helplines where you can reach a counsellor by phone 24-7 if you need one, creative arts centres, services to support your family to understand and more. Your community is full of recovery resources if you think creatively. If you can’t find it in your community, there’ll probably be an app or website to help fill the gap.
