Mental health: Let’s get back to basics

“It has become appallingly obvious that our technology has exceeded our humanity”.
Albert Einstein

Becoming mentally ill delivers a double whammy. First off, you have to deal with the condition itself, with all its attendant anxiety – even terror – and accompanying feelings of hopelessness and disconnect from people around you.

Then, on top of that, you have to cope with your feelings and thoughts about what you have been experiencing – which can include fear that you’ll never get better, lowered self esteem and feeling ‘different’ from other people, or as if you are nothing more than the illness and have lost any real sense of who you are.

What comes first – the illness or the person?

A real danger for us is that because our culture is so focused on our technical achievements and marvellous drug developments, simple humanity gets squeezed out of the calculation.

Mental illness has become so ‘medicalized’ that we tend to see the condition first and the patient (with their unique personality, idiosyncrasies, interests and strengths) second. If at all.

It’s only comparatively recently that we’ve brought the language of physical medicine to bear in emotional distress. There is nothing inherently wrong with this, and it is sometimes very helpful. But the danger is that normal human experience gets tagged as having a ‘medical’ cause, and the wider life issues of the person who is distressed get discounted.

A psychiatrist I know commented to me: “It’s like some of us want to deal with the condition by treating it with drugs, but not look at the person behind the condition, with all their very human needs and wants.”

The rising tide of mental illness

If we take a wider view for a moment, we see that increasing numbers of people are experiencing mental illness. (1) I doubt that this is due to a sudden rise in the incidence of ‘faulty brain chemistry’ in people who live in industrialized nations (where there are much higher rates of mental illness than in non-industrialized nations (2)). I think it is much more likely that there is something about the way we are living nowadays that may be producing greater rates of depression, fear, addiction and anxiety.

Why are so many of us unhappy? Why do hundreds of millions of people take medication every day to try to help them manage their lives or to numb the pain of living?

And why are levels of mental illness and addiction rising so frighteningly fast? If we assume it’s ‘all to do with chemical imbalance’ (i.e. – there is a relatively clear cut physical cause) then we stop looking at how life is lived and at the inevitable effects living a certain way has on our mental wellbeing.

People have mental illnesses in the context of their lives.

Unhealthy environments

For example, if – as research has shown – people can heal better from physical illness when they have a view of nature (3) then it behoves us to ask: What is the impact of our environment and day-to-day life on our mental wellbeing? And how does a frightening environment, or a built-up concrete environment, or an isolated environment, affect the mind?

Genetic vulnerability

It is true that some people seem to have a genetic vulnerability to developing mental illnesses like bipolar disorder or psychotic illness. However, when long term recovery rates for even such ‘genetically influenced’ disorders are much better in so-called ‘primitive’ cultures (4) and when other mental illnesses such as clinical depression are actually unknown in such cultures (5) then we can surely draw two conclusions.

Something about the way we’re living is tipping increasing numbers of those people predisposed to certain mental illnesses over the brink. And something about the way we’re treating these conditions isn’t working.

It’s safe to say that both society and treatment need to change in order to really help the mental health of those who live in it.

So what can we do?

Do you know what you need?

Take a simple analogy. If the flowers in your garden start to wilt and droop, you don’t first check for pests or wonder whether you’ve planted a genetically duff lot from your garden centre. You get out your hosepipe or watering can. You know that your plants have a ‘genetic predisposition’ to die if they don’t get water. Water is their first essential need.

People have both physical and emotional needs. The extent to which any of these needs are not met closely corresponds to how physically and mentally ill we become.

The Human Givens approach to health and wellbeing lists the needs we all have to meet in life if we want to stay healthy and thrive rather than just survive. (6)

These needs include:

• Security: You need to feel safe and secure and feel you have some safe territory. This might also include the need for privacy.
• Sustenance: You need sufficient balanced nutrition, adequate physical exercise and regular good quality sleep to maintain your physical health.
• Attention: You need to regularly give and receive quality attention.
• Volition: You need to feel that you have some influence and control over your own life.
• Emotional connection: You need to be connected to others through friendship, work relationships, loving relationships and physical intimacy.
• Community: You need to feel part of something larger than yourself, a community of people.
• Status: You need to have a sense of your standing with others, to feel you have a recognizable and valued role in life. This also connects to a sense of competence and achievement.
• Achievement: You need to find activities and occupations that stimulate and stretch you, learning physical and mental skills and exploring and developing your potential.
• Meaning: When these needs are adequately met then life feels meaningful and enjoyable.

The more fully a person’s needs are met, the more healthy their self esteem will be.

Human needs and mental health

Consider: a bully always seeks to block one or more of the above needs from being met in their victim. And we know that being bullied is a significant predictor for developing emotional conditions such as depression and post traumatic stress disorder. (6)

This neatly illustrates how very central the meeting of these needs is to good mental health. And could it be that in some ‘non-developed’ cultures these needs are more often better met than in ours by the way day-to-day living is structured?

I have seen even the most severely mentally ill psychotic patients slowly, and then increasingly, begin to thrive once their needs – the needs they share with the rest of humanity – start to be properly met.

We are all of us somewhere on the continuum of mental wellbeing at any given time. We need to stop looking at those who are suffering ‘mental illness’ as different from the rest of us and instead see that their distress, even if it seems shocking or extreme, is a normal and fully understandable aspect of being human and trying by every means possible to cope with very inadequately-met essential needs.

This change of perspective will help us focus on and improve not just our own mental health and that of those close to us, but the wellbeing and health of the world in general.

Big claim. But I will stand by it.

Mark

Notes

(1) According to the Royal College of Psychiatrists report No health without mental health(2011), a quarter of all patients in general hospitals now have mental health problems.

(2) Depression has become the number one psychological disorder in the western world, yet is much less prevalent and even non-existent in non-industrialized cultures. Recovery rates for all mental illnesses, including ones supposedly difficult to fully recover from such as schizophrenia, are much better in such cultures according to recent studies by the World Health Organization. See: People can recover from mental illness. Daniel Fisher, M.D., Ph.D. and Laurie Ahern (1998)

(3) See: Healing Spaces: The Science of Place and Well-Being. Esther M. Sternberg, M.D. Harvard University Press (2009)

(4) One research finding, confirmed by several major studies in five-year follow ups, shows that around 64 per cent of people in third world countries recover fully after a first schizophrenic breakdown. Yet the comparative figures for the developed world show only around 18 per cent recover fully. See: Schizophrenia: Manifestations, incidence and course in different cultures: A World Health Organization ten-country study. Jablensky, A.; Sartorius, Norman; Ernberg, G.; Anker, M.; et al. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, Vol Mo Suppl 20, 1992, 97.

(5) See: Culture and depression : Studies in the anthropology and cross-cultural psychiatry of affect and disorder. Edited by Arthur Kleinman and Byron Good. University of California Press, 1985.

(6) See: Human Givens: A new approach to emotional health and clear thinking. Joe Griffin and Ivan Tyrrell, Human Givens Publishing (2003).

(7) See: The Social Outcast: Ostracism, Social Exclusion, Rejection, & Bullying. Williams, K. D., Forgás, J. P. & von Hippel, W. (Eds.) Psychology Press: New York, NY. (2005)