Unpacking Mental Illness: Five Questions and Answers On a Misunderstood Epidemic

There have been some great improvements over the last decade in removing the stigma from the term “mental illness” or "mental disorder". 

Recent examples include many high profile people speaking up about their personal struggles, corporations like Bell championing awareness through Olympic athlete Clara Hughes and the critical acclaim for such movies as “A Beautiful Mind” and “Silver Linings Playbook". However, much stigma still remains and stigma often feeds ignorance while starving healthy conversation and education.

When you look up the term mental illness on the internet even the most educated sources admit that there is still some confusion about how to consistently define it across different organizations and nations – however there are some very basic and fundamental things that are common to all definitions and, in the interest of keeping things simple and clear, we will focus on those.

In this paper we will ask, and seek to answer, five questions.

> What is mental illness?

> Why is it important to “unpack” or understand mental illness?

> Is mental illness just an excuse?

> What causes mental illness?

> How can we treat mental illness?

What is mental illness?

The first thing that should be considered is the difference between mental health and mental illness. Like physical health, mental health is not just the “absence of an illness” but really a lifestyle and outlook that promotes health and seeks prevention of or early diagnosis of an illness.

Webster’s dictionary simply defines a mental disorder (i.e. illness)  as 

“noun: a mental or bodily condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological functioning of the individual—called also mental illness" 

Wikipedia describes it as “…a psychological pattern or anomaly, potentially reflected in behaviour, that is generally associated with distress or disability, and which is not considered part of normal development in a person's culture.”

It further states: “Mental disorders are generally defined by a combination of how a person feels, acts, thinks or perceives."

This paragraph from a Canadian government website on the topic describes some of the different types of mental disorders that have been determined:

“The complete list of mental disorder diagnoses is available in the DSM and ICD manuals.  Some of the major groupings of mental disorders include:

mood disorders (depression and bipolar disorders),

anxiety disorders (generalized anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder),

psychotic disorders (schizophrenia and schizoaffective disorder),

eating disorders (anorexia nervosa and bulimia)….”

( http://www.parl.gc.ca/Content/SEN/Committee/381/soci/rep/report1/repintnov04vol1part2-e.htm )

We all have our quirks and idiosyncrasies but the key sign of a mental illness is that it seriously impairs our daily lives.

Why is it important to “unpack” or understand mental illness?

Simply put – because it has become an epidemic of suffering and a leading cause of death that affects all types of people all over the world.

It's not like mental illness is new to the world but like an older relative of mine said “We just didn't have names for it back then”.

The World Health Organization (WHO), reports that "over a third of people in most countries report problems at some time in their life which meet criteria for diagnosis of one or more of the common types of mental disorder."

We are seeing it in every area of life:  the home, work, school, church, sports - you name it.

Is mental illness just an excuse?

Is there a difference between mental illness and things like bad behaviour, laziness,  character weakness, substance abuse or addiction?

Short answer?  A resounding NO it is not an excuse and YES there is a difference.

In many respects, having a mental illness is no different than having a broken leg.  Regardless of how strong or determined you are or how much you “will” yourself to walk normally – the fact remains that you have a fractured bone and you need to acknowledge that and take the proper steps in order for it to heal.

Even a small attempt to research this issue will reveal that It’s hardly an excuse or "imaginary". Ask any medical or scientific professional. Talk to anyone who has been through it or who has seen a loved one go through it. It affects every walk of life regardless of age, race, religion or social class. It is very real and the sooner we own up to that the sooner we can begin to help people live and live well.

Another point worth making on this topic is that , although mental illness is a separate thing from the afore mentioned “flaws”, it can make a person more susceptible to them. In other words, someone who is struggling with a mental illness can become so tired, confused and frustrated that they may well exhibit bad behaviour or more quickly resort to substance abuse in order to self-medicate.

Judging these people harshly (or ignorantly) will only further compound the root problem; whereas having a sympathetic or empathetic attitude may help them ( and you) to discover the real problem ( in other words – diagnose it). This, in turn, can eventually help to heal them and clear up the “symptoms” we see acted out.

This is not to say that people struggling with a mental illness bear no responsibility or accountability. However, the root issue must been understood and treated  first and, socially speaking,  we should view it no differently than any physical illness that we would readily understand and seek help for.

What causes mental illness? 

Is it physical? Is it emotional? Is it spiritual?

As far as the physical and emotional – well it can often be a mix of both which in turn can sometimes make for a vicious cycle. We can trace it to both nature ( including heredity  and chemical imbalances) and nurture ( emotional trauma for example).

However, it cannot be overstated how important it is to recognize the difference between what is known as “Clinical” depression and prolonged sadness caused by life events. The former is a brain disorder – a chemical imbalance that affects a person regardless of what is happening in their life. The latter is specifically related to the circumstances of life such as the loss of a job or the death of a loved one. 

As WebMD.com explains:

“There are times you may feel sad, lonely, or hopeless for a few days. But major depression -- clinical depression -- lasts longer and is disabling. It can prevent you from functioning normally. An episode of clinical depression may occur only once in a person's lifetime. More often, though, it recurs throughout a person's life.”

The Canadian Mental Health Association states:

Everyone feels "blue" or sad from time to time. It's a normal life experience. But when these emotions increase in intensity, persist for more than a few weeks, and start to interfere with a person's life, it may signal depression. No amount of "cheering up" can make the depression go away; no amount of exercise, vitamins or vacation can make it disappear. That's because depression is an illness, not a weakness.

It is important to note that this same principle applies to Anxiety ! Go back and read those statements and replace words like sad with words like afraid or anxious  and the word depression with the word anxiety.  We can accurately rephrase the last sentence to say  "That's because an anxiety disorder is an illness, not a weakness."

Now let’s talk about the spiritual for a moment because for most people of faith separating what is spiritual from what is a mental illness can be very confusing and difficult. As a Christian, I believe that humans do indeed have a spirit and therefore can have spiritual problems brought about by sin etc… However it is of the utmost importance to distinguish between spiritual problems and mental illness. Psychologist and Christian, Dr. Mark Crawford, wrote a brilliant book on the topic of Obsessive Compulsive Disorder (which I suffer from). In it he states:  

Because obsessions and compulsions can have religious or spiritual themes, there are some within the Church who see OCD as a “spiritual problem.” I have even spoken with some who claim that the symptoms of OCD are caused by demonic oppression or even demonic possession. For a Christian already tormented by anxiety cause by OCD, having someone suggest that these symptoms are caused by demonic involvement can literally push them over the edge.

I’ve seen too many Christians with OCD who have been harmed by well-intended church members who suggested that if they only had more faith or prayed more, their symptoms would disappear. I’ve also heard far too many stories of Christians with OCD who were told by church members (or even church officials) that their symptoms were present because of “unconfessed sin “ in their lives. This type of uneducated advice can be extraordinarily harmful to someone with OCD whose symptoms include obsessive concerns that their normal, everyday behaviours are sinful; fears of not being a “good enough Christian”: or fears of being condemned because of bad thoughts.

How do we treat Mental Illness?

Are anti-depressants and other psychiatric medications appropriate to take? Are there any alternatives?

Most professionals will recommend a combination of medication and therapy.

I realize that some people will have a real aversion to the idea of taking a medicine that specifically affects your brain. I know because I was such a person. I had to learn the hard way that mental illness was indeed real and that treating it appropriately was very important for you and those around you (if you wish you can read more of my personal story at the link below “A Beautiful Mind”).

In my experience (and upon the medical advice of professionals I have personally dealt with) I have found the best treatment is indeed a combination of treatments.

They include:  

The right medication  - which, admittedly,  can be hard to find as they take a while before results will become evident. Patience is the key here but once you have found one that helps you it will be more than worth it.

Therapy – in my case Cognitive Behaviour Therapy (and this is becoming the case for increasingly more people).  CBT is a very practical and common sense psychological approach to effectively managing mental illnesses.  It’s a lot like physical therapy but consists of exercises for the mind.

A good support system – people who know you and understand mental illness. This can include your MD, a psychologist or mental health professional, professional counsellors, pastors and of course – your family. My wife and parents have been my biggest supporters.

A healthy lifestyle – a good diet, exercise and sleep are extremely important in treating mental illness and improving overall mental health.

Other things such as journalling and planning ahead to manage your stress are also very helpful.

In conclusion, mental health and mental illness are very real issues that affect us all whether we “believe” in them or not.  Personally acknowledging that you or a loved might be suffering from a mental illness and being brave enough to speak up about it and to seek help are the first steps that will lead to removing stigma and restoring heath for those close to you and for society in general.

Further Reading:

A Beautiful Mind: My Personal Story of Depression and OCD

Cognitive Behaviour Therapy and OCD - Managing Compulsions and Obsessions (Dr. J.M. Schwartz)

Some Practical Advice when in Depression and Despair

Christians and Mental Illness: When OCD Gets Spiritual

Sports and Mental Illness : LANDSBERG: HIS DEPRESSION AND HIS FRIEND, WADE BELAK

Charles Spurgeon on Depression

Invisible Disease ( Poem)

War of the Minds (Song on youtube)