Reframing Mental Health Awareness: The Need to Ask "Why?"
By Noël Hunter, author of the upcoming book Trauma and Madness in Mental Health Services
The vast majority of people meet criteria for a mental disorder at some point in their life. In other words, using current diagnostic standards, most of society is mentally ill. This begs the question: What is mental illness? Is it a disorder of the brain? A genetic disease passed down through the generations? Or is it a misnomer describing variations of common human suffering?
There are massive campaigns, dedicated months and days, celebrity-fronted galas and public service announcements, all meant to make the public aware of mental health issues and to decrease stigma. Politicians, people carrying diagnoses, family members, and friends alike plead for improved services and for greater understanding of "mental illnesses." These efforts are certainly well-intentioned, and, for sure, services meant to help people in distress sorely need overhauling. These crusades, however, too often tend to contribute to, rather than amend the problem. Studies continue to show that, despite best intentions, what they actually do is "other" those who suffer, increase prejudice and misunderstanding, and decrease empathy.
Humans do not need to be reminded of the fact that we suffer - we need to start discussing why people are suffering so much.
Most people understand that depression or anxiety arise for a reason. We can empathize with the person who feels helpless, scared, unable to let go of the need for control, or who sometimes panics under the stresses of our industrialized and unforgiving society. But, as soon as these issues are framed as problems in the brain or genetic flaws, we stop understanding and a sense of helplessness and hopelessness creep in. And, when people suffer in more extreme and less understandable ways, empathy and understanding nearly disappear altogether.
The reasons for the distress or suffering become secondary to discussions of chemicals, neurons, and categorization.
In reality, there is little evidence that emotional distress is caused by defects in biology. What has been found are large, general differences in brain function that are correlational (meaning no causal relationship can be assumed) and that cannot be differentiated from reactions to stress and trauma. That is, our bodies react to stress, but do not necessarily cause said stress. There also are genetic studies done on extremely large populations that find statistical differences, but they are so tiny so as to be meaningless and are rarely, if ever, reproduced in future studies.
On the other hand, trauma, adversity, and chronic stress are consistently found to be ubiquitous across diagnoses. And, the more severe the diagnosis, the more severe the adversity.
For instance, schizophrenia is taken for granted to be a meaningless, un-understandable disorder of the brain that is genetic in nature and requires life-long treatment. In actuality, the diagnosis of schizophrenia is highly correlated with, and predicted by, experiences of childhood trauma, including abuse, bullying, and chronic discrimination. Further, many can and do recover - those who adhere to current treatment recommendations tend to have the worst outcomes.
Before the professions of psychiatry and psychology started framing emotional distress as medical diseases, such conditions were described as part of a spiritual journey, as common human variation, and/or the result of tragic life circumstances. The term "being driven mad" inherently implied that something must have happened to a person that resulted in madness. In our modern era, however, we stop asking what has happened to a person and simply focus on what is wrong with them.
How does a person who grows up witnessing frequent violence, who is chronically discriminated against or oppressed, experiences interpersonal violations or abuse, or is struggling to gain employment or pay for housing supposed to remain calm, happy, friendly, and tolerant? Why should they be accepting and easy-going? Why is emotional distress considered as either a flaw in character or an illness? Should we really strive to be unaffected by violence, war, oppression, tyranny, child abuse, and injustice?
Those who do not demonstrate any noticeable distress in the face of adversity and injustice may, in fact, be the abnormal ones. Those who are the "happiest" also tend to be those who are more authoritarian, do not question the status quo, blame victims for their own misfortunes, and are often blind to the greater realities of the world. Is it healthy to not be affected by what others think or by the cruelty of the world?
Anxiety, depression, panic, altered states of reality - these are warning signs that something is wrong. These are attempts to cope, not illnesses. And when we cannot cope any longer, we break down. We go mad. Awareness needs to be brought to the meaning in these experiences, not the need to eradicate them.
Certainly, helping others to heal from past wounds, to become more trusting and tolerant, and to allow for vulnerability and intimacy is an important journey for many. No one deserves to suffer. Suffering cannot be alleviated, however, without first appreciating and grieving what has happened in a person's life to cause their suffering in the first place.
As the campaign for greater awareness of mental health issues charges on, the conversation needs to shift to the uncomfortable: how we are impacted by experiences of adversity, trauma, toxic family dynamics, structural social problems, child abuse, oppression, and bullying. Instead of focusing on purported illnesses of the brain, without any evidence to suggest that this is the case, let us look at the sickness of our current society. We need to start acknowledging that people are suffering for a reason. It hurts to face reality sometimes - until we do, "mental health" will continue to be an ever-increasing issue without resolution.