Mental Health and Mental Illness are not the Same Thing
I have an issue. Okay, I have many issues but I’ll get to that later. I have a problem with how people use the terms mental health and mental illness interchangeably. And I am not the only one. There are a plethora of articles and forum entries about just this. And the reason is not that anyone wants to devalue the pain of those that are struggling, the reason is that if you use those terms interchangeably, then you devalue the struggles of those who actually suffer from serious mental illness. See, the same as poor physical health is not the same as physical illness, poor mental health is not the same as mental illness.
Let me start with saying that I am coming from quite a biased perspective. I am diagnosed with Dissociative Identity Disorder, Bipolar Disorder, Complex Post-Traumatic Stress Disorder and Generalized Anxiety Disorder. I am seriously mentally ill.
Mental Health vs. Mental Illness
The issue that I have with all of this is that an appropriation of terms, and with that resources, is happening. But first things first. Let us define things! Mental health is the state of your emotional and mental well-being. Just like with physical health, you can have good days and bad days. Sometimes you are sad, or you are stressed, or you are anxious. Some days you feel absolutely terrible, but other days, you are well.
The general mental health of people without mental illnesses is usually somewhere in the middle of the spectrum. No one is always happy, calm or satisfied. And it sucks. I am not devaluing the pain of bad days, or even bad circumstances. Everyone goes through break ups, the death of a loved one or other kinds of loss. And those things hurt. Bad. But they pass, and they can pass without any kind of intervention being needed.
Mental illness, on the other hand, is a diagnosed health condition. That means that you need to go to a doctor and what you are struggling with needs to fit the sets of symptoms of a mental illness. Examples of mental illnesses are: depression, anxiety disorders, trauma disorders, dissociative disorders, bipolar disorder, schizophrenia and personality disorders.
If the difference isn’t clear yer, let me try to explain it from a different angle. You have a headache that lasts for a few hours so you are frustrated, drink lots of water, take over the counter pain medication and go to bed early. The next day, you are better. You had a bad physical health day. And then there is your friend, who has constant migraines, missed work a lot and can’t get out of bed for weeks on end. She has a physical illness.
If you struggle with your mental health for a while, there are a lot of things that you can do on your own to make things better. You can do mindfulness, take care of your routines, talk to your friends, focus on self-care.
If you have mental illness, those things won’t sort your illness. You can do those things to maybe generally feel better, but they won’t cure your depression or anxiety disorder, they won’t magically make your schizophrenia disappear. If you have a mental illness, especially when it is a serious and chronic one, you need professional interventions and help. You need medications, therapy and maybe even hospitalizations. Your whole life is affected by your illness, so you can’t function anymore: you can’t work. you can’t socialize, you can’t take care of yourself.
Someone with mental illness can have good mental health days, and someone with a lot of bad mental health days, can develop a mental illness. But mental health and mental illness are not the same thing.
Mental Health = Mental Illness? – The Consequences
What happens when people assume that those two terms describe the same thing, is that they use terms out of the mental illness repertoire to describe a bad day. Saying things like “I am depressed” when you are really just sad or tired, or “I feel so bipolar” when you have had an emotionally unstable day, or “I went all psycho on him” when you really were just angry, is hurtful to those who are actually struggling with serious mental illness.
Another thing that happens is that people give unsolicited advice to those who are diagnosed with mental illness, even going so far as saying that taking medication is not necessary. Self-care and mindfulness can help improve everyone’s mental health, but they are not going to cure someone’s clinical depression or OCD. If you equal mental health and mental illness, you are continuing the stigma and misconceptions about mental illness and treatment.
I have talked about something similar before: I don’t feel like part of the #metoo movement because those that have actually been through sexual abuse, are being pushed into the shadows. It is about who the most priviledged people are, those who shout the loudest, those that have the resources, financially and socially, to spread their personal stories. So we hear loud stories about groping butts, but no women who used to be victims of human trafficking, or those who have been through complex sexual abuse during childhood.
Another area where it is really obvious that people confuse mental illness with mental health and common adversities, are trauma disorders. I volunteer in the area of mental illness and I also spend a lot of time in online groups on mental illness. And I have seen a very confusing trend. White privileged women yelling about their childhood abuse, toxic people and narcissists.
The thing is, when they then continue to tell their stories, then the “abuse” that they have been through is a mother that missed one of their birthdays because she was at the hospital at the time. The toxic people in their lives are the neighbours that play loud music at 10 PM, and the narcissist is the boss who sometimes has a bit of a powertrip. That is not what complex trauma is, this is not even what single trauma is. These women do not have a single symptom of mental illness. They are upset about small every day adversities.
Life sucks. Mothers can’t always be perfect. Your neighbours need a telling. And your boss is an idiot at times. But those things are not even in the same ballpark as someone who has mental illness. I don’t want to deny the “Karens” of this world support. Everyone deserves to get heard, validated and supported. But they have absolutely nothing to do in a group on mental illness. In general, I wouldn’t want to gatekeep, but what happens when those women scream the loudest is that those who actually need help with some serious shit, get pushed aside. They don’t know how to ask for help, they don’t know how to speak up. It is part of their illness that they can’ do those things, for fuck’s sake.
So, summarizing so far: Mental health and mental illness are not the same thing. But by assuming they are, people are not only appropriating terms falsely, they are also pushing aside those with actually illnesses.
But that is not all. The rise of raising awareness around mental health does not help those with mental illness. Why, you ask? Because they get pushed to the back of waiting lists for professional help. Karen doesn’t want to talk to a counselor or life coach. She has heard all about mental health now, someone gave her a flyer at Whole Foods. Karen wants to talk to a therapist with a PHD, and Karen can pay them lots of money. So Karen gets help. That is the simplified version.
In almost all Western countries, there hasn’t been a revision of the power of psychologists and psychiatrists. They govern themselves. That means that there are no rules that those who need help the most get helped first. And it isn’t always about money either. I mean. someone who goes into private practice will get the Karens and can make easy money just being an active listener. It is a bit of a waste of talent, and those who suffer from serious mental illness often can’t afford a private therapist because their illness, as we learned earlier, ruins their functionality and with that their ability to make big bucks. But my beef isn’t with capitalism. At least not this time, ha!
But did you know that therapists can actually choose their patients? There has been a huge debate about that in Germany as of late that I have been following with interest. Psychologists do not take on patients depending on need and severity of struggles, they can pick whoever they want. And naturally, we are all lazy human beans after all, they pick the easy cases. So yes, even in countries with free health care, those with mental illness get pushed to the back of the line, because they are ill, and that makes supporting them more difficult.
I actually experienced the confusing reality of this. After I had been released from the hospital after a suicide attempt, there was no help waiting for me. Instead, I was on a waiting list to see a therapist. I had to wait for six months. During those months I ended up hospitalized many times. My friend who was going through grief after the loss of her mother got to see a licensed therapist after waiting for two weeks! At the same psych center!
Assuming that mental health is the same as mental illness, washes out the severity of illness that holds risks of suicide. It also invalidates the struggles of those with illness. I wanted to talk about the difference between mental health and mental illness because we are talking about people’s lives here. I am not saying that someone who is going through adversities in life doesn’t deserve support. But I am saying that there is a spectrum of suffering, and those with mental illness need to be prioritized, at least when it comes to professional help. Because what kind of society are we living in if we push into the shadows those who are suffering from serious illnesses?