Discussion Point: The difference between 'poor mental health' and 'mental illness'.

Depression and mental illness in general has always been associated with the idea of a 'chemical imbalance'. This notion of it being innately located in the brain has been touted by many - myself included - but recent research is suggesting that there's a bit more to it than just that.

I was talking to a very good friend recently about this very topic, and the dangers of conflating mental health issues with mental illness itself. We both agreed that mental illness is a very difficult thing to define - the research behind it is still exceptionally young, (after all, it was only a few decades ago that the mentally ill were considered 'undesirables' in many sociopolitical aspects...) which means our conclusions we make are slapdash and at a best, lucky predictions based on the data we have. Fifty years or so from now, we'll probably look back and cringe at the measures put in place to accelerate mental illness science - but isn't that what history's all about anyway?

Because of this lack of focus in the research community, (to no fault of their own - we can't 'Go Back To The Future quite so easily as Marty McFly) the surge of mental health discussion in social media has been encouraged - nobody really knows what we're talking about, so why not discuss it freely in an exchange of ideas with the purpose of supporting and helping the vulnerable? 

In addition, the term 'illness' is so broad yet so technical. We have to be careful when it comes to defining it. There is a slight overlap when it comes to defining mental disorders and mental illness (disorders often implying something more disruptive, whilst illness implying something more pathological) but overall, in daily, casual conversation the two tend to be used for similar, if not the same, meaning.

A satisfying entry for 'illness' comes from this paper:

"Illness...is a feeling, an experience of unhealth which is entirely personal, interior to the person of the patient. Often it accompanies disease, but the disease may be undeclared, as in the early stages of cancer or tuberculosis or diabetes. Sometimes illness exists where no disease can be found."

Although somewhat esoteric and at first ambiguous, I think it's a statement where people can build a discussion on this topic. A discussion which does not necessarily have to assert a firm stance on either end of the argument.

If we take the above definition to be true, we can define certain conditions such as depression or anxiety or PTSD to be diseases. Following the logic from the statement, surely everyone's perception of what it means to have anxiety, depression etc. is their own personal illness? They may not have the disease itself (e.g. free from depression) but the ailments that persist - or rather, the symptoms - will still be there. In other words, you can have a bad life, or a life filled with mental 'illness' so to speak without being formally diagnosed with a disease. You can suffer the stress, sadness, and existential angst a mental disease (let's use that word just to express the point here) can offer without there being a disease in the first place. 

I think this a potentially sound argument, and one worth exploring. Circumstantial and external factors can influence our 'mental illness' so to speak - for instance, being given a bad grade at university after putting in a tremendous amount of effort; having your hard work ignored within your career endeavours; or suffering romantic rejection can all open up a portal through which snakes and demons crawl inside and nestle within our psyche. There the seed of doubt or darkness is planted and if not weeded out immediately, tends to grow and fester into something larger and more menacing. In other words, illness can be produced through our own maladaptation to life events without having a disease prior to developing the ailments.

Nonetheless, there definitely appears to be a biological factor present when it comes to interpreting mental illness, which suggests that there is a difference between diagnosed ailments and informal, poor mental health in general. There are cases such as schizophrenia and bipolar that are undoubtedly more pathological in nature than circumstantial. We can also see underlying biology linking personality traits and states of mental wellbeing, too. With regards to individuals with neuroticism, for instance - who have higher sensitivities towards anxiety - its underlying biology stems in part from the hippocampus, and generated in part by the amygdala, and another part of the brain which seems to associate itself with the experience of pain. In terms of measurement, pain is a complex phenomena; it cannot be boiled down to mere physical attributes like the stubbing of a toe, but also to factors such as depression, grief, rejection, isolation and deprivation. Neuroticism thus acts as a threshold of activation towards these negative emotional systems; if you are higher in neuroticism as a personality trait, one instance of uncertainty or stress might produce three times the psychophysiological response than in individuals who are lower in neurotic tendencies. It could be implied - though I would tentatively say it's a correlation, rather than a causative link - that individuals who are wired to be higher in traits pertaining to neuroticism have a higher likelihood to suffer from diagnosed mental illness. Could this make it easier for us to discern between those who currently suffer from mental illness, and those who are leading difficult, traumatic lives? The latter could arguably be helped in a socioeconomic matter - whereas the former is about coping strategies, therapy, psychological restructuring and even tackling a lack spiritual fulfilment. There is a reason why people say depression doesn't discriminate - you can be economically well off and suffer from it, which implies something that goes beyond the material and fundamental, and delves into something deeper and arguably transcendental.

Linking all of this with the discussion of mental health within social media comes the highly satisfying conclusion of: it's actually quite relative. From the data and research I have seen, (although there is so, so much out there the mind boggles) it's never quite black and white, and the science behind mental health is still so young and constantly developing that the best we can do is go off of the empirical evidence that we have whilst combining it with holistic and spiritual wisdom from thinkers long gone. Personally, I do think there is a differene between poor mental health and suffering a mental illness; (or disease, as mentioned earlier) one describes a situational result which leads to the symptoms of the ailment, whilst the other is a psychological state which can be deadly. Regardless, both absolutely require discussion, awareness, and destigmatisation - so whichever way you talk about mental health - whether you discuss about dealing with stress and self-care after a long day of work; or promoting spiritual care in a selfish, consumerist society; or raise awareness of the tragic male suicide epidemic - you are doing so much good for a sensitive topic which, as a bunch of chattering apes, we are all cautiously exploring.