May is Mental Health Awareness Month.
The theme is Together for Mental Health (from the National Alliance for Mental Illness, NAMI).
We do not do a great job of taking care of our mental health, or even acknowledging that we have mental health as well as physical health to take care of! Most people do not think they need mental healthcare – but I think we all do!
First, there is a difference between mental illness, mental health, and mental well-being or wellness.
Mental Illnesses are the disorders defined by the APA’s DSM (currently in version 5R) – these are the things we usually think of, and cause the most distress – like eating disorders, mood disorders, anxiety disorders, etc.
Mental Health is made up of our emotional, psychological, and social well-being. It is made of our thoughts, feeling, and behaviors. How healthy we are determines how we deal with life stressors, connect to people, and the decisions we make. It is important at all stages of life.
According to the World Health Organization, mental wellness is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”
We need several things to achieve this, and all of them are important. As an eating disorder professional, I want to highlight a few that I think are most impacted by issues around eating and body image:
Physical Health
“Take care of your body, it’s the only place you have to live”
Jim Rohn
We all know what we should do – or we think we do. There are a lot of messages out there, and a lot of them are driven by marketing instead of altruism. In the simplest terms, the things that have the biggest impact on our overall physical health are:
- Eat fruits & vegetables every day
- Exercise moderately 3-5 times a week for at least 30 minutes
- Drink moderately (no more than 7 drinks in a week or 4 at one time, it is supposed to average one a day)
- Do not smoke or use drugs
- Sleep at least 7 hours a night
To be clear, this is a complicated issue, and there are a lot of things we can do to be healthy and live longer, but I am talking about the things with the biggest impact. This is the SAMHSA worksheet about developing a comprehensive wellness plan, and another article about 100 things you can do to live longer. When you have an eating disorder, some of these get very complicated, and all are effected. One goal of treatment, though, is to bring all of these back to baseline or “normal functioning.”
Resilience
There is no doubt that physical health has an impact on mental health and vice versa. Caring for your mental health is about more than managing normal everyday behaviors. We also need to think about stress differently, and plan for stress instead of acting like it is not supposed to happen to us. Resilience (here is a great TED talk about that resilience). There are several life events, some of which we usually consider positive, that are the most stressful, and here are the ones we generally consider positive.
- Marriage
- Birth of a child
- Moving
- Starting a new job
- Retirement
- Graduating (transitioning to adulthood)
These also tend to be the transition times that make relapse more likely. Not surprising, and we should all be on the lookout for these to cause earthquakes in our mental health.
Connection
And just to contrast, here are the things we argue with out partners about the most:
- Finances
- Parenting
- Housework
- Extended Family
John Gottman, who has been researching couples and relationship patterns for 40 years, found that 69% of the time, these problems are perpetual – meaning you cannot solve the problem, you have to manage them and compromise. In my experience, this percentage is about true for all relationships, not just couples.
We all need a certain amount of connection to others. Eating disorders, being the secretive and stigmatized disorders that they are, tend to make connecting a lot harder. They isolate us, tire us out, make it hard to function.
Did you see the parallels? There is a lot of commonality in these lists.
Taking care of your mental health is not just about addressing disorders. Disorders happen well outside of the course of normal life – they disrupt our functioning to the point we cannot go to work or school or interact with others within normal societal limits. Events like the ones above stress everyone out, no matter how positive they are, and we have to stop using ‘stress’ as the bad guy.
We are all so conditioned to say we are “fine” even when we are not. What is we all talked about mental health concerns like my uncle talks about his gout? Something to manage and deal with, not something to be ashamed of. How different would everything be if we could just talk about it when we are sad, angry, or anxious instead of always saying we are “fine” – and here is a blog I wrote recently about the word “fine” and expressing emotions.
So what is mental health awareness?
It is being aware of not only the disordered behavior(s) associated with mental illness, but also that we need preventative care. We need connection to other people, to take care of our physical self, to do things we enjoy, and to talk about emotions. Emotions are useful, necessary, and not just things to ignore or get rid of.
The people we are connected to, our family and friends, are not always the ones we can talk to about tough stuff. A lot of people need a sounding board, someone to vent to, and someone that will not judge them or automatically try to solve the problem, or someone with no emotional attachment to a situation. Those are all things a therapist can do – it is a close, trusting relationship that exists outside of normal social convention. There is no way a family member, partner, friend, or co-worker can be all of those things for you.
Reducing the stigma around all of these will help. If we are able to stop seeing therapy as an extreme intervention, too, and start using it as a resource, that would also help.
For more information about how to get involved and general mental health information, check out the National Alliance for the Mentally Ill.