World Mental Health Day is on October 10. Each year, those of us in mental health try to engage with the public in a manner that supports the destigmatization of mental illnesses, give information about various disorders and generally espouse the message that it’s “okay not to be okay”. However, what gets discussed far less than it should is what mental wellness means and what we can do to promote it. As far as the World Health Organization (WHO) is concerned, mental health is “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in.” The WHO goes on to declare that mental wellness is a human right and yet, many of us struggle to even define what it is for ourselves as well as how to cultivate it. Today, I feel moved to help address this so that we can look at our mental state from a place of strength rather than pathology.
Mental wellbeing is not just the absence of mental illness in exactly the same way that being “healthy” is not the absence of disease. Instead, if we take the approach of functioning optimally, it becomes clear that the manner in which we have been societally encouraged to view mental health is from the “disease perspective” rather than a model of health. This is one of the things that those of us who work in mental health know all too well, mental wellness is profoundly impacted by social determinants of health.
Social determinants of health (SDH) are the non-medical factors that influence health outcomes, (WHO website). Examples of this abound but include socio-economic status (SES), exposure to discrimination, (think racism, sexism etc.), insecure housing, food insecurity, exposure to war, geopolitical strife and environmental problems, and belonging to a marginalized group count as social determinants of health. These problems definitely exist and in terms of health outcomes for those who live with them, they definitely matter.
Numerous studies have shown that those with greater financial security have better mental health outcomes, (this is also tied to the educational level of parents since higher education usually translates to higher SES). This means that the children of those of humbler means are more predisposed to developing a mental health concern than those of greater means. Those exposed to violence are also at a significantly higher risk of developing symptoms of mental illness.
What we also know is that the inability to access mental health support compounds this issue. Approximately 450 million people globally struggle with mental health challenges making it the most common disability facing human beings. If we understand the scale of the problem, how can we prevent it in the first place?
Setting aside our collective outrage about the fact that mental health, (like all other types of health), is a human right which we have not adequately addressed at the state level in most countries, there are things we can do to promote our own mental wellbeing. Here are a few of them:
1. Connecting with community
The desire to belong is an innate human need. As the recently departed Sue Johnson stated, as human being we are “wired for connection”. No one actually does better alone despite what people are led to believe or have adapted to doing as a response to trauma. The hyper independence promoted by western democratic societies is antithetical to what we know works in helping people thrive. There have been several cases in which therapists like myself have seen huge improvements in the emotional, psychological and social lives of our clients once they connect with a support system. In fact, this issue of belonging and connection is so important for health that it has been reported that the number one cause of failure to thrive, (a medical condition in which children do not grow or gain weight appropriately over a consistent period of time), in children in orphanages is the lack of love.
2. Engaging in actual self-care
In explaining what self-care is, it is essential to explain what it is NOT. Self-care is not candlelit bubble baths, vacations and lavish meals. Those are nice indulgences to have but, if one is sleep deprived, hungry, stressed and physically unhealthy, none of that matters and is the equivalent of slapping a band-aid on cancer and wondering why there has been no remission.
Instead, we need to see self-care as attending to our needs. It means not pushing ourselves to perform at 100% all the time and to be okay with setting boundaries with other people to protect ourselves from over-doing. No one is “on” all the time and the expectation that we should go above and beyond for others at the expense of self is a dangerous one. This shows up in the modern workplace of most industrialized countries where the capitalist machinery continues to turn. Most of my clients feel that they are unable to set boundaries with their employers for fear of not getting a promotion and therefore, they squander hours of their lives giving free labour to a thankless institution that would happily replace them within days should they drop dead from exhaustion. (I delve more into this issue here).
Self-care means taking the best care of our bodies as we can. This DOES NOT mean shaming ourselves or anyone else for how their bodies “look”. Any doctor worth their degree will tell you that you cannot judge health by looking at someone. Only blood work and deeper examination of the person’s physical body can do that. A thin body is not necessarily a healthy body. Instead, focusing on fitness not as an obsession but to help us achieve optimal functioning is a far healthier, productive and realistic way to take care of our bodies.
However, especially among women, body shaming others and the loathing of one’s own body is not only common but indeed encouraged. Just scroll through the comments section of pretty much any video of someone simply living while not “thin” and anyone with an iota of compassion would recoil in horror at the vitriol directed at the person posting.
3. Doing our work on ourselves in therapy
I am not saying this simply because I am a therapist myself. There are some who believe that I am simply selling my services rather than having any actual concern for my clients. This is categorically untrue and uninformed. Several studies across time have shown that of those who enter therapy, 75% or more derive benefit from it. (One source is mentioned here). This is because therapists are trained professionals who have used evidence-based interventions to work with their clients to better their psychological outcomes in a manner similar to how doctors train to help cure physical ailments.
Your therapist DOES care about you. You are never just another case. We go into this profession out of a genuine desire to help others and are screened to ensure that exploitative personalities have a significantly low chance of entering the field. Your therapist is held to very high ethical standards that place your needs above theirs. Your friends, family members and neighbours may care about you but, they do not have to consistently think about your best interest in the same way that your therapist does.
What therapy does is to help you to examine underlying beliefs and patterns that are largely unconscious and maladaptive, deconstruct them and learn new ones. Therapists help you make connections between seemingly unrelated experiences in a manner that helps you understand yourself better. Once you are able to unlearn what are often generational patterns, you do not have to repeat them. You can free yourself and live a more congruent life.
Therapy may not always be comfortable which is why it is called “work” on yourself however, the end process is greater peace of mind. Going through that work is also self-care.
4. Embracing joy
The late, great Albert Ellis, (founder of Rational Emotive Behaviour Therapy), made one of the most profound statements I have personally ever heard. He famously said “the purpose of life is to have a fucking good time”. He encouraged others to enjoy life. I most enthusiastically concur.
Life can be difficult yes, but it is important to find or create moments of joy and meaning when we can. Those moments of joy can be found in large and small moments. Something as simple as a hot cup of coffee on a misty morning, a stroll on the beach relishing in the sensation of sand underfoot and the smell of the sea, embracing a lover or anything else that brings simple, (often sensory), pleasure is worth us being truly present.
The benefits of joy have been measured in study after study. We know that “positive emotions can decrease stress hormones and build emotional strength” (Mental Health America). Who doesn’t want to experience these benefits? There are many problems in the world but, our resilience is bolstered by the ability to feel joyful whenever we can. Yes, life is short so it is a good idea to make each moment count.
This year, I invite everyone to shift attention not towards the things that make us mentally ill, but to those that make us mentally well. Connect with a community that cares about you, take care of and love yourself, put your job into its appropriate context as a transactional relationship, and create moments of joy. This World Mental Health Day, resolve to embrace optimal mental wellness and encourage those around you to do the same.
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