FREQUENTLY ASKED QUESTIONS
Regarding mental health issues
Please note these are my opinions only. Although I am a licensed psychologist, there are many differing thoughts regarding mental health issues. If you believe you have significant mental health problems, please seek competent medical care.
WHAT IS MENTAL ILLNESS?
By most definitions, mental illness happens when emotional and other related problems create significant disruption in normal life functioning. Mental health professionals use a tool called the Diagnostic and Statistical Manual of Mental Disorders to diagnose mental illness. In almost every case, in order for a diagnosis to be made, the associated symptoms must cause “clinically significant distress or impairment” in multiple areas of functioning.
With the wide availability of information on the Internet, many individuals have a tendency to “self-diagnose” using online tools or symptoms lists. Please resist the temptation to do this. If you believe you have mental health challenges that are in need of treatment, seek professional mental health intervention. Generally speaking, the more specialized the professional, the greater the diagnostic skill. For example, you are more likely to get an accurate diagnosis from a licensed psychologist or counselor than you are from a general practice physician.
IS THERE A DIFFERENCE BETWEEN MENTAL ILLNESS AND JUST HAVING A BAD DAY/WEEK/YEAR?
As noted above, being diagnosed with a mental disorder almost always requires two general criteria. First, a specific symptom cluster must be met. Second, the symptoms must cause “clinically significant distress.” Whether the distress is “clinically significant” is determined by the diagnosing professional after consulting with the client. We all have bad times and will experience symptoms of anxiety, depression, stress, and the like. On occasion these times will last longer than others. Most of the time we are able to cope with these issues even though they cause distress. Other times our emotional issues overwhelm our existing coping resources.
In my experience, labeling a set of symptoms with a diagnosis is only marginally helpful. It can provide more efficient communication between professionals and inform treatment planning. However, regardless of the label, action still needs to be taken to create lasting change. In addition, mental health diagnoses can be very temporary. Just because you have been diagnosed with a certain mental health condition does not mean you will have those symptoms forever. The whole point of mental health treatment is to correct what is not working and develop better coping skills. Focus on your symptoms instead of whether you are “mentally ill” or not. Learn what you need to do to overcome symptoms and become more emotionally resilient.
IS MENTAL ILLNESS CAUSED BY BIOLOGY, THE ENVIRONMENT, OR BOTH?
This is the perennial “nature vs. nurture” question. Are we born with certain conditions or do they develop in us as we are exposed to different environmental influences? In my opinion, the answer is “yes.” Surely, we have genetic predisposition towards certain attitudes and behaviors. However, I have seen the environment have significant impact on the way people develop. I believe the vast majority of mental illness is a product of the way we think about things and perceive our environment. People talk about “chemical imbalances” as it relates to mental health issues. While this is technically accurate, it also tends to lead people to believe they cannot change because they think brain “chemistry” cannot be changed. However, the connections and patterns in our brains that produce different chemicals can absolutely be changed.
Some say, “I inherited anxiety issues from my parents.” That’s probably true in many cases. But did they inherit a genetic issue, or did they learn patterns of behavior as they observed anxiety in their parents for decades? For almost all mental health issues, in the end it does not really matter how the symptoms developed, as the treatment is the same. If someone came to me and said they were depressed and wanted to learn to be less depressed, it would make very little difference to me “how” their depression came about. The key is change is always possible, although it often comes only after considerable and consistent effort.
CAN MENTAL HEALTH ISSUES BE CURED?
The answer is complicated because the question is not as simple as it seems. There are many factors that contribute to mental health symptoms. Some are almost purely biologically driven, such as schizophrenia. Years of research and study suggests this disorder is caused by faulty brain chemistry. If the correct medication can be applied, the symptoms can decrease and sometimes even be eliminated. However, if the person stops taking the medication, the symptoms will resume. These types of mental health conditions seem to be purely biological and do not respond well to counseling. It’s difficult to “talk someone out” of the fact the hear and see things that aren’t there. This type of mental health disorder is similar to type one diabetes, in that the only thing that will fix it is medical intervention.
Most all other mental health disorders can be fixed through counseling. Among the more common of these issues are mood disorders (with depression being the most typical), anxiety disorders, behavioral problems, eating disorders, and addictions. Medication can be helpful in some cases, but lasting change and being “cured” will only happen as permanent changes are made to the way the brain processes information. Medication does not make permanent changes to the way the brain processes information. Cognitive and behavioral intervention can make permanent changes to the way the brain processes information. These types of mental health disorders are more similar to type two diabetes consequent to excessive weight gain. While medication can help regulate blood sugars, the diabetic condition remains. Most professionals recommend dietary changes and weight loss which in many cases can actually cause the condition to disappear. In my opinion, almost all mental health issues can respond to counseling and can be permanently fixed with consistent, dutiful effort.
WHEN DOES A PERSON NEED PROFESSIONAL HELP TO DEAL WITH MENTAL HEALTH ISSUES?
I think it is interesting that we even ask such a question. It is strong commentary on our society’s overall perceptions and historical reticence to seek mental health assistance. For whatever reason, we think we should be able to handle mental health issues on our own. That is simply untrue. We are able to handle some emotional struggles without assistance. Yet there are other things that are overwhelming and need professional assistance. When does a person need to reach out for professional help? I don’t have a specific set of instructions. I suppose if you find yourself even asking that question, then you would probably do well to seek assistance. You can never go wrong asking for help. If you have been unsuccessfully trying to manage a mental health issue on your own for more than a few months, it’s not a bad idea to reach out for professional help.
If you have an insurance company, it’s a good idea to contact them first and see if they have a list of providers to choose from. When choosing a counselor, remember you are the consumer. If you don’t like a counselor, you can change and find someone else. No one counselor is going to be the perfect match for every client. You might have to go through some trial and error to find one that seems like a good match. Also remember to be as open as you can with your counselor. She or he will likely be more helpful the more information you share about your situation.
WHAT IS THE ROLE OF MEDICATION IN DEALING WITH MENTAL ILLNESS?
As noted in a previous question, medication can be helpful to address mental health issues. However, it is rarely the solution in and of itself. A very, very small subsection of mental disorders (such as schizophrenia and bipolar disorder) must have medication in order to improve. However, almost all mental health issues can change without the use of medication. Consider this example. Let’s say you went to the gym and tried to lift a weight that was too heavy for you. You couldn’t lift it on your own, so you ask a friend to help. With your friend’s help, you are able to lift the weight. If you went back to the gym each day but did not exercise and did not lift other weights, you wouldn’t get stronger. You would always need your friend’s help to lift that particularly heavy weight. However, if you went back every day and built your strength through effort and work, you would eventually develop the ability to lift that weight on your own, without your friend’s help.
In the analogy, you are the person, your friend is the medication, and the mental health issue is the heavy weight. Some mental health issues are very challenging, and we do not have the natural strength to deal with them on our own. That is when medication can be helpful. It provides temporary assistance to lift the heavy load. However, if we just take the medication and do nothing else to change the way we think, we will not develop additional emotional strength. If you feel medication will help with your condition, don’t be afraid to use it. But always combine this with professional counseling so you can develop emotional strength in the meantime. By doing this you will eventually be able to lift the burden on your own, without the help of medication.
I know not everyone who reads this will agree, but this has been my experience over decades of working in the mental health field. Your individual situation may not be similar, and I understand that. I’m speaking in general terms and know that it will not apply to all readers. Hopefully that is clear.
WHY DOES IT SEEM EASIER TO GO TO A DOCTOR TO TALK ABOUT PHYSICAL HEALTH SYMPTOMS (SUCH AS THE FLU), WHILE THE THOUGHT OF GOING TO A COUNSELOR TO TALK ABOUT EMOTIONAL ISSUES SEEMS SO MUCH MORE DIFFICULT?
I think this is because we often believe we should be able to manage our mental health issues on our own. In reality, there is very little difference between how to effectively manage either physical or mental health issues. If I have a cold, I don’t run to the emergency room for treatment. I can use common remedies or even get advice on the Internet. However, if I were to sustain a compound fracture, I wouldn’t hesitate to go to the hospital. No one goes up to their friend, having a bone protruding from their arm, and asks, “do you think I should get professional help for this? Maybe I can just wrap it in duct tape and see if it will heal by itself.”
Some mental health issues are the equivalent of common colds, and others are more similar to compound fractures. We can and should be able to handle life’s ups and downs on our own or with the support of family and friends. Yet more serious problems are going to require external help in order to properly heal. Without proper medical training and equipment, you can’t fix a compound fracture on your own. Don’t presume you can fix a serious mental health problem without assistance either. It is okay to ask for help with emotional issues. We can’t fix all of them ourselves and were never intended to. When it seems beyond your ability to fix, confidently reach out for help and don’t feel ashamed.