By: Dr. Eric R. Maisel, Ph.D. on Psychology Today
Let’s say that you've done a lot of personality work, growth work, and healing work on yourself and you feel that emotionally you’re in pretty good shape. Then something unfortunate happens. You’re hit with an episode of sadness, an incident of anxiety, a period of overwhelm, a stint of confusion, a bout of malaise, a meaning crisis, a week of upset. As much work as we do on ourselves, these events still do happen.
These emotional changes make themselves felt in very powerful and painful ways, just as a broken leg or a severe rash would. But with emotional upheavals of this sort we typically do a funny thing. We let the incident define us. We don’t “have a bout of sadness,” we “are depressed.” We completely identify with the problem. With a rash we say, “I have a rash,” not “I am a rash.” With an episode of sadness we do the exact opposite. We say, “I am depressed” instead of “I have sadness.” This is a huge difference and a huge problem.
Our current model of mental health and mental illness prevents us from speaking subtly or correctly about human emotional states. It misleads us on purpose into believing that when we experience emotional pain we have become “mentally ill.” The truth is quite different. We may be essentially mentally healthy but dealing with a profound emotional problem, just as we may be essentially physically healthy but dealing with a broken leg or a severe rash. “I am mentally healthy but currently experiencing emotional pain” is a very different reality from “I have the mental disorder of depression.”
It is certainly the case that the itchy rash may be the only thing on our mind. Still we do not choose to have it define us. We know that it would be a fundamental mistake and misunderstanding to say, “I am rash.” The sadness may likewise be the only thing on our mind and yet here we find it easy, and maybe even convenient, to say, “I am depressed.” It is almost as if we want to distance ourselves from the possibility that this sadness is caused by something that we might need to address.
Consider the following example. Picture someone who is deeply upset in an ongoing way because the actions of her youth have resulted in her inability to have children. She continues to grieve that loss, she continues to feel guilty about her part in the situation, and she continues to feel angry about how society and the people around her, including family members, contributed to her current reality. She is very strong and very healthy in many ways but this particular pain is never-ending.
In a real way this grief colors her days and makes her sadder (called “depression” in the inaccurate parlance of the medical model mental health industry) than she otherwise would be. At the same time she manifests emotional strength in all sorts of ways and actually feels good, except for this sadness. As it turns out, and really strangely enough, we do not have a way to talk about emotional situations of this sort. With physical problems we use language to make exactly these sorts of distinctions and with emotional problems we do not.
With physical problems we say, “I’m feeling just fine except that I’m dealing with a broken arm.” We say, “My health has never been better but this allergy season is killing me!” We say, “I am bothered by a chronic neck ache from sitting at the computer for so many hours each day and I’m doing exercises to help with that but otherwise I feel just fine.” That is, with physical ailments we have a way of distinguishing a particular problem from our general state of being. With emotional states we don’t.
We are not accustomed to saying and don’t seem to want to say, “I am feeling emotionally very well except that I am currently sad.” We are not accustomed to saying and don’t seem to want to say, “I am feeling emotionally very well but I still get anxious when I think about flying.” In the first instance we say “I’m depressed” and in the second instance we say “I’m phobic,” perhaps not quite realizing what a disservice we are doing ourselves by characterizing ourselves in such globally disabled ways.
By saying “I’m depressed,” “I’m attention deficit disordered,” “I’m phobic,” “I’m anxious,” and so on, we not only do a poor job of honoring our wellness but we may completely forget about that wellness and begin to see ourselves as essentially not well, as opposed to essentially well but burdened by issues that need attention. Yes, it is odd and cumbersome to say “I am sad but essentially well” or “I am anxious but essentially well” but if that is the truth, if in fact we are emotionally in pretty good shape except for some current sadness or some current anxiety, then it pays us to honor that reality and remind ourselves of the well part as well as the current difficulty.
This odd, cumbersome but truthful way of speaking to yourself will help remind you that this is quite likely a passing event (though of course it may be very painful and though of course it may reoccur) and that, as a real but passing event like a broken arm or a case of poison ivy it must be addressed. If, for example, this episode of sadness is being caused by your sense that neither you nor your efforts matter, if, that is, you are experiencing a meaning crisis and an episode of existential sadness, then that must be addressed. It will not pay you to just mouth the words, “I am depressed.”
It is possible to envision many varieties of mental health that mirror more closely how people actually live and actually feel. The one I've just described, of a woman plagued by regrets and sadness about her infertility but who is also emotionally healthy and strong, we might call “healthy but in recurring emotional pain.” This is as much a state of health as it is of illness. Her basic emotional strength must be honored just as her enduring pain must be addressed. She is not “mentally ill,” she is a healthy person in real pain. There is a difference!
There are many such varieties of mental health, where a person is essentially healthy but also really troubled. For example there is the following one: “Sad and not sad at the same time.” Let’s look at that variety of mental health in our next installment.