Mental Illness Is an Explanation for Distress, Not Inaction

Mental illness isn’t a new problem. Yet in the distant past, people knew little about how the brain and body worked, so when people behaved in odd or inexplicable ways it was often assumed they were under the influence of evil spirits. This led to practices such as drilling holes in the skull and torturing people to drive those forces out.

Later, the mentally ill were isolated in institutions that were often little more than warehouses or prisons. The term Bedlam, denoting “madness,” is derived from the name of the Bethlem Royal Hospital in London which was famous for its inhumane treatment of patients—which included allowing paying visitors to taunt or even abuse the “inmates.” Although such systemic abuse is no longer allowed, a lack of mental health facilities, inequities in insurance coverage, uneven care, and the widespread stigma around mental illness still prevent people from getting the help they need.

What is gradually changing, however, is our willingness to talk about mental illness. As a society, we are starting to acknowledge the prevalence of mental disorders among the homeless, our prison populations, our military veterans, our youth, and ourselves. Public figures—including Olympic champions Michael Phelps and Simone Biles—have talked openly about how much therapy has helped them, and younger people are more openly sharing their psychological issues than the generations before them.

I have been teaching psychology for 40 years and find students more willing to talk about their mental health than they were when I started. Not only do they freely disclose information in class, but they email the details of their mental health struggles when asking for leniency on assignments and exam due dates.

Hopefully, this movement towards talking more about mental health is akin to our greater openness about cancer that arose after Betty Ford revealed her diagnosis. But acknowledging and identifying a problem is just the first step in the quest for a solution. Once we understand a problem, we need to take steps to solve it.

Mental illness can be an explanation for cognitive, emotional, physiological, and behavioral difficulties that impede your ability to meet your occupational, social, or academic goals. But just as we don’t expect a person with a cancer diagnosis to ignore or be denied available treatments, we need to ensure that people experiencing mental health issues seek and receive the treatment they need. Feeling poorly, physically or mentally shouldn’t be an excuse for inaction.

When students tell me they are so depressed they can't take a test, I always ask them what they are doing to address their symptoms. Far too often, they tell me they don’t have insurance, haven’t seen a doctor, don’t have time for therapy, or are too busy to practice self-care in the form of sleep, exercise, and social connection.

This bothers me since, as college students, they have access to care through the university health center and counseling service, as well as numerous campus well-being programs. In part, their lack of action may be caused by their depression which is characterized by fatigue, feelings of hopelessness, and a lack of motivation. But physical pain and illness also make it difficult for people to seek medical care, yet most people persist in doing so.

What is the difference? I argue that culturally, we have a widespread belief that highly educated physicians, using state-of-the-art medical techniques and medications, can cure diseases and/or reduce suffering. Unfortunately, most people know far less about mental than physical illness, believe that it can’t be treated effectively, and view psychological distress as a sign of weakness or a moral failing.

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Too often, well-meaning friends and family tell people to shake off their distress or that only “crazy” people need treatment. Unfortunately, these attitudes are supported by our entertainment media. Physicians are often portrayed as brilliant, selfless heroes, while therapists are sometimes depicted as flaky and unethical.

In many people’s minds, seeking psychological help won’t be useful and will result in being labeled and stigmatized. The private clinic where I see clients is located in a medical building. The doctor’s offices around us have glass windows that enable people to see who is in the waiting room. But our office is enclosed to protect client’s privacy. Unfortunately, this reinforces the message that seeing a physician is normal, but you should conceal your visits to a therapist.

Clearly, we need to continue to talk about mental illness, but we also need to pay attention to what we say. Recognizing the symptoms of common forms of mental illness and understanding the causes is a start. But then, we need to make sure that people know how to seek help, recognize that it is effective, and see treatment as empowering rather than stigmatizing.

The goal should be to convince people that physical and mental health are two sides of the same coin. Just as we would expect someone with diabetes to actively seek treatment to control their blood sugar, we need to teach people that the neurons and transmitters in our brain can malfunction and that the combination of medication, talk therapy, and noninvasive treatments like transcranial magnetic stimulation and neurofeedback could reduce their psychological distress.

Mental difficulties, just like physical pain, let you know that something is going on that you need to pay attention to. And just as we support people when they have physical symptoms of illness, we need to provide resources and support when their symptoms are psychological. In addition, we need to encourage people to seek help, and to take an active role in their treatment.

Ultimately, mental illness is an explanation for a problem and a call to action, not a reason to turn away or an excuse for giving up.