Behind happy faces: Taking charge of your mental health

Presented by Ross Szabo, Founding Wellness Director at Geffen Academy (UCLA) and author

Many people either don’t understand mental health or refuse to address it, which can lead to significant problems down the line, undiagnosed psychiatric conditions, poor quality of life, and poor functioning. People’s reasons for avoiding addressing their mental health or getting professional care may differ.

Still, one thing that can help everyone, no matter who they are, is challenging misconceptions about mental health, going beyond simple awareness, improving mental health literacy, and empowering people to make positive changes in their lives.

Correcting the misconception about mental health

There are many misconceptions about mental health. The term “mental health” doesn’t necessarily denote a diagnosis or problem. That phrase is “mental health disorder.” Mental health refers to our social, emotional, and psychological well-being and how we address challenges in our lives. (1)

Much like physical health, mental health should be preventative instead of reactive, although many people don’t treat it that way. Instead, they wait until something is seriously wrong and then try to address it. It’s like saying that you don’t need to eat a nutritious, well-balanced diet until you get diabetes or high blood pressure. But mental health is about tending to your well-being and checking in with yourself; it’s about knowing what coping mechanisms to use and when. 

One damaging and stigmatizing misconception about mental health is the separation of mental illnesses and states into a spectrum of diagnoses. Many people without a mental health disorder don’t think they need to care about their mental health or go to therapy.

Meanwhile, they may view anxiety and depression as “mild” mental disorders, although they can be severe and debilitating. And then conditions like schizophrenia, bipolar disorder, and borderline personality disorder are often classified as “severe.” This spectrum is unhelpful because it classifies people as either needing help or not needing help, plus it doesn’t acknowledge the variability of functioning and well-being within these disorders.

Below is a helpful reframe for contextualizing and discussing mental health:

  • People who don’t have stressors or mental health challenges: These people typically don’t think about their mental health and don’t experience much distress.
  • Difficult to balance: People who are aware they aren’t sleeping enough or eating enough and may be aware that they’re stressed but aren’t using help actively.
  • Using help to balance: These individuals may be in therapy or on medication, or they may simply know that they need to use a particular coping skill every day, such as listening to music or reading a book, to reduce stress and stay balanced.
  • Need constant assistance to balance: These individuals may be in a treatment program or have experienced a significant life stressor and gone from someone who needs help to balance to needing a significant amount of help from loved ones to function.
  • Unable to balance: These people may require intensive treatment in a residential facility to learn to cope and practice using these skills to achieve balance.

Beyond mental health awareness

Many mental health campaigns focus on mental health awareness, which is a great first step toward helping people. Still, they often stop there, not providing people with the tools they need to care for their mental health, manage stressors, recognize and cope with triggers, communicate with their loved ones, and seek help.

The one unintended effect of spreading mental health awareness is that these campaigns often advise people to talk to a counselor or mental health professional without also providing them with the everyday strategies they can employ in their daily lives to help achieve balance and better quality of life.

A physical health campaign focused on preventing heart disease doesn’t simply spread awareness—it teaches useable strategies people can integrate into their lives to help prevent this condition. Mental health campaigns should do the same for psychological well-being.

Why don’t people seek help for mental health? 

There are many reasons people don’t seek help for their mental health. These barriers to care may include: (2), (3)

  • Shame
  • Stigma
  • Embarrassment
  • They feel weak
  • Don’t want to burden other people
  • Pessimism about the effectiveness of treatment

There are systemic barriers, too, such as: (2), (3)

  • Cost
  • Insurance coverage
  • Geographical locations
  • Racism
  • Transphobia
  • Homophobia
  • Weight stigma

But when talking about people who can obtain and pay for quality treatment, they may avoid it because they aren’t comfortable talking about mental health. One of the easiest ways to help people feel more comfortable is to compare mental and physical health.

People often don’t have the vocabulary for their mental health. They might simply refer to it as good or bad, but with physical health, people can identify the body part that hurts or feels weak and seek help. We need to do the same for mental health and equip people with the language they need to get them the help they need.

Breaking down mental health language

The first step to breaking down mental health language is differentiating between feelings, experiences, life-changing events, mental health disorders, and developmental disorders. 

For example, everyday challenges may include:

Environmental influences and challenges may include verbal abuse, bullying, or sexual abuse. Meanwhile, a significant life event is something like the death of a loved one, a major illness, or a divorce.

These challenges, environmental factors, and events can influence a person’s mental health, but they don’t necessarily signal one. 

Examples of mental health disorders include:

And developmental disorders include:

  • Intellectual disabilities
  • Autism spectrum disorder
  • Attention-deficit/hyperactivity disorder (ADHD)

Promoting mental health literacy

Change how we talk about stress

Whenever we hear the word “stress,” we most likely immediately categorize it as bad. And research tells us that people who categorize all stress as bad are more likely to have mental health disorders, die younger, and have a poorer quality of life.

All stress doesn’t have to be bad. For example, good stress can help us: (4)

  • Meet daily challenges
  • Motivate us to reach our goals
  • Engage in the fight or flight response
  • Improve our hearts and protect against infection

On the other hand, bad stress doesn’t help us achieve our goals or get tasks done. Bad stress leads to problems such as: (5)

  • Inability to concentrate or complete tasks
  • Reduce immune system functioning
  • Body aches
  • Headaches
  • Irritability
  • Trouble falling or staying asleep
  • Appetite changes
  • Increased anger and anxiety

Nervousness vs. anxiety disorder

People often mistake nervousness for an anxiety disorder, but they differ in many ways. 

Nervousness:

  • Lasts for a short time and goes away
  • Feelings like butterflies in our stomach
  • Produces sweaty palms
  • Has a clear cause, like a presentation or a performance review
  • Can have a recurring trigger but only lasts a short time
  • The opposite of nervousness is calm

Anxiety disorder:

  • Can feel like nervousness but is much more severe, and feelings can last for hours or longer
  • Can feel like the walls are closing in, having a heart attack, or being unable to breathe
  • Can have recurring triggers, and the feelings are debilitating
  • The opposite of an anxiety disorder is being able to see reality

Feeling depressed vs. clinical depression

As with nervousness and anxiety, people may confuse feeling depressed and full-blown clinical depression, which is a psychiatric condition. 

Feeling depressed:

  • Has an identifiable cause like death or divorce
  • Feelings are understandable based on the situation
  • We may need to talk to someone about how it’s affecting us
  • The opposite of feeling depressed is feeling happy

Clinical depression:

  • Doesn’t often have a clear cause or can manifest from loss
  • Stop doing things we enjoy
  • Lose motivation
  • Sleep all day or have insomnia
  • Stop taking of ourselves
  • Stop engaging with others
  • May have uncontrollable thoughts about death or suicide
  • Symptoms last for weeks or months
  • The opposite of clinical depression is vitality

Our adult patterns start in adolescence

A lot of our adult patterns start in adolescence. Being an adult is often just undoing our patterns from adolescence or reliving the patterns we established during adolescence, depending on our level of self-awareness and commitment to change. (6)

One study found that people’s first experiences with loss, change, and rejection happen during the second largest period of brain growth: between the ages of 12 and 25. The changes that occur during this time matter a lot. We develop coping skills during this time as well as our internal voice and our identities, and they can last forever. (6)

We can change our unhealthy coping mechanisms

We can’t control whether we have mental health disorders or experience trauma, but we can control how we cope with stressors, triggers, and challenges in our lives. 

We develop coping mechanisms from a very young age—often, these skills are maladaptive or unhealthy, such as disordered eating, substance abuse, or excessive exercise. The longer and more frequently you use a coping mechanism, the deeper the brain pathways get and the more automatic your behavior becomes, which means it becomes harder to change this behavior. (7)

However, that doesn’t mean it’s impossible to change. Our brains constantly create new neural pathways in response to what we do. If we want to change our coping mechanisms, we can do so by following these steps:

  • We have to want to change the behavior
  • We have to identify the coping mechanism then while we are doing it
  • Next, we must replace the ineffective coping mechanism with an adaptive one
  • Once we replace it, we then need to practice using the healthy coping skill whenever we are distressed

For these steps to work, we must create and cultivate an environment that helps us change, which may include a strong support system, patience with ourselves, self-compassion and forgiveness, and professional help.

Resources

  1. U.S. Department of Health and Human Services. (2022). What Is Mental Health?
  2. Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C. (2011). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychological medicine, 41(8), 1751-1761. 
  3. Muhorakeye, O. and Biracyaza, E. (2021). Exploring Barriers to Mental Health Services Utilization at Kabutare District Hospital of Rwanda: Perspectives From Patients. Frontiers in Psychology, 12.
  4. Jaret, P. (2015). The Surprising Benefits of Stress. Berkeley University of California.
  5. Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI Journal, 16, 1057-1072. 
  6. Arain, M., Haque, M., Johal, L., Mathur, P., Nel, W., Rais, A., Sandhu, R., & Sharma, S. (2013). Maturation of the adolescent brain. Neuropsychiatric disease and treatment, 9, 449-461. 
  7. Cabib, S., Campus, P., Conversi, D., Orsini, C., & Puglisi-Allegra, S. (2020). Functional and Dysfunctional Neuroplasticity in Learning to Cope with Stress. Brain sciences, 10(2), 127.