I published this piece last year, shortly after the Olympics, on Mentriz.com. I’m not sure what happened, but Mentriz no longer seems to exist. So, I’m reposting it here for the time being.
The past year and a half have been seemingly great for mental health advocates. Starting with the onset of the global pandemic and continuing with Naomi Osaka’s withdrawal from the French Open and Simone Biles leaving the Olympic gymnastics team competition, there has been a lot of public discourse around mental health. We all know, or at least feel, shining a light on a problem is the best way to educate people and reduce stigma. That would make this current conversation great. Unfortunately, this particular spotlight is obfuscating more than illuminating. There are two basic ways it is going wrong. One is relatively minor but shows a common mistake we all make. The other is huge.
The smaller of the issues is that the current talk about mental health is leaning too heavily on celebrity. It is great that Osaka, Biles, Kit Harrington, and Chrissie Teigen (among others) are being open about their struggles. It is also great that they are seeking the help they need rather than pushing through and pretending that everything is fine. It is even greater that the public and their sponsors are (mostly) being supportive. The problem is that celebrities are simply in a different position than the rest of us who deal with mental health issues.
Most of us don’t have sponsors at all (Although, I’m open to it if anyone is interested in sponsoring me). Taking time off for our mental health risks our jobs. And we don’t have a cushion that would allow us to survive without those jobs. Many people don’t have broad support systems. It doesn’t matter how bad I feel on any given day if my kid’s gotta eat and no one else is around to feed her. Throw in the fact that insurance is less likely to cover mental health issues and, even when they are covered, there are often still large out-of-pocket fees, and most people who suffer from mental health issues can’t deal with it the same way as the role models that everyone is talking about.
Like I said, that is a relatively minor issue. It would be nice to see the struggles of regular people talked about more, but we have to fix the big issue before that would do too much good. The big issue is that we need to stop talking about mental health as if it is just one thing. The phrase “mental health” doesn’t say much of anything. It covers everything from agoraphobia to social anxiety to depression to schizophrenia. Have you ever looked at the DSM? It’s a really thick book. There are a lot of different issues covered by “mental health.” Imagine talking about “physical health” without bothering to distinguish between a toothache and appendicitis or a broken arm and cancer. The phrase doesn’t do any real work.
The reason this is a problem is because, like those “physical health” issues just mentioned, every mental health issue is different. They have different causes, different symptoms, different treatments, and should have different expectations. Some are chronic and some are temporary. Some are inconveniences while others are debilitating. I, for example, have battled depression. Its trigger was my divorce. Insomnia, low mood, overeating, inability to find pleasure in things that should bring me joy, and feelings of worthlessness and failure were my main symptoms. The lack of sleep made simple things like driving legitimately dangerous for me to try. It tested friendships; I was certainly no fun to be around. It put my job at risk (I managed to show up most days, but there’s only so much sick time to use if you’re lucky enough to have sick time at all). Many others with depression are nodding along right now. But someone with obsessive compulsive disorder isn’t going to recognize themselves in that. Nor will someone with anxiety or PTSD or bipolar disorder.
Throughout the pandemic and with the celebrities’ stories the conversation stays at such a high level that we don’t learn anything. For some, COVID brought trauma, for others grief. That was talked about on the news. But, without equal coverage, anxiety and dysthymia have been a lot more common. They can’t and shouldn’t be treated the same way as grief or trauma. With Naomi Osaka (I don’t know what her diagnosis is, and I don’t want to know. It’s not anyone’s business but hers.) avoiding the public was what she needed to get better. For other people, social engagement might be just what the doctor ordered (It helped my depression).
People often say, “Mental health is health.” That is absolutely true, but when we talk about “mental health” as if it is something rather than the myriad things it is, we cover it up. “Mental health issues” isn’t a diagnosis. In order to manage and treat something, we need to know what we are dealing with. And we need to be able to share it with others. We can’t very well expect our jobs to make accommodations without knowing what they are accommodating. Family and friends want to help but keeping things a mystery doesn’t allow that. Someone with a peanut allergy isn’t going to say, “I have a physical health issue,” and expect people to know to keep peanuts away. That person will say, “I have a peanut allergy.” If mental health is health, we need to treat it the same way. I don’t have a “mental health issue.” I have depression. Now, let’s start talking.