The Words We Use When We Talk About Mental Illness

Why talk about mental illness?

In measuring happiness and life satisfaction, a United Nations report revealed that mental health explains more of the variance of happiness in Western countries than income does. In fact, the authors found that mental illness was the strongest predictor of misery, more so than poverty, unemployment or even physical illness.

If you just re-read that last sentence thinking you must not have understood it properly or that it has to be wrong somehow… let’s take a closer look at why the presence of a mental illness can be, and often is, a more potent influence on a person’s happiness– or lack thereof– than income, employment and physical health.

Just to clarify: in presenting this data we by no means intend to perpetuate the notion that people with a mental illness are doomed… on the contrary, research shows we can be successfully treated & can indeed live satisfied lives. BUT these disorders need to be taken seriously in order for things to get better (and the data invariably points to that).

Why mental illnesses are serious:

• 1 in 5 people will suffer from one of these disorders in the course of their lifetime [*].

• Approximately 4 to 5% of the cases become truly disabling [*].

• 90 % of suicides are related to a mental illness [1] and suicide is the second leading cause of death in 15 to 29-year-olds worldwide [2].

• They start very early in life: 50% will have onset by age 14 and 75 % by the age of 24.

According to Thomas Insel, former director of the National Institute of Mental Health, mental illnesses (MI) are the chronic disorders of young people. The fact that on average MI start early in life distinguishes them from most of the major illnesses (i.e. cancer, heart disease, diabetes, hypertension) that we think about as being sources of morbidity and mortality.

A mental illness is an “invisible illness”, But not always a disability.

It’s possible to say MI's are Invisible Illnesses considering that, unlike other diseases, they show no outward signs. We’re using this term to emphasize the fact that the symptoms are invisible to the onlooker, which means the individual might look completely healthy, making it harder for others to acknowledge there’s anything wrong or that the person’s pain is real.

And yet, as stated above, for about 1 in 20 people the MI becomes truly disabling– which means that the condition significantly impairs normal activities of daily living.

Basically, a MI turns into a disability when it persistently interferes with your work/education, family, social & romantic life, and overall health. Because the impairments are invisible, others may not perceive the challenges you are experiencing, and may find it hard to comprehend or believe you genuinely need help. Therein lies the appeal, for some of us, to talk about INVISIBLE DISABILITIES.

“Mental Illness” or “Brain Disorder”?

Finally, let’s take a second to consider another idea:

What if instead of referring to them as “mental illness” we used the term “brain disorder”? [3].

Could that change how we view them?

Even if science hasn’t yet been able to fully understand what happens to the brain in these illnesses… scientists have identified some differences in the brain circuitry of individuals with a MI.

During a depressive episode, for example, we know [4] that there are:

• changes in neurotransmitter function;

• changes in synaptic function;

• increased or decreased excitability between neurons;

• alterations of gene expression;

• hypometabolism in the frontal cortex (usually) or hypermetabolism in the same area;

• raised levels of thyroid releasing hormone (TRH);

• disruption of function in the amygdala and possibly the hypothalamus;

• altered levels of melatonin;

• increased prolactin;

• flattening of twenty-four-hour body temperature;

• distortion of twenty-four-hour cortisol secretion;

• disruption of the circuit that links the thalamus, basal ganglia, and frontal lobes;

• increased blood flow to the frontal lobe of the dominant hemisphere;

• decreased blood flow to the occipital lobe; amongst others.

“When we talk about the brain, it is anything but unidimensional or simplistic or reductionistic. It depends, of course, on what scale or what scope you want to think about, but this is an organ of surreal complexity, and we are just beginning to understand how to even study it, whether you're thinking about the 100 billion neurons that are in the cortex or the 100 trillion synapses that make up all the connections.”

– Thomas Insel

The evidence points to undeniable alterations in the brains of people with MI. Therefore, would we as a society perhaps be better disposed to act with concern and comprehension towards those dealing with a Brain Disorder? (rather than a mental illness).

Can this adjustment in terminology produce a transformation in people’s attitudes and prejudices against MI?

As a person living with one, I would undoubtedly use the term Brain Disorder– casting aside the academic or philosophical arguments against it– in favor of greater acceptance and prioritization.

How about you?! What do you think? I’d love to read your comments below ⬇

October 10th is World Mental Health Day

[Disclaimer: I studied psychology but I’m not a doctor nor a psychotherapist, please consult a professional if you have any personal doubts or worries]

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Sources:

[*] https://www.ted.com/talks/thomas_insel_toward_a_new_understanding_of_mental_illness/transcript?utm_source=tedcomshare&utm_medium=referral&utm_campaign=tedspread#t-252067

[1] It’s very important to make perfectly clear that the great majority of people who experience a Mental Illness do not die by suicide. Rather, of those who die from suicide, more than 90 percent have a diagnosable mental disorder. https://www.samhsa.gov/suicide-prevention

[2] http://www.who.int/mediacentre/factsheets/fs369/en/

[3] As proposed by Thomas Insel in his TED Talk “Toward a New Understanding of Mental Illness”.

[4] The Noonday Demon, by Andrew Solomon

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