Mental distress can be an unknown territory.
Consider, for example, being a 16-year-old boy and feeling like your whole world is crumbling, but not understanding why.
You are living with your parents who are constantly fighting. Your mother is overworked, working at a local factory. She is being treated badly by her boss and she cannot seem to find another job. She comes home exhausted from work and often feels overwhelmed by the tasks of taking care for two children. This sometimes fills her with anger, with her outbursts often spilling over on you and your brother. She does not really know how to handle her emotions well.
In fact, emotions are never spoken of in your family. When there are problems happening, everyone just pretends there aren’t any, until they pass. Sometimes you can hear your parents arguing late at night, though.
You often feel unwell, not really knowing why. You spend a lot of time in your room, listening to angry music. It is the only space you feel safe in.
Your dad is withdrawn and away most of the time. He is exhausted working, too. He works for a local real estate company and he is under constant pressure to increase sales and profit. When he comes home, he just stares at the tv.
Home does not really feel like a safe space to you.
Things at school are not any better. Though you do have some friends, nobody seems to understand what you are going through. This makes you feel misunderstood and you start avoiding people. You spend your days on Tumblr and Instagram, even though the latter just makes you more depressed. Everybody seems to enjoy life except you.
You do not really feel like getting out of bed in the morning. You cannot seem to understand why you feel this way, but it continues. You stop doing your homework and even miss some classes.
You spend months like this. Then a year. And then another.
At one point you start feeling like you cannot breathe. You have the feeling that the air is being sucked out of your lungs. You feel like you are going to die. At first this is light, but after some time it makes it hard for you to get through the day. You feel as if the floor under your feet is disappearing.
You do not understand what is happening. After some time, you share it with some of your friends from school and they suggest you should see a therapist.
You are a bit ashamed that you should have such problems and fear that if you go to see a therapist, someone could label you as “mentally ill.” You have seen some kids from school getting laughed at for this.
After some time, it becomes so hard to get through the day that you just desperately need any help.
Depending on where you live you are or are not lucky enough to have free access to some support.
You are able to go to psychotherapist because the area where you live provides one to young people for free. The therapist seems understanding and full of support. He tells you your problem is anxiety and helps you understand that this is related to understanding of your feelings. Your feelings have bottled up. Emotions get stored in the body and can wreak havoc there if we do not pay attention to them, you learn. This is why you sometimes cannot breathe. It is a way in which your organism is trying to tell you something.
The therapist helps you to learn that we all feel emotions. They function like a guidepost to what we need. But if we are not aware of this, we cannot understand what they are trying to convey to us. Then we cannot give ourselves what we need in certain moments.
The therapist gradually teaches you how to handle your emotional distress. He also helps you in understanding that it is not your fault your parents are having a hard time at home due to economic circumstances and lack of communication. He helps you to process your emotions.
After some time, you feel better. The floor under your feet somehow reappears. You start getting out of your room. You start feeling like going out and seeing people again. You sometimes still have trouble breathing, but you get better at understanding what happens to you and how to handle it. The problems of your parents do not stop, but you get better at handling situations. You no longer think this is your fault. You start thinking about your future and making plans for it.
Or, in an alternative scenario, your parents cannot afford therapy. You yourself do not have money to provide for it.
When you contact your GP, you just have a quick conversation with him and you are given medications.
You may or may not be labelled and get a diagnosis. They tell you your state is purely biological. Think of yourself as a malfunctioned machine, they say. The biology in your brain is messed up and you need medicine to fix it.
After this, you start viewing yourself differently. You start having lower trust in your capabilities. If the floor under your feet does not hold, what is it that you can do in life anyway?
You start getting depressed because of this, so they give you more meds. Now there is no point getting out of your room because your future seems cemented. There is no point in trying if you are malfunctioned, right?
Now let us stop and consider. Which of the two scenarios is the one we want to live in when encountering mental distress?
In one scenario, it makes every difference for that teenager to have support enabling him to understand what is happening to him. And to do so in a way that does not label human beings, but tries to understand complex states of mental distress.
It would also make every difference if his parents had some sort of support to understand what is happening to them and how to handle things more constructively.
It is therefore urgent to think of another way of approaching mental health in our society. Education in emotional literacy is something we urgently need.
Recent research is showing more and more that emotion regulation is the most important dimension of emotional competence that impinges on mental health.
If this is so, doesn’t it seem a bit strange that in our educational system we are dealing with everything except emotions, so very basic for our human functioning? Why is the awareness of emotional regulation left to chance?
We need to see just how important understanding of our own emotional states is when it comes to prevention in mental health.
We need programs that will embed this into our public policies.
We need to explore ways of doing this.
Mental Health Europe, as the largest independent network organisation representing mental health users, professionals, and service providers across Europe, recommends including mental health in school curricula and the curricula of teaching staff. It also recommends providing social, healthcare and educational workers with the skills and resources to recognise mental health risk factors, provide basic support, and provide referral to mental health services when needed.
It is important to note that those services should function in the way I have described above, and not in the manner of pathologization. Instead, they should offer understanding of the basic ways in which human beings function, ways of recognizing and understanding what is happening when one is not feeling well, as well as understanding what one can do when this happens.
There are existing approaches that could be employed in this service. There are plenty of psychotherapeutic approaches that employ an existential-phenomenological understanding, which, instead of putting an emphasis on labelling people, helps them to understand their mental distress. There are also other approaches that support people in distress in a non-pathologizing manner, such as Open Dialogue. Furthermore, there are organizations such as INTAR that advocate for a different kind of mental health system.
All these approaches and organizations offer a valuable pool to assist in the development of the above-mentioned programs.
Perhaps embedding this kind of education in our current societal system seems like an expensive task. But let us return to the story of that above-mentioned boy.
In the long-term, wouldn’t it be less expensive if this boy was taught earlier in life in school the basic understanding of how human psyche works and how mental distress can be tackled in a non-stigmatizing sort of way?
Like Ben Franklin famously advised his fellow-citizens in 18th century, “an ounce of prevention is worth a pound of cure.”
This still applies today.
It would be more effective to teach us all about our own mental states and how to keep us well when growing up, rather than leave it to chance, socioeconomic status, and accessibility of therapy in the latter years. It would also be more effective to do so in a non-stigmatizing manner.
This is not to say that some mental distress will not always exist. As the COVID-19 pandemic has shown, we live in a complex world with unexpected events putting our collective mental health to the test.
Precisely because of this, it is more important than ever to understand ourselves and how to navigate it.
On a wider scale and systemwide.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.