Our business coordinator, Tom, talks about mental health, suicide, seeking help, and what you can do to support those around you.
Please note – this article discusses suicide.
Today is World Mental Health Day.
If, 12 years ago, you had asked me what “mental health” means, I would not have been able to give you a constructive response.
What is mental health?
Broadly speaking, ‘mental health’ is a catch-all term for a person’s emotional, psychological and social wellbeing. It is comparable to ‘physical heath’, which refers to all aspects of a person’s physical wellbeing.
Poor mental health can affect anyone, with 1 in every 4 people in the UK affected by a mental health condition. Mental health conditions can have a significant impact on a person’s daily life, from impacting their physical health to affecting their ability to work or manage their affairs.
The most common mental health conditions are anxiety and depression, but there are many others. Mental health conditions affect people in different ways, and it is common for one person to experience more than one mental health condition.
Until then, cultural understanding of psychological wellbeing was limited, and the only education I might have received on the topic usually involved lazy stereotypes of individuals presenting at the extreme end of problematic mental health. You were either okay, or there was something wrong with you.
I was not okay.
As far back as I can remember, I have lived with (what I now understand to be) severe mixed anxiety and depression. The depression comes in episodes, but the anxiety is almost constant. For 6 of these years I suffered with unmanaged Bulimia nervosa, an eating disorder.
Types of mental health conditions
Mental health conditions are crudely categorised according to guidelines published in diagnostic manuals DSM-V and ICD-10. Among others, there are 5 major types:
Anxiety disorders (including PTSD, social anxiety, panic disorder and phobia) are a group of conditions characterised by feelings of anxiety or fear and accompanying physical symptoms, such as palpitations, nausea and panic attacks.
Mood disorders (including depression and bipolar disorder) are a group of conditions characterised by a disturbance in a person’s mood, either through manic or depressive symptoms. Bipolar disorder is characterised by cyclical shifts in mood, typically between manic and depressive states.
Psychotic disorders (including Schizophrenia) are debilitating conditions which involve difficulty in perceiving reality, often characterised by false beliefs, hallucinations and incoherent behaviour.
Eating disorders (including Anorexia and Bulimia) are conditions defined by abnormal eating habits which negatively affect mental and physical health, these are commonly associated with depression, anxiety, substance-abuse and self-harm.
Personality disorders (including Borderline Personality Disorder) are complex conditions characterised by maladaptive patterns of behaviour and thinking, often associated with trauma and neglect.
It’s hard to imagine that you would fail to identify yourself, or another, as a person with a severe illness. The problem with symptoms of poor mental health is that they tend to become obvious only when a person is unable to function normally. This is typical only in the most extreme circumstances, or with specific mental health issues, and people affected by them tend not to realise how severe their situation is.
Most people living with mental health problems are capable of functioning normally.
Many, if not most people with mental health problems, suffer in silence. Often unaware that their symptoms are severe, and too often believing that their symptoms are not severe enough to require treatment.
Unmanaged, mental health conditions do not usually get better on their own. As conditions worsen without attention, affected individuals tend to isolate themselves and withdraw from regular activities and from their social support. Without help, many individuals develop thoughts of worthlessness progressing to self-harm and suicidal thoughts.
Every day, 15 people kill themselves in the UK and Ireland.
It is estimated that at least 1 in every 200 people attempt suicide at some point in their life.
I am one of them.
Suicide is a person ending their own life. Suicide accounts for nearly 1 million deaths worldwide each year. Of these, as many as 90% have underlying mental health conditions. It is not common for individuals to talk openly about thoughts of suicide, but there are some common signs that someone may be having suicidal thoughts:
- Talking about killing themselves
- Saying they have no reason to live
- Consuming drugs or alcohol more than usual
- Seeming on-edge or anxious
- Talking about feeling trapped or having no hope
- Withdrawal from their social group, social media or regular activities
- Severe mood swings or uncontrollable emotions
- An increase in reckless or dangerous behaviour, even if seemingly innocent
It wasn’t until I was in my 20s, after my suicide attempt, that I first sought psychological help and began to understand the severity of my illness – or even that I had one. It is, without exception, the most challenging thing I have ever done.
Addressing personal problems and talking about thoughts and feelings related to mental health is difficult, even with people we love and know care about us.
Words were totally inadequate to express the pain and distress I felt.
It is very difficult to know where to begin, or how to explain it to a stranger, or someone who may occupy a position of authority in your life (e.g. GP, employer, teacher, tutor, parent). It is even harder to explain it to someone close to you.
Seeking help is the first step to getting better.
It is always okay to ask for help.
It’s difficult to advise where it’s best to start, but there are usually a few options:
Friends or Family may not be experts, or even understand what you are going through, but they are best placed to support you immediately. They may be able to help with managing day-to-day things when you are overwhelmed, they can come with you to appointments and help you find information. They are likely to be your most accessible source of emotional support.
Your doctor or GP is usually your gateway to psychological support, they can make a diagnosis and prescribe if necessary, or refer to specialists.
Charitable organisations often have directories of local support, information about mental health conditions and advice for seeking help. Some also run free helplines with staff trained to support individuals in crisis.
Trained therapists and counsellors can provide structured support and therapy. They will often take self-referrals and can refer to specialists or contact your GP. Many operate privately, but some are available through your local NHS, charities or social prescribing networks. If you are a student at school, college or university you will have access to institutional support services. Many employers and workplaces are also adopting wellbeing policies; they may have specialised support available or can refer to an appropriate practitioner.
Community, group and peer support is arranged locally, and can be a great source of emotional support, empathy and understanding. These usually focus around shared experiences and self-care.
The biggest obstacles to seeking help are usually fear of judgement from friends, family or employers, and general stigma around mental health problems.
Struggling with a mental health problem is normal.
It’s painful to think how many people could have identified that I was struggling. The number of opportunities passed by to just ask if I was okay. There’s no way of knowing whether it would have been better or not, but I may have sought help earlier than I did. Too many of us are only seeking help when it is almost too late.
As you are reading this, someone around you is suffering with a mental health problem. It’s almost certain that members of your family or social circle struggle with their mental health. It’s just as likely they don’t know how to talk about it.
You can help them.
What can I do?
Check in. Ask if they are okay, especially when they haven’t been in contact.
Reach out. Try to involve people in your life and events, even if they don’t appear interested.
Stop and listen. Giving someone the time and space to talk without judgement can be the most helpful thing. Listen to how they’re feeling. If they are finding it difficult, let them know you are there when they’re ready.
Be calm and patient. It might be upsetting to hear, but they will be calmer if you are. Show them they can be open with you without upsetting you. Don’t pressure them in to getting help or disclosing thoughts and feelings before they are ready.
Don’t make assumptions. Let them tell you what is going on, don’t assume you already know what they feel or why. Try to remember you are unlikely to know what is best for them before they do.
Today gives us an opportunity to remember that it isn’t possible to be perfect or happy all the time. We do not always have to be at our best. We are not weak for admitting when we can’t cope. Mental health problems are normal, and there is support out there for those who seek it. Let’s try to keep our ears and doors open to those who might need it.
It’s okay to not be okay.
Tom Cardigan is Business Coordinator for The Minded Institute. He is a psychologist who has worked in first contact support for victims of abuse, and with children and younger people in education.