Sometimes, conversations around mental health can be problematic. Photo: Sage Friedman, Unsplash
Once taboo, conversations about mental health have grown in recent years. Individuals, corporations, and governments have become more aware of and proactive about providing support and advocating for greater resources to cope. Now, every other video on your TikTok For You page is talking about trauma, and more organizations are offering mental health days. While this is definitely a move in the right direction, an important distinction is missed in these discussions: Mental health is more than just mental wellbeing.
As someone who was diagnosed with bipolar disorder at 17, I have seen this evolution firsthand. While most people no longer look at me like I’m crazy when I talk about my illness or therapy, the conversation somehow always turns to things I should try to feel better. Yes, I know exercise, meditation, and acupuncture exist and have many benefits. Yes, I believe that these have helped you in your mental journey. But no, they cannot replace my medication or therapy. This is just one of the ways confusing mental health and mental wellbeing can be harmful rather than helpful.
Using the two terms interchangeably is problematic because the lived experience and support needed for each are different. Mental health refers to both mental wellbeing and mental disorders, and by focusing on the first, specifically the short-term emotional challenges and stresses, it can minimize very real struggles and maybe even reduce the likelihood of people seeking help. At the same time, wanting to improve your mental wellbeing, which includes developing as a person, contributing to society, and feeling satisfied, happy, and fulfilled, is a valid concern and deserves its own space. Different resources are needed to help with disorders versus wellness, and companies or organizations may provide only one or the other without taking both into consideration.
Sonal Govila, a practicing psychologist from Columbia University, told VICE that there is a difference in how mental health and mental wellbeing are approached.
“When we speak of mental health in the field, we often adopt a holistic and comprehensive outlook that centers the needs of those living with mental illnesses or disorders, whether that be diagnosed or undiagnosed, and other emotional, behavioral, and mental stressors. Mental wellbeing, on the other hand, is increasingly being used in a more general sense to refer to a state of emotional fulfilment, peace, and resilience.”
Similarly, a recent meta-analysis asserts that “states of mental wellbeing can be seen as independent from states of mental illness, despite their overlap and interrelation.”
Simply put, mental health refers not only to your life satisfaction or happiness, but also encompasses mental disorders and illnesses. When a disturbance gets in the way of your day-to-day functions, it is considered a mental disorder. The types of conditions can range widely, from anxiety and depression to eating and personality disorders. They are far more prevalent than previously thought, with one in eight people in the world living with some mental disorder.
The diagnosis of a mental disorder usually involves seeing a general practitioner, a psychiatrist, or a psychologist, and is based on factors like genes and brain chemistry. It took almost two years of seeing both a psychologist and a psychiatrist (and being hospitalized) for me to be diagnosed, but it has helped me gain a deeper understanding of myself and find the right medication and support to make episodes manageable. And while there are criticisms of modern-day psychology, including that the diagnostic criteria was created by and tested only on cis white able-bodied middle-class men, these definitions can still be helpful.
Mental wellbeing, on the other hand, is not the absence of mental illness. While defining it has not been easy, one paper refers to it as a state of having “psychological, social, and physical resources needed to meet a particular psychological, social, and/or physical challenge.” Stress, loneliness, burnout, and turbulent relationships are all factors that can affect your mental wellbeing. When you have a robust mental wellbeing, you are able to tackle your daily challenges and invest in the pursuit of a fulfilling life.
“The conversations around mental wellbeing and health are crucial and need to occur at as large a scale as possible. However, the difficulty arises when we conflate the two and insist on generic blanket treatments,” Govila said.
“The conversations around mental wellbeing and health are crucial and need to occur at as large a scale as possible. However, the difficulty arises when we conflate the two and insist on generic blanket treatments.”
One way of distinguishing whether you have a mental disorder or need to work on your mental wellbeing is by the length and severity of moods and symptoms. For example, depression is a term that gets thrown around a lot. Having a low or depressed mood is a regular part of life, but it becomes a mental illness (like major depressive disorder or clinical depression) when it hinders your ability to participate in everyday activities. Perhaps you’re unable to get out of bed, can’t finish work, or have no desire to engage in activities that you previously loved.
These distinctions can help you assess whether what you have is depression or just “one of those days,” which can then help you figure out how to address the situation.
While interventions such as exercise, healthy eating, and even strong social bonds help to elevate your mood and reduce anxiety, they should not be used as the only tactic. Meditation and mindfulness practices are recommended to help calm the mind and find center, but they can also have a negative impact on one’s mental health, including inducing panic attacks, oral hallucinations, or even a worsening of their depression. And while there is a lot to benefit from gratitude practices and journaling for your wellbeing, it’s less likely to stop a psychotic break or a schizophrenic episode. Getting appropriate treatment, under the supervision of an expert, is essential for managing mental illnesses.
On the flip side, this distinction is necessary as those who are wanting to work on their mental wellbeing might feel isolated or alone due to the stigma surrounding mental illnesses and disorders. The wellbeing tools mentioned, and others studied by positive psychology, are great first steps in your wellness journey, but there is still a belief that in order to access therapy, you must have a mental illness. In fact, in the United States, you still need a diagnosis in order to have insurance cover your therapy sessions. This thinking that something needs to be “wrong” in order to get help glosses over the benefits of preventative care and nullifies those who want to live happier, healthier lives.
My psychologist has been instrumental in my journey, not just in managing my bipolar disorder, but even in working on my mental wellbeing. Working through dilemmas such as a challenging work environment that left me feeling burnt out, a desire to have a better relationship with my parents, and even just wanting to find hobbies or careers that leave me fulfilled, were all discussed in my therapy sessions. So, I have been recommending therapy to anyone who will listen—because everyone deserves the time and attention to work on themselves and be that little bit happier and more fulfilled.
“Everyone deserves the time and attention to work on themselves and be that little bit happier and more fulfilled.”
Finally, perhaps the biggest problem with confusing mental health and mental wellbeing are the resources and accommodations that are provided by corporations and other organizations.
“For example, meditation offerings are great tools for building a workplace culture that emphasizes employee wellness. However, offering a robust healthcare package that covers psychological and psychiatric care and providing customized accommodations for individuals with mental illnesses are important for addressing employees’ mental health needs,” Govila said.
A part of why I ultimately chose to become a freelancer is because the organizations that I worked for were unable to provide me with the resources needed to be a full-time employee. No amount of mental health days or yoga sessions were able to capture the support I needed, which ranged from starting my work days at noon to taking regular time off to see my psychologist and psychiatrist, and managing workload based on my ever-changing energy levels and outputs. There were no insurance benefits for mental health services, and so I was still spending out of pocket anyway.
There is no band-aid solution for employers to deal with all mental illnesses. Certain studies have found that the most effective workplace intervention for those with mental disorders is one that provides access to effective mental health treatments, like cognitive behavioral therapy (CBT) and medication. But for less common illnesses, be it bipolar disorder, ADHD, or anorexia, it requires investment and effort from managers, senior leaders, and HR, to work with the employee and find the best accommodations that ensure their health.
The conversations about mental health and mental wellbeing need to continue. Emphasizing their differences supports both the people who need diagnoses and accurate treatment as well as those who wish to improve their situation to have a more fulfilling life.
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