Increased use of psychiatric language means ordinary distress is being medicalised, while the seriously ill are not being heard, says psychologist Lucy Foulkes
Evidently, since my friend’s acute distress passed within a few weeks, he didn’t sit clearly in the territory of what we might call “mental illness”. But he certainly wasn’t mentally healthy for those weeks either. Instead, I realised, he sat somewhere in the vast grey plains between the two. Everything we might think of as a “symptom” of mental disorder – worry, low mood, binge eating, delusions – actually exists on a continuum throughout the population. For each symptom, we vary in terms of how often we experience it, how severe it is, how easily we can control it, and how much distress it causes. In the terrain of mental health, there is no objective border to cross that delineates the territory of disorder. On top of this, the thoughts, feelings and behaviours that appear temporarily as a natural response to hardship and stress – like when we’re heartbroken – exactly mimic those that, should they persist, are defining features of mental disorders. So blurry are these boundaries that some psychologists argue we shouldn’t use the terms “illness” or “disorder” at all, and should only view all of this as matters of degree.
The current conversation can be summed up as follows: you should notice, scrutinise and seek help for negative psychological experiences. Of course, for some people, this message will be essential. For those who are suicidal, it can be lifesaving. But the message misfires when it implies that all negative states are problems, health problems – and things that can and should be fixed. That’s not how life works.
Interpreting your low mood as a sign of depression, for example, can actually cause you to spiral into the very depression you’re worried about. We know this from research into mindfulness-based therapies for people with recurrent depression: learning to view low mood as “just” that, rather than as a start of a new depressive episode, can help reduce risk of relapse.