What do you think about mental health?

Lots of news items on mental health recently. While it’s good that the stigma of mental health is diminishing, and that key issues are increasingly being debated openly and prominently, many individuals still fear the thought that they may have mental health issues. And yet that fear parallels the incontrovertible growth of those seeking help from doctors and therapists. The wider world seems beset with declining mental health.

We all know that a major proportion of the population of all western countries are, or will be, seeking help for conditions such as depression and anxiety. In 2015, the “top five” countries ‘on’ antidepressants are USA, Iceland, Australia, Canada and Denmark. Which is interesting as the last three also share a high ranking of happiest populations in the world, with Denmark topping the happiness league table, according to a global study of 156 nations (http://worldhappiness.report). Happiness, with or without antidepressants, does seem a Nordic/Scandinavian monopoly: in 2016 the top four countries were Finland, Norway, Denmark, Iceland. In 2017: Finland, Norway, Denmark, Iceland. In 2018 Finland, Norway, Iceland and Denmark. Is this a pattern or what?

Interestingly, South Korea has a low incidence of anti-depressant use, possibly because it is widely regarded as a weakness to admit to not being strong mentally as it would bring about loss of face; this is, sadly, reflected in a high rate of suicide.

So why are politicians now taking more of an interest in mental health? Simply because the number of people seeking medication and other forms of support for anxiety-related and associated conditions are growing exponentially in inverse proportion to resources. Which is good — if it means mental health cannot remain the poor relation of physical health. There is compelling evidence that demand for help with mental health outstrips available resources. How’s that for a gloomy perspective for those who find it hard to enjoy life because of a debilitating condition?

We all know overworked family doctors are very quick to prescribe of medication to re-balance our brain chemistry. The pharmaceutical industry benefits massively. I saw one report recently that stated that if the U.S. health care system was a totally separate nation it would actually be the 6th largest economy on the planet.

We also know that there are a plethora of psychotherapists and others in allied fields offering therapy to deal with the symptoms of mental discomfort.

But in view of this massive response to adversity in mental health, do these interventions actually work? Whenever I ask my local doctor what happens if anti-depressants don’t work, the invariable response is to prescribe stronger medication. I guess that must work, because I rarely see zombies in a doctor’s waiting room. For every one person who seems to feel they benefitted from therapy, there seem to be many more who found that therapy didn’t work for them.

So is the answer to better mental health pouring in more resources to do more of the same?

Or, perhaps our thinking on this is fuzzy. Perhaps we’re not as smart as we like to think we are. And I doff my proverbial hat to anyone who correctly predicted the election of Trump, Brexit, Leicester City to win the UK football premiership, and Boris Johnson as Foreign Secretary. If you did, I hope you cleaned up at the bookies!

But few of us seem to understand what is happening in the present. If we are better educated, have better health care and are more prosperous, longer lived, travel more extensively, and have access to a world of information literally at our finger tips… why are so many people unhappy and on antidepressants? Last year in Britain over 60 million drugs were prescribed, double that of 2005. Similar trends can be found in most other developed countries.

Traditional thinking considers depression to be a disease. Indeed, many sufferers consider that it’s an actual condition or a disorder that gives rise to anxiety, low mood and gloomy thoughts.

But what if the condition isn’t really an actual condition in its own right, but is instead an outcome of our own creation that develops BECAUSE of habitual worry, low mood and gloomy thinking? What if the ‘condition’ is then maintained by not managing our thinking more effectively? How many of us really do understand the complex interplay between emotions, feelings, rational thinking and personality? Apart from those in advertising industry who so often have the insights to trigger how they want us to feel.

If many “disorders of the mind” really are our own creation, would that not suggest that much of the effort to deal with depression and allied conditions — pharmacological and therapeutic — have been missing the target? Could that perhaps be why their effectiveness is so limited? Instead, should we be trying to better understand how our mind works, how our emotions and behaviour and the language we to talk to ourselves be the collective as the focus of any intervention?

Even if those struggling with mental health strongly believe they “have” a condition that “causes” their depression, there is the option to try something different, and test whether the reverse is true – because just trying to change the way we see ourselves opens up a whole new set of empowering possibilities that can succeed where antidepressants failed. We can choose, with considerable effort imbued with belief, to challenge poorly managed thinking, and reign in catastrophising language and develop the confidence to do things that bring about higher levels of esteem, rather than allow negative predictions -- “you always fail because you can never do anything right L ” – to constrain us.

What if we were to start believing that we ourselves CAN bring about the change we traditionally hope doctors and therapists would provide for us?