We need to adopt a new perspective for mental wellness and treatment
More and more people are challenging the notion that therapy is actually helpful and whether or not it's actually providing benefit to people. The more we examine the mental health industry and ask some of the difficult questions, the more we might find ourselves working to avoid one big uncomfortable truth and it's that many therapists aren't helping and that therapy, in general, isn't helpful. While many therapists are definitely helpful, a large percentage of them aren't. Our rates of mental illness continue to spike and large swaths of people report chronic depression and anxiety among other life issues such as issues with addiction or even things like confidence and self-esteem. It's become reasonable to conclude that the mental health industry is looking at mental health all wrong.
"Cure," is a dirty word in mental health but not dirty enough. Experienced mental health clinicians will tell you that the concept of curing mental illness isn't a fitting perspective and when we approach mental illness like we might approach physical ailments, we find ourselves impossibly stuck to find solutions and it's because the accepted model for mental illness as well as mental wellness is terribly broken and misguided.
Sometimes you get physically sick and you can effectively cure that sickness with an antibiotic medication. Take the medication for a week and just like that, the ailment is gone, it's been cured. Mental illness and mental wellness has managed to fall into the rut of this same kind of model though it doesn't fit. I've noticed that a lot of people talk about mental illness as though there is a cure and we even treat mental illness like there is a cure will all of the medication that is handed out for mental health issues. We've all seen the commercials. Life is dark and dreary but if you take these pills you'll be off sail boating and going to parties in no time. Medications might look like a cure to things like depression, when in fact, they are not.
Do medications work?
Universally, I see people accepting that medication is viable option for things like depression or anxiety. A lot of people have taken these meds at some point or another, it's not exactly rare for people to have given these medications a shot so where are all of the success stories? People try them and they often stop taking them because they don't notice any significant changes. When someone tells me that they keep taking their medication it's usually because they're afraid of what might happen if they stop. It's also common for people to report that instead of feeling down, they just feel blah which many people report is worse than feeling down.
Medication for depression is a topic with a high level of controversy and it's highly polarizing. Some people feel very strongly that medication for things like anxiety and depression is positive and extremely important. When I've expressed my stance that medication isn't that effective or useful for most people, it has been met with many people voicing their agreements and gratitude while others are horrified that I would suggest this as a therapist and who tell me that I shouldn't be practicing in mental health. It's not a black and white issue. Medication helps people with things like schizophrenia and bipolar disorder and it can also offer some help for issues that rooted in trauma. It's virtually useless for personality disorders and so it honestly depends on what you're dealing with.
"Life is going to be hard no matter what you do."
For those who are experiencing day to day depression, they don't seem to be doing much good. I almost never see medications offer help for depressed teenagers who have been forced by parents to take medications that don't work or help when the kid usually doesn't need to be medicated in the first place. We've accepted the disturbing trend of pathologizing normal behaviors associated with normal growth and development and I think before we go and medicate ourselves we should first ask ourselves if we're just experiencing the normal growing pains that comes with being alive or if we're experience a natural response to normal struggles.
I realize there are people out there who believe that their psychiatric medications provide them with benefits and I'm not here to dispute those claims or encourage those people from discontinuing their use of medication but they are also the exception rather than the rule. At best, the medication just helps people function day to day and while I recognize that's important and a big deal and I don't want to discount that but we should recognize that the companies that manufacture these drugs are grossly misrepresenting how effective they are. They aren't going to pick you up off the floor and get you on a sailboat. They aren't a cure. Again, cure is a dirty word.
We shouldn't be treating mental illness like we treat physical illness, it gets us almost nowhere. Medical doctors treat mental illness this way because it's what they know. They see everything through this lens. Everything is a pathogen and needs to be treated with drugs but this has yielded extremely lousy results with overall negative outcomes. The rates of mental illness continue to rise and worsen and yet many people remain fiercely loyal to a medical system that has largely failed us and a model of treatment that isn't helping. Things are getting progressively worse but that doesn't stop many people from taking the hard stance that the medical model is a progressive one even though we clearly don't see any real progress.
We continue on this way, people generally trust the medical system almost implicitly even though it's not getting them anywhere. We've been taught, incorrectly, that we need someone like a doctor or something like medication to cure us of our mental ailments. After many years of doing clinical work and after working with countless individuals, I'm more certain than ever that we have it all wrong when it comes to mental illness and mental health.
"Medication can help pick you off the floor long enough to make some changes but they don't solve the problem."
Mental illness and mental health are a lot more like physical fitness. When we are out of shape, physically, it's usually the result of lousy diet and the lack of exercise. If you're eating fast food all the time and never getting any physical movement, you're likely going to experience some health issues. You could go to the doctor who will prescribe some medications to deal with the problems caused by a particular set of habits. Pharmaceutical companies, by the way, would be pretty stoked if everyone ignored good health and fitness habits and just took their pills. The other solution here is to eat better and to get more exercise. If you change your habits, you'll see a difference in how you feel. If you dedicated yourself to being fit and turned it into your lifestyle, you'd bee a major difference in your life. You'd be healthier and you'd be happier, plain and simple. That's not to say that you still wouldn't have issues, problems or setbacks but the bottom line is this, good habits lead to good health. Plain and simple.
Mental health is the same way. We shouldn't be looking at mental health as though you have a sinus infection or something, we should be treating it like it's mental fitness. I realize how many people there are out there that hate the idea that it's up to them to improve their mental health, I always get resistance and pushback on this point and I even sometimes get a lot of anger and hatred directed at me. People become quite reactive when I imply that it's their job to manage their mental health, they sometimes think that I am blaming them, when I'm not. I'm simply stating that even though it's not their fault, it is their job. If they don't do it, nobody else will.
Let me put it this way. If someone came through your yard, trampled on the flowers, killed the grass and left mountains of trash there it wouldn't be your fault that your yard is a complete mess but it would unfortunately be your responsibility to clean it up. It's your yard and nobody is going to come by and clean it up. It sucks having to clean up a mess that somebody else made but if you don't clean it up, it's not going to get cleaned up.
Our mental health and our lives are often this way. We are the product of the messes that somebody else made. Almost all of us endure trauma from our parents, for example, and it can really put us in a bad spot because of how many things stem from that trauma. We didn't ask for that trauma or cause it necessarily, but it is up to us deal with it in a healthy and positive way. We don't choose the cards that were dealt to us, it's our job to learn how to work with the cards that were dealt to us.
Good mental health doesn't happen because a doctor gave us some pills. Every happy, strong and healthy person you can find is more than likely the result of a long, arduous and determined fight through difficulties and overcoming a series of negative events in their lives. You'd be hard pressed to find a single inspirational person or teacher that hadn't walked their mile or five through hell and back. They're mentally fit for the same reason that certain people are physically fit. They've earned it.
There are distinct differences between those who see an improvement in their mental health and those who don't and one of those distinct differences is that those who get better are those who learn to approach their life and their mental health from the same mindset of physical fitness.
Let's get a lot more specific and concrete here.
In the same way that you should be careful and discriminating about what you eat, how much you eat, how often you eat, and so on, you should exercise the same discernment about what you allow into your mind. Our minds get filled with junk whether it's the local news filling us with fear and discouragement or we allow ourselves to get wrapped up in unnecessary drama. We've grown far to comfortable with just mentally consuming whatever is placed in front of us without making an effort to be discerning about what is good for us and what isn't. It's reasonable to say that most people just aren't aware of what is good for their mind and what is bad for their mind. Our understanding of mental health and mental illness just isn't universally good enough for people to know or understand what might be bad for them or good for them or why they should be really careful about what they allow their minds to consume but it's not just about consumption, it's about what we allow to live in our heads as well. Sometimes good mental health is about learning to manage what movie is playing in our brains.
"The current models of mental health treatment isn't working."
So we should be careful about what we consume and we should be concerned about exercising our mind and that can mean a few things including discipline. Having a mind that is more disciplined equates to better mental health. For a lot of people, this task seems monumental, there is such a lack of mental discipline these days and so it's no wonder that people are an emotional wreck and it's no wonder that people feel completely lost in this regard.
One of the most important and basic things that I teach people to do in order to improve their mental health and exercise some discipline is to begin with building awareness around their thoughts and their emotions. Most of us have experienced our minds being a tangled mess of thoughts, emotions and impulses. They are all tangled together in a big frayed jumble. Internal Family Systems Therapy or IFS calls it blended while Acceptance and Commitment Therapy or ACT calls it being fused. By building awareness around what our thoughts, emotions and feelings are doing, we can begin taking many other actions in several positive directions.
For example, we can start discerning what things need our direct attention and what things need to be let go of. The most important and core skill for mental health and building mental fitness is to build awareness around the thoughts and the observer. There's a difference between the part of you that observes the thoughts and the part of you that is performing them and we want to untangle them. This core practice around this important area of awareness will enable you to become more mentally fit.
One of my favorite skills and easy skills that I find can be done by anyone of any age or skill level is what I call changing the channel. Your brain is like a TV and sometimes we can veer away from something like a panic attack by choosing to think about something else entirely. It's most effective when you have some easy fun and/or enjoyable topics that are preloaded like books, movies, music or travel just to name a few. When you recognize that you're over thinking, you can change the channel and divert your thoughts into something that is harmless but again, it has to start with learning to observe your thoughts and recognize when it's happening. The earlier you can catch it, the more effective you're going to be so it takes time and practice. This is just like working out, the more you do it, the better you get at it and the stronger and more effective you become.
Anxiety and depression can often be a mental fitness issue
A teenager told me that she was feeling really shut down and depressed and I tasked her to see a homework assignment through for one week. We made two lists, the first list were things that are good for her and the second list was things that she enjoyed. I told her that I wanted her to do one thing on both lists every day for one week. For one week she spent time doing things like going for a walk, getting sunshine and going to bookstores or spending time with animals as a few examples. After one week she came back and reported that she had done her homework and she had found that she felt much better and that her depression wasn't nearly as bad. Doing things that we know are good for us and doing things that we enjoy are just simple ways to be practice mental fitness. Sometimes we have to force ourselves to do what we know will help us feel better and sometimes the trick is getting up and doing it even though we don't feel like it. When this one small trick is tackled, the struggle gets so much easier.
This is the same trick for being physically fit. You create habits and routines that help you build a healthier lifestyle and it's hard. Sometimes its extremely hard but it's important to remember that life is hard and it's going to be hard no matter what you do. If you don't choose your own difficulties, then life will roll the dice and difficult things will be chosen for you. Being mentally fit requires us to deliberately do things that we know will help us to be in better shape.
I'm convinced that sometimes anxiety and depression are the result of us not being in good mental shape but the trouble is that we aren't taught good mental habits, in fact the opposite is true. We aren't just taught bad mental habits, we are taught some of the worst ones and are conditioned to follow all of the others. When you really stop to think about it, it shouldn't be any wonder that we are doing as poorly here in the west collectively with our mental health, high levels of addiction, divorce with the list going on and on and on.
Here's a brief list of some of these bad mental habits that most of us haven't learned that are causing us issues and areas where we can work to become more fit.
Choosing our battles - Most people engage in so much unnecessary drama and bullshit. They don't realize that they can just ignore most of it.
Focusing on what we can control - Most people are trying to control things that they can't control and it leads to anxiety, depression, anger, hatred and relationship issues just to name a few.
Avoiding comparisons - Most people are making comparisons when those comparisons are neither accurate nor fair.
Complaining - There is no use or purpose in rehashing the things in life that we perceive are negative. Complaining only makes everything worse.
Avoiding discomfort - Growth cannot happen inside our comfort zones. We require discomfort if we want to grow and one thing that I see with a lot of people who are struggling with anxiety and depression are those who just stay locked inside their comfort zones because that's what's easy.
The real "cure"
There is at least one or two exercises that I've found for the mind that are extremely effective for us and are almost always guaranteed to help us get the results that we want out of life.
The first is personal accountability and personal responsibility. This is simply the practice of taking responsibility for everything that is happening in our lives. If we are in a destructive relationship, for example, it's easy to blame that person and that relationship for our problems when we are the ones who choose to continue that relationship and when we might need to be the one to realize and own up to the fact that we are placing unrealistic expectations onto the other person to change; this is just an example. By taking responsibility for our experience in life, we come to the important realizations that motivate us to make changes.
I have found that people avoid this important and even potentially life saving practice because they mistake it for blame and it feels like accountability and responsibility seems like it's absorbing toxic blame when it's not. Accountability and responsibility are an action of personal empowerment because it ushers you into a state where you are taking ownership of your life when blame causes you to feel ashamed which makes you want to run and hide from your life rather than making changes that feel extremely good.
The other exercise that can work wonders for your life is learning acceptance and letting go. Sometimes we need to work through things and understanding the difference between the two which can get a bit tricky. They key is realizing what you have no ability or power to change. But I also find that people make a big deal out of things that aren't a big deal. We can create our own trauma from things that don't cause trauma but I know that the older that I get, the more I learn to practice acceptance and letting go with noticeable differences in my wellbeing.
As a side note, there is one more thing that truly is proven to help with depression and anxiety and it's getting physical exercise. Whether you like it or not, physical movement and exercise has proven, repeatedly, to be more effective for depression than any anti-depressant medication. The trick is often finding the kind of movement that you personally enjoy but it's been proven that even going for walks on sunny days does more for depression and anxiety than most pharmaceutical interventions.
There are so many things that most people can change that will help improve their mental wellbeing. You can and should work to train your brain, it will help with nearly any and every issue that you have but it won't always cure it or solve it completely. Every mental health issue under the sun benefits from some added discipline, effort and work. Do yourself a favor. Reject and abandon notions and beliefs about finding a cure to mental illness.