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Why Do People Say “ Mental Health”When They Mean “ Mental Health Problems”?

113 replies

RabbitsRock · 21/01/2025 12:42

It’s annoying! Everyone has mental health! Anyone else find it annoying?

OP posts:
SoManyTeeth · 22/01/2025 17:20

StrikeForever · 22/01/2025 12:33

Sarcasm doesn’t change the fact that you minimised depression, saying it isn’t a significant mental illness.

To be fair depression has a big range.

An analogy off the top of my head (not perfect, obviously, and there are lots of differences) is that it could be compared to something like asthma vs lung cancer, in that asthma can range all the way from

  • mild, occasional, maybe partly outgrown, easily treated, and with without significant impact on your ability to live your life as you want, to
  • severe, hard to treat, extremely limiting and disabling, and potentially life-threatening.

Whereas you pretty much can't have lung cancer without the disease and/or the treatment having a significant impact on your life, and, even with the more readily-treated lung cancers, there's still a high chance you won't survive it.

Someone who dies from asthma is just as dead as someone who dies from lung cancer, but it probably wouldn't be useful to group someone with mild asthma and someone with stage 1 lung cancer together.

Obviously the analogy I made doesn't match in every way — the similarity I meant to highlight is just that different mental illnesses can have a different range of likely severity of impact, as well as different types of symptoms.

But this comparison doesn't even take into account the broader use of terms like depression/depressed and anxiety/anxious in everyday speech.

The word "asthma" isn't often used in everyday speech to talk about a self-diagnosed wheeze, or to refer to normal experiences like feeling out of breath when you run or coughing when you inhale smoke.

But people do sometimes self-diagnose with depression or anxiety for whatever reason, though may not always technically meet criteria for the medical conditions of generalised anxiety disorder or major depressive disorder or whatever (or may have a different disorder). And I think even more commonly, without even intending to self-diagnose, people use terms like "depressed" and "anxious" in their ordinary, everyday meanings, to refer to normal (if unpleasant) emotional experiences.

So when talking about depression, there's a massive range of things that can mean, from severe major depressive disorder which can include psychosis or catatonia, through moderate and mild clinical depression (and other related disorders like dysthymia, adjustment disorder, complicated grief etc.), through people who are struggling with their mood but may not technically meet diagnostic criteria, to people who just happen to be using some of the same words but who mean it in an everyday sense of feeling glum, low, fed up, flat, blue, down, sad, dejected, demotivated, or whatever.

Depressive disorders (and anxiety disorders) are some of those mental illnesses that have a big range of expression (and like asthma can range from totally manageable to deadly) — in some people they can be mild or temporary or a one-off, can be managed well with easily-tolerable treatments, and/or can be accommodated without severely affecting a person's ability to function, while other people with the same diagnosis can experience severe, lifelong, intractable and/or deadly illness.

Then there are also mental illnesses which, when a person is diagnosed with them, mean that that person is very likely to have significant symptoms and may struggle with even basic daily living tasks, sometimes even with the best treatment available.

For people with these diagnoses, aside from the suffering that results directly from the mental illness, they'll often have to endure highly unpleasant treatments such as medications that cause organ damage, permanent movement disorders or diabetes, involuntary hospitalisations with forced medication, intrusive and painful psychotherapy, enhanced state involvement in their life, and so on. There's a high chance their illness will persist or recur throughout their lives, and they have a strongly elevated risk of experiencing other illness or disability, discrimination, loneliness, poverty, and early death. Not everybody with these diagnoses experiences these, but some mental illnesses are associated with much more difficulty on average than other mental illnesses.

Severe mental illnesses are often considered to include eating disorders, personality disorders, schizophrenia, bipolar disorder and other psychosis. (With the last three diagnoses, your GP will put you on a SMI register, so you get targeted for extra health checks. It's not that other mental illnesses aren't or can't be severe, it's just that the psychotic disorders are the ones they thought worth targeting for extra health checks, as many of us die young from physical conditions.) Other mental illnesses can be severe in some people (so severe depression is a severe mental illness) but aren't considered to be intrinsically severe, in the way that any diagnosis of bipolar disorder will automatically get you added to the SMI register.

When GreenTea said it is actually not useful to have "everyday depression" and "psychosis" lumped into the same category I think she was referring to this issue of the range of meaning, specifically with regard to "mental health problems".

I don't know whether she used the term "everyday depression" to mean mild-to-moderate clinical depression, or to those experiences people refer to with the words "depressed" or "depression" which are either normal emotional reactions or which don't meet the threshold to be diagnosed with a mental illness.

Either way, I don't read her comment as dismissive of depression — I read it as an expression of frustration at the inability to easily define the group you're discussing, when the term commonly in use can encompass serious mental illness (including severe depression), other less severe or impactful mental illnesses (and mild depression is less severe and impactful than severe depression, or schizoaffective disorder), people with difficulties not diagnosed as mental illness, people struggling for any number of external reasons, and people experiencing normal healthy emotional responses to normal life events and stressors.

GreenTea didn't say that depression "isn’t a significant mental illness", rather I think she was referring to something that's become a real problem in the popular "mental health" discourse.

People with mental illness have all but disappeared from the conversation, especially those with severe mental illness like schizophrenia, anorexia nervosa, and yes, severe depression.

There's awareness-raising and discussion everywhere but it's all about "chat to your mates, they might be feeling down" and "if your friend always shows up late just ditch them altogether, you've got to have boundaries to protect your mental health" and "I need my emotional support dog because I've got mental health" and "mental health tips to help you through exam time", and maybe the odd sanitised personal story from someone with one of the more socially palatable, relatable diagnosed mental illnesses.

There's no real way to discreetly indicate the fact that I have a mental illness or that I am currently experiencing a relapse without being explicit about my severe mental illness. It used to be that if I said I had mental health problems, people knew that was referring to a psychiatric condition without me having to disclose specific stigmatised conditions. If I mention "mental health" now, there's nothing to differentiate someone with bipolar disorder from people who like to take a day off every so often, or someone who's feeling sad and lonely because their girlfriend has gone away for two weeks.

But all this awareness-raising has done very little to mitigate the discrimination I'll experience if I just come out and say I have bipolar disorder. The push for conversation about mental health pretends to be at least partly for me and people like me, but it's almost entirely for people with mild to moderate common mental health problems, as well as people who are mentally healthy and could benefit from some wellbeing tips.

StrikeForever · 22/01/2025 17:52

@SoManyTeeth I haven’t read your entire post. It’s just too long and I don’t have the time. That said, I agree there is a lot of incorrect self diagnosis of various mental health problems, including depression. However, mild intermittent, or short lived low mood doesn’t meet the diagnostic criteria for clinical depression. Therefore, the range of severity of clinical depression is not as broad as you suggest.

SoManyTeeth · 22/01/2025 18:13

StrikeForever · 22/01/2025 17:52

@SoManyTeeth I haven’t read your entire post. It’s just too long and I don’t have the time. That said, I agree there is a lot of incorrect self diagnosis of various mental health problems, including depression. However, mild intermittent, or short lived low mood doesn’t meet the diagnostic criteria for clinical depression. Therefore, the range of severity of clinical depression is not as broad as you suggest.

Strike no worries, I took some amphetamine earlier and it's made me way too verbose. I usually try to avoid posting when I'm medicated Grin

I don't know that I specified the severity and duration required to meet criteria for a major depressive episode, though… I think you're perhaps inferring something different to what I intended. But my post was difficult to read.

StrikeForever · 22/01/2025 19:11

SoManyTeeth · 22/01/2025 18:13

Strike no worries, I took some amphetamine earlier and it's made me way too verbose. I usually try to avoid posting when I'm medicated Grin

I don't know that I specified the severity and duration required to meet criteria for a major depressive episode, though… I think you're perhaps inferring something different to what I intended. But my post was difficult to read.

It was when you were drawing a comparison with asthma and saying that like that depression can be mild and occasional.

SoManyTeeth · 22/01/2025 19:50

StrikeForever · 22/01/2025 19:11

It was when you were drawing a comparison with asthma and saying that like that depression can be mild and occasional.

It can. Why do you think that depression can't be mild and occasional?

I also said that the analogy wasn't exact. Mild occasional asthma might be five minutes of slight wheeze every so often, whereas mild occasional depression might be two or three weeks of symptoms just severe enough to meet the criteria, which resolves on its own and happens every few years.

My point was that asthma has a big range from severe and deadly to mild and manageable, and depression has a big range from severe and deadly to mild and manageable (and that doesn't necessarily mean they're exactly the same kind of mild and manageable). But there are also other lung diseases that are invariably severe and life-impacting, and other psychiatric diagnoses that that are almost always severe and life-impacting. And we don't generally have campaigns about "lung health awareness" focussing mainly on mild asthma and what to do when a bit of your drink goes down the wrong way, while patting ourselves on the back for how much we're improving things for everyone with all kinds of lung problems.

GreenTea was saying that it's not always useful to lump all these things together, and I agree. It's tricky to find good language, because some people with depression have a severe mental illness and should be categorised as such, some have moderate or mild depression (and still need and deserve help and empathy, obviously), and depression is also widely used in a nonclinical sense. But subsuming everything under "mental health" can make it more difficult to be clear about what serious mental illness can be like.

I didn't think it was fair to jump on her for minimising depression when what I think she was trying to say is that some of changes in the language we use can risk the needs of people with severe illness getting hidden behind those of a larger number of people with milder illness, or people who may have other kinds of problems but no mental illness.

hopsalong · 24/01/2025 23:11

I've already mentioned that I have bipolar disorder. I have ADHD as well. If I only had ADHD (and sometimes I do only have ADHD, because I have long periods of mild or no symptoms of bipolar disorder due to taking lithium daily) then I wouldn't say that I was mentally ill. Nor would I say that I had mental health. Or mental health problems. That's mostly because I'm a pedant, but it's also because the problems aren't as general or unhappy-making as that suggests. I would find 'concentration problems' or even 'cognitive deficits' more accurate.

During my two periods of full-blown mania I was psychotic and knew I was deeply unwell. During early episodes of hypomania I thought I was merely (at last!) well, happy, and very high-functioning. As I got to know the illness better (the brevity of the episodes, the inevitable and subsequent severe depression, the shame and guilt over poor choices) I learned that the sleepless exuberance and feelings of excitement were in fact part of a complex mental illness.

Anyone who suffers from mental illness knows that mental illness is devastating and often worse than many nasty illnesses in other parts of the body. The sufferer has no reason to say 'I'm not mentally ill, I just have mental health problems', any more than someone with diabetes would say 'I'm not ill, I just have blood sugar problems'.

Anyone who shrinks from the label mental illness is, in my opinion, more likely to be suffering from unhappiness or situational and explicable depression or anxiety. That's not to say that they aren't suffering. But the illness isn't organic, from within, in the same way.

UnicornWorld · 24/01/2025 23:13

People are using it to shorten mental health issues or problems etc, as people usually know what they mean as not many people say they have good mental health in conversation

I don't think it's accurate, but equally I don't agree with calling them thick or some of the various other comments on this thread from people thinking them a cut above.

DazedAndConfused321 · 25/01/2025 15:25

HeffalumpsAndWoozlesAreHoneyRobbingTwats · 21/01/2025 17:54

Sounds reasonable and smart.

0/10 ragebait haha

mondaytosunday · 25/01/2025 15:35

Or US YouTubers who talk about someone's 'mentals'.

Madisoncha · 05/04/2025 09:51

This reply has been deleted

This has been deleted by MNHQ for breaking our Talk Guidelines.

sashh · 05/04/2025 10:06

People have always done this.

My Nana always said she had, "Blood pressure", well everyone has.

ihavebecomecomfortablynumb · 05/04/2025 10:21

Just like during Covid when people were saying that they were shielding because they had ‘underlying health’.

HuskyNew · 05/04/2025 10:26

Idratherbepaddleboarding · 21/01/2025 12:44

It makes me so annoyed, particularly when professionals use it. TBH it just makes people sound a bit thick!

Because people don’t think about what they’re saying.

same as “I’m raising money for breast cancer”

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