The diagram that you have in front of you
helps us understand mental health and mental illness
better.
In our field, we are often confusing each other
by the language that we use.
When we use a phrase such as mental health issue,
nobody really knows what we're talking about.
A mental health issue could be a two-year-old having a temper
tantrum, or it could be a 17-year-old
in the middle of a psychotic break,
or it can be a 16-year-old girl with severe panic attacks so
bad that she can't go to school, or it
can be a 20-year-old college student who is housebound
because of social anxiety.
Those things are all very, very different,
and it is really important that we understand
what we're talking about.
Because if we don't understand what we're talking about,
if we don't use the right language,
how can we intervene effectively?
On this triangle at the bottom, you
will see a category that says, no distress, problem,
or disorder.
That is many of us much of the time.
We're having fun with our friends and with our families.
We're off at school doing our work.
We're enjoying ourselves in a recreational activity,
or even asleep.
So much of the time over a 24 hour period,
we can be in that zone of having no distress, no problem,
or no disorder.
On the other hand, all of us experience,
over the course of pretty well every single day,
mental distress.
And mental distress is the brain's signal to us
that we have a problem in our environment
that we have to deal with.
And this signal tells us we need to adapt,
we need to solve the problem.
The signal, which we call the stress response,
is the basis of resilience.
It's the basis of adaptation.
And once we successfully solved the problem,
the stress response goes away.
We no longer feel distressed, and we have
another arrow in our quiver.
We have not only become more resilient,
but we have developed new skills.
And we need to ensure that we don't protect
young people for these slings and arrows
of outrageous fortune.
Because it is through engaging with the normal stressors
of life that we develop the capacity to become
successful adults.
The next part on this triangle is
labeled mental health problems.
And mental health problems also arise
from environmental stressors, but these are stressors
that are quite intense.
They're not like taking an exam, or going for a job interview,
or not making the school basketball team,
or being rejected on your request for a romantic evening
with someone that you fancy.
These are serious things like your parent died,
or you've lost your job, or you're moving to a new country.
And they also elicit a stress response.
And this stress response is also normal.
When someone dies, it's normal to grieve.
When you lose your job, it's normal to feel demoralized.
And when we have these feelings, we
reach out to other people for support,
and guidance, and assistance.
But we don't need psychiatrists or clinical psychologists
if we lose our job.
We need a job.
And here we have to be very careful not to medicalize
normal human experience.
Mental health problems can be difficult.
They can be challenging.
They can hurt emotionally.
But as a species, we've learned how
to get through these things, and we count on each other
to help us.
We also have socially sanctioned healers that assist.
If we're religious, we go to our religious leaders.
If we're more secular, we often go to people like counselors.
That can be quite helpful.
And we always rely on family and friends.
At the top of the triangle are mental disorders.
These are the illnesses that are found in ICD or DSM
categorizations.
They are internationally agreed upon as diagnoses.
And they're very different than a mental health problem.
And they're very different than the mental distress signal.
They require therapeutic evidence-based interventions
provided by people who have been specially
trained in how to do that.
And we don't progress from distress to disorder.
This is not a spectrum.
This is not a continuum.
We can feel unhappy and distressed,
and we can feel very unhappy if we have a disorder.
Those emotions occur across each of these components.
And this is really important.
This and is we can be in every single one of these states
at the same time.
For example, an individual can have attention deficit
hyperactivity disorder, ADHD, which is a mental disorder.
They can be dealing with the loss of a loved one,
say their mother, so they're going through grief.
They can be experiencing distress.
They didn't make the school basketball team.
And they can be having no distress, no problem,
or no disorder at the moment, as they're
hanging out with their friends, enjoying watching a movie.
And these things can be happening
all in the same period of time.
All these are components of mental health.
We can have mental health and mental illness
at the same time.
These are not separate categories.
And it's very important that we tailor our interventions
to the state in which the person is in.
Intervening for normal expected mental distress
can cause problems for young people.
It can make it difficult for them to learn how to adapt.
It can lead to things like learned helplessness.
I can't do with.
A mental health problem that requires additional supports,
but it doesn't require medications,
and it doesn't require CBT, cognitive behavioral therapy,
or specialized clinical psychological treatments.
However, if somebody has a mental disorder,
then we have to provide best evidence-based treatments
for them.
And so let's use the language correctly.
If we mean mental distress, let's
use words such as disappointed, disgusted,
angry, pessimistic, distressed, to clarify what state we're in.
If we're dealing with a mental health problem,
let's use words like sorrowful, demoralized, grieving,
despairing.
Those are good words to describe a mental health problem.
And if we're describing the mental disorder,
well, let's use the word depression.
If we use the word depression for every single one
of those states, I have no idea what you're talking about,
and you have no idea about what I'm talking about.
It's really essential.
Our language has many different ways
of expressing the nuances of all these important emotional
states.
Let's not confuse them.
Confusion can lead to inappropriate treatment.
Confusion can lead to protecting people
from the challenges of life that they need to embrace themselves
in order to become successful, independent, resilient
human beings.
So let's think about our language.
When we're using the word depression,
let's use it to mean depression and not
every single negative emotional state that we experience.
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