Mental Health, Mental Illness, and Mental Disorder

[DISCLAIMER]

One shared experience regarding my graduate studies for counseling (2009-2011) and social work (2012-2014) related to confusion about terms within the field of mental, emotional, and behavioral health (collectively “mental health”). For instance, what does “mental health” mean?

Mental Health

The concept of mental health may seem like a no-brainer (something that requires a minimum of thought). However, I find it useful to offer varying definitions and descriptions of this term which may be worthy of consideration. Per Merriam-Webster, mental health is defined as:

[T]he condition of being sound mentally and emotionally that is characterized by the absence of mental illness and by adequate adjustment, especially as reflected in feeling comfortable about oneself, positive feelings about others, and the ability to meet the demands of daily life; also: the general condition of one’s mental and emotional state.

That definition is fairly straightforward. It acknowledges both cognitive (i.e., mental) and emotive (i.e., emotional) aspects of psychological (of, relating to, or occurring in the mind) health. Expanding upon this description, Wikipedia thusly defines mental health:

Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. Mental health plays a crucial role in an individual’s daily life when managing stress, engaging with others, and contributing to life overall.

According to the World Health Organization (WHO), it is a “state of well-being in which the individual realizes their abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to their community”. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making.

Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one’s intellectual and emotional potential, among others.

That definition is a bit convoluted. It appeals to erudite (having or showing knowledge that is gained by studying) scholars. Nevertheless, the American Psychological Association synthesizes and expands the aforementioned descriptions by thusly defining mental health:

[A] state of mind characterized by emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life. See also flourishing; normality. […]

Flourishing – a condition denoting good mental and physical health: the state of being free from illness and distress but, more important, of being filled with vitality and functioning well in one’s personal and social life. Compare languishing. […]

Languishing – the condition of absence of mental health, characterized by ennui, apathy, listlessness, and loss of interest in life.

Normality – a broad concept that is roughly the equivalent of mental health. Although there are no absolutes and there is considerable cultural variation, some flexible psychological and behavioral criteria can be suggested: (a) freedom from incapacitating internal conflicts; (b) the capacity to think and act in an organized and reasonably effective manner; (c) the ability to cope with the ordinary demands and problems of life; (d) freedom from extreme emotional distress, such as anxiety, despondency, and persistent upset; and (e) the absence of clear-cut symptoms of mental disorder, such as obsessions, phobias, confusion, and disorientation.

Given that elaborate definition, metal health is how subjectively well one thinks, feels (i.e., emotional and sensational), and behaves. I’ve attempted to locate a similarly concise description of mental health from the American Psychiatric Association, to no avail.

Mental Illness

If mental health is how well one thinks, feels, and behaves, it stands to reason that mental illness is how unwell these elements are subjectively considered. Still, it may be worthwhile to consult the aforementioned sources for this term. Per Merriam-Webster, mental illness is defined as:

[A]ny of a broad range of medical conditions (such as major depression, schizophrenia, obsessive compulsive disorder, or panic disorder) that are marked primarily by sufficient disorganization of personality, mind, or emotions to impair normal psychological functioning and cause marked distress or disability and that are typically associated with a disruption in normal thinking, feeling, mood, behavior, interpersonal interactions, or daily functioning.

As was suspected, that definition is merely the inverse of mental health. This makes sense, given that one may be in good health or may be well. Alternatively, one may be ill, in poor health, or unwell. Expanding upon this description, Wikipedia thusly defines mental illness:

A mental illness is an illness of the mind. It can be a psychiatric disorder, a psychological disorder, mental disease, mental breakdown, nervous breakdown, or mental health conditions. Historically, people with mental illness were called lunatics.

People with a mental illness may behave in strange ways, or have strange thoughts. Mental illnesses can create problems for what a person has to do every day.

Mental illnesses develop during the life of a person. This may be linked to genes and experience. What people call mental illness has changed over time. The Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association is used around the world.

People with a mental illness sometimes have problems dealing with other people, or have a hard time doing what would be easy for everyone else. Some mental illnesses can be treated with medicine.

In some cases, mental illnesses change the way the brain works. Many conditions which affect the brain are not mental illnesses, because they do not change the way people think: Neither epilepsy nor Parkinson’s disease is a mental illness, even though they both affect the brain.

Leave it to Wikipedia to complicate a relatively forthright concept. One could walk away from that description with the misperception of relatively anyone qualifying for this term. I argue that if virtually everyone qualifies for mental illness, then there’s nothing unique about this term.

Unfavorably, the American Psychological Association doesn’t help much by thusly stating of mental illness, “See mental disorder.” I’ll address what a “mental disorder” is in the next section. For now, the American Psychiatric Association thusly defines mental illness:

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses can be associated with distress and/or problems functioning in social, work or family activities. […]

Mental health –

Involves effective functioning in daily activities resulting in:

·  Productive activities (such as in work, school or caregiving).

·  Healthy relationships.

·  Ability to adapt to change and cope with adversity.

Mental illness –

Refers collectively to all diagnosable mental disorders — health conditions involving:

·  Significant changes in thinking, emotion and/or behavior.

·  Distress and/or problems functioning in social, work or family activities.

As alluded to, mental illness is how un-well one’s thinking, feeling, and behaving is subjectively considered. Fortunately, a separate American Psychiatric Association source states of mental illness:

If several of the following are occurring, it may useful to follow up with a mental health professional.

·  Sleep or appetite changes — Dramatic sleep and appetite changes.

·  Decline in personal care – Difficulty caring for oneself including bathing.

·  Mood changes — Rapid or dramatic shifts in emotions or depressed feelings, greater irritability.

·  Withdrawal — Recent social withdrawal and loss of interest in activities previously enjoyed.

·  Body Pain – Difficulty managing pain such as stomach aches or headaches

·  Drop in functioning — An unusual drop in functioning, at school, work or social activities, such as quitting sports, failing in school or difficulty performing familiar tasks.

·  Problems thinking — Problems with concentration, memory or logical thought and speech that are hard to explain.

·  Increased sensitivity — Heightened sensitivity to sights, sounds, smells or touch; avoidance of over-stimulating situations.

·  Apathy — Loss of initiative or desire to participate in any activity.

·  Feeling disconnected — A vague feeling of being disconnected from oneself or one’s surroundings; a sense of unreality.

·  Illogical thinking — Unusual or exaggerated beliefs about personal powers to understand meanings or influence events; illogical or “magical” thinking typical of childhood in an adult.

·  Nervousness — Fear or suspiciousness of others or a strong nervous feeling.

·  Unusual behavior — Odd, uncharacteristic, peculiar behavior.

·  Changes in school or work — Increased absenteeism, worsening performance, difficulties in relationships with peers and co-workers.

One or two of these symptoms alone can’t predict a mental illness but may indicate a need for further evaluation. If a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work or relate to others, he/she should be seen by a physician or mental health professional. People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

That helpful description of symptoms may serve as a pre-diagnostic indicator of mental illness, if one finds that sort of thing useful. Now, as both mental health and mental illness have been addressed thus far, I conclude with an examination of what constitutes a mental disorder.

Mental Disorder

Mental health is how well one thinks, feels, and behaves, as mental illness relates to how unwell these elements subjectively are. Now, it may be meaningful to consult the aforementioned sources for “mental disorder.” Merriam-Webster redirects “mental disorder” to “mental illness.”

This is understandable, as these terms are often used synonymously. Offering more information on what a mental disorder is, with admittedly a lengthier description than any of the other terms discussed herein, Wikipedia thusly defines mental disorder:

A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning.

A mental disorder is also characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting.

There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health. The causes of mental disorders are often unclear. Theories incorporate findings from a range of fields.

Disorders may be associated with particular regions or functions of the brain. Disorders are usually diagnosed or assessed by a mental health professional, such as a clinical psychologist, psychiatrist, psychiatric nurse, or clinical social worker, using various methods such as psychometric tests, but often relying on observation and questioning.

Cultural and religious beliefs, as well as social norms, should be taken into account when making a diagnosis. Services for mental disorders are usually based in psychiatric hospitals, outpatient clinics, or in the community. Treatments are provided by mental health professionals.

Common treatment options are psychotherapy or psychiatric medication, while lifestyle changes, social interventions, peer support, and self-help are also options. In a minority of cases, there may be involuntary detention or treatment. Prevention programs have been shown to reduce depression.

So far, Wikipedia hasn’t disappointed when it comes to a flexible expectation for the resource to offer a longwinded description of a relatively frank concept. I now remind you that the American Psychological Association redirected “mental illness” to “mental disorder,” as thusly defined:

[A]ny condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.

Specific classifications of mental disorders are elaborated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (see DSM–IV–TR; DSM–5) and the World Health Organization’s International Classification of Diseases. Also called mental illness; psychiatric disorder; psychiatric illness; psychological disorder. See also psychopathology. […]

Psychopathology – 1. the scientific study of mental disorders, including their theoretical underpinnings, etiology, progression, symptomatology, diagnosis, and treatment. This broad discipline draws on research from numerous areas, such as psychology, biochemistry, pharmacology, psychiatry, neurology, and endocrinology. The term in this sense is sometimes used synonymously with abnormal psychology.

2. the behavioral or cognitive manifestations of such disorders. The term in this sense is sometimes considered synonymous with mental disorder itself.

Does any of this seem redundant? For those who have paid close attention, “mental illness” and “mental disorder” are virtually indistinguishable terms. Also, each carries differing stigmas (sets of negative and unfair beliefs which a society or group of people have about something).

Succinctly, the American Psychiatric Association states, “A mental disorder is a major disturbance in an individual’s thinking, feelings, or behavior that reflects a problem in mental function. Mental disorders cause distress or disability in social, work, or family activities.”

Conclusion

Years ago, when receiving education, training, and experience in the mental health field, I realized that there was confusion about terms relating to mental health, mental illness, and mental disorder. Depending on the individual or agency, some terms were wholly disregarded.

For instance, some entities fundamentally refrained from using the antiquated term “mental illness,” reportedly due to the stigmatizing history related to the phrase. Other professional bodies refused to use “mental disorder,” because it reportedly implies abnormality.

Generally, individuals and organizations with which I’ve had contact report no problem using the terms “mental health,” “emotional health,” or “behavioral health.” As long as “health” and not “illness” or “disorder” is indicated, people appear to approve of wellness rather than un-wellness.

Personally, I’m not wed to any of these terms. I find utility in being able to speak truth about reality, so I’m not opposed to describing someone as healthy, unhealthy, well, ill, disordered, or otherwise. Why unnecessarily convolute matters relating to the mental health field?

Besides, Rational Emotive Behavior Therapy (REBT), the psychotherapeutic modality I favor, is a transdiagnostic approach to wellness. Therefore, it doesn’t matter to me what terms one uses. Rather, I try to help people improve their subjective levels of functioning and quality of life.

Ergo, I’ll leave the bickering over terms to other individuals. Meanwhile, I’ll be working with mental health, mental illness, mental disorders, or psycho-fucking-fantabulousness—if you prefer—irrespective of whatever people in the field are choosing (or not) to label conditions.

If you’re looking for a provider who tries to work to help understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.

As a psychotherapist, I’m pleased to try to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.

At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!

Deric Hollings, LPC, LCSW

Photo credit (edited), fair use

References:

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Hollings, D. (2024, January 5). Sensitivity. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/sensitivity

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