Mental ill health isn't always a mental or health issue

Written by
Alan Watkins
Complete Coherence

05 Dec 2019

05 Dec 2019 • by Alan Watkins

The mental health epidemic will only improve if we stop medicalising normal emotional stagnation, suggests Dr. Alan Watkins.

We are apparently in the middle of a ‘mental health’ epidemic which even seems to have attracted royal sponsorship. The statistics make sobering reading: in 2017, female suicide rates were at their highest in decades and a quarter of young men said they had intentionally harmed themselves.

Clearly people’s struggles are not just a work issue, but organisations have both a moral and a legal responsibility to protect their staff from stress. However, while organisational spend on wellbeing is increasing rapidly, the problem, if anything, appears to be getting worse. For example, according to a CIPD study, the number of people who experience anxiety, stress and depression at work has risen from a quarter to a third over the past five years.

So, despite the dream combination of greater awareness and more investment in the problem, we are going backwards. I believe there are two primary reasons for this: first, the problem isn’t even ‘mental’ it is emotional, and second, the problem isn’t ‘health’ it’s development.

Digging deeper

In most cases of anxiety or depression, mentation, or thinking, is normal. In people troubled by anxiety or depression, there is nothing wrong with their cognitive processes. So why do we believe they have a ‘mental’ health problem?

The reason we mistakenly call anxiety, depression and many related disturbances a ‘mental’ health issue is because we have a simplistic view of the human system. There are five levels to the human system but most clinicians only recognize two: thinking and behaviour. We never dig deeper than behaviour (level one) and cognition (level two).

But what determines what and how we think? The answer is our feelings (level three), which are themselves driven by a deeper level, our emotions (level four). Our emotions are, in turn, composed of the raw physiological signals generated by our bodily systems (level five).

If your approach stops at level two and you collapse the bottom three levels to this level, you will mistakenly assume anxiety or depression is a ‘mental’ problem, because you don’t recognise deeper levels.

Rethinking the abnormality of mental illness

The truth is that the real issue exists in levels three, four and five, and cognition is normal. To treat the problem effectively, we have to address it at the level at which it really occurs. Until we do this, our best treatment will only ever be partially effective and most organisational wellbeing initiatives will continue to fail.

Most of the problems we see diagnosed as ‘mental’ health disorders stem from an individual’s inability to regulate their emotions (level four). People who suffer with anxiety, depression or many other unhelpful emotional states are unable to turn on and sustain more positive emotional states. This is not their fault. No one has taught them how to do this. They have yet to develop this skill.

Being unable to turn on a more productive emotion , such as resilience, determination or compassion, often leaves people stuck in a ‘world’ of negative emotion. If they stay stuck on the ‘planet’ of depression for too long, they start to believe this is who they are – depression becomes an identity issue. They say, “I am depressed”. But depression is not who they are; they need to learn how to switch to a more helpful emotional planet.

We must stop medicalising a normal developmental challenge. Every person would benefit from developing the ability to regulate their inner emotions. Failure to do so is a failure of development, not a failure of the individual. Such people are certainly not ‘mental’. They do not have a ‘condition’ called ‘mental health’. They are not helpless victims.

We must get off the ‘mental health bandwagon’ and start actually helping people develop. They are wonderful human beings who need support to develop their self-regulation capabilities, their maturity, their identity and their wisdom.

Dr Alan Watkins is co-founder and CEO of transformational coaching company Complete, and a former medical doctor and neuroscientist.

Complete Coherence