“Mental disorders, such as depression, anxiety, and substance-use disorders, impose an enormous global disease burden that leads to premature mortality and affects functioning and quality of life.”
-quote from The World Bank, Understanding Poverty
Reports on mental health throughout the globe focus primarily on statistics. They confirm that mental health is a global issue requiring a global response. The World Health Organization has said that 300 million people, 4% of all global occupants, have depression. They estimate that 1 in 4 people will suffer from depression in their lifetime. In the Global Northern regions 35–50% will receive no treatment. In the Global Southern regions 76–85% will not receive treatment. As always, women and the poor will be the last, and least likely, to be served even though they are most at risk.
We have seen that the differences in treatment between the Global North and South reflect accessibility, differing understandings of mental health, and varying beliefs on the need for support. Much needs to be done not only to bring equity but also to broaden our understanding of mental health and its overall impact on society. Each step in my career, studying for me PhD in psychotherapy, as a graduate-school teacher, clinical instructor at a medical school, author, and founder of an institute of healing – The Institute of the Healing Arts and Sciences, has led me to believe that focusing solely on mental health, as if it is an isolated reality, apart from physical or spiritual health, is a misguided approach.
Our spiritual health is the greatest impactor on our emotional/mental health. Spiritual health – believing in a spiritual purpose, believing that do not walk alone, believing in the goodness of life and the beauty of the journey – versus a lack of spiritual health and healing, which feels much more like being caught in the endless struggle for meaning, a feeling of personal or global powerlessness, or a life of endless struggle, has immense emotional and/or mental import. The battle becomes joy and hope versus rage and depression.
The science of epigenetics (changes in organisms caused by the modification of gene expression) has taught us also that our beliefs and emotional states have a significant and direct impact on our DNA function. Feeling alive spiritually, in love with life and the world around us even in the midst of difficulties, supports us emotionally and physically. We know that in the concentration camps of World War II those who were able to focus on the smallest joys and the smallest triumphs, fared far better than those who lost all hope. Conversely, we know that patients going into surgery with a defeatist or fear-packed attitude not only have a more difficult surgery, but their recovery is significantly affected as well. Faith, hope, and the experience of personal freedom literally affect us on all levels as do sadness, depression, and anxiety.
If we are looking at the effect of poor mental health on the “functioning and quality of life” mentioned in the quote above, then we must look at the importance of mental health on every aspect of life, up to and including mortality. “Premature mortality” in this instance doesn’t mean solely the tragedy of suicide, but also the effect of anxiety and stress on the immune system that is well documented. A weakened immune system makes us susceptible to the smallest and largest of diseases, and to disorders we might otherwise resist.
We cannot afford to be mentally shaky for extended periods. We all have moments, but days, weeks, and years of mental distress take a toll on our body, mind, and spirit. Because of unique stress patterns, each of us is also predisposed to particular physical disorders. Given that mental health translates to physical health, in the future our mental and emotional wellbeing needs to be considered as essential to physical care. This agenda may be the only way to increase spending on and validation of a much-needed service.
Mental health issues reflect what is happening in the culture and they are judged according to the culture of the day. They also show up differently in each culture. However, a willingness to challenge the prevailing worldview, regardless of location, can only help. Some of us are willing to embrace this challenge while others may be far more reticent. Some of us are meant to be out front – the thought-leaders, the mavericks, the disruptors – while others are called to take a more supportive role. All, however, can “own” their archetype of leadership: thought-leader, team-leader, supportive-leader, visionary-leader or organisational-leader.
Each archetype requires of its owner a solid decision to address mental health issues, and to rise to the opportunities in front of them, rather than falling back on outdated or destructive messages from their past. Whether we are supporting a village woman in the midst of South Africa who longs for a business of her own, or a corporate woman in a global organisation who is searching for her authentic voice in a male-dominated structure – if these individuals are going to remain healthy on all levels, we must acknowledge that their mental health and their spiritual beliefs concerning their right to be there and to have success are of immense importance. Believing that each of us possesses the skills to make our goals reality, and the ability to ask for assistance, gives us the emotional strength and, ultimately, the physical capability needed for success. Anxiety and depression may arise, but the likelihood of long-term impact will be lessened if these women are each guided in the skills necessary to maintain their mental health.
Women who are held back, who give up, who believe they don’t “have what it takes” are frequently women who live with depression, anxiety, and poor mental health. All of that is capable of being shifted. It doesn’t necessary require a mental health practitioner or even medication. Often, good mental health may simply require a hand-up, guidance, and permission to go for it. That is a message the poor and women – those least likely to be offered mental health assistance – rarely receive. Undoubtedly, mental health can be psychiatric; I have had to hospitalise numerous patients over the years. However, I do believe to a large extent mental disorders such as anxiety and depression, which loom the largest in the long list of global mental disorders, are most frequently situational.
Having someone believe in you and being given the opportunity to grow, to succeed, and to challenge yourself, whether in working out, in a career, or even in a relationship, can be immensely healing on all levels. Spiritually having hope, seeing a light at the end of the tunnel or knowing someone actually sees who you are, can shift mental illness to mental health quickly.
Fundamentally, mental health is of utmost importance because it has such impact on our physical health, our survival, and our success. Whether we approach it as a disease or as a situational occurrence, due to a loss of self, an unhappy home, abuse or extreme poverty, it calls on us to look at the whole picture, to understand the wants, needs, and desires of those afflicted and be open to supporting them in coming alive, whole, sane, and successful – whatever that means to them.
This article is featured on The Sisters.