What do you think when you see the words ‘mental illness’?

I had my first manic episode in 2013 and was an involuntary admission as I didn’t realise I was ill. My second manic episode was December 2019 and I got out of hospital just before the Covid-19 lockdown. It was also an involuntary admission. Over the years, I have read much about bipolar disorder, or manic depression as it was formerly known as. I have received excellent counsel from psychiatric nurses. psychotherapists, doctors and psychiatrists. I take the medications, exercise and reach out for counselling or Aware’s Support Line when needed.

However, I have become increasingly disillusioned about the term, ‘mental illness.’ I have started to question whether people who have been diagnosed with diseases such as bipolar disorder, schizophrenia, anxiety disorder and clinical depression are really ‘mentally’ ill. In my case, I have stopped referring to bipolar as a mental illness as I become more familiar with my diagnosis. Last time I checked, my brain was fully integrated with my body. Yet we still insist on inserting a ‘border’ between physical and mental illness. Diabetes, multiple sclerosis and cancer are very challenging conditions to have but they are considered diseases south of the ‘border’. They can also take a toll on the mental health of those who have these conditions, as physical and mental health are so intertwined. Yet, when my brain’s neurotransmitters and limbic system are malfunctioning (there is no one definitive explanation for bipolar) I am considered to be mentally ill.

You might think I should get over the semantics but it is more than that for me. Once you bring up the term ‘mental illness’ you unfortunately open the door to misunderstandings and stigma. This is because we as a species pride ourselves on our resilience and mental fortitude. We want to be winners; not losers. So, for those people who have never experienced clinical depression or anxiety disorder (again ‘physical’ neurotransmitters contribute to this), they find it very hard to see beyond the word ‘mental’. Those of us with medical conditions that cause havoc with our moods and our life are often dismissed. We have a ‘first world problem’ and will be fine once we ‘get our act together’ and get back to work and doing lots of exercise. We have nothing to be depressed about and should stay positive. We should focus on the positives, as what do we have to be depressed about?

Yet, we would never say to someone with cancer, ‘What do you have to be cancerous about?’ or to someone with diabetes, ‘What do you have to be diabetic about?

It is well established that mental and physical wellbeing go together. The brain is like the horse pulling the wagon. It drives us on but, unfortunately for some of us, our brain doesn’t operate at full capacity. The brain is one of approximately 100 physical organs in the human body. It is not a sign of weakness or lack of willpower if you feel depressed or anxious. And it is exhausting for those with mental health diagnoses to continually be upbeat and positive when they feel the opposite inside. We take psychiatric medication for conditions such as bipolar to impact our central nervous system, so why not call it what it is; a disease.

While I totally understand how the term ‘mental Illness’ came into being, I think now is the time to stop distinguishing between diseases of the brain and diseases in the rest of the body. That alone would boost my mental health!

– Niall O’Keeffe

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