When we think of mental health we usually think in terms of symptoms, syndromes, disorders, and diagnoses. We focus on mental illness rather than considering what the qualities of mental health and well-being might actually be. These definitions are important in helping us to define and treat different problems such as anxiety, depression, or OCD. However, it can also be useful to consider the qualities of mental health and well-being beyond these definitions.
We can then consider mental well-being as sitting in a field or continuum with mental health disorders through to emotional, cognitive, and relational states where we thrive, grow, and achieve. In fact, we can often experience anxiety and other issues and still thrive! Despite adverse experiences people often demonstrate incredible resilience and capacity for growth and well-being.
Mental Health and World Health Organization
The World Health Organization define mental health as a “state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to her or his community.” Other factors can include “subjective well-being, perceived self-efficacy, autonomy, competence, and self-actualization of ones intellectual and emotional potential etc.” So the definition of mental health can be quite broad and inclusive and more than just the absence of mental disorders or disabilities.
Of course, different theories and cultures define mental health and well-being using different criteria. Broadly we can understand mental health as encompassing our emotional, cognitive, behavioural, and social well-being. Furthermore, it is important to state there is not a one size fits all as we define well-being separately for each person. Each individual that comes to therapy (and really outside of therapy as well) is usually working in some way to achieve greater harmony in some aspect of life. Sometimes this might be finding deeper purpose and meaning in life, or it might be about achieving greater harmony in intimate relationships, or similarly reducing self-criticism and harshness towards oneself (e.g. the relationship with oneself).
Evolving Awareness Around Mental Health
Developmentally we are not necessarily taught about mental health or the self. or how this might be defined. Furthermore, developmentally we might be limited to the implicit teachings we receive from our family of origin. If that encompasses physical, verbal or sexual abuse then these experiences may only serve to distance us from healthy organization, functioning, and well-being.
However, if we start to cultivate a better understanding of mental health and well-being, then this might act as a guide, set of values, or goals that we are specifically aiming for in our day to day life. At a societal level we are becoming more aware of our mental well-being and what a psychologist does. Fostering mental well-being is becoming more accepted as a process to undertake. The work I do as a psychologist is to assist you in achieving greater well-being to help you find your self-at-best. In my work, I often tend to view our symptoms as actual adaptations to difficult experiences we might have been through in the past, and where we are at in terms of our emotional growth. So, depending on circumstance and learning we might actualise different potentials and states of resilience.
Impacting Factors On Mental Health
There are are many factors that can either reduce or enhance mental well-being. The World Health Organization state that “Multiple social, psychological, and biological factors determine the level of mental health of a person at a give point in time.” Socio-economic pressures, ongoing violence, discrimination, inequality, rapid social changes, work-stress, unhealthy life-styles, exclusion, physical ill-health, and human rights violations all impact mental well-being.
Conversely, conditions such as equality, respect, freedom, access to rewards and resources, physical health and fitness, and security or stability can all enhance our mental health. The recent COVID-19 pandemic have had widespread effects on our mental health. Increasing our level of stress, anxiety, depression, frustration, relational conflict, and uncertainty as we have to adapt to rapid changes and lockdowns in society.
Maslow’s Hierarchy Of Needs
We can also consider mental health along a number of domains that encompass our needs. Abraham Maslow conceptualised well-being in terms of a hierarchy of needs. These needs extend from physiological, to safety, love-belonging, self-esteem, and self-actualization of potential. Depending on what our circumstances are our needs and their focus shifts. If we meet the needs highlighted at the base of the pyramid we might then strive to meet more complex needs in other domains.
However, there are some criticisms in that our needs don’t necessarily follow such a linear continuum. for example, needs in the love, connection, and belonging category are often valued and of great importance. In fact, love, belonging, and connection are vitally important for establishing safety and security and meeting physiological needs. Although there are criticisms of this model and what needs are primary, it helps to highlight where we might be on our journey. If you have had lousy sleep for the last six months it might be difficult to consider achieving well-being in other domains until rest is restored.
Positive Psychology And The 7C’s
The field of positive psychology has also helped to advance our awareness of positive aspects of human experience and mental health. This model describes happiness at the subjective levels to include joy, well-being, satisfaction and contentment, happiness, optimism, and flow. This encompasses states of feeling good. At the next level, well-being is defined according to what constitutes the ‘good life’ and personal qualities. This can include strengths and virtues such as capacity for love, courage, perseverance, forgiveness, originality, wisdom, interpersonal skills, and giftedness. Finally, positive psychology explores facets at the group or community level such as responsibility, nurturance, altruism, civility, tolerance, work ethics, and other factors that enhance a community.
Linked in to positive aspects of experience, Schwartz the founder of Internal Family Systems defines the 7Cs of the self and well-being. These states include courage, creativity, clarity, calm, compassion, congruence, and connection. A lot of therapeutic work is aimed at restoring aspects of the 7Cs , whether that be a willingness to take a healthy risk requiring courage, establishing greater clarity in terms of who we are, or fostering calm in our interactions at work.
DSM-V And Functioning In Life
The Diagnostic and Statistical Manual 5th Edition now defines a number of domains of functioning that can help us to understand mental well-being. These domains are defined as identity, self-direction, empathy, and intimacy. Often these domains might be compromised depending on stressors and life experiences. The identity domain is composed of sense of self, self-esteem, and emotional range and regulation. Self direction is composed of ability to pursue meaningful goals, constructive prosocial internal standards, and self-reflective functioning. The empathy domain is comprised of comprehension and appreciation of others experiences and motivations, tolerance of differing perspectives, and understanding the effects of our own behaviour on others. Finally the domain of intimacy includes depth and duration of connections, desire and capacity for closeness, and mutuality of regard reflected in interpersonal behaviour. Essentially these domains help to guide interventions and bring awareness to areas to work on.
As you can see there are many ways to define mental health and well-being. We can consider human experience to encompass both symptoms, disorder, and states of surviving through to experiences of thriving, fulfilment, and sustenance. My goal as a therapist is to help you work towards mental health and well-being or your best self. Improving our understanding and awareness at an individual, familial, and societal level is a key step to improving our mental health. By recognising patterns and problems and what constitutes mental health we can take steps in the right direction.