What we know about mental health

Earlier this evening, my friend Kelly posted a link to an article about mental health. It’s a good article and I used it as a springboard to post something that’s been on my mind about mental health. Specifically, as a society, we are in our infancy with what we know about mental health and how to deal with it. In my current day job as an Enhanced Disability Management Steward, I am reminded daily that what I know about mental health is as close to nada as you can find.┬áIt’s not that I don’t want to know about mental health, it’s more like: I just have no idea where to start on how to be supportive and frankly, neither does most of our society.

Our understanding of mental health runs at the same place as our understanding of bacteria 160 years ago.

I think of it this way: when my daughter was little, I taught her to wash her hands. I didn’t need to be taught to teach her to wash her hands. It’s so ingrained in our society as a normal thing, I just taught her. In the beginning, I gave her age-appropriate tools to learn to wash her hands. We collected “special rocks,” (every parent on the planet knows what a special rock is, right?) and then at appropriate times, we would go wash her special rocks. For me, it was the easiest way to make sure she didn’t leave the bathroom with her hands wet, not clean, and that all the soap was gone, so her hands were truly clean. As she got older, she stopped washing rocks and just started washing her hands. She’s twenty-two now. I don’t have to check her hands to make sure they are clean. She learned. She will teach her children. She may not parent my future grandchildren as I parented her, but she will teach them to wash their hands.

View through a fence knothole

“The worst thing about depression isn’t the depression. It’s seeing the world through a black fog that you know you can’t do anything about.” -Me in 2013

We know a lot about hand washing. We see signs in public washrooms. We know that hand washing reduces the transmission of colds, bugs, bacteria, and all sorts of nasties. We take this knowledge for granted because it’s a scientific fact. It’s such an accepted fact that public washrooms are being built with an open wall where once you would encounter a door you needed to touch. You do your business, wash your hands, then sail around the tiled wall into the food court to get your latte and keep on shopping.

About a hundred and sixty years ago, this wasn’t common knowledge. In fact, it was new. And not only was it new, doctors were offended that anyone would suggest they needed to wash their hands. It was a Viennese doctor, Ignaz Semmelweis, who noticed that women died of infection after giving birth at alarming rates in his hospital. What he noticed was that doctors frequently went directly from the morgue, where they examined corpses, to the maternity wards to help women give birth. These same healthy women then contracted puerperal fever and died. Dr. Semmelweis wondered what would happen if hand washing were instituted. Could women be saved?

What happened was that Dr. Semmelweis was shunned by the entire medical community. Modern science of the time was outraged by his suggestion that it was the doctor who was causing women to die of childbed fever. He pointed out that midwives, who did not go from the morgue and then from bed to bed, had significantly lower mortality rates. He wasn’t thanked for this information either and, in fact, was later dismissed from the hospital. He eventually died in an insane asylum.

However, his insights stuck and scientists elsewhere did the research and vindicated his claims. Now, not all that long after science insisted that his outrageous idea of instituting hand washing was an offence to medicine and science, we all wash our hands and don’t give it much thought. Of course we wash our hands before we eat and after we use the potty, and after we touch things in public places, and just because we feel like it. And about 150 years after he failed to convince doctors to wash their hands, I had my toddler balanced on a stool washing her special rocks.

Which brings me back to mental health.

After WWI, soldiers returned from war shell-shocked and were accused of cowardice. We now know they had PTSD and should have been treated with compassion, not to mention therapy. But a hundred years ago, we didn’t know this and therapy was really yet to be invented. Now we can’t believe what those poor soldiers endured in those dark, dark times, because we understand that soldiers see terrible things. But while we are pretty good with the whole soldiers and PTSD thing, we aren’t really sure how to support civilians who have had a traumatic event. We tell them to shake it off, because that’s the only real tool most of our society has in their tool kit when it comes to mental health. Suck it up, snowflake, and move on. It’s all in your head.

As a society, we are only just starting to understand that childhood abuse, bullying on the playground, and the myriad of life’s difficulties all play a role in our current mental health. A few decades ago, we didn’t discuss anxiety, depression or suicidal thoughts, but if it did come up, it was cloaked in shame. Those sorts of things were best not shared lest the neighbours talk or the chances of you finding a good marriage were affected. We do talk about it now, which is great, because if we can talk about it, we can finally get an understanding of it. Much like an absence of hand washing can lead to death, so can an absence of mental wellness. Poor mental health can kill, except that it looks like an overdose or a self-inflicted gunshot wound or a rope and not a fever.

We don’t talk about that last bit nearly enough. But I firmly believe that the reason we aren’t talking about it isn’t because we are embarrassed or hotly opposed to finding ways to support stabilized mental wellness. Instead, it’s because we don’t have words. What we are missing is some sort of language that allows us to accept it, support it, talk about it, and heal from it.

When we get a cold, we know to take vitamin C and wash our hands a lot. Friends ask us if we are run down and wonder if we are getting enough sleep. We are fed chicken soup and tucked in to ride it out, or fed cold pills and sent back into the world to carry on delicately. No one tells us to walk it off. That our cold is a choice. That putting on a smile will shake that cold right off. We are not blamed for our weakness. There’s a reason for that: we don’t consider it a sign of weakness to have a cold. We consider it part of our human-ness.

But then we watch our friends deal with anxiety and depression and words fail us. We don’t suggest chicken soup. Instead, we avoid them. We change the topic when they bring it up, although every so often we pay homage to it by reposting something about how the “coffee is always on if you want to talk.” So let’s assume one of our friends takes us up on our invitation to talk and they confess they cry a lot. The only language we have is to ask them if they are seeing their doctor. We don’t have an equivalent tool to colds when it comes to mental health. We are empty-handed.

As an EDMP Steward (that’s the Enhanced Disability Management Steward thing I talked about at the beginning of this post), people tell me daily they are coping with depression and I have not yet found a way to ask them how they are coping beyond seeing a doctor and seeing a counsellor. I have nothing. I don’t have a chicken soup recipe to help them get through their anxiety any faster. My heart is good. My intentions are great. I still have nothing.

Our understanding of mental health runs at the same place as our understanding of bacteria 160 years ago. We have no equivalent to “go wash your hands” when it comes to maintaining good mental health. We don’t teach our children how to maintain a normal range of … whatever the opposites of anxiety and depression are. We don’t have enough understanding of what “normal” is to be able to encourage it’s maintenance. More importantly, we have no idea how to support someone when their normal range is breached and they have become mentally sick.

Articles like the one Kelly posted are finally giving us some room to formulate words of support. We aren’t there yet, but it is my greatest hope that a future generation will have some version of emotional hand washing that they will teach their children. It won’t be considered unusual. It will be normal. And with that preventative tool in place, maybe future generations will avoid the mental health stigma that has plagued us for generations.