Not what it seems — World Mental Health Day

This is the official day to recognize mental health at a global scale. As a physician and the co-founder of a company focused on mental health, I wanted to take the moment to talk about why mental health is not actually what it seems.

Mental health is not illness

In the US and Canada, among some other countries, we are understanding more and more that mental health is more than illness. As a physician, I’ve often joked about how healthcare too often acts more like “don’t-die-care.” We would torture ourselves over how to squeeze a few weeks or days of life out of a cancer patient. But then we would be completely oblivious or lost as to how to teach that same patient how to live those final days with gratitude and fulfillment.

We spend a lot, perhaps even too much, on preventing the final event of death. However, we spend incredibly little time, money, or attention on getting a person to thriving.

Mental health is similar. Because of our medicolegal fears and considerations, we become extremely high alert the moment a patient tells us they have a plan to kill themselves. But in the months to years of discomfort, distress, and trauma leading up to that moment, we patch over the problem with pills and kind words. So long as the patient is “functioning well in society,” they are just fine according to our healthcare system.

Health should encompass the entire spectrum of deep illness to wellness to flourishing. This includes mental health as well.

Mental health is not vacation

Too often, we hear about people taking time off to care for their mental health. How often have you sat in front of your TV or booked a beach vacation for your mental health? When I was going through medical residency, I would sleep for 75% of my two weeks off and call that (incorrectly) focusing on my mental health. A company may proudly state that they prioritize mental health because they have generous policies for time off.

But mental health is not vacation. Of course, we all need a moment to reset from especially distressful times, but it is not not enough to sleep off your troubles. Truly working on your mental health involves actual work. The emotional processing of past traumas, discomfort with your current circumstances, career, relationships, and so forth is integral to building a strong mental health foundation. This is how you resist the future challenges we will all face (because you cannot escape challenges by vacationing forever).

Mental health work is not just feeling better

The work we must do to truly improve our mental health is both important and difficult to do in a lasting manner. It goes beyond simply feeling better and into deep excavation of the darkest corners of our minds and souls.

This work may come in many forms, but it involves 3 main things:

1. Awareness — This first, incredibly difficult step is the awareness of the past trauma or current events and behaviors impacting your life. It is self-awareness as to how your behaviors are affected by and which continue to affect your relationships, emotions, actions, and decisions. It is awareness of what you can and cannot change about all such ingredients. Awareness can be so challenging to us because it involves confrontation of deeply distressing subjects. Many of us spend our entire lives avoiding this confrontation and can certainly survive. But the opportunity lying on the other side of the awareness is that of deep thriving. Note that unearthing such traumas can sometimes require the support of a professional such as a therapist or physician.
2. Processing — Understanding what you are aware of is the next, also difficult step. This means understanding why you have come to be your present self. It means understanding why you fall back into old patterns of thoughts and behaviors. Sometimes this understanding requires a drastically changed perspective, which can come with years of work with a therapist or an intervention such as with psychedelics. Seeing your life from an outside perspective or with new knowledge will enable you to see clues invisible before. This processing comes with the acceptance of what you cannot change. This acceptance allows you to not hold any more grudges or regrets so that you can instead turn to the present and future.
3. Integration — This phrase which comes up often in psychedelic work is also applicable to any other processing work. It refers to the act of applying all your learnings from your emotional processing to your actions in life. This is no less difficult than steps 1 and 2, but mostly because it is easy to forget to do. Once we’re feeling good, even briefly, we are distracted from the necessary action of integrating past learnings. Eventually, however, we fall back into those negative thought loops or behaviors which leads to turmoil again. So we must remember to hang onto those learnings and practice them each day.

Mental health is not a secluded part of life

As a final note, mental health is a part of every single moment, experience, success, loss, or thought in our lives. Without our understanding of our values, we would not be able to make decisions. Without our inner narrative guiding us, we would not be able to make sense of the randomness in our universe.

Recognizing its significance in our lives allows us better to train and develop our mental health, or emotional, resilience. It makes us less surprised or distracted by the extreme events or dark moments which will inevitably happen in life.

In other words, mental health is life. Let’s take this day, World Mental Health Day, to bring that important idea to the forefront.