Why Mental Health Struggles Can Be More Difficult and Challenging?

Any illness, mental or physical, is difficult, but I consider mental health illness to be much more challenging based on my experience as a therapist and the lessons that I have gained from people as well as from studies.

When we hear the term "mental health", we think of something that is serious, but mental health is much bigger and broader than mental illness, just like how physical health can fluctuate based on lifestyle, environment and other factors, mental health can get affected by stress, relationships, experiences and circumstances.

When I mentioned the topic to my mom, she asked several questions about whether the article was about serious illnesses like Alzheimer’s, bipolar disorder, or schizophrenia. It made me wonder whether the word “mental” by itself is a barrier, as it has been used in a different connotation for quite some time, unlike the word “physical.”

When I talk about mental health, I am not talking only about severe mental illnesses. I am also talking about the psychological and emotional struggles and stress that many of us experience, such as anxiety, distress, feeling overwhelmed, and difficulty coping.

Physical health and illness are often easier to attribute to external factors such as food, environment, contagion, genetics, etc., where it is easier to shift the blame and not be held responsible. Evolutionarily, diseases that were considered to occur due to behaviour were frowned upon. For example, obesity and alcoholism are often viewed as problems that occur due to a lack of self-control.

Mental health struggles is mostly attributed to internal factors, namely willpower, strength, weakness, control, etc., making it hard to accept and therefore making it difficult to take action.

In psychology, there is a bias called self-serving bias, where, for oneself, we attribute success to internal factors and failure to external factors. For example, if a person succeeds in an exam, they may think it is because of their abilities or skills, and if they fail, they may attribute it to the paper being tough, not having enough time, or not being taught properly, etc.

So, from this, we can infer that it is easier to attribute problems that one faces to external factors. When it comes to physical health problems, self-serving bias takes place, and the problems are attributed to external factors, making it easier to get internal acceptance to seek external help or make a change.

However, I have also observed recently that some people are finding it difficult to seek help for physical health issues too, possibly because today's diseases are majorly attributed to lifestyle and habits. This guilt makes some people stay in denial and stop seeking help. Due to awareness and information being widely spread about physical health, along with social support to seek help, mostly people take action to get better.

In mental health problems, self-serving bias does not work in the same way as in physical illness, as there is an ambiguity. Mental health problems are real, but they lie deep and cannot be inferred in the same way as physical health illnesses. Physical health problems are observable and concrete; you can see them through bloodwork or through a scan. The evidence is solid and concrete.

However, with mental health struggles, although there are tests, the results could be subjective. There is often no single concrete test that can establish a mental health condition in the same way that a blood test or scan can establish some physical health conditions. Assessment often involves symptoms, behaviour, personal experiences and clinical evaluation. Mental health struggles causes changes in behaviour. It might affect the person and the people around that person profoundly, but it is only observable and needs to be analysed by that person. At times, people around that person cannot help, or they may be the cause or trigger for the problem, which makes it more difficult. If a person is able to recognize and accept that there is a problem, along with receiving support from the people around them, they would be able to seek help and take action.

From a social perspective, a psychological phenomenon called fundamental attribution error causes problems. Fundamental attribution error is when we tend to attribute another person's behaviour to their personal qualities while overlooking the situation or circumstances that may have influenced their behaviour. For example, when a person is depressed, people may say that it is because they lack the ability or willpower, instead of considering biological, environmental, or other external factors.

Socially, mental health difficulties in others may be viewed through the lens of fundamental attribution error. When a person has mental health struggles or seeks therapy, they may be viewed as being weak or incapable, or as not being strong enough to make changes in their life or lacking willpower, etc.

So, a person has to fight internally as well as externally when that person does not have the capacity to fight. It is like asking a person who has a fracture to go on a marathon.

However, today I find that the younger generation is much more open and vocal about their mental health and willing to seek help, and the older generation is observing them and catching up. What I observe today is awareness and the normalizing of seeking help during the beginning stages, when stress affects a person's day-to-day life activities.

If there is no action taken in the beginning stage and the problem persists, then long-term medical treatment may become necessary instead of short-term talk therapy or counselling.

Given that mental health struggles are much more challenging than physical health illness, with internal and external struggles, I feel much more hopeful and inspired when I see people accept their stress, embrace vulnerability, courageously talk about their problems, let go of their excessive stress, and become resilient and antifragile in their lives.