Nuance is important in discussions about our mental health

Depression and other illnesses must not be confused with being generally fed up with lockdown life, says Colette Sheridan
Nuance is important in discussions about our mental health

We need to differentiate between feeling low, and depression, when sufferers often take to their beds. Picture: iStock / Getty

I LEARNED a new word in the lexicon of phobias that we’re prone to, particularly in this time of pandemic.

‘Monophobia’ is the fear of being alone, something that not many people would admit to, but which drives people to bar counters (in the days when that was an option) so that they can engage in convivial conversation, oiled by drink.

You could spend hours and hours in your local, whittling the day away on a bar stool with nothing more onerous on your mind than the decision to order or not to order something strong from the top shelf. Those were the days.

Now, if you have a drink habit, you have to buy takeaway booze and, if you’re living alone, there’s the danger of succumbing to over-indulgence in the tipple of your choice. (“What else is there to do?” might be your excuse.)

Suffering from monophobia can be eased by alcohol, presumably. But that is the slippery slope that beckons when you are prey to the seductive powers of drink. Being able to come up with a term like ‘monophobia’ that you’re trying to live with could justify an alcohol habit.

But we have to be wary of labelling ourselves. It’s too easy to box ourselves into psychiatric conditions that supposedly describe everything from feeling anxious about going to the shops (a touch of agoraphobia) to orophobia (fear of mountains, even being in the vicinity of them).

One thing we’re not slow to identify with is depression in this time of privation. We have lost our liberty so that we fret about chatting to someone outside our front door. “Is this allowed?” we ask, half-laughing at the weirdness of it all.

It’s no wonder that some folk retreat to the garden with a bottle of plonk to be downed with a friend. That’s not allowed yet. But who hasn’t broken at least one rule?

If you can still enjoy the company of a friend, then you’re not depressed in a serious way. You may have symptoms such as low mood and comfort eating. But hard core depression (which I’ve battled) sees sufferers taking to the bed with curtains drawn and a deep desire for the oblivion of sleep.

It’s not something that people can easily talk about. But it’s not to be confused with being generally fed up and feeling down.

“Everything we think of as a ‘symptom’ of mental disorder —worry, low mood, binge eating, delusions — actually exist on a continuum throughout the population,” says Lucy Foulkes, psychology lecturer and author of Losing Our Minds: What Mental Illness Really Is — And What It Isn’t.

Writing in the Guardian last week, she pointed out that for each symptom, we vary in how often we experience it, how severe it is, how easily we can control it and how much distress it causes.

In the area of mental health, “there is no objective border to cross that delineates the territory of disorder. On top of this, the thoughts, feelings and behaviours that appear temporarily as a natural response to hardship and stress — like when we’re heartbroken — exactly mimic those that, should they persist, are defining features of mental disorders.”

Lucy goes on to say that these boundaries are so nebulous that some psychologists say we shouldn’t use the terms ‘illness’ or ‘disorder’ at all, and “should only view all of this as matters of degree”.

Nuance is important. It’s too easy to identify with a condition when all you might be experiencing is a normal reaction to a difficult situation.

It is misguided to imply “that all negative states are problems, health problems — and things that can and should be fixed. That’s not how life works”.

But Lucy adds that this is not to say that people who don’t actually have a diagnosable disorder should be silenced or ignored.

It’s important that people with milder or more transient difficulties talk.

“But we need to figure out a way to talk about these negative emotions without sending the message that there’s something dysfunctional about you for feeling that way.”

When we describe all low moods as ‘depression’, the term loses any meaning.

Lucy Foulkes says there’s a need to promote the idea that a great number of distressing psychological experiences can be managed — sometimes with professional help — without needing to reach for the psychiatric dictionary.

Very sensibly, she says that we need to gain confidence in talking about mental health and illness not as a neat dichotomy but as a messy, nuanced spectrum.

We all like simple categories and answers “but the sooner we recognise that mental health doesn’t play this game, the better”.

Next time someone asks you how you are, it might be accurate to say “not bad, considering”.

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