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A post on twitter yesterday got me thinking about the terms mental health and mental illness.

The post in question was “People using ‘mental health’ when they mean ‘mental illness’ are really starting to grate on me”. I asked what the difference was to that person because I find that these terms are much like the terms African American, black, and person of color when it comes to race. A term that is “good” to one person is offensive to another. It is often hard to know which term to use even if you are trying to be aware of effect.

Her response to my questioning was basically that we all have mental health, it is like physical health. Everyone has it. What we don’t all have is mental illness or a mental health problem. This seems like a reasonable distinction, and when I think about it I personally haven’t heard the term “mental health” by itself used to describe a person with a mental illness. Generally the term “mental health problems” is used.  The distinction seems valid, and one that we should be aware of.

Another person added their opinion on the question and that was to “take out the word mental”. This made me think. Why is the word mental even there? It’s a really good point, and something I’d never thought about. I also distinguished  between mental health and physical health, as well as mental illness and physical illness. But where exactly does the distinction lie?

At the time the terms were first used as distinct things I assume that they seemed as such. There was either a known “physical” problem: tumor, broken bone, cut or a problem that appeared “mental”, it appeared to effect the person’s mental state with no physical cause. It makes sense that it was termed “mental illness”.

Now, however, I feel that the distinction is somewhat old-fashioned. We are well aware of the underlying physical causes and changes associated with “mental” illness. People with schizophrenia for example have visible differences in the structure of their brains. It is a brain disorder. Changes in the brain cause changes in behavior in the same way that a tumor in a certain part of the brain may cause behavioral changes.

Taking things down to a genetic level, it would seem that most “disorders” have some sort of genetic basis, and genes are a physical part of us. Would that not make all of these disorders physical?

I have simplified things considerably here. I am sure a person could write an entire thesis on the history of the distinction between mental and physical disorders, and what they mean. Personally, now that I have thought about it more, it would seem that nowadays the distinction mainly holds so as to separate people: those with the “real” physical illnesses, versus those with the “mental” illnesses.

A person with a long term physical illness is often referred to as having a disability, and while having a disability brings with it its own other set of societal problems and discriminations it is a lot easier to be taken seriously when one can name a “physical” disability. A person with severe anxiety for example will have a much harder time being taken seriously as having a disability because it is not “real;” it is merely a “mental problem”.

Maybe this is all just semantics, and most people don’t think about it (obviously, I didn’t really until it was brought to my attention) but I wonder how much it affects the way we view a disorder. We are all very comfortable “admitting” to a physical illness, but anyone with any “mental” illness knows how hard it is to “come clean” about the problem. The term “mental” seems to imply and inherent fault in the one with the disorder.  Maybe it’s time for a refreshing of the terms used so as to change our inherent biases associated with those disorders that are “mental” versus those “real” physical disorders.

What do you think? Is this a meaningful problem or is it taking the world of political correctness and the desire to not offend too far?

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