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Missing the Point on Mental Health

Originally Published on January 13, 2019

When my yoghurt dropped on the page next to a radiant instagram snapshot it was a disturbing contrast.

It seemed somehow irreverent that I was slopping my cereal on an article announcing the suicide of Annalise Braakensiek. As it soaked through the page I felt a profound inaneness in that moment, like I was normalising something that should never be normal . A “private pain” headline as common as stumbling across a Harvey Norman ad.

If I gave you $100 for guessing at the content of the article you didn’t read, you’d nail it. “Everything to live for” “Friends dined with her earlier in the evening said she was going well” “If you or someone you know… call Lifeline.”

Let’s be clear about the silent epidemic of mental health. For a start, there is nothing silent about it. It’s an epidemic.

An epidemic we are doing our best with but nonetheless have failed to abate. Cyberbullying, financial distress, low self esteem, and relationship breakdown are often quoted as we search for logic to feed our need for order. At the same period in time science races to cure cancer and lengthen life, we have unprecedented numbers of people who want to end it.

Let’s pause throwing resources into the ring and say that all the medicare rebates and pharmacological advancement do not appear to be solving much.

For the last 30 years we’ve increasingly been knocking back anti-depressants and rescue remedies like shot glasses off a bar; muddling through mindfulness apps like some kind of GPS.

I can’t help but think maybe as a society that the solution is going to come from the Why. Psychology offers 3 ways to frame the causes of poor mental health in what is known as Biopsychosocial approach, suggesting its root cause lies in one of all of the following:

  • Biological - our genetics, biology and chemistry

  • Psychological - the way we think, feel and behave

  • Social - connection and interaction with others.

Which of these has changed the most that might account for the increasing struggle so many people experience?

There is no suggestion that our biology is causing more mental health issues, though there is better evidence that distress starts to impact on our sleep, autonomic function etc. Genetic, melancholic (biological) depression is probably the easiest kind of depression to pick up - with sleep disturbance, foggy thinking and psychomotor slowing some of the signs. But this doesn’t appear to be the kind of mental health diagnosis that is on the rise. We probably all arm wrestle with psychological factors such as low resilience, perfectionism, poor self esteem and unhelpful assumptions - a signpost that the world moves so much faster than our cognitive adaptation to it.

Social influences are possibly where a lot of the answers lie. More of us work in virtual teams or cubicles. Yammer doesn’t fix an office cubicle. A cooler chat about the weekend is not connection. At home those who don’t actually live alone often are not considered candidates for isolation, even as they sit side by side on the couch in their own devices and rooms akin to a cross section of a doll’s house.

Having 8000 followers and a full diary doesn’t dull isolation, it pronounces it.

Being stunning in appearance, with hundreds of Likes as was Annalise, doesn’t mean anyone really sees you - it is a greater misnomer that they think they have. There is a relatively low correlation between actual connection and perceived connection.

Given 10 people in a line up and a list of facts about their lives, we cannot pick out loneliness as if it were an antibody in a pathology lab. Human beings don’t need company. Depression is markedly higher if you don’t share something that is meaningful with others, and the increasing absence of that for many people is probably as hard to express as it is agonising.

It all begs the question as to why the American Psychological Society continues to declare that depression treatment best practice is in a therapist’s room, a bottle, or both. Yohann Hari’s Lost Connections is probably the closest explanation I’ve seen to why we need to redirect our resources.

Back to the headline of Annalise’s death.

There’s something disturbing, if we are really honest with ourselves, that a homeless or outwardly disadvantaged person taking their own lives is somehow less of an affront to our order, or less of an aberration than a famous chef, model or fashion designer.

It tells us that while we are immersed in our own assumptions about who is lonely and who is not, maybe your friend, neighbour or colleague’s distress might not really be seen. I didn't know Annalise but for her and so many others, I wish somehow we could have done better.

It is a comforting conclusion in a way, to remind ourselves that for all the world’s advancement, technology and science, human beings just need meaningful connection with other human beings. Not judgement and no assumptions.

And that’s a part we can all play.

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