Good mental health is not only the absence of mental illness; it's also our ability to enjoy life, achieve balance, psychological resilience, and well-being. It requires that we function at an optimal emotional and behavioral level.
What is mental health?
"Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential." ~ World Health Organization.
Our well-being flourishes in the realization of our abilities, coping skills to deal with life stress, productive work, and contribution to our community.
In the United States, the American Psychological Association defines various mental disorders through the Diagnostic and Statistical Manual of Mental Disorders. In this manual, a mental disorder is defined as "a syndrome that is present in an individual and that involves clinically significant disturbance in behavior, emotion regulation, or cognitive functioning." In other words, if the way we think, behave, or react to our emotions is creating significant problems in our life or preventing us from functioning well in key areas, we may have a mental disorder.
To be considered a mental disorder, a person's symptoms must stem from a dysfunction in biological, psychological, or developmental processes that are necessary for healthy mental functioning, and not merely predictable or culturally approved responses to common life stressors or losses.
For example, if a person acts with extreme anxiety or depression after the death of a loved done, this is typically not considered a mental disorder but a reasonable response to a difficult life event. In contrast, if a person feels depressed for long periods of time for no "apparent" reason thus deviating from societal norms and expectations on how a person should think and behave, that person may have a mental disorder.
Defining mental health, however, is more complex than it seems. Before considering someone as having a mental disorder, we must look at cultural differences and values of the society where the person lives. For example, in some Latin American cultures, it is common to see people at funerals demonstrating a great sense of grief and despair as a sign of love and respect. In the languages of certain Native Americans, Alaskan Natives, and Southeast Asian cultures, there's no word for "depressed."
The importance of detecting mental distress in youth.
Mental health problems and substance abuse are more common than we think and often develop during adolescence. Youth and young adults may not have the information that they need to get well or they may have misconceptions about mental health, drugs, or the way they feel. Misunderstanding and discrimination often aggravate a person's state of mind, overall mental health, and well-being.
Professional help may not always be on hand and readily available to young individuals; they may not know how to ask for help, where to go, who to talk with, or what to say. The sooner a person gets help, the more likely they are to get well.
To know more about youth mental health and learning to recognize when someone may be experiencing mental health distress or substance abuse challenges, see Youth Mental Health.
What causes people to develop mental disorders?
If we knew the causes of mental disorders, we would be able to prevent it. Understanding what causes mental disorders in some people and not in other people is a work in progress for mental health professionals.
Human behavior is complex — it relies on different brain functions and processes as well on social experiences. For example, trying to understand the reason why a person has social phobia requires an analysis of that person's thought processes, brain functioning, memories, childhood experiences, social conditioning, culture, present circumstances, etc.
Through research studies, mental health professionals have discovered that people with a preexisting vulnerability for a disorder who experience a major stressor, are more likely to develop mental health disorders than people with no preexisting vulnerability and no major life stress.
Stress often occurs when an individual experiences frequent, undesirable life events that exceed coping abilities and result in psychological, cognitive, and behavioral readjustments or changes. Interestingly, low vulnerability and a highly potent life stressor can cause a mental disorder in the same way that high vulnerability and a low potency stressor can also cause a mental disorder.
Most common mental disorders in the United States.
Major depressive disorder.
Alcohol abuse.
Specific phobias.
Social phobia.
Conduct disorder.
What can protect people from developing mental disorders?
Protective factors have proven to decrease the risk for mental disorders in people with some risk factors. Protective factors, like having a nurturing parent, good friends, a supportive community, and emotional intelligence, act as a buffer against the likelihood of a negative outcome.
Risk factors, on the other hand, are characteristics at the biological, psychological, family, community, or cultural level that are associated with a higher likelihood of negative outcomes.
For example, being a female, in early puberty, with low self-esteem, not college-bound, and from divorced parents (all characteristics considered "risk factors") can increase the likelihood for negative outcomes or mental disorders. However, if that same person has nurturing parents and good emotional regulation (characteristics considered "protective factors") the chances of developing a mental disorder decrease.
Some life stressors that are dealt with successfully can be beneficial in building self-confidence and self-esteem — essential blocks for developing resilience, which acts as a protective factor.
Individual Risk Factors:
Female
Early puberty
Difficult temperament: inflexibility, low positive mood, withdrawal, poor concentration
Low self-esteem, perceived incompetence, negative explanatory and inferential style
Anxiety
Low-level depressive symptoms and dysthymia
Insecure attachment
Poor social skills: communication and problem-solving skills
Extreme need for approval and social support
Low self-esteem
Shyness
Emotional problems in childhood
Conduct disorder
Favorable attitudes toward drugs
Rebelliousness
Early substance use
Antisocial behavior
Head injury
Marijuana use
Childhood exposure to lead or mercury (neurotoxins)
Individual Protective Factors:
Positive physical development
Academic achievement/intellectual development
High self-esteem
Emotional self-regulation
Good coping skills and problem-solving skills
Engagement and connections in two or more of the following contexts: school, with peers, in athletics, employment, religion, culture.
Family Risk Factors:
Parental depression
Parent-child conflict
Poor parenting
Negative family environment (may include substance abuse in parents)
Child abuse/maltreatment
Single-parent family (for girls only)
Divorce
Marital conflict
Family conflict
Parent with anxiety
Parental/marital conflict
Family conflict
Parental drug/alcohol use
Parental unemployment
Substance use among parents
Lack of adult supervision
Poor attachment with parents
Family dysfunction
Family member with schizophrenia
Poor parental supervision
Parental depression
Sexual abuse
Family Protective Factors:
Family provides structure, limits, rules, monitoring, and predictability
Supportive relationships with family members
Clear expectations for behavior and values
School, Neighborhood, and Community Risk Factors:
Peer rejection
Stressful events
Poor academic achievement
Poverty
Community-level stressful or traumatic events
School-level stressful or traumatic events
Community violence
School violence
Poverty
Traumatic event
School failure
Low commitment to school
Not college bound
Aggression toward peers
Associating with drug-using peers
Societal/community norms favor alcohol and drug use
Urban setting
Poverty
Associating with deviant peers
Loss of close relationship or friends
School, Neighborhood, and Community Protective Factors:
Presence of mentors and support for development of skills and interests
Opportunities for engagement within school and community
Positive norms
Clear expectations for behavior
Physical and psychological safety
--------------------
References:
-Hooley, J. M. (2017). Abnormal psychology. (7 ed.). Pearson.
- O’Connell, M. E., Boat, T., & Warner, K. E.. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press.
-U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2009). Risk and protective factors for mental, emotional, and behavioral disorders across the life cycle. Retrieved from http://dhss.alaska.gov/dbh/Documents/Prevention/programs/spfsig/pdfs/IOM_Matrix_8%205x11_FINAL.pdf