Stress and Mental Illness: Are They One And The Same?

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In my previous post I discussed Is Stress A Trigger For Mental Illness? In this post I’m hoping to highlight how stress and severe mental illness are not one and the same.

We all go through periods of stress, where we feel run down, overwhelmed and generally feel like we need a reset button for life. It does have an impact on our mental health, but it isn’t a mental illness.

I have worked with colleagues that have misinterpreted my mental illness as stress, or the more important distinction that I couldn’t handle stress. Comments such as,

“Well, some of us can deal with stress better than others.” and “At least I’m here all the time unlike some people who are always signed off with stress.” Stress was a trigger for my mental illness, bipolar, and yes, I did have to take time off work because of it. It didn’t mean I couldn’t handle stress, it meant I had a severe mental illness that had not been properly diagnosed, or been provided with the proper treatment.

How we effectively deal with stress can be managed through self care techniques and adapting our work/life balance. If someone starts to show signs of mild to moderate depression or anxiety they can seek help such as CBT or other forms of therapy for a short period. Severe mental illness on the other hand, needs much greater intervention. A psychiatrist, hospital admissions, long term medication and therapy. Significant lifestyle changes such as cutting out alcohol may be not advised, but desperately needed. Can you see the difference? Stress in our lives can be managed, if we want to do so; mental illness cannot. Your lifestyle is a choice, mental illness is never chosen. I think it’s important here to highlight one glaringly obvious cause of stress; poverty. This can’t be eradicated by a simple change in lifestyle by the individual. It’s society at large that needs to work towards this. Is there a difference between the stresses of the upper and middle classes and those living in poverty? Yes, I believe there is. Are those in poverty more likely to have a severe mental illness? Again yes. According to the Mental health Foundation,

“Poverty increases the risk of mental health problems and can be both a casual factor and a consequence of mental ill health. Mental health is shaped by the wide-ranging characteristics (including inequalities) of the social, economic and physical environments in which people live.”

Many people with severe mental illnesses also fall into poverty because of being unable to work. This exacerbates already difficult to manage conditions and leaves the individual extremely vulnerable to self medicating, self harm and suicide.

When many people speak up about mental illness, often it’s from their own experiences. That’s fine, but when it’s highlighting stress and lumping it in as a mental health condition, it devalues the impact of severe mental illness. Bipolar, BPD, PTSD, Schizophrenia to name a few are long term, life altering conditions that need psychiatric intervention and expertise to assess, treat and manage. Stress is damaging, physically and mentally I’m not denying that. I feel though that there needs to be more room for conversations surrounding severe mental illness. Too much noise is made around stress, and mild to moderate mental illness. Already sufferers feel marginalised and isolated in society and need more spaces where their voices can be heard.

Talking About Mental Health Is Vital, But It’s Not Enough

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I often find myself saying,

“Talking about mental health is so important.” and “Just be open and honest and you’ll feel so much better!” I have done so many times on this blog.

But in my heart, I know it’s not enough. So many of us are being let down again and again. Services are spread thin and desperately underfunded. Recent reports that young people are being denied care until they’re at crisis point, and receiving little to no help unless they have attempted suicide, is disgraceful.

We do need to talk about mental health. Talking can save lives, but our friends and family are not experts. There is only so much that they can do to help and often unfortunately, it’s not enough. It puts a strain on our relationships which can further the isolation and hopelessness of our situation. I’m lucky enough to have a supportive family and group of friends. I do what I’ve been told helps; to talk. I’ve been talking and reaching out for years, but it’s not always enough.

I’ve sought professional help when I’ve contemplated suicide. I was given a number for the crisis team if ever I needed them. I was told they were available 24 hours a day and would help. I’ve had very different experiences to what I was told I would have. After the phone call I wished I’d never picked up the phone. Firstly, I was given the wrong extension number, and then when I finally got through to speak to someone they simply said,

“Carry on taking your medication and you’ll start to feel better soon.” I talk more about this in the post My Experiences of Mental Health Crises Care

GP’s need more training to identify severe mental illnesses and provide the correct referrals. I like many others with bipolar were misdiagnosed countless times, and it took 12 years for me to be diagnosed. Therapy needs to be far more accessible and not just a one size fits all solution on the NHS. Talking therapies is not always provided by a trained psychologist. In my experience it was a counsellor, who had been trained in basic techniques in order to provide talking therapies. It wasn’t enough and he wasn’t prepared to deal with the symptoms I was displaying. Specialist, long term therapy is still out of reach for many. The price tag attached is as if it’s marketed as a luxury rather than a necessity for those with severe mental illness.

Mental health has had budget increases, but they’re far smaller than budgets for physical health. It’s been five years since the government pledged to create “parity of esteem” between NHS mental and physical health services. People are suffering and we demand better. We need to recognise the role of poverty and discrimination in determining access to formal mental health services. We need to address the reasons why so many people from ethnic minorities, the LGBT+ community and those with disabilities suffer from mental ill health. There are still disgustingly long waiting lists. Having an assessment due in eighteen months when you’re suicidal is not only callous, but negligent. Still we’re seeing mental health services strained to their limits. Still people are told,

“You’re not ill enough” and “Come back when you’ve attempted suicide” Change is desperately needed right now.

In the end investment, not rhetoric, is needed to save lives.