A Missing Piece of the Mental Health Puzzle

By Terri Klein

August 23, 2017

Mental health is a topic that is both front and center these days. It is a pervasive problem that affects everyone on some level and thus needs to stay at the forefront. But in addition, I am suggesting a slight, yet very important, shift of focus.

Many associate “mental illness” with extreme emotional suffering and “mental wellness” with emotional flourishing. This, however, is a very black-and-white understanding of mental health. I envision them both on either end of a spectrum, with a whole lot of middle ground (grey area) in between.At one end, I see the more serious mental disorders such as schizophrenia, bipolar disorder, clinical depression, and panic disorder, each with specific symptoms as outlined by the Diagnostic and Statistical Manual of Mental Disorders. (This comprehensive manual offers a common language and standard criteria for the classification of mental disorders.)

At the other end, I see “human flourishing” as described by the positive psychology movement: people thriving, embracing the power of positive emotions, engagement, positive relationships, meaning, and achievement.

My intention in writing this blog is not to oversimplify mental health but rather to speak to what I consider to be a missing piece of the mental health puzzle: “the neglected middle ground.” I hope to share a perspective that will do more than spread a message—one that will also initiate an essential call-to-action.

I would like to target and be a voice for those amongst us who are living in that vulnerable, middle ground space, with very real, albeit “less serious” emotional issues.

Here are just some of the issues that I am referring to:

  • Loneliness, disconnection, and unworthiness
  • Sadness, loss, and grief
  • Stress, overwhelm, and pressure
  • Obsessive thinking, worry, and unhealthy stories
  • Addiction and “over-ing:” over-eating, over-drinking, over-shopping, over-teching – to numb and buffer negative feelings and emotional states
  • Brain fog, scatterbrain, and digital distraction
  • Limiting and self-sabotaging beliefs

This is what I see as a huge problem: These “less serious” emotional issues, if left neglected, unacknowledged, and/or untreated have a tendency to get worse over time. Meaning, those who are suffering, yet are still able to function, may soon suffer to the degree of dysfunction and end up at the more serious end of the spectrum.

This is how I make sense of this and my reasoning behind why these people often suffer and don’t reach out for help, and I’m speaking from my own personal experience as well. As human beings we are conditioned to belong—to fit into a “norm” and/or category. So, we look for a language, a structure, or for something to embrace that we can immerse ourselves into to feel safe, validated, and understood.

Someone who’s been diagnosed with a pre-existing disorder such as clinical depression and/or anxiety, has a defined structure to embrace—a common language, a sense of the symptoms, an understanding of the treatment, and an expectation of what is “normal.” Best-case scenario: things are described, prescribed, and there’s a specific plan in place.

But someone who’s not in “crisis mode” doesn’t necessarily think there’s a problem, yet they could be struggling with very real issues, like some of those listed above. They may not have a common language to use, a medication to take, and/or a set of tools to access; they may not have a structure to embrace or a label with specific criteria to fit into.

For example: Someone who is feeling very sad may not understand that feeling this kind of negative emotion can be normal. But know that there is a fine line between feeling sad and feeling depressed AND between feeling depressed and being diagnosed as clinically depressed.

My concern regarding people who are “feeling depressed” in this middle ground, grey area is that they are not being properly assessed and therefore not provided with appropriate tools and a treatment plan. The consequences of an inaccurate assessment can be vastly different but equally detrimental to a person’s mental health.

On the one hand, people may be “undertreated,” left feeling helpless and unsupported in their sadness. On the other hand, they may be “overtreated,” needlessly prescribed medication for an assumed diagnosis of clinical depression. (Diagnostic inflation)

If someone is experiencing grief or loss in any capacity, like the loss of a loved one, a job, a relationship, or other, it is only natural for them to feel sad. Being that life is filled with both positive and negative experiences, it is so important for people to understand how to be with and manage a negative emotion. But who teaches us how to do this? How do we learn about emotional agility and emotional intelligence?

Mental Health Symposiums are fully booked, as are workshops targeting mental illness. People are looking for something—anything to help buffer and ease the emotional suffering. But I strongly suspect that they leave these sessions without a broad enough understanding of the entire “wellness spectrum.”

This is my call-to-action part one: Let us look at the entire spectrum and begin to pay more attention to the middle ground—to help treat those feeling vulnerable yet functional, to prevent them from shifting to the more serious end of the spectrum.

Let us teach and spread wellness tools and practices. Let’s speak the language of thoughts and feelings, of character strengths and core values. Let’s talk about shame and worthiness—connection and loneliness—and about sadness and happiness. Let’s have real conversations around fear, vulnerability, and imperfection. Enough people have fallen through the cracks of a system that is failing them.

Let us also learn how to nurture the body’s natural anti-depressants, which can be cultivated by being compassionate, connecting with others, attaching to a worthy cause, finding meaning and purpose, and/or expressing gratitude to name just a few.

We can all begin to learn how to quiet the overthinking mind, how to build emotional muscle, and how to rewrite our very limiting stories in order to access the best parts of ourselves and thus live our best lives. It is so important to offer a very real and usable “wellness toolkit” that can be customized and utilized by those struggling in the middle ground, who have become silent victims of their very real suffering.

We need to expand the mental health conversation from education, awareness, and stigma reduction, to include the burden of daily struggles and discussions around how to effectively achieve mental wellness.

In so doing, by focusing on this piece of the mental health puzzle, we may be able to reduce the number of people who end up at the more serious end of the spectrum—those who meet sufficient criteria to be labeled as having a mental disorder. Let’s target the earlier, less serious stages of emotional suffering and step into “prevention.”

This is my call-to-action part two: Let us take the time to speak to parents, to educators, to medical professionals, to businesses, and to leaders and politicians and let us share this idea and new curriculum to better advocate for those in the “neglected middle ground.” We do have what to offer to help heal this large segment of the population—who likely suffer in silence and/or are needlessly medicated. The curriculum necessary to create this toolkit is available, and it is a beautiful blend of both science and psychology (my two favorite subjects).

In my one-on-one coaching as well as my workshops I teach people who are in this middle ground, especially the overthinkers, how to evoke transformation by accessing the power that already exists within them to change their brain and thus their lives. It is one of my greatest passions to be of service in this capacity—to coach and thus facilitate self-directed neuroplasticity.

If anyone feels driven to support this worthy cause, I ask you to please get in touch with me. I am a firm believer in the power of collaboration—together we can achieve that much more!

Coach Terri


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