Sanity is a myth, none of us are sane, yet insanity feels scary, foreign and a million miles from the life that most of us lead. Insanity conjures up images of mental asylums, white coats, sedated patients, a ‘one flew over the cuckoo’s nest’ hive of panic-stricken individuals. Our 19th and 20th century foray into locking up the clinically ill has only served to heighten a perception of mental illness as being a million miles away from normal. A black and white divide between those who are sane and those who are not. As a result, we’ve come to fear any sign that we may be less than 100% normal, deeply burying signs of ‘weakness’ and fearing the stigma of what it means to be mentally ill.
Why sanity is a myth!
In reality there is no divide between being OK and being insane, we all suffer from symptoms of one kind or another. It’s only when the volume gets turned up to a deafening or debilitating pitch that it gets labelled, but it’s always there. If any one of us were to pick up the DSMV (The Diagnostic and Statistical Manual of Mental Disorders) which lists out psychiatric conditions, we could pick out symptoms that we recognise in ourselves. Just take a look at the list below which relates to GAD (Generalized Anxiety Disorder):
- Too much anxiety or worry over more than six months. This is present most of the time in regards to many activities.
- Inability to manage these symptoms
- At least three of the following occur:
Note: Only one item is required in children.
- Tires easily
- Problems concentrating
- Muscle tension.
- Problems with sleep
- Symptoms result in problems with functioning.
- Symptoms are not due to medications, drugs, other physical health problems
- Symptoms do not fit better with another psychiatric problem such as panic disorder
It’s the frequency and intensity (in italics) which tip these symptoms from everyday annoyances toward mental illness i.e. impaired cognition (thinking), emotions or behaviour. It’s easy to see how the tipping point is similar to physical illness. We don’t go to the doctor until the pain in our side has been there for 3 months, or the headaches have become so severe that we can’t go to work.
So what is mental health?
Earlier this year I spoke to Lord Stevenson about raising awareness of what’s normal and what’s not when it comes to mental health. Stevenson and Farmer put together an independent review of mental health in the workplace for the Prime Minister and they open their review by saying:
By mental health we do not mean “mental ill health”. We mean the mental health we all have, just as we all have physical health. The World Health Organisation defines good mental health as “A state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community.”
With that in mind I put together the diagram below to show the parallels between physical health and mental health and the comparative places in which we seek help. As always I emphasize the fact that a better understanding of psychology could help everyone at every stage of this continuum.
Realising Our Own Potential
Bringing this into the world I work the focus lies on the peak performance end of the continuum. A large part of my job is to help exceptional people remain in or reach their place of peak performance – to keep them at their absolute optimum. They need to be there so that they can realise their own potential, cope with the stresses of life but in most cases make a significant ‘contribution to his or her community’. These people have a responsibility not just to themselves but to those who they lead or influence, it’s critical that they understand their tipping points and avoid falling off the edge.
In my book I refer to stress and peak performance within the context of the Human Function Curve developed by Cardiologist Peter Nixon. This model is useful because while developed in the context of physiological stress and performance it also readily applies to mental stress and performance bringing together the similarities between physical and mental health.
The model helpfully points out that stress on either the body or the mind isn’t always detrimental—we need a certain amount in order to perform at our optimum which is just as well because and in reality we cannot escape stress. Both stress on our body and our mind are part of the equilibrium that is life. The curve illustrates that there is a need for a balance of good and bad stress, with optimal stress and performance at the midpoint.
Taken from Defining You
If you think of this in the context of an athlete training – they need to keep stretching their body out of their comfort zone in order to improve, but then allow time to rest in order to train again. That stress will cause physical discomfort when the athlete is training but also allow them to improve their performance. However too much time training without a rest will result in injury.
When it comes to our minds, at a low level of stress, we may feel bored or disinterested, finding it hard to get ourselves going. As stress increases, so does our physiological and psychological arousal until it reaches an optimal level, enabling improved performance: for example, performing better in a presentation or exam, finding it easier to concentrate and get things done, or being more able to think on our feet. In the same way that the stress causes a degree of physical discomfort for the athlete training, the mental annoyances that personally bother us are turned up in volume as we move along the spectrum. I for example get really anxious in the run up to giving a big talk and as a result experience more of the items in list C above e.g. restlessness, irritability, muscle tension and problems with sleeping. They aren’t however sustained, once I’ve done the talk they subside. Too much stress, too many talks in one week or one month could however be crippling. In the same way as too much stress on an athletes body can cause a muscle or tendon to tear, too much stress on our mind can cause us to tip over the edge with a need to take time to recover. At this point our performance follows a downward trajectory, leading to negative emotions and overall cognitive decline, risking mental ill health.
The Cyclical Nature of Mental Health
Over the years working with high performers, I have become acutely aware of the fine line between brilliance and denial, or talent and collapse. Individuals who are at the top of their game are vulnerable and can quickly face mental deterioration. This is not helped by the picture that has been painted of insanity. The most successful high achievers see nothing of themselves in people who fit this description, in fact they often fear this more than most – mental illness has also been branded as failure and failure is a long way from what they identify themselves with. Yet we only have to look at the list of those who have fallen prey to mental illness to see how close these two ends of the spectrum lie. From the brilliantly funny and talented Robin Williams who took his own life to Kurt Cobain, Ernest Hemmingway, Vincent Van Gogh and Virginia Woolf are just a few. In reality, peak performance is often knocking on the door of mental illness.
In this sense I see mental health as existing in a cyclical nature rather than on a continuum. We need to inhabit the right hand side of the cycle, moving back and forward from comfort zone, stretch zone and peak performance as we listen to our body and our mind, responding to the need to rest and refuel. Without this continual fine tune and awareness peak performance or even being stretched leads to the normal stresses of life becoming too much and tipping us over into mental illness. At this point it’s not so easy to pick up where we left off – we have to recover before we can perform at our peak again or even exist in our comfort zone. In the worst case, for those like Cobain and Williams, that recovery never happens.
The Cycle of Mental Health
We all face immense pressures which we cannot just get rid of, but we can be more aware of both in ourselves and others. We don’t generally swing from OK to mentally ill. There aren’t just two ends of a spectrum – we all pass back and forward through the cycle. If we compare it to physical health, we are not in hospital or running a marathon, there are a whole host of physical states in between. With the brain, which is the most complex organ of the body, those states cover even more shades of grey.
I’m passionate about being a voice and joining other voices to move our societal understanding of mental health toward the richness and complexity that inhabits life. To help society understand that there is no sane or insane, rather a constantly changing state of mental states, influenced by a complex set of external and internal factors. At a personal level, we not only need to understand this but learn to understand our own mental tendencies and weak spots, how to refuel, how and when to ask for help. We need to improve everyone’s understanding of behaviour so that we can not only destigmatize mental illness but so that we can optimise mental health and realise human potential across the human race.
The Myth of Sanity – was a title borrowed from the brilliant US Clinical Psychologist Dr. Martha Stout the book is below.
For more from me –
Mirror Thinking – How Role Models Make Us Human is available via the links below
Links and references:
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing
Murden, F (2018) Defining You: How to Profile Yourself to Unlock Your Full Potential
Stevenson, D and Famer, P (2017) Thriving at Work: The Stevenson / Farmer Review of mental health and employers
Stout, M (2002) The Myth of Sanity: Tales of Multiple Personality in Everyday Life