Mental Health vs. Emotional Health
We hear so much about mental health, but what about emotional health? Is there even a difference? If you're tired of that ubiquitous buzzword, hashtag mental health, it may be time to sort out the differences between issues of the brain and matters of the heart.
Mental health used to be known as mental illness until the stigma of the term rightfully led to a change in terminology. I tried to find out exactly when this happened, but when I searched Google for "when did mental illness become" it tried to finish my sentence with:
a social problem
Hmm. Finally I found a 2008 paper linking the origins of the term 'mental health' to that interesting institution, the World Health Organization. Uh-oh. Well, regardless of who invented it, we all know mental health is indeed a substantial problem in the modern era. Pharmaceutical companies want to medicate it, doctors want to study it, sufferers want to defeat it, and Big Tech and Big Government pay lip service to it while pushing products and policies that clearly worsen it. We've all heard that the government response to the COVID-19 pandemic, for example, has created a secondary wave of mental health problems whose effects will be experienced for decades, maybe generations, to come.
But what is mental health? According to the WHO again, mental health is "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community". Depression and anxiety are the top two of five common mental health disorders that interfere with those natural human goals, the list being rounded out by bipolar disorder, schizophrenia and dementia. Other types of mental health problems include personality disorders, which are more my bag: narcissism, psychopathy, borderline and other antisocial PDs, many of which are co-morbid with mood disorders like depression and anxiety.
One characteristic of mental health issues is that they affect the brain in ways that can be measured. We know very little about the brain as a whole, however, we are able to measure differences in brain chemistry, function and structure between people with clinical mental health diagnoses and those who do not report any symptoms of mental illness.
Often lost in the ongoing mental health conversation is the concept of emotional health, perhaps because in our metrics-oriented culture, what cannot be measured doesn't exist.
What about emotional health?
Right now, I'm finishing up the first draft of my book, A Narcissist Walks Into a Bar, about the sixteen years I spent in a Twelve Step Recovery fellowship. In the book, I talk about the vast amount of suffering in the rooms - not just among still-fragile newcomers, but old-timers who came to AA and similar fellowships for substance abuse recovery and stayed, but whose underlying problems went unrecognized even as they worsened, refusing to yield to the power of prayer and community. I was talking about this phenomenon when visiting a friend last week who told me that was all very well, but although she was not an alcoholic, her kids were driving her crazy. I looked over at my own children and was struck by a sudden feeling of unease. For a person with CPTSD, even one who is actively working on it, the chaos of being a working single parent of two strong-willed, combative children can just be too much. There are days I can almost feel my hair turning white. And then I thought of the line on Page 52 in the Big Book of Alcoholics Anonymous:
We were having trouble with personal relationships, we couldn't control our emotional natures, we were prey to misery and depression, we couldn't make a living, we had a feeling of uselessness, we were full of fear, we were unhappy...
Of course, the Book goes on to say we'd better find faith in God, and quickly, or these things will consume us. But it struck me that the AA model is describing not mental health, but emotional health, in this passage. Alcoholism, it theorizes, is a spiritual disease, and the spirit can be described as the inner world that is apart from the mind. But the Western focus, when dealing with distress, is always on the mind. What about the emotional aspect? Do emotions play a bigger role than we give them credit for?
Emotional health is how you deal with life
Emotional health, unlike mental health, is not that complex (or maybe we just don't talk about it enough to complicate it). It's defined as having both an awareness of your emotions and the ability to manage and express those feelings appropriately. Appropriate management of feelings is, of course, subjective, but the gold standard is efficacy: in other words, is the way you express and manage your emotions working for you, or is it negatively affecting your life? Emotional dysregulation is a hallmark of Complex Post Traumatic Stress Disorder, Borderline Personality Disorder, and all the Cluster B disorders, even NPD. It's often misidentified as strictly a mental health problem, but it's called emotional dysregulation for a reason. How we feel influences how we think and act in an endless feedback loop, so when we suffer from mood swings, rapidly fluctuating emotions and disproportionately intense feelings, it naturally affects our ability to cope with stress... which then gets labeled stress or overwhelm.
Feelings are the messengers we often choose to ignore. We may feel sad or angry or lonely or frustrated and fail to even recognize it. When emotions become too powerful to deny, the pressure is to escape by acting out or numbing out, or rationalizing away their existence rather than giving them space.
The good news is that it is possible to improve your emotional health, which in turn has a massive effect on mental health. It all starts with identifying your emotions. As Richard Grannon, British psychologist and CPTSD expert recommends, it all starts with learning to recognize your feelings - because if you don't, who will?
Tips for improving emotional health
If you suspect you have a mental health problem, it's obviously a good idea to seek professional advice. However, even if you go the route of of medications and therapy, it is still very useful to take a few moments each day to write how you are feeling. You can do this as a simple list of three: Write out three feelings you've had today. Then expand on those feelings: sad can become disappointed, anger may really be rage or frustration or annoyance, fear can be worry or obsession. Explain why you felt that way: what do you think caused it? What did that experience reminded you of? No one has to look at the notes but you.
When you do this consistently, you'll soon find yourself able to recognize kindled emotions before they become raging bonfires. You'll have a sense that your emotions are valid, they're trying to tell you something important, and you can take positive actions on them - like taking a break or connecting with someone you care about. There's no quick fix for improving your emotional health; the secret is consistent, self-interested action over time, as Grannon points out.
We are more than our minds. We are also our hearts - our feelings, emotions and intuitions. Don't let the world tell you otherwise.