Rachel Tuchman

Given that this week’s 5TJT issue is all about health, I decided to deviate a bit from my typical Q & A format and instead write a more formal column on mental health. When speaking about mental health, people often assume they can skip over the conversation because they don’t have any problems (literally, impossible), are not in therapy, “don’t need therapy,” are not on psychiatric medications, or don’t have any formal mental health diagnosis. If you are a living, breathing human, you have mental health. Yes, you read that right, let me explain. We ALL have mental health, not everyone has mental illness though. Mental health and mental illness are not the same thing. It is important to know the difference between the two in order to properly care for our health as individuals and as a community.

Mental health is defined as our overall well-being. It is our thoughts, emotions, and social connections. It is also how productive we are, our ability to have relationships, and our ability to adapt to change and adversity. Mental illness on the other hand, affects the way people think, behave, and interact with others and themselves. With mental illness, individuals will have significant changes in their thoughts and behaviors. There is significant impairment in overall functioning and it is usually long term.

I find it most helpful to give the analogy of physical health and illness to help better understand the difference between mental health and mental illness. Just as we will all have some issues with our physical health at some point (maybe many points) in our lives, everyone will experience some kind of mental health issue. You may get a cold, have a headache, migraines, have back pain, pull a muscle, get strep throat, have an ear infection, vision issues, a broken bone, or sprained ligament. While these issues are usually not permanent, they definitely impact your life and can interrupt your daily living even temporarily. The same goes for mental health issues. Some events in our life like grief, divorce, being single in the Jewish community, infertility, losing a job, stress with your children, in-law tension, financial stresses, or friend drama can cause distress or upset to our overall wellbeing; this is a mental health problem (it is not the same as mental illness). I think it is safe to say that over the past three years of a global pandemic we have all certainly faced stress, fear, anxiety, or loss, among many other things. These are examples of mental health issues.

Not everyone will develop mental illness throughout the course of their lifetime though. Mental illness can be compared to any chronic medical condition like diabetes, MS, PCOS, arthritis, or high cholesterol. While it can add a level of complication (many things in life do, FYI) this does not mean people with mental illness will always struggle or fail in life. Mental illness can be managed with the appropriate care and support. Many people with mental illness diagnoses can live healthier lives than those without any mental illness diagnosis and they do! Just like you treat a physical illness or disease with medications and lifestyle interventions and it’s possible that you would never even know someone is affected by a chronic condition, we can do the same for mental illness.

Poor mental health can lead to mental illness much like leaving any illness/injury untreated can lead to more severe, complicated illness, but, just like chronic physical conditions, there are also many other factors that influence the development of mental illness such as genetics and environmental causes. There is no one cause for mental illness and it is not always the result of trauma, contrary to pop psychology’s current narrative. There are so many links and possible causes for mental illness that we cannot say it is the result of any one event or factor. That being said, it is important to deal with your mental health struggles so that they don’t progress into more serious issues.

Statistics tell us that 1 in every 5 adults may have some form of mental illness and 1 in 17 will have serious mental illness (like schizophrenia or an eating disorder). The occurrence of mental health issues and mental illness in the Jewish community are not any different than the secular world. There may even be underreporting due to lack of awareness and stigma so we may have even higher rates; we can’t know. Depression and anxiety are the most commonly diagnosed issues along with mood disorders like bipolar, personality disorders, trauma disorders, addiction, and eating disorders (which I speak and write about frequently because the Jewish community has a LOT of work to do in this area.) Being Jewish and religious does not exempt us from the realities of the human condition. We do not live in bubbles and it is naive to think, no matter how sheltered you, your family, or your community are, that you would be exempt from these very human challenges. If we could acknowledge and accept the importance of prevention rather than intervention in mental health, we would be far better off in the long run.

As a community, we should be normalizing and encouraging people to seek out help from licensed mental health professionals. It is irresponsible to neglect our mental health and think it will not negatively affect our physical health. We know that chronic stress is strongly linked to some of the leading causes of death in the United States: heart disease, respiratory disorders, cirrhosis of the liver, and suicide. Our world would be better off if we were less focused on calorie deficits and weight loss plans (which I am sure you have read a lot about already) and more focused on the actual factors that influence health starting with the many systemic issues that are barriers to people’s health and quality of life.

When we are sick, we go to a doctor to ask how to manage and treat our condition. We should be doing the same for mental health. There is no health without mental health. I know many of you have experienced physical symptoms when feeling emotional upset like a stomach ache, gastro issues, headaches, jaw pain, skin issues, joint pain, etc. The mind and body are deeply connected. Mental and physical health are one and the same. Our society is obsessed with pursuing health, often to the point that it is actually unhealthy and a lot of the time not even about health. We are always reading about the benefits of exercise (yes!) and taking care of our bodies nutritionally and while these are important contributing factors to health, there are many other more complex factors that influence our health.

We have to acknowledge that mental health matters and mental illness exists. We must do the work to remove the stigma from talking about and getting help for it. While the Jewish community has started this work, it is slow and still has a very long way to go. Removing stigma is the first step we take in helping improve our community’s health. Stigma is when you view something or someone in a negative way because they have something that you think is a disadvantage. We all hold stigmas and we should pause and reflect on them, where they came from, and how they are harmful. We remove stigma when we can talk about things openly. We gain more understanding, insight, knowledge, education, and empathy when conversations happen. When we can better recognize symptoms and issues and know the proper resources, then we can guide people to get the best help for themselves.

It is interesting that we encourage and sometimes even have campaigns for health interventions like blood drives, bone marrow donations, flu shots, and childhood vaccinations but we don’t have the same campaigns for mental health. Instead, we keep it silent because “It’ll ruin your sister’s shidduch,” or “He won’t get in to that yeshiva,” ugh. This needs to change. We need to encourage equality between mental health and physical health. We need to prioritize it like we prioritize doctor’s visits, the allergist, dental visits, and orthodontic work. We make Tehillim groups for people with cancer but we whisper or more often just fall completely silent when there is mental illness. It is possible to be open while still being private. Parents: please normalize therapy for your kids. Remove the shame. If they need help, don’t make it a shameful secret. Tell them how strong and mature it is to get help when you need it. Get help for yourself and tell your friends and family that it is a form of self-care. It happens to be that the phrase “My therapist told me…” is becoming much more common today which is really wonderful. My hope is that the conversations keep going.

I call on all of you who are reading this to go to the leaders in your community and be the leaders in your community. Create awareness campaigns, learn about and share mental health information and resources, encourage your local rabbi to stand up in shul and acknowledge and name the struggles that are occurring in your community. Let your circle know that therapy is not for the weak, it is for the strong. Very often we end up in therapy to deal with the people in our lives who refuse to go to therapy! Talking about our challenges in a safe and supportive environment can be so healing even if nothing actually changes on the surface. Language is how we connect, heal, learn, and grow. Emotional language specifically (like labelling feelings and experiences) helps build resiliency. When we can make sense of our feelings and adequately express ourselves, we can manage our emotions in a way that helps us get through them in a productive and healthy way.

I encourage all of you to take this information and redefine health. Instead of (just) salads and workouts, understand that health is more about the things that directly and strongly impact our mental health on a daily basis like the quality of our social connections, our spiritual connection, financial security, job security, a stable home, and feelings of safety and belonging. Learning more about mental health and mental illness allows us to show up better and more compassionately for ourselves, our loved ones, and our communities which is the real pathway to better health.

Wishing you all a year of TRUE health and happiness! n

 

Rachel Tuchman, LMHC, is a licensed therapist in private practice. She treats a variety of mental-health concerns and also shares psychoeducation via her social media platform, public speaking, and online courses. You can learn more about Rachel’s work at RachelTuchman.com and follow her on Instagram @rachel_tuchman_lmhc.

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