6.2: Challenges to our Mental Health

Although it is important to focus on reaching your full potential and embracing positivity, this does not mean you will not have challenges to your mental health. Many factors contribute to mental health problems, including:

• Biological factors, such as genes or brain chemistry
• Life experiences, such as trauma or abuse
• Family history of mental health problems
• Experiences related to other ongoing (chronic) medical conditions, such as cancer or diabetes
• Use of alcohol or drugs
• Having feelings of loneliness or isolation

Mental Health Statistics

Mental illness is very common. It is so common that more than 50% of Americans will be diagnosed with a mental illness or disorder at some point in their lifetime, with 1 in 5 Americans experiencing a mental illness in any given year. Mental illness does no just effect adults, 1 in 5 children, either currently or at some point during their life, have had a seriously debilitating mental illness. Mental illness varies in degree of severity from mild to severe with about 1 in 25 Americans living with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression.

The National Institute of Mental Health categorizes mental illness into two broad categories, Any Mental Illness (AMI) and Serious Mental Illness (SMI).

• Any mental illness (AMI) is defined as a mental, behavioral, or emotional disorder. AMI can vary in impact, ranging from no impairment to mild, moderate, and even severe impairment (e.g., individuals with serious mental illness as defined below).
  • In 2020, there were an estimated 52.9 million adults aged 18 or older in the United States with AMI. This number represented 21.0% of all U.S. adults.
  • The prevalence of AMI was higher among females (25.8%) than males (15.8%).
  • Young adults aged 18-25 years had the highest prevalence of AMI (30.6%) compared to adults aged 26-49 years (25.3%) and aged 50 and older (14.5%).
  • The prevalence of AMI was highest among the adults reporting two or more races (35.8%), followed by White adults (22.6%). The prevalence of AMI was lowest among Asian adults (13.9%).
• Serious mental illness (SMI) is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.
  • In 2020, there were an estimated 14.2 million adults aged 18 or older in the United States with SMI. This number represented 5.6% of all U.S. adults.
  • The prevalence of SMI was higher among females (7.0%) than males (4.2%).
  • Young adults aged 18-25 years had the highest prevalence of SMI (9.7%) compared to adults aged 26-49 years (6.9%) and aged 50 and older (3.4%).
  • The prevalence of SMI was highest among the adults reporting two or more races (9.9%), followed by American Indian / Alaskan Native (AI/AN) adults (6.6%). The prevalence of SMI was lowest among Native Hawaiian / Other Pacific Islander (NH/OPI) adults (1.2%).

Warning signs of Mental Illness

Not sure if you or someone you know is living with mental health problems? Experiencing one or more of the following feelings or behaviors can be an early warning sign of a problem:

• Eating or sleeping too much or too little
• Pulling away from people and usual activities
• Having low or no energy
• Feeling numb or like nothing matters
• Having unexplained aches and pains
• Feeling helpless or hopeless
• Smoking, drinking, or using drugs more than usual
• Feeling unusually confused, forgetful, on edge, angry, upset, worried, or scared
• Yelling or fighting with family and friends
• Experiencing severe mood swings that cause problems in relationships
• Having persistent thoughts and memories you can’t get out of your head
• Hearing voices or believing things that are not true
• Thinking of harming yourself or others
• Inability to perform daily tasks like taking care of your kids or getting to work or school

Coping Mechanisms and defense mechanisms

When confronted with something that is challenging to our mental health or stress, many people respond with coping mechanisms^[5] or defense mechanisms^[6]. The main difference between coping mechanisms and defense mechanisms is that coping is something you consciously do and a defense mechanism is often employed unconsciously. Both actions are intended to manage a situation that is creating a problem for the person.

When confronted with a challenge, people might consciously employ problem-focused, emotion-focused, meaning-focused, or social-focused coping mechanisms. Many of these coping mechanisms can be helpful, however people might employee maladaptive coping mechanisms which could lead to poor mental health such as using drugs or alcohol to avoid a problem.

Table \(\PageIndex{1}\): Coping Mechanisms

Coping Mechanism Category	Description	Example
Problem-focused	An individual focuses on solving the problem	Active coping, problem-solving, planning, restraint coping, and suppression of competing activities.
Emotion-focused	An individual aims to reduce the negative emotions associated with the problem	Positive reframing, acceptance, and humor
Meaning-focused	An individual uses cognitive strategies to derive and manage the meaning of the situation	Focus on beliefs and values to support well-being
Social-focused	An individual reduces stress by seeking emotional or instrumental support from their community	Reach out to people

Good coping skills include:

• Practicing meditation and relaxation techniques
• Having time to yourself
• Engaging in physical activity or exercise
• Reading
• Spending time with friends
• Finding humor
• Spending time on your hobbies
• Engaging in spirituality
• Spending quality time with your pets
• Getting a good night’s sleep
• Eating healthy.

Negative coping skills include:

• Using drugs
• Drinking alcohol excessively
• Engaging in self-mutilation
• Ignoring or bottling up feelings
• Taking sedatives
• Taking stimulants
• Working too much
• Avoiding your problems
• Being in denial.

Of the negative coping skills listed above, two of them are considered defense mechanisms, avoidance and denial. Defense mechanisms are psychological mechanisms aimed at reducing anxiety. They were first discussed by Sigmund Freud as part of his psychoanalytic theory and further developed by his daughter, Anna Freud. Often unconscious, defense mechanisms are used to protect an individual from psychological pain or anxiety.

Defense mechanisms include avoidance, repressions, regression, dispalcement, sublimation, reaction formation, projections, and rationalization as shown in the following Table.

Table \(\PageIndex{1}\): Defense Mechanisms

Defense Mechanism	Description	Example
Avoidance	Any behavior used to escape, distract, or avoid difficult thoughts, feelings, or situations.	Utilizing drugs or alcohol to numb feelings or making up excused to avoid attending social gatherings.
Repression	Unknowingly placing an unpleasant memory or thought in the conscious	Not remembering a traumatic event such as being sexually abused as a child.
Regression	Reverting back to an immature behavior from an earlier stage of development	Throwing temper tantrums as an adult when you don’t get your way
Displacement	Redirecting feelings or actions from the intended source to a safer, substitute target	Taking your anger towards your boss out on family members by yelling at them in place of your boss.
Sublimation	Replacing socially unacceptable impulses with socially acceptable behavior	Channeling aggressiveness into playing football
Reaction formation	Overacting in the opposite way to one’s true feelings.	Being overly protective of an unwanted child.
Projection	Attributing one’s own unacceptable feelings and thoughts to others and not yourself	Accusing your boy/girlfriend of cheating on you because you have thoughts about cheating on him/her
Rationalization	Justifying actions, thoughts, or unwanted outcomes with excuses or faulty logic	Blaming the teaching style of a professor for why you failed an exam.