How Mental Health Is Defined and Maintained

Most of us can discern signs of mental illness when we observe them. Mental illnesses manifest in behaviors that do not appear normal, and which can sometimes cause a risk of harm to self or others.

Speech or actions might be inappropriate to the context or environment. Social cues might be unrecognized. Moods may be volatile and disruptive. Perhaps there is a loss of reality testing or a loosening of associations and a person becomes psychotic.

We can detect these signs of mental illness because they are outside of our expectations of what is normal. Granted, definitions of normal are highly contextual and ever-changing. But we still recognize mental disturbance when we see it or feel it in our midst.

What Is Mental Health?

Identifiers of optimal mental health can be less recognizable and harder to define than signs of mental illness. Let’s start with the CDC’s definition of mental health: Mental health is the component of behavioral health that includes our emotional, psychological, and social well-being. Mental health is a state of well-being that enables us to cope with the stresses of life, realize our abilities, learn well and work well, and contribute to our community.

Suppose we break this down and expand it from a psychological and behavioral perspective. In that case, we establish these indicators that a person is functioning in life from a relatively positive state of mental health:

• They maintain a stable, consistent sense of identity and personality.
• They can self-regulate their emotions.
• They can express thoughts and emotions appropriately according to social environment or context.
• They have agency and can work toward productive, goal-directed actions.
• They consider the rights and needs of others and not just their own.
• They can introspect and correct course when necessary.
• They can tolerate mild-to-moderate levels of stress, pain, grief, and uncertainty without experiencing a psychological crisis (e.g. psychosis, intense suicidal urges, severe substance abuse disorders).

It is important to recognize that mental health is not simply the absence of mental illness, but the ability to continue functioning and even flourishing in the presence of the expected and unexpected difficulties of life.

Mentally healthy people are not in a constant, subjective state of happiness or well-being. This would require being emotionally disconnected from legitimate, inevitable experiences of grief, fear, disappointment, boredom, sadness, or loneliness.

These are biologically wired emotional responses to internal and external conditions. No one in the world is spared; we are all subjected to some degree to threats to our well-being. Mentally healthy people do not unrealistically claim control over painful events and circumstances or deny their impact. They maintain the capacity to experience strong reactions that some might call negative emotions.

The distinction is that these emotions do not pervasively or permanently overtake a person’s sense of self, or ability to function and care for themselves. They can maintain and find strength in connections with people close to them.

An Analogy From Music

Suppose a guitar is found in an attic. It has been left there for 20 years. The wood is parched and warped from two decades of changing temperature and humidity. The neck is out of alignment with the body. Some strings are broken and the others are hopelessly out of tune. The instrument has great value but is unplayable in that condition.

Once found, a musician begins to restore the guitar. She straightens the bent neck and resets the bridge. She lubricates and polishes the wood and metal parts. When all is clean and restored, she carefully installs shiny new strings.

Now it is time to tune the guitar. Using an electronic tuner, she adjusts each tuning peg until the frequency of each string lines up with the center line on the tuner. The flat notes are raised and the sharp notes are lowered until the entire guitar is in tune with itself. When in tune with itself, she knows it will also be in tune with other instruments tuned to the same point of reference.

The neglected guitar is a picture of those suffering from mental illness. Broken parts need healing and care. Unhealthy, unsafe environmental conditions must be replaced by conditions where they can become well. Perhaps new tools, like the new strings, must be applied so they can function and find their purpose again.

Once they are well, they can be tuned and can gain the ability to tune themselves. This is a state of ongoing mental health—the ability to tune oneself.

No one stays in tune constantly, even the most mentally healthy among us. Life can throw us all off daily. Constant self-awareness and adjustment are necessary. We must listen to our souls to keep them well.

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Those who are psychologically well come to know their center of reference and can bring themselves back in line with it when they see they have veered off to the right or left. Sometimes this requires the support of medication, therapy, or other professional or spiritual intervention, and there is nothing shameful in that.

The important thing is detecting when we’ve become out of tune and using every tool at our disposal to get back to center.