What Is Actually Healthy? Part 1

 What Is Actually Healthy?

Recently, I’ve noticed how some people who have traditionally been defined as “healthy” have been making people around them “less healthy.”

According to the current cultural standards of health, people are generally considered healthy if they don’t qualify for a diagnosis, meaning they aren’t reporting painful feelings and aren’t engaging in behaviors seen as pathological.

And that’s all well and good. However, there are many things our diagnostic manuals don’t thoroughly account for, such as how people make OTHERS feel. When I am diagnosing, I typically am not sending assessments out to my clients’ friends and family to get their subjective experience of the client.

When we take a look at that metric, we can find more subtle ways that some “healthy” people infect others with mental illness, like asymptomatic virus carriers. Except, there actually are some symptoms. Here is a generic family case I might see:

-A teen boy having trouble in school, who spends too much time sleeping, gaming, and scrolling. Diagnosis: Major Depressive Disorder

-A hardworking and financially successful father who is very busy and doesn’t know his kids very well. He denies any symptoms of mental illness.

-A busy mother, either employed or heavily involved in the community and/or with her children, who spends lots of time helping/getting her kids do things. She denies any symptoms.

So, did this child’s depression arise from nothing? Maybe this kid just has a weird “chemical imbalance” that an absurd number of kids his age happen to have? It’s possible, but there’s an easier explanation that comes with gathering more data.

I learn that the father feels immense pressure to not only provide the basics, but to spend long hours away from his family to provide luxuries. He also gains a sense of validation from his work, which might compensate for a sense of failure in other parts of his life. This validation seems to be preventing a pending depressive disorder (which might hit during a midlife crisis, or soon after retirement). Right now, it’s COVERT Depression, the symptoms of which are felt by his wife feeling lonely, and his kids having a distant relationship with him, leaving them lonely and less-resourced. His guilt about this makes it hard for him to enforce healthy rules (like limits on screens). He also might have an unhealthy weight or diet, which we don’t tend to see as symptomatic of excessive stress for middle-aged men. (But it really is)

I learn that the mother often feels lonely in the marital relationship. It might not be tense, but it doesn’t feel intimate. And she feels that it is shameful to not be a super-busy woman in modern society, and for her kids to not be super-busy in the “right” kind of extracurricular activities. She maintains a high stress baseline, perhaps fueled by an unhealthy relationship with Diet Coke or chocolate chips. The symptoms of this Covert Anxiety? Kids that feel controlled and judged by their mother, a husband who feels criticized by her perfectionistic demeanor, and burgeoning arthritis or a migraine issue. 

So, who is “healthier” in this scenario? Are the parents healthy, since they don’t meet any DSM criteria? Could it be the son? Since he can actually identify his feelings and underlying sources of stress, whereas the parents may have immense trouble admitting the existence of their issues? Or is it the whole family that is sick, but the diagnosable symptoms are showing up in the child?

See Part 2