I have been thinking about mental wellness over the past few days, in response to the idea that a patient might not accept a diagnosis and the role diagnosis plays in mental wellness. I’ve also been thinking about the concept of “reframing” that my therapist has me working on, and the concept of mental illness. I wanted to try to reframe the idea of mental illness to approach it from the perspective of mental wellness instead.

Western medicine, in my experience, is very reactive. In recent years there has been a push, usually as a result of insurance companies trying to save money in the long run, for preventive care and general physical wellness. There has been no obvious mental wellness push, even though the effects of mental illness are devastating and extreme interventions are costly.

I was 14 when I first became symptomatic with my first major depressive episode. I was an intensely private person with a lot of anger and resentment, and I had a real drive to “fix” my problems on my own. Like many other people facing issues of mental illness, it took hitting an absolutely impervious wall for me to understand that my problems with depression and instability, with anger and anxiety, were not issues I could “fix” on my own. Without any support or help from my family, I privately sought out counseling through a school program. While generally unsuccessful at the time, it did get me on the road to insight, which is really necessary in order for any patient to be an educated and accountable partner in their mental well-being.

In the following series, I want to explore the concept of diagnosis, the role it has played in my life, the conundrum of misdiagnosis, and patient rejection of diagnosis. I will discuss denial, the idea of kindling, and the progressive and cumulative nature of mental illness. I also want to cover medical interventions, treatment, adherence to a treatment plan, hospitalization, compliance vs. adherence, and the role of stigma. Finally, I want to discuss personal accountability in mental wellness, the difference between accountability and self-control, treatment resistance, and our responsibility as patients.