• Claire Higgins

Defining Key Terms in Mental Health & Wellbeing

Updated: Oct 24, 2019



This blog entry is the second in a series on Sport, Exercise and Physical Activity for Mental Health and Wellbeing. If you missed the first entry please check it out here.


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Before diving into the benefits of sport, exercise and physical activity for mental health and wellbeing, it's important to first understand what we mean when we talk about mental health and wellbeing. What do these terms mean and why do they matter so much in life and work today?


Defining Mental Health


The World Health Organisation (WHO) describes mental health as "a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community."


Other organisations have their interpretation. The UK's Health Education Authority describes it as having "the emotional and spiritual resilience which enables us to enjoy life and survive pain, disappointment and sadness. It is a positive sense of well-being and an underlying belief in our own and others' dignity."


The Mental Health Foundation considers a person to be in good mental health if they can make the most of their potential, cope with life, and engage with family, friends, community, and the workplace.


There is a common theme among these definitions of coping with stress in a productive way and maintaining significant relationships when it comes to good mental health. In terms of the absence of mental health, this is usually referred to as "mental illness" with clinically defined terms to describe what people may be going through, such as:


Anxiety: "an emotion characterised by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat." American Psychological Association (APA)


Depression: "a common mental disorder, characterised by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration... It can be long lasting or recurrent, substantially impairing a person’s ability to function at work or school, or cope with daily life. At its most severe, depression can lead to suicide." World Health Organisation (WHO)


Schizophrenia: "a severe long-term mental health condition. It causes a range of different psychological symptoms. Doctors often describe schizophrenia as a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality." National Health Service (NHS)


While mental health includes elements of physical, mental, emotional, and spiritual wellbeing, mental illnesses include significant changes to psychological and/or physiological functioning that are defined in clinical and diagnostic terms. A person struggling with a mental illness may require medication and/or non-medicated support such as psychotherapy or counselling.


Mental illness may be temporary and possible to overcome with the right support. It can also be a life-long situation that a person may need to accept and adapt to. Wellbeing on the other hand has been a related field of enquiry with researchers and psychologists discussing and dissecting what makes a person "well". It is both a component of mental health and a lifestyle practice that returns us to better health, furthers our resilience to mental illness, and might even prevent such illness from occurring in the first place. But how might we define it?


Defining Wellbeing


Dodge et al. (2012) refer to two well-researched approaches, hedonistic wellbeing and eudaimonic wellbeing. These have been spoken of, debated, and practiced since the time of Aristotle in ancient Greece. You could say hedonistic wellbeing is about happiness and life satisfaction while eudaimonic wellbeing is about positive psychological functioning and human development.


Both of these approaches to wellbeing could be narrowed down to feeling good and doing good but as researchers explain, it isn't so simple as either-or. By the 1970s, people and workplaces began to speak of "quality of life" and checklists of what made a life of quality began to emerge. While these were perhaps helpful in large data collection for the purpose of analysis, what was lacking was the human dimension. How did (and do) people define their wellbeing? Is a questionnaire really able to capture that?


Of the many models of wellbeing that exist, there are two that I'd like to focus on here. The first is a theory developed by Mihaly Csikszentmilyi (2004) on achieving flow.


Diagram 1: Flow Channel (Csikszentmihalyi, 2004)



Csikszentmihalyi suggests that people can develop the skills or resources they need to perform at an optimal level. Performance and wellbeing are linked here. When a person is sufficiently challenged and has the right level of skill for the task at hand, they are likely to enter the flow channel. Flow is described as a state of full immersion into and energisation from a particular task.


A person in flow or "in the zone" enjoys what they are doing and loses track of time due to their level of absorption. But if the challenge is too great and skills required absent, they may feel anxious (note: this is a passing feeling and not a state of mental illness). If the challenge is too low and skill set relatively high, then the person is likely to feel bored.


The flow channel theory is one that matters to people at work. Ensuring staff members are adequately trained to perform and sufficiently challenged on the job is one of the core functions of a good manager and positive organisational culture that encourages its staff to reach for their very best. Yet as any manager knows, achieving this can be easier said than done. For now, let's park the reality of making this happen and move onto the second theory, PERMA, or the "science of wellbeing" (Seligman, 2011, 2018).


Video 1: Professor Seligman on PERMA



PERMA is an acronym from Positive Psychology that stands for Positive Emotions, Engagement, Relationships, Meaning, and Achievement. When a person experiences more positive emotions than negative ones, has opportunities to engage in enjoyable tasks and experience "flow" by using their natural strengths, has largely positive relationships, finds meaning in life and/or work, and feels a sense of achievement, then they are more likely to "be well."


PERMA is both an approach to flourishing in life and an interesting model for the workplace to draw on when it comes to staff wellbeing. It offers areas and markers that managers and HR staff can look at when exploring and evaluating how much of a positive environment the company or organisation is creating for their staff, and how staff members may feel about these areas of their own lives and work in return.


Environmental Effect on Wellbeing


The wider environment both in and beyond work can also have a significant impact on a person's mental health and wellbeing. Someone who is not in control of where and how they live and work, or perceives that they lack control or influence over where and how they live and work, is less likely to "be well". Sometimes they may have contributed to this state through learned behaviours that don't serve them, such as learned helplessness (experiencing negative events as permanent, pervasive, and personal) and catastrophic thinking (expecting the worst). Other times they may have walked right into a negative place and found their optimistic outlook waning.


A toxic environment in any domain of life or work can drag even the most positive of people down. Repeat exposure to this type of negativity can eventually wear a person out. Take for example a woman experiencing physical violence at home who is unable to leave, or thinks she is unable to leave. She may still be performing well at work despite the stress at home or take pride in her mothering abilities but how well does she feel inside? And what makes her feel that she cannot walk out? Is it due to an environmental factor (social), financial lack (resources), absolute fear (emotion), or a learned pattern of thought and behaviour that she doesn't deserve more?


Another example where someone may feel trapped by their environment is a worker with a bully for a boss. What limits that person from re-asserting their position and dignity at work? Is it that the workplace allows for such behaviour and a culture of normalisation surrounds it? Are there no staff protection policies in place or accountability for inappropriate behaviour? Is it that the worker lacks the skills and confidence needed to stand up for themselves in confrontational situations and put an end to being abused? Or perhaps it is that the person expects dysfunction in their environment due unhealthy patterns acquired in the past?


Why Mental Health and Wellbeing Matter


Mental health, mental illness, and wellbeing as definitions and theories are relatively easy to grasp. They are much more complex to grapple with in reality. What is much more difficult than awareness and superficial understanding is getting and keeping people (and ourselves) in sound mental health and a state of positive wellbeing. What works for one person may not work for another, and some people have greater access to inner and outer resources than others.


If you have ever experienced a challenging phase in your mental health and/or wellbeing, you will likely understand why creating, achieving, and maintaining positive mental health and wellbeing matters in life and work today. It is only when we struggle that we realise what a profound effect they have on our overall performance in life and work. But one of the gifts of having struggled is that we tend to be more humble afterwards. We understand that reaching the other side is a personal process and nobody can be hurried along.


There are benefits to getting and staying well. When we are well and in sound mental health it is easier to process our thoughts and emotions with more clarity and accuracy. This helps us to make better decisions and develop healthier coping strategies. With positive mental health and wellbeing, our responses to life and work are often more effective. While we might not always have the answers or means to change our situation, and while we may continue to experience adversity and tragedy along the way, we will better cope with these situations and become more resourceful in our responses. When we have recovered and feel resilient enough, we might even be able to pass those insights and support strategies onto others.


Over the coming weeks, I'll be I'll be looking at research-driven and evidence based approaches to being and staying well through various kinds of movement and social connection. I'll also be looking at ways to recover and bounce back from difficulties, setbacks, failures, and adversities using sport, exercise and/or physical activity as positive anchors. These aren't the only ways to recover from mental illness and a lack of wellbeing but they do offer an approach that serves our overall physical and mental health. They also happen to be the areas I understand best!


I hope you'll be able to join me in these virtual conversations. Whether you are new to the topic of mental health and wellbeing or a seasoned practitioner in these fields, I would love to connect and hear your thoughts on how sport, exercise and physical activity can make a positive difference to people's lives and performance at work.


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This blog entry is the second in a series on Sport, Exercise and Physical Activity for Mental Health and Wellbeing. If you missed the first entry please check it out here.


References


Dodge, R., Daly, A.P., Huyton, J., Sanders, L.D. (2012). 'The challenge of defining wellbeing.' International Journal of Wellbeing, 2:3, pp. 222-235.


Seligman, M. (2018). 'PERMA and the building blocks of wellbeing.' The Journal of Positive Psychology, 13:4, pp. 333-335.


About Inner Athletics


Inner Athletics is a research, coaching, and training company based in the UK. Our purpose is to bring research-driven and evidence-based interventions and support strategies on performance, stress, and recovery to athletes, coaches, and executives.


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For those of you who are working (or plan to work) in health, fitness, sport, coaching, training, or any other related domain, I invite you to check out an upcoming course I'll be leading at the Positive Psychology Network on Train the Trainer (ToT) Mental Health First Aid and Wellbeing. This course will touch on exercise and physical activity and so much more. You'll learn how to identify mental health risks, create psychologically safe spaces at work, and teach others to harness their personal strengths to create positive wellbeing strategies for themselves.

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