Will Berard is a stand-up comedian who lives with MS. In the first in a new series of blogs on mental health and MS, Will urges us all to value our mental wellbeing as much as our physical.
As our society has become more aware of mental health issues, an important concept has come to light: that of parity of esteem. That is, “valuing mental health equally with physical health”: not only by health professionals, but also by peers, employers, and the general population.
A common illustration of the principle (and of the road left to travel in order to achieve parity of esteem*) is to compare the reaction one would get, at work, when showing up on crutches with a broken leg, to the one caused by a mental health diagnosis.
But esteem, whatever form it may take, is not the sole realm in which there’s a disparity between mental and physical health. In fact, the disparity of esteem itself stems from a disparity of understanding, which in turn originates from a disparity of descriptibility.
For instance, when my MS manifests as a physical symptom, it is easy for me to describe it with precision: I can say I have paraesthesia in my left arm, particularly in the extremities, I can zero in on the particular set of nerves involved (in this instance the ulnar nerve) and even attempt to trace it back to a particular lesion based on my latest MRI. Compare this with my MS flaring up with a mental symptom. If I say I’m experiencing anxiety, it’s not saying much at all. Am I apprehensive, fearful, stressed, or worried? Is it a diffuse sense of anxiety, or does it have a particular object? Does it manifest in physical symptoms (dry mouth, palpitations, tremors), or is it a more abstract, intellectual fear?
We lack the categories and the vocabulary to describe mental and emotional symptoms with the same accuracy as physical ones. This is a fundamental problem: if you lack the words for colours, you cannot be expected to describe a rainbow, let alone paint a picture of one. As in my post about fatigue, this is not an issue specific to mental illness, or indeed mental health symptoms in MS. The ramifications of the difficulty of describing emotions in language span far and wide, as any relationship counsellor will attest.
But as far as we people with MS are concerned, it is, here again, all the more salient. I wanted to start with a post on this before going into individual mental health symptoms of MS, because the description and classification of those symptoms very quickly hits upon a shortcoming in language itself.
Physical anatomy is an objective classification: we can unambiguously distinguish the Ulnar Nerve from the Median Nerve. But the anatomy of the mind and its processes is mapped with language, so the boundaries and descriptors are necessarily going to be arbitrary, especially when compared to the scientific precision of anatomical diagrams.
It is worth bearing in mind that psychiatry is a relatively new science, to the extent it even is one at all, and that the job of mapping the mind (the psyche, the spirit, the soul) with language was for centuries the remit of priests, gurus and shamans. Nowadays psychiatric symptoms, disorders, and their classification are the remit of official bodies with acronyms (APA, WHO), and the maps, drawn using statistics, bear such cryptic names as DSM-5 and ICD-10. For all their outwardly scientific language, those maps can be as hermetic to the layman as the most mystical of sacred texts.
If the message of my previous piece was to listen to, or indeed try to better understand, your body, here the takeaway is to develop a knowledge, a language, a map of your psyche, so as to have better insight on your mental health symptoms, and your mind in general. The methods to achieve this are numerous, ranging from spirituality to therapy, and mindfulness to self-help, just to name a few. They are by no means mutually exclusive, in fact combining them yields better results, and gives a wider perspective, than sticking to just the one.
If an unexamined life is not worth living, is an unexamined mind worth living with?
*For an insightful take on parity of esteem listen to Will Self on A Point of View.
*These are Will's views and not those of the MS Trust*
