Every living thing has some version of an instinct to stay healthy. Animals migrate to escape harsh weather, look for food and shelter, and generally avoid the things that hurt them. Humans aren’t really any different on the body side of that picture. But “healthy” turns out to be a much wider word than people usually give it credit for. The World Health Organization defines it like this:
“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
That second clause is the one that gets forgotten.
Why mental illness gets dismissed
One in seven adolescents lives with a mental health issue, and most of it goes unnoticed. The most common reason I hear is that mental illness isn’t a “real” problem. I don’t actually blame people for thinking that, because mental illness usually has no visible symptoms. Someone with anxiety, paranoia, PTSD, or schizophrenia can look completely fine on the outside while their inside is on fire.
Agoraphobia, the fear of being somewhere you can’t easily escape from, is a good example. To someone who has never felt it, it sounds like an overreaction. To the person living with it, it shapes which doors they walk through and which ones they don’t.
What’s actually happening in the brain
The word “mental” comes from the Latin mentalis, which just means “of the mind.” So “mental illness” is something wrong with the mind. The question I want to answer is whether that’s purely abstract, or whether something physical is actually happening.
The short answer is that something physical is always happening. The brain runs nearly every system in the body through hundreds of thousands of chemical reactions per day. Those reactions generate signals that travel through neurons, which are the functional units of the nervous system.
A quick anatomy detour. The brain has three main parts:
- The brain stem controls the involuntary things like breathing, and connects down to the spinal cord.
- The cerebrum is the part that does speech, emotions, judgment, problem-solving, and pretty much everything you think of as “thinking.”
- The cerebellum is the little brain at the back. It handles balance and the fine motor stuff.
Mental illness is, in current understanding, miscommunication between neurons. The miscommunication can come from chemical imbalances, from genetics, or from the environment. In Alzheimer’s disease, for instance, toxic build-ups of “plaques” and “tangles” damage neurons and break the signalling between them. The result is the memory loss and cognitive decline people recognize as the disease.
So mental disorders aren’t imaginary. They have measurable physical effects on the brain. Sometimes the direction even runs the other way: psychological conditions can cause physical symptoms without an obvious medical cause. That used to get called “hysteria.” It’s now better understood as psychosomatic or conversion disorders. The historical mass-hysteria events, like the Salem Witch Trials or the Tanganyika Laughing Epidemic, are extreme cases of the same underlying mechanism playing out in groups.
Why adolescents
I’m writing this as an adolescent. Mine is a stage of life full of transitions, and that’s the part that makes us especially vulnerable to mental health issues. Anxiety, depression, and OCD aren’t adult problems that occasionally happen to teenagers. They’re very often teenage problems first.
I experience anxiety attacks regularly. The racing heart, the vertigo, the nausea, occasionally the hallucinations. They’re real, they’re terrifying, and they get dismissed as overreaction or attention-seeking more often than I’d like to admit. There’s a small number of cases where someone genuinely is performing illness (Munchausen’s syndrome, for example), but those are rare. Most adolescents struggling with mental health issues are not performing.
When teenagers can’t talk about what’s happening inside their head, they internalize it, and internalized struggle tends to grow into something worse. That’s how depression and OCD show up. It’s also how it gets harder to ask for help the longer you wait.
Closing
I’m not going to pretend I have a fix. What I do think is that mental health needs to be treated with the same seriousness as physical health. The first move is to talk about it openly. The second is to listen when someone else does.
If you’re a teenager reading this and any of it sounds familiar, you’re not making it up.