Mental health – its not all black and white.

Recently we ‘observed’ RUOK day – a day that is designed to encourage people to reach out to those around them and ask “Are you OK”? It seems like a great question to ask, but it can also be problematic. This is because mental health is not a binary concept – things are just not all ‘black or white’. There are many reasons why it may also be a challenging question to ask.

Mental health is not binary

People are not just ‘ok’ or ‘not ok’. Mental health is not so simple. Consider how many other ways people could describe their experience. There is perhaps a whole spectrum of ways to describe how someone is feeling, coping or managing beyond just ‘OK’/ ‘not OK’. What if the spectrum included ‘not ok’, struggling, just hanging in there, languishing ,being ok, doing great, and even blissful? What if you were rarely OK, but something so much more nuanced?

On top of this, it is useful to acknowledge that our state can shift. We are not fixed into a single ‘category’ of how we feel. Life doesn’t work like that. We have the ability to be so many things at different times, shades of grey on the spectrum of black and white of how we feel and how we are coping. We can freely shift as we respond differently to the moment to moment changes in our circumstances.

Selecting from the binary choice the question suggests may be difficult. Sometimes we are not OK, but not ‘not OK’ either. Sometimes we ‘languish’ (a term coined by sociologist Corey Keyes), where we are getting by but due to how we see things, we lack joy and feel aimless in what we do. We are not hopeless (heading further down to more depressed sense of experiences), but rather we are getting by but things are just ‘colourless’.

Another state is perhaps “just hanging in there” or surviving. This is that state of survival, when we have no bandwidth to think about how we ‘are’, but rather just focus on putting one foot in front of the other and just get by.

I know from my own experience that even over a short space of time during COVID lockdown I have felt a range of ‘states’. I felt like I was surviving, then struggling, sometimes I was languishing, not ok….then I was. When I experience a range of states and am not fixed as one thing, how do I answer the question if someone were to ask ‘Am I OK?’ How I am right now? Or how I think I am doing generally? Or perhaps how I think I am relative to what I think I should be?

Asking someone if they are OK also encourages people to evaluate their experience. If they are just ‘surviving’, then asking them to reflect on their state of experience might invite them to experience negative sentiments they were otherwise overlooking. It can also shift their focus from just ‘getting by’ to socially comparing themselves – How should they be feeling? When the answer seems to be that they should be feeling somewhat ‘better’ than they are, this can also have a negative impact upon their experience.

Therefore asking someone ‘Are you OK’ might actually make them feel worse.

For example, consider Lisa. She had an incredibly tough week. She had a run in with her ex, she had her car damaged in a minor incident, and had been subjected to some bullying behaviours at work. She admitted she didn’t want anyone to ask her if she was OK – because she wasn’t, and asking would only remind her of what she had just gone through and would have made her burst into tears. For her, she knew that ‘just getting through’ was all she had the bandwidth for, and any self reflection would have been unhelpful just then.

Asking the “Are you OK” question can also be challenging for the person asking it – what they ask and you honestly reply that you are not OK? It can be scary to open a box that you don’t know how to manage. People want to help, but the idea of you admitting that a you are not OK can provoke challenging moments for them too.

Perhaps this is why RUOK day is synonymous with well meaning Facebook and social media posts, and rarely anyone actually asking someone if they are OK in person or on the phone? Suggesting that you can ‘reach out of you are not OK’ is not really asking, is it? But this may be the most that people can commit to. Not everyone is trained to help, or wants to engage at that level, regardless of how caring or empathetic they are.

So what can we do?

• Ask a different question: instead of ‘Are you OK?’ Perhaps ask “regardless of how you are feeling, how can I help you do a little better?” Or ‘where can I help you find some extra happiness/joy/motivation right now”.
• Another question might be ‘tell my what is going OK for you right now – to get them looking towards more positive aspects of their experience.
• Being open to not being OK, but realising that you can be OK again soon. Realise that we all are flexible in our experience of the world, and can feel many ways about many things, even at the same time.
• Find the smallest first thing you can do for yourself or others to help you/them make the first shift to feeling better.
• Remind yourself of when you felt good, or even just ‘OK’.
• Take time to appreciate the small things that matter right now – being present in appreciation is a powerful way to help you refocus back from more negative ways of thinking.
• Don’t wait to be asked – people may not know how or may not be comfortable. If you feel that someone can help you feel ‘better’ then take control of going first and asking them to assist you.

So you may be OK, or maybe not. What you do next to change how you feel is entirely up to you.