I had an interesting conversation with my sister yesterday. I hope she won’t mind me sharing.

Somewhere in the middle of the conversation I mentioned the physical pain that comes with mental health. She expressed surprise that it actually physically hurt.

I explained that yes, sometimes my entire body aches for no reason. And because at that precise moment your brain is not working properly, and because we are trained to think of mental health as a mental issue, you forget to take pain killers. Because the pain is all in your head right? Except pain killers do work in these situations. And it is no surprise that sometimes pain killers are over used to numb the pain.

And of course that is why so many people with mental health issues turn to alcohol, drugs, food, etc., to help ease the pain. The advantage is that these not only take the physical pain away but they also can take away some of the dark thoughts and mental pain. If only for a short time.

Sometimes the physical pain is connected with your body tensing up at stress, or linked to physical exertion, that would normally have not been tiring, but now feels like carrying bricks. However often times it strikes for no reason or in reaction to a psychological stress.

There is a fundamental misunderstanding – that for mental illnesses the cause in mental. That your thoughts do not work properly and that causes you issues. Little wonder that so often the advice given is to man up, pull yourself together, get in the sunshine, cheer up, look at everything you have to be happy for, some people have it much worse than you.

Fundamentally these do not work and there is physical pain, because for many, if not most (or confirmed as yet all of us), mental illness is a physical, physiological illness. The mental aspects are symptoms not causes of poorly understood physiological problems in our bodies.

I explained to my sister about the Fight or Flight or Stress response to stress and how that is a natural process. But if your body stays in a heightened fight or flight response for a prolonged period of time, that is unhealthy. That your body finds it difficult to return to equilibrium. Like a diabetes where the body has lost the ability to control blood sugar levels.

The stress response gets both your mind and your body ready to deal with risky situations. Spend too long in that state and what is sometimes referred to as your lymbic system breaks. Your mind and body can no longer cope properly with either stressful situations, or in fact normal situations.

The stresses can sometimes be purely mental in that they are psychological stresses rather than physical. But the body’s reaction is physiological and the same mix of hormones.

So physical symptoms are common. Chronic tiredness, pain, inability to sleep, weight gain or loss, headaches and the physical symptoms of panic attacks.

For many treatment such as Cognitive Behaviour Therapy can be very effective. But it is often only treating the mental symptoms, not the underlying physical (or even mental) cause.

Anti depressants generally work indirectly to repair the broken systems. Providing a platform for the body to repair itself. But that does not always work either.

I would like to think that as much as I did not understand how horrific having depression is, that when I was younger, I at least appreciated that mental illnesses often had a major physiological underlying cause to them. That taking medication is no failure, any more than taking insulin is for diabetes. That you cannot magically cure yourself by will power and positive thinking alone.

Which brings me back to my post of two years ago, when I had been diagnosed with stress and anxiety and before I had a diagnosis of clinical depression and started taking anti-depressants:

The distinction between Mental and Physical illness is unhelpful at best