of change and uncertainty.
Both Mind and the World Health Organization's definition of mental health refer to a person's wellbeing. But is wellbeing the same as wellness?
When you think about wellness, think prevention and health. When you think about well-being, think happiness.
Susie Ellis. Chair of the Global Wellbeing Institute
Certainly, happiness is important, but there is more to wellbeing than the positive feelings that come with happiness. Both WHO and Mind recognize that wellbeing involves not just happiness, but crucially, the ability to manage difficulties, problems, and challenges; the ‘normal stresses’.
In 2012, Cardiff Metropolitan University Professors Rachel Dodge and Annette P. Daly et al. published their report The Challenge of Defining Wellbeing. Having reviewed and analyzed past attempts by other researchers to define wellbeing, they concluded that ‘it would be appropriate for a definition of wellbeing to centre on a state of equilibrium or balance that can be affected by life events or challenges’. Consequently they define wellbeing as: ‘the balance point between an individual's resource pool and the challenges faced’.
In other words, wellbeing occurs when a person is able to enjoy life and has the resources to draw on to manage life's ups and downs without feeling overly stressed. Therefore, an important component of wellbeing is resilience; the ability to cope with, as well as bounce back and recover from, difficulties and challenges.
Dimensions of Wellbeing; Social and Spiritual
There is no health without mental health.
World Health Organization
One of the key aspects of mental wellbeing is our social wellbeing; the ability to build and maintain good relationships with others. Social wellbeing is the extent to which you feel a sense of belonging and social inclusion. The UK Faculty of Public Health suggests that social wellbeing is ‘the basis for social equality and the antidote to issues such as racism, stigma, violence and crime’ and that it is dependent on, amongst other things, ‘the norm with regard to interpersonal relationships in a group, community or society, including respect for others and their needs, compassion and empathy, and authentic interaction’.
Another feature of wellbeing – just as important as social, mental, and emotional wellbeing, but not so widely acknowledged – is spiritual wellbeing. Spirituality refers to a sense of being connected to something bigger and more everlasting than yourself.
Spiritual wellbeing means the ability to experience and integrate meaning and purpose in life through a person's connectedness with self, others, art, music, literature, nature, or a power greater than oneself.
Spiritual wellbeing is about our inner life and its relationship with the wider world . . . Spiritual wellbeing does not just reflect religious belief although for people of a religious faith it is obviously a central feature.
Dr Ritika Srivastava
Physical and Mental Health and Wellbeing
Distinctions are often made between mind and body but when it comes to mental health and wellbeing and physical health and wellbeing, we can't think of them as separate entities. Poor physical health can lead to a person developing mental health problems. And poor mental health can have a negative impact on our physical health and wellbeing.
A physical health problem can impact on our cognitive and emotional abilities; adversely affecting our daily lives, our work, and our relationships. Conversely, if our mental health is suffering as a result of, for example, stress, depression, or anxiety, we are less likely to eat and sleep well and may be less physically active which, in turn, can impact our immune system and so our ability to resist infections and illness can be depleted.
Just as when we neglect and ignore our physical health we can become physically unwell, it's also the case that if we ignore or suppress difficult feelings we can become physically unwell.
When we are exposed to stressful experiences or trauma, we can, without realizing it, banish the experience to the unconscious; it's too much to deal with and it's pushed down to the basement of our minds. Eventually – sometimes years later – the stressful/traumatic experience can present as a mental health problem, for example an anxiety disorder. But a stressful or traumatic experience can also manifest itself as a physical disorder.
Case Study
One evening, Catrice was reversing her car into into the garage, when she heard a scream. She had reversed the car over her partner, Julie. Unknown to Catrice, Julie was sitting on the floor at the back of the garage, fixing her bike. Horrified and shocked, Catrice called an ambulance and Julie was taken to hospital. Although she had sustained serious injuries, they were not life threatening and in time, Julie recovered. However, a week after Julie's admission to hospital, Catrice developed a weakness in her lower limbs. Eventually she found that she was unable to stand; each time she tried, her legs gave way from underneath her.
Following weeks of tests, x-rays, physiotherapy assessments, and orthopaedic referral, Catrice's GP, believing that she was experiencing a ‘somatic response’ – a physical response to an emotional trauma – referred her to a psychotherapist.
Catrice had blocked the feelings – the trauma, stress, and guilt – she experienced as a result of Julie's suffering but those blocked feelings had manifested themselves as physical symptoms. With support from a psychotherapist, Catrice recovered; she was able to forgive herself for the pain and suffering Julie had been through as a result of her actions.
People with mental health problems are more likely to develop physical health problems and vice versa. Furthermore, people with mental health problems can present to their GP or employer complaining of physical symptoms that have no physical cause. This can sometimes lead to missed or delayed detection of the underlying mental health problem. The interaction between physical and mental health is complex and it is often difficult to determine the direction of causal relationships.
Professor Dame Carol Black
In the same way that the repression of stressful experiences can become a physical problem, physical health can impact on our mental health.
Psoriasis – an auto-immune condition affecting a person's skin – is an example of a condition which can impact on mental as well as physical wellbeing. A 2010 study published in the journal Archives of Dermatology found that those living with psoriasis are a third more likely than people without the disease to be depressed or anxious. The physical and psychological impacts can be cyclically linked: the condition can cause emotional distress which can trigger a psoriasis flare and, as a result, cause further distress.
Wellbeing is Subjective
A myriad of factors influence health and well-being, though many are familiar only to those who experience them.
Professor Dame Carol Black
Although there are key aspects to wellbeing – physical, mental and emotional, social and spiritual – wellbeing is subjective; each and every one of us has our own individual thoughts and beliefs about what makes for wellbeing. Our thoughts, ideas, beliefs, and experiences are framed in a narrative – we each have our own story – our own explanation or account of our wellbeing
