Mental wealth: managing your mental health budget

#BlackMentalHealthMatters — Scroll down to the bottom of the article for Black mental health resources and material for mental health allies.

2020, so far, has been the year we faced a pandemic, authoritarian governmental abuse, senseless murders, wildfires, devastating floods, nationalism, and a global recession. If you look up “2020”, you will find countless articles and videos stating that “2020 sucks” or “2020 is a horrible year.” Some people call 2020 “the year that everything went wrong.”

While human beings are incredibly resilient, we have not been designed to endure the current levels of violence and insecurity. And there is only so much your mental health can sustain. We have a limited mental health budget. For some people, daily aggressions make this budget much smaller. If we want to be able to enact change and contribute positively, we need to manage that mental wealth carefully.

Whether you are feeling empty, exhausted, unable to withstand one more blow; or if you are feeling relatively fine but want to manage your mental health to be able to keep on contributing and address important issues, whether cultural, political, environmental, or medical; or if you want to be a better mental health ally—this article is for you.

N.B. I’m not a therapist. If you struggle with your mental health beyond heightened stress and anxiety during these difficult times, you should consider talking to a qualified professional. List of mental health local websites and emergency contact numbers »

Your mental health is a wallet

A useful metaphor is to see your mental health as a wallet: money comes in, money comes out. How much money is in there is how many adverse events you can experience while sustaining your mental health.

We unfortunately tend to only worry about our mental health during traumatic events, but there are many daily events which empty your mental health wallet, often without you realising it in a conscious manner. And these daily events are not equally distributed—some populations have a higher risk of experiencing these events. For instance, a low-income Black woman will encounter many more of these on a daily basis. These events, habits, and environments include:

• Negative use of social media. While many people think social media use is bad for mental health in itself, it’s actually a controversial research topic. Instead, recent research found that the ways people are using social media has more of an impact on their mental health than just the frequency and duration of their use, and that the benefits and harms associated with social media use varied across demographic, socioeconomic, and racial population sub-groups. In particular, the benefits were generally associated with younger age, better education, and being white, while the harms were associated with older age, less education, and being considered a racial minority. In the words of the researchers: “We know that education, income, race, and ethnicity influence people’s access to, and ability to act on, health information from the media, including the Internet. The concern is that social media may perpetuate those differences.”
• Microaggressions. Research shows that microaggressions have a negative impact on mental health, in particular in groups such as Black women (invisibility, sexualisation, and racial microaggressions leading to anxiety, depression, and trauma), people of colour in general (microassaults such as slurs, microinsults and microinvalidations such as how they got their jobs or where they were born), and people with a mental health illness (assumptions of inferiority, assumptions of coldness, using mental illness as an excuse, invalidating the experience of having a mental illness by doubting existence, doubting severity, and avoiding acknowledgment of the mental illness).
• Discrimination. Beyond microaggressions, studies found that prejudice and stereotypes such as belief systems, images, norms of the larger culture, institutional racism, or individual‐level discrimination have an impact on both mental and physical health.
• Urban life. Urbanisation and mental health do not play well together. Researchers have found that urbanites are 21%  more likely to have anxiety disorders and 39% more likely to have mood disorders. According to a 2017 meta-analysis, PTSD and generalised anxiety disorder have much higher rates in cities. Not to mention the long-term exposure to road traffic noise, ambient air pollution, and cardiovascular risk factors which elevate your levels and stress hormones and may result in much mental distress. Living in a city will empty your mental health wallet much quicker than living in the countryside.
• Money worries. Financial worries have been linked to mental health issues among university students, and about half of people in problem debt (who self-identify as “seriously behind” on payments such as bills, rent, mortgage or credit cards have a mental health problem. In general, financial difficulty drastically reduces recovery rates for common mental health conditions.
• Lack of sleep. Sleep and mental health have a chicken-or-the-egg relationship. Traditionally, researchers have viewed insomnia and other sleep disorders as symptoms of mental health disorders. But studies in both adults and children suggest that sleep problems may also directly contribute to the development of some mental health disorders. And if you look back at the few adverse events we just looked at—social media use, discrimination at work and daily life, road traffic noise, financial worries—it’s easy to see how they can prevent someone from sleeping well and sleeping for long enough. Over time, not getting enough sleep will take a toll on your mental health.
• Alcohol consumption. Drinking alcohol is associated with poor mental health. Regular, heavy drinking can interfere with chemicals in the brain that are vital for good mental health. In this study about alcohol consumption and mental health in a university setting, students with poor mental health or depression were more likely than their peers to be female, non-white, and from lower socioeconomic status families; as likely to report frequent and heavy drinking. (n.b. these two statements do not mean Black women are more likely to drink too much, they mean that students with poor mental health are more likely to be Black Women, and more likely to drink too much)
• Poor diet. Not eating well will also empty your mental health wallet quicker. “A very large body of evidence now exists that suggests diet is as important to mental health as it is to physical health,” says Felice Jacka, President of the International Society for Nutritional Psychiatry Research. “A healthy diet is protective and an unhealthy diet is a risk factor for depression and anxiety.”

These are just a few examples. In addition to these daily adverse events, traumatic events whether personal (losing a job, losing a loved one, long-term physical illness) or external (environmental, political, economic) also empty your mental health wallet in a more visible way. Ensuring you have a big enough mental health budget is crucial to withstand small or major adverse events.

Investing in your mental health

When it comes to managing your mental wealth, small investments can lead to big returns. While it can be difficult to find the mental energy to care for your mental health, which is why it is so hard to fight depression for instance, a little can go a long way. Here are some activities which will help you replenish your mental health wallet—they are all free and don’t require any special equipment or software.

• Journaling. Fewer stress-related visits to the doctor, improved mood, feeling of greater psychological well-being, reduced depressive symptoms, fewer post-traumatic symptoms: journaling has many science-based benefits. It can be used to reduce your anxiety or process traumatic events. Journaling is a personal experience—it’s about creating a space for yourself to examine your thoughts and emotions without fear of judgement. It doesn’t need to be long; it doesn’t need to be structured; and you don’t need a specific app for it.
• Exercising. Exercise is a powerful medicine. A large body of research in humans has demonstrated that consistent aerobic exercise (e.g. 30 minutes every day) induces positive neurobiological effects. A systematic review found exercise reduced depression and increased self-esteem in children. Whenever you are feeling stressed, anxious, or depressed, try to go for a short run to clear your head. It can be extremely hard to force oneself to put your running shoes on and go outside, but it will help you feel better.
• Talking it out. Bottling your feelings up will not help you process them. If you have a friend or colleague you are close to, talk things out with them. Ideally, find a person who is a good listener. Talking it out is not about receiving advice. Instead, it’s about having an ear to share what you are going through.

I haven’t included meditation in the list as it is unlikely you will be building a meditation habit while struggling with your mental health. These simple activities will help you come back to a mental health baseline, which will then allow you to explore more involved activities to further improve your mental health.

How to be a mental health ally

If you are in a position to support someone else with their mental health, consider applying these principles suggested by mental health writer Geetika Mantri:

1. Educate yourself. Take a bit of time to read about mental health, common adverse events impacting people’s mental health, and the different realities faced by different populations when it comes to mental health. Don’t limit yourself to purely scientific research: learn about the historical stigma around mental health and how it may impact people’s ability to openly communicate about it.
2. Emphasise. Listen with an open mind and without judgement. Do not be dismissive. Validate the person’s experience. As tempting it can be, do not jump to giving advice. Offer them a space to share.
3. Be mindful of your language. Avoid vocabulary such as “crazy” or “insane” which may dehumanise the person you are trying to help. A good resource is Self-Defined, a dictionary made by Tatiana Mac, which lists such derogatory terms and suggests appropriate replacements.

It can also be useful to be able to detect some symptoms of deeper mental health issues so you can encourage the person to seek additional help if necessary. I personally took a Mental Health First Aider certification, and I have a friend currently taking the Psychological First Aid course from Johns Hopkins University, which is free.

Black mental health resources

As you have seen in this article, people of colour and in particular Black people are more likely to experience adverse events which keep on emptying their mental health wallet. Black women specifically are at one of the highest risk levels when it comes to their mental health.

In fact, The Health and Human Services Office of Minority Health reports that African Americans are 10% more likely to experience serious psychological distress, and only 30% of African American adults with mental illnesses get help each year. And it’s not better elsewhere. In the UK, the admission rate for Black people is six times higher than average. Furthermore, according to Black Mental Health UK, people of African or Caribbean descent are 50% more likely to be referred to mental health services via the police than their white counterparts.

Because they’re at much higher risk, and because Black mental health matters, here are some resources specifically for Black mental health:

• Black Mental Health Matters
• Black Minds Matter
• Black Mental Wellness
• Black mental health matters: what does breaking the stigma look like?
• Therapy for Black Girls
• Therapy for Black Men
• Melanin & Mental Health
• LGBTQ Psychotherapists of Color
• Sista Afya
• The Safe Place

In the US, therapy costs an average of $80 to $200 per session. If you are in a position to do so, please consider donating to the Loveland Therapy Fund, which provides financial assistance to Black women and girls seeking therapy.