Distress is not illness

Written by Carolyn Spring
05 May 2017
Distress is not illness

I’m not comfortable with the term ‘mental illness’.

I know there’s a lot of rhetoric around ‘parity of esteem’ for physical illness and mental illness, and that’s why the term has been pushed to the fore. But for me, mental illness and being traumatised are two different things. One is a malfunction, a disease – something that has gone wrong in the brain, such as dementia. The other is the way that our brilliant brains have adapted to something that has gone wrong in our environment.

If I hadn’t been abused in the first place, I wouldn’t have developed a dissociative disorder. Simples. There has never been anything wrong with my brain.

And yet I am full of paradox, because I don’t mind the term ‘disorder’. When I look at how life was for me after my breakdown, my life was very much disordered, and I wanted it to click back into straight boxes. It was unbearable to live like that. Suffering drizzled out of me day and night.

But I wasn’t ill. I was just distressed.

It’s a strange thing that as a society we pathologise sadness and hurt and fear. On the one hand, yeah. Because when life is disordered, let’s not pretend that we were meant to live like this – terrified of eating, terrified of trees, of dogs, of people, of new places, of anything and everything that ever resembled our original trauma. That gut-gripping terror is not how life is supposed to be.

But on the other hand, do we tell people they’re mentally ill so that we can euphemise their pain? This isn’t someone – we say – who’s distressed because she’s lost her family, her children, her very life. This is someone who’s ‘mentally ill’. Puts the emphasis on something being wrong with her, doesn’t it? And takes the pressure off us to be compassionate – to sit with her in her suffering, to mourn with her, grieve with her, protect her, sustain her.

People talking about mental health is a great thing, because everyone has mental health, and we shouldn’t be surprised when we have big emotions when big things happen to us.

It doesn’t worry me when someone responds to the death of their child with vehement emotions – when they can’t stop crying, or they’re too numb to cry, when they can’t sleep or eat, or they can’t stop sleeping or eating. It’s normal that our natural, bodily and mental mechanisms go awry after such an enormous event. Of course they should. It’s our grief speaking.

It’s more worrying when we think that they should ‘act normal’ and contain our emotions into a narrow tube of socially acceptable behaviour. If we love deeply, we will hurt deeply. Our feelings spray out of us like watercolours depicting our experience. Of course we feel feelings when we are hurt: big feelings, overwhelming feelings, feelings that we never knew we had, feelings that we don’t even know are feelings and transmute into somatic symptoms. Feelings are meant to be felt. Let’s not call them mental illness.

Being distressed by distressing events is normal. Being traumatised by trauma is normal. Calling someone ill when they’re being normal isn’t normal. Surely?


  • ffraid9 on 5 May 2017 at 1:38 pm

    I used to think there was something fundamentally flawed with me, caught up as I was in a maelstrom of emotions I did not understand, reactions I did not understand, a depth of pain which seemed excessive for my gentile middle class upbringing. Then a friend kept nudging me over the past 3 years, that I had clearly been traumatised.
    After 10 months of therapy, I can truly say ‘yes, I was severely traumatised as a child’, coping the only way a child can (and mercifully can), by dissociating. I do not have an organic mental illness. I have been injured. My pain is down to those who have injured me, not something inherently wrong with me. This has been so, so liberating to realise.
    The other truly liberating, healing event was coming on your day on child sexual abuse in Nottingham. You gave me hope – which is one of the greatest gifts that can be given to a traumatised soul.

    • Carolyn Spring on 5 May 2017 at 10:02 pm

      Thank you – and you’re so right. I like ‘injured’ – very apt. Running that same day in London tomorrow. I wouldn’t be at where I’m at today if someone hadn’t kept on giving me hope when I had none myself. Just paying it forwards.

  • Hazel on 31 July 2017 at 1:51 pm

    Beautifully written, as always, Carolyn. Accurate and truthful.

    Thank you for sharing, here and at your excellent training days. Your courage in saying how it is gives comfort, clarity, confidence to many.

  • Sharon Staten on 31 July 2017 at 4:17 pm

    Thank you Carolyn. I have thought it more of a brain injury and the DID being my brains way of rescuing and keeping as much brain for me as possible, so to avoid being totally and utterly broken and being severely mentally ill.
    I have learned that dissociation saved my brain from madness.
    Sharon Staten

  • sad on 29 October 2017 at 4:57 pm

    When I first began to connect with my distress, a friend told me I was getting ‘it’ (the fact of my abuse) all out of proportion… Oh, and that fantastic advice that I should ‘forgive and forget’.

    It was a long time before I realised that I was injured, not ‘ill’ and that I had normal reactions, to very abnormal experiences. I think that sometimes it is easier to blame the victim, than to accept that some very bad things are forced on children.

    • Carolyn Spring on 29 October 2017 at 5:02 pm

      You’re absolutely right. We HAVE got it out of all proportion … because we MINIMISE it, not maximise it – as people like your friend think we do. We play it down. We hide it from ourselves. We protect everyone else despite not being protected ourselves. And when we disclose, we are often punished for speaking the truth, because it makes people deeply uncomfortable. Victim-blaming is ALWAYS the easy option. But it’s colluding with the abuse. That’s why we mustn’t blame ourselves either …

  • Tree on 1 November 2017 at 3:15 am

    I appreciate this more than I can ever say. After enduring endless abuse from my ex husband, after that trauma & the trauma of divorce, during all of it, those closest to me were so quick to say I had mental illness, that I needed medicated & I felt insulted. I felt them minimizing and dismissing my pain. I felt judged. And in no way am I judging anyone living with mental illness in saying any of this. Please do not think that! I am no one to sit in placement of judgement of anyone at all. This really hit home, though. It is something that perfectly expressed how I felt going through those horrible events and how it felt to listen to those closest to me tell me that I was mentally ill. I was in pain. I was grieving. I was terribly abused. I was traumatized and I felt like no one could truly understand, that they even understood, and that in and of itself…that hurt me deeply on top of the hurt I already felt.

  • Kiya on 2 November 2017 at 4:50 am

    This description is perfect, thank you.

  • Audrey on 2 November 2017 at 7:29 pm

    It’s quiet good to know it’s okay to allow myself to feel my emotions. I worry when I dwell on negative emotions for so long . So what are some of the ways to combat distress resulting from childhood sexual abuse. Thank you

  • Annette on 24 October 2018 at 7:43 am

    So true and very well put.
    As a survivor of trauma and abuse ,it took me the last 23years to allow my self to feel and express my real feelings.
    Once I got real with my self,my life started to change for the better.
    Thank you for sharing
    Carolyn Spring

  • Deborah J Crozier on 23 August 2019 at 6:01 am

    I absolutely love this – it is spot on!

    This echos my beliefs exactly. When someone is experiencing anxiety & panic attacks and they live within a fearful environment such as a violent and abusive relationship, their reactions are ‘normal’ for that situation.
    I remember thinking this when my Doctor suggested medication because I couldn’t stop crying. My violent ex-partner had lost his temper and almost strangled me to death.
    I was in shock, I was distressed, I was fearful, I was traumatized – and so would anyone else have been had they experienced the same situation.
    I recall thinking – ‘hes the one that needs medicating, not me – I’m not unwell – he is. I am just reacting to what has happened to me!
    Thank you for this Carolyn – I actually felt a sense of relief whilst I was reading this, seeing that someone else believes the same thing.

  • Bradley Riddell on 6 June 2021 at 7:00 pm

    Just this morning I was talking to a colleague about “mental health issues” & saying I didn’t feel comfortable with the stigmatisation or pathological label given to those with “mental health issues” when as you express clearly here they are responding to trauma, fear, or threat in a very normal way but they need understanding & help not ostracisation & condemnation!
    We all have physical health issues we need to address why not address mental health issues too as openly & transparently? Evolutionary psychology I would suggest preempts that bit with understanding of that would come permission for its healthy expression wouldn’t it? Just like trauma healthily encouraged can then be healthily expressed?
    Great work Caroline, thank you ??

  • Rob Cray on 9 August 2021 at 11:16 am

    I totally agree

  • Linda Collins on 12 January 2023 at 8:48 pm

    Thank you for this. As human beings are not meant to fit into boxes our experiences are our own, being compassionate with ourselves and others can help us understand better.

  • Dianne Foy on 20 March 2024 at 5:00 pm

    Thank you – this has confirmed for me something I believed strongly about my own experience. When I visited the doctor to get a sick line after experiencing a pregnancy loss and subsequent surgery, the doctor wanted to prescribe me antidepressants. I felt very strongly that I was not ill or depressed, but having an appropriate response to a traumatic and upsetting experience.

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