5 ways mental disorders are like asthma

One of the challenges with mental illness that I’ve found in trying to explain it to people is that it seems so vague. I mean, seriously, how do you wrap your mind around an illness in the mind—or in your mind?
I think it might help you understand mental illness a bit better if I compare it to something we’re all more familiar with. Like asthma. I bet everyone has known someone who had asthma: a brother or sister, a parent, a friend, someone you barely knew. And maybe you’ve even see them smack in the middle of an asthma attack, or had to take them to the hospital.

Before I begin, though, I want to make a little rant. You probably know that mental disorders are (mostly) long term conditions. The proper medical term for that is “chronic.” But most people, I find, think “chronic” means something is very serious. (Probably because a long-term medical condition is probably serious—but that’s still two very different things.) So for instance you see in our Nollywood home videos: “She has a very chronic sickness…” I hear that and I’m thinking, really? Here’s the thing: “Chronic” has its roots in the Greek, chronos, which is the word for time, and related to “chronological.” Just so you know. So when you hear “chronic condition,” think long-term condition, not serious sickness. Anyway. Back to the point of the post.

So mental illnesses are mostly long-term. In other words, most mental disorders are more like hypertension than malaria. See?

There’s another thing I need to make clear before I go on. I’ve said it before, but I don’t think it can be overstated: mental illness isn’t just one thing. It’s many different conditions that are as diverse as can be. So even though I’m going to be talking here about them as a group, please keep that in mind and don’t think it’s just one thing.

Okay, so what are the 5 ways mental disorders are like asthma?

1. Many mental disorders are long-term.

I know, I already mentioned this, right? But let me talk about asthma. It’s often diagnosed in people while they’re children (although sometimes not until they’re adults does it become obvious), but once it’s there, it often stays around pretty long—like, you know, for years. And during that time they may have long periods of no asthma attacks, but that doesn’t mean it’s gone, right? Often it’s still there, just in the background, and if the person isn’t careful it can easily pop right back up. In many mental disorders (including depression, bipolar disorder, schizophrenia, the various anxiety disorders) it’s pretty much the same. They don’t go away in two days or three weeks. You know, like how malaria does.

Does this mean that mental disorders (or asthma) are part of the person? No and yes. No because a mental disorder is not part of anyone in the sense that it defines them. Yes because it’s part of a person in the sense that, say, the shape of your nose is part of you. But you are more than the shape of your nose; it is part of you but it doesn’t define you, nor would you want to be defined by it. (Well, maybe you might if it’s a particularly beautiful shape, but still…) :-)

2. Many mental disorders require long-term treatment.

Asthma isn’t malaria. You know, take the tablets for three days, with some paracetamol, and you’ll be fine. No, you often need to take it for weeks at a time, or even months. And even then many people always keep an inhaler close by, just in case. (The middle of an asthma attack is not a very good time to go looking for an inhaler!) Then people with very bad asthma often have to be on steroid meds for long, too, to prevent further attacks. It’s similar with many mental disorders. Many require treatment for anything from six months to a year, and often even longer.

Are you thinking, “That’s crazy! Why should anyone have to take medicine for that long?!”

Good question. But think about it for a second: aren’t there many conditions where people take medicine for long, besides even asthma? Treatment in hypertension and diabetes is for life. Same with HIV/AIDS. Tuberculosis treatment can be anywhere from six to nine months, or more. Epilepsy often requires treatment for years and years. Many people with sickle cell are either on medication, or on and off it, depending how they’re doing. And there are cancers, arthritis, blood disorders, and many more—you get the idea. Is this long-term treatment a bad thing? Many people think so, I know. But that’s usually because you’re simply looking at the fact that someone has to take medicine for a long time. If you appreciate the severity of the conditions the medicines are treating, you’ll realise that it’s a pretty small trade-off to make.

3. In many mental disorders, it’s possible to have episodes of acute illness from time to time.

If you know anyone with asthma, you know it’s not like they have asthmatic attacks every other day. Yes, it can be quite frequent for some, but even then it’s often just for a period of time, like close to school exams. On the other hand, some people go months, and even years, with not a single attack. But that doesn’t mean the asthma is gone: some may still have an attack after a long time of not having one; or maybe not an attack, but the beginnings of one, and if it’s managed properly, they can often actually stop it before it gets worse. That kind of attack is what we call, in medical parlance, an “acute episode.”

That kind of thing happens in many mental disorders as well. And like with asthma, even though medications greatly reduce the chances of this happening, it’s not 100%—sometimes an episode can still break through, especially if there’s some major trigger, but hopefully it’ll be less severe. That’s doesn’t sound like very good news, I know, because it’d be nice to have 100% guarantee that nothing will happen once you take the meds! But the reduction of the chances of something happening is really big, and can be up to 80% so it’s not as bad as it might seem.

4. Knowledge is still power, in both asthma and mental disorders.

Many people with asthma have attacks less frequently as they grow older, which is why people talk of “growing out of it.” But much if this “growing out” is really the result of a better understanding of what triggers their attacks and knowing how to manage those things: like watching out for dust and fumes, learning to listen to their bodies and pick up danger signs earlier, and keeping a inhaler close at hand, just in case. Of course, that kind of knowledge and understanding comes with age.

In mental disorders, too, a good understanding of the particular disorder a person has goes a long way to their being able to stay well for longer, and live fulfilling lives. As I like to put it, you should know your specific disorder almost as well as your doctor. That includes knowing what tends to trigger it and what the early symptoms are, plus what kinds of treatment are available and why you’re given the treatment you’re taking. And if someone you care about has a mental disorder, the best way you can help them too is to learn more about it. This is one place where ignorance is definitely not bliss.

5. Both asthma and mental disorders are best managed by the person with the condition.

This is related to the last point, but maybe I should explain. In moments of crisis, a democratic approach doesn’t work very well: there’s no time (or presence of mind) to vote on what to do. At such times what you want is simply someone who’ll come in, take charge, and set things right side up. So malaria, for instance, is that kind of crisis situation, as are many short-term illnesses: the medical team sees the patient, admits if necessary, gives some medications, and sorts out anything else that needs to addressed and in a few days, you’re good to go.

But what if the problem lasts a little longer? Would you want someone taking decisions for you for years? And even if you did, what if they have to go? So with long-term medical conditions (yes, like asthma and many mental disorders), the usual model of the doctor being in charge doesn’t work so well. You can’t be on admission forever, you can’t be seeing the doctor everyday. And even if you have a doctor who has the time to do all of that, they (or you!) may migrate, be transferred, or something. And then what? So you’re going to have to take charge yourself. That means the doctor and the rest of the medical team will only be supporting you. Which is why it matters how much you personally know. And truth is, the people who do that tend to do much better overall in the long run.

Whew! This has been a pretty looooong post! :-)

I hope you gained a thing or two, though? I just want you to better understand mental disorders, by comparing them to asthma, which for most of us is a far more familiar condition. I hope it’s helped! Are there any questions you still have, or any other similarities you can think of? Fire away in the comments below!

Published by Doc Ayomide

I’m a medical doctor with specialty training in psychiatry, and I love thinking and writing about what it means to be human.

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  1. Whoa!You are gradually turning into a family physician and the thing is that u haven’t even realised it!
    You mentioned asthma, SCD, tuberculosis(including the treatment regimen). Shows you are managing undifferentiated diseases in your mind even though I know u will say u are a behavioural medicines man.
    Bro u are the best family guy in the making.
    Kudos bro!!!!
    Great piece!!

    1. Lol! Thanks, man! Like I said in the post, the idea is to deconstruct mental disorders, and better explain what they’re really about, using what most people already know, right? :-)

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