All in your head...

I was reading a story about a person with anxiety/panic disorder, who told of her relief upon diagnosis. "What I had was real," she said. "It wasn't just all in my head!"

Although her problem was real, it was also in her head. She had a mental illness- where else could it have come from? But this got me to thinking about the assumption behind something being "all in your head," and that you are thusly making things up. While many people (and their doctors) might misattribute symptoms, few out-and-out make them up. Yet when presented with something baffling and frightening, it's much easier for someone to think that a person is just making this up than to understand it for what it is: a brain disease.

I felt enormous relief when I was diagnosed with OCD in college. The obsessions terrified me, and the compulsions left me exhausted and in despair. I was both relieved and reassured to learn that my problem had a name, and there was a treatment for it. Yet this, too, was "all in my head" in the most literal sense. Not that I was making things up--my symptoms were very real--but that I had a mental illness.

This phrase always grated on me, and now that I think about it, I'm realizing why. It's that a mental illness is somehow not real, or at least less real than another illness of another body part. I mean, brain cancer is "all in your head," so is Alzheimer's disease. But even when people believed my depression symptoms, there was often a pull-yourself-up-by-your-bootstraps attitude. I was making things out to be worse than they really were, if I just tried harder (which, as anyone who has been depressed will know, is just so simple, right? Ha!) then I wouldn't feel so bad.

When my paternal grandmother was diagnosed with Alzheimer's disease about 15 or so years ago, I don't think anyone in our family told her, "Oh, you're just not trying hard enough to remember things!" Yet her illness was as much in her head as mine were.

Obviously, environmental factors are important in any illness. But a real physiological definition of mental illness is so important because they aren't treated on par with other brain diseases by either society or the medical world. I don't know that mental illness has a chance until we have a better understanding of what causes them and, to a lesser extent, how to treat them.

All in your head might not mean you're making your symptoms and feelings up- it could just mean that you have a brain disease. And that's okay.

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Anonymous said...

My father is an internist, and patients often ask him variations on, "Is this leg pain just all in my head??" He always replies, "Of course it's in your head -- everything you think or feel is. Where else would it be?"

Lauren said...

This post is dead-on: The number of people -- our co-workers, friends, relatives and even medical professionals -- who don't recognize the legitimacy of mental illnesses such as eating disorders, addictions, depression and anxiety is startling -- and really disappointing. It's one big reason I'm still uncomfortable with openly talking about being an eating disorder survivor -- the myths are still there, the stigma is still there, the misinformation is still there.
Research done in the field over the past decade has been ground-breaking: Ten years ago, EDs were thought to be "conditions" caused mainly by societal, cultural or familial factors. Now, finally, they are classified as biologically based mental illnesses. But unless you're looking for the studies and news, you're not going to find it in mainstream media. EDs just aren't on society's collective radar.
So they continue to be cast off as diets, "phases" and, worst of all, jokes. I've cringed and cried at TV shows -- most recently "Family Guy" -- and many a movie that use anorexia and bulimia to get laughs. And I've taken a co-worker to task for doing the same thing.
When will they stop? When can WE stop -- being on guard, rattling off stats and findings, defending our disorders?

Carrie Arnold said...


I agree. Part of the reason I'm not more open about my ED history (as present tense as a lot of it may be) is just the amount of effort it would take to continually clear up misconceptions. And I was also genuinely afraid that people would look at me as some sort of vain, vapid idiot when they heard I had anorexia.

Anonymous said...

Heads are real!

Another great post today Carrie, as usual.

MelissaS said...

i've recently begun to feel better emotionally -- i gave up alcohol and prescription drugs. i find myself booming loudly about my better mood, so people will think i can "pull myself up by the bootstraps", and i hope they will believe i WAS really miserable before. you are so right.

Libby said...

A friend was telling me last night about a relative, who, after losing his wife of 50+ years, went into a lengthy depression. After a while he was prescribed an antidepressant, but his children were just mortified by this. For whatever reason, his children were "in charge" of giving him his daily meds, and they decided that he didn't really need the antidepressant, except for in certain cases or on certain days when he "wasn't doing well." He ended up at the doctor because he felt so awful with flu-like symptoms from going on and off and on and off the SSRI. But as far as he knew, he was taking all his meds, and so the doctor couldn't find anything wrong. Finally, a nurse in the family found out what was going on and corrected the situation, and now he takes ALL of his meds EVERY day.

Funny how they never stopped giving him his blood pressure medicine...

We have a long way to go.

A said...

Thanks Carrie,

I needed this today. . .

Too many people have told me that if I just try harder, this would all go away -- the depression, the anxiety, the ED -- the coping skills I am using KEEP me afloat but they will not heal me. . .

I wish people would understand that mental illness is an illness....not a state of mind someone can talk themselves out of -- certainly CBT/DBT help and have been proven almost as affective as antidepressants but they will not return a person to the prior mental state. . .


mary said...

"heads are real!"
Thanks Jane. I love the comments on Carrie's posts as much as her posts.
I suppose that it might help to know that the fears aren't the monster under the bed...and are just exaggerated wanderings of a wayward mind or Aria.
There's still so much ignorance regarding many things in this world. The FG is a warped show as it is and other than wishing Stewy would just kill them all I try not to let that show be on. ;O Keep sharing what you learn Carrie. It's the best way to dispel the myths.

alice said...

i have an aunt, that had the attitude of 'give yourself a good talking too'. i kind of lost some respect for her, however i had been so close to her for many years. i persisted on speaking to her, even though at times it was difficult. then a breakthough was made. she admitted to overeating, and had panic problems, i couldnt believe this. now when we speak, we are talk deeper then usual.

this people that say 'pull yourself together' what does it say about them?

sarah-j said...

Its so true that 'heads are real' as Jane said!

I think a good illustration of this, is when you suddenly realise for yourself that something is real and how its affecting you instead of continuing to buy into the whole bootstraps thing.

I used to feel so so guilty about a stage of major non-functioning and not studying that I went through when I was really struggling with anxiety and OCD. I really felt like I was just being so lazy. Then I read a book about nervous disorders and I realised that my nervous system was so stressed and overwrought that there were good physical reasons why I couldn't get my brain to work the way I wanted it to. And as I become less stressed, the links between my body and mind become even clearer.

Anonymous said...
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Anonymous said...

I found this very interesting. Recently, after having them for over 10 years and not knowing what the hell was going on, and being afraid to even tell anyone, I was diagnosed with migraines. I felt a great sense of relief- probably because I didn't have to hide it any more and also because I didn't have to worry that I had a brain tumor. I know it was kind of stupid to never have mentioned it to even a doctor, but as time went on I concluded it couldn't have been that serious because I was still alive and functioning.

And why are people posting links to buy stuff on here?

Carrie Arnold said...


One of the problems about letting anyone post means that people shilling stuff can also post. I try to keep up with it and delete them as I see them.


seeleelive (for the love of peanut butter) said...

couldn't agree more. mental illnesses are not real, tangible things. thinking about that in association to my own issue really helps me put things into perspective. it's curable.

Harriet said...

Bravo, Carrie, for this one and for your Purple Hearts post. So revealing of how we see mental illness in this culture. Heads are real indeed. :)

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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