Mental versus Physical Illness: How to Describe Depression and Bipolar Disorder

When mental illness is described as being identical to physical illness, I can’t help but cringe. Don’t get me wrong, I know what advertisers and mental health representatives are trying to accomplish by making these comparisons, and it is a very noble goal. They want legitimate treatment and understanding. They want the prejudice associated with mental illness to come to an end. But mental illness is not identical to physical illness. Mental illness is most often not easily cured through a step-by-step process (for example, medication, therapy, and rest) as many physical illnesses are; there are as many environmental influences contributing to the sickness as genetic and biological; and, in severe cases, mental illness can never be cured. Mental illness is something that dwells in one’s heart and mind constantly. It can affect relationships, school, and work — it can even go so far as to completely change one’s personality. To simplify mental illness by equating it with physical illness can be dangerous, and it also usually isn’t that easy: you can’t wrap mental illness up and prop it on a pillow with a bag of frozen peas.

That being said, there is one very important commonality between physical and mental illness, and it is that they both surpass logic and are uncontrollable. Just as a person with the flu cannot decide to stop vomiting, so a person with depression cannot decide to change his or her mood, or “snap out of it,” as they say. I like to compare mental illness, and bipolar disorder in particular, to swimming. About two and a half years ago I was diagnosed with having mild bipolar disorder, but only recently have the symptoms flared up once more, and seemingly stronger than ever. I have found it infinitely useful to have a simple analogy at hand when talking with people who don’t quite understand the disorder.


A drawing from Lewis Carroll’s “Alice’s Adventures in Wonderland” — Alice, swimming in her own tears.

Yes, it is like swimming. Or, when I am depressed, like drowning. When I am depressed it is like I am only half-swimming, floating three feet or so below the surface of the water, unable to breathe. I can see the sunlight above, shining through the water, and so I know, from what my senses tell me, that everything is as it always was. But I am still drowning. I still can’t breathe, and I still can’t swim to the surface. Something inside of me has malfunctioned. Something has broken the connection between logic and conscious thought. The manic episodes are as if I can suddenly and inexplicably swim with great strength upward, bursting from the water and sucking in the air. I can dash and roll and race and splash. I can swim front crawl across the entire lake (I can read novels and complete school work  and exercise and write blog posts — yes, now you know what state of mind I was in while writing this). I can do anything. In fact, I couldn’t do nothing if I tried. The energy pounding through my body is like electricity that will zap me if I slow down. But, after a time, I sink back under the water, unable to swim when moments before I couldn’t do anything but swim. I drown again, forgetting that I ever knew how to swim, just as when I was swimming, I had forgotten it was possible to drown.


3 thoughts on “Mental versus Physical Illness: How to Describe Depression and Bipolar Disorder

  1. You said ‘to simplify mental illness by equating it with physical illness can be dangerous’
    Mind me asking in what ways it can be dangerous? Do you fear that the helpless will be left stranded behind the false assumption that they can be helped, but choose not to be?

    “Something has broken the connection between logic and conscious thought”
    This is very true. Depression can control your you thoughts despite perfectly logical reasons to think positively. It can sometimes even make you feel guilty for feeling good about yourself when you happen to stumble across a bit of happiness. It makes absolutely no sense. So, to me, the difference between depression and just being ‘sad’ is that someone with depression lacks the ability to ‘cheer up’ by conscious decision.

    If I were to try to ‘cure depression’, I would try to target whatever is “breaking the connection between logic and conscious thought”. I’d find out the reason you can’t just swim to the surface when you feel like you’re drowning. Ideally, It would be physiological pattern within the brain that I can recognize and treat, without any subjective diagnosis. I realize that its not that simple, and I agree that treating mental illness isn’t the same as treating physical illness. But don’t you think that technology can eventually get to a point where that’s possible? Bear in mind, not all physical illnesses can easily be cured through a step-by-step process, ether. But there are medical advances every day for them.

    I’m interested to hear what you think about the future of mental health research. Shouldn’t we still hope for a solution comparable to a physical treatment?

    Great post!


    • Oh yes, I definitely agree we should not give up hope in finding a comparable treatment to physical illness. Mainly what I meant by saying that it could be dangerous to equate mental illness to physical illness is that some might begin thinking that mental illness is as simple as physical illness. Now, I know that some physical illnesses can be quite complicated as well, but they often don’t have nearly as many environmental influences, and they don’t usually affect as many aspects of a person’s life (relationships, work, school, personality, etc.). Each different case of mental illness is so extremely diverse and dependent on the person who is experiencing it that I find it difficult to look at it completely objectively and scientifically. And yes, ideally connecting the conscious brain with whatever part creates the feelings of depression or hysteria would be the way to find a cure.
      Thanks for the comment!


      • Ok, that makes a lot of sense. I guess all those external influences make a huge grey area between medical personal causes. That’s probably why medication/treatment is such a tricky topic


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