# Mental health & mental illness: the basics

Before any disorder can be named, three questions have to be answered: what is mental health, where is the line between normal and abnormal, and what causes the line to be crossed. This is the CTEVT curriculum's opening block (M2 · Mental Health · Tasks 1–2).

## Definitions, and the normal–abnormal line

**Mental health** (WHO/your class notes): a state of psychological, emotional, and social well-being in which a person realises their own potential, copes with the normal stresses of life, works productively, and contributes to their community. **Mental illness**: a clinically significant disturbance in cognition, emotional regulation, or behaviour that causes distress or impairment in functioning. Health is not merely the absence of illness: a person can lack a diagnosis and still be languishing.

**Where is the "abnormal" line?** No single test decides it. Clinicians triangulate with the **4 D's**:

- *Deviance*: far outside cultural norms
- *Distress*: it hurts
- *Dysfunction*: it breaks daily functioning (work, school, relationships, self-care)
- *Danger*: risk to self or others
Culture sits inside every D: hearing a dead relative's voice during mourning is deviant in Berlin and expected in Bhaktapur. Frequency, intensity, and duration turn an experience into a symptom.

| Myth | Fact |
| --- | --- |
| Mental health problems come from personal weakness or weak willpower | They result from interacting biological, psychological, and environmental factors |
| Counselling is only for "severe" or "mad" cases | Counselling helps with life transitions, stress, grief, trauma, and everyday emotional regulation |
| People with mental health conditions cannot work | With support, most work productively and thrive |
| Children do not get mental health problems | Distress can emerge at any age; early intervention improves lifelong outcomes |
| Mental illness is a spirit's curse or the fruit of karma | It is a health condition; respectful bridge-building with traditional explanations helps families seek care sooner |

## What causes mental illness: two models to memorise

**1 · The biopsychosocial model** (Engel, 1977). Every case has three strands braided together:

- *Biological* (genes, brain chemistry, physical illness, substances)
- *Psychological* (coping style, thought patterns, self-concept, learning history)
- *Social* (poverty, family conflict, displacement, discrimination, support networks)
The curriculum's own list (biological, psychosocial, environmental) is this model in different words.

**2 · The diathesis-stress model.** A disorder appears when an underlying *vulnerability* (diathesis: genetic loading, early adversity, temperament) meets enough *stress* (loss, migration, exam pressure, disaster). High vulnerability needs little stress; low vulnerability needs a lot. This is why one sibling breaks after an earthquake and another does not, and why "why now?" is one of assessment's most powerful questions.

| Domain | Risk factors | Protective factors |
| --- | --- | --- |
| Individual | Genetic predisposition, chronic illness, low emotional regulation | Problem-solving capacity, resilience, physical health |
| Social | Family conflict, domestic violence, isolation, loss | Strong social support, healthy family communication |
| Structural | Poverty, discrimination, displacement, no access to care | Economic stability, safe environment, social inclusion |

The stress-performance curve (Yerkes-Dodson, 1908). Some arousal helps: a student with zero exam stress does not study. Mental-health work is not removing stress but keeping people near the middle, and catching them when life pins them to the right edge for months.

## Keeping a mind well: one thinking skill and ten habits

**Cognitive restructuring** is the skill of catching a thought, checking it, and replacing it with a fairer one. The two distortions the class notes name (two of the five listed on [Approaches & forms](https://manoatlas.com/approaches.md)): *catastrophising* ("I failed one paper, my life is finished") and *black-and-white thinking* ("if I am not the best I am nothing"). The check is three questions: what is the evidence, what would I tell a friend, what is the most likely outcome. It pairs with the body skills on [Tools & techniques](https://manoatlas.com/tools.md) (breath, muscle relaxation, 5-4-3-2-1 grounding) and with behavioural activation on [Depressive disorders](https://manoatlas.com/depression.md).

| Habit | Why it holds a mind up |
| --- | --- |
| Sleep on a schedule, 7 to 9 hours | Sleep is when the brain files emotion and resets stress hormones ([Sleep-wake disorders](https://manoatlas.com/sleep.md)) |
| Move every day | Walking, farm work, yoga: movement lifts mood through the body's own chemistry |
| A daily calming practice | Slow breathing or muscle relaxation keeps the alarm system from idling high |
| Keep people close | Belonging is the strongest single buffer against distress |
| Boundaries | Being able to say no protects time, energy and self-respect |
| Eat and drink regularly | Stable blood sugar and water; go easy on caffeine and alcohol |
| Face problems, don't dodge them | Self-compassion and problem-solving beat avoidance, which grows anxiety |
| Limit screens and news | Especially before bed: less overload, less rumination |
| Do something that matters | Hobbies, creativity, helping: purpose and a sense of mastery |
| Ask for help early | Distress caught early is easier to turn; that is what this course exists for |

Key points

1. Mental health is more than the absence of illness: it is coping, working, relating and contributing.
2. The normal-abnormal line is drawn by distress, dysfunction, duration and danger, never by being different.
3. Illness comes from biology, mind and social world together (biopsychosocial), often as a vulnerability meeting stress.
Learn more

Pick one, not all: these are chosen to be light, not exhaustive.

Video series[Crash Course Psychology #1–2](https://thecrashcourse.com/topic/psychology/): what psychology is and how it became a science.

Paper**Engel (1977), "The need for a new medical model", Science**: the original biopsychosocial paper; short and readable.

Book chapter**Introduction to Psychology: opening chapters**: the course text's history and methods chapters pair with the Roots page.


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*Source: https://manoatlas.com/basics · Licence: CC BY-NC-SA 4.0. Mano Atlas is an educational resource, not a diagnostic tool.*