We all look up to certain people for their ability to get stuff done. You probably have a friend who just never seems to stop moving, and can get more done in a day than you can in a week. We tend to think of these people as being better at “adulting” than us. But maybe other people see us the same way. Despite how many of us feel inside, we can move through the day, complete our to-do lists, but still not feel comfortable with our lives or with our selves. But maybe we also don’t feel as *bad* as other people, so we don’t reach out for assistance.
One of the more difficult concepts that lies at the foundation of the method of diagnosing mental health disorders by professionals is "functioning." To be considered a "disorder" or something that is otherwise considered clinically noteworthy, a person must demonstrate impacted ability to “function”. It’s also key to how our billing systems work with insurance coverage in this country. Companies don’t want to pay for something that isn’t effecting the person they are covering. To some, this may sound harsh; and to others, it may sound like a very high threshold to have to cross to get help.
To unpack this a bit further — and hopefully provide some education and comfort — let’s talk about some different kinds of "functioning" that may be impacted.
Probably the most obvious kinds are abilities to take care of yourself. Can you bathe yourself? Remember to eat? Act in ways that don't endanger yourself or others? These kinds of daily tasks that many people take for granted can be difficult for some people because of what they are experiencing, thinking, or feeling.
Another area people probably have considered is ability to work and make money. This one gets tricky sometimes and is why we have terms appearing in social media like "functional depression." Many people are able to cope well enough to make it through the work week, pay their bills, and be a "responsible member of society." However, this may be at the cost of a lot of emotional energy, at the expense of other aspects of life. It also doesn’t seem fair to folks who have chronic conditions or disabilities to say that they can’t get care for their diagnosis because they can still work and spend money. This is why mental health professionals take a more wholistic approach to the idea of “functioning.”
It’s also important to keep in mind that “functioning” is relative to the society that we live in. At its core, the concept should be thought about as being able to independently live and have an enjoyable, fulfilling life within the society that we live.
That last part is why other elements of functioning are so important. We all deserve to have a happy and fulfilling life. Sometimes, a mental illness or stressful life event can make it difficult to achieve goals or take care of our families. Social impairments or anxieties limit our ability to “function” by making it hard to connect with loved ones or make new friends. It may also mean we don’t want to spend time doing things we enjoy, or that we know are important for us to do. Having positive relationships and being able to engage in leisure activities are other areas to be considered when thinking of “functioning.”
So why are we talking about this? It’s because people may think “oh, I’m not bad enough to meet with a therapist” or “I want to get help, but I can’t get it because I’m still capable of getting through the day.” Some people may also feel offended or marginalized by being labeled “functionally impaired” by a diagnosis because they still go to work, take care of chores, and meet their, and their families', basic needs. It’s important for everyone who may be considering therapy or other mental health treatment to remember that our mental health touches every facet our of lives, which includes us feeling happy, spending time with friends and family, and doing things for fun - not just going to work, paying bills, and cleaning your home. We are complex people with complex needs, wants, and desires in life.
If you find yourself struggling with anything mentioned above or unmentioned, don’t be afraid to reach out. We are here to talk with you and help you meet your definition of functioning.