IT’S THE middle of summer. There are no exams to worry about and my job isn’t stressful. But I am hyper-aware of my heartbeat: I can hear and feel it in my chest every second of the day, and my chest feels physically tight. This can last for weeks, and it’s painful and exhausting.

At its best, anxiety is a strain on your daily life. At its worst, it’s literally incapacitating. If you speak to someone who has had a panic attack, they will tell you that it feels like a heart attack must feel. I’ve only had one once, but I was knocked out for four hours afterward.

For me, anxiety is even more physical than depression. Normally, generalised anxiety takes the form of persistent worrying about anything that could be going on: exams, job interviews, your relationship.

But I have a steady job, a stable relationship and essentially nothing to worry about at the moment. It feels as if there is something the matter with my body, that I must be sick, and when the doctor says nothing is wrong, that only makes it worse.

Categorising illness

People categorise mental and physical illnesses because they like to think of the mind and body as separate. But mental illnesses work in the same way that physical ones do. They can be random or situational, they can be treated with medication or lifestyle changes, and they can be mild or serious.

People think of mental illnesses differently because they don’t know enough about them. Campaigns like Please Talk are trying to break this down, but they rely on people feeling comfortable and confident enough to talk about their mental health. And that can’t happen when people feel that their illness isn’t important.

I was suffering from depression and anxiety for nearly three years before I saw a psychiatrist. Plenty of other people have similar stories. People with depression often keep it quiet because they’re afraid that they aren’t really sick. You convince yourself that you must be making this up and that you should just get through it.

Bad advice

This isn’t helped when reputable publications and famous people say that depression is “attention-seeking” and that we should all just “get some fresh air”. Shaming people with mental illnesses doesn’t help them get treatment and, unsurprisingly, the ones doing the shaming aren’t qualified enough to know what they’re talking about.

People like to think that we can control our attitudes toward life. Everyone has a bad mood once in a while and we tell ourselves to stay positive. But mental illnesses affect the brain, not the outlook.

The worst thing you can say to a depressed person is “just stay positive”. We don’t tell people with diabetes to just balance their blood sugar, which would be equally useless advice. Sadness and depression are not the same thing. Depression is not a mood – it’s a mood disorder. Because people associate mental health with emotion, they assume they understand how mental illnesses work.

Physical symptoms

Mental illnesses can be reactive, but they’re more often chronic. Being depressed isn’t like being sad – your mood won’t be low all the time. But it can be low for weeks at a time, and with depression, low moods are profoundly physical. Your body feels heavy, your energy is low, you lose your appetite and you can start losing weight. These are physical symptoms as much as mental – they can’t be cured with a can-do attitude.

Chronic illnesses require self-care. You need to take time to feed yourself, to relax, otherwise your health can deteriorate even more. But even taking care of yourself takes energy, and if you spend all of your energy on college or a job, you end up with less time for yourself.

Calling your counsellor can take hours of preparation, talking to a friend can be agonising and it only gets worse when that friend acts as if your problems are the same as anyone else’s.

Living a full life

People’s view of mental health comes in extremes: you must either be fine or suicidal. Most people can function very well and accomplish their goals. I maintain a full-time degree, a part-time job and a fairly full life for a 20-year-old.

Depression is, hopefully, something anyone can live with if they manage it effectively. But it’s harder to do that if you try to ignore it, and stigmatising mental illness only makes that more likely.

Taking all of that on board, imagine how alienating it is to tell someone about your mental illness – to speak out about something that already makes you feel insecure – and to have them tell you to get over it, to smile, be positive, look at the clouds and breathe.

When someone says they have chest pain, you tell them to call a doctor. But everyone likes to think of themselves as emotionally mature and an authority on feelings. So when someone tells you they’re anxious or depressed, you tell them they can talk to you. They should be talking to a professional.

Of course we should encourage people to talk about mental health and to spread awareness, but we need to treat mental illness in the same way we treat physical illness: get people the help they need and don’t assume it will just go away.

Not everyone needs a diagnosis and not everyone needs medication. But the ones that do won’t get the help they need if they feel like they aren’t really sick.

Dee Courtney is a student at Trinity College Dublin and the online editor of Trinity News, its student newspaper. You can follow her on Twitter here.