The recent celebrity suicides have many people talking about mental health, which is a good thing the comes from such horrible circumstances. I like looking for tools and techniques that anyone can use to support their mental health, and the Simple Mental Health Pain Scale is one of them.
I’m sure everyone has had the experience during a doctor visit resulting from an injury or as part of a post-surgery follow-up of being asked to rate their physical pain on a 1 – 10 scale. This assists doctors and nurses in figuring out what your issue might be and how best to treat it. Wouldn’t it be great to have a way to communicate mental and emotional pain, which might show up as something physical, but often does not? Rori, the blogger behind TheGracefulPatient, thought so and created her own, and I think it works.
Rori is not a mental health professional, which to me makes her scale more useful. It uses simple language and is even, dare I say, cute.
If simple and cute can save lives, I’m all for it.
Here is the not as cute full-text version.
A Simple Mental Health Pain Scale
1 is totally fine. Much like my feelings on the physical pain scale, I’m not sure anyone really feels like a 1 for very long, if at all. Maybe when they’re surrounded by kittens and someone else has just made them a perfect cup of tea.
2 is the smallest amount of ‘something isn’t right’. You might be frustrated that your partner threw their socks next to the laundry hamper rather than in it (again). It’s the groan when another register opens at the supermarket, and you’re in the exact wrong spot in your current queue (too close to the front to dash over and get served more quickly, but far enough back that you’re going to silently judge what other customers are buying while you wait).
3 is a slight amount of distress – the mental health equivalent of a headache. You have the tools to cope with how you feel, but it’s not pleasant. Your distress isn’t impacting on your life in a meaningful way yet, but you know that if it gets much worse, you may start to struggle.
4 is just a really bloody bad day. Even though you’re still coping with your pain, you may not be able to hide that from others as easily anymore. At a 4, this is starting to impact on your normal daily living, but not across the board. Maybe you’re not sleeping very well, or you’re getting anxious and it’s harder to deal with social situations. This is a great time to exercise your self-care. Take some time out for you, because it’s much harder to cope with things if we’re running on empty. Pick up a book, watch Netflix with a friend, have a shower with your music turned up loud. Be kind to yourself.
At 5, distress is starting to become more evident. If you’re prone to mania or intrusive thoughts, you might find that it’s getting much harder for you to do the things you usually do, the way you usually do them. Your mental health is really starting to impact on your normal life. When I’m a 5, I start avoiding friends because I don’t want to deal with the hassle of socialization and the ways that affect my mental health. If you haven’t already reached out to a mental health professional (counselor, psychologist, psychiatrist, or even just your local doctor), now is probably a good time to do it. Early intervention is the best intervention.
6 is getting pretty serious. I know it’s just over halfway, but remember that totally healthy, happy people are a 1. You’re not halfway between ‘happy and unhappy’, you’re halfway to ‘this is as bad as I can possibly imagine’. Don’t underestimate the pain you’re in. By 6, your mental health is really getting in the way of your normal life. You’re starting to have significant trouble doing the things you usually do (sleeping, socializing, thinking, eating, exercising, working or studying, and doing stuff you enjoy). Depending on your specific problems, this might just be a simple ‘these things are hard’, or it might be ‘I can’t do them the way I used to do them’ (like if you have OCD, mania, or other problems with impulse or compulsiveness). If you haven’t spoken to a mental health professional by now, you need to. Now is also a good time to make sure you have a support person who can advocate on your behalf if you struggle to communicate your needs. Remember that a 6 on the physical pain scale means that it’s hard to talk outside your pain (like contractions in labor). If you do become more unwell, it can be very difficult to advocate for the care you need.
At 7, you’re reinforcing your distress because of the way you’re coping with it. This is where things like depression are really, really hard to manage without some kind of intervention. Socialising causes you distress, so you avoid it, and that just reinforces the entire pattern. Insomnia stresses you out, which releases stress hormones and makes it harder to sleep. You don’t have an appetite so you eat less, and that makes you less hungry. You need someone else to step in to help you. I know it often doesn’t feel as serious as this when you’re experiencing it, but to a healthy person, this is really concerning if it’s affecting multiple areas of your life. Healthy people don’t feel this way. Not for extended periods, not across multiple parts of their daily life. You’re unwell, and you need help.
8 is serious distress. On the physical pain scale, you can’t function with the sort of pain you’re in here. It’s not much different with mental health. You’re avoiding normal daily living tasks because they’re too hard. Your behavior and personality have changed in ways it’s impossible for those around you to ignore. You’ve run out of the ability to cope with things, and this is probably starting to come out in some ways that are pretty dangerous for you. Impulsive and compulsive behaviors, considering or actual harm to yourself, not taking care of your basic needs (hygiene, nutrition, etc). If this was physical pain, we’d be cranking up the morphine and trying to fix the problem. Your mental health supports need to be doing the same. Make sure your advocate understands your distress.
9 is critical. Don’t be afraid to use your 9. Don’t wait until 10 to say ‘this is the worst I’ve ever felt’. Don’t wait until you can’t imagine things getting any worse. Use your 9 now if it’s necessary. It’s important for us to remember that the peak distress point isn’t always suicide. While that is absolutely an issue that should be treated with most importance (you can’t treat a dead person), it’s possible for someone to completely neglect all areas of their health and still not be suicidal. Those people should still be treated seriously. Don’t discount yourself or a loved one just because they aren’t actively suicidal. At a 9, all or most major daily life functions are seriously affected – sleep, appetite, hygiene, socialization, work/study, exercise, leisure. At a 9, someone is existing, not living.
10 is the worst you can imagine your distress to be. Like with the physical pain scale, if something else could make you feel worse (like losing a loved one), then you’re a 9. If you honestly couldn’t tell if anything else terrible happened in your life, this is your 10. For most people, this is actively planning a suicide attempt, but it doesn’t necessarily have to be. Curling up in your bedroom and no longer attending to any of your body’s needs can still be a 10. Planning to hurt others can be a 10. Having no attachment to reality anymore can be a 10. There are lots of ways mental health and mental distress can be experienced, and this is not just a suicide scale.
Use the scale to track your mental health state. Use it to communicate with friends and family. You could even share it with your doctors, counselors, and therapists to have a common language.
Talking about suicide doesn’t lead to suicide. Not talking about it does.
A Simple Mental Health Pain Scale was originally published at TheGracefulPatient and is shared with the author’s permission.
What’s your take on what you just read? Comment below or write a response and submit to us your own point of view at the red box, below, which links to our submissions portal.
Are you a first-time contributor to The Good Men Project? Submit here:
Have you contributed before and have a Submittable account? Use our Quick Submit link here:
Do you have previously published work that you would like to syndicate on The Good Men Project? Click here:
Got Writer’s Block?
We are a participatory media company. Join us.
Participate with the rest of the world, with the things your write and the things you say, and help co-create the world you want to live in.