Is Mental Health a Chronic Condition? Reframing My Invisible Illness

Back in my early twenties, I was a young woman on a mission to find the corporate job of my dreams. I have a distinct memory of sitting in a well-appointed waiting room, filling out a job application, and suddenly feeling the worst impending doom I’d ever experienced. 

I started to see my big dreams unraveling before my eyes.

I was at the part of the application where it asks if you have a disability. There was a list of conditions, including several mental illnesses that I was ashamed to admit I had. 

On one hand, I knew my conditions were real, but they didn’t feel like they fit the word “disability.” 

When I saw the word disability, I thought of someone in a wheelchair, not little me, just secretly navigating a seesaw of emotions. 

My mental illnesses were certainly a burden, but I didn’t feel like they would prevent me from working a job. Not to mention, they weren’t visible to the unknowing coworker. And, this was the mid-aughts, when job applications were still mostly completed on paper and mental health was still a very hush-hush topic.

On the other hand, the good girl in me didn’t want to lie on my application! But the truth was, my mental health conditions were my least favorite part of myself. I couldn’t bring myself to check them off for everyone in the company to see.

So I left it blank and pretended that my diagnoses only existed after work or on weekends. 

Looking back, I now realize I wasn’t just avoiding a checkbox on a job application. I was creating a story that I believed for the next 15 years—that mental illnesses are shameful and don’t count as chronic conditions or disabilities. 

The Evolution of Mental Health Awareness 

Throughout those years, the narrative around mental health slowly began to change. And I changed, too. I found a job I was deeply passionate about in the life sciences industry, which, for a long time, kept my mental illnesses at bay. The job also allowed me to advocate for many other illnesses and conditions that felt far more important than mine.

Until one day, my mental health began to deteriorate, and my corporate existence unraveled faster than I could keep up. It all came to a screeching halt when I decided to leave my beloved job to “realign and reset.” (Even after all that time, I still couldn’t tell people the truth about needing a mental health break.) 

Despite feeling like an utter failure, I made an important decision around this time. I would work on accepting myself, and I would also join the growing mental health advocacy movement. After all, I began to realize the irony of working in the healthcare ecosystem and not talking about the very conditions that impacted me on a daily basis. 

After spending a year getting back to myself, I decided to start my business, Lauren Perna Communications. That decision was one of the best decisions I’ve made in my life. I began to thrive in ways I never thought possible. The ability to make my own schedule and nurture my mental health on my terms allowed me to become the best, most confident version of myself.

With my newfound confidence, I began telling my mental health story publicly, and that’s when Mentally Fit Founder was born.

But that’s not where the story ends.

Yes, Mental Health is a Chronic Condition

In 2023, I reconnected with Lilly Stairs, a former colleague. She told me about her idea for the Chronic Boss.

“I would LOVE to do something like that for Mentally Fit Founder,” I told her.

“But, Lauren, mental illness IS a chronic condition. I want you involved.”

That conversation was eye-opening. I thought I had come to terms with mental illness, but deep down, I still saw it as “less than.” I was still treating my mental illnesses like a back-burner condition.

Despite sharing my story, advocating for others, and shouting from the rooftops that “mental health is health,” I still didn’t see mental health as an equal to physical health.

Awareness Isn’t Enough

This realization taught me something else: awareness doesn’t always equal action.

If awareness alone could change how the world treats mental illness, my story would end here. But the reality is, there are still gaps in treatment, barriers to care, and persistent stigma.

Yes, the world is more accepting of mental health—but does it carry the same weight as physical health? Not even close.

The World Health Organization recently reported:

• Over 1 billion people live with a mental disorder, yet most remain underserved.
• Governments spend a median of just 2% of health budgets on mental health—unchanged since 2017.
  
• Even in high-income countries, only 1 in 3 people with major depression receive treatment.
• People with mental health conditions face higher mortality rates than the general population.
• The absolute level of mental health research output increased by 12% between 2013 and 2019; however, other health research output rose even faster, resulting in a slight decline in the proportion of health research focused on mental health during that period. 

And even though mental health fares somewhat better in developed countries, the care needs still far outweigh the resources. Mental Health America reports that in the U.S. alone, more than 28 million adults with a mental illness receive no treatment at all. 

The data also confirms what we’ve known all along, that mental health disorders disproportionately impact women. In 2021, while an estimated 5% of the global population lived with anxiety disorders, the rate rose to around 12% among working-age women in the Americas.

Nearly 20 years ago, I sat in that waiting room telling myself that mental health doesn’t “count” the way physical health does. Today, that narrative is still very much present, despite the work we’ve done to generate more awareness and acceptance of mental illnesses.  

Getting Mental Health on Par with Physical Health 

Mental health belongs at the same table as every other chronic condition because our lives depend on it.

So what’s the solution? How can we transform awareness into action and change how our world sees and treats mental illness? 

On a global level, Dr. Dévora Kestel, director at WHO’s Department of NCDs and Mental Health sums it up best: “We need urgent systemic transformation of mental health systems worldwide, and this includes sustained investment in mental health workforce and services, a decisive shift toward community-based, person-centered care as part of universal health coverage, legal and policy reforms that uphold rights and dignity.” 

On a personal level, it’s about consistently reframing my thinking. I realized that I can be as open about my mental health as much as I want, but if I don’t start seeing it as a chronic condition, I am part of the problem. 

I encourage you (and me!) to keep this in mind: Just because a condition is manageable or invisible, it does not make it any less real or disabling. Invisible doesn’t mean insignificant.

As Chronic Bosses, we can own the truth that mental health is a chronic condition. Because when we do so, we stop apologizing for existing and start demanding to be seen.

Below is a chart from the WHO’s World Mental Health Today report that illustrates just how stark these disparities remain. World mental health today: latest data