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Writer's pictureChris Colcomb

The Mental Health Continuum

I'm a great believer of keeping things simple. Where mental health is concerned, we all get bamboozled with jargon-like terms, labels and 'conditions'. These will be helpful in some arenas, of course, but in terms of understanding where a person is at any given time, these terms may be challenging in their application.


I came across a model called The Mental Health Continuum from a company called Delphis and it just struck me as being pretty easy to understand.


It helps us view mental health as a positive and it highlights signs and symptoms that we can all recognise and proactively improve.


It acknowledges that mental health is not a binary state of being 'mentally healthy' or 'mentally ill'


This model suggests five zones into which we can categorise ourselves. It is important to recognise that each zone is broad, and can come with its own shades of severity. The following article has been adapted and paraphrased from the original source.


The five zones can be summarised in the following diagram :



1. Excelling

The highest level of mental wellbeing in the continuum is ‘Excelling’. Given the right conditions, and a positive mindset, excelling sees us functioning at our peak level. This might be at a time of great joy or fulfilment, or a major personal success.


Another form of ‘Excelling’ could be when we are performing at our fullest potential. This may be in relation to an interest, or it may apply to work. The more often someone is in this state, the better their outcomes. How can we get into the Excelling zone? And how can we stay there? This is a great example of where coaching can help - as it helps to lift us into a state of high performance.



2. Thriving

A 'healthy' state of mental health is indicated by the light green zone, which is called ‘Thriving’. In this zone you would feel fine – perhaps not completely free from troubles, but more or less calm and content. You cope with any worries, annoyances or concerns well. They do not unsettle you in the longer term.


In terms of your basic behaviours you would function normally - for example when it comes to eating or sleeping. Your social and work patterns are what you would consider normal (within the confines of your own personality type and functioning).


You may benefit from a coaching approach, which will help lift you from Thriving to Excelling - if you are so motivated.



3. Surviving

Surviving is represented by the yellow zone. This points to an unsettled state of mind. Slipping into this zone can be fairly easy and it is sensible to watch for the signs and symptoms. This is not a severe state of stress but it can be an indicator that things may get worse - so we should pay attention here and take action.


Worries prey on the mind more than usual. Thoughts may be more negative than usual. Appetite and sleep may be affected. It will be harder to concentrate on work or other tasks. You may just feel on edge without knowing why.


We try to identify a reason for our unease. This may be obvious on the surface but the underlying cause may be difficult to understand. It is important not to blame the wrong cause, as we may start to think negatively about the wrong thing. And that can lead to a snowball effect of problems gathering momentum.


For example : a poor night’s sleep makes you feel tired and annoyed. You incorrectly blame that irritation on someone else. You get annoyed with a colleague over some minor comment, and this leads to conflict or poor work relationships.


This is a scenario where a good counselling relationship will help you to pull yourself out of the surviving zone. As part of this process, things that may help could be :

  • Employing rational or 'Adult' thinking

  • Positive thinking

  • Relaxation or mindfulness meditation techniques

  • Making time to be yourself, and enjoy yourself

  • Consider constructive conversations to fix poor relationships

Sadly, if steps aren’t taken, there is a danger of slipping into the orange zone.



4. Struggling

In the orange zone you may be significantly troubled. You may feel so much anxiety that life becomes miserable. Your mood may be so low that you feel it is hard to do anything well. Your concentration may be poor, energy may be low, your work and family life may suffer.


In this state you may feel pain emotionally and physically, or you may feel numbed and empty. Your thoughts will almost certainly be negative. This might include ideas of worthlessness or that others don't like you. Your basic habits may be affected. For example, you may have little appetite or sex drive, and sleeping may be poor.


However, the good news is that you remember how you felt better in the past and you wish you could feel better now. In the orange zone it is important to take steps to pull yourself out of it. This is a place where psychotherapy will help. Here, you find a place to really explore and understand your feelings, as well as where they originate. Psychotherapy is a place of treatment where you will be striving to get better.



5. In Crisis

Unfortunately there is a state of mental health beyond Struggling. People with diagnosed mental health conditions may have found themselves in this zone in the past, which led to their diagnosis and treatment. But anyone can fall into this state in the right circumstances.


‘In crisis’ means a person is in a state of great suffering and needs immediate help. Their emotional pain may be so unbearable that they want to take their own life. Symptoms include severe anxiety or depression, or even both at the same time. There will be great difficulty in performing work and other ordinary daily acts such as personal hygiene, eating and sleeping. They may just stay in bed all day and avoid all social contact. It is likely they will stay off work sick. If they are ashamed of their condition, which is sadly often the case, they may give some other reason for their absence.

People may attend work through a sense of duty or habit, but likely not get much done.


In the red zone, you will certainly need professional help. Typically psychotherapy and psychiatry can help but it will likely be a lengthy process to recovery.


People in this zone may also need crisis help at times of severe difficulty. The Samaritans are fantastic in these situations.


If the person seems at immediate risk of suicide, stay with them and call local mental health services or the police. Make sure there are no dangerous items around which they could use to harm themselves. Two important things to remember are:

  • talking to someone about their suicidal thoughts does not make them more likely to end their life

  • you can help someone who is feeling suicidal by listening, without judging them.


At most points on the continuum, I can help. I have helped people achieve their goals and dreams via coaching, and have helped people to change their negative thoughts via a counselling or psychotherapy approach. Often, a combination of all three approaches is highly effective.


Contact me using the details below, or book a FREE consultation using the button above.


Phone : 07581088211


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Source : Delphis

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