Lipstick won't cure depression
And therapy won't end worklessness
The British Association for Counselling and Psychotherapy (BACP) has launched a new campaign: No More Stiff Upper Lip. It aims to end the ‘epidemic of silence’ surrounding the two-thirds of women over 50 who ‘struggle with midlife mental wellbeing’ but keep their difficulties hidden.
To help break the stigma surrounding women’s mental health, and to ‘show how therapy can help’, BACP has developed a ‘limited edition’ make-up range. The No More Stiff Upper Lip collection is designed to provide ‘positive inspiration for those in need of support’. Women can choose from shades named ‘empowered’, ‘heard’, ‘unapologetic’ or ‘resilient’.
I came across this campaign while commenting on news that the NHS is urging nine million people suffering from anxiety and other mental health conditions to get therapy. An ‘epidemic of anxiety’ is, apparently, behind Britain’s ‘worklessness crisis’ - and NHS bosses are relying on therapy to get people back into employment.
If you are not depressed or anxious already, these awareness-raising initiatives seem deliberately designed to tip you over the edge.
First up, there’s the hyperbolic language. According to NHS England’s national medical director for mental health and neurodiversity, people in their 30s and 40s are ‘suffering under an avalanche of anxiety’. While everyone is at risk from an ‘epidemic of anxiety’, middle-aged women face the additional blow of ‘an epidemic of silence’. The president of the Royal College of Psychiatrists upped the ante: she said that Britain was suffering from a ‘silent mental health pandemic’. Honestly, all these quotes are from the same two short articles. I wish I had been forced to search for them.
This language is designed to shock, which is, ironically, probably very unhelpful for people who may be prone to anxiety. Having lived through COVID, we all know that epidemics, and especially pandemics, are scary. But we also learnt that illness was contagious. Words like ‘epidemic’ and ‘pandemic’ suggest that anxiety is not simply a mental state to which some may be especially vulnerable but a disease that anyone can catch. During COVID, we were told to wear masks and practice social distancing; now we are told to get therapy.
Then come the statistics. BACP tells us that 64 per cent of women over 50 have ‘struggled with their mental wellbeing’. Meanwhile, the latest NHS data suggests that one in four adults below the age of 45 has a diagnosable mental health condition, a rise of a quarter in a decade. The NHS claims - a surprisingly precise - 9.4 million people are ‘affected by a common mental health condition’, with unspecified ‘millions’ missing out on the support they need. According to ONS data, in 2024, 23 per cent of people reported ‘feeling high anxiety’.
But just how reliable is this data? Take the BACP claim that two-thirds of middle-aged women struggle with their mental wellbeing. ‘Mental wellbeing’ is a slippery term. It does not mean mental illness. So what, exactly, is it? Happiness? Contentment? The absence of stress, sadness or worries? The problem here is obvious. ‘Mental wellbeing’ is such a subjective concept that it not only varies from one person to the next, but from one moment to the next within the same person.
The vagueness surrounding ‘mental wellbeing’ means that a great deal of what is being described is simply normal human emotion. As a woman falling squarely within BACP’s target audience, I can testify that life can be challenging. Juggling the needs of almost-adult children, ageing parents and work (each perhaps miles apart) with - as a million celebrities remind us every day - menopause, and on top of that all the same daily annoyances that everyone else faces - can be stressful. The older you are, the more likely it is that you will have experienced the death of those close to you and worry about those still alive. It would be abnormal for these things not to disturb a person’s sense of contentment. But this is not a mental illness; it is called ‘being human’.
Shockingly, BACP leaps from vague claims about ‘mental wellbeing’ to claiming that suicide rates are highest among women over fifty. (It omits to mention that this is two-thirds lower than among men the same age.) Then, in the very next sentence, it introduces its new ‘awareness raising’ lipstick collection. To be clear: feeling suicidal is NOT the same as ‘struggling with mental wellbeing’. And while a nice new lippy might cheer someone up on a wet Wednesday afternoon, it will be no help to people contemplating suicide.
The lipstick is there to remind women not to have a ‘stiff upper lip’ - in other words, not to do what women (and men) have been doing since time immemorial and just getting on with things. Resilience, fortitude, and stoicism are not qualities to aspire to, BACP suggests, but problematic responses that prevent us from seeking help.
Neither is BACP suggesting middle-aged women get together with pals and share a bottle of wine; the help we are supposed to seek out is of the professional variety. In other words, it is not lipstick that BACP is marketing but the services of therapists. And - as Freya India explores in her superb forthcoming book Girls - for all the empathetic rhetoric, women’s emotional realm becomes a problem to be fixed by those looking to sell us a service.
The NHS campaign pulls off a similar sleight of hand. Claims that more than nine million people need therapy for ‘common mental health conditions’ tell us nothing about what these conditions actually are. Stress, anxiety and depression, the most commonly reported mental health conditions, can mean anything from feeling worried or sad to experiencing a far more debilitating state. A prevalence rate of ‘1 in 4’ suggests we are dealing with normal, human emotions far more than clinical conditions.
I am not trying to argue that there is nothing to see here. There are issues that should concern us, as a society and as individuals. However, the solutions put forward by BACP and the NHS - awareness raising and the mass uptake of therapy - only make things worse.
So, it should trouble us deeply that 2.8 million people are economically inactive owing to long-term sickness, with ‘mental health’ the leading cause. It should worry us that over 1.5 million people receive Personal Independence Payments for ‘psychiatric disorders’. We should be concerned that younger, working-age adults are more likely to receive benefits for mental health conditions than pensioners.
These figures suggest several things happening in conjunction. First, normal emotional states are being problematised as ‘mental health conditions’. Second, campaigns to ‘stop the silence’ and ‘end the stigma’ make people more likely to seek a label to describe their feelings, and this, in turn, becomes part of their public identity. Third, there are financial incentives - and in a culture that validates victimhood, social incentives - for people not just to get diagnosed as having a mental health condition but, significantly, to sustain illness rather than aim for recovery.
It’s not that people are simply inventing problems; rather, they are more likely to feel genuinely ill when they spend time alone at home, dwelling on their emotional state. ‘Worry’ becomes ‘anxiety’ when you are bombarded by messages telling you to protect your mental health. And ‘sadness’ becomes ‘depression’ in a culture that creates hierarchies of victimhood and lavishes attention on those at the pinnacle.
By contrast, having to get out of bed to go to work, being forced to mix with other people, and ending the day with a sense of having done something productive (even if just earning a crust) - or putting on a stiff upper lip in front of friends and family - can all help shift the focus away from the interior realm.
Awareness-raising campaigns like that planned by the NHS will backfire spectacularly. They tell people negative emotions are a problem. They tell people not to turn to friends and neighbours but to professional therapists. And they tell people to get a label and see themselves as having a condition.
Wes Streeting’s target of getting 9 million more people into therapy is likely only to lead to 9 million more people with diagnosed mental health conditions. And while therapists are kept in work chatting to those with anxiety, people with schizophrenia or psychosis struggle to access any help at all.
Our voice of reason, as always, Joanna. Thank you!
It’s a job creation scheme for otherwise useless graduates who will also probably vote Labour. And it will create vague justifications for benefit claimants. I wonder what would happen if the only NHS-approved therapy for anxiety and depression was “go and get a job. Any job. Get money and you might even make some friends.”