I’ve had several different topics up for consideration on the blog this week, but in the wake of the tragic suicide of Robin Williams I’ve decided to continue my focus on mental illness.  As our country, indeed our world, tries to come to terms with the paradox that a comedian as brilliantly talented as Robin Williams could suffer from depression so severe that he would end his own life, I hope that we will each open our minds to understanding the true gravity of mental illness.

Every few years when a celebrity commits suicide or dies of a drug overdose, our society gives a cursory nod to mental illness & the same old platitudes are rolled out over & over: “Anyone can suffer from depression.”  “Get help.”  “Don’t suffer alone.”  While all of these things are true, the sad reality is that true change never happens.  The same old stigmas against mental illness persist which only contribute to the negative cycle of these diseases, making it difficult for people to even seek treatment.  For those who overcome the stigma & do seek treatment, the lack of adequate resources continues to make finding & continuing treatment a true challenge.

To understand the gravity of mental illness, one must first understand the prevalence of the problem.  According to the National Institute of Mental Health, a branch of the National Institutes of Health, some 18.6% of adults in the US suffer from some form of mental illness.  Read that figure again: 18.6%.  That is almost 20% of the population!  (Please note this does not even include substance or alcohol abuse.)  Anxiety & depression make up the largest percentage of this figure with schizophrenia representing about 1% of the US adult population & bipolar disorder about 2.6% of the US adult population.  While these figures may seem low, consider that out of every 100 people you know, at least one or two of them are probably suffering from one of these serious disorders.  Regarding anxiety & depression, the NIMH reports that almost 7% of the adult population in the US has suffered at least one major depressive episode in the past year & that about 18% of the adult population has suffered a major anxiety episode in the past year with a life-time prevalence as high as almost 29%.  Furthermore, it is estimated that as much as 25% of homeless people are suffering from a severe mental illness.  Shockingly, suicide is the tenth most common cause of death for adults in the US, according to the CDC.

I do not mean to overwhelm you with numbers & statistics, but my point here is that mental illness is extremely common.  It does not discriminate against age, race, gender, religion, wealth, intelligence, or talent.  ANYONE can suffer from mental illness & many do.  For some people mental illness is transient & with proper treatment they may never suffer from it again (this is more common with SOME cases of anxiety or depression).  But for others it is a chronic condition that will persist throughout their lifetime (for example, bipolar & schizophrenia are rarely, if ever, transient conditions).

Sadly very little is understood about the causes of mental illness.  Certainly most doctors & scientists would agree that mental illnesses are affected by both nature (genetics) & nurture (environmental factors).  But for the most part we are just treating the symptoms with mental illness because we really don’t know the exact cause.  There is little research in this field so sadly there are not as many advances in treatment as one would hope.

As I mentioned earlier, the accessibility to treatment for mental illness is sorely lacking in this country.  Not only are there far too few psychiatric facilities for the seriously ill, but access to outpatient therapy is far from adequate.  For example, without insurance my therapist would cost almost $200 a session, a price I could not afford to pay more than a few times a year & a price that would be absolutely prohibitive for many Americans.  Prior to the 2008 passing of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, more commonly known as the mental health parity act, insurance companies were not required to provide equal access to mental health treatments.  Even after this, many insurance companies provided minimal access to mental health treatment.  With the passing of the ACA, we can only hope that mental health services will finally begin to expand & that greater accessibility will finally take shape.  The sad reality is that those suffering from mental illness, particularly severe mental illness, are more likely to have difficulty holding down a steady job which translates into being uninsured & unable to afford the treatment they so desperately need.  It’s a vicious cycle that often never ends.

Despite the prevalence of mental illness, Americans have been slow to understand the gravity of these disorders.  The stigma against mental illness is real.  Far too often those suffering from anxiety or depression are accused of “just not being thankful enough for God’s blessings in their lives,” showing a clear misunderstanding of these disorders.  Or how often have you heard someone casually scoff that a person who is a bit moody or difficult to handle “must be bipolar”?  Indeed the lack of knowledge of mental illness has led a great deal of the population to confuse schizophrenia with multiple personality disorder, the latter of which is actually an extremely rare condition.  I for one grew up thinking schizophrenia was the same as “split personality” when in reality schizophrenia is a completely different, though just as serious, disorder.  Again a lack of understanding of mental illness leads to a great deal of fear surrounding these conditions.  How many times have you read a novel or seen a movie in which a serial killer or some other heinous villain is depicted as being schizophrenic, psychotic, or otherwise mentally ill?  Indeed, after almost every mass shooting or bombing, the accusations of bipolar, schizophrenia, & general mental illness are thrown out by every media outlet.  Once again this feeds into the fear of mental illness.

The reality is that research has consistently shown that those suffering from mental illness, particularly severe mental illness such as bipolar & schizophrenia, are actually far more likely to be the VICTIMS of violence, be it abuse, rape, or murder, than to be the perpetrators of such violence.  But this is NOT the picture depicted by the media, whether in response to real-life tragedies or in books & films.  Tragically, even within the healthcare field, there is a great deal of prejudice against mental illness.  Far too often the moment a nurse or doctor sees a mental health diagnosis, an eye-roll ensues & the patient is viewed though a considerably different lens than someone without such a diagnosis.  What I’ve found in my own practice as a nurse is that patients who are actually mentally ill, if treated properly, are in fact no more difficult to care for than anyone else.  While I’ll be the first to admit that I feel ill-prepared to handle patients in acute psychosis, in general I’ve found that mentally ill patients do not deserve the negative stereotypes so unfortunately assigned to them.

My point in writing all of this today is to help people understand that mental illness is extremely common, but it’s not something of which we should be afraid or ashamed.  Though the treatments available are far from perfect, they can & do make a tremendous difference.  If you’re looking for a personal perspective, I am happy to report that I am already feeling significantly better since starting my own anti-anxiety medication just a week ago.  With a combination of cognitive behavioral therapy with my therapist, regular saturation in music & other such relaxing activities, & now Prozac, I can honestly say my anxiety is becoming more & more controlled.  While I have no idea what it’s like to suffer from a severe mental illness, I do know that having my anxiety better-controlled is greatly contributing to my quality of life.  But I couldn’t say that if I hadn’t sought treatment last year (first through therapy & now additionally with medication).

Furthermore my hope is that after reading this you will become more aware of your own prejudices against mental illness.  We’re all guilty of them at times.  Having a dear friend who is bipolar has radically changed how I view mental illness, as have my own struggles with anxiety.  What I’ve learned is that mental illness is just one aspect of a person; it doesn’t define them.  No one chooses to be mentally ill just as no one would choose to have diabetes or heart disease or cancer.  I’ve also learned that sometimes just being a friend & lending a supportive hand & a listening ear is one of the greatest things you can do for someone suffering from mental illness.

As former NJ governor Richard Codey stated, “For too long we have swept the problems of mental illness under the carpet…and hoped that they would go away.”  But the reality is that these problems are not going away & probably never will.  But if our society can decrease the stigma against mental illness & increase our understanding of these conditions, we can offer more hope to those suffering.  Remember, if you’re not part of the solution, you’re part of the problem.  Be an advocate for proper understanding & treatment of mental illness.  Stand up to those around you who propagate negative, harmful stereotypes against the mentally ill.  The grim situation of the mentally ill in this country will never change until our attitudes about mental illness change.

Most importantly, if you’re reading this & you feel like you might be suffering from a mental illness of any sort, I hope you’ll have the courage to get help.  The world can be a cruel place for the mentally ill, but nothing is worse than suffering in silence when help really is available.  To those who are lucky enough to not suffer from mental illness, open your eyes & your mind to those hurting around you.  Don’t diminish their disease by telling them it’s not real or they’re just looking for pity.  Encourage them to seek proper treatment & be that listening ear when they need it.  You never know when you might save a life by doing something so simple.

Statistics & other information found at:

http://www.cdc.gov/nchs/fastats/suicide.htm

http://www.nimh.nih.gov/Statistics/index.shtml

http://www.nationalhomeless.org/factsheets/Mental_Illness.pdf