Despite Medical Advances, Mental Health Care Lags

Kerri Cooke Wednesday, July 22, 2020 Comments Off on Despite Medical Advances, Mental Health Care Lags
Despite Medical Advances, Mental Health Care Lags

Mental Health Disorders And Treatment

By Kerri Cooke

Mental illness — what comes to mind when you hear this phrase? Perhaps you associate it with someone exhibiting erratic behavior. After all, when there’s a mass shooting, the defense often tries to plead mental illness. Perhaps the phrase means nothing at all to you. Or, perhaps, mental illness is something you’ve had to come to grips with as a sufferer.

I’ve been going through my own mental health journey over the past few years, and I must admit, even I balk at the mental illness label. Two of the most helpful pieces of advice I’ve received are “Emotions know no IQ” and “You wouldn’t deny a diabetic their insulin.”

Everyone has to take into consideration their mental health. Nobody has good mental health all the time. If we did, then there would be no reason for us to cry, be sad or lonely. However, there’s a difference between being able to easily rebound from a mental health decline and your brain learning negative patterns which make the problem spiral out of control.

Some things you may not know are that Michelangelo suffered from obsessive compulsive disorder (OCD); Beethoven and Winston Churchill were bipolar; Abraham Lincoln had clinical depression and Lady Gaga suffers from dissociation, PTSD, panic attacks and fibromyalgia, which can be brought on by trauma. Even Prince William and Prince Harry rallied to destigmatize mental health as they suffered from the loss of their mother at a young age.

I’ve been diagnosed with depression, generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). I still feel the guilt over not having enough mind over matter because of how society has trained me to think in the past.

According to The State of Mental Health in America 2018, 18 percent, or 43 million, Americans suffer from a mental health disorder in any given year. To simplify things, this statistic estimates that a mental health disorder affects one in five Americans, which makes it one of the most common maladies.

Non-sufferers can tend to think of mental illness as something severe, like schizophrenia or bipolar disorder. But mental health disorders are as common as depression and anxiety. Just think of mental health in terms of physical health. You get a cold and your body reacts a certain way. Certain things can cause your brain to get sick and cause certain effects as well. Whether it’s cancer or anxiety, a person can’t help what has happened. But a person can get treatment and perhaps even go into remission.

Mental Health in America

Anxiety and depression are much more common than one might think. Anxiety disorders are the most common form of mental illness, affecting 19.1 percent of the population according to NAMI, which has compiled the information from various national sources. 

Depression levels can vary from minimal to moderate to severe. The number of people who suffer from a major depressive episode is 7.2 percent. (This doesn’t include minimal or moderate levels of depression.) Also, you can suffer from anxiety and depression at the same time, as anxiety can cause depression and vice versa. 

Other disorders see much smaller number of cases in the U.S.: 2.8 percent experience bipolar disorder; 3.6 percent experience PTSD; 1.2 percent experience OCD; 1.4 percent experience borderline personality disorder and less than 1 percent has schizophrenia.

Mental illness is an epidemic in the U.S., but has yet to be taken as seriously by the general population as it should be. You should never tell a person with mental illness to “just get over it.” 

Luckily, there are treatments which can help reduce the severity of mental disorder or help you rewire your brain to respond less negatively to a situation.

Unfortunately, when you look at the numbers, people aren’t getting treated due to a lack of providers, a lack of insurance, reluctance to seek treatment or a delay in being diagnosed.

Many sources say that if you can treat a mental disorder sooner, the recovery rate is higher and quicker. As time goes on without treatment, a person can sink further and further into their mental funk. It is harder to pull yourself out of a hole than it is to not fall down to begin with. 

Unfortunately, as NAMI’s report states, “The average delay between onset of mental illness symptoms and treatment is 11 years.” I concur with this finding because it took me years to find an effective treatment for myself. I went to doctors, but they didn’t seem to get to the root of the problem until my situation was dire. 

I have a family member who started having digestive issues. The doctors didn’t even bring up the possibility that her problems were caused by anxiety until years later. Once she was treated for anxiety, the problem went away.

It’s not necessarily the doctors’ fault, though. I just think they’re asking the wrong questions. 

At the beginning of a mental illness, doctors ask you if you’re depressed or feel anxious. Well, someone who is experiencing these states for the first time might not recognize what they feel like. When I was first asked if I was depressed, I said no because I couldn’t recognize depression. My relative said no to feeling anxious because she didn’t recognize the feelings either. Instead of a blanket term, perhaps, we need a simplified question and answer session.

NAMI reports that another problem is that only 43.3 percent of adults in the U.S. with a mental illness received treatment in 2018. So less than half of the people with a mental illness got treatment. 

One reason for this is 11.3 percent of adults with a mental illness didn’t have insurance coverage during that year. What we don’t have statistics for is the number of people who didn’t seek treatment because of the stigma attached to mental illness or because they didn’t know how to connect with the resources available or didn’t recognize what their symptoms meant.

Also, women are more likely to seek treatment for their mental health than men are. But females seeking help are still under 50 percent annually, at 48.6 percent. Males who sought treatment for mental illness made up only 34.9 percent. Men, in general, are less likely to receive treatment for all conditions across the board, though, so this really shouldn’t come as a surprise.

Another reason people might not seek treatment is lack of access to care. The lack of mental healthcare providers is a problem across the United States, but particularly in Louisiana.

It is estimated that “60 percent of U.S. counties do not have a single practicing psychiatrist.” According to The State of Mental Health in America 2018, “In Alabama, there’s only one mental health professional per 1,260 people.” And “to meet the need for mental health care, providers in the lowest ranked states would have to treat six times as many people than providers in the highest ranked states.” (Spoiler: Louisiana is one of the lowest ranked states.)

Risk Factors for Mental Illness

Want to know a secret? Anyone, even you, can develop a mental illness if exposed to certain conditions.

Other things to keep in mind are an individual’s personality type, life events, brain chemistry and genetics.

One surprising finding is that a person is more likely to develop anxiety in a high-income country versus a low-income country. The affects of capitalism?

Also, the Americas have much higher rates of anxiety than do the European and African continents. There is no significant difference in the rate of depression though.

Besides this risk factor, which is pretty much uncontrollable, more common risk factors include experiencing “abuse, neglect, violence, parent mental illness, prenatal substance abuse, poverty and developmental disabilities,” according to the CDC Behavioral Risk Factor Surveillance System.

I came upon an interesting tidbit of information as I was researching. I’m sure many of you have heard of Sylvia Plath – most commonly known as the poet who stuck her head in a gas oven to commit suicide at 30. 

There’s something known as the “Sylvia Plath effect,” which claims that those with creative careers or pursuits are at a higher risk for mental illness than the rest of the population. There have been several studies, and while there’s still not a complete consensus on the idea, there does seem to be a correlation between creativity and mental illness; creativity and writing; and creativity and poetry. In fact, two separate studies have shown that those who write poetry are even more at risk than those who write in other genres. 

Mental health issues are also something which many children in foster care deal with.

Lifestyle factors can also increase a person’s risk of developing mental illness. A lack of physical activity, insomnia, smoking, and insecurity when it comes to a familial situation, such as stable housing or food supply, are all risk factors according to the CDC report.

Adults between the ages of 18 and 44 have a higher risk than others for developing anxiety and depression.

Also, the lower your education level is, the more at risk you are, although you are not immune if you have a significant level of education.

Poverty is a significant risk factor as it brings on insecurity and stress. Unemployed adults and those 25 and older who make less than $25,000 a year are at a higher risk.

Your relationship status can also be an indicator in mental health. For example, people who have never been married or are married are less at risk of developing mental illness than those who have been widowed or are divorced from their partner. Of course, if you are in an unhappy marriage, the opposite would be true.

In America, those who are uninsured are usually eligible for health insurance but are not taking advantage of it, perhaps because of the soaring costs of premiums, according to the Associated Press.

One crucial point that The State of Mental Health America 2018 makes is that the youth in the nation and in Louisiana are at high risk for developing a mental illness. Take depression due to bullying as an example. Just remember the video that went viral of the little boy with dwarfism, Quaden Bayles, in Australia. According to his mother, he gets bullied every day and became suicidal at the age of nine.

But if you want to take the idea of mental illness in juveniles a little further, you should know that anorexia and bulimia are considered mental illnesses as well. Easy access to social media and constant exposure to impossible beauty standards are definitely not helping the situation.

When taking mental illness into consideration, remember every child is not the same. Some children respond more negatively to stimuli than others. This is why one child can seem to “act up” after a divorce and another child seems fine with the matter.

By recognizing warning signs early and having our youth treated, we can potentially avoid worse problems in the future. Most children just want to be heard. And sometime they don’t even realize what they’re mad or upset about until they see a therapist.

The CDC says that early intervention is crucial and can even help prevent mental illnesses such as anxiety or depression. 

Overall, receiving therapy and connecting with your family, friends and community can be a big help, because when we feel isolated, there’s more room for negative headspace to grow. 

So, when assessing mental health risk factors, doctors and therapists will take into account your economic situation, your overall health, your education level and your family and community connections to assess your situation and hopefully learn how to fill in the gaps when it comes to treatment.

Mental Health and Behavioral Problems

We all have seen troubled kids and wonder why they are always so uncooperative. The causes of behavioral problems can be complex. But one thing many of these kids have in common is unhealthy mental health. Here are some more statistics for you from NAMI. 

“High school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers.” Also, “70.4 percent of youth in the juvenile justice system have a diagnosed mental illness.” 

These are staggering numbers. We tend to blame the child for acting up. But are we perhaps failing them? Kids act up for a reason. Negative behaviors point to unhappiness.

According to The State of Mental Health America 2018, as many as 7.7 percent of minors are not covered by their parents’ (or others’) insurance when it comes to mental health care. 

Also, while Millenials are deemed the most anxious generation by far, I wouldn’t be surprised if anxiety numbers continue to skyrocket among younger generations. Life is just different today — blame it on technology, a more competitive job market, etc. — and it is causing high levels of uncertainty, which leads to anxiety. 

Rates of severe bouts of depression in minors have sharply increased over the past five years. Also, behavioral problems in other age groups tend to point to some level of mental health issue. 

NAMI says, “20.1 percent of people experiencing homelessness in the U.S. have a serious mental health condition.” Also, “37 percent of adults incarcerated in the state and federal prison system have a diagnosed mental illness.” The key word here is “diagnosed.” How many inmates, I wonder, have an undiagnosed condition? Being a psychopath or a sociopath is considered a mental illness. 

Obviously, many people who struggle with mental illness never become criminals. Each individual deals with problems differently.

And when it comes to our precious veterans, VA patients register as high as 41 percent when it comes to a diagnosed mental illness or drug abuse problems.

Louisiana ranked No. 40 when it came to adults who didn’t get any treatment for their mental illness. We ranked 35 when it came to the amount of people in our state who are underinsured. (As the prices of insurance policies skyrocket, many cannot afford quality plans.) Our access to care ranking was 45.

However, there is a bright spot. States that expanded Medicaid, such as Louisiana, to help eliminate the coverage gap saw improvements in mental health care. For example, Medicaid expansion essentially lowered the rate of the uninsured, which allowed more people with mental illness to receive treatment.

Treatments

There are plenty of proven treatments for anxiety, depression and other mental illnesses. The key is letting go of your fear of asking for help.

No matter how much your brain tells you that you are weak, worthless and incapable of anything, you are brave because you are still fighting. 

But there are ways to make it easier on yourself. Don’t wait until you feel like you are at your breaking point to get help.

Also, remember that finding the right treatments for yourself is a matter of trial and error. It took me several different medications and therapists until I found the right ones.

I was one of the individuals who never wanted to get on a medication because I felt like that was a failure. I felt I should be strong enough to conquer this thing myself. Unfortunately, all that mindset did was make life harder until I had to get on medication or else. 

But one important word of advice I received was that medication is like a band-aid. It numbs the negative feelings but it can’t get rid of them. That’s why everyone should use therapy in addition to medication.

There are different types of therapies, such as cognitive behavioral therapy, in which a counselor teaches you how to channel your thoughts in a more positive vein in order to avoid anxiety. For example, I can freak out over an event and get anxious or I can choose to believe there’s a better opportunity out there instead. It’s all about mindset. It isn’t easy, but it is possible.

Another therapy, one that I happen to be doing, is EMDR or Eye Movement Desensitation and Reprocessing. It uses eye movements to follow light patterns, hand clappers to alternately vibrate or alternate beeps in a headset to help your brain reprocess traumatic events. It helps to get rid of the fear related to those memories. The theory is stimulating both sides of the brain alternately helps the memories to become less emotionally based and more factually based because, let’s face it, our feelings lie to us constantly.

Whatever you are feeling and whatever your needs are, don’t be afraid to speak out. A first step could be simply being honest with a friend. But reach out. Nobody can help you if you bottle it all up. With the right steps, you can start the road to recovery. It might take a while, but life will get better.

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