Stigma, Roadblocks Keep Those Living with Depression Suffering for Too Long
By Frederick Langheim, M.D.
Mental illness affects about one in four adults in the U.S. every year. Unfortunately, many people suffering from mental illness – including anxiety disorders and depression – never seek treatment.
Dean Clinic psychiatrist and University of Wisconsin – Madison adjunct assistant professor of clinical psychiatry Dr. Frederick Langheim can see how our modern life is significantly impacts our mental health – and he says there are ways to not only treat depression, anxiety and other mental illness, but also to prevent it.
“Our drives for success often lead us to put sleep, diet, exercise and the nurturing of our relationships aside – which we believe is only for the time being – as we pursue our goals,” says Dr. Langheim. “Instead these decisions lead to poor habits, which have the power to undermine our physical and mental well-being.”
These habits and daily coping mechanisms lead to relationship discord, substance abuse and a growing economic burden of mental illness in society. According to the National Alliance on Mental Illness, $193.2 billion dollars in earnings are lost every year because of serious mental illness.
“While the stigma of mental illness may appear to be improving, we can all help to reduce this by paying attention to ourselves and our loved ones,” says Dr. Langheim. “We need to encourage help-seeking and strive for balance in our lives.”
Preventing mental illness begins early in life
Though we rarely think about the ways we can prevent mental illness in the ways we think about preventing other chronic illnesses, prevention can be effective.
“While vaccines don’t exist, it is increasingly evident that it may be possible to avoid development of mental illness – whether suicide, depression and possibly even schizophrenia,” says Dr. Langheim.
Prevention should start early in life. Effective means of prevention include protecting our youth from adverse life experiences including child abuse and substance abuse. Making health lifestyle choices is also paramount in the prevention of mental illness. A healthy diet, regular exercise and proper sleep are vital to giving your brain the tools it needs to maintain chemical balance – thus warding off depression, certain anxiety disorders and other mental illnesses.
Screenings and early detection lead to successful treatment
Depression and anxiety disorders affect a large number of Americans, but stigma, lack of health care access and other roadblocks, cause many to suffer in silence.
Other risk factors also play a big role in the development of mental illness. Because we don’t have much control over risk factors like genetics and brain chemistry, it’s – important to talk to your doctor about mental health screenings and your risk of mental illness.
“Early detection of mental illness leads to more rapid treatment and the resolution of symptoms,” says Dr. Langheim. “Mental illnesses like depression appear to impact our ability to recognize these changes in ourselves. Screening can bring these changes to our attention and the attention of health care providers.”
Bringing these symptoms up with your primary care doctor is important because mental health issues can have a significant impact on your overall health and well-being.
“The mind-body connection is also increasingly evident,” says Dr. Langheim. “Depression and anxiety may worsen our experience of physical pain, decrease our social connectedness and reduce our physical activity in ways which may lead to ill health.”
Dr. Langheim says the road runs both ways – in that sedentary lifestyles, poor diets and interrupted or inadequate sleep can contribute to depression, anxiety and impaired cognitive function. Mental illness can also lead to longer hospital stays, more frequent use of emergency services, a lower quality of life and early death.
Treatments are personal, require commitment and consistency
If you are diagnosed with mental illness, understand there are a variety of effective treatments. Talk therapy and anti-depressants are the most common forms of therapy for depression.
One of the most heavily studied forms of talk therapy is cognitive behavioral therapy. During cognitive behavioral therapy, an individual and therapist examine day-to-day experiences to learn and analyze the individual’s automatic thoughts, behaviors and emotions.
“Because we spend so much of our lives on ‘autopilot,’ we have developed rapid assessment and response abilities that can be helpful,” says Dr. Langheim. “Without them we would spend our days having to analyze every situation and response – much like a toddler walking down a sidewalk examining every flower and insect. Instead, over years of experience, we relinquish conscious control over much of our behavior and these automatic responses take over.”
Dr. Langheim says many responses may start out as helpful, but some – like black and white thinking or catastrophizing – are more common and can create more problems than you might realize. Additionally, consistency is important when it comes to the success of cognitive behavioral therapy.
“Just like physical therapy or learning to play a musical instrument, successful cognitive behavioral therapy requires daily practice of the techniques and exercises learned in your regularly scheduled appointments,” says Dr. Langheim. “If psychotherapy is not effortful and challenging, it will not move you forward. At best, it will only keep you from getting worse.”
Aside from psychotherapy, many people with depression are prescribed anti-depressants called selective serotonin reuptake inhibitors – or SSRIs. These medications block the reabsorption of the naturally occurring chemical serotonin in the brain. Changing the balance of serotonin helps your brain cells send and receive messages, thus boosting your mood.
While it can be tempting to self-medicate with over-the-counter remedies like St. John’s Wort, Dr. Langheim notes that it is important to work with your doctor to find the right medications for your specific needs.
Treatments like St. John’s Wort promise similar outcomes to prescription medication, but dosing is uncertain, and these “natural” medications can interact with other prescriptions you may be taking. Additionally, these medications are unregulated and when tested, many products show no actual genetic markers of their active ingredients. Dr. Langheim says your doctor can tailor a selection of medication based on any additional symptoms you may have, like insomnia or low energy.
Help is available
Even though help is available for people living with depression, the average person with depression often waits up to a year before receiving treatment. If you are struggling with a mental illness diagnosis, Dr. Langheim urges you to seek help. While there are many barriers to receiving care – including self-stigma, lack of health care and lack of access to mental health care providers – the longer you wait, the longer it will take to help you achieve successful treatment.
“There are people out there who can help you, people who are trained to help you, and are available to answer your questions and help guide you back to health and high function,” says Dr. Langheim.
If it’s a loved one suffering from depression, Dr. Langheim says there are real ways you can support them through treatment – and it doesn’t take special training to do so.
“First and foremost – listen. Many of us so desperately wish to help that we jump in with solutions and suggestions before our loved one can finish their thoughts,” says Dr. Langheim. “This can lead to reluctance to talk and a sense that they are somehow not doing enough for themselves. Instead, take time to hear out responses to open-ended questions and only then suggest that there are people who can help and that you would like to help them find treatment.”
If you or a loved one is depressed or showing signs of any kind of mental illness, talk to your doctor. You can also find help by reaching out to the National Alliance on Mental Illness, Wisconsin Chapter by calling (800) 236-2988.