Originally Published: 10 October 2021

<Audio file available for download here>

Mental Illness Awareness Week runs every first week of October.  Today, 10 October 2021, marks World Mental Health Day.  Considering the global state of affairs, it is no stretch of the imagination that record numbers of people are experiencing some kind of mental health episode.  As a mental health advocate and someone who deals with mental illness, I would feel remiss if I could not in any small way express my support in this arena in which so many of us are fighting for our lives behind the scenes.  So many of us day in and day out fight private battles just to survive, just to get by.

The stigma of mental illness is about as prevalent as it has always been, despite there being more visible advocacy than ever before.  The isolationism and uncertainty of the COVID-19 pandemic has certainly brought many of these secret arenas to the surface for folks.  It’s a battle that no one can win alone.  And, unfortunately, it’s a battle that so few observers are equipped to support.

I forget who originally coined the comparison between mental illness and broken bones, but it goes something like this:

~ If you break a bone, everyone gathers around to sign your cast and wish you well.  If you are experiencing, for example, a manic episode, no one seeks to confront or help quell your neurosis.  Rather, you become a paria to be avoided, a burden, a hindrance. ~

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Say, your co-worker threw out her back and is currently undergoing physical therapy; does this affect your perception of her?  Say, another colleague of yours is a recovering drug addict who regularly attends NA meetings and has sessions with a counselor; does this information affect how you view him?  Both of these individuals are taking responsible actions to manage their conditions and improve the quality of their lives.  Physical therapy is a common enough and openly discussed conversation piece.  While I’m grateful to hear that psychotherapy is slowly becoming less taboo, it is no argument that most of us would rather entertain a conversation around kinesiology over one centered on mental wellbeing.

Is there really such a dramatic difference in physical injury from emotional injury that elicits such dissonant demeanors?  If you wait long enough, your body will surely tell you there is not.  The sickness response is the human body’s adaptive way of telling you, “something’s wrong.”  Say, you experience a panic attack that causes chest pain, sweating, hyperventilation — easily observable physical responses.  If left untreated, your anxious condition can manifest into a coronary artery disease, which puts you at risk for heart attack.  A relatively curated example, maybe, but replace panic attack with cortisol (the “stress hormone”) and the same afflictions can reveal themselves.  Would you say you engage in any sort of stressful lifestyle?  Can you say you (pre-COVID, at least) take part in a high-stress work environment (I aim this question more heavily at my Atlantic coast audience)?

If that example doesn’t speak to you, then let’s talk numbers.  Comorbidity is an oft-heard term in the mental health field.  The Oxford dictionary defines comorbidity as “the simultaneous presence of two chronic diseases or conditions in a patient.”  For example, suffering from depression while also suffering from a substance use disorder.  Nineteen percent of adults in the US experience this kind of comorbidity according to the National Alliance on Mental Illness (NAMI).  To double-back on the last paragraph’s example, adults with serious mental illnesses are twice as likely to suffer from cardiometabolic disease; that curated example doesn’t sound quite so contrived now.  The leading cause of disability worldwide is depression.  In fact, the global economy suffers $1,000,000,000,000 each year in lost productivity due to depression and anxiety disorders.

According to the CDC, 24% of the adult US population (of 258,608,849 according to 2019 census data) experiences mental illness.  Forty-seven percent of that 24% receive treatment in any given year.  Out of the youth population (6-17 years old) of 72,940,958, 17% experience mental illness while roughly half receive treatment.  That leaves 12% of the total US population — or 39,281,358 (I did the math) — untreated or undiagnosed.  There is an average delay of 11 years between symptom onset and diagnosis, which, of course, means that this untreated demographic is left exposed to myriad and potentially life-threatening comorbidities or other health crises.  I don’t need to impress upon you how costly this notion of stigma can be.  The one paying the price could be your neighbor; it could be a loved one; it could be you.

Okay, enough with the statistics.  Why did I bother writing any of this?  Knowledge is useless without action.  As you can see, mental illness is quite prevalent; likely much more so than what is reported as we are still learning to recognize and diagnose these conditions.  We are also still learning — and are woefully inept at — ways of appropriately addressing and providing resources for people who experience mental illness (I am not speaking of the mentally ill, but those who experience mental illness; while that might seem small, it’s important!).  I imagined I’d have used the word, stigma, more than twice (not including just then) in this post up until now.  Because I feel that is the heart of what I want to convey:  getting rid of the stigma around mental illness and enabling more candid conversation around this topic.  That alone can improve the quality of life for so many of us, not just those of us who are suffering.  How we get there…is beyond the scope of this post.  But it starts with an honest intent.  A leap of faith.  Candid, nonjudgmental conversation around someone’s overall wellbeing.

No one should be made to feel guilty about who they are or how their nervous system happens to be wired.  Questions like, “why don’t you just …?” are counterproductive and accusatory, quite frankly.  You may as well just as soon find fault in someone who has diabetes or blame someone for being colorblind; or just blind!  A simple yet earnest  “how are you feeling?”  or a “how can I help?” will go a much longer way.  This education flows both ways, of course.  We must meet people where they are and that includes those trying, maybe not-so-effectively, to offer support.  This level of acceptance and candor opens channels up for bidirectional learning.

I speak from personal experience when I say this is certainly easier said than done.  I have struggled with varying intensities of moderate to severe depression over the years and talking about it was, for me, the only way I got through it.  It’s been a strenuous journey and I lost some people along the way, as is apt to happen in matters such as these.  It’s not hyperbole to say that having a support system of people who care about me saved my life.

To quote a character from a Guinness World Record-holding anime/manga with a decidedly impressive run of 22 years and counting (looking at you, “Straw Hat!”), “There can be no happiness in a world where the undesirables are thrown away.”