HEALTHY LIVING

5 Real Ways To Combat The Stigma Around Mental Illness

02/03/2015 07:28 am ET | Updated Feb 03, 2015
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An estimated 43.7 million American adults -- 18.6 percent of all adults in the U.S. -- suffer from a mental illness. But only 13.4 percent of U.S. adults get any mental health treatment at all. The reasons why are complex and include structural policy problems like the lack of mental health research and a growing psychiatrist shortage.

There's at least one way that all of us, however, can help more people get the care they need. It's through understanding and combatting the stigma associated with mental illness.

Mental health experts and thought leaders Mohini Venkatesh of the National Council for Behavior, John MacPhee of the Jed Foundation and William Emmet of the Kennedy Forum discussed the issue of stigma in mental illness with psychiatrist Dr. Gail Saltz at a panel last week during the 2015 Clinton Foundation Health Matters Summit in Indian Wells, California. During the event, they zeroed in on some crucial ways communities can help more people who suffer from mental illness get the care they need:

1. Make sure "going to the doctor" includes going to a therapist, if needed.
doctor

For most people, visiting a primary care doctor and visiting a behavioral therapist are two very different things. But what if a checkup with your primary doctor led to a visit down the hall to a behavioral therapist, all before your appointment is over?

Integrating behavioral therapy into primary care was the panel's main focus. Doing so would allow patients to truthfully tell family members or friends that they are visiting the doctor, without having to face any static about going to therapy. It would also recognize how deeply intertwined the mind and the body are, said Saltz.

"When you talk about mental health, we really are talking about people with cardiovascular disease, diabetes, COPD, with asthma," she said. "Because chronic illnesses absolutely cause mental health issues, and mental health issues make those chronic illnesses worse, we have to start talking about that in an integrated sort of way."

Finally, integrating therapists into a primary health care setting could improve compliance for patients with chronic conditions like addiction, obesity and sleep disorders. For example, behavioral therapists could help doctors learn about the problems that prevent an obese patient with Type 2 diabetes from changing his or her diet, or the obstacles that prevent a sleep-starved person from creating a soothing evening routine, said Saltz.

2. Train community leaders on how to screen for the signs of depression.
college dorm

Almost 80 percent of college students who commit suicide on campus never sought help from a college counseling center. But, as Emmet pointed out, many of those people did go at some point to a campus medical center.

The key to connecting more college students to counseling services, therefore, is to train campus health center personnel or college RAs on how to "recognize the growing signs that someone is in distress, and to help them feel comfortable about knowing what to do to refer [someone] to care," he said. "I would say that the traditional model of separation between mental health services and the health centers on college campuses hasn't worked."

3. Emphasize mental health, not mental illness.
healthy

In 1999, then-Surgeon General David Satcher issued a groundbreaking report on the state of mental health in America. It described mental health in four components: productive activities, fulfilling relationships, adapting to life's changes and dealing with adversity.

Perhaps a better way of addressing mental illness, Emmet said, is to discuss how to maintain mental health, not just how to treat a mental illness.

The strategy emphasizes a common goal that we all share (mental health), while allowing for the diversity of ways people can achieve and maintain that state -- anything from healthy eating, exercise and sleep habits to counseling and medication.

"For some people, it's about being clear that you're enhancing your capacities already, not addressing flaws," he explained.

4. Recognize that friends and families can be powerful allies.
black family

It may seem daunting at first, but family members and friends have a crucial role to play in helping someone struggling with a mental health issue. Acceptance from your inner circle has "incredible value," said Venkatesh, as it helps a person realize that it's "okay that they need extra help."

We've still got a long way to go when it comes to communicating our concern for people affected by mental illness. A 2010 Centers for Disease Control and Prevention report on stigma showed that while 57 percent of adults without mental illness believe that people are generally caring and sympathetic toward those with mental illness, only 25 percent of adults with mental health symptoms believe the same.

Check out MentalHealth.gov for a list of questions and discussion points for those who want to start a conversation about mental health with a loved one.

5. Own it.
smiling friends

MacPhee encouraged every individual to "own" the fact that we are all, in one way or another, affected by mental illness. Whether we have a loved one who's struggling, someone we've known who died of suicide, or even personal struggles, talking about mental health illness can demystify it, which might then empower others to seek help.

Talking openly about mental illness signals to others that they're not alone, and it also opens up a dialogue about how we can better treat people with mental illness in the future, which happens to be the impetus behind Huffington Post's Stronger Together series.

"[If] every individual can own it, where we all talk about it and we can all admit it, we can really accelerate the removal of the stigma and prejudice around it," said MacPhee. "This is an issue that affects all of us."

Also on HuffPost:

  • Summer Weather
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    Seasonal Affective Disorder (SAD) is most commonly associated with winter blues, and it afflicts about 5 percent of Americans. But for less than 1 percent of those people, this form of depression strikes in the summer. Warm weather depression arises when the body experiences a "delay adjusting to new seasons," says Alfred Lewy, MD, professor of psychiatry at Oregon Health and Science University, in Portland. Instead of waking and enjoying dawn, the body has a hard time adjusting, he says, which could be due to imbalances in brain chemistry and the hormone melatonin. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression
  • Smoking
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    Smoking has long been linked with depression, though it's a chicken-or-egg scenario: People who are depression-prone may be more likely to take up the habit. However, nicotine is known to affect neurotransmitter activity in the brain, resulting in higher levels of dopamine and serotonin (which is also the mechanism of action for antidepressant drugs). This may explain the addictive nature of the drug, and the mood swings that come with withdrawal, as well as why depression is associated with smoking cessation. Avoiding cigarettes -- and staying smoke free -- could help balance your brain chemicals.
  • Thyroid Disease
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    When the thyroid, a butterfly-shaped gland in the neck, doesn't produce enough thyroid hormone, it's known as hypothyroidism, and depression is one of its symptoms. This hormone is multifunctional, but one of its main tasks is to act as a neurotransmitter and regulate serotonin levels. If you experience new depression symptoms -- particularly along with cold sensitivity, constipation and fatigue -- a thyroid test couldn't hurt. Hypothyroidism is treatable with medication.
  • Poor Sleep Habits
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    It's no surprise that sleep deprivation can lead to irritability, but it could also increase the risk of depression. A 2007 study found that when healthy participants were deprived of sleep, they had greater brain activity after viewing upsetting images than their well-rested counterparts, which is similar to the reaction that depressed patients have, noted one of the study authors. "If you don't sleep, you don't have time to replenish [brain cells], the brain stops functioning well, and one of the many factors that could lead to is depression," says Matthew Edlund, M.D., director of the Center for Circadian Medicine, in Sarasota, Fla., and author of "The Power of Rest."
  • Facebook Overload
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  • End Of A TV Show Or Movie
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    When something important comes to an end, like a TV show, movie, or a big home renovation, it can trigger depression in some people. In 2009, some "Avatar" fans reported feeling depressed and even suicidal because the movie's fictional world wasn't real. There was a similar reaction to the final installments of the Harry Potter movies. "People experience distress when they're watching primarily for companionship," said Emily Moyer-Gusé, Ph.D., assistant professor of communication at Ohio State University, in Columbus. With "Avatar," Moyer-Gusé suspects people were "swept up in a narrative forgetting about real life and [their] own problems."
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    You can endlessly debate whether city or country life is better. But research has found that people living in urban settings do have a 39 percent higher risk of mood disorders than those in rural regions. A 2011 study in the journal Nature offers an explanation for this trend: City dwellers have more activity in the part of the brain that regulates stress. And higher levels of stress could lead to psychotic disorders. Depression rates also vary by country and state. Some states have higher rates of depression and affluent nations having higher rates than low-income nations. Even altitude may play a role, with suicide risk going up with altitude.
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  • Lack Of Fish In The Diet
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    Low intake of omega-3 fatty acids, found in salmon and vegetable oils, may be associated with a greater risk of depression. A 2004 Finnish study found an association between eating less fish and depression in women, but not in men. These fatty acids regulate neurotransmitters like serotonin, which could explain the link. Fish oil supplements may work too; at least one study found they helped depression in people with bipolar disorder.
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    Although unhappy relationships with anyone can cause depression, a 2007 study in the American Journal of Psychiatry found that men who didn't get along with their siblings before age 20 were more likely to be depressed later in life than those who did. Although it's not clear what's so significant about sibling relationships (the same wasn't true for relationships with parents), researchers suggest that they could help children develop the ability to relate with peers and socialize. Regardless of the reason, too much squabbling is associated with a greater risk of developing depression before age 50.
  • Birth Control Pills
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    Like any medication, the pill can have side effects. Oral contraceptives contain a synthetic version of progesterone, which studies suggest can lead to depression in some women. "The reason is still unknown," says Hilda Hutcherson, M.D., clinical professor of obstetrics and gynecology at Columbia University, in New York. "It doesn't happen to everyone, but if women have a history of depression or are prone to depression, they have an increased chance of experiencing depression symptoms while taking birth control pills," Dr. Hutcherson says. "Some women just can't take the pill; that's when we start looking into alternative contraception, like a diaphragm, which doesn't contain hormones."
  • Rx Medications
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    Depression is a side effect of many medications. For example, Accutane and its generic version (isotretinoin) are prescribed to clear up severe acne, but depression and suicidal thoughts are a potential risk for some people. Depression is a possible side effect for anxiety and insomnia drugs, including Valium and Xanax; Lopressor, prescribed to treat high blood pressure; cholesterol-lowering drugs including Lipitor; and Premarin for menopausal symptoms. Read the potential side effects when you take a new medication, and always check with your doctor to see if you might be at risk. More from Health.com: 10 Tips for Dating With Depression The Most Depressing States in the U.S. Depressing Jobs: Career Fields With Hight Rates of Depression
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