Changing the Language for Mental Health

In my book,” Things I Think About”, I wrote a chapter about mental health issues, which are close to home for me. I have been considering if the term, “mental illness” was, in and of itself, a disservice to those of us who occasionally struggle with our mental health diagnosis. I believe it is.

A mental health diagnosis is like any other diagnosed condition: Defined by criteria and, when appropriately treated, a state of wellness is achieved with treatment. Mental health issues need not constitute a continuation of a state of “illness”. In the physical, medical world, if one is “ill”, one is actively sick.

Properly treated, persons with mental health diagnoses are no different than persons with an appropriately treated chronic medical illness, like hypothyroidism, or glaucoma, or diabetes, or Crohn’s disease, or rheumatoid arthritis, or…. I could go on. For most of us with a mental health diagnosis, if we did not reveal to you we had a mental health diagnosis, you would never suspect it.

Here are some statistics on mental health diagnoses:

Key Findings

  • Over 44 million American adults have a mental health condition. Since the release of the first State of Mental Health in America report (2015), there has only been a slight decrease in the number of adults who have a mental health condition (from 18.19% to 18.07%)
  • Rate of youth experiencing a mental health condition continues to rise. Therate of youth with Major Depressive Episode (MDE) increased from 11.93% to 12.63%. There was only a 1.5% decrease in the rate of youth with MDE who did receive treatment. Data showed that 62% of youth with MDE received no treatment.
  • More Americans are insured and accessing care. We can continue to see the effects of healthcare reform on the rate of Adults who are uninsured. This year there was a 2.5% reduction in the number of Adults with a mental health condition who were uninsured.  
  • …But many Americans experiencing a mental health condition still report having an unmet need. 1 in 5, or 9 million adults reported having an unmet need.
  • Mental health workforce shortage remains. Many states saw some improvement in their individual to mental health provider ratio. But in states with the lowest workforce there was almost 4 times the number individuals to only 1 mental health provider. (Mental Health America, 2019)

From this same website, Mental Health America, statistics for my home state, North Carolina, show a rate of 18.98% of adults have some type of mental health issue. Substance abuse affects 7.03% of our population. Those adults in North Carolina who have serious thoughts of suicide are 4.23% and persons in North Carolina who have any mental health issue and do not get treatment constitute 50.7% of the population. (Mental Health America, 2019)

From the National Alliance on Mental Illness, (NAMI), the site states:

“A mental health condition isn’t the result of one event. Research suggests multiple, linking causes. Genetics, environment and lifestyle influence whether someone develops a mental health condition. A stressful job or home life makes some people more susceptible, as do traumatic life events like being the victim of a crime. Biochemical processes and circuits and basic brain structure may play a role, too.” (National Alliance on Mental Illness, 2019, para. 3)

In addition, on the NAMI website it also relays:

“If you have a mental health condition, you’re not alone. One in 5 American adults experiences some form of mental illness in any given year. And across the population, 1 in every 25 adults is living with a serious mental health condition such as schizophrenia, bipolar disorder or long-term recurring major depression.

As with other serious illnesses, mental illness is not your fault or that of the people around you, but widespread misunderstandings about mental illness remain. Many people don’t seek treatment or remain unaware that their symptoms could be connected to a mental health condition. People may expect a person with serious mental illness to look visibly different from others, and they may tell someone who doesn’t “look ill” to “get over it” through willpower. These misperceptions add to the challenges of living with a mental health condition.” (NAMI, 2019, paras. 1-2)

I contacted the NAMI information site to ask the organization to consider changing the language for mental health diagnoses from mental illness to mental health condition or mental health diagnosis. I give my rationale for this request as discussed above. The response I received from Luna was as follows;

“As far as the term “mental illness,” there has been a lot of internal debate about the best terminology to use. And there are discussions coming up this year about how we will move forward in the future, so I will bring this perspective to my team!”

 There have been many public persons who have struggled with mental health conditions. Per Web MD. persons such as, Mariah Carey, Demi Lovato, Brian Wilson, Russel Brand, Kurt Cobain, Jimi Hendrix, Ernest Hemmingway, Mel Gibson, Catherine Zeta-Jones, Vivian Leigh, Frank Sinatra, Jane Pauley, Carrie Fisher, and Winston Churchill all have or had bipolar disorders. (Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017, 2017)

Depression as a diagnosis is, I think, one of the less stigmatized, although that may be an overstatement.  Within our population, beliefs about depression vary. There is the assumption of some that those who are depressed could “will” the depression away if they so choose. Put on a happy face, so to speak. Go do something happy. None of which works to resolve true depression. Then there are those who think the diagnosis of depression means someone will inevitably commit suicide so they avoid persons with a diagnosis of depression. Neither is true, of course.

If one thinks about mental health conditions, many require medications to reset one’s brain chemistry. If mental health conditions were just a state of mind, why would medications resolve the issue? Makes no sense, does it? Yet, that is the way many persons think. Mental health conditions are either horrible or present because one does not have any will power. Silly thinking. Uneducated thinking.

Because mental health conditions are so stigmatized-even by the medical community-many persons just don’t want to know or do not wish to take medications, so they avoid treatment. It would be akin to a diabetic refusing to diet or, if needed, take medication for his/her high blood sugar. Or someone with a thyroid condition refusing to replace his/her thyroid hormone.

If the public would stop considering anyone with a mental health diagnosis as dangerous or weak, it would go a long way to preventing persons with mental health issues using drugs or alcohol to self-treat their symptoms, (Ernest Hemmingway, Carrie Fisher, Demi Lovato, Winston Churchill, and Jimi Hendrix for examples). Without appropriate medical treatment, this is a method to ease symptoms or at least the person recognizing the symptoms exist.

I have bipolar II disorder. There are times I struggle with severe depression and a few times I did not sleep well and participated in some less than safe behaviors. But I am not less than you who have no mental health diagnosis. I can look at my life and say it has been a successful one.

If one in five Americans have some type of mental health issue in their lifetime, chances are you are somehow associated with someone-whether you know it or not-who has a mental health condition. After seeking help over and over again for depression, a psychiatrist asked more in-depth questions than usual and found I was not just depressed, but I had bipolar II depression. I am the same person I was prior to my diagnosis, just better now.

One of the signs of bipolar II depression versus unipolar depression is the person’s reaction to antidepressants. Over the years I had tried many and had severe problems with all of them-the old ones and the new ones. Another sign of the diagnosis of bipolar is the age of onset of depression. If one experiences depression that begins in adolescence or early adulthood, this is a symptom of bipolar depression. Unipolar depression begins later in life. I had finally come to a point I was willing to take medication long-term for my issue, despite my fear of the diagnosis and of medications. It was a difficult diagnosis to accept. I knew how the public viewed mental health conditions. I felt shame and the need to hide my diagnosis from everyone, even my doctors. But, medication made me feel so much more stable.

Some of the medical professionals still seem to think because one has a mental health diagnosis one is liable to do all types of unusual things-verbally and physically. I think some are waiting for the patient’s head to spin around like in” The Exorcist”.

Winston Churchill was an amazing statesman,( although he did drink a bit). Look at those persons above noted in the article by Web MD. Did they not and, the ones living, still, make significant contributions to our society. Of course, they did.

Wake up, grow up America. Recognize we are not to be feared or shunned or stigmatized just because you have not taken the time to educate yourselves on mental health issues. Come into the 21rst century. If you can spend time learning technology, you can take the time to educate yourselves on this subject. One in five, people, one in five.

Works Cited

Mental Health America. (2019). Mental Health America. Retrieved April 10, 2019, from The State of Mental Health in America: http://www.mentalhealthamerica.net/issues/state-mental-health-america

NAMI. (2019, paras. 1-2). Living With A Mental Health Condition. Retrieved from National Alliance on Mental Illness: https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition

National Alliance on Mental Illness. (2019, para. 3). Mental Health Conditions. Retrieved from National Alliance on Mental Illness: https://www.nami.org/Learn-More/Mental-Health-Conditions

Reviewed by Arefa Cassoobhoy, MD, MPH in October 2017. (2017, October). Celebrities With Bipolar Disorder. Retrieved from Web MD: https://www.webmd.com/bipolar-disorder/ss/slideshow-celebrities-bipolar-disorder

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5 Comments

  1. You know, I believe the numbers. I really do. I would almost suggest it could be higher than one in five, ya know? I just think of me and how afraid I am to admit to it to the people in my life, and then I think of all the people out there who are probably in the same position. It’s such a horrible stigma, I wish we could break.

    Like

    1. Me also. This blog is my coming out about my diagnosis. I am 63 years old and the stigma issue was still a huge road block. I had an attorney who knew about my diagnosis tell me to never tell an employer about it. I think unless we who suffer do not blog or do something to tell someone it eats us alive!

      Liked by 1 person

    2. I think I sent this, but not sure it went. I am 63 years old and just now coming out about my diagnosis to close friends and on this blog. I understand how you feel. Just take care of yourself and blog to get our your feelings. It is so nice we can be honest when we blog.

      Like

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