How About a Marathon for Mental Illness?

I’ve never heard of a marathon for mental illness.* We have them for birth defects, breast cancer, AIDS, muscular dystrophy, heart disease and even some “orphan” diseases. But not for mental illness. Not for depression, anxiety, bipolar disorder, schizophrenia or other kinds of psychosis.

It can’t be because there aren’t that many people affected by mental illness. Mental illness is the leading cause of disability in the U.S. and Canada. (See source below.**) What if it could be treated successfully, or even cured? Just think of all the anguish that could be assuaged, the marriages that could be salvaged, the prison populations that could be reduced and the individuals who could be restored to full productivity. And of course all of that translates into billions of dollars in savings.

So why don’t we do more to alleviate the problems associated with mental illness? There are principally three reasons why we don’t.

1) Mental illness is grossly misunderstood. Most people are confused about what constitutes mental illness. We don’t know how to differentiate between “normal” depression or anxiety and the kind of depression or anxiety that completely debilitates a person, for instance. Not even the medical profession agrees on the causes and appropriate treatments.

2) Crazy people scare us. We are afraid that they’ll do damage to themselves or others. We steer clear of them whenever possible. Sometimes we even act like we think that mental illness is contagious. We joke about it (“Mental illness is catching. I caught it from my kids”), but never treat it seriously. We don’t talk about it in polite company in the same way that we would talk about cancer or even alcoholism.

3) Because mental illness can’t be “seen” in the same way as other diseases, we tend to think that it’s all in the sufferer’s head. It’s a figment of his or her imagination or a matter of learning how to think good thoughts. We don’t believe that it can be a real disability; we assume that the mentally disabled person is just playing the system.

I’m very familiar with all of these reasons. I don’t even understand my own mental illness. And yes, it scares me sometimes. And I constantly doubt whether or not I’m really disabled.

It’s humiliating to admit that you can’t handle things that other people seem to be able to. It’s frightening when you exhibit behavior that others consider to be just plain crazy. And it’s a terrible feeling when you realize that you don’t have control over your own mind.

One thing I try not to do is blame my mental illness for my behavior and personality traits. But it’s hard to draw the line between staying home and feeling sane and putting myself in situations where I get so anxious I can barely function. I try to keep my life as uncomplicated as possible because I don’t handle stress well at all, but even I get impatient about the lack of excitement in my life.  I understand why some people go off their meds: they’re tired of not feeling anything.

The problem is, there is no one effective treatment for mental illness. (Not to mention that there are so many different kinds of mental illness.) And so far there is no cure. I will probably always have to take medication for my depression and anxiety. When I don’t (as I have discovered when I run out of meds or am lax about taking them), I fall apart. Even when I do take them, I can easily tip over the edge. And yet I hate that weakness within me.

But what is even worse is how others look at you when they know you have a mental illness. Some people just flat out don’t believe you. Others worry about you unduly. And still others steer clear of you completely. You become afraid that people won’t want to befriend you, date you, marry you, have children with you, vote for you, or hire you. And often you’re right. Sometimes even you doubt your ability to do these things. And the sad thing is, sometimes you can’t. At least, not without help.

My own children doubt the extent of my mental illness. They think it’s awful that I take so many medications. They think if I had a different psychiatrist I’d be able to overcome them.

Each mentally ill person deals with their condition as best they can. It’s easy to be on the outside and prescribe ways to “get over it.”  But until you’ve suffered from a mental illness, you have no idea what the mentally ill person is up against. She has to use her own mind to deal with things that are going wrong with it. He may not even realize that he has a mental illness. But the main reason why the mentally ill don’t get treatment is because of the stigma associated with it.

It’s obvious that society is not willing to deal with mental illness. Most health insurance plans are woefully inadequate when it comes to mental health coverage. 10-15 visits a year is average; inpatient care has high deductibles, and brand name medications, which are usually Tier Three, are expensive. Hour-long visits for psychotherapy are almost never covered; you’re lucky to get a 15-minute medication check for when you go in for one of your limited number of appointments.

We don’t lock people up in insane asylums the way we used to (partly because the state doesn’t want to pay for mental hospitals any more). But being mentally ill is like being in prison and even when you’re being treated for it, you feel like an ex-con.

When there are marathons for breast cancer the participants proudly advertise that they are or know breast cancer survivors. No one would announce that fact if we were having a marathon for mental illness. In fact, it’s likely that no one would come.

**Read David Schimke’s essay on mental illness from the latest issue of Utne Reader.

Read about the father who has run over a hundred marathons on behalf of his daughter who suffers from schizophrenia. His dream is to organize marathons to help to erase the stigma associated with mental illness. I hope he is successful.

*That’s not entirely true: I did find some information about a STOMP OUT STIGMA  (SOS) marathon to be run in October, 2011 which is sponsored by the Depression and Bipolar Support Alliance of Greater Chicago. But that doesn’t erase the fact that public support for mental illness is almost non-existent.

Women and Depression

Women are almost twice as likely to experience depression as men are. I don’t mean that they get the blues more often, although that may be true as well. What I mean by depression is clinical, or major, depression, the kind where your mood seriously impairs your ability to live a normal life.

That doesn’t mean that getting depressed occasionally isn’t normal. Most people react with sadness, grief or despair when certain events occur in their lives. But what differentiates normal depression from clinical depression is that the latter comes over you when there is no apparent reason or doesn’t go away within a reasonable amount of time after the precipitating episode has passed.

Many of you reading this will go, “Yeah, whatever,” and stop reading. You either don’t think that it can happen to you or you have an ingrained prejudice against the idea of depression being a mental illness. You think that you, or others who are depressed, should be able to “just get over it.” If that works, then you were probably experiencing normal, or situational, depression. If it doesn’t work, they you may be experiencing clinical depression.

You’ll need a doctor to determine if you’re experiencing a major depression. But there are warning signs. Some of them are:

  • Persistent sad, anxious, or “empty” mood
  • Loss of interest or pleasure in your usual activities, including sex
  • Restlessness, irritability, or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
  • Sleeping too much or too little, early morning awakening
  • Appetite and/or weight loss or overeating and weight gain
  • Decreased energy, fatigue, feeling “slowed down”
  • Thoughts of death or suicide, or suicide attempts
  • Difficulty concentrating, remembering, or making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, or chronic pain

Generally, if you’ve been experiencing more than 3 or 4 of these symptoms for more than two weeks, you should see your doctor. That doesn’t necessarily mean that you have to book an appointment with a psychiatrist. Your family doctor may be able to treat you initially, or determine whether or not you need further treatment. However—and this is an important point—if your family doctor doesn’t take your complaints seriously, bypass him and make an appointment with a psychologist or psychiatrist. Tell the doctor’s office that you want an assessment to determine whether or not you’re clinically depressed.

Be prepared to be prescribed medication. Most doctors will try some kind of anti-depressant for at least a trial period. If you’re not comfortable with that, say so, and ask about alternative therapies. But I urge you to remain open to the idea of taking meds, at least for a while. Sometimes that’s all that’s needed to “jump-start” your body’s natural resources for dealing with depression and then you can discontinue the medication, but only under your doctor’s supervision. Some medications have withdrawal symptoms that are worsened when you abruptly stop taking them.

There are two other kinds of depression that women need to be aware of. One is manic depression, or bipolar disorder. This is where you cycle between mania and depression. During the manic periods you might experience:

  • Abnormally elevated mood
  • Irritability
  • Severe insomnia
  • Grandiose notions
  • Increased talking
  • Racing thoughts
  • Increased activity, including sexual activity
  • Markedly increased energy
  • Poor judgment that leads to risk-taking behavior
  • Inappropriate social behavior

The other kind of depression is dysthymia. A person suffering from dysthymia will experience symptoms of depression to a milder degree but for more than two years. Although I was never diagnosed with dysthymia prior to being diagnosed with major depression, I’m convinced that I was dysthymic for most of my life. I can’t remember ever not being depressed. I used to wake up every morning with this overwhelming feeling of self-loathing and despair, even as a child. Once I was treated for major depression, these feelings went away. I can’t tell you how wonderful it is to wake up and look forward to living!

Sources: Psychology Information Online and the National Institute of Mental Health (NIMH).