THOUGHTS FROM A THERAPIST: Bringing Mental Illness Out Of The Shadows

Have you ever wondered why it’s natural to talk about physical illness in everyday conversation, but not mental illness? Why is it perfectly acceptable to say, “I have a history of heart disease,” yet not to say, “I have a history of depression”?

Poor diet and lack of exercise can potentiate the onset and exacerbate the progression of heart disease; early-life trauma and adult trauma can dramatically increase one’s likelihood of experiencing depression. Despite this, there’s an undeniable reticence to speak with equal frankness about depression (or any mental illness that carries multiple predisposing factors) as we do heart disease.

Most of my patients are educated; many have advanced degrees. Though, generally, they find themselves in circles with others who are equally well informed, many have said that disclosing their depression or anxiety creates uncomfortable silences, stares, and is generally met with a lightning-quick move to another topic.

Yet, those of my patients who are burdened with a physical illness report no such discomfort or difficult silences when revealing that diagnosis.

What accounts for the vast difference in how physical and mental illness are conceptualized? Are mental illnesses rare?

Some numbers to consider:

It’s estimated by the National Alliance on Mental Health that approximately 1 in 5 adults in the United States — 43.8 million people — will experience some form of mental illness in a given year. Approximately 1 in 5 young people ages 13 to 18 (that’s 21.4 percent of teens) experience a severe mental disorder at some point during this crucial life stage.

Among the 20.2 million adults in the United States who are positive for a substance use disorder, 50.5 percent of these individuals have an additional co-occurring mental illness. Suicide is the second-leading cause of death for Americans ages 10 to 34.

If we look at one of the deadliest of all mental health problems, addiction, we find that our small corner of the world holds a disturbing ranking. Among all counties in New York State, Suffolk County ranks among the highest in incidence of deaths due to overdose.

Less often referenced is that, according to the State Department of Health, suicide is the second-leading cause of death among all age groups in our state. Within New York, suicide has increased an alarming 27 percent since 2000.

In fact, self-inflicted injuries (intentional injuries to oneself, either with or without suicidal intent) were the leading cause of inpatient hospitalizations for 15-to-24-year-olds, and the second-leading cause for all age groups. Statewide, self-inflicted injuries increased a startling 25 percent in four short years, from 2010 to 2014, for this 15-to-24-year-old age group.

Nationwide, in 2016, 45,000 individuals died by suicide, and in 2017, over 70,000 deaths were due to some form of addiction. Worldwide, a 2012 World Health Organization study found that there were 804,000 deaths by suicide — that’s one death every 40 seconds.

With numbers like these, why the reticence to really talk about depression, addiction, anxiety or any mental health issue in everyday conversation? Why the reluctance to say, “My son … my daughter … my wife … my friend” is depressed, anxious, bipolar?

Twenty-four years ago, my brother took his own life. His death forever changed my own and prompted me to become a psychotherapist.

It’s my hope that future editions of this column, which will examine a full range of mental health challenges (many a direct result of the pandemic), will contribute to a more open dialogue about depression, anxiety, addiction and all mental health diagnoses.

Lisa Wolf, MSW, LCSW holds a Master of Science from Columbia University and a Bachelor of Arts from the University of California, Berkeley. She is a practicing psychotherapist with offices in Bridgehampton and Manhattan. Her website is lisawolftherapy.com.

The contents of this column are for informational purposes only. Nothing found in this column is a substitute for professional advice, diagnosis, treatment or professional psychotherapy. If you are in crisis or experiencing suicidal thoughts, call 911 immediately.