Opening Minds About Mental Health Stigma

With common concerns about health, safety and finances colliding with 24/7 news headlines that highlight the latest political or societal upheaval, it’s no surprise that anxiety in America is nearing a record high.

Almost 40 percent of adults who responded to a national poll in March reported feeling more anxious than they did a year ago,  putting the country’s average ‘anxiety score’ at 51, based on a 100-point scale, according to the American Psychiatry Association research. That’s up five points from 2017.

Along with the rising number of Americans experiencing anxiety comes another bothersome statistic. Only 40 percent of the 43.8 million U.S. adults experiencing mental illness in a given year are receiving medical help for their condition.

Stigma often prevents the one in five Americans affected by mental health conditions from seeking help, says the National Alliance on Mental Illness (NAMI). People experiencing a mental health condition are often bullied, rejected or discriminated against. Doctors, researchers and behavioral health specialists have long been advocating the need to eliminate the stigma, and get people to understand the importance of treating a mental health disorder like any other medical condition.

Rachel Rohaidy, M.D., a psychiatrist with Care & Counseling at Baptist Health South Florida, agrees.

“Behavioral health issues like anxiety, depression and post-traumatic stress really affect the way a brain functions,” Dr. Rohaidy said.  “There’s a real science behind the neurological component to mental illness. The body’s hormones and neurotransmitters in the brain fluctuate when responding to a stressor or perceived threat, creating imbalances that can interfere with a person’s ability to function normally in everyday life.”

Just like a diagnosis of hyper- or hypothyroidism is a clear aberration of a thyroid imbalance, a diagnosis of anxiety or depression is based on neurological science and the huge body of research and academia addressing mental health, Dr. Rohaidy adds.

“People with diabetes, asthma or high blood pressure who need to take medication regularly, or follow certain diets to stay healthy, aren’t shamed or judged because of their illness,” she said. “Getting help for depression, anxiety or other mental health issue deserves the same understanding.”

Public education and technology advancements are helping to bring the topics of mental health out in the open. The Internet enabling online forums and TV shows featuring characters addressing mental health issues are among positive changes Dr. Rohaidy sees.

“Topics that were never discussed before are now becoming part of everyday conversation,” she said.

Substance Misuse and Mental Health

While depression and anxiety are among the most commonly known mental health conditions, the mental health aspect to addiction is less known. Just over 50 percent of the 20.2 million adults in the U.S. who experience a substance use disorder in any given year have a co-occurring mental illness, according to the National Survey on Drug Use and Health.

“It’s human nature to try and find relief. The brain is wired to seek something to lessen uncomfortable feelings, and that pleasure can be anything from ice cream or pizza, to prescription drugs or alcohol,” says Dr. Rohaidy, who completed a fellowship program in addiction psychiatry. “The problem with alcohol, drugs and other sedatives is they actually work to calm the brain and make the person feel better – temporarily.  But it doesn’t address the real underlying issue that’s leading the person to self-medicate. They need to find more positive coping skills.”

Breaking Down Barriers to Mental Health Treatment

Whether it’s substance abuse, depression, anxiety or any of the many other mental health conditions, taking that first step to seek treatment can often be one of the most difficult challenges.

“Many people feel afraid, unsure of what’s going to happen and, unfortunately, judged,” Dr. Rohaidy said. “It’s important to explain that feeling like that is a normal part of the healing process.”

In addition to medication and behavioral health therapy, family support is key to overcoming a substance or mental health disorder. “Family’ doesn’t necessarily have to be a mom, dad or sibling, explains Dr. Rohaidy. ‘Family support’ could be spousal, close friends or even a community support group.

“When we talk about ‘support,’ we mean understanding, being there to help with daily activities, listening and providing positive reinforcement,” she said. “Even community support, like what NAMI coordinates, can be very strengthening.”

Stigma can also have a negative impact when a patient has a slip in therapy or relapses.

“People with diabetes, asthma or high blood pressure actually have a relapse rate similar to those with substance use disorders. But they aren’t shamed or judged when they don’t take their medication or follow healthy diets as prescribed,” Dr. Rohaidy says. “Those of us who treat mental health disorders use the same approach. We don’t shame or kick patients out of a treatment program. Being able to continue treatment is often a matter of reeducation.”

In addition to addressing any medical deficiencies, getting patients to move past stigma barriers and draw upon the strength of their support team are keys to treating patients with mental health and substance use disorders, she adds.

“The most successful treatment focuses on acceptance, reeducation and getting the person well,” Dr. Rohaidy said. “Just because you can’t see it, doesn’t mean it’s not there.”

Tags: anxiety, behavioral health, Care & Counseling, depression, mental health, Rachel Rohaidy MD, substance use disorder