what is mental illness?

Depression is an illness.

This is probably not news to you, but it is for many people, including those suffering from depression and some of the people who love them.

I occasionally have clients in my office who ask me to explain depression and other mood disorders to their wives, parents, or children. They feel misunderstood and often stigmatized by what, to the client, can be a debilitating condition. If you’ve ever suffered from depression, anxiety, PTSD, or bipolar disorder, you’ve probably heard one or more of the following: “You need to pull yourself up by your bootstraps”, or “Why can’t you just snap out of it”. These comments often come from well-meaning people who feel helpless in the face of a loved one’s symptoms. But these comments are no more effective or accurate than advising a diabetic to pull himself up by his bootstraps.

One in four families – that’s 25% of the population – has a loved one with severe mental illness. Approximately 10% of us struggle with depression, anxiety, bipolar disorder, or other mood disorder. Even with such significant numbers of people suffering, the stigma surrounding mental illness still exists. To some, depression is perceived as pessimism, laziness, or emotional weakness. Anxiety is sometimes mocked or dismissed as irrational or silly. Bipolar disorder may be called “craziness” or misperceived as evidence of a person’s poor character or inability to make good decisions.

Like any illness, mood disorders have specific and recognizable symptoms that should be identified and monitored. Look for symptoms of depression, such as feeling “low” or “down” for an extended period of time, feelings of hopelessness, guilt, and/or worthlessness, and a loss of interest in once-enjoyable activities. Symptoms may also include irritability, anger, or restlessness. The physical symptoms of depression often include digestive problems, fatigue or exhaustion, weight loss/gain, and chronic pain.

Symptoms of anxiety include exaggerated and excessive worry, irrational dread of common situations, persistent and unwanted thoughts, tension and irritability. Physical symptoms can include heart racing, chest pain, fatigue, muscle tension, sweating and dizziness. Some anxiety disorders may include specific, chronic fears, emotional numbness, and/or ritualized and compulsive behaviors.

Bipolar disorder is often misunderstood and minimized as “mood swings” or simple irritability that anyone can experience from time to time; but it really involves the cycling from extreme highs known as mania to the extreme lows of major depression. Someone suffering from bipolar disorder during a manic phase may go without sleep for days, speak and move rapidly, behave and speak in grandiose ways, and engage in high-risk behaviors. As they cycle out of mania into depression, they tend to become exhausted, experience feelings of guilt and worthlessness, and often become suicidal.

It’s important to recognize the symptoms and treat them as a medical condition that requires a combination of medical and mental health care. Just as diabetes and high blood pressure are treated with medications, mental illness can be effectively treated with a wide range of medications by a qualified psychiatrist or other physician trained in mental illness. And just as most medical illnesses are best treated with a change in lifestyle, so are depression, anxiety, and bipolar disorder. Eating healthy, exercising even a few times a week, and treating the body with care can have tremendous benefit. One of the most important aspects of treatment is adequate rest. In the beginning, this may require extended periods of sleep to feel fully rested, but certainly sleep will always be a top priority for those with mood disorders.

In the case of depression or anxiety, medication is not always necessary, and in cases that it is necessary, it may only be required for 6-12 months. Mental health counseling or therapy is sometimes sufficient to help people think and feel differently and move them through the most difficult aspects of their illness. If a person is taking medications for their mood disorder, however, therapy is almost always necessary to help maintain and improve functioning.

Receiving understanding and support from family members and friends is just as important as the other forms of treatment. If you care about someone who suffers with depression, anxiety, or other severe mental illness, educate yourself. Talk to your loved one about their specific symptoms. Ask how you can help. Avoid trying to fix the problem and just sit with them. Hold their hand. Offer comfort. Remember that the psychological and physical pain of mental illness is real. And seek professional help, because it CAN get better.