May is Mental Health Awareness Month, and because of the coronavirus pandemic, this year it is more important than ever to raise awareness about the ways mental health affects us as a society, and the different mental health issues that may be affecting those individuals that are closest to us.

Mental illness impacts everyone

Chances are you know someone who is currently suffering from a mental illness. In a more normal year, the statistics regarding the prevalence of mental illness in the United States and abroad are staggering. For example, in the U.S. nearly 20% of the adult population currently suffers from some form of mental illness and up to 17% of America’s youth (ages 6 to 17) experience a mental health disorder.¹ In fact, a 2008 study by the World Health Organization found that a disproportionate amount—38%—of all ill health in developed countries was caused by mental illness, higher even than heart disease, stroke, cancer, lung diseases and diabetes combined, at 22%.²

In the United States, perhaps unsurprisingly, the most common forms of mental illness are anxiety and depression, at 19% and 7% respectively. Unfortunately, a majority of adults with these illnesses go untreated; indeed only 43% of adults and 51% of youth receive treatment in a given year. Perhaps most surprisingly, according to the National Alliance on Mental Illness (NAMI), “the average delay between symptom onset and treatment is 11 years.”

The costs of untreated mental illness

The consequences of not treating mental illness are perhaps as staggering as the prevalence of these disorders. “Our mental health and our physical health are very, very connected and influence each other,” notes Callie Krauel, Licensed Clinical Social Worker at Door County Medical Center. “When people are feeling stressed,” she adds, “they’ll often have headaches, or an upset stomach, or probably won’t sleep well.” Numerous studies have shown that untreated mental illness resulted in an increased risk of developing other chronic diseases like diabetes, cancer and cardiovascular disease. One Oxford University study found that serious mental illness could reduce life expectancy by between 10 and 20 years—a greater life expectancy reduction than a lifetime of heavy smoking.³

In fact, the costs of not treating mental illness extend to economic considerations as well. One study found that mental illness was the most prevalent disease in working age people, accounting for nearly half of all disability benefits in most developed countries, and in 2016, the European Molecular Biology Organization found that “Mental disorders…account for more economic costs than chronic [physical] diseases such as cancer or diabetes.”⁴ According to NAMI, depression and anxiety disorders alone cost the global economy $1 trillion each year in lost productivity.

Overcoming barriers to treatment

Perhaps the most common reason that people with a mental illness avoid or don’t receive treatment is one of stigma. The negative stereotypes and characterizations that often accompany mental illness—that the illness is a sign of weakness, or that it is a personal failing or character flaw—often run deep in society (and sometimes in individuals with the illness) and present some of the biggest barriers to getting effective treatment. These negative attitudes that are attached to people suffering with mental illness frequently result in discrimination, isolation, and shame and an unwillingness to seek treatment.⁵ However, there is cause for hope. Callie remarks that she sees the stigma associated with mental illness declining, “I think, the more people hear about mental health issues the more people realize, ‘Hey, a lot of people struggle with anxiety and depression—a lot of people struggle with mental health issues,” they start to feel less alone. And, as they start to recognize that family members and friends are struggling, it becomes a little more acceptable and that stigma is reduced overall, and I do think we’re headed in that direction. It just takes time, but I think we’re getting there.”

And, the truth is that mental illness is just that—an illness. As a society, we don’t say to someone with cancer, diabetes or multiple sclerosis that his or her disease is a personal failing or a sign of weakness. Instead, we do everything we can to cure or alleviate the symptoms of the disease. And, like any other disease that affects the body, mental illness is highly treatable, usually with a combination of medication and therapy.

Mental illness during the coronavirus pandemic

From a mental health perspective, 2020 is turning out to be a year like no other. The combination of fear generated by coronavirus pandemic itself, as well as the economic toll of the “safer at home” orders many countries have put in place to slow the spread of the virus, is expected to result in an increased rate of trauma, anxiety and depression worldwide. “Right now, with what’s going on, many people are experiencing changes in their jobs—hours are being reduced, or jobs are being cut altogether,” Callie points out, adding, “I think this is especially stressful on folks, and as a result, there is a lot of uncertainty regarding what lies ahead.” Indeed, there is a strong correlation between economic disruption and mental illness. According to the Washington Post, “Nearly half of Americans report the coronavirus crisis is harming their mental health…A federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April compared with the same time last year.”⁶ Undeniably, feeling stressed, anxious or depressed during this time is quite common.

Coping with the coronavirus

The National Alliance on Mental Illness writes, “Recognizing how you’re feeling can help care for yourself, manage your stress and cope with different situations. Even when you don’t have full control of the situation, there are things you can do.” Techniques that NAMI suggests for coping with the stress caused by the coronavirus pandemic include:

• Reducing screen time. Constant news consumption, especially watching the news, can increase anxiety. While it is important to stay up to date, NAMI suggests limiting news consumption to 15 minutes a day.
• Following established daily routines. Daily routines help keep us grounded, and following the established routines of our pre-pandemic lives can help you feel in control. Small actions, like making your bed and getting dressed, even if it’s not required, can make a big difference.
• Keeping physically active. As noted above, there is a strong correlation between physical and mental health. Exercise of any type will naturally reduce anxiety and depression. In fact, exercise has been shown to be as effective as antidepressants in treating moderate depression.⁷
• Focusing on the present moment. Callie points out that thinking too much about an uncertain future can cause anxiety, and ruminating on the past can lead to depression. She suggests, “Staying focused on the present—what’s happening here and now—and not getting too far ahead. If we focus on what we have control over today, it’s going to directly influence how we feel, and help us feel better.”
• Maintaining social connection. While we may not be able to meet with people in person during this time, it is important to stay connected to close friends and family via phone, email and social media.

Warning signs of mental illness

Mental illness is not a “one size fits all” type of disease, and each individual will present with different symptoms. Nevertheless, there are common warning signs that someone is developing a mental illness, which include: feeling sad or withdrawn for more than two weeks; out-of-control, risk taking behavior; marked weight gain or loss; extreme changes in mood; difficulty concentrating; and continuous and strong worries and fears that inhibit daily activities.

1. Unless otherwise noted, all statistics are provided by the National Alliance on Mental Health (NAMI), and can be found on line at: https://www.nami.org/Home.
2. https://wol.iza.org/articles/economics-of-mental-health/long
3. http://www.ox.ac.uk/news/2014-05-23-many-mental-illnesses-reduce-life-expectancy-more-heavy-smoking
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007565/
5. https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/
6. https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/
7. https://slate.com/technology/2018/03/exercise-is-as-effective-as-antidepressants-for-many-cases-of-depression.html