Or there was always the other possibility. That I would suddenly be saddled with the stigma automatically associated with people who suffer from any form of mental illness. It's OK to ridicule those who suffer in silence. It's OK to treat them like less than a person, to ostracize them. People don't understand mental illness and at times they seem to think it's contiguous. So many millions of people in the world continue to suffer in silence. Like I did for years.
"It is often swept under the covers. People keep it private.
Family members, co-workers and friends aren’t sure how to react and are often counter supportive. Traditional perceptions of mental health issues are attached to sign of weakness in character. This is slowly changing. We know now there are biological reasons and triggers for depressions. Sometimes another disease, medical disorder or medication has created depression as a side effect.
It’s not easy for most people to understand why!
So instead they come up with solutions and comments like “buck it up” or “your a smart person, you can beat this” and so on are harmful. Subtle reactions and assumptions that you are dangerous and should be avoided do more harm than good. Negative judgements and harmful comments are often a part of what someone suffering (yep suffering and in pain) has to go through.
Not pleasant.
Pretty patronizing.
People avoid you, ignore your real needs, dismiss your concerns and expect you to get on with life in a regular fashion. It can lead to shame and low self-esteem or confidence. It certainly gets you angry and frustrated."
Copied without permission from http://www.copewithlife.ca/depression/the-stigma-of-mental-health-issues/
People avoid talking about mental illness, like they're going to catch it if do. So many suffer in silence. They fear the stigma. They don't want to be labeled as the "crazy" person at the office, or at Christmas dinner. Even AIDS had less of a stigma attached to it today.
Mental Disorders in America
Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.1 When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.2 Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.1 In addition, mental disorders are the leading cause of disability in the U.S. and Canada.3Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.1
In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).4
Mood Disorders
Mood disorders include major depressive disorder, dysthymic disorder, and bipolar disorder.
Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder.1,2
The median age of onset for mood disorders is 30 years.5
Depressive disorders often co-occur with anxiety disorders and substance abuse.5
Major Depressive Disorder
Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.1, 2
While major depressive disorder can develop at any age, the median age at onset is 32.5
Major depressive disorder is more prevalent in women than in men.6
Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.1, 2
While major depressive disorder can develop at any age, the median age at onset is 32.5
Major depressive disorder is more prevalent in women than in men.6
Dysthymic Disorder
Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis. Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year.1, This figure translates to about 3.3 million American adults.2
The median age of onset of dysthymic disorder is 31.1
Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis. Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year.1, This figure translates to about 3.3 million American adults.2
The median age of onset of dysthymic disorder is 31.1
Bipolar Disorder
Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year.1, 2
The median age of onset for bipolar disorders is 25 years.5
Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year.1, 2
The median age of onset for bipolar disorders is 25 years.5
Suicide
In 2006, 33,300 (approximately 11 per 100,000) people died by suicide in the U.S.7
More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder.8
The highest suicide rates in the U.S. are found in white men over age 85.9
Four times as many men as women die by suicide9; however, women attempt suicide two to three times as often as men.10
In 2006, 33,300 (approximately 11 per 100,000) people died by suicide in the U.S.7
More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder.8
The highest suicide rates in the U.S. are found in white men over age 85.9
Four times as many men as women die by suicide9; however, women attempt suicide two to three times as often as men.10
Schizophrenia
Approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year,11, 2 have schizophrenia.
Schizophrenia affects men and women with equal frequency.12
Schizophrenia often first appears in men in their late teens or early twenties. In contrast, women are generally affected in their twenties or early thirties.12
Approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year,11, 2 have schizophrenia.
Schizophrenia affects men and women with equal frequency.12
Schizophrenia often first appears in men in their late teens or early twenties. In contrast, women are generally affected in their twenties or early thirties.12
Anxiety Disorders
Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).
Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).
Approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder.1,2
Anxiety disorders frequently co-occur with depressive disorders or substance abuse.1
Most people with one anxiety disorder also have another anxiety disorder. Nearly three-quarters of those with an anxiety disorder will have their first episode by age 21.5 5
Panic Disorder
Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder.1, 2
Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.5
About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.12
Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder.1, 2
Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.5
About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.12
Obsessive-Compulsive Disorder (OCD)
Approximately 2.2 million American adults age 18 and older, or about 1.0 percent of people in this age group in a given year, have OCD.1, 2
The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.5
Approximately 2.2 million American adults age 18 and older, or about 1.0 percent of people in this age group in a given year, have OCD.1, 2
The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.5
Post-Traumatic Stress Disorder (PTSD)
Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.1, 2
PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.5
About 19 percent of Vietnam veterans experienced PTSD at some point after the war.13 The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.
Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.1, 2
PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.5
About 19 percent of Vietnam veterans experienced PTSD at some point after the war.13 The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.
Generalized Anxiety Disorder (GAD)
Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year.1, 2
GAD can begin across the life cycle, though the median age of onset is 31 years old.5
Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year.1, 2
GAD can begin across the life cycle, though the median age of onset is 31 years old.5
Social Phobia
Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia.1
Social phobia begins in childhood or adolescence, typically around 13 years of age.5
Agoraphobia
Agoraphobia involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.5
Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia.1
Social phobia begins in childhood or adolescence, typically around 13 years of age.5
Agoraphobia
Agoraphobia involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.5
Approximately 1.8 million American adults age 18 and over, or about 0.8 percent of people in this age group in a given year, have agoraphobia without a history of panic disorder.1, 2
The median age of onset of agoraphobia is 20 years of age.5
Specific Phobia
Specific phobia involves marked and persistent fear and avoidance of a specific object or situation.
Specific phobia involves marked and persistent fear and avoidance of a specific object or situation.
Approximately 19.2 million American adults age 18 and over, or about 8.7 percent of people in this age group in a given year, have some type of specific phobia.1, 2
Specific phobia typically begins in childhood; the median age of onset is seven years.5
Specific phobia typically begins in childhood; the median age of onset is seven years.5
Eating Disorders
The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.
The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.
In their lifetime, an estimated 0.6 percent of the adult population in the U.S. will suffer from anorexia, 1.0 percent from bulimia, and 2.8 percent from a binge eating disorder. 14
Women are much more likely than males to develop an eating disorder. They are three times as likely to experience anorexia (0.9 percent of women vs. 0.3 percent of men) and bulimia (1.5 percent of women vs. 0.5 percent of men) during their life. They are also 75 percent more likely to have a binge eating disorder (3.5 percent of women vs. 2.0 percent of men).14
The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.15
The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.15
Attention Deficit Hyperactivity Disorder (ADHD)
ADHD, one of the most common mental disorders in children and adolescents, also affects an estimated 4.1 percent of adults, ages 18-44, in a given year.1
ADHD, one of the most common mental disorders in children and adolescents, also affects an estimated 4.1 percent of adults, ages 18-44, in a given year.1
ADHD usually becomes evident in preschool or early elementary years. The median age of onset of ADHD is seven years, although the disorder can persist into adolescence and occasionally into adulthood.5
Autism
Autism is part of a group of disorders called autism spectrum disorders (ASDs), also known as pervasive developmental disorders. ASDs range in severity, with autism being the most debilitating form while other disorders, such as Asperger syndrome, produce milder symptoms.
Autism is part of a group of disorders called autism spectrum disorders (ASDs), also known as pervasive developmental disorders. ASDs range in severity, with autism being the most debilitating form while other disorders, such as Asperger syndrome, produce milder symptoms.
Estimating the prevalence of autism is difficult and controversial due to differences in the ways that cases are identified and defined, differences in study methods, and changes in diagnostic criteria. A recent study by the Centers for Disease Control and Prevention (CDC) reported the prevalence of autism among 8 year-olds to be about 1 in 110.16
Autism and other ASDs develop in childhood and generally are diagnosed by age three.17
Autism is about four times more common in boys than girls. Girls with the disorder, however, tend to have more severe symptoms and greater cognitive impairment.16,17
Personality Disorders
Personality disorders represent "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it."4 These patterns tend to be fixed and consistent across situations and are typically perceived to be appropriate by the individual even though they may markedly affect their day-to-day life in negative ways. Among American adults ages 18 and over, an estimated 9.1% have a diagnosable personality disorder.18 Several more common personality disorders include:
Antisocial Personality Disorder
Antisocial personality disorder is characterized by an individual's disregard for social rules and cultural norms, impulsive behavior, and indifference to the rights and feelings of others.
Approximately 1.0 percent of people aged 18 or over have antisocial personality disorder.18
Avoidant Personality Disorder
Avoidant personality disorder is characterized by extreme social inhibition, sensitivity to negative evaluation, and feelings of inadequacy. Individuals with avoidant personality disorder frequently avoid social interaction for fear of being ridiculed, humiliated, or disliked.
I read though all that and realized that more than one apply to me and have for most of my life. Except I never realized it. Why? Because people simply don't talk about it. If you are among friends or coworkers and you start coughing people say "Sounds like you've got a cold" and then tell you what you should do about it. If you fell down and broke a leg people would jump to your aid, take you to the hospital and get you taken care of. If you're suffering from clinical depression you get told to suck it up. Why is that?
When you hurt on the outside people notice and everyone seems to have a solution for you. Kind of like weight loss. Well, if you would only ____________ you'd fix that right up. When you suffer on the inside people don't know what to say to you. Or they assume you're just in a bad mood. Because that's how it for them. They have a bad day, get over it and life goes on. Someone like me has a bad day and that turns into a bad week and the next thing you know it's 20 years later and that bad stay hasn't gone away.
I didn't understand what was wrong with me until just a couple years ago when I finally went to see a professional. It was either that or a bullet in the head, I took the shrink route. It took all of maybe 10 minutes for the first in a long line of councilors to look at me and say, very clearly, Rain, you're depressed. It's not just in your head and it's not just a bad day. And I thought, what do you mean I'm depressed, only crazy people get depressed. And then I starting thinking about what I was thinking. And so began the journey.
I know that if I had never talked to a person that actually understood what was happening with me and that person had not bothered to tell me I wasn't alone and I wasn't crazy that I would still be suffering alone. I would still be trying to "suck it up". Because that's what you do, right? That's what we are taught by society. You certainly don't talk about it.
Except I will talk about. I will talk about it a lot. To anyone who will listen. I am not ashamed any longer of who and what I am. I accept that my wiring is a little off. I accept that depression will always be a part of my life. What I don't accept is that it will control my life. I won't allow that again. I want people to know that I deal with depression, panic and anxiety, PTSD and social phobias. I want people to know that I can still live my life while dealing with my issues. That I don't let my issues control what and who I am. And I hope that by being vocal, by writing this blog, by not hiding in the dark, that I may help one person realize that they are not alone. To realize that there is hope. To finally understand that what they suffer from is not just a bad day or an off mood.
If you see a person in a wheel chair what is your first thought? Or a person on crutches? A person with a chronic disease like cancer? You don't look at them and think "buck up little camper, it's gonna be alright". But how many millions of people suffer every day from things you can't see? Mental illness, chronic pain, all those things that go on inside of us that we don't share.
References
1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.
2. U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh/
3. The World Health Organization. The global burden of disease: 2004 update, Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland: WHO, 2008. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf.
4. American Psychiatric Association. Diagnostic and Statistical Manual on Mental Disorders, fourth edition (DSM-IV). Washington, DC: American Psychiatric Press, 1994.
5. Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.
6. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 2003; Jun 18;289(23):3095-105.
7. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) : www.cdc.gov/ncipc/wisqars accessed April 2010.
8. Conwell Y, Brent D. Suicide and aging I: patterns of psychiatric diagnosis. International Psychogeriatrics, 1995; 7(2): 149-64.
9. Kochanek KD, Murphy SL, Anderson RN, Scott C. Deaths: final data for 2002. National Vital Statistics Reports. 2004 Oct 12;53 (5):1-115.
10. Weissman MM, Bland RC, Canino GJ, et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, 1999; 29(1): 9-17.
11. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto mental and addictive disorders service system. Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry. 1993 Feb;50(2):85-94.
12. Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press, 1991.
13. Dohrenwend BP, Turner JB, Turse NA, Adams BG, Koen KC, Marshall R. The psychological risk of Vietnam for U.S. veterans: A revist with new data and methods. Science. 2006; 313(5789):979-982.
14. Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007; 61:348-58.
15. Sullivan PF. Mortality in anorexia nervosa. American Journal of Psychiatry. 1995 Jul;152(7):1073-4.
16. Centers for Disease Control and Prevention (CDC). Prevalence of Autism Spectrum Disorders―Autism and Developmental Disabilities Monitoring Network, United States, 2006. MMWR Surveillance Summaries 2009;58(SS-10)
17. Fombonne E. Epidemiology of autism and related conditions. In: Volkmar FR, ed. Autism and pervasive developmental disorders. Cambridge, England: Cambridge University Press, 1998; 32-63.
18. Lenzenweger, M.F., Lane, M.C., Loranger, A.W., Kessler, R.C. (2007). DSM-IV personality disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 62(6), 553-564.
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