Monday, April 2, 2012

That's Crazy!

A survey of 1,000 random Americans revealed something that has been suspected for a long time--people don't value treatment for mental illness like they do physical illness.

The surveyed people said they would pay more to avoid some serious medical conditions, such as diabetes, below-the-knee amputation or partial blindness than they would to avoid severe mental illnesses, such as schizophrenia and depression. The respondents said this despite recognizing that severe mental illnesses, such as schizophrenia and depression, had a health burden comparable to or higher than the physical ailments.

The survey shows how the public "devalues" treatment for mental health by expressing willingness to only pay 40% less for such treatments versus those for physical health. Although respondents felt that the burden of amputation was considerably less than schizophrenia, they were willing to pay about the same to prevent both conditions. In simple monetary terms, participants said they were willing to pay $2.76 for each unit of increased quality of life they would get by avoiding the physical conditions, but only $1.70 per unit for the mental illnesses.

For most of the early and mid 20th century, mental illness was considered taboo, and going for therapy was something no one spoke about. Families were embarrassed by mental illness among their ranks and desperate measures were sometimes tried. For example, Rosemary Kennedy, sister of John Kennedy, was subjected to a frontal lobotomy because her parents wanted to treat her depression once and for all.

In the late part of the 20th century, treatment for mental illness became more mainstream, so much so that pharmaceutical companies rushed to develop a full arsenal of pills to treat a variety of conditions. The availability of these drugs caused a proliferation, if not outright excessive, use of anti-depressants, anti-anxiety and sleeping pills. Our society went from one extreme to another. Yet, we still undervalue treatment of depression and other mental health issues.

I see many patients who would benefit from consultations with psychologists and psychiatrists. However, even though they gladly and willingly embrace pills for their problems, they are reticent, if not outright resistant, to speaking to someone. I think this is a shame and a tragedy. They suffer needlessly and if they avoid treatment because they are embarrassed about needing it for some reason, the HIPAA Privacy Laws now fully protect their confidentiality. No one needs to know and no one will know unless the patient tells them.

Yet, pills rule the day, both in the form of prescription drugs and dietary supplements like St. Johns Wort. Pills, however, usually do not address the underlying cause of one's problems. They simply mask the symptoms.

Our world has become complicated and our brains are attempting to absorb far more inputs and stimuli, good and bad, than ever before, and it is overwhelming us. People are getting lost in their heads, struggling to make sense of many thoughts, and without proper reassurance and guidance, becoming partially incapacitated by it all. This not only leads to daily dysfunction, but also to the development of chronic depression, anxiety and sleep problems. These, in turn, are well documented to increase physical health issues that cause serious problems like dementia and heart disease.

Medicare recognizing this issue in the early 2000s, implemented greater coverage of psychology services and as recently as last year, introduced screening for depression.

The good news is that many cases of depression can be treated without drugs but it is helpful to have a trained professional help you make that determination. I think it's illogical to avoid seeing someone that could help you make sense of and organize all those thoughts you struggle with to reconcile in your mind in a constructive manner. As I often tell my patients, "thoughts are not facts." Yet, I find must people need someone to remind them of that reality.

Please, if you are suffering from depression or your thoughts seem to be somewhat morose, solemn, erratic, mangled, or just different, take advantage of the resources available to help you. There is no reason to suffer alone when professional help can make a huge difference. Mental health is just as important as physical health and besides, ignoring it will ultimately have a huge adverse impact on your overall health. It's crazier to avoid help than to seek it.

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