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“Is depression funny?” St. Paul radio personality John Moe asks this question at the beginning of each episode of his podcast The Hilarious World of Depression, which invites comedians to share the impact depression has had on their lives. Season one included personal stories by Andy Richter, Maria Bamford, Paul F. Tomkins, and Jen Kirkman. The podcast is distributed by American Public Media, in collaboration with the Make It OK campaign, an initiative launched in 2013 by HealthPartners, Regions Hospital, NAMI Minnesota, and several community organizations.
The goal of the initiative is to help Minnesotans understand mental illness by shedding light on it through education and encouraging dialogue. Since the podcast launched in 2016, traffic to MakeItOK.org has tripled.
Roughly one in five Americans experiences mental illness in their lifetime. Three-quarters of chronic mental illness begins by age 24, but many people don’t seek help until much later. “A person may wait up to 10 years to seek treatment due to barriers and stigma,” says Donna Zimmerman, senior vice president of government and community relations at HealthPartners, and a leader at Make It OK.
Fortunately, that stigma is starting to peel away and people recognize that mental illness is not a problem of character, says Dr. Lane Pederson of Mental Health Systems. “It’s a medical condition that people experience, and it’s something that is very treatable, especially with early intervention.” Treatment for mental illness is just as necessary as that of other illnesses, whether it’s medication for high blood pressure or insulin for diabetes.
Recognize the Signs
Mental illness doesn’t target a specific demographic; it can affect anyone at any time, but some people are more prone than others. And it can be especially hard to identify in young people, who are in a constant state of mind and body change. According to the National Alliance on Mental Illness, half of people with chronic mental illness show signs by age 14.
“Teens and kids do not always understand their emotions and have a difficult time communicating to adults about what is happening,” says Lisa Thistle, LMFT, clinical services supervisor at Nystrom & Associates, Ltd. While some of those emotions are not necessarily mental illness, there are signs to watch out for: defiance, loss of interest, social withdrawal, and chemical use.
“Most teens crave independence and may be uncomfortable talking about their feelings with parents, however they do hear you,” says Todd Archbold, LSW, MBA, chief operating officer at PrairieCare. “Even if they don’t appear to want to engage, your words of support and comfort—even cautionary tales—can be heard and internalized.” A way to tackle this potential issue is to designate a trusted adult—family member or friend, counselor or teacher—that children can turn to for advice or help if they are hesitant to talk to their parents.
As for adults, some are more likely than others to experience anxiety and/or depression. “Research shows that women are more prone to anxiety because of their hormone levels,” says Thistle. “They’re more affected by stress than men are—with the daily activities of career, family, and life.” But women are also more likely to talk about symptoms with friends and family, and to seek help. Men do experience high levels of stress, but they are not likely to discuss or seek help for depression symptoms.
Both adults and kids can benefit from listening. “To help someone struggling, you can initiate the conversation, and really listen in a way that’s accepting and nonjudgmental,” says Pederson. “This allows for the person to communicate what it is they’re feeling and experiencing.” Even when it’s well intentioned, advice can be off-putting; lending an ear is more effective at getting someone to open up and be receptive to help.
Coinciding Conditions
Almost half of those who have been diagnosed with depression also have an anxiety disorder. “While anxiety and depression are separate illnesses, it has long been known that they often occur together,” Archbold says. While the Anxiety and Depression Association of America has not yet found a concrete explanation as to why the two disorders often coexist, its statistics draw a link. The good news is that both are very treatable with psychotherapy, medication, or a combination of both.
Aside from coexisting anxiety and depression, research also shows those with anxiety and depression are at a slightly greater risk of addiction. “About 20 percent of those who struggle with clinical depression or anxiety also have a substance abuse disorder,” says Sarah Nowak, PhD LP, mental health supervisor, Hazelden Betty Ford Foundation. “Drugs and alcohol can be the best and worst solutions to anxiety and depression . . . the person may feel immediate and great relief from their emotional turmoil once they take a drink, pop a pill, or smoke.” Eventually, the person is unable to tolerate feeling anxious or depressed without a drink or drug, which leads to abuse and dependency.
An effective way to approach someone who may be struggling with addiction is to show concern and compassion, and express how their behaviors are impacting others. “Ask open-ended questions and listen, without trying to tell them what to do,” says Nowak. “Get support elsewhere for your frustrations and disappointments, and only approach them when you can be calm and patient.”
Retrain the Brain
As hard as it may be for those struggling with mental illness to ask for help, there are more avenues of support than ever before. “Many primary care providers administer annual depression screenings and many have become adept in asking the right questions about mental health,” Archbold says. “All health care professionals in Minnesota have access to the statewide Psychiatric Assistance Line, a free service that provides mental health triage, expert consultation, and mental health training to service providers.”
If therapy is suggested, there are many options, including two that are most commonly used to treat anxiety and depression: Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). These therapies are not new, but they’re considered highly effective in managing anxiety and depression.
Different therapies are recommended based on individuals’ diagnosis and goals for managing their illness. “CBT focuses a lot on how people’s thinking influences how they feel, how they get along with other people, what behaviors they choose to do,” says Pederson. This therapy is often used for those suffering from anxiety where unrealistic or worrisome thoughts impact emotions, the body, and how that interferes with everyday life.
DBT focuses on managing emotions and developing skills to improve behavior, and is often used to treat those with depression. This therapy teaches skills around tolerating stress, how to regulate emotions, and how to have healthier and more effective relationships with others.
Incorporating skills from CBT or DBT must be part of daily life when managing mental health. “As difficult as it can be for people stuck in anxiety and/or depression to initiate these changes, it’s really important for them to know that even if they start slowly, they have to keep going to pick up the momentum each day for a better outcome,” says Pederson.
For loved ones with mental illness who also struggle with addiction, Hazelden offers a 90-minute Comprehensive Chemical Use Assessment, which provides treatment recommendations to the families as well as an introduction to the 12-step recovery program. Treating more than addiction, doctors and specialists are on-site to help patients through a variety of mental illnesses.
In addition to those listed in this article, more resources can be found within these organizations:
- Make It OK, makeitok.org
- National Alliance on Mental Illness, Minnesota, namimn.org
