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For the Public Health by Laura H. Gunn, Ph.D.
No shame in seeking treatment for mental illness
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    I will never forget the call I received at 4 a.m. from a Georgia state trooper. 
The police found my mother on the side of I-95 at 3 a.m. trying to flag down traffic and repeating nonsensical talk. Standing in front of my mother at a police station at 6 a.m. in a town not too far away, I began to discover that I no longer knew the eyes gazing back at me.  It was a scary moment for a daughter not to recognize her own mother. 
    My mother had exhibited other symptoms in previous months, including lowered inhibitions, agitation, spending sprees, poor judgment, rapid speech, euphoria, no need for sleep, and insulting others. Although these are typical signs of bipolar disorder, it is not a common diagnosis for a 65 year-old woman, since most individuals diagnosed with bipolar disorder are adolescents and young adults.  After displaying varying degrees of manic behavior in the past two and a half years, and after numerous medical tests, she was eventually diagnosed with a unipolar mania mental illness.
    Bipolar disorder is a chronic mental illness causing extreme shifts in an individual’s mood, from deep depression to mania with varying degrees of severity and existence in each state.  According to the National Institute of Mental Health, approximately 5.7 million American adults (about 2.6 percent of the adult population) have bipolar disorder in a given year.  Most diagnoses of bipolar disorder occur in late adolescence, though some individuals are diagnosed as children or later in life. 
    Although there is no cure for bipolar disorder, many individuals with bipolar conditions live manageable lives with the help of medications.  However, treating patients with mental disorders is more of an art than a science, and not all patients will find effective medications since brain chemistries across individuals can respond differently to the same medications.  Those with unipolar mania, or rapid cycling – those who experience at least four episodes of mania or depression in a given year – are often most difficult to treat, since standard therapies often prove non-effective.          Because she experienced toxic lithium levels several times during her treatment, my mother needed to seek alternative treatments, but her treatment options are quickly being exhausted.  We are finally resorting to electroconvulsive therapy, a treatment in which seizures are electrically induced in the patient with a severe case of bipolar disorder where other treatment options have failed.
    There are those on the other side of the spectrum who avoid seeking treatment for their mental illness.  A study conducted by the Rand Corporation found that of all the U.S. troops returning from Iraq and Afghanistan who have developed mental illness from experiencing war, only half are actually seeking medical attention.  Many returning soldiers suffer from post-traumatic stress or unipolar depression, but are afraid or embarrassed to seek treatment due to the stigma associated with mental illness.
    After dealing with my mother’s condition, that stigma is difficult to miss.  For example, many health insurance plans do not treat mental illness fairly in their coverage.  Simply walk down any hospital psychiatric unit and see the lack of available rooms and care for patients. Sufficient care and insurance coverage for those suffering mental illness simply are not available, so jails and homeless shelters, especially in larger cities, become alternative providers of mental health services.  Until our nation treats mental illness like any other illness that requires treatment, it will continue to be a growing public health problem.
    The patient is not the only one suffering mental illness. Care-givers often suffer as much, or in some cases more, than the patient. But one thing is certain: the mental health of caretakers is essential.  If you are a caretaker, remember to find time for yourself away from the patient to engage in activities you enjoy.  Your own mental wellness depends on it.

    Laura H. Gunn, Ph.D. is an Assistant Professor of Biostatistics in the Jiann-Ping Hsu College of Public Health at Georgia Southern University
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