By Sheila Coleman, DSW, LMSW, Program Director, Community Health and Well Being, Trinity Health Of New England
There are many common mental health conditions that affect our population, including anxiety, post-traumatic stress disorder (PTSD), depression, bipolar disorder, attention-deficit hyperactivity disorder (ADHD), and schizophrenia. Addiction, or substance use disorder (SUD), also falls under the mental health umbrella. These conditions often lead to psychosocial disabilities that can disrupt daily functioning, increase the risk of self-harm, and create strained relations between an individual and their loved ones.
Mental health conditions are often associated with a cloud of stigma and might be difficult to talk about.
Mental health conditions can be the primary cause of difficulties taking shape in one’s daily life, such as increased work absences, strained family relations, heightened isolation, and an overall feeling of significant emotional distress. Friends and family may be the first people to recognize changes in their loved one’s mood and behavior but find themselves at a loss as to how to respond. These conditions might also affect how a person shows up in their community, as their world becomes extremely small, and the illness begins to feed on secrecy and isolation. Stigma, secrecy, and isolation are powerful accelerants for the progression of these often debilitating conditions because they reduce the likelihood of a person seeking help.
People with an SUD may also have other mental health disorders, and people with mental health disorders may also struggle with substance use. We refer to this as dual diagnosis or co-occurring disorders, which means someone is experiencing both conditions simultaneously. This could show up as a person using alcohol to ease their depression, which in turn makes the depression symptoms worsen. It’s often difficult to pinpoint whether the substance use disorder, or the mental illness developed first, but in dual diagnosis cases, it’s typical for a person experiencing a mental health condition to seek relief through their drug of choice. Unfortunately, using drugs and alcohol tends to heighten symptoms, so it’s usually best practice to get treatment for both conditions at the same time rather than separately.
According to the National Alliance on Mental Illness (NAMI), one in four people per year experience a mental health episode – almost 16 million adults across the nation. In Connecticut, 31.7% of adults reported symptoms of anxiety and/or depressive disorders according to a 2023 pulse survey, which is slightly lower than the 32.3% of adults nationally that reported symptoms during that time. Women are 70% more likely to experience depression than men, and 10-15% of new mothers experience postpartum depression. New mothers living in underserved communities have a 50-60% greater risk for perinatal complications which go undiagnosed and untreated. Substance use disorders are among the most prevalent mental health problems we face today. In 2021, opioid overdose deaths accounted for 90% of all drug overdose deaths in Connecticut. In 2018, more than eight million young adults reported having a mental illness and over five million reported having an SUD. Mental illness, including addiction, does not care about age, ethnicity, or where one lives; it can affect anyone.
Both SUDs and other mental disorders can be hereditary, so it’s important to know your family’s health history. This can be challenging if discussing mental health is a cultural taboo. In many cultures, admitting you “have a problem” is a sign of moral failing, or a source of shame for the family. When this sense of failure is internalized, it can prevent a person from seeking help. But having a mental health or substance use disorder is nothing to be ashamed of. Sure, it can be embarrassing to see and acknowledge the damage these conditions may cause, but no one ever wakes up and decides to choose this destructive path. Environmental factors such as stress, trauma, and poverty can cause genetic changes that are passed down through generations and may contribute to the development of mental disorders.
Imagine walking through the world with the weight of guilt and shame for having an illness on your shoulders and thinking there’s no safe place to turn to for help.
Or gathering the courage to ask for help only to be met with judgmental disdain.
These are examples of how stigma operates; it is rooted in outdated ideas and myths about things that are misunderstood, which force the affected person to bear the weight of societal ignorance. For anyone coping with any mental health condition, you may want to consider how widespread this issue is and know that you are not alone.
It is common for a person to think that the consequences of telling someone their secret outweigh the benefits of asking for help, especially with SUDs. We encourage people to identify a trusted family member or sober friend to be a part of your early recovery journey. The burden of secrecy comes with a high price and having just one person to call can lighten the load.
We know that addiction is a chronic, treatable medical condition that affects a person’s brain and behavior, leading to their inability to control their use of substances. We also know that people can achieve abstinence, learn to manage debilitating mental health conditions, and go on to create healthy and abundant lives, as evidenced by countless examples. In practice, we operate from the expectation that recovery is possible and reject the idea that “willpower” and intrinsic motivation are the true indicators of client success.
As health care providers, we must understand the value of engaging in a holistic approach to treating mental health and substance use disorders, simultaneously, by recognizing that we are treating the person, not their disease, and considering the many obstacles they have already encountered prior to finding help. Perhaps we could abandon our old ideas, take time to listen and identify strengths as they are revealed when the person shares their story. Mental health and addiction disorders are bigger than their symptoms and both have thrived on stigma and secrecy long enough. Let’s destroy the stigma associated with these conditions by adopting a new approach and changing the language we use to discuss these issues – in every room, in every conversation, and with each other.
REFERENCES
Clarke, Diana PhD, MSc, et al., (2023) “Perinatal Mental and Substance Use Disorders.” American Psychiatric Association https://www.psychiatry.org/getmedia/344c26e2-cdf5-47df-a5da2d444fc1923/APA-CDC-Perinatal-Mental-and-Substance-Use-Disorders-Whitepaper.pdf
https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/connecticut
Opioid Overdose Deaths and Opioid Overdose Deaths as a Percent of All Drug Overdose Deaths
National Alliance on Mental Illness https://www.nami.org/NAMI/media/NAMI-Media/Images/FactSheets/Depression-FS.pdf
Sit, Dorothy K, & Wisner, Katherine L. (2009) “Identification of Postpartum Depression”. Clinical Obstetrics and Gynecology 52(3): p 456-468, September |DOI: 10.1097/GRF.0b013e3181b5a57c
Substance Abuse and Mental Health Services Administration (2024) Mental Illness and Substance Use in Young Adults https://www.samhsa.gov/mental-health/children-and-families/young-adults
