You're On My Mind

by LaSonya Roberts-Lopez, MD March 15, 2023

Today, let’s talk about mental health. During medical school, we would spend approximately 6 weeks rotating through the psychiatry department (at least when I was at Emory School of Medicine). The expectation was that we would graduate with a keen sense of discernment, allowing us to detect mental health illness in the patients for whom we cared for. Now, I know that most people, including my colleagues, would say that we all do a pretty good job at it, but the reality is that we don’t. Unless we went on to train in a psychiatry residency program, there is a very high probability that we would typically miss the mark. In fact, one study published in a journal of clinical psychology found that approximately 30% of patients with major depressive disorder were misdiagnosed by their primary care physician (1). Another study published in the Journal of Clinical Psychiatry discovered that approximately 21% of patients with bipolar disorder were initially misdiagnosed (2). There are other clinical research papers that quote even higher percentages than those. Recent social campaigns have made enormous strides in raising awareness. Given the plight of the COVID pandemic and the reality of mental illness in children and young adults, it is long overdue.

In the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by a massive 25%, according to a scientific brief released by the World Health Organization (WHO)- March 2022.

Misdiagnosis can occur for a variety of reasons, including the complexity of mental health conditions, the overlap of symptoms between different disorders, and biases that healthcare professionals may have. Additionally, some mental health conditions may be more challenging to diagnose than others, and misdiagnosis may be more likely in these cases. A lot of people deal with mental illness in silence. Many cultures stigmatize mental illness, which can influence whether or not a person seeks treatment. Some people are so caught up in the whirlwind and demands of life that whatever they are going through becomes their norm until all hell breaks loose—even us doctors. Burnout, anxiety, depression, suicidal ideation, drug addiction—the list does not end here.

"More than half of people with mental illness don't receive help for their disorders. Often, people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood. That's because stigma, prejudice and discrimination against people with mental illness is still very much a problem.-" American Psychiatry Association, https://www.psychiatry.org/patients-families/stigma-and-discrimination

So I am sure you are wondering, Doc, what does this have to do with me? Everything! Not to downplay severe cases of mental illness, but do you ever feel stressed? While stress is not a mental illness, chronic stress or prolonged exposure to stressors can have negative effects on mental health and lead to mental health problems. For example, chronic stress can contribute to the development of anxiety disorders, depression, and other mental health conditions. Sure, there are factors that increase the likelihood of developing mental illness, but hopefully knowing these facts will encourage you to prioritize mental health in your life and the lives of those you care about. They always say it is easier to see things from the outside of a situation than from the inside. Mental health is a basic human right, and mental illness can be treated. We can no longer look away from others or ourselves. One of the things that I find most encouraging about the current conversation around mental health is that people are beginning to recognize that mental health is just as important as physical health. We need to treat mental health issues with the same level of seriousness and urgency as we do physical health issues. There are many mental health campaigns that are making a lasting impact. https://fanbytes.co.uk/mental-health-campaign

Just as there are campaigns for mental illness and awareness, we need to start a campaign for mental maintenance. What is mental maintenance? Well I am glad you asked. Mental maintenance refers to the ongoing efforts and practices that you can engage in to promote your mental health and well-being. It involves taking proactive steps to manage stress, maintain emotional balance, and cultivate positive relationships and experiences. It’s okay to put you first. Here’s a short list of some fun stuff we can all try to promote mental health:

1. Yoga: Practicing yoga is a great way to reduce stress, increase flexibility and balance, and promote a sense of calm and relaxation. Trending: Pranayama Yoga.

2. Hiking: Going for a hike in nature can help reduce stress, increase physical activity, and promote a sense of well-being. If you want to spice it up try fast hiking, not too fast and not too slow.

3. Dancing: Dancing is a fun and energizing way to get moving, release endorphins, and boost mood and self-confidence. Not brave enough to go onto the dance floor? Try salsa lessons online with Latin Dancing online. https://www.latindanceonline.com/

4. Art therapy: Engaging in art therapy activities, such as drawing, painting, or sculpting, can help promote relaxation, reduce stress, and provide a creative outlet for emotions. If you live in Atlanta, The Splatter Studio is a must-try. https://www.thesplatterstudio.com/

5. Pet therapy: Spending time with animals, such as a therapy dog or cat, can help reduce stress and promote feelings of calm and well-being. So cuddling with your pup can be a little medicine. If you can find me a dog that does not shed, does not have a strong odor, and is well behaved with a calm temperament, I’m in.

6. Reading: Reading is a great way to escape into a different world, reduce stress, and stimulate the mind. Has anyone read “Finding Me: A Memoire” by Viola Davis? Definitely my next read.

7. Cooking: Preparing healthy and delicious meals can be a fun and creative way to practice self-care and promote a healthy lifestyle. Not sure if a charcuterie board counts (my fav), but if not jump onto the Food Network for some yummy creations.

Remember I’m riding this journey with you, we are all in this together. Until next time….

Please post your thoughts. I look forward to hearing from you.

References

1. Mitchell, A. J., Vaze, A., & Rao, S. (2009). Clinical diagnosis of depression in primary care: A meta-analysis. The Lancet, 374(9690), 609-619. doi: 10.1016/S0140-6736(09)60879-5

2. Zimmerman, M., Ruggero, C. J., Chelminski, I., Young, D., & Posternak, M. A. (2008). Diagnosing bipolar disorder and the effect of antidepressants: A naturalistic study. Journal of Clinical Psychiatry, 69(2), 191-197. doi: 10.4088/JCP.v69n0207