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Commentary: Navigating Mental Health Challenges with Compassion—and Accurate Information

19/09/22 Michael B. First, MD, Columbia University|New York State Psychiatric Institute;

Nearly half of adults experience a mental illness at some point in their lives. Yet despite how common these conditions are, there’s still a stigma around mental health disorders. Many people don’t want to talk about what they may be going through, and what’s more, they may avoid talking to a doctor. In fact, less than 20% of people who have a mental illness receive professional help.

The good news is that the stigma has lessened in recent decades, and people are more aware of mental illness in general. However, misconceptions still persist, and people are reluctant to talk about mental illness, which keeps them from getting the help they need. The reality is, that there are effective treatments for most conditions. People need to watch for signs and symptoms that may be indicate of mental illness in themselves—and others—to ensure they get the proper attention if and when they need it.

We all go through periods of mental health challenges. But if you find yourself often having any of these thoughts or hear others saying any of the following phrases in reference to you, it’s worth considering a conversation with a medical professional.

“Who wouldn’t be depressed or anxious right now?”

Life can be stressful, especially these days. Feelings of depression and anxiety are a normal reaction to the vicissitudes of everyday life. We all feel sad after the loss of a loved one or in the wake of a national tragedy, and we all get anxious about work or family life. Doctors typically diagnose mental health challenges as mental illnesses based on how severe the symptoms are and how long they last, and how much they affect the ability to function in daily life. Depressive and anxiety disorders are the most common mental disorders worldwide, in 2020, more than 8% of all adults in the United States had at least one major depressive episode.

Phrases like “of course I’m stressed” or “who wouldn’t be depressed right now” point to individuals attempting to downplay the seriousness of their symptoms and therefore miss out on receiving treatment, such as counselling or medications that they could benefit from.

“It will go away on its own.”

While many times mental health challenges work themselves out on their own, often individuals are doing themselves a disservice by keeping mental health challenges to themselves and hoping it goes away. The longer they wait to seek help, the longer they suffer and the worse the condition is likely to get. If a condition regularly and consistently impacts your daily life, it’s worth speaking to a professional.

One condition for which getting professional help is especially important is bipolar disorder, in which, as the name suggests, is characterized by periods of elevated or irritable mood at times (mania), and periods of depression at other times which may be especially severe. Often individuals with bipolar disorder look forward to their periods of being “up” because they feel especially self-confident, productive, energetic, social, and sexual during those times (hypomania). Unfortunately, almost invariably, as the mood elevation gets more intense and evolves into full-blown mania in which they become grandiose, impulsive, and get involved in activities without regard to the potential painful consequences of their actions. It’s important to note that while depression and anxiety often overlap and tend to respond similar treatments, bipolar disorder requires a different approach to treatment since many of the medications used to treat depression can trigger a manic episode in susceptible individuals, especially those with a family history of bipolar disorder. 

“A doctor won’t be able to help me.”

This is another phrase that suggests an individual is attempting to suffer through the symptoms of a mental illness rather than seeking help. There’s no denying mental health treatments have challenges. There is a significant shortage of mental health providers, and patients may face the possibility of having to wait a long time before getting to see the right professional. That’s all the more reason to begin the process sooner rather than later. If you find yourself waiting for care, research potential conditions and treatments online from reputable sources such as, the National Institute of Mental Health, or published books.

Doctors don’t always pick up on mental health challenges during appointments for other medical issues, especially if the patient comes in complaining of physical symptoms such as low energy, trouble sleeping, palpitations, GI disturbances, and pain, which can be common manifestations of depressive and anxiety disorders. Instead of waiting for the doctor to ask you about depression or anxiety, patients need to speak up and address the issue head-on. For many people, treatment from a medical doctor is key, because they can prescribe medication. Often, a conversation with your primary care physician is a good first step.

“I’m thinking of harming myself or that I would be better off dead.”

Suicide is the biggest problem in mental health today. The rise in substance abuse, the availability of guns, and the pressures of social media, and social alienation are all contributing factors to suicide risk. Individuals who feel isolated or alone or have a more severe mental illness may have thoughts of suicide.

Friends and loved ones should always take it seriously when people threaten to or try to kill themselves. It’s a myth that asking a person about suicide will make that person more likely to attempt it. Asking the question, “Are you feeling so bad that you’ve had thoughts of taking your own life?” can show a person that others care about them and alert them that their behavior is causing concern in others.

When individuals are having suicidal thoughts, talking to someone can help. Here are some resources:

Call the emergency number (911 in the United States)

Call for emergency help if a person is seriously threatening suicide or has already tried to commit suicide. Keep talking to the suicidal person in a calm, supportive voice until help arrives.


For more about mental illness, visit the Manuals page or the Quick Facts page on the topic.