It's Okay to Not Be Okay

By Denise White-Perkins, M.D., Ph.D. Chair, Department of Family Medicine, Henry Ford Health

At least one out of every five people likely experienced anxiety, depression, or other mental health conditions in the last year1. In fact, about half of all people in the United States will be diagnosed with a mental disorder at some point in their lifetime2, and an estimated 62% to 75% of people will experience at least one traumatic event in their lifetime3. Exposure to trauma or adverse childhood experiences increases risk of poor health outcomes and health risk behaviors.

Mental health challenges may show up as depression, worry, or other changes in thoughts, feelings, and daily activities, including eating, sleeping, and working. Sometimes symptoms can be more subtle and show up as low energy, chronic pain, or reoccurring skin or digestive issues. Mental health conditions can affect anyone—regardless of gender, age, race, ethnicity, or income level—yet many people may face obstacles to obtaining mental and behavioral health care, due to bias/discrimination, insufficient health insurance, lack of culturally sensitive clinicians, language barriers, financial strain, and stigma4.

• More than 60% of rural Americans lack access to specialty mental health care5.
• People who identify as LGBTQIA+ are nearly 3 times more likely to develop a mental health disorder such as depression or anxiety and are also significantly more likely to attempt suicide and abuse substances6.
• A recent report from the Centers for Disease Control and Prevention (CDC) evaluating causes for maternal death indicated issues related to mental health, such as depression, anxiety, death by suicide, and substance use disorders as the most frequent underlying cause7.
• In 2021, more than 4 in 10 (42%) students felt persistently sad or hopeless and nearly one-third (29%) experienced poor mental health8.
• Suicide rates are on the rise, especially among adults ages 65 and older9.
• National Surveys show that Mental health of Black, Hispanic, and Asian respondents worsened relative to White respondents during the pandemic, with significant increases in depression and anxiety among racialized minorities compared to Whites.

If you have mental health concerns talk to your family doctor—they know you and are trained to take your health history and your medications into account. When needed they can also connect you with case managers, integrated behavioral health, and treatment for substance use disorders. To make it easier, many of these services can be provided via telemedicine.

As we approach the holiday season find your own recipe for self-care. This can begin with taking small moments for self-care like eating a healthy meal/snack , getting a good night’s rest, exercising, or offering support to a friend or family member who is struggling. Additionally, meditating, taking a yoga class or doing some breathing exercises may reduce feelings of stress and anxiety. Volunteering or engaging in random acts of kindness can also boost your mood and sense of purpose.

Too often in society there is an emphasis on living the perfect carefree life, which in actuality does not exist. We all have challenges, struggles, and days that are just plain hard. But when we take care of our mental and emotional health, giving ourselves permission to heal, our physical health also improves.

Remember, it’s okay not to be okay.

Mental health conditions are treatable and there are well trained compassionate health care teams to help support your healing process.

• Call your primary care physician or behavioral health specialist to schedule an appointment.
• You can also get 24/7 advice if you or someone you know is struggling or in crisis. Call or text 988 or visit the Lifeline Chat to connect with a trained crisis counselor.

References:

1. www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdf
2. www.odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders
3. Centers for Disease Control and Prevention, Office of Health Equity. Prioritizing minority mental health. 
4. Health Resources and Services Administration. Designated health professional shortage areas statistics. Bureau of Health Workforce. U.S. Department of Health and Human Services, 2019 www.hrsa.gov
5. Mental Health By the Numbers | NAMI
6. www.cdc.gov/maternal-mortality/php/data-research
7. www.cdc.gov/healthyyouth/mental-health
8. Thomeer MB, Moody MD, Yahirun J. Racial and Ethnic Disparities in Mental Health and Mental Health Care During The COVID-19 Pandemic. J Racial Ethn Health Disparities. 2023 Apr;10(2):961-976. doi: 10.1007/s40615-022-01284-9. Epub 2022 Mar 22. PMID: 35318615; PMCID: PMC8939391