Mental Illness: Do We See It Coming?

In the movie “Philomena,” Philomena joyfully recounts each nuance of her latest romantic novel to her beleaguered journalist friend, ending every description of the cliché stories with a bubbly, “I never saw it coming!”

Judi Dench (Philomena) and Steve Coogan (Martin Sixsmith))

I’ve heard that same expression countless times when I’ve ended a talk about my experience with clinical depression. Friends or family members whose loved one has drifted deep into mental illness or has been lost to suicide ask for help. They wear the stunned expression of the hoodwinked no matter how brilliant they might be in their professional lives. I listen, direct them to resources and celebrate with them when they remember to call and relay their progress. Lately, I wonder how much better our outcomes might be if we distributed simple information about caring for the brain.

On the American Heart Association website, there is a crystal clear message about cardiac health: When it comes to reducing early deaths, medical care has a relatively minor role, potentially preventing 1 in 10 premature deaths. Rather, the single greatest opportunity to improve health and reduce premature death lies in favorably modifying unhealthy behaviors, which account for approximately 40% of all deaths in the United States.

The site then lists the top habits to ensure cardiac health as: good nutrition, exercise and not smoking. Those with a genetic predisposition for heart disease are not singled out as the only beneficiaries of this information. Everyone has a heart, therefore, everyone needs to be aware of heart health. The predisposed are more vulnerable, but certainly not helpless, in prolonging their lives with good habits.

Mental illness has not made this quantum shift in treatment from illness repair to proactive brain health maintenance. We wait for a problem and attempt to fix it. This goes against what we know in medicine. Dr. Kenneth Cooper, founder of the Cooper Aerobics Center, sums the notion of protective health care simply. “It is much easier to maintain good health than regain it once it is lost.” This maxim applies doubly in mental health. We need to teach people how to maintain brain health, not wait for disease to strike.

Most of the information I see pushed by well-intentioned organizations identifies outward symptoms of depression, and is often presented with the tilt of a do-gooder helping the poor, helpless, and unstable mentally ill. No wonder no one wants to fess up to having mental illness. We need to replace pity with compassion and education. In our efforts to protect those who have lost a loved one to suicide from any more guilt, we neglect to share information that might make a future difference to someone else. Sleep. Exercise. Nutrition. Medication. Social Support Groups. Stress Management. Instead, we watch people neglect all these things and are surprised when mental illness lands on our doorstep.

Julie and Ken Hersh on a trip this fall

Often people ask my husband what he did to prevent my suicide. “I didn’t,” he answers, “we got lucky.” I agree. At that stage of depression, my chance of survival hinged on the ventilation of my garage. I don’t like those odds. I prefer to know my body, know the form of my flavor of depression, so I can see it coming a long way off. Obviously mental illness prescience won’t be always possible, but I’ve been able to stay remarkably healthy for the past eight years with early intervention and small adjustments. That’s hopeful. In the dark of the garage during my last suicide attempt so many years ago, I never anticipated the life I have now, one filled with joy and wonder. Now, like Philomena, I shake my head in disbelief at the gloomy forecast of my pessimistic brain and the surprise happy ending. My depressed brain could not visualize all the good stuff ahead of me, stuff that I have now lived. I never saw it coming.

For more information about Julie K. Hersh and speaking engagements, check out her Struck by Living website.