Friday, May 14, 2010

For Mental Health Month, Join a Former First Lady In Bringing Down Barriers to Mental Health Treatment.

By Roberto Blanco, M.D.

I was seeing a very depressed patient the other day and we were discussing how far he had fallen in his functioning since he had gotten ill. He said, “I used to be strong. I used to be able to provide for my family.” And yes, there was no doubt that he was unable to provide for his family now. Despite being relatively healthy physically, mental illness had made it so that he could not work, had difficulty leaving the house, or finding enjoyment in anything.

I try not to read too much into simple statements. But the phrase “I used to be strong” resonated with me because I think that it had something to do with why he waited until it was almost too late to seek treatment. While I think that he was trying to express the depths of his feelings of helplessness and need, his statement implied that he was now weak. Fatigue, lack of energy, and poor sleep from depression could make anybody weak. However, I don’t think that this is what he meant.

I often hear people stigmatizing mental illnesses like depression by saying that it only happens to “the weak”. One thing that I’ve learned from my experience practicing psychiatry is that it can affect anyone from CEOs to valedictorians to world-class athletes. Just like this patient indicated, it doesn’t matter how strong you are or think you are, mental illness can affect you if life and genetic predisposition put you in the wrong circumstances.

One of my main concerns with the stigmatization of mental illness is that if it is seen as a weakness, then the solution is often seen as needing to “be stronger”, deny a physiologic problem, and not seek help. As many mental illnesses are quite treatable with medications, psychosocial interventions, and therapy, this can often have tragic and unintended consequences such as loss of close relationships, occupations and careers, or even death.

The other concern is that if mental illness is seen as a fault of character and not as a group of illnesses, then appropriate and necessary resources and medical services won’t be available. In North Carolina, where I work, acknowledging that you need help is not the biggest barrier to treatment. Actually, it is trying to find a provider or an inpatient bed.

With the demand for inpatient psychiatric services skyrocketing in North Carolina, the number of psychiatric beds available has decreased and the outpatient mental health system, which was once a model nationally, has crumbled. It’s hard to imagine that with greatly increasing rates of kidney disease in this country that dialysis clinics or transplant services would be closing down. However, this is exactly what is happening to psychiatric services in North Carolina. It is a complex issue but is due to the national trend of closing state psychiatric hospitals as well as to the privatization and decentralization of outpatient mental health services.

Some people are taking notice of this disturbing trend, including the former First Lady of the United States, Rosalynn Carter. She has written a book on the mental health crisis in the United States and is encouraging people to be vigilant in taking care of their mental health, to overcome challenges, and to get involved.

May is Mental Health Month. So, please take this opportunity to join our former First Lady in advocating for mental illness treatment. Go to your local legislatures or call your congressional representatives and ask that they support funding for mental health services.


  1. My oldest son seems to have depression I can not convince him to see a doctor. I need help to guide me how to go about it to get him to seek a doctors help. Can you get me a contact on Long Island in New York. Please I beg whoever is going to get his to help me. He has more than 5 symptoms to define him as depressed. He does not sleep at nights, he feels worthless at days and he is sad and he does not know why, he is always tired, he stopped contact with his friends he does not go out with them anymore, there are days he sleeps for 24 to 36 hours, he can not function properly at work,he lost a lot of weight, he does not want to do anything he used to love, like going to the gym, playing golf, hanging out with his friends etc. Can you suggest a group that I can come in contact to help me? my e-mail address is I would appreciate any help you can give me.
    Ruby Tsaousis

  2. Thank you for reaching out. There are groups in your area that can help. The National Alliance on Mental Illness has a New York chapter ( and you can call their helpline at (800) 950-3228. They also have a Family to Family Education Program. In addition you can contact the Greater Long Island Psychiatric Society to locate a psychiatrist in your area(

    Please also visit this list of resources for additional online help. (

  3. For me, it's not so much "I used to be strong" but rather when I'm feeling well, I have no need/desire to seek help (as if the other part of me no longer exists). When I'm depressed, I'm unable to seek help, unable to even pick up the phone to try. That said, if others could recognise that pattern in other, they might be able to encourage those who need help to seek it...

  4. There doesn't seem to be any discusion on Agoraphobia. On FaceBook there is a group but no one to give advise just to tell there stories and share. Is there anyone that helps in this matter ?

  5. Thank you for posting about the former First Lady and her discussion on mental illness. I have had Agoraphobia 1 1/2yrs now and it has devistated my life. Never thought I would be in a place of weekness, I used to be so strong and go anywhere do anything. But somedays I can't even get out of my bedroom. I am so thankful the little things. They mean so much to me. It seems the medications are not working, I have tried 6 of them. But I know I have faith that someday I will be out in the world again doing as others do. I have worked so hard all my life and to stop like to a brick wall has been very devestating. Maybe this discussion will help someone else since there is no discussion on this illness.

  6. The Mayo Clinic has information about agoraphobia( and you can find local mental health resources from the National Alliance on Mental Illness ( We hope you find the information on this blog and the Web site useful. It is not intended as a substitute for medical advice. Please consult with your doctor about a specific medical condition. Additional resources can be found here:

  7. I just finished a course put on by NAMI it greatly helped me understand my sons depression. We have been looking for help for six years and he has symptoms just like your son. (On bad days they do not want to seek help or have anyone see them or talk to anyone) Your son needs to know that its not a weekness and it is not his fault. Nothing to be ashamed of. If he had a broken ankle he would go get help. This is a physical chemical thing (in his brain)that can be helped and treated. You may need to admit him to the hospital to get the help he needs. Call someone from NAMI. They are the most compassionate people I know all with knowledge and personal experience. God Speed


Comments are reviewed before posting, and comments that include profanity or other inappropriate material will not be posted. The comment section is not intended as, and is not, a substitute for professional medical advice. All decisions about clinical care should be made in consultation with your treating physician. If you need help with a mental health issue, please visit our resource page.