October 5-11th is Mental Illness Awareness Week. During this week, the National Alliance on Mental Illness (NAMI) and its affiliates will shine a (green) light on mental illness. Mental illness will affect everyone in the U.S. at some point in their lifetime, whether personally or through a friend or family member. NAMI wants to take Mental Illness Awareness Week to build awareness and understanding on the prevalence of mental illness, a condition that can also accompany chronic pain.

Mental health is more than just being happy, and mental illness goes deeper than just the absence of happiness. In the past, many organizations have defined “health” as the absence of disease or illness, but in 1948, the World Health Organization (WHO) broadened that definition, saying that health is “a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity.”

While this statement has been criticized by some as being unrealistic to maintain for any long period of time (the term “complete” is a high bar to set), this is one of the first official definitions that includes mental well-being as an indicator of health.

The mental health website of the federal government cites the following statistics from 2011:

  • One in five U.S. adults experienced a mental health issue
  • One in 10 young people experienced a period of major depression
  • One in 20 people in the U.S. lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

There is some evidence that people living below the poverty line suffer mental illness disproportionately, but are they living below the poverty line due to mental illness, or are they mentally ill because they are living in poverty? Although many people with mental illness, either chronic or episodic, live complete, full lives, poor people generally have less access to excellent mental health care that includes not just medication but also counseling and support.

Another startling connection is that of poverty to domestic violence and mental health issues. One in four women will be victims of domestic violence in their lifetime, and these women often suffer long-term mental health issues including post-traumatic stress disorder (PTSD), anxiety, and depression. Poverty causes tremendous stress to a family, and many families are caught in a cycle of poverty and domestic abuse. Children who live in homes where domestic violence is present experience high rates of neglect and often become abusers when they grow up. Domestic abuse is the third leading cause of homelessness, a state that causes considerable trauma, both long- and short-term.

People suffering from chronic pain have an increased incidence of mental health issues which makes awareness of this issue even more important. According to a study cited in “Etiology of Chronic Pain and Mental Illness: How To Assess Both,” Regier, Boyd, Burke, et al found that:

“…most study patients demonstrated a higher prevalence of depression, anxiety disorders, and substance use disorders compared with those with acute chronic pain or the general population.”

In addition, “…rates of current major depressive disorder (MDD) ranged from 23% to 78% in chronic pain groups compared with rates of 5% to 17.1% in the general population.”

Chronic pain and mental illness can perpetuate a vicious cycle, and it is difficult to say which comes first. The presence of a chronic pain condition such as fibromyalgia can cause depression and anxiety, and depression and anxiety can exacerbate the symptoms of chronic pain. An average of 65% of people diagnosed with depression also report pain. Those people who suffer from pain that is restrictive or limits their activities are also more likely to be depressed.

Depression isn’t the only mental condition closely related to chronic pain. Anxiety and chronic pain are often diagnosed together. Patients with fibromyalgia report higher incidences of anxiety than do those without. From the study above:

“Many patients with chronic pain also appeared to suffer from symptoms of anxiety. Several studies have reported that 10.6% to 62.5% of patients with chronic pain meet current criteria for any anxiety disorder compared with 1% to 25% in the general population (ibid).”

This anxiety can lead to insomnia and something called catastrophizing that causes fibromyalgia patients to focus on the worst possible outcome of a situation. Hypervigilance can be another mental byproduct of anxiety. In the case of anxiety and chronic pain, the chronic pain patient would focus all of their attention on the pain, thereby intensifying and heightening their perception of it.

Mental Illness Awareness Week focuses attention on education and understanding. Local affiliates may hold many different activities for Mental Illness Awareness Week such as:

  • Health fairs
  • NAMIWalks
  • Fine arts exhibitions, including art exhibits, concerts, or poetry readings
  • Candlelight vigils
  • And many more

The National Alliance on Mental Illness is spreading the word about Mental Health Awareness Week via social media as well. Turn your Facebook and Twitter profile picture green to show your support, and share your story using the hashtags #stigma and #MIAW. Some suggested tweets and Facebook posts include the following:

  • “Checking in” on a friend or loved one can go a long way in making a difference in their life; it can help save a life. #MIAW http://ow.ly/y6tAJ
  • Almost 50% of children aged 8-15 with a mental illness received no treatment last year. We must do better. #MIAW http://ow.ly/y6tAJ
  • Mental Illness affects 1 in 4 American adults. You are not alone in this fight. NAMI is there to help. http://ow.ly/y6tAJ

Whether you are sharing your story, walking in support of a loved one, or tweeting to build awareness, take a moment to get involved and educate yourself and those around you during Mental Illness Awareness Week.

Image via the National Alliance on Mental Illness

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