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Mental Health: Breaking the stigma

Altus Times - 7/6/2018

One in five Americans lives with an illness that is often difficult to explain to others and difficult to understand themselves.

The National Alliance on Mental Illness (NAMI) reports that one in five adults in American experiences a mental illness, and nearly one in 25, approximately 10 million, adults in America live with a serious mental illness — schizophrenia, bipolar disorder, major depression and severe anxiety.

What comes to mind when you think of mental illness? Perhaps the only encounter you’ve had with the disease is through television or movies or other media. But it’s more likely that you’ve encountered someone in your life who suffers from a mental illness without knowing it or have dealt with a mental illness yourself.

Approximately 18 percent of American adults live with an anxiety disorder, according to NAMI, that is characterized by prolonged feelings of worry or fear that interfere with job performance, school work and relationships, according to the National Institute of Mental Health. While anxiety, like all other emotions, is a normal part of life, people suffering from mental illness experience those emotions in a way that their peers do not.

In Oklahoma, one in four adults lives with a mental illness, according to Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services, who has called mental health the “biggest health issue facing Oklahoma.”

White cites misunderstanding and stigmatization as the source of the problem.

“Mental illness and addiction are diseases of the brain,” White told attendees at the Altus Wellness Symposium in June, adding stigma and fear connected to mental illness have caused it to be treated differently than other physical diseases.

White compared mental illness to diabetes. Just as the pancreas no longer regulates glucose as it should in a patient with diabetes because of imbalances in insulin, a patient with a mental illness has a chemical imbalance in his or her brain that does not allow the organ to function as it should.

“The difference is, no one tells a person with diabetes to just get over it,” White said.

NAMI reports that approximately 10.2 million American adults have co-occurring mental health and addiction disorders.

Like mental illness, addiction changes the functionality of the affected person’s brain, but White said that with sobriety and treatment, those dealing with either mental illness or addiction “can and do recover,” and have functionality restored — as with other diseases.

“But the success of the treatment depends on how soon we intervene,” White said. “If we don’t break the stigma, people won’t ask for help.”

Cathy Costello has shared her family’s story since her husband, former Oklahoma Labor Commissioner Mark Costello, was stabbed to death by their son in 2015.

In August 2015, Christian Costello had what his mother describes as a severe psychotic break coupled with paranoia believing his father, a government employee, was conspiring against him. Christian, diagnosed with schizoaffective disorder with psychosis — a combination of schizophrenia, bipolar disorder and psychosis — at age 19, was not taking his medication.

Along with the stigma of having a mental illness, Costello said those who have this disease feel their medication is one of the few things they can control, have the sense to read the side effects and are often paranoid at what they discover.

“Christian felt as if he had things crawling all over him when he took his medication,” Costello said at the Altus Wellness Symposium, and the medication came with other side effects, like impotence.

She imagined it from his point of view: “Here take this pill that will make you uncomfortable so you don’t make the rest of us uncomfortable.”

Costello described her life with her family as “so perfect, it scared me,” and her son as a gentle, creative soul who loved writing scripts and making films starring his friends and family. She also described him as “prayerful.“

One-half of all chronic mental illness begins by age 14 and three-quarters begins by age 24, according to NAMI.

A 2008 study published in “ Nature Reviews” states the emergence of certain mental illnesses is likely related to anomalies of typical adolescent brain maturation and hormonal changes, drug abuse and relationships that accompany adolescence.

In the case of schizophrenia, which is characterized by delusions, hallucinations and social withdrawal, the study states schizophrenia patients have an exaggeration of typical adolescent changes associated with the frontal cortex — the part of the brain associated with planning, decision making and expression of personality.

“Mental illness is not a result of bad parenting, a lack of intelligence or because the person is lazy,” Costello said.

White said mental illness is the third leading cause of chronic disease in Oklahoma and “is not a result of a personality flaw.”

Costello recounted her late nights before her husband’s death when she researched their son’s illness.

In her research, she discovered a connection between Christian’s mental illness and a physical illness he suffered from previously. As a teenager, Christian had Postural Orthostatic Tachycardia Syndrome, commonly called POTS, that causes less blood flow to the brain which affects chemical levels.

Costello said at the time, their doctor told her Christian had four times the normal amount of norepinephrine in his brain, but she hadn’t thought anything of it. In her research she found it to be “a red flag for schizophrenia,” she said.

Costello said she had the perfect family and perfect career. She never had to deal with mental illness and didn’t know the signs of it.

“The ignorance that I had about mental illness,” Costello said, “is, unfortunately, prevalent.”

This is part one in series on mental health in Oklahoma.