Another Word on Mental Health

Some time ago I wrote a post about some myths about mental health, lifestyle and religion. Since it’s May (mental health month), I figured I’d share a few more thoughts on the topic, particularly as it relates to substance use, violence and prevalence.  A few common myths are below, along with my thoughts on each.

(Sort of) Myth #1.) Substance use problems and mental illness go hand-in-hand.

Yes, and no. It is common to have both a substance use disorder and another mental health disorder, such as depression or anxiety. It is also common for people who have a mental health disorder to “self-medicate” with drugs or alcohol.  But, sometimes people find that once they recover from their substance use, their mental health is actually pretty good!  Additionally, many people who experience mental health disorders have no problem with substance use at all.

Myth #2.) People who take meds to treat addiction are trading one addiction for another.

There is no “one size fits all” solution for addiction. Sometimes medication is necessary to heal from addiction, and taking a prescribed drug in order to function is a lot different from taking an illegal drug to get high. That being said, people sometimes use prescription drugs to get high, so motivation is important. There can also be physical side effects from heavy medication use, so the goal to eventually become medication-free is not a bad one for some people to have – it just requires careful monitoring by yourself, friends, family, and medical professionals. For some individuals, it is healthier to remain on certain medications for long periods of time, or throughout their lives.

Myth #3.)  Addiction is (purely) a choice.

It is true that in order to become addicted to a substance, one must first try the substance. There is often an element of choice involved, and there is always a major element of choice in recovery.  The reason that addiction is often talked about in terms of something that happens to you rather than something you choose though, is that there is a great deal of evidence to show that certain people’s brains are far more inclined to become addicted than others. So while Joe may be able to drink alcohol and even use some drugs safely, Sally may try a relatively “benign” substance such as alcohol one or a few times (most of us have, after all, and it is legal to do so), and become so intoxicated that she becomes addicted very quickly, eventually moving on to more powerful substances due to… *her addiction.* On the other hand, sometimes it can happen so slowly and subtly that people don’t realize it’s happening to them until they have a full blown problem and they can’t find a way out. Sometimes people become addicted to prescription drugs by simply following their doctor’s orders.  Sometimes people have a serious mental illness (apart from a substance use disorder), and cope with it through drinking and drugs rather than through medical intervention they need, often because they don’t realize they’re not well or because stigma prevents them from seeking help. Those of us who know and love people in addiction or have experienced addiction understand that no one chooses to be a slave to a substance.  It’s a horrible way to have to live.

Myth #4.) Harm reduction interventions make drug use more acceptable and worsen the problem.

Harm reduction interventions are those such as: housing first (not kicking someone out of housing/shelters solely due to substance use); needle exchange programs (where an intravenous drug user could exchange used syringes for clean ones); and increasing availability for fast-acting drugs that reverse overdose (like naloxone – available to anyone in a pharmacy near you). These interventions are described as “harm reduction,” because while they may not cause a person to conquer their addiction, they are likely to increase the odds that they will stay alive.  While a person who survives an active addiction may or may not enter recovery, a person who dies from harm associated with drug use (such as exposure to the elements, infectious disease, or overdose) definitely will not. My personal belief is that a person who is in active addiction should understand that while I don’t support their drug use, I do value their life. I think this type of support is more likely to lead a person to recovery than the judgement that their life is not worth preserving if they are actively using drugs, and this is why I support harm reduction interventions. 

Myth #5.)  People with mental health problems are violent.

People with mental health problems are much more in danger of being the victim of a violent crime than committing one. There are occasions where people become violent because of a delusion or other type of psychosis, but this is rare, and the risk can be mitigated by effective treatment.

Myth #6.)  People who are violent are mentally ill.

Health and morality are intertwined in ways that we can’t always understand, but it is safe to say that they are two different things.  Labeling anyone who is violent as mentally ill is hurtful in two ways – 1.) it gives the perpetrator an excuse where oftentimes they shouldn’t have one 2.) it leads one to assume that people with mental illness are inherently violent which is not the case at all, but further stigmatizes them. There is certainly something wrong with incredibly violent individuals such as serial killers and mass shooters; but it is something morally wrong – there are plenty of individuals who are lonely, depressed, anxious, etc., who are also perfectly non-violent. It is worth noting that research shows that a history of domestic violence is a much better predictor of who might perpetrate a shooting than a mental health diagnosis.

Myth #7.)  Talking about mental illness and suicide makes it worse/more prevalent.

One of the most powerful tools we have in helping people identify mental illness and thoughts of suicide, and get the help that is needed, is talking about it directly.  Because of all these misconceptions, people are often reticent to seek help or admit that they are having problems.  When we speak comfortably and directly about it, we help make it possible for people to reach out for the help they need, rather than waiting for a crisis to emerge.  Of course, the way we talk about it matters – respect and care should be shown during this (and most any) conversation.

Myth #8.) Mental illness and suicide are rare.

Suicide is the tenth leading cause of death, and happens every three days in our little state of Delaware alone.  Mental Health America estimates that one in four people will suffer from some sort of mental illness in their lives.  These issues touch all of us, so we all need to address our own misconceptions and do our best to learn about mental illness, for our own sake and that of our loved ones.

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