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Dr. Hideg: Causes of mental illness still difficult to pinpoint

Tue., Oct. 12, 2010, midnight

Ever had a day when you felt so sad or angry that you wanted to do nothing? What about a month or longer? You may have had depression.

There are many symptoms, and you should talk to a health care professional for a diagnosis. If you have suffered from this or another mental illness, it can help to know you are not alone.

Although there are differences in the frequency of mental illness across cultural, racial and ethnic groups, it can happen to anyone.

Approximately 26 percent of American adults (ages 18 and older) suffer from mental illness yearly – more common than many other illnesses. Fortunately, the prognosis for recovery for many people is good.

Mental illness was once something people were embarrassed to have, even embarrassed to have in the family. Perhaps because people did not understand its causes (it was sometimes attributed to things like weak moral character) and there were few effective treatments, which meant little hope of recovery.

There have been great strides in recent years to eliminate the stigma of mental illness, but we still have a long way to go.

The brain is complex. We do not completely understand mental illness’s causes, but we certainly understand them better than we did even 20 years ago. This means more effective treatments, from medications with fewer side effects to cognitive-behavioral therapy.

Mental illness comes in many shapes and forms, including:

• Anxiety (generalized anxiety, post-traumatic stress, obsessive-compulsive, panic, social anxiety, phobias)

• Mood (depression, mania, bipolar)

• Psychotic (schizophrenia, brief psychotic, delusions)

• Impulse control and addiction (pyromania, kleptomania, compulsive gambling, alcohol, drugs)

• Eating (anorexia nervosa, bulimia nervosa, binge eating)

• Personality (antisocial, obsessive-compulsive, paranoid)

Mental illness can be relatively mild. For example, mild depression in which the sufferer gets through daily activities but has consistent feelings of hopelessness and unhappiness.

And mental illness can be severe. For example, life-threatening depression that includes suicidal thoughts and/or attempts.

Genetics, environment, unhealthy lifestyle choices, specific events and disease all play a role in the development of mental illness symptoms.

Some mental illnesses, like depression and schizophrenia, run in families. Even then, there may be environmental factors or specific events that contribute to the illness manifesting.

Living or working in a high-stress environment for sustained periods of time may trigger a mental illness like anxiety or binge eating. Poor relational boundaries or inadequate self-care can trigger mental illness.

Traumatic events, a car accident or the death of a loved one, may cause post-traumatic stress or depression.

Talk with your health care provider about ruling out other health problems that can mimic symptoms of depression such as diabetes, thyroid problems and other illnesses.

You may want to take a depression screening test. (You can find them online by searching “depression screening tests.”)

If it shows you may be depressed or you have other symptoms, talk with a health care professional about evaluation and treatment.

Treating mental illness today is a world away from what it used to be. Although psychiatric hospitals and electroconvulsive therapy still exist, they are rarely used and most people are treated as outpatients with medication and/or therapy.

Medication with therapy usually has the best results. Treatment can sometimes mean medication for a few months, but for some it is part of a lifetime commitment to managing mental illness.

As with all disease, focusing on your general health with a healthy diet, physical activity, and relationships with friends and family can reduce your risk. However, because we do not yet understand all the causes of mental illness, I cannot tell you that if you do (or do not do) certain things you will never develop a mental illness.

Be vigilant for signs of mental illness in yourself and other family members, especially if you think there is increased risk. Many therapists will teach you techniques to help prevent worsening when you notice mild symptoms of recurrence.

If you suspect mental illness, do not ignore it. Seek help, especially if you fear that you or your loved one may come to harm or harm someone.

Mental illness can happen to anyone, but no one needs to suffer with it.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to

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