Guest Blog Post: Sue Abderholden Executive Director, National Alliance on Mental Illness (NAMI) Minnesota

I attended the 10th anniversary recognition event for Minnesota Bridges to Excellence where clinicians who delivered improved care resulting in better outcomes for patients with diabetes, vascular disease, and depression were honored. Delivering better care to people with these conditions can drive down the costs of health care, benefiting the people themselves and their employers.

I was especially pleased to have been invited to speak because of the attention being paid to depression. I was part of the committee that provided input into the development of the toolkit, “Help and Healing: Resources for Depression Care and Recovery.” The toolkit includes things like patient and provider talking points, treatment planning guides, and self-management techniques. Not only does it promote the involvement of family and education of the individual, it also provides information about suicide, (which has been rising in Minnesota), and recognizes that effective treatment is more than taking a pill – it involves nutrition, exercise, meditation, mindfulness and more.

Next to anxiety, depression is one of the most common mental illnesses in the U.S. According to the National Institutes of Mental Health, about 6.7 percent of U.S adults experience major depression.

While the Minnesota Health Action Group seeks to improve health, reduce health care costs and ensure the economic vitality of all Minnesota communities, reducing the impact of depression on the individual, their families and employers is equally important.

Families and employers intimately understand the impact untreated depression has on people’s lives.

As families, we watch as our loved one loses interest in once enjoyable activities, they become more distant, less responsive.

Employers see workplace productivity affected due to absenteeism and presenteeism. Employers see workers who have difficulty handling time pressures and stress, who have problems concentrating or remembering things.

Untreated mental illness results in 27 lost workdays per year, nine to sick days, and 18 to lost productivity. It is the leading cause of short-term and long-term disability. Many people with depression lose their jobs because they are unwilling to talk about their symptoms, obtain treatment, or ask for accommodations. It’s ironic since we know that work helps people get better – it provides structure, interaction with others, and a reason to get up in the morning.

So when clinicians do better at early identification of depression and improve the quality of treatment, it’s not just the patient that benefits – but their family and employer as well.

A friend of mine writes an inspiring and thoughtful blog on dealing with his depression. He recently wrote “Depression and anxiety can rob you of the desire to interact with the world:  learn nothing, do nothing, be a part of nothing. Thinking of yourself as nothing, as of no worth…or worse yet, as a drain to all that surrounds you…this is the absence of any sense of health.”

In another post, when he was really struggling with his symptoms he wrote, “During my deepest bouts with depression I cannot get myself to enjoy much of anything. And it really hurts for me not to be able to enjoy music. It’s a very weird feeling. To be so consumed with — so frustrated with, so pained by — my inability to care.

“You doubt yourself and everything you do. You are convinced you are worthless…worse than that, a drain on everyone and everything. For me, it shakes me to my core. I doubt every role I think I usually fill well: advocate, yogi, gardener, friend, husband.

“And with this doubt, comes an intense feeling of loss. I remember who I once was and what I once was capable of. And I don’t question if I will ever have that ‘me’ or those ‘capabilities’ again. In fact, I am certain I never will.”

Despite the number of people who develop depression and the effectiveness of treatment, few seek treatment. Some studies have reported that people live with their symptoms an average of 10 years before seeking help.

Think of how much pain they and their families must experience before they seek help. We do know that stigma plays a role in the reluctance to seek treatment.

People worry about what others will think and frankly, mental illnesses are the “no hot dish” illnesses – you don’t get meals brought over, there are no get-well cards or CaringBridge sites.

Starting the dialogue in every clinic, by asking a few simple questions, is how we break down these barriers, how we make it O.K. to talk about depression, thus opening the door to talking about other mental illnesses as well.

Depression, even the most severe cases, can be effectively treated. But the earlier treatment can begin, the more effective it is.

I am grateful for the work everyone involved with Minnesota Bridges to Excellence does to help people get better, to not be disabled by their depression. The outcomes are impressive, and the financial rewards are validating, but the true reward comes in having helped people recover from their depression and let them take on their roles again as a family member, friend, employee and contributing member of our communities. Providing hope for recovery is the best reward of all.

Sue Abderholden is Executive Director at National Alliance on Mental Illness (NAMI) Minnesota

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