Understanding Why Your Brain Does What It Does When You Struggle with Anxiety and Depression

By Carissa Weber, MA, LPC, CSAC

You may be seeing the green ribbons all over social media lately. That green ribbon represents mental health awareness month. As I work and write about mental health, it isn’t a secret that it is something that I am passionate about. I think this is a great time to bring up what mental health awareness month is and ways you can help yourself (and your fellow humans) end the stupid stigma associated with mental health.

Mental Health Awareness Month

Founded in 1949 (that’s right, 75 years ago), mental health awareness month was created not only to grow awareness around mental health among Americans, but to celebrate the people who were thriving with their mental health. It really put emphasis on showing Americans (at the time) that you can prevent and treat your mental health and go on to live “normal” lives. The original goal was to decrease the stigma and fear that went along with people who were struggling with their mental health and show them compassion, understanding, and help them hold on to the hope so many people feel disappear when their mental health spirals into the pit of despair.

During that 75 years (and counting), Mental Health of America (MHA, which is now known as the National Association for Mental Health) would put out public and school screenings to help people identify if they were struggling with mental health. They would also provide resources and mental health “toolkits” to promote healthy lifestyles for those who were struggling with their mental health. About 20 years ago, the National Association for Mental Health partnered up with the Substance Abuse and Mental Health Services Administration (or SAMHSA for short) to include the struggles with addiction. Within that same time frame, The Department of Health and Human Services has pitched in to try to grow the awareness of needing to take care of our mental health. This collaboration has been able to promote mental health at the government level in such ways as:

• The Affordable Care act expanding insurance coverage for both mental health and substance use disorders
• Mental Health Parity and Addiction Equity Act of 2008. This is the bill that essentially lays the smack down on health care providers if they do not offer equal medical treatment for people presenting with mental health and/or substance use disorders
• Several individualized state grants to assist in bringing mental health providers into the school systems, Indiginous American reservations, and even to rural communities.
• One currently sitting in congress; H.R.6082 – overdose prevention and safety act. This will help establish a federal chain reaction to help a person struggling with substance use disorder get the help they need versus criminal charges that only make life harder.
• And the one (still) sitting in congress and holds a special place in my heart: Mental Health Improvement Act of 2019. This would allow therapists (like myself) to practice across state lines, just like doctors and nurses can. That means, we can help make mental health more accessible, as well as draw some new potential therapists in to the career calling (that would help a ton with the therapist shortage). This bill would also help people on Medicare to be able to access therapy easier as well. Let me tell you, after this year, we all need that one to pass! (If you want more information, look up Georgia’s Interstate Compact)

Want to help make mental health a priority of congress? Write your local congressman (or woman) and let them know! You can reach them by looking at
U.S. Senate: Contacting U.S. Senators

It It is no secret the story that our mental health tells us. Based on the facts from the World Health Organization (WHO), 6.8 million adults across the United States reported having generalized anxiety disorder. That number is huge! What is even crazier, is the average age of onset of anxiety is 13 years old. If we look globally, 7% of the world’s population reports struggles with anxiety. When we think about what is going on in our brain during that time, our prefrontal cortex isn’t nearly developed enough to challenge that darn amygdala. Pair that with the pressures of finding your own identity, school work, home life, sports, maybe even experimenting with drugs or self-harming, there is enough sensory information coming in to that darn amygdala to justify it thinking the world is on fire!

Mental Health Stigma

What bothers me the most is people will live with their symptoms of anxiety, on average, for 10 years before they seek out any sort of help with them. 10 flippin’ years! Why on Earth would you wait that long? Some people say it is due to the cost of mental health services, or they don’t have insurance. For others, they don’t feel like they have the time to take care of their mental health. Yet for others (and like the population I serve in Wisconsin) the closest therapist could be over 30 miles away and have a 3 month long waitlist. Or it could be a simpler reason: stigma. That icky six-letter word that keeps everyone second-guessing how people are going to view them if they knew they had anxiety.

Depression

When we take a look at depression, the numbers show another startling story. Depression is the current leading cause of disability in individuals ages 14-44 years old. According to reports, 16.1 million American adults reported having depression. The average age of major depressive disorder onset is 32 years old. It seems so late compared to the average age of onset for anxiety, doesn’t it? Coincidently, another form of depression, called dysthymia, has an average onset age of just 18 years old. Do you ever remember having the case of “the blahs” or perhaps complete lack of emotions when you did anything? That would be dysthymia.

Another intersting fact about depression is this diagnosis contributes to 490 million days missed of work in the United States of America. That is a lot of days missed! This is because people either:

• Recognize they need a mental health day and take time for self-care
• Taking time to visit with their therapist and/or doctors about treating their depressive symptoms
• Physically or emotionally cannot get out of bed
• might be hospitalized due to the severity of their symptoms

Suicide

The scariest statistic about depression (at least to me) is 123 people a day die by suicide in the US of A. That is equivalent to one person dying by suicide every 12 minutes. To put more math in your head, that equates to over 41,000 people each year.

A lot of people share how scared they are to talk to their safe support network about having suicidal thoughts, depression, and/or anxiety. For some, they are afraid how it may change how people view or treat them. Remember, one in five people are struggling with mental health concerns. That’s around 20% of the population. In most cases, your safe support network may already notice something is a bit “off” if you have been struggling.

Safe and Supportive People

Before we continue, I think I need to define a safe support network. These are people in your life that provide healthy support to you emotionally and physically. They aren’t going to make fun of you for having feelings, nor are they going to dismiss what you are experiencing. These people are safe because that darn amygdala allows you to see their kindness and desire to help you as part of a healthy relationship. These people don’t necessarily have to be family members, but they could be:

• a close work friend
• your neighbor
• a trusting family member (like an aunt or grandparent)
• a faith leader
• a fellow hobby goer (like some of my friends I ride horses with)
• That amazing friend that has stuck with you through thick and thin
• a spouse
• a coach or teacher
• your therapist
• your doctor

If you don’t have those kind of close relationships in your life, it is okay! At the end of this post, you will find ways to connect with people who are safe (and confidential) to help you if you are feeling overwhelmed with feelings.

Coping Skills Alert!

One way to start the conversation with someone in your safe support network is to first be honest with yourself. Knowing what place your own mental health is in allows you to be honest with that person about how you are feeling. It may be scary to be that vulnerable with someone (especially when you are used to tackling things on your own), but this honesty will not only show the person you are telling you trust them, but you are playing an active role in breaking the stigma of mental health!

“Mental health healing is an active process of participation and patience.”

– Carissa Weber

When you do have this conversation, not only are we focusing on honesty, but we are also focusing on what action(s) you need help with to improve your mental health. This could mean you let that safe person in on what you have been doing to help your mental health (example: medications, therapy, leisure skills, mindfulness activities). This also could mean you keep that person in the loop if your mental health isn’t too hot and ways they can help you get back on track. It could be as simple as asking that person to go on a weekly walk with you, or play pickle ball, or maybe just checking in every once in a while. This is being proactive with your mental health, identifying what your needs are, and knowing you have at least one person in your corner.

“Our mental health is just as important as the next person’s!”

– Carissa Weber

Part of that action plan and honesty includes taking responsibility for your plan. That means practicing your healthy coping skills, taking your medications every day, and participating in that activities that make life go round. If you haven’t gotten the hint yet from my other posts, mental health healing is an active process of participation and patience.

On the opposite end, how do you react when someone lets you know they are struggling with their mental health? Even harder question, what if you know someone is struggling but they won’t say it or accept help? These two situations right here can bring up anyone’s anxiety levels. People have shared with me that they are afraid of saying they wrong thing, or that talking about it may make someone act on their suicidal thoughts. Other people have commented to me that mental health just makes them nervous.

How to be Supportive

First things first, don’t get freaked out! As I have said a couple different times in this post, one in five people struggle with their mental health. It is a fairly common thing nowadays. By freaking out, dismissing what someone is feeling, or just avoiding what they are saying is the opposite of being supportive.

Next, you have to listen. Like really listen. Hear what they are saying. Don’t try to interrupt them, just let them say what needs to be said. Once they have done that, thank them for being so vulnerable and honest! This allows the person sharing to understand you are a safe person to talk to.

Once that is done, ask them how they would like you to help them. This could take various forms. It could be as simple as checking in with them or as complex as going with them to their therapist or doctor about their struggles. Be present with them as much as you mentally can. We cannot take accountability for someone’s mental health, but we can be supportive without over-exerting ourselves and placing our own mental health in jeopardy.

What do you do if you notice someone’s mental health is declining, but they are not able to talk about it yet? There are various ways in promoting mental health without having a direct conversation about mental health symptoms. Below are some ways to start a conversation about mental health with a person:

What the Hell is PLATE??

Asking someone about their mental health can be intimidating, daunting, and anxiety provoking. During these conversations remember to PLATE:

• Be Present
• Listen to the person’s experiences and needs
• Be authentic and active in the conversation
• Be a Team player
• extend a helping hand when you can

As I said above, you can be there for a person, but you cannot take accountability for what they do with their mental health. It is tough to watch someone we care about struggle and shoot down any offers or attempts to help. Maybe they are in that triple F response. Maybe they are feeling hopeless. We can be present with someone as long as we mentally are able to. Our mental health matters just as much as the next person’s!

Mental Health Resources

If you don’t feel like you have a safe person to talk to, or you feel like you are at a point in your mental health where there doesn’t seem to be a way back out of the Pit of Despair, you are not alone! Below are some great resources you can connect with if you need help ASAP:

• National Suicide Prevention Lifeline: 1-800-273-8255
• LGBTQ support center: 1-888-843-4564
• The LGBTQ youth hotline:  1-800-246-7743
• First Responder/Firefighter self-care hotline: 1-844-550-HERO (4376)
• SAMHSA substance use and mental health hotline: 1-800-662-HELP (4357)
• Eating Disorder hotline:  1-800-931-2237
• The crisis text line: Text SUPPORT to 741-741
• Sexual Assault hotline: 1-800-656-4673
• Veteran’s Association crisis line: 1-800-273-8255
• Love Is Respect: domestic and dating violence hotline: 1-866-331-9474
• Farmer Crisis Advocacy Hotline: 1-866-586-6746
• The Jed Foundation: 1-800-273-TALK (8255); Text “START” to 741-741

I just threw a lot of (heavy) information at you. I want to thank you for taking that scary plunge in to learning how the importance of talking about mental health, how to talk about mental health, and resources available to you when life feels to be too much in the moment.

To recap this post:
– May is Mental Health Awareness Month
– 1 in 5 people struggle with their mental health
– You are not alone! It takes courage to reach out for help
– If a friend comes to you to share their struggles, remember to PLATE!
– You can help end the stigma of mental health

Resources

• Anxiety and Depression of America (2020). Facts and Statistics. Retrieved from https://adaa.org/understanding-anxiety/facts-statistics
• Harrison, Jami (2020). 7 Hotlines That Exsist if You Need Them. Retrieved from https://spoonuniversity.com/healthier/7-hotlines-that-exist-in-case-you-need-them
• Merikangas KR et al (2007). The Impact of Comorbidity of Mental and Physical Conditions on Role Disability in the US Adult Household Population. Arch Gen Psychiatry/vol 64 (no.10). Retrieved from https://www.hopefordepression.org/depression-facts/?gclid=Cj0KCQjw4cOEBhDMARIsAA3XDRgm8H6tjfuhu9x2XV8enpOisuYhG7AruoogQYt-sqfS7o0N5g81X5MaAtHcEALw_wcB
• Moore, Natalie (2018). 7 Tips for Explaining Mental Illness to Your Partner. Retrieved from https://www.awakentheself.com/mental-wellness/explaining-mental-illness-to-your-partner
• youth.gov (2021). May is National Mental Health Month. Retrieved from May is National Mental Health Month | Youth.gov

Image Sources

• Carissa Weber at www.thatdarnamygdala.com
• www.pexels.com