As women, we are often well versed in being selfless. We are natural born nurturers. This is one of our best qualities, yet it may not always translate into taking care of ourselves.
We sometimes spread ourselves too thin and put our own needs aside. In fact, it is estimated that nearly half of all women in the US do not attend their six week post-partum obstetrics appointment. After all, who has time for that with a new baby?
See what I mean? We can justify or push aside what we need and deserve for the betterment of our loved ones. Maybe we are engineered this way or maybe we have evolved this way. Even so, avoiding our health needs is recipe for disaster, no matter which way you spin it. As a healthcare provider, I find this to be especially true with regards to our mental health. If we can push aside something as essential as post-partum care, caring for our mental health is likely dead last on our priority list. Let’s change around our thinking on that and imagine for a minute that becoming “self-ish” benefits everyone. Because becoming the best personal version of ourselves helps us be better nurturers for those we care for.
How do I know if I’m not okay?
Recognizing and identifying symptoms of mental illnesses can be a challenge in itself. For the same reason mental health disorders are often stigmatized, they can also be difficult to identify; you can’t see them. There is no blood test or brain imaging that states “Oh look! Her depression is right there!” Most mental illnesses are diagnosed clinically, which means certain symptoms experienced during a defined time period must be identified for the diagnosis to be made.
How does one then differentiate between having a bad day and having a mental illness? Experiencing two or more of the following symptoms daily for a period of two weeks or more warrants a visit with your medical provider:
- Persistent sad mood or feelings of anxiety
- Feelings of hopelessness/ emptiness
- Irritability/ anger
- Feelings of guilt/ worthlessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating or with memory recall
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite or weight changes
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause
Your first point of contact should always be your primary care provider. Not only can they help give you the proper diagnosis, but they can also help facilitate care and referrals to other mental health care specialists, if needed. Intrusive thoughts about harming yourself or persistent thoughts of suicide should be treated as an emergency and requires an evaluation by a mental health professional right away. This can be facilitated by medical providers at your local emergency department.
What kind of help is available to me?
Treatments for mental health disorders are highly individualized and there are a variety of options available. Physical illness often requires lifestyle modifications for a full recovery or remission status—this also holds true for mental illness. There is not a single treatment option available that can mimic what an endorphin can do for the mind, therefore maintaining an exercise regimen is a must. Yoga and meditation practices are also highly effective at reducing overall stress of the body and mind. Fueling your body with healthy food choices and avoiding empty calorie options like fast food and refined sugars can help avoid unnecessary gastric distress and further feelings of guilt.
It is much easier said than done to eat healthy and exercise while battling mental illness. Staying accountable for these changes can be achieved with the right support team in place. The MVP of that team is your therapist. A psychotherapist well versed in cognitive behavioral therapy (CBT) is an essential piece to the recovery pathway. CBT focuses on changing thinking patterns while also providing new coping skills. It is highly effective for a wide range of mental illnesses including depression, anxiety and post-traumatic stress disorder (PTSD). Your therapist can also recommend other treatments that might be helpful for your individual situation such as trauma based focus therapy or somatic therapy.
Medications used for treatment of mental illness are an essential tool for recovery. Your clinician can help you determine if a medication is necessary and which one might best fit your needs. It is important to remember that mental illness is not “made up” and is not something that you can control. There is a real chemical imbalance that occurs in the brain and this is what the medications aim to correct. It is also important to remember that medications control but do not “cure” the illness. It is vital that you work with your clinician on medication and dose changes. These medications most often take four to eight weeks to start taking effect, as they need to build up over time to correct the chemical imbalance. You should never abruptly stop a medication without talking to your provider first, as doing so may cause significant withdraw symptoms. Just like any other medication that could be prescribed, these medications can cause side effects. This is another reason why it is important to work with your medical provider closely to ensure you are getting the best possible response from your medication.
There are two other treatment modalities that can be used in place of medications, or alongside medications when they have not been successful on their own. Transcranial magnetic stimulation (TMS) is non-invasive and involves using magnetic fields to stimulate nerve cells in the prefrontal cortex; the area of the brain that is responsible for mood regulation. This option is approved for the treatment of depressive disorders only. Electroconvulsive therapy (ECT) is performed under general anesthesia and involves sending small, brief electrical stimuli to areas of the brain causing changes in brain chemistry that allows relief of severe and chronic depressive disorders.
Recovery from mental illness is individualized and multifactorial. It requires time and commitment, but it is very treatable and remission is possible.
What can I do to help someone else who is not okay?
I am often asked how we can help someone else who may be drudging through the dark path of mental illness. The most important thing you can do for someone struggling is check in on them—ask them how they are doing and let them tell you how they really feel. Let them know that you are a safe place to vent without judgement. Bring them a meal, help them with house chores, but above all else, really listen to them.
There are several resources available to uninsured individuals or those with limited insurance in West Michigan. Often, therapists are willing to work with their clients on a sliding scale fee schedule based on one’s ability to pay. Services like www.opencounseling.com and www.betterhelp.com will help you connect with a local therapist who offers a sliding scale fee schedule. Network 180 is the community mental health authority in Kent County and will help connect uninsured individuals with the mental health care they need.
Mental illness knows no race, socioeconomic status or gender. It can affect anyone at any time, however research suggests that women are twice as likely to experience depression or anxiety in their lifetime compared to men. Early identification and treatment of mental illness is crucial to our wellbeing. Don’t be afraid to put yourself first. Please put yourself first. We give our best when we become our best.
Erin Walker, PA-C, MSM is a psychiatric physician assistant at Grand Rapids OB/GYN with a specialty in gynecology and women's sexual health. Erin has been practicing in the Grand Rapids area since 2012 and has worked in both primary care and psychiatry. Erin also has a special certification in perinatal mood disorders.