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Mental Medicine: How The Stigma Around Mental Health Affects Doctors

Many Millennials suffer from mental illness.

CREDIT: Pexels.

Millennials aren’t feeling well.

As a generation, Millennials are putting up startling figures for measures of mental health. Suicide rates, after years of decline, have jumped back up by nearly 25 percent. The trend is worst among adolescent girls, but many Millennial subgroups, like those in the military, are also at elevated risk.

Depression is also rampant among this age demographic, according to numerous studies–even though it is routinely under-diagnosed among adolescents, which helps exacerbate the suicide risk among teens as well as the risk of more severe mood disorders in adulthood. Psychologists have observed that stress and anxiety disorders are the norm today, afflicting upwards of one in every five Millennials.

There is even emerging evidence that the crushing weight of student debt and financial insecurity in the wake of a succession of financial crises may be having a pointed psychological effect on this generation as well. More than one-third of Millennials exhibit the symptoms of PTSD, specifically in response to financial stressers. Rather than making decisions based on optimism, confidence, or a sense of strategic self-discipline, fear is governing the behavior of the new majority in America.

It might be tempting to use growing awareness, better diagnostics, or even a lack of resilience to explain away the whole spike in behavioral health problems among Millennials, but the continuing rise in suicide rates shows that the impact is all too real, and devastating. And although Millennials are the new face of the crisis, the effects of their struggle with behavioral health go far beyond a single generation.

Healthcare in the United States has been extremely slow to embrace behavioral health. This is at least partly a result of the historic (and continuing) tendency in American society to treat emotional problems as a personal choice or individual failing, rather than a legitimate clinical concern. The lack of compassion and understanding helped create a stigma surrounding mental health that has persisted even in the face of awareness campaigns, improved counseling and psychological treatment, and of course, the recent rise in suicides among the nation’s youth.

Given the real and perceived social risks of asking for help, it should come as no surprise that many victims of depression try to self-medicate. Depression has a strong correlation with substance abuse (this is often referred to as ‘dual-diagnosis’), which carries its own cultural baggage. It is hard for those suffering from addiction or other behavioral health problems to seek help, because treatment can carry as much of a stigma as the original complaint.

To understand just how severe the issue still is, one need only look at America’s physical medicine establishment.

Medical students learn early on to fear talking openly about depression, suicidal thoughts, or anything else that might wind up in their professional record and taint their reputation among colleagues, patients, or potential employers. This same fear–of being found out, of disappointing the many people counting on them or expecting great things–has made suicide the second leading cause of death among medical students, after accidents.

Those that survive medical school and go on to practice carry this magnified perception of the mental health stigma with them. More than 400 physicians commit suicide every year. It is no coincidence that physicians, unwilling to admit to their own depression or seek professional help, are also notoriously poor at screening their patients. So even though some 80 percent of Millennials are at least getting their annual physicals and have access to a primary care physician or similar provider, they are not being sufficiently diagnosed with behavioral health problems, much less referred to the appropriate specialists.

Although it hasn’t been well publicized, this has been the scale of the situation for some time. Now, however, the demographics of the country are shifting. Millennials are, by most measures, officially the majority, and well on their way to dominating employment as they enter their prime working years. At the same time, baby boomers (formerly the largest cohort) are both dying and retiring, which adds even greater momentum to the shift.

That all means that a generation of high anxiety, depression- and suicide-prone individuals are going to become the primary care providers to America, working in the field that, sadly, takes the worst care of itself.

Science has given us the ability to live longer than ever–baby boomers will be the first generation to fully experience the progress that was made in medicine throughout the 20th century. This, along with the expansion of health insurance through the Affordable Care Act, means there is more demand for medical care than ever before. Meeting this demand is now the responsibility of Millennials.

To take care of America, Millennials must learn to take better care of themselves, and that starts with a new approach to mental health. Fighting the stigma requires more than a change of policy; the culture of silence, tolerance, and personal blame needs to give way to one of compassion, understanding, and openness. No generation can afford to allow current trends to continue unchallenged.

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