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There is an overriding tendency within human nature to fear what we don’t understand. Throughout history, this “fear of the unknown” has shaped our perception in regard to those who suffer from mental illness.

Assumptions and judgments are formed about people with mental health issues often without any understanding of the causes, symptoms and treatment of a particular disorder. Moreover, people tend to believe that those who are mentally ill have a greater propensity toward displaying violent behavior.

However this is simply not the case. Numerous studies have shown those with mental disorders are no more likely than anyone else to commit violent acts. In fact, the mentally ill are more likely to be the victims of violent crimes than the perpetrators.

The Stigma Softens

In the past, the portrayal of those with mental illness in books, film and television were major contributors to the negative reaction that terms such as “mental disorder” and “schizophrenia” often received from the general public.

However, in more recent years, a greater effort has taken place to educate the public about mental illness.  These positive developments include:

  • Mental health centers with educational programs that raise public awareness  about the truths of  mental disorders, as well as addressing successful treatment modalities for OCD, ADHD, depression,  and eating disorders.
  • Organizations such as the National Institute of Mental Health (NIMH) that work with media and news organizations to raise awareness about mental illnesses.
  • TV shows and documentaries focusing on the lives and struggles of people with bipolar disorders, obsessive compulsive disorders and other illnesses.
  • The emergence of celebrities who are beginning to discuss their mental health issues in public forums.

By increasing exposure to the facts and attaching names and faces to various disorders, the stigma and stereotypes surrounding mental illness are gradually fading. All these factors contribute to encouraging those with mental illness and other mental health concerns feel empowered to discuss their issues and seek help.

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On the 10th anniversary of 9/11, Americans took the time to reflect upon the events of that horrific day. Observances and ceremonies were conducted throughout the country to pay respect to the victims and to memorialize the heroes that emerged from that devastating day. Nearly 3,000 people lost their lives in New York, Washington and Pennsylvania, but many more continue to acutely feel its after-effects.

Ten years later, many 9/11 first responders and those that followed them to “ground zero” to address the aftermath are not only experiencing severe physical ailments, but are suffering with serious mental health issues as well. The lives of these individuals have been forever changed as they continue to deal with the repercussions of that fateful day.

A Traumatic Impact

As millions around the world watched the terrifying and almost surreal scene unfold in the middle of New York City on Sept. 11, 2001, the impact was intensely magnified for those in close proximity to ground zero. After having been directly involved with such a traumatic event, thousands of responding firefighters, police personnel, doctors, nurses and even construction and utility workers developed Post Traumatic Stress Disorder (PTSD), anxiety problems and depression in its wake.

Attempting to Heal

In January 2011, the James Zadroga 9/11 Health and Compensation Act was federally approved. This bill offers assistance to ground zero workers suffering from a physical or mental illness as a result of 9/11. It also establishes medical and mental health centers dedicated in part to the treatment of those affected by the travesty.

The Zadroga Act has greatly benefited workers and their families experiencing mental health issues. Those who might lack the financial means to receive treatment for depression , PTSD  and treatment for other mental health issues associated with the traumatic events of 9/11 are now able to get the help they need.

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed behavioral disorders in children. In the U.S., ADHD affects roughly 8 percent of children ages 3-17, according to the Centers for Disease Control and Prevention (CDC). According to the National Institute of Mental Health (NIMH), up to 60 percent of children with ADHD will experience symptoms through adolescence and into adulthood.).

Countless studies from reputable health organizations have been conducted on the causes, symptoms and treatment of ADHD. But a decisive ADHD diagnosis can often be difficult to pin down, especially in young children.

Core Symptoms of ADHD

ADHD encompasses a wide spectrum of symptoms. While the “attention deficit” and “hyperactivity” aspects of this disorder can occur separately, they coincide in cases of ADHD. Attention deficit characteristics include trouble listening, inattention to detail, forgetfulness, lack of organization and an inability to stay focused on a subject or activity. Hyperactivity symptoms include the inability to sit still,  the constant need to be in motion and excessive talking.

Not Hard to Misdiagnose

Some of the symptoms of ADHD can also be present in adolescent depression, bipolar disorders and other mental illnesses such as anxiety disorders and mood disorders. While ADHD can occur in conjunction with another disorder, it is also possible for a child exhibiting symptoms common to ADHD diagnosis, to be actually be suffering from a different  problem altogether.

When a child is disruptive in class or has difficulty listening and cannot sit still at home, ADHD is often the first concern  a teacher or parent has. However, a recent Michigan State University study reports nearly one million children in the U.S. might  have been misdiagnosed with ADHD. This can translate into ADHD treatment such as medication being initiated too soon, which in some cases might have a negative long-term impact on a child’s health.

It is important for a child displaying ADHD symptoms to be thoroughly evaluated over a period of time by a mental health professional. Any initial treatment should begin with behavioral therapies in lieu of medication.

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Stress shows no boundaries. It hits everyone—not just the patient in your waiting room, or the parent who says they’ve hit bottom and don’t know where else to turn, or your staff person working endlessly to meet deadlines and improve the bottom line. Economic pressures, unrelenting competition, never-ending work hours and shoestring budgets can take a toll on the high level professional or executive as well.

“We know that stress has physical and emotional effects on people and can create positive or negative feelings,” says Dr. Robin Arthur, Chief of Psychology at Lindner Center of HOPE. “Stress can help compel us to action,” she says. “But stress can be brutal and cause health problems such as anxiousness, depression and addiction issues. Often when leaders are stressed they look for ways to help them cope and those ways aren’t always healthy,” says Dr. Arthur. Busy executives self-medicate with alcohol or sleep aids or experience deteriorating relationships, irritability and isolation.

Research conducted by global business management, Towers Watson which surveyed HR professionals at 316 US organizations identified “opportunities for promotion” as the top reason that high performers would leave a company.  In a separate survey of 10,000 employees across the country, results indicated that the number one reason high achievers leave a company is because of—stress.  Interestingly, out of the five potential causes cited by HR professionals that top-performing employees would leave, not one of the reasons included stress.

Most business executives, care providers and other high level employees are conditioned to not show their stress. So symptoms manifest in anger, increased substance use, depression and difficultly at home or with relationships. But when the culture of an organization permits their executives to acknowledge their stress and its subsequent reactions, only then can progress and wellness take place.

“Balance is the key,” Dr. Arthur said. “The goal should not be to eliminate stress but to learn how to manage it and use it to our benefit. Finding the optimal level of stress can be motivating without being overwhelming.” Just as there are many sources of stress, there are many possibilities for its management. All require working toward personal change – changing the source of stress and reactions to it.

Tips for Managing Stress:

  • Become aware of stressors and emotional and physical reactions
  • Focus on strengths, recognize what you can change, pursue realistic goals
  • Reduce the intensity of your emotional reactions
  •  Learn to moderate your physical reactions to stress
  • Exercise; eat well; avoid nicotine, excessive caffeine and other stimulants
  • Develop supportive relationships
  • Create a game plan and think things through

About Lindner Center of HOPE:

Lindner Center of HOPE provides patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, free-standing mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization for individuals age 12-years-old and older, outpatient services for all ages, research and voluntary, residential services. The Center’s clinicians are ranked among the best providers locally, nationally and internationally.

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In recent years, many high profile actors, politicians and athletes have opted to take the step of disclosing their battles with mental disorders to the general public.

In doing so, these people have elevated public awareness of conditions such as bipolar disorders, depression and attention deficit hyperactivity disorders (ADHD). In some cases, the decisions by these public figures to reveal their struggles have been the catalyst for everyday people to seek help for their own mental conditions.

Public Figures Reveal Mental Health Issues

After a stressful period in which she was caring for her cancer-stricken husband actor Michael Douglass, Catherine Zeta-Jones decided to check herself into a mental health treatment center. Zeta-Jones had reached a point where she was fluctuating between periods of joy and deep depression and knew she had to take additional action to address her condition. As a result of her decision to seek treatment, the famous actress discovered she had bipolar II disorder.

Not long ago, comedian and game show host Howie Mandel was officially diagnosed with obsessive compulsive disorder (OCD) and ADHD. After years of dealing with racing thoughts, an inability to sit still and obsessing over germs, Mandel decided to get help. After seeing improvements in his mental health with ADHD treatment and OCD treatment that included the use of psychotherapy and medication, Mandel is now a spokesman for these disorders and fights to diminish stigmas attached to them.

Mental health issues surrounding professional athletes have also come to the forefront. Reigning National League MVP Joey Votto of the Cincinnati Reds and boxer Mike Tyson both endured bouts of severe depression. Additionally, a Duke University study found that nearly half of all U.S. presidents have at some point battled mood disorders that include depression.

Mental illness is not something an individual should be embarrassed about or feel they have to keep secret. Numerous agencies and mental health centers offer treatment that allows individuals struggling with mental disorders to live normal and productive lives.

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A fairly recent study has found evidence linking Attention Deficit Hyperactivity Disorder (ADHD) to genetics.

A team of scientists scanned gene maps of more than 1,400 children for the study. After comparing the abnormal samples to the DNA of children without ADHD, the researchers discovered those with ADHD were more likely to have small pieces of their DNA missing or duplicated.

The DNA irregularities among ADHD children were prevalent in the same region where schizophrenia and autism is believed to develop; solidifying the belief ADHD is a neurodevelopmental condition.

ADHD is commonly diagnosed in childhood and causes impulsiveness, restlessness and difficultly focusing. In the U.S., ADHD affects roughly two million children and three to five percent of the global child population. Medication and behavioral therapy are common forms of ADHD treatment.

The results from the study are expected to help researchers develop better methods for ADHD treatment. However, it is doubtful the findings will lead to an ADHD genetic test, as many experts consider environment part of the cause as well.

Speaking of environmental factors, another recent study suggests children with high levels of the pesticide malathion in their urine have a greater risk of developing ADHD.

The new study is the first to base its findings on a general U.S. population sample rather than on children from farm-working families or those living in locations where high chemical exposure is prevalent. Researchers estimate the majority of participants in the study were exposed to the malathion through food consumption.

The study compared data from National Health and Nutrition Examination Surveys conducted during 2000 to 2004. The findings concluded children with malathion metabolite levels 10 times above the normal rate are 55 percent more likely to have ADHD.

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Paul E. Keck, Jr., MD
President & CEO Lindner Center of HOPE
University of Cincinnati College of Medicine, The Craig and Frances Lindner Professor of Psychiatry and Neuroscience and Executive Vice Chairman of the Department of Psychiatry

The news this week announcing the passing of legendary businessman, entrepreneur and great philanthropist Carl H. Lindner Jr. brings profound sadness.  It also gives pause to reflect on the enormous contributions Mr. Lindner made, not only to the city of Cincinnati, but our nation. Over a period of five decades his footprint has made more than a deep mark–it has touched countless lives and in so many instances, laid the foundation for care and treatment opportunities for those in  need. Carl H. Lindner Jr. represents what it means to be a visionary, an advocate and champion of social services across the spectrum.  From mental healthcare to children’s dyslexia learning centers, Carl Lindner Jr. is proof that we all have the ability to affect change.

Mr. Lindner recognized the tremendous unmet needs of people suffering with mental illness and understood that 1 in 4 Americans suffer from these biologically based brain disorders. Courageously, Mr. Lindner and his family became champions for mental health in this community, despite the stigma and unpopularity surrounding mental illness.  Without their generosity, Lindner Center of HOPE would not be here to serve more than 30,000 patients a year.

At Lindner Center of HOPE we believe the Lindner name on our facility has helped to bring mental health care into the spotlight, helping to increase understanding and awareness and lessen stigma. We will be forever grateful to have had the honor of knowing Mr. Lindner and we greatly appreciate his and his family’s foresight and generosity in establishing the Lindner Center of HOPE. Together they have made a enormous impact on the lives of people touched by mental illness in our community, in the region and nationwide.

It is our privilege at Lindner Center of HOPE to carry on Mr. Lindner’s legacy of quality care for people in need of mental health services. We hope others will join us in carrying this torch forward.

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The subject of mental illness is still considered taboo in many social circles. It remains the “elephant in the room” that those who are suffers are reluctant to discuss.

Positive strides have recently taken place to make the public more aware of the wide range of mental health issues affecting many individuals around the globe. However, stigmas and stereotypes associated with mental illness continue to have destructive repercussions that cause sufferers to keep their problems hidden instead of seeking treatment.

Society and pop culture have sensationalized mental illness within movies, news stories, books and documentaries. Extreme cases of schizophrenia and personality disorders are depicted in movies and TV shows, causing a reflexive fear within people. Countless movies have portrayed deranged or psychotic characters as villains, agents of fear and purveyors of edge-of-your-seat thrills. Images such as these reinforce negative stereotypes placed upon those suffering from mental illness.

It isn’t difficult to understand why many who suffer from mental illnesses — whether it is depression, bipolar disorder, addictions or eating disorders — feel they will be judged if “exposed.”

Steps are being taken in an attempt to diminish stigmas surrounding mental illness. One method of garnering public attention is having celebrities shed some educational and positive light on the issues.

It is also important to publicize corrections regarding misinformation on mental health disorders. For instance, most people would probably be somewhat surprised to discover only three percent of those suffering from mental illness actually turn violent.

Additionally, mental health organizations are better educating the public about mental illnesses by expanding their roles and increasing publicity about their service offerings.

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Over 400,000 infants are born each year to mothers suffering from perinatal depression. The most undiagnosed obstetric complication in the U.S., perinatal depression typically affects mothers during pregnancy or within the first year following childbirth.

Types of Perinatal Depression

At least half of new mothers develop what is known as the “baby blues.” This type of perinatal depression involves crying, anxiety and mood swings and lasts no longer than a few days following childbirth.

Affecting between 13 to 20 percent of mothers, postpartum depression can have an impact on mothers that lasts well over one year. This type of depression affects a mother’s ability to properly care for her child as well as her capability to perform simple daily tasks. In addition to having thoughts of harming herself or her child, women affected with this depressive disorder might also feel inadequate, shameful and withdrawn from friends and family.

How Postpartum Affects the Child

A study conducted by the American Academy of Pediatrics (AAP) found infants residing in environments where depression was present are more likely to have impairments in their social interactions and cognitive development. If the mother’s depression remains untreated, it is less likely a strong relationship bond will develop between mother and child.

Treatment is Key

In order to reduce the impacts of postpartum on an infant, the mother must seek treatment. Methods of treatment commonly include counseling and medication. Within roughly four months of being diagnosed and treated, mothers will begin to recover from postpartum treatment.

Recognizing the Problem

Primary care providers should screen new mothers for postpartum depression and provide the appropriate resources if symptoms are found.

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Written by Paul E. Keck Jr., M.D.,  president and CEO of Lindner Center of HOPE and a professor of psychiatry and neuroscience at the University of Cincinnati College of Medicine

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Abraham Lincoln, Virginia Woolf, Eugene O’Neill, Leo Tolstoy, Tennessee Williams, Winston Churchill, Charles Dickens, Carrie Fisher, Mike Wallace, Patty Duke, Demi Lovato, Catherine Zeta-Jones – all talented and gifted individuals, each has made unique contributions to society, are heroes to many and all have touched our lives in one way or another.

Is it surprising that these individuals have experienced a mental illness such as schizophrenia, bipolar disorder, obsessive compulsive disorder, and/or personality disorder? It shouldn’t be. Mental illness affects one in four individuals, and five of the top 10 causes of disability worldwide are due to psychiatric illness. They strike men and women in almost equal proportions and affect people of all ages, ethnic groups and socioeconomic levels.

Although we have never had better evidence-based treatment and more achievable recovery for most psychiatric disorders, substantial stigma still exists and creates barriers for people needing and seeking treatment. Massive improvement is also needed in reimbursement for mental health care. Though these illnesses are as devastating for families as cancer and heart disease, society perpetuates disparities in support for individuals and families faced with mental illness.

Through research, great advancements in genetics, diagnosis and treatments have been made. In addition, we continue to increase awareness about the nature of suicide and the co-occurrence of mental illness and addiction.

Mental illness can be an uncomfortable topic, but when people share their stories, awareness grows and compassion is cultivated. We have an opportunity, in our community, to be leaders in improving access to high-quality mental health services, not only for humanitarian reasons, but based on economic imperatives.

Enhancing the health and well-being of our communities depends on a collective effort. No one organization, business or advocate can do it alone. I commend the nationally well-known individuals who share their stories of hope and also thank the everyday heroes in our communities who also face the effects of mental illness.