Untreated Mental Illness: Recognizing the Signs

According to the National Institute of Mental Health (NIMH), nearly half of people with a mental illness do not receive treatment. In this episode, Tina and Serena delve into some of the signs of mental health struggle and share their own experiences of realizing and knowing when more support is needed.

Notes and Mentions

Warning Signs of Mental Illness from American Psychiatric Association Youth Mental Health Resources for Parents from Youth Mental Health Project Warning Signs and Symptoms from NAMI

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Tina: Hey everyone, I'm Tina

Serena: And I'm Serena, and we are the Mental Health Mamas.


Tina: Welcome to No Need to Explain. We are so glad you're here.

Serena: First, as always, a quick disclaimer.

Tina: We come to you not as mental health professionals or experts in the field, but rather as parents would lived experience who are on a mission to normalize the conversation around mental health.

Serena: If you or someone you love is experiencing a mental health crisis, please seek professional support. You'll find a variety of resources and our show notes and on our website, noneedtoexplainpodcast.com.

Tina: This episode has been brewing for a while in my head anyway, for a really honestly, really long time. As our listeners know, mental health is not something I thought about growing up. And that's probably likely true for a lot of us of a certain age, right?

Serena: Yes, I would totally agree with that. I do remember having some, I guess what I would refer to as exceptional teachers in elementary school who really kind of folded social emotional learning into what they taught, but I'm not sure that term even existed at that time, or if it did, it certainly wasn't used to talk about what these teachers were doing.

Tina: So I totally agree and I would say, we've talked about our Be the One campaign. I certainly had teachers who were that safe, stable, nurturing, caring person. I totally agree with that. And I don't think it was anything formal back then. I think it was just, and having been a teacher, it is definitely something that is folded into teachers and some not, so anyway. So the word social emotional learning and emotional intelligence, they were not part of my growing up. And yet over all of my 53 years, I've learned so much about mental health, my own mental health, that of my family and my friends. And the truth is, we say it all the time, we all have mental health, are you well or do you need support? And it has really for me become a connection point.

Serena: I would agree with that. I too knew so little about mental health. And now it's just a part of everyday life. And you know, I can, looking back, I can actually recall pushing back on the whole idea when my now 14 year old was little and struggling with what I would refer to as behavioral and maybe sensory issues. I was certain that I could find that solution. If I just looked hard enough, I was gonna find the thing that was gonna fix everything. Maybe like a magic feather, right? I don't know if you ever felt like that, Tina.

Tina: We looked for it for a long time.

Serena: Yes, Dr. Google, right? So I think in some ways, I pushed back on the idea of sort of a mental health diagnosis or just a treating the mental health of my kids because it felt vague and undefinable. I think one of the things that we talk about on the podcast is that when our kids are sick, we seek treatment. So, you know, an ear infection, we go to the doctor, broken arm, you're gonna see a doctor and be treated and then we echo that idea with mental health. If our kids are unwell, we should seek treatment. But I will also say at the same time, there's no blood test or a specific treatment for mental health challenges, at least not yet.

Tina: Yes, and I would say because it is so normal for me and my family and my friends, it's still so very shocking for me to read some of the statistics on untreated mental health challenges. From an article on Constellation Behavioral Health and the quote specifically from a study from the National Institutes of Mental Health, 51% of adults in the US with bipolar disorder and 40% with schizophrenia were untreated during a one year study period. For any mental illness, the statistics were even worse. Just 43% of people with mental illness received treatment in 2016, men are more likely to go untreated. Around the world, approximately two thirds of people with mental disorders go untreated.

Serena: Okay, so let's pull apart those statistics for a moment and look a little bit more closely at the quote. And I'm curious about the definition of what they refer to as treatment. So we know that taking good care of our mental health requires a toolbox full of useful and accessible tools. We talk about that all the time. And so some of these stats might be referring to actual, like maybe very specific treatments, like actual outpatient or inpatient treatment by psychiatrists or psychologists. So a therapist or medication might be part of your toolbox. And another thing to note, when I think about diagnoses, the specific diagnoses of bipolar or schizophrenia, I wonder if the idea that they are quote untreated means that they're not taking medication. I don't really know, but I also have to wonder about the statistics of individuals going untreated. So the statistic was from 2016 and that was a number of years ago. And now we know at this moment in our country waiting lists to receive treatment are months and months long.

Tina: That's absolutely true. Yeah, and again, Serena and I wanna be very clear as we always disclose, we are not mental health professionals. And what we say is only informative and not diagnostic. And that said, we are gonna delve into the topic a bit more and we're gonna talk about how to recognize signs that you or others need support. The levels of care, perhaps, and the ways we personally have sought treatment for ourselves and our people.

Serena: Yeah, so I'm gonna approach this as a parent because we often speak with our parent hats on. And I would say that we saw different things in each of our kids that led us to seek treatment. And so I'm gonna start with my teen first, because she was the first one we actually sought treatment for. And I've mentioned on the podcast before that from the age of 18 months, she began vomiting daily and often several times a day. And I'd say we went down oh so many different avenues to figure out what was going on with her. And like I said, looking for those answers, seeking all the different professionals, and there were literally no answers. So we started to make some connections between sensory stimulation and the vomiting, but it didn't always add up, unfortunately. And it was actually an occupational therapist who was seeing her through early intervention that suggested we try some counseling for her. And again, I pushed back on this idea because it just didn't feel like it was gonna fix what was going on.

And I would also say that she's a unique case in that mental health concerns don't usually manifest quite so early. And I guess I would say, overall, we weren't functioning well as a family. And that was kind of the thing that pushed us in that direction. So we couldn't go to the playground. There were no play dates, even going to the grocery store was virtually impossible. So ultimately, we sought out mental health support. So that we could be more functional as a family. And that was our hope anyway. And go out and public, which we did succeed at, you know? So that's good news. And I will say that counseling continues to be one of the tools in her toolbox.

Tina: But your oldest had a more kind of, putting quotes around typical paths to seeking out mental health support. 

Serena: Yes, she did. I would say that she was a very sensitive child, just like her sisters. And I would put myself in that category too. But there weren't any, what I would call red flags until she was about 14.

Tina: And I'm just gonna insert here that according to NAMI, the National Alliance for Mental Illness, 50% of all lifetime mental health conditions begin by the age of 14 and 75% by the age of 24.

Serena: Right. So often we see mental health concerns rising to the surface in the teenage years, which of course, there's a lot of stuff going on in the teenage years. So it makes it, it makes it extra complicated. So personally, what I saw in my oldest was this pretty happy kid, she loved to learn and go to school. And then suddenly became a kid who wouldn't get out of bed in the morning for school. She wasn't sleeping well, her grades were slipping. She wasn't doing her homework and she wasn't going to school. So some kids may take a more gradual slide into struggle. She literally hit a wall and it was painfully clear that she needed support. So luckily the counselor who was supporting her younger sister was able to take her on as well. And we were able to get her into counseling right away. And I just wanna acknowledge that I know that isn't the case for most people and especially right now that counselors are just not available for people who need them right away. But I'm curious, so Tina, what was your experience?

Tina: Yeah, so I would say with my child, it was similar to your oldest. It was an earlier onset, but certainly a decline that was quick enough and I noticed that inability to certainly engage with the world. That was the part that I guess we as parents trusting ourselves say, this is not what we've seen every day and we need to think about it. But I think I'm gonna delve into this from my own perspective. Those of you who are listeners know, I was in a car accident a few summers ago and I sought help, literally when I couldn't make it through the day, I had these intrusive thoughts that just continued to paralyze me really. I mean, I wasn't able to do anything and I was physically unwell also, which I think adds sometimes when you are a person who has chronic pain, when you are somebody who has any kind of physical ailment as well as, it challenges you in any way. So I feel like when I did not feel like I had what I'd call a normal flow of my day, like I really was sitting around more, not doing the things that I would normally do. I really was stuck in those negative thoughts, I needed support.

Serena: And I just wanna point out here that what you just said is that you didn't feel like you could do the things that you normally do, right?

Tina: I think that's exactly.

Serena: Yeah, so that when you get to that point of you're not functioning, right? And I wonder if I can share just a little bit from my perspective as an outside observer of what was going on with you.

Tina: Sure.

Serena: So she says. So two things, one I would say, you cried a lot, I would say more than usual, right?

Tina: My mom would say that's not unusual. Well, I did, I do remember, 

Serena: no, I hear you. And like I've had those moments in my life too. And for me, when I wake up in the morning and start crying, like that's bad. I know that that's, I really need to seek support at that point.

Tina: I honestly think that I was even crying in my sleep, and I remember kind of waking up with crusty eyes in the morning, yeah, you're right about that. Yeah, yeah.

Serena: And then the other thing that I noticed in here is that you would say things that were really out of character for you. I guess just thinking about you’re a very strength-based person and tend to be an optimist. And that is not what I was hearing coming out of your mouth.

Tina: Yeah, I was not in a good place. I was not in a good place. And I did seek support and had a wonderful therapist that really helped me through that time. And I would never hesitate to go back. I'm currently not in therapy, but you know, I just feel like at any point I could be and I'd be fine with that. So don't hesitate if you are on the edge, seek support. So let's just go to this place of, I was not at the point where I needed emergency care. I think that's a tough place to be. And I've seen, not only have we supported people in that place, we've been there. It's a tough place to be. So let's talk a little bit about that leveling of care. While I didn't need emergency support at that point. I know that there is that need, right? So like calling 911, calling 988, which is the suicide crisis and prevention line. And you can text them as well as call them. So that might be the kind of top emergency in that might also include showing up at an emergency room.

Some communities like the one you live in Serena definitely have walk in hours for immediate care. And I say that not lightly, right? Because we didn't always have that where I used to live and you currently live. I don't know about that in my community. I should really find out about that, but it's important. So really feeling open to get that care at that immediate level. Now, you might also be at the level where you can wait for an appointment with a therapist or you can make an appointment with your primary care doctor, which might be quicker than trying to see a therapist. And there might be a good referral procedure there. 

And perhaps you're looking for some medication to support your building of skills. And let me just say a little bit about that because it's an important, it really is an important thing that came to light for me. Again, those of you who listen know I pushed back on medication for a bit. But when someone finally said to me, here's the thing, medication allows that anxiety, at least to be brought down to a level where you can access those tools. And for us, my child was smart enough to know like all the tools on a good day, all the tools were there and available. But when that anxiety rose to a point where it was unmanageable, none of those tools are accessible. So I think that is when they talk about the gold standard of medication and therapy working together, I think that's where it leveled out for us, right? So that's super important. And that can just help you change your mood, help you support your brain health, and really continuing to build that toolbox because it's important that we have the toolbox, all of us need a toolbox, not just people who are struggling, right?

Serena: Right, right, yes, we shall have that toolbox beside us. I'm imagining here beside you. I'm going to open it up, right? We need to be able to,

Tina: I kind of feel like it's like the magic, like Mary Poppins in some way. It's like in my pocket or just this little thing and I open it up and all these things come floating out. Yeah. It's just my world.

Serena: I love it. Yeah, so, and what we're talking about with the toolbox, it's not necessarily about acute care. It could be in your toolbox, but really we're talking about sort of that preventative or maintaining good mental health, right?

Tina: Exactly, so every one of us should have our toolbox to maintain that emotional health. So I'm curious, Serena, what is in your toolbox?

Serena: So I think it changes sometimes, right? Or maybe it's all in there and I'm using different things at different times, but getting outside for a walk is definitely in there, all here.

Tina: Not today, because it's icy, right?

Serena: Really icy, yes, you know, dangerous, but yes, I try to get out year-round. In summer, working in my garden makes me really happy, especially while listening to a good audiobook at the same time. And I listen to audiobooks year-round, so I just do different things while I'm doing that. I would say my four-legged friends, my fuzzy friends or fuzzy carnivores, as we like to call them, Are a constant support, they're nice carnivores.

Tina: And you have a really big fluffy one. That's amazing. That's amazing. Size of a small child, right? And it's a cat to just saying, it's a cat.

Serena: Right, and there's a dog too, but yes, the cat is huge. And I also find that learning new things, like a language, or just learning about something I didn't know about before is really fulfilling to me. So what's in that toolbox of yours, you know, what's coming flying out when you open it up?

Tina: So I would say some things, like you said, are constant while others, I totally revisit. So currently, regular exercise, certainly a tool that is making my brain feel good. I love to walk in nature, I do some strength training, which is good for my muscles, and even though they yell at me sometimes, it's a good, it's a good shouting, so it's good. I also always have a good book at the ready when I need to just settle my body and read for a bit. I have a, I still have a book club in Ithaca, New York, which welcomes me to read the same books and meet with them, and I love that, and they keep me reading, so it's awesome. I would also say, and this is gonna shock you. That sleep, sleep is a constant for me, and I talk about sleep a lot, but I don't really get into the details, which I'd like to for a moment, will you indulge me?

Serena: Go for it.

Tina: So I am really big on my sleep routine, which is quite multifaceted. I start about an hour before I actually get into my bed, turning down the lights. I might still be watching TV, but I make sure it's not loud that it's not news, because news is that messes with my emotions and I don't like it. I usually like something light and fun, but at bed time, I actually get in my room, my room gets ready, a cool, I like it really cool, and a fan, quiet, the lights off. I might read my Kindle with very low light for a little bit, in fact, last night, my husband had his on super bright light, and I thought, what are you doing? That's so bright. And this week, a few weeks ago, I was totally thrown off by events and staying up a little bit later, and it really does mess with me when things aren't, when I can't, what do I have now again?

Serena: Yeah, I hear you. So I'm curious about that sleep routine. Is it, did somebody support you in creating that? Did you just kind of figure it out over time, inquiring lines want to know?

Tina: That is a really good question that I've never thought about before, but I guess I would root it back to my mom who, she was such a good role model for sleep. My dad was a police officer and his schedule was a mess. He was seven to three, three to 11, 11 to seven, whatever they needed him to do, he did that. And my mom always kept the four of us on a very good schedule, and probably for her own sanity quite honestly. Bath, we had baths, we had bedtime. It was just very scheduled, and we always ate at the same time, and it was just really a good schedule, and I would say in my adulthood, we have babies, things are disrupted, and teenagers are struggling, so you have to pick them up late from places. I know you're living this right now, and the mental health struggles did not help with the sleep, and I think I just started listening to my body, and really, when I could control it, I did and tried to appreciate that good sleep routine.

Serena: And I would say that's a great reminder that we need to model using all of our tools for our kids, for us as parents, right? I would say that we can't expect our children to be able to access their own tools if we don't show them how we do it.

Tina: Yeah, it's so funny because we talked a few episodes ago about completing your stress cycle, right? So I saw this video a few days ago online, and it's a mom whose two-year-old is really having a moment, right? Just like screaming, and I don't know if it's the right term is tantrum anymore, it certainly was when my kids were little, but anyway, that's the video.

Serena: It’s a meltdown.

Tina: A meltdown.

Serena: I’ve seen this video!

Tina: Have you, and what does the mom do?

Serena: She runs.

Tina: She runs, not away from her child, but she runs around a circle in her house, including her child in every pass, and by about the third time, the baby's laughing instead of crying. So I just think that is a good model.

Serena: Right.

Tina: Completing the stress cycle, right? Like, oh my gosh, I could do a lot of things right now and what I'm gonna do is just run in circles until I don't feel stressed anymore.

Serena: Right.

Tina: Oh my gosh, I love it. If you haven't looked it up, you should, cause it's really quite entertaining. I'm excited and entertaining. So a few messages today from this episode that we hope that you might take with you today. Please normalize your feelings. We all have feelings, feelings are normal, good, bad, and otherwise there's no good and bad, right? It's just really about feeling all the feels. We will say it now and we will say it a hundred times more and maybe a thousand times more. We all have mental health. Are you well or do you need support? And if so, where might you look in your community? Important to know. 

Serena: And being aware of what the signs of distress are for you or your children, we talked about a few of them. But what I would say is bottom line, trust your gut. If you think that you or your child is a need of support, please seek out that additional support.

Tina: Exactly. And there, by the way, are tons of resources online about signs of distress from suicide prevention websites to, I don't know, Serena maybe we'll include some of those links in the episode. We have some good parental links that we used to use quite regularly when we supported parents face to face, which hasn't happened in quite a while with the pandemic at the ready. So continue to build that toolbox so that when you can access it, you have all those tools at the ready.

Serena: And so podcast friends, we are as always grateful for you spending your time with us today and listening. If you get a chance, go to Apple Podcasts and leave us a review, subscribe and share with others. It just helps our podcast get to more people, which means it's the longer we can continue offering this podcast to the world. You'll find more content on our website, noneedtoexplainpodcast.com. Find us on the socials. Leave us a voice message. You'll find that number in our notes. Tell us what's in your toolbox. We love getting everybody else's ideas and sharing them with the world, or just call to say hi.

Tina: And this is your gentle reminder to take a care of yourself while you are also taking care of your people.

Serena: Thanks for listening.

Tina: Bye.