It’s Time to Stop Hiding Mental Illness

Naomi Judd visits the Lieber Institute for Brain Development in Baltimore, MD on July 27th.
Naomi Judd visits the Lieber Institute for Brain Development in Baltimore, MD on July 27th.

Same Voice, New Message: Naomi Judd talks depression and the need for greater awareness and new treatments

Naomi Judd, Daniel R. Weinberger

America, we need to talk about mental illness. It’s a topic that we have consistently shrouded in shame. Fall down and break your arm? You happily hand friends a marker so they can sign your cast. A more serious condition like cancer—although often discussed in whispers—still elicits flowers and get well cards.

But when someone is depressed, has panic attacks or schizophrenia, or is caught in the clutches of addiction, people tend to go quiet. Friends and relatives often try to hide the problem, as if suffering from mental illness is a sign that someone is weak, did something wrong, or can’t seem to just shake things off.

As a singer who has spent decades in the spotlight while secretly struggling with mental illness, and a physician who has spent decades researching cures for mental diseases, we feel this has to stop.

Mental illness is a medical condition of the brain and it should not be hidden or considered any more shameful than getting heart disease or cancer treatment. Part of the problem is that so few Americans know how common mental illness really is. In fact, over 43 million adults have a mental illness in the United States every year, which represents around 17.9% of our adult population. So why do we continue to hide it?

In our respective careers, we work daily to do the exact opposite. “River of Time: My Descent into Depression and How I Emerged with Hope,” details firsthand what it’s like to battle severe depression. Sharing this very personal story is done so with the hope that it will provide others with the courage and resources to overcome their own struggles.

People avoid talking about depression, the most common mental illness, yet this is also the most likely reason that someone will see a psychiatrist. The correct medical term for depression is “major depressive disorder” or MDD and it’s different than just feeling upset or down in the dumps for a day or two. It’s an enduring and disabling condition. Some of the symptoms include constant sadness, not being able to experience pleasure, fatigue, weight changes, sleep disruption, problems thinking clearly, and thoughts of suicide. Again, these are not fleeing moments of sadness, but persistent feelings that last for two months or longer and cause major problems in a person’s life.

Just acknowledging that depression is a brain issue is a major step forward, because it helps focus on the importance of studying the brain. Just like we study the heart and blood vessels to understand cardiovascular disease, we have to study the brain to understand mental illness and find new treatments.

It has been over 65 years without a major breakthrough – the treatments for mental disorders available now are modifications of their original prototypes, created without any understanding of the actual mechanism of illness. These limitations of modern medicine and desperate need for new treatments are personified throughout “River of Time.” And although the current toolkit is helpful for most people, it is limited; research to better understand how genes increase risk for depression provides a beacon of hope for new and better therapies.

Today’s understanding of depression is far removed from decades past, where we thought there might be a specific “depression gene.” We now understand that no single gene is involved in any mental illness. Instead, tiny differences across many genes put us at risk. This is the same story for most common medical conditions, such as heart disease, diabetes, stroke, etc.

This explains why there is genetic overlap between depression and other psychiatric disorders, such as schizophrenia and bipolar disorder. In fact, around 50% of people with bipolar disorder have a parent with a history of clinical depression.

Examining how the risk genes influence the function of specific parts of the brain also lets us to understand how these genes may have been altered by our experiences in life. We know that people with a history of childhood trauma and abuse are two times more at risk of developing depression later in life. These people are also likely to experience more severe symptoms and respond less well to treatment. Researchers are now beginning to study how this early childhood stress can alter the brain by silencing some genes that put us at risk for mental illness.

Research is also revealing that the future lies in what is being called, precision medicine, to overcome conditions like treatment-resistant depression. Everyone is not likely to respond to the exact same treatment, and as we learn more about basic causes and genetic risk, medicine will become more personalized. But researchers and advocates must continue to work together to destigmatize mental illness; to remind everyone that it’s biology, not character. If facing a personal struggle, leaders must continue to take interest in brain research to help overcome find new solutions and to inform their critical advocacy work. Together we must continue to invest in cutting-edge scientific research to find new treatments for mental illness, and never give up on the fight to overcome conditions like depression.

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Naomi Judd is a country music singer and songwriter, best known as half of The Judds singing duo with her daughter, Wynonna. They have had more than 20 top ten hits, and The Judds have won five Grammy Awards. Naomi Judd is also the mother of actress Ashley Judd. Naomi is a mental health advocate and recently published a book on her struggles with depression, River of Time: My Descent into Depression and How I Emerged with Hope. The paperback edition was released on December 5.

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