Experts: Important to know causes, symptoms of mental illness

When Rosie Bollinger spent a year in Iraq, she was confined mainly to Tallil Air Base near the city of Nasiriyah, about 225 miles south of Baghdad.

She was serving in the Army National Guard during Operation Iraqi Freedom, and her job was to supervise cooks from the area.

Although Bollinger didn't engage in hand-to-hand combat during her tour of duty, she didn't come away unscathed.

Every day of her deployment was spent expecting, preparing for and fearing an attack from forces loyal to deposed Iraqi leader Saddam Hussein. That vigilance left Bollinger with what she later learned was post-traumatic stress disorder.

"I guess it was being under so much pressure the whole time," the Millersville resident said. "You always had to be alert and aware."

When Bollinger came back to what she calls real life, it didn't take long to recognize she had a problem.

While Bollinger's PTSD symptoms were more overt, other types of mental illnesses may not be as obvious. There are more than 400 types of mental disorders, but many of them, such as PTSD, can be caused or exacerbated by stress or trauma.

Experts say many people who suffer from mental illnesses may not be aware of the toll stress and other unhealthy habits can take on a person. It's important, they say, to take stock of potential symptoms and seek treatment, if necessary.

For Bollinger, her symptoms included a heightened sense of alertness, insomnia, anxiety and paranoia.

"You can drop something and be scared out of your wits," she said, and the sound of a car backfiring instantly would catapult her into a defensive posture.

If Bollinger spotted something out of place by the side of the road, she would go to great lengths to avoid it, fearing the object might be an improvised explosive device often seen in Iraq. One time, she whipped into another lane just to get away from a bit of trash on the road. She would have nightmares and anxiety attacks that left her short of breath, her heart racing.

"I was just having a hard time sleeping and a hard time concentrating. I was always fearful that something was going to happen around here," she said.

Bollinger's paranoia became so great, she would find reasons to avoid leaving her home. That's when she visited the U.S. Department of Veterans Affairs, which referred her to a therapist, and she soon began taking medication.

"It took a while to help. It took probably about until a year or two ago," she said.

Even so, Bollinger still deals with PTSD symptoms and takes medicine to help alleviate them. When all else fails, she turns to prayer.

Recognizing symptoms

Not everyone recognizes mental-health symptoms for what they are.

Sometimes, barriers to treatment can be financial or geographic, but people often don't realize their stress has become a problem, said Dr. Stephen Jordan, a neuropsychologist at Saint Francis Medical Center in Cape Girardeau.

"Many people with mental illness do not seek treatment," he wrote in an email. "There are several reasons for this -- lack of insurance coverage, lack of availability of providers in their area, hesitation to be labeled with a mental illness and sometimes not really identifying their problems as related to mental illness or stress."

Nationwide, the most common mental health disorders are depression, which affects 7 percent of the population, and anxiety, which affects 7 percent to 9 percent of people. Severe mental illnesses such as schizophrenia and bipolar disorder occur in less than 1 percent of the population, he said.

Although the severity and duration of such disorders vary, and mental-health diagnoses cut across a broad spectrum of issues, Jordan and others said some things are sure signs of a mental illness:

• Disruptions in sleep, appetite, energy and enthusiasm or pleasure;
• Poor concentration or being dominated by fearful or pessimistic thoughts;
• Changes in emotion including fear, sadness and irritability;
• Poor grooming;
• Diminished performance at work or school.

"Many of these symptoms are common in people without mental illness, (but) when the number of symptoms increase and when they persist for long periods of time ... we begin to worry that mental illness may be developing," Jordan wrote. "Some people are more resilient to stress than other people, so different people react differently to similar situations."

To Dr. Thad Lake, a psychiatrist at Southeast Hospital, the key word in many mental health situations is stress. It's not the kind of stress that gets people up for work in the morning, but the kind that can be hazardous to health.

Although mental illness isn't something a person can catch, such as a cold, prolonged exposure to poorly managed stress can result in an issue that needs treatment.

"Mental illness in general is a lot more common than people realize," he said.

On the Southeast psychiatric unit alone, 1,000 people are admitted each year for issues that have become serious enough to require hospitalization.

Although some patients are moved there from other parts of the state because of psychiatric bed shortages, most are from the local region, Lake said.

Lake and Jordan both emphasized that, despite the dangerous nature of some mental illnesses, the majority of people who are mentally ill can function well in society. Mental illness is not a lack of faith, a personal weakness or character defect, but a medical condition like any other, often with a genetic component.

Treatments

"We as a society have to realize these things are illnesses, they do have treatments, and not to let those obstacles get in the way," Lake said.

Cases of mass shootings or other forms of public violence often result in intense media coverage, which can give the impression severe mental-health issues are more of a public-safety threat than they are.

Most severely mentally ill patients are much more likely to be targeted than to target others, he said.

"The vast majority of those patients are at risk for that kind of act," he said.

The key to preventing and treating mental health issues is first to avoid substance abuse, as addictions often go hand in hand with depression and anxiety disorders, Lake and Jordan said. It also is important to get enough sleep and exercise, socialize with positive people and find enjoyable things to do.

While people with mental illnesses face a stigma, it's not as crippling as it was.

"There is better understanding that problems can be managed with treatment, that many people with mental illnesses are 'just like us' and perhaps have more stressors in their lives," Jordan wrote in an email. "Veterans coming home from war have opened up the conversation about post-traumatic stress disorder. If our proud, strong, courageous young people can be affected by mental illness, then anyone could have the potential to experience depression or anxiety."

ljones@semissourian.com

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