Many struggle to claim lives in face of depression, anxiety

WEST FARGO -- Brittany Hoffman knows the struggles of living with mental illness first hand.

She has been dealing with depression and anxiety since she was a pre-teen.

But she also knows what it's like to watch a family member struggle with a mental health disorder.

Mental illness claimed the life of her brother, Josh, when he died by suicide in October of 2009. He was 25.

Now Hoffman, of West Fargo, advocates for suicide prevention and awareness, but she still struggles against society's misguided beliefs that suicide and mental illness are something to be ashamed of, she said.

One in four adults, or almost 60 million Americans, experiences a mental health disorder in a given year, according to the National Institute of Mental Health. And one in 17 Americans lives with a serious mental illness, according to the National Alliance on Mental Illness (NAMI).

'Couldn't take it anymore'

Hofffman's struggles started when she was 11 years old and her family moved from Minnesota to Georgia.

"I was leaving all my family and my little niece who I loved so much, and it was just devastating to me," she said.

She moved closer to family, this time to Wisconsin, less than a year later, but her mental health didn't improve.

At age 13 or 14 she knew it was more than sadness and she needed help, Hoffman said.

"It got to a point where I just couldn't take it anymore," she said.

It took a while to find the right medication, but when she did, Hoffman said it was so exciting to feel like herself again.

At one point, her brother, Josh, asked her what it was like to be getting treatment.

Josh had been diagnosed with depression, anxiety and attention deficit disorder. He was not diagnosed with bipolar disorder, though Hoffman said he had bipolar tendencies.

The only treatment he was getting was a small dose of antidepressant medication, Hoffman said, adding that she was more apt to try different medications than her brother was.

Josh couldn't work full time because of his anxiety, so he lived at home with his parents and was ridiculed by people for that, Hoffman said. He had also received threats because he was biracial, she said.

Her family felt like they'd been on suicide watch around her brother for years before he died in 2009.

"I don't blame him, and I think that's a huge thing," she said. "His illness robbed us of him."

Suicide is the 11th leading cause of death in the United States, and the third leading cause of death for people ages 10 to 24 years old, according to NAMI. More than 90 percent of those who die by suicide have a diagnosable mental disorder, NAMI stated on its website.

Yet Hoffman has had people turn and walk away when she's told them how her brother died, she said.

Hoffman said she wishes more people would talk about suicide and mental illness so those suffering aren't afraid to seek the help they need.

"Depression and anxiety are not character flaws and so many people have them," she said.

<'It's something real'

Mental health covers a wide spectrum of conditions, said Chuck Summers, clinical manager and in-office counselor in The Village Family Service Center's Fargo office.

"A mental disorder can go anywhere from being totally debilitating to being something we wouldn't even recognize as we were interacting with the person," he said.

Mental health disorders are caused by both genetics and experience, said George W. O'Neill, a clinical psychologist with Knowlton, O'Neill & Associates, an independent mental health clinic in West Fargo.

"People have genetic predispositions to certain disorders and then there's experience," he said. "You may inherit the tendency to be more anxious than the average person. Whether or not you develop an anxiety disorder would depend on the experiences you have."

If someone who might be prone to a mental health issue is under stress long enough, he or she is bound to become symptomatic, said Susan Helgeland, Mental Health America of North Dakota's executive director.

"The brain is vulnerable to stress just like the heart and the colon and everything else in our body, but people tend to forget that," she said. "There's a lot of leftover judgment from decades past of not understanding that the brain is the same as other organs in the body."

Rachel Blumhardt, an outpatient mental health counselor in The Village's Fargo office, said it's similar to how high blood pressure or diabetes runs in families.

"You wouldn't look at someone with one of those things and say, 'There's something wrong with you. How could you have that? Why can't you just deal with it? Why can't you just snap out of it?' " she said. "It's something that's real, and it's something that you need help dealing with."

Diagnosis is based on the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

The difference between just feeling down or anxious and a mental health disorder is that the disorder disrupts your life, said James Pfiefer, a licensed professional clinical counselor with Prairie St. John's in Fargo.

"We all feel down. We all feel sad. We all feel stressed. We all feel overwhelmed at times," he said. "It's a disorder when it affects your ability to function normally in life."

But certain conditions, like depression, might actually keep people from seeking help, he said.

"The frustrating part of it is that if I have persistent shoulder pain, I'm not embarrassed to go in and talk to a physical therapist about it, but it's really hard for people to say, 'I'm depressed,' " Pfiefer said.

'A sense of relief'

Once someone with a mental health disorder seeks help, Blumhardt said he or she sometimes feels a sense of relief to be able to define what's going on. But people might not seek help because they're afraid they won't feel any better, she said.

"Those feelings are influenced by thoughts we have about ourselves and if we can change some of those thoughts, we can change some of those feelings," Blumhardt said.

In fact, fewer than one-third of adults and one-half of children with a diagnosable mental health disorder receive mental health services in a given year, according to NAMI. Yet the organization also states that between 70 and 90 percent of people with a mental health disorder have a significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments.

Treatment can involve medication, counseling or a combination of both.

Medications can be very helpful, but O'Neill said they aren't always necessary.

"There is no evidence that depression or any other psychiatric condition is actually caused by a chemical imbalance," O'Neill said. "It's kind of like aspirin will cure your headache, but that doesn't mean headaches are caused by not enough aspirin in your system."

Blumhardt said in her experience, it depends on a person's level of mental health. She likened it to how people with high blood pressure can eat healthy foods and exercise to improve their conditions, but sometimes medication is needed even with diet and exercise.

"It's not about the person being weak or defective or not capable," Blumhardt said. "It doesn't have to do with strength or ability. It's really hard to seek help. It takes a really strong person to admit there is something going on and they need help."