A few weeks ago, a reporter asked me: Do real-life stories like in Struck by Living, and the tragic loss of a beloved entertainer like Robin Williams serve as wake up calls that mental illness needs to be addressed? Without doubt, Williams' death touched people in a way that most suicides don’t - a spike of 63,000 tweets on the day of his death, a surge in downloads of his movies, CNN tripled its audience and who knows how many conversations about the tragic loss took place that day. Even for those like me who never knew Robin Williams personally, his sudden absence in the world stung. Do I think Robin’s death will cause a quantum shift in the eradication of mental illness? I hope so. But as I told this reporter, as long as we focus on the tragedy of suicide, we will never get ahead of the disease.
We live a culture of quickness, 147 characters or fewer, usually with photo or video evidence. Mental health is not so neatly defined. Instead of a permanent state we reach after a hard slog, mental health is like one of the many trails I hiked this summer. If I stay on the trail, I don’t get lost. If I veer off the trail a bit and hop back on, I rarely have a problem. My most serious problems with depression occured before I lunderstood what throws me off the trail (lack of sleep or exercise, nutrition - see my wellness list). Even then, in 2005, I chose to ignore a critical component of my list (medication) and tore up my map. I recovered from that expedition, but I got lucky. Robin Williams, unfortunately, did not.
Last week, in Alaska on a trip with the Rasmuson Foundation, I saw an innovative form of medicine practiced that I believe will help people create their own path not just for mental health, but overall health. Southcentral Foundation’s Katherine Gottlieb described the vision of the Alaskan Native Medical Center (ANMC): A Native Community that enjoys physical, mental, emotional and spiritual wellness. Instead of the classic western doctor fixes the patient approach, ANMC works in teams with the individual in care as a responsible, driving force of that team. They call patients customer-owners, and incorporate behavioral health support into routine medical care. In creating a wellness plan with an individual, ANMC involves the family and community all with a heavy focus on relationships. The results are impressive. 36% reduction in hospital stays, 42% reduction in ER and urgent care use, and 58% reduction in specialty clinics.
In 2001, when I went to my primary care physician complaining of insomnia, weight loss and fatigue, my doctor took a blood test, my blood pressure and told me I was physically fine. No follow-up ensued. My first suicide attempt was within 90 days, followed by second and then a third. Finally, with electroconvulsive therapy (ECT), I was able to regain stability. I wonder, however, if emotional and spiritual wellness were on the radar of my physician, if I could have halted that steep spiral into suicidal depression.
My guess is I could have. I’ve managed my depression very well for the past 13 lucky years, but only after learning the hard way about my own responsibility in maintaining my own health. In my experience, managing depression is not that hard, day by day, bit by bit with the help of family and friends. For some, with a strong genetic predisposition, the struggle is far more difficult. Looking at the stats from ANMC, however, I can’t help wondering if the majority of those who suffer from mental illness could do better if they understood how their behavior impacts their brains and took an active role in defining their own path to wellness. I’ve done this proactively with my own physician, psychiatrist and counselor and found them incredibly receptive.
Do you have a wellness plan? If you don’t, I challenge you to create one. Here’s my Top Ten List for wellness. Tell me yours. Share yours with your health care provider. Perhaps if we share our stories of wellness as well as our stories of illness, we can truly honor Robin Williams’ life.
For more information about Julie K. Hersh, Struck by Living or Decidí Vivir (the Spanish translation for Struck by Living, check out the Struck by Living website).