While an increasing number of Americans see mental and physical health equally, viewing depression and bipolar disorders as risk factors for suicide, a new study suggests that few understand that when unmitigated, anxiety disorders too can endanger one’s life.
The study, released by the Anxiety and Depression Association of America (ADAA), the American Foundation for Suicide Prevention, and the National Action Alliance for Suicide Prevention, showed that although 90 percent of respondents have been affected by suicide and knew of its link to depression and bipolar disorder, less than half knew that anxiety could inflict the same damage.
In August, researchers from the three mental health and suicide prevention groups asked more than 2,000 adults about their perceptions about mental health and suicide. They took into account age, gender, region, race and ethnicity, income, and education level in an effort to ensure the sample group reflected the U.S. population.
“There’s a significant body of research that demonstrates that individuals suffering from anxiety disorders and depression face an increased risk for suicidal thoughts and attempts,” Dr. Mark Pollack, president of the AADA, wrote in a press statement. “Effectively diagnosing and treating both anxiety disorders and depression, especially when they co-occur, are critical pathways to intervening and reducing suicide crises,” said Pollack, also chairman of psychiatry at Rush University Medical Center in Chicago.
Anxiety, while considered a normal part of life, can become serious when feelings interfere with job performance, school work, and relationships. Signs of anxiety disorder often include fatigue, headaches, muscle tension and aches, irritability, and nausea. The National Institute of Mental Health designates post-traumatic stress disorder, obsessive-compulsive disorder, and phobias among the most common types of anxiety, affecting more than 40 million Americans annually.
Risk factors for anxiety disorder include gender, childhood trauma, and stress brought on by an illness, a buildup of tension from seemingly insignificant situations, genetics, and alcohol and drug abuse.
Though both conditions are different, anxiety disorder can coexist with depression when untreated, with the former causing a constant nagging feeling and the latter bringing on hopelessness and despair. Experts say this combination often debilitates its subjects and cause fluctuations in mood. In recent years, clinicians have observed that suicidal risk factors for those with depression increase when they also have anxiety disorder.
Studies in years past have made this assertion. The National Institutes of Health, for instance, conducted in-person interviews with nearly 35,000 Americans in the mid-2000s, 70 percent of whom had an anxiety disorder. Researchers said the data showed a significant link between the presence of anxiety disorder and a suicide attempts, concluding their report with a recommendation that clinicians continue to assess suicidal behavior among patients who experienced anxiety. Subsequent analyses have shown this link, with a focus on generalized anxiety disorder — caused by extreme worrying about several aspects of life — and PTSD.
Such realizations have compelled mental health practitioners to make more targeted treatments for types of anxiety disorder. Despite antidepressants’ success, clinicians found difficulty in eliminating symptoms of anxiety in some patients, partly because some depression medications don’t treat all of its symptoms. Rather, it’s cognitive-control therapy that shows promise in lifting patients out of perpetual melancholy, when taken with depression medicine. Under this treatment option, therapists train their subjects in dwelling less on the negative and frame ambiguous situations positively through a series of mental exercises.
“Many depressed people think about things they don’t want to think about over and over again,” neuropsychologist Greg Siegle told ThinkProgress earlier this year. “Medications don’t help decrease rumination much. This suggests that even if you’re taking them, it might be helpful to get the rumination under control. In our research we set out to use these exercises to improve executive control and working memory.”
But mental health treatment may be out of reach for a significant number of people, as shown in the AADA’s study. One out of three respondents said they couldn’t access the appropriate care. Forty percent of those polled also counted cost as a hurdle. That difficulty stems from insurance companies’ reluctance to offer mental health benefits equal to that for physical health, even after the passage of the Mental Health Parity and Addiction Equity Act. Techniques to circumvent the ruling include use of the “medical necessity” review, a process that allows insurance providers to determine if there was a pressing need for the care sought.
Though some insurers say it’s difficult to distinguish between mental and physical health, advocates like Carol McDaid, an affiliate of the Parity Implementation Council, say that providers only want to cut treatment costs at the patients’ expense.
“[Patients] end up with this perception that they have access to care, but when they’re in a crisis for themselves or their loved one, lo and behold, the care’s not available because of these cost-control techniques,” McDaid, a helpline operator, told NPR in April.