CleanSlate Blog

Mental Illness Isn't Crazy

by Malissa Barbosa, D.O. | May 17, 2019

More than 43 million Americans live with a mental illness. Sometimes, people cope with more than just one mental illness.

One of those 43.8 million people may be you.

Mental Health Month, observed throughout May, calls attention to the stereotype of mental illness projected by our society. It's the “crazy” homeless person mumbling to himself, or the seemingly out of control person who should obviously be committed.


Talking it out

Sure, those are the displays of mental illness that are easier to observe. But hiding in plain sight is the “perfect” carpool mom secretly struggling with depression. Or the star male athlete suffering from an eating disorder. Or the “easygoing” friend who doesn’t tell you he’s crippled by anxiety.

How many lives must be lost to suicide before we realize that mental illness is a pervasive problem? 

1 in 5 Americans experiences mental illness

Some estimate that a suicide is attempted somewhere in the world every 29 seconds.

Every. 29. seconds.

Last year, amongst the many celebrities and ordinary people lost to suicide, the news of Kate Spade and Anthony Bourdain committing suicide in close succession led to calls for action and awareness. The high-profile tragedies caused such an uproar that news organizations worried about how to tactfully report on the topic to keep people informed without exacerbating the problem.

According to the National Alliance on Mental Illness (NAMI), one in 5 Americans experiences mental illness, and nearly 1 in 25 adults in America live with a serious mental illness that substantially interferes with or limits one or more major life activities. As with addiction, the barrier of shame, fear, and silence prevent far too many people from seeking help.

Consider these mental health facts, as cited by NAMI:
  • 90% of those who die by suicide have an underlying mental illness.
  • Although preventable, suicide is the 10th leading cause of death in the United States,  and the 2nd leading cause of death for people aged 10–34.
  • Half of all lifetime mental health conditions begin by age 14 and 75% begin by age 24, but early intervention programs can help.
  • African Americans and Hispanic Americans used mental health services at about half the rate of whites in the past year, and Asian Americans at about one-third the rate.
  • The best treatments for serious mental illnesses today are highly effective; between 70 and 90% of individuals have significant reduction of symptoms and improved quality of life with the right treatments and supports.

Related blog: Emergency Rooms Are Starting To Treat Addiction Patients Like They Have A Disease. Because They Do.

Mental illness and addiction: gasoline meets fire

Mental health issues are closely tied to addiction, feeding upon each other and becoming so intertwined that it becomes difficult to treat one without addressing the other. We now refer to this phenomenon as co-occurring disorders, replacing the older terms dual diagnosis and dual disorder.

Research has shown a clear link between mental illness and substance use. NAMI states that among the 20.2 million adults in the U.S. who experience a substance use disorder in a given year, 50.5%—or 10.2 million adults—had a co-occurring mental illness.

A study published in Journal of the American Board of Family Medicine showed that more than half of all opioids are distributed to adults with mental illness. Nearly 19% of the estimated 38.6 million people with the two most common mental health disorders - anxiety and depression - received at least two prescriptions for opioids during a year, with more than half of all opioid prescriptions going to individuals with these disorders. The researchers concluded that adults with mental health disorders are much more likely to use prescription opioids than people without mental health disorders  — 18.7 percent vs. 5 percent.

Other data from the National Bureau of Economic Research shows that people who have at any point been diagnosed with a mental health disorder are responsible for 69% of all alcohol consumption and 84% of all cocaine consumption. According to SAMHSA's 2014 National Survey on Drug Use and Health, co-occurring disorders are highest among adults ages 26 to 49; for adults with serious mental illness and co-occurring substance use disorders, rates were highest among those ages 18 to 25.

Walking and talking

Untangling co-occurring disorders

Why is addiction so often linked with mental illness?

Mental health and substance use disorders both occur because of environmental and biological factors. Unfortunately, the two issues can easily become entwined and exacerbate each disorder. People often seek relief from mental illness symptoms through drugs and alcohol, which can then compound or create mental health disorders, such as when a drug induces paranoia, depression, or panic disorder. There is great variability and severity amongst co-occurring disorders, and when the disorders are combined they can mask one another and make diagnosis and treatment more difficult.

When co-occurring disorders exist, concurrent treatment for both addiction and mental illness is necessary to address the underlying causes and symptoms of each. SAMHSA recommends an integrated approach that coordinates substance use and mental illness interventions. Treatment is possible for both disorders, but without addressing each disorder as a distinct condition, the intertwined problems with one or both illnesses may persist.

Related blog: Choosing The Best Treatment Path For Your Addiction

Addressing mental illness is the first step

Many national organizations - such as NAMI, Mental Health America, and other affiliates  - spotlight Mental Health Month to raise awareness about the importance of mental health and to stop the stigma associated with mental health disorders.

Stigma isolates people with mental health conditions, leading them to feel a sense of blame and secrecy that creates huge barriers to reaching out for help. For Mental Health Month, NAMI has launched the WhyCare? campaign to replace stigma with care.

As stated by Nami:

"The WhyCare? campaign is an opportunity to share the importance of mental health treatment, support and services to the millions of people, families, caregivers and loved ones affected by mental illness and a challenge to address broken systems and attitudes that present barriers to treatment and recovery.

Care has the power to make a life-changing impact on those affected by mental health conditions. Through our own words and actions, we can shift the social and systemic barriers that prevent people from building better lives. Demonstrating how and why we care brings more to awareness by showing our actions and connections to others. Care has the power to make a life-changing impact on those affected by mental health conditions."

There's nothing crazy about mental illness. If you think you have a mental health condition, don't be ashamed, and do reach out for help. For the rest of us, Mental Health Month is a reminder of our collective responsibility to destigmatize mental illness so that people who need help can get the support they need to live well. 

If you are struggling with thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255. You are not alone. The call and assistance is free and confidential.

CleanSlate treats patients suffering from opioid or alcohol addiction with medications and a continuum of integrated care to support each individual's journey to recovery. If you or someone you love needs help, contact us at 833-505-HOPE, or visit our website at to find the center nearest you.

Also read:

A Reassuring Mother's Day Message For Pregnant Women Struggling With Addiction

They Were Losing The Battle Against The Opioid Epidemic. Then Plymouth County, Massachusetts Revolutionized The Playbook.

"Now I Can Buy Groceries!" What Insurance Coverage Vs. Cash For Addiction Treatment Means To Patients


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Picture of Malissa Barbosa, D.O.

Malissa Barbosa, D.O.

Dr. Barbosa is the Medical Director for the CleanSlate locations in Orlando and Sanford, Florida. CleanSlate is a leading national medical group that creates addiction with outpatient medication treatment and a continuum of care.

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If you or someone you know suffers from the disease of addiction, please call 833-505-HOPE to speak with a professional.

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