Mind and body: Mental health is physical health
Covid has damaged the mental health of many. We must make care widely available. We must also fight the stigma of mental health. Health is health.
Warning: the post is about mental health and discusses suicide. Please call the National Suicide Prevention Lifeline at 800-273-8255 or contact other mental health professionals immediately if you are having suicidal thoughts. Get help, please.
Every day we hear how Covid threatens our physical health—illness, hospitalization, long-Covid, and death. It is also a threat to our mental health:
During the pandemic, about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder, a share that has been largely consistent, up from one in ten adults who reported these symptoms from January to June 2019.
Young adults are most likely to suffer:
Young adults have experienced a number of pandemic-related consequences, such as closures of universities and loss of income, that may contribute to poor mental health. During the pandemic, a larger than average share of young adults (ages 18-24) report symptoms of anxiety and/or depressive disorder (56%). Compared to all adults, young adults are more likely to report substance use (25% vs. 13%) and suicidal thoughts (26% vs. 11%). Prior to the pandemic, young adults were already at high risk of poor mental health and substance use disorder, though many did not receive treatment.
Why don’t they get treatment? The reasons are many and pre-date Covid. The cost of care is often prohibitive since many insurance plans do not cover mental health services, and some people lack any health insurance altogether. Another reason that discourages people from seeking care is the stigma surrounding mental health and the mistaken belief that people simply will themselves back to good health.
Mental health is personal.
I know how hard it is to stay healthy when you have a mental health condition. I know the stigma and feelings of shame firsthand. I know I need help to stay healthy.
In 2011, I was diagnosed with bipolar mood disorder during a manic episode. The stress of working at the Federal Reserve while raising two young children overwhelmed me and triggered a latent condition deep in my wiring.
As I shared in my “economics is a disgrace” post, I had been depressed every winter after starting at the Fed in 2007 until my diagnosis. After receiving care—both medication and therapy, my episodes were rare. My most recent depressive episode was in the winter of 2019. During that wave of depression, I dragged myself out of bed on the weekends to work on the Sahm rule. Each episode included suicidal thoughts and attempts at self-harm. I received incredible support from my family and health professionals. I recovered. I am fortunate. And I am grateful.
Mental health affects loved ones too.
This weekend I listened to U.S. Representative Jamie Raskin discuss his son Tommy’s struggle with mental health and suicide on New Year’s Eve 2020.
He refers to the statement he and his wife, Sarah Bloom-Raskin, shared after his death. It’s profound. Please read it.
I read it that night and cried. I worked for Sarah when she was a Governor at the Fed. I remember her talking about her kids once in the Boardroom. I cannot imagine the grief that they must feel and how hard it is to speak about their son’s struggles.
Stigma must end. Silence must end.
We are each better for the Raskin’s openness. Stigma leads to silence. Silence leads to shame. And shame makes people reluctant to seek help.
I have been open about my mental health struggles because I do not want anyone to feel as alone and hopeless as I did. As with many physical health conditions, many mental health conditions are chronic, albeit episodic. It’s an ongoing effort to stay healthy. These conditions are not the fault of the individual or their family. They do not define the person. Those who lose the battle are not weak in spirit. Their body turned against them, and after a fight, their body won.
It’s also essential to understand people cannot solve their mental health conditions themselves. It is counterproductive to tell someone to “cheer up” or “it’s all in your head” or “you have no reason to feel this way.” We would never say that to a cancer patient. We would never shame them for being ill. People with mental health conditions deserve the same respect, support, and medical care.
I put “well with bipolar” in my Twitter bio in 2019 after Alan Krueger, a highly-regarded economist, committed suicide. Alan was wildly successful by all professional metrics. Had he lived, he would have shared the most recent Nobel Prize with his long-time collaborator, David Card. He did not. Alan was not alone. In recent years, economics has suffered a string of high-profile suicides, including Emmanuel Farhi’s—a leading light in the next generation of macroeconomics. There are others too.
In the outpouring of remembrances for Alan and Emmanuel, their colleagues repeatedly said that they would never have guessed of their internal battles. That’s often true. Very few people knew about my struggles with mental health. Many people are good at hiding it, which makes it all the more important to seek help.
Respect your boundaries and seek support
I am open about my health condition and my care to encourage others who are suffering to seek support. You cannot fix this on your own. Care truly helps.
Covid was extreme stress for me, and stress tends to trigger depressive or manic episodes. I have used every therapy I know: medication, good sleep, calls home to mom (at times every day), daily walks with music, joining a gym, and what is best described as an ‘anger management course’ for economists. At times, I have also had to step away from my advocacy and attempts to ‘fight the good fight’ in macro.’
I am always here to talk privately with economists, students, research assistants, and pre-docs about their struggles. I have spoken to dozens. I always tell them to get professional care for mental health. I often make it a prerequisite before we talk about their careers in economics. I have seen many of them fight back to good health. One lost their fight, and it is crushing.
Stigma against mental health is not an individual effort alone. It requires systemic change. I have also talked with several institutions about creating a healthy environment for economists. Here is my Substack post describing it:
Health is health. Mental health is the same as physical health.
Everyone suffering deserves our love and support, and treatment. Do everything you can to fight the stigma against mental health. Refer others to professional help. If you suffer, seek treatment today, not next week, not tomorrow. You deserve good health.