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By Lindsay Holmes, Huffington Post

A new study revealed that the majority of American adults now value mental health as much as physical health.

More people are starting to see mental health as a crucial part of staying well. Nearly 90 percent of American adults value mental and physical health equally, according to a new survey.

The findings were part of a nationwide analysis on mental health and suicide conducted by the Anxiety and Depression Association of America, the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention. Experts surveyed more than 2,000 respondents and are pleased with the results, given the stigma that’s generally associated with mental health disorders.

“Progress is being made in how American adults view mental health … and the importance that mental health plays in our every day life,” said Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention, on a conference call with reporters. “A greater understanding is occurring with the American people, which is very encouraging.”
An overwhelming majority of respondents — 93 percent — said they’d intervene if they discovered someone close to them was contemplating suicide. Young adults in particular seem to be taking the conversations about mental illness in a more positive direction.

“The younger generation is more likely to seek help and to have a greater understanding that mental health is a very valid and real aspect of their health,” Moutier said. “[They’re] going to progress into middle age and the older generation before long and those attitudes can spread.”

However, it’s not all good news. While the findings are indeed heartening, there’s still a long way to go when it comes to recognizing mental health risks and seeking treatment. Approximately half of respondents said they believed they had a mental health condition, yet fewer than two in five people have received treatment.

Perhaps most alarmingly, the survey found that men are significantly more likely to hide thoughts of suicide — a worrying statistic given that the highest rate of suicide in the U.S. occurs in middle-aged men.

“In general, we’re glad to see that Americans are starting to recognize the importance of mental health as part of their overall wellness, but with over 40,000 Americans committing suicide every year … it remains a significant concern that many Americans don’t seek help,” said Mark Pollack, president of the Anxiety and Depression Association of America.

Previous research conducted by the Association for Psychological Science suggests that stigma prevents people from seeking mental health care. After analyzing this survey’s results, Moutier, Pollack and other experts also noticed another obstacle: inaccessibility. Approximately one third of people surveyed said finding proper help is a challenge, and four in 10 people said they view cost as a barrier to treatment.

Social support is also a large factor when it comes to suicide, according to Doryn Chervin, director of the National Action Alliance for Suicide Prevention. Most respondents realized how important their role is when it comes to helping a loved one who is experiencing harmful thoughts.
“People want to do something — they’re willing to do something — and the more we as a field help them know what to do, the more likely loved ones can play a role in helping to prevent suicide,” she said.

The findings do offer some refreshing insight into an apparent uptick in society’s understanding of mental illness. The common belief that someone can just “suck it up,” or “get over it” is a negative stereotype that plagues many sufferers of mental health conditions, which could lead to dangerous consequences, but experts believe the survey’s findings suggest that people are beginning to promote a greater acceptance of mental health issues.

“I believe [the results] are a reflection of this change that’s happening in terms of increased awareness and stigma going down,” Moutier said. “There’s certainly more work to be done, but I believe this does reflect a trend in the right direction.”

If you — or someone you know — need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.

If you’ve been reading my blog for a month or more, you know that I have found nutrition to be a powerful force in my recovery from depression. Since 2008, I haven’t responded to medications or have had only a minimal, partial response, so I have been on amission — for myself and for the millions of other people with treatment-resistant depression — to find other, drug-free, ways to lift debilitating depression.

Recently I have been following the research of Julia J. Rucklidge, PhD, professor of clinical psychology at the University of Canterbury in Christchurch, New Zealand, who conducts compelling studies using micronutrients — vitamins and minerals in small quantities — to treat depression and other serious mood disorders.

You can check out Dr. Rucklidge’s research as part of the work conducted by the Mental Health and Nutrition Research Group, and the blog that she writes withBonnie J. Kaplan, PhD, for Mad in America. Rucklidge recently delivered a fascinating TEDx talk (you can watch it below) about the role of nutrition in treating mental illness. I interview her here so that she can share her research with you.

Therese Borchard: Your research is fascinating. I couldn’t stop reading. If you had to pick two breakthrough studies that you would like everyone who has ever been depressed or has been a loved one of someone depressed read, which studies would you choose?

Julia Rucklidge: The study by Felice Jacka and others published in the American Journal of Psychiatry in 2010 had a tremendous impact when it was published. The study demonstrated an association between habitual diet quality and the high prevalence of mental disorders. I conducted a study in 2012 showing a simple intervention of micronutrients following a natural disaster reduced stress and anxiety and improved mood over just a four-week period. The ADHD randomized clinical trial showed that for those who entered the trial depressed, twice as many went into remission in their depression for those taking the micronutrients compared with those taking placebo.

TB: You said something in your TED talk that intrigued me. You said medications work better initially than they do over time, that drugs save lives, but they often fail to work on a long-term basis. Can you say more about that, and point us to the studies that you mentioned as part of your talk?

JR: We all know of people who have benefited from medications and who would swear that the medication saved them. These reports are really important and there are people who benefit in the long-term. I am sure every psychiatrist has patients like that. But if we look at the data and the published literature, the situation is more uncomfortable.

Stimulants. Most people know that Ritalin is a drug prescribed to treat ADHD. It is typically viewed as the most efficacious drug in child psychiatry because it works quickly. Parents and teachers alike often report a dramatic change in a child who begins taking it. It has been used to treat hyperactivity for almost 80 years but surprisingly, only in the last decade are we learning about the long-term outcomes of people treated with it.

In the United States, there is large clinical trial that has followed 579 ADHD children who were initially randomized for 14 months to receiving various treatments, including medications and psychological treatments. In the first 14 months, those on medications did the best and this reinforced the perception that medications should be the primary way to treat ADHD. But at the end of 36 months, medication use was a significant marker not of beneficial outcome, but of deterioration. That is, participants using medication in the 24-to-36 month period following randomization actually showed increased ADHD symptoms during that interval relative to those not taking medication. Medicated children were also slightly smaller and had higher delinquency scores. At the end of six years, medication use was “associated with worse hyperactivity-impulsivity and oppositional defiant disorder symptoms,” and with greater “overall functional impairment.”

Similarly, in Canada, the Quebec Naturalistic Study found that medicated ADHD girls are more likely to be depressed compared with those not medicated, and boys who are medicated are more likely to drop out of school than those unmedicated. In other words, both of these studies show that while kids do well in the short-term on these medications, in the long-term they do worse.

Antidepressants. In 2012, about half a million New Zealanders were taking anantidepressant, a rate 38 percent higher than five years previously. But despite this increasing reliance on these drugs, outcomes for depressed people can be worse than they were before the advent of antidepressants. In 2014, a paper in the Australian and New Zealand Journal of Psychiatry compared the outcomes of people who were depressed prior to the advent of antidepressants with the outcomes of people who were depressed since the widespread use of antidepressants. If the drugs are working, then the recovery rates and relapse rates should be better now than 50 years ago. They aren’t. This review provided no support for the belief that pharmacological treatments have resulted in an improvement in the long-term outcome of patients with mood disorders.

Other research shows that in some cases, antidepressants have altered the course of disease in negative ways. For example, young people prescribed antidepressants are more likely to convert to bipolar illness than those not medicated. A study in 2004 in the Archives of Pediatrics and Adolescent Medicine showed that those people with anxiety and depression who were treated with antidepressants converted to bipolar illness at a rate of 7.7 percent per year, three times the rate for those not exposed to the drugs, with pre-pubertal children at highest risk for conversion. These means antidepressants are a risk factor for developing another psychiatric illness, bipolar disorder.

Antipsychotics. Similar to prescription trends around the world, prescription rates for antipsychotics more than doubled in this country from 2006 to 2011. But are these medications helping patients in the long-term? Aside from the serious side effects such as weight gain and increased risk for diabetes, a study that came out last year in JAMA Psychiatry should make us seriously consider whether long-term use of these drugs is doing more harm than good. The study was a seven year follow up of a randomized controlled trial and demonstrated that those people with schizophrenia who were randomized to dose reduction or discontinuation of drugs were twice as likely to recover as those who remained at their original dose of medications. Again, we see that medications are increasing relapse rates in the long-term.

TB: You presented at the last American Psychiatric Association conference about using micronutrient to treat depression and said the reception among psychiatrists was better than previous years. Do you think that the more data we have to support the use of micronutrients, the more doctors will introduce this concept? Or will the information not get through because the profit margins aren’t the same as with pharmaceutical medication?

JR: I think there are a lot of challenges to this work becoming mainstream and for physicians to start suggesting it in their mainstream practices. There will be concerns about it not being evidence-based or that they may be liable if something goes wrong. There is also the challenge of which formula to recommend? Which blend of nutrients? However, given that there are quite a few people writing about psychiatry under the influence of drug companies, maybe there will be a change in behavior. Perhaps if there could be independent reviews of whether what we currently do is working people might pay attention to the fact that we have a seriously comprised system for treating people with mental health issues.

TB: What else would you like people to know about treating depression and other mood disorders with micronutrients?

JR: I think it is worth giving it a go first to seriously change diet and if necessary, try a broad spectrum micronutrient supplement, and if that approach doesn’t work, then there is always medication to fall back on.

There’s an absolute link between your emotional health and your physical well-being, so take time to nurture both.

To be completely healthy, you must take care of not only your physical health, but your emotional health, too. If one is neglected, the other will suffer.

Understanding the Physical Health and Emotional Health Connection

There is a physical connection between what the mind is thinking and those parts of the brain that control bodily functions. According to Charles Goodstein, MD, clinical professor of psychiatry, New York University School of Medicine in New York City, and president of the Psychoanalytic Association of New York, the brain is intimately connected to our endocrine system, which secretes hormones or chemicals that can have a powerful influence on your emotional health. “Thoughts and feelings as they are generated within the mind [can influence] the outpouring of hormones from the endocrine system, which in effect control much of what goes on within the body,” says Dr. Goodstein.

“As a matter of fact, it’s very probable that many patients who go to their physician’s office with physical complaints have underlying depression,” he says. People who visit their doctors reporting symptoms of headache, lethargy, weakness, or vague abdominal symptoms often end up being diagnosed with depression, even though they do not report feelings of depression to their doctors, says Goodstein. Depression causes you to be over-aware of physical discomfort.

While unhappy or stressed-out thoughts may not directly cause poor physical health, they could be a contributing factor and may explain why one person is suffering physically while someone else is not, Goodstein adds.

Physical Health and Emotional Health: Examples of Links

There are many circumstances that support the link between physical health and emotional health, including:

• White-coat syndrome. This is a condition in which a person’s blood pressure increases the minute they step into a doctor’s office. In white-coat syndrome, anxiety is directly related to physical function — blood pressure. “If you extrapolate from that, you can say, what other kinds of anxieties are these people having that are producing jumps in blood pressure? What is the consequence of repeated stress?” asks Goodstein.
• Personality and heart disease. Some people are more at risk of heart attack because of their personality, specifically those “hard-driving, hard-charging” Type A individuals.
• Chronic disease and depression. People who are having a hard time coping with a chronic illness are more likely to become depressed.
• Physical symptoms of emotional health distress. People who are clinically depressed often have physical symptoms, such as constipation, lack of appetite, insomnia, or lethargy, among others.

And on the other hand: “Those individuals who have achieved a level of mental health where they can manage better the inevitable conflicts of human life are more likely to prevail in certain kinds of physical illness,” says Goodstein.

Physical Health and Emotional Health: Caring for Both

The best way to care for your total health, emotional and physical, is to follow the advice of your mother:

• Eat right. A healthy, regular diet is good for the body and mind.
• Go to bed on time. Losing sleep is hard on your heart, may increase weight, and definitely cranks up the crankiness meter.
• If you fall down, get back up.Resilience in the face of adversity is a gift that will keep on giving both mentally and physically.
• Go out and play. Yes, work is a good thing: It pays the bills. However, taking time out for relaxation and socializing is good for your emotional health andyour physical health.
• Exercise. Exercise is proven to improve your mood and has comprehensive benefits for your physical health.
• See the right doctor, regularly. Going to the right doctor can make all the difference in your overall health, especially if you have a complicated condition that requires a specialist. But if your emotions are suffering, be open to seeing a mental health professional, too.

Why do some relationships stand the test of time, while others fall apart? Here are some simple strategies for building a relationship that will thrive.

If you read gossip pages or celebrity magazines, you may think that no relationship lasts in this country anymore. Unfortunately, the reality of our romantic relationships isn’t too far from that. It is currently estimated that almost half of all marriages in the United States end in divorce.

With so many breakups going on, how is it that some couples thrive while the rest fail to survive? The truth is that it takes some work to keep relationships healthy. And most people find that the work is well worth the effort when their relationship is still going strong decades after it began. Some simple strategies can help couples strengthen their romantic relationships, no matter what obstacles they face together.

Maintain the Right Ratio

Christine M. Allen, PhD, knows about maintaining a romantic relationship. Not only is she a psychologist and a life coach, but she has also had a strong, healthy relationship with her husband for more than 25 years in the hustle and bustle of New York City.

The secret, Dr. Allen says, is to make sure the positives in the relationship outweigh the negatives by at least a 5:1 ratio. “If you have a lot of complaints, it helps to counterbalance that with a lot of praise, recognition, and affection for all the things that go right in your life,” she says.

Allen has important suggestions to help you maintain that special balance. “When possible, turn a complaint into a request,” she says. “In other words, rather than say, ‘It is thoughtless to be late,’ say, ‘I would like you to call me if you are going to be late.’ Also make any complaining specific to an action. For example, say, ‘When you do X, I feel Y.’”

Striking a Balance

This idea of finding the right ratio in a healthy relationship applies not only to the positives and negatives, but to all aspects of the relationship. Says Allen, “It is important to have shared activities, whether they be going to the movies, playing golf, or having conversation. Each partner in a couple can enjoy time together and time apart from the other. In a healthy romance, you do not expect to get all of your needs met by your partner in some idealized or unrealistic way.”

When there are children in the relationship, the same rules of balance need to apply, says Allen. “Have a date night, even if you don’t go out of the house,” she suggests. “Have dinner together without the children one night a week. Feed them early, and let them watch a DVD while you have a grown-up dinner.”

Handling Arguments

Of course, some fighting is inevitable in a relationship, but Allen says it’s how you handle those disagreements that marks the difference between healthy and unhealthy relationships. “Do not avoid conflict, as avoiding conflict can be the kiss of death over time in relationships. But don’t vent anger toward each other in a conflict,” she says. “Instead, manage hurt and anger, so it is neither withheld nor vented on your partner. Use awareness of hurt and anger to express more directly and constructively your needs and concerns.”

Keeping the Romance Real

The other critical component of a healthy relationship is to make physical contact and intimacy a priority. Here again, you have to actively work at this part of your relationship to keep it fresh and vital through the years. And this aspect of the relationship doesn’t always have to be about sex, says Elaine Ducharme, PhD, a licensed clinical psychologist and an adjunct professor at at the University of Hartford in Connecticut.

“People can actually feel more intimate just sharing a cup of coffee in a small café or walking hand-in-hand than having sex,” Ducharme says. “Take time in the evening to touch, not necessarily have sex. Lie in bed together, or sit on the sofa and gently massage your partner’s arm or neck. It is a wonderful way to connect and have feelings of relaxation connected to each other.”

Ultimately, a healthy, long-lasting relationship is a partnership. “A healthy romance is one in which each partner sees the best in the other and each of you becomes better than you would have been on your own,” says Allen. “Your partner’s love for you and appreciation of you helps you continue to believe more in yourself. We also accept the other person’s foibles and do not judge him or her on the small stuff.”