The First Lady recently spoke at the launch of The Campaign to Change Direction, “a nation-wide effort to raise awareness around mental health in America.” This effort, sponsored in part by the Substance Abuse and Mental Health Services Administration (SAMHSA), is “designed to change the story of mental health across the nation by urging all Americans to learn the five signs that someone might be in distress.”

Shame of having a mental health issue keeps far too many good people from seeking treatment. I see it all the time at the addiction treatment center I founded and serve. Addicts and those with co-occurring disorders such as depression, anxiety, or PTSD are frequently overwhelmed by shame. This is not just an internal issue of being ashamed of past behaviors. All too often, shaming is an external experience too. Those who suffer from mental health disorders are told to “get it together” and “pull yourself out of it” when they should be urged to seek treatment. You wouldn’t tell a colleague or parent with a broken wrist to “shake it off.” Mental disorders are no less in need of treatment than physical ones.

The SAMHSA blog states:

“While there has been much media attention on mental health in the military and veteran community, it is incredibly important to understand that mental health isn’t just a military issue — it is a human issue. Mental health conditions impact our children, our grandparents, and our neighbors. Every year, roughly one in five adults — or more than 40 million Americans — experience a diagnosable mental health condition like depression or anxiety.”

For those who have addiction, our experience is that co-occurring disorders like depression or anxiety occur at rates that are closer to fifty percent or higher. Mental health issues can cluster together, no different than physical issues.

The Campaign to Change Direction has identified five signs that are warnings that a friend is in need of mental health services. Not every person in need of psychological care will exhibit all these signs, but the more signs a person exhibits, the more urgent it is to try to get that individual appropriate care. The five signs are:

• Personality Change
• Agitation (from anger to anxiety)
• Withdrawal (from activities and/or other people)
• Poor Self Care
• Hopelessness

To this list, I would also add substance abuse. Many individuals who are experiencing mental health issues self-medicate with alcohol or other drugs. If a friend or colleague seems to be abusing substances in ways s/he did not previously, that too is a warning sign of mental distress. These individuals require help immediately, as it is very often possible to help a person with the underlying cause of their psychological distress before s/he becomes a full-blown addict.

Mental health disorders are nothing to be ashamed of. They are not your “fault” or caused by anything you or your loved one did “wrong.” Often, mental health disorders have a biochemical basis than can be remedied by the short or long term use of medication. In many cases, whole health treatments will relieve symptoms, along with psychotherapy. There is help and hope.

You did not ask to have a mental health problem, but you can and should ask for support in treating your mental health issues. There is a great deal of support and many different kinds of quality treatment available. Seek help if you or someone you care about needs it.