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Commentary: The Desperate Need for Better Mental Health Care in America

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Her name was Sophie. Our mutual friend Joan had introduced us last Friday. On Monday, just three days later, Joan called to tell me Sophie was gone, that she had committed suicide.

Joan had informed me before our meeting that Sophie had bipolar disorder and had just come off a manic episode. But when we met, Sophie seemed fine, a gentle soul with a warm smile willing to share advice for the documentary I’m working on. We drank English Breakfast tea with milk and ate slivers of cake filled with chocolate mousse. These details aren’t relevant, but they seem more vivid to me now. Everything seems more vivid.

Sophie showed me a short video of her latest project. As I watched it, I laughed and told her, “It’s such a fun, feel-good story. You can’t watch it without smiling.”

As our meeting wrapped up, she said she would send me the contact info for someone who could help me with my film. I had planned on sending her a thank-you note to tell her how much I enjoyed meeting her and reiterate how much I believed in her project. And then I couldn’t. Because she took her own life.

I’m still trying to understand it. She was 41, beautiful, fit, talented, highly creative, successful. She was also the mother of two young daughters.

I’ve been troubled by this for days.

I am familiar with depression. I’ve had dark, suicidal thoughts of my own, the worst of it after my husband died unexpectedly. In my case the light has always won out over the darkness. What kept me going was my dogs. Who would take care of them if I was gone? I couldn’t abandon them, these innocent animals who not only loved me unconditionally, but seemed to recognize their role as saviors. They would jump onto the bed, lick my tears, and remind me to keep living. Then we would go for long walks in the forest, where nature and dogs—and twice weekly sessions with a grief counselor—gradually eased my sadness.

Depression, however, is only one half of bipolar disorder, which also presents itself with a flipside of mania, delusions, and hallucinations. What causes the brain to misfire like this, sending signals so desperate and blinding that one sees no other solution than to end it all? Why didn’t the thought of Sophie abandoning her little girls prompt her to check into a hospital instead of the hotel where she overdosed?

I googled the hell out of the questions: What triggers a bipolar episode? Does it get better with time? Hormones, childbirth, stress, lack of sleep, and even medication can exacerbate it. And no, it doesn’t get better. Sadly, it can get worse.

Sophie’s dog had died not long after she had her babies. She had just lost a bid for a new client. And her marriage was in trouble. Any one of those stressors alone could trigger her illness, but all three combined must have felt insurmountable.

Part of me understands the desire to be relieved of such debilitating pain, the notion that death is the only path to ultimate peace. But circumstances can improve, and brain chemistry changes; there is always the potential that things will get better. And while there is no cure for bipolar disorder, I wish Sophie had trusted that her deeply depressive episode would pass. I wish she had gotten the help she needed.

But getting help is a big part of the problem. Over one-fifth of the U.S. population suffers from mental illness—let that number sink in: one-fifth of all Americans suffer from mental illness—but over half of those don’t get treatment. There’s a shortage of doctors with wait times for an appointment often several months long. There’s a continuing social stigma that causes shame and discrimination. There’s also a lack of knowledge in the field of psychiatry, often leading to misdiagnosis and medications being prescribed in a luck-of-the-draw way to see what may or may not work. Even with new initiatives like the 988 Suicide and Crisis Lifeline, mental health care in America is not improving; it’s getting worse. Over the past two decades, the U.S. suicide rate has climbed 36-percent.

The brain is the final frontier in science. If only the billionaires who are building rockets and searching for other planets that could support human life would instead allocate that money to mental health research and increased services. The investment could pay off exponentially, helping to solve issues like gun violence, domestic abuse, substance abuse, poverty, and homelessness—and it could save the lives of beautiful young mothers like Sophie.

To honor Sophie and help others, please consider making a donation to The Mental Health Coalition.org.

Beth Howard is an author and filmmaker who lives in Donnellson, Iowa. Her website is The World Needs More Pie.com.

Ms. Howard changed the names and some details in this commentary to protect the privacy of the woman and her family.

The opinions expressed are not necessarily those of Western Illinois University or Tri States Public Radio.

Diverse viewpoints are welcomed and encouraged.