At Least 37% of All New Yorker City Adults Have a Mental Illness. What Should You Know?

Published JUNE 15, 2035

What is the difference between mental health and mental illness?

Mental health has to do with what condition your mind is in. If you can handle your emotions and cope with everyday stress, you have a positive mental well-being. You are happy, you feel your life is fulfilled and you deal with life’s challenges as they come along. But mental health can also lean in the opposite direction. You may have times where stress gets the better of you and so you are not as productive as you could be. You are not satisfied with life. You feel sad. In sum, mental health is the state of your emotional and mental well-being.

Mental illnesses, in contrast, are mental health disorders that medical professionals can identify and treat. If you are living with a mental illness, you may find it difficult to perform daily tasks because of difficulties managing your emotions or relationships with others. In New York City, the two most common mental illnesses are anxiety and depression, affecting 18% and 11% of all adult New Yorkers, respectively. Less common illnesses include post-traumatic stress disorder (PTSD)(.05%), bipolar disorder (.02%), and schizophrenia (.01%). All mental illnesses have identifiable symptoms that help doctors make a diagnosis. For example, irritability and fatigue are common symptoms of anxiety, while prolonged sadness and social withdrawal are often seen in depression.

Are mental illness genetic or environmental in origin?

Anxiety and depression stem more from environmental risk factors than from your genetic make-up. Stress and social isolation can contribute to anxiety disorders while early childhood traumas—such as sexual and physical abuse—or chronic stress later in life can increase your risk of depression. Research shows, however, that genetics still plays a role in the onset of anxiety and depression, accounting for 30 to 50 percent of the overall risk. It is not unusual for anxiety or depression to run in families.

Genetics plays a much larger role in the origins of schizophrenia and bipolar disorder. Scientists estimate that genetic factors account for about 80% of your risk of developing schizophrenia. For bipolar disorder, genetic influences are thought to explain between 60% and 85% of the risk. In both cases, environmental factors such as illicit drug use and alcohol consumption can further increase your likelihood of developing either condition. Women, meanwhile, appear to be more genetically prone to PTSD than men, with genetic influence estimated at 35.4% compared to 28.6%.

Are there natural ways to treat mental illness?

For anxiety and depression, lifestyle changes often work best. Going to the grocery store is a good place to begin. Load up on fruits and vegetables and make sure to eat plenty of fiber to reduce anxiety symptoms. At the same time, cut back on sugar, artificial sweeteners and high-fat diets. Diets high in fat and cholesterol are inflammatory and have been associated with anxiety. For depression, get a full night’s sleep and exercise regularly two to three times a week. Walking, jogging, yoga, and strength training all help; the more intense, the better.

On the other hand, schizophrenia, bipolar disorder, and PTSD often require more structured supports, typically coordinated by a mental health provider. If you’re living with schizophrenia, mutual support groups where participants meet regularly for about an hour and discuss their challenges can assist group members in socializing more and reintegrating into daily activities. For bipolar disorder, both mutual and formal peer support groups—sometimes led by a person with lived experience—can reduce self-stigma and boost individual empowerment. If you have PTSD, mobile apps can reduce symptoms by introducing coping skills, encouraging reflective writing, and showing you how to better understand and manage your condition.

Which therapy gives the most bang for the buck?

Studies show that a type of talk therapy called cognitive behavior therapy (CBT) can have a long-term impact on changing people’s lives for the better. Psychologists, licensed social workers, and psychiatric nurses all work with CBT by encouraging patients to open up about what is troubling them. If you struggle with anxiety, for example, you might worry that you will remain unemployed forever. Licensed professionals try to promote more balanced thinking by encouraging you to think that it is not necessarily a forgone conclusion that you will never find a job again. Using CBT gives you the power to cope in a healthy way. Normally, CBT requires 5-20 sessions of talk therapy.

Cognitive behavior therapy is also the go-to talk therapy for schizophrenia and bipolar disorder, though its effects on both illnesses is less studied. If you live with PTSD, an effective therapy is Prolong Exposure (PE), a type of CBT where you talk first about people or places you have been avoiding since your trauma. Gradually, you confront these stressors and realize that you can re-engage with these people and places. After a few sessions, a therapist will talk about your past trauma and help you deal with your fears and sadness and eventually regain control of your life. PE sessions last for about three months.

Which is better, therapy or medication?

It is not so simple. Medications doctors prescribe to treat mental illnesses have not improved much over the past 50 years, although some may have fewer side effects. Psychiatric medications prescribed to treat anxiety, for example, work in this manner:

 Medication → target protein → changes brain signaling → affect symptom Antidepressant → target protein → changes brain signaling → uplift mood

Common side effects for anxiety and depression medications include drowsiness, dry mouth, nausea, and sexual dysfunction.

The good news is that both CBT and medication are evidenced-based treatments designed to support individuals with mental illness. Which option is best for you may depend on your tolerance to side effects or your availability to attend CBT therapy sessions. Be sure to consult with your medical provider first, but eating your fruits and vegetables, exercising daily, and spending time with others can only help create a more positive mental well-being.