“In Canada, suicide accounts for 24 percent of all deaths among 15 to 24 year olds and 16 percent among 16 to 44 year olds. Suicide is the second leading cause of death for Canadians between the ages of 10 and 24.”
The Canadian Mental Health Association

Over 23,000 Canadians are hospitalized each year for a suicide attempt.
Canada Safety Council

“In clinical samples, about 50% of persons with bipolar disorder (BD) were found to have a history of a suicide attempt. In the largest epidemiological study on the topic to date, the suicide attempt rate in persons with BD was twice that of individuals with unipolar depression.”
Suicide Attempts and Completions in Patients With Bipolar Disorder; May 1, 2007

“The causes of physical illness and death among psychiatric patients are much the same as those in other groups — cigarette smoking, obesity, diabetes — and are treatable. The problem is that people with serious mental illness tend to be low on the socioeconomic totem pole and often don’t get the best available health care. Frequently, their own doctors pay little heed to their patients’ physical health.”
Time Magazine: Why Do the Mentally Ill Die Younger? Dec. 03, 2008

I was diagnosed with manic depression in 1989 in a pre-Internet era when information regarding the disease was almost impossible to find. But I knew the basics. Some days I felt like dying, and some days I didn’t.

It has been twenty years since, and I am only now becoming aware of the damage done to my body over that time. I’ve only recently begun the basics of trying to repair my body from the damage done by living so long untreated and unmedicated.

That process of trying to change, even just modify, the damaging behaviours which have become my life has been slow. And it’s only within the past few months where I’ve begun to realize most of the damage is permanent, and will be the cost.

And the cost of resisting treatment, of misunderstanding what the disease is, and my outright general ignorance, will be a severely reduced life expectancy, not of days or years, but of decades. According to several recent studies into mental illness, the cost will be my death from natural causes decades too early.

“Anxiety and major depression are both markers of increased cardiac risk, it is imperative that these patients receive the best treatment for both their cardiac and psychiatric conditions”, said Dr. Nancy Frasure-Smith in a 2008 article. Frasure-Smith was the principle author of a research paper called “Depression And Anxiety Can Double Chances Of Heart Ailments”. She’s a professor at McGill’s Department of Psychiatry and a researcher at the Centre hospitalier de l’Université de Montréal (CHUM) and Montreal Heart Institute.

Her conclusion was, left untreated severe depression, clinical or bipolar, increases our chance for heart attacks, and doubles our chance of having a second heart attack. In a separate study it was found “the cardiovascular mortality was 6.6 times higher in clients of the Massachusetts Department of Mental Health” than the general population.

In that 2006 American study, Morbidity and Mortality in People with Serious Mental Illness (MMPSMI), it was found people with a serious mental illness, such as manic depression or schizophrenia, “are now at risk of dying 25 years younger than the general population, compared with 10 to 15 years younger just two decades ago.”

We’re dying earlier, and our life expectancy is dropping faster than ever, and that’s not taking into account the numbers of us dying from our own hands. Close to 60 percent of these premature deaths are from natural causes such as cardiovascular and pulmonary disease and other so-called “natural causes” brought on by the side effects of having an untreated mental illness.

The causes in these jumps are simply increased levels of poverty, and a lack of resources and treatment.

According to the Canadian Community Health Survey, “30% of people with a diagnosed mental illness in Ontario did not work in 2003. This is a conservative figure because the survey did not include persons with a diagnosis of psychosis who were unemployed.

“In 2006, there were 77,430 people receiving income support through the Ontario Disability Support Program (ODSP) with a serious mental illness, representing 1 in 3 ODSP recipients. Individuals on ODSP are 34% below the poverty line, while those on Ontario Works (welfare) are 63% below.”

People who are considered permanently disabled by mental illness, such as myself, receive less than $1000/month (£500 or US$900) in support from the government ODSP program. According to the Canadian Council on Social Development the poverty line in my part of Canada is $14,000.

Mental illnesses breed poverty, and poverty breeds early death. Poverty breeds diabetes, it breeds addictions, it breeds obesity, it breeds respiratory diseases, infections, insomnia and failure.

There’s also deaths caused by smoking. Nearly half of all cigarettes smoked in Canada and the United States are consumed by people diagnosed with a mental illness, and nearly 75% of us smoke.

People with our conditions die an average of twenty-five years earlier than others, and now it has been shown a huge majority of these premature deaths are from natural and preventable causes such as diabetes and severely limited lifestyle options.

So, it’s a question I have to ask again…

Why are our doctors not bringing dietitians into our appointment if diet is so important to our recovery? Why are we not being handed massive amounts of Vitamin D along with our Lithium? Why, if sleep is so all fucking important to our recovery, are we not being handed a sleep aid along with our Lithium and Vitamin D?

A Perfect World Would Start With An Intervention; Jan. 12, 2007

Why are we not being given the tools which will help us recover at the time of diagnosis? Where are the programs designed to help us maintain our employment, or find new employment, or get retrained?

Jobs, even part-time, are critical to our recovery. According to Statistics Canada, “275,317 persons in Ontario with a serious mental illness are unemployed”. Work, according to the Canadian Mental Health Association, is central to the recovery of most people from mental illness.

Even with a sporadic or erratic work history, people with a mental illness who have the opportunity to work recover faster and have fewer relapses than those who don’t have the opportunity.

And with the vast majority of people with a mental illness unemployed and relying solely on government assistance, those people are slowly dying from poverty which they, for the most part, had no hand in creating.

People with a mental illness need more of everything, it is not shocking that every health care unit across the world is underfunded and over used. But, it seems to me the deaths of a lot of people could be prevented very easily, and at least the small burden of our care could be lifted off the health care systems simply by paying more attention to the health concerns we all share which are not directly related to the psychiatric ones.

Money. Food. Shelter. Work.

When I was diagnosed with Type-2 Diabetes, Ontario’s disability program started giving me an additional $50/month to cover the costs of my special diet. According to the diet guidelines given to me by my doctor which, if followed, will help me keep my feet and prevent my heart from deteriorating, the money from ODSP barely covers the cost of my recommended monthly intake of apples.

I live in chronic poverty, and have for almost my entire life. Diabetes, which I’ve had at least since 2002, causes heart damage. Chronic depression, which I’ve suffered from since I was a child, causes heart damage, and the eighteen years I smoked causes heart damage, respiratory illnesses and cancers.

How many years can I look forward to being hooked into longterm health care, disabled from heart, lung, circulatory malfunctions, plus kidney damage and probable amputation from the diabetes? After she’s borne, how many healthy years will I have with my daughter? Because, right now, I think I’m looking at ten or fifteen.

I can almost understand how we could have been diagnosed in the pre-WWW era, and then set free into the wild with nothing but a prescription and a promise we’d do our best to take the pills. But we know now how we’re effected by things beyond the disease. We know our mental illness doesn’t exist in a vacuum.

If the mental health system is changing, maturing, it’s moving far too slowly.

According to Frasure-Smith, anti-depressants, even with their side effects, helped people with chronic depression to avoid the risks associated with our potential cardiac as well as our psychiatric conditions. But in a 2007 interview with New England Psychologist Magazine, the author of the MMPSMI study went further.

“The stopping smoking is huge,” said Dr. Joseph Parks, medical director of psychiatric services for the Missouri Department of Mental Health president of the Medical Directors Council for the National Association of State Mental Health Program Directors. “Forty-four percent of the cigarettes that are smoked in this country are smoked by people with mental illness.”

Parks would like to see mental health officials ask us about our smoking habits, and urge us to stop.

“It’s going to take a lot of little interventions,” Parks says. “We’re going to have to get into smoking, activity, diet. You can successful treat somebody’s anxiety or depression only to have them die of a heart attack. What kind of treatment is that? That’s like winning the battle and losing the war.”

“It goes to thinking about the whole person. Otherwise we don’t serve our clients well. Health is an integral part of mental health.”

Poverty is the root of all the evils we experience. Treating manic depression, getting it under control, takes years and must be the first step in our recovery. Our minds must be clear and lucid and able to reason. But during those years we can also be learning how to keep our entire body healthy, so that when we come out the other side we can do more than just die from a heart attack.

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