Start with empathy, stop the stigma

By Dr. Mia Wise
Thursday, May 10, 2018

Think of five people you know, adult or child. One of them is going to suffer from a mental health condition in their lifetime. That’s 20 percent of the American population.

Today the Blue Cross Blue Shield Association (BCBSA) released a national study, Major Depression: The Impact on Overall Health. The report showed a 33 percent rise in major depression diagnoses between 2013 and 2016 for BCBS members. For teenagers, this rate surged to 63 percent, and 47 percent for millennials.   

With numbers like these, it’s time to move from Mental Health Awareness to action.

Shame and stigma     

Mental health, or behavioral health, is our emotional, psychological, and social well-being. It’s related to our physical health. The most common mental health diagnoses are anxiety and depression. The BCBS report cited that 85 percent of members diagnosed with major depression have one or more serious chronic health conditions.

Scientific research that shows that mental health conditions result from a variety of factors: genetics, environment, and ongoing stress. They drive massive cost and suffering. Yet we don’t think or talk about mental health the same way we do physical health. Why?

With physical conditions, we can touch it, feel it, and measure it. It’s harder to get those objective, measurable, concrete definitions that the non-clinical person can recognize around mental health. People have viewed depression and anxiety as personality or character flaws.

People suffering from mental health conditions often believe those same biases too, and they socially withdraw. Stigma keeps people suffering alone, and it keeps them from speaking out to ask for the help they need.

How do we break this cycle? We need to start talking about it more openly. As a practicing primary care physician, I focus on the relationship that I build with each patient. Healthcare is not a transaction service focused on one problem; I try to address health as a whole person issue.

Once you have the trust with the patient, you can start the dialogue around mental health conditions such as depression and anxiety.

Helping Someone: Do’s and Don’ts

If you know someone who may be struggling, reach in so that person can reach out for help.


  • Know the warning signs of a mental health condition
  • Keep it neutral. Share observable changes, like, “I noticed that you haven’t gone out with us in a while,” or, “I noticed that you’d normally get this report done on time.”
  • Ask, “Are you okay?” It can be an opening for someone to share how they’re feeling and can be a turning point for getting help. Stay connected.
  • Offer to help that person find help, such as Employee Assistance Programs at work, a doctor, a counselor, or a crisis line 


  • Expect that the person will come to you first
  • Use words that can come across as judgmental, like “unstable,” “weepy,” “emotional,” or “overwhelmed”

Be mindful of what you say. How we talk about this can shape whether someone can step out of the shadow and get the help they need. We need to be more open on how these conditions affect us, and what we need to do to be stewards of our own emotional/cognitive well-being.

Dr. Mia Wise is a medical director, at Premera Blue Cross, and practicing medical professional. 

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