M.D. Medical Director, Psychiatrist
And still, most of us treat it like an extra. Something to get to once the deadline lifts, the kids settle, or the budget allows. We would not ignore a broken arm for six months hoping it would resolve on its own. But we routinely do exactly that with anxiety, depression, burnout, and chronic stress.
This year’s theme from Mental Health America, “More Good Days, Together,” asks a simple question: what would it take for more of us to have more good days? The honest answer starts with how we frame mental health in the first place.
Mental health is not separate from physical health
The World Health Organization defines health as a state of complete physical, mental, and social well-being, not simply the absence of disease. That framing matters because the body does not actually divide itself the way our healthcare system does.
People living with chronic physical illnesses like cancer, diabetes, COPD, and cardiovascular disease show higher rates of mental health conditions, and depression appears in anywhere from 13 to 80 percent of chronically ill patients. The reverse is also true: anxiety and depression measurably increase the long-term risk of cardiovascular disease, stroke, and metabolic conditions. The relationship runs in both directions, and the evidence base for it grows every year.
When we treat one without the other, we are not really treating either.
Why we still treat it like it’s optional
Three forces keep mental health at arm’s length, even now.
Stigma. Asking for help still carries a quiet penalty in many American workplaces and families. People worry about being seen as fragile, unreliable, or unprofessional, so they wait. They wait until the symptoms are loud enough to override the shame, and by then, recovery takes longer and costs more.
Access. Even when someone decides to seek care, the system often turns them away. SAMHSA’s 2024 National Survey on Drug Use and Health found that 23.4 percent of U.S. adults, or 61.5 million people, experienced any mental illness in the past year, and roughly half of them received no treatment at all. Cost is a major reason: in earlier NSDUH analyses, nearly one in four adults with moderate to severe anxiety or depression who were not in treatment had skipped or delayed therapy because they could not afford it.
Cultural framing. We talk about mental health as a private, individual project. But mental health is shaped by sleep, work hours, financial pressure, social connection, caregiving load, and community resources. Treating it as a personal optimization problem misses most of the picture.
What it costs us
The cost of treating mental health as optional is not abstract. It shows up in real numbers.
The World Health Organization estimates that depression and anxiety alone account for roughly 12 billion lost working days every year, costing the global economy about $1 trillion in productivity. In the United States, the American Psychiatric Association has reported that unresolved depression drives a 35 percent reduction in productivity and contributes to a $210.5 billion annual loss through productivity decline, medical costs, and absenteeism.
The personal cost is harder to quantify and often heavier. Untreated mental illness erodes relationships, sleep, focus, parenting, careers, and physical health over time. It compounds. A depressive episode that might have responded well to therapy in month two can become a chronic, treatment-resistant pattern by year two. PTSD that goes unaddressed shapes how someone parents, partners, and works for decades.
The cost is also not evenly distributed. Hispanic and Black adults with mental illness receive treatment at significantly lower rates (39.6 percent and 37.9 percent) than white adults (56.1 percent), reflecting longstanding gaps in access, representation, and culturally responsive care.
What changing the frame looks like
If mental health is health, then care for it should look like care for any other health condition: early, accessible, evidence-based, and ongoing.
For most people, that starts with psychotherapy. Approaches like cognitive behavioral therapy, EMDR, and other evidence-based therapy modalities have decades of research behind them and remain the foundation of treatment for anxiety, depression, PTSD, and many other conditions. They work. They are also underused, often because people assume they need to be in crisis to deserve them. They do not.
Lifestyle factors matter more than most people realize. Sleep, movement, time outdoors, social connection, and limits on alcohol and screen time all measurably affect mood, anxiety, and resilience. None of this replaces clinical care when it is needed, but it shapes outcomes meaningfully alongside it.
For people whose symptoms have not responded to therapy and lifestyle changes, additional clinical options exist, including TMS therapy for treatment-resistant depression and thoughtfully managed medication when clinically appropriate. The point is not that any single tool is the answer. The point is that real care is layered, personalized, and matched to where someone actually is.
What this month can actually do
Awareness months can feel performative, and sometimes they are. But they also create permission. Permission to ask a colleague how they are really doing. Permission to call a therapist before things get worse. Permission to take a mental health day without explaining yourself. Permission to push our workplaces, our insurers, and our communities to do better.
Mental health is health. Not optional. Not a side conversation. The longer we pretend otherwise, the more we pay, individually and collectively. This May, the most useful thing any of us can do is stop treating it like an extra.
If you or someone you love is navigating anxiety, depression, trauma, or burnout, BestMind Behavioral Health is here. Reach out to schedule a consultation or learn more about how we approach care.
