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Naomi Osaka is being fined $15,000 for being ill?

By Alan Manevitz, MD

Would the NBA fine LeBron James if he had disabling pain from a groin injury? Would the MLB fine Mike Trout if he was too nauseous from a stomach flu to meet with the media?

Miss Naomi Osaka withdrew from a Grand Slam tournament because of the health problems she is facing. Yet, she faces backlash from the media.

Is it because she is a woman? Asian? Bi-racial? Or is it another bias that afflicts at least one out of every two households: mental illness?

Mental illness and mental health are dynamic, ever changing phenomena. They reflect the brain’s BioTechPsychoSocial interaction of genetics, individual behaviors (proper sleep, healthy diet, exercise), and life experiences (trauma, social environments, family & peer groups, physical and cultural surroundings).

Anyone who has suffered Major Depressive Disorder and any of its symptoms knows the crushing pain it can cause. Symptoms affect sleep, appetite, concentration, energy, helplessness, hopelessness, worthlessness, guilt, and libido, impairing one’s ability to function daily. Major Depressive Disorder is also accompanied by feelings of sadness, anxiety, irritability, and withdrawal. In fact, depression is mediated by neuro chemicals, such as serotonin and noradrenergic, which also mediate physical disorders such as fibromyalgia. Mental illness impacts individuals across all age, racial, ethnic, religious, spiritual, geographical, economic, sexual identity, and gender populations. Access to help is a difficult social injustice issue, and unfortunately, is limited for many.

In a typical year—and 2020 was an atypical year, in which these numbers were even higher—14.8 million Americans experience Major Depressive Disorder. Of that number, 7 million get treated, and less than half of those, 3.2 million, are adequately treated (1). The Surgeon General Report on Mental Health (2) stated that 20-25% of people suffer mental illness in their lifetime but only a fifth of those get treatment. The World Health Global Burden of Disease Study (3) has stated that only ischemic cardiovascular disease outweighs major depression as the highest cause of death.

Years ago, Mike Tyson, heavyweight champion of the world, behaved bizarrely in a championship fight with Evander Holyfield. Tyson bit a piece of Holyfield’s ear off! Newspapers and doctors discussed various diagnoses that may have caused this outrageous behavior, including Bipolar Disorder. Tyson’s mental health was covered in a way that was sensational, but unfortunately not educational on matters of medical/psychiatric illness.

Like the COVID-19 pandemic, this is another opportunity for the media to help bring mental health and mental illness into the public eye, to help educate individuals and families who are suffering on how to compassionately help. It is an opportunity to highlight the importance of access to treatment. We can educate others about the ways that stress can cause physical changes in the brains of all people, even athletes, and how those changes result in real, painful symptoms that affect our ability to function in daily life. Finally, we can demonstrate that utilizing the new paradigm for an integrative approach to psychiatry, the BioTechPsychSocial Model (4), can result in precision treatments and better outcomes.

(1) the National Comorbidity Survey Replication Study Kessler Et al

(2) Surgeon General Report on Mental Health

(3) Global Burden of Disease Study (commissioned by the World Health Organization and The World Bank as the largest and most comprehensive study to estimate morbid burden of human diseases, not just their mortal risk)

(4) BioTechPsychoSocial Model

Manevitz et al APA 2017

Dr. Alan Manevitz, MD, is a clinical psychiatrist in New York City who specializes in treatment-resistant depression and family therapy.


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