Feeling sad? Maybe get a puppy or a kitten

Alright, alright, I know that my entry earlier in the week was a bit of a bummer. Well, let me qualify that: It could be a bummer on the surface, since it was about my recently deceased dog. But if you look beyond just the words I wrote, you’ll see that the overarching theme of the entry was more than just sadness. I’m obviously heartbroken that Molly is gone, but the point of my entry wasn’t just how sad it was: It was how much joy the dog gave us for ten wonderful years.

Obviously, I’m not the only one who felt that way about their pet, and there’s real science there.

The Anxiety & Depression Association of America calls it “The Pet Effect”:

 It’s also no surprise that 98% of pet owners consider their pet to be a member of the family. Not only are people happier in the presence of animals, they’re also healthier. In a survey of pet owners, 74% of pet owners reported mental health improvements from pet ownership, and 75% of pet owners reported a friend’s or family member’s mental health has improved from pet ownership.

And let’s be clear here – the benefits of pet ownership go beyond one survey and beyond the notion of just feeling good. According to a meta-analysis of 17 studies, pet ownership was associated with major mental health improvements. According to the meta-analysis itself, 15 of the 17 studies reported positive mental health benefits of pet ownership (though 9 actually also reported negative benefits as well).

The study then broke the benefits of pet ownership into broader themes. These included:

  • Providing comfort, emotional support and companionship, as well as mitigating worry and stress. This was particularly true for veterans suffering from PTSD. Pets also provide a role as companions and comforters and were perceived by humans to be replacement family members, and friends capable of listening without judgement.
  • Encouraging physical activity and distracting someone from their negative symptoms. One study went as far as finding that people with pets were more likely to get out of their house for mental health care than those who didn’t have pets. Furthermore, the distraction of a pet was found to help alleviate ruminative symptoms by encouraging humans to stay more in the present.
  • Encouragement of social interaction. Pets encouraged humans to interact more with others and better integrate their humans to the community.
  • Pets provide their humans with a sense of self worth and identity. For many, a pet is another reason to live – its something that you love and care for, and becomes a positive part of who you are.

Pets can create negative symptoms too, of course. They are financial costs (potentially significant ones – also, again, GET PET INSURANCE) and may create a burden in terms of housing.

So, if you’re down, should you get a pet? Well, yeah, maybe. It’s not a cure all. Nothing is a cure all. But if you are ready for the responsibility (and it is a major responsibility, trust me), having a two or four legged companion may ease your suffering and give you joy and love.

How to cope with losing the pet you love

“Hey, something’s up with Molly. She’s not right.”

On Monday, April 8, we were getting ready in my house like any other day. I was going to Harrisburg, my wife was getting ready for school and the kids were eating breakfast. It was around 6:45am. Molly, our ten year old German Sheppard, was having trouble walking. She had an old leg injury, but it didn’t usually bother her like that. She was stumbling and just looked off.

Hmm.

I let her out to the backyard to load my car, as per usual. When I got back from the garage, she was lying down and panting. Not like her at all.

We made a vet appointment, but by the time my wife got home from work it was apparent it was more serious than that. I was in Harrisburg, ironing a shirt in my hotel room, when I gave Brenna the number for the vet. She ran Molly to the veterinary hospital, and I could feel a chasm opening in my chest. My father in law had run over to watch the kids, and he said, “Mike, Molly really doesn’t look good. She’s having trouble walking.Be prepared.”

Brenna had the kids hug Molly goodbye before she went to hospital with her, just in case. I’m glad she did.

Molly collapsed in the lobby of the hospital. They put her on a journey and ran her back. I was at a dinner that I abruptly left, and I was in the car, in the parking lot of the hotel room, when Bren called me back. She put the Vet on speaker phone, and the very nice woman sadly explained that Molly had a tumor around her heart. There was nothing we could have done, and nothing we could do.

I was able to get home in time. And we said goodbye.

Losing a pet is agonizing. I’d been through it once before, but it was my childhood dog. Losing the dog that your rescued and raised from puppyhood to old age is horrible. She was our practice child. We got her before we were married, before kids, before I was an elected official, before books. Molly was with us for more than 1/4 of our lives. Losing her has created a puppy-shaped hole in our lives.

Broadly speaking, some thoughts:

It’s gonna take time: It’s been about two weeks now. We’re getting there, but still have plenty of moments where we just burst into tears. I mean, the last time I cried was…yesterday. This is gonna take time. A lot of time.

The grief comes in waves: Let me acknowledge how lucky I am. I still have my parents and most of the people in my life who are close to me. So, this was one of the worst grief-laden experiences I’ve ever had. And it comes it waves. The first couple of days are horrible. Then it fades. And then out of nowhere…you find a dog hair. Or you drop food that the dog would normally eat. And it feels like you’ve been punched in the gut and you’re a weeping mess. Best advice I can give: Ride the storm. It fades. And it does get easier. Try to remember that.

Try to put your pain in perspective: Bren and I have both repeatedly commented on how we thought she had more time – how badly we wanted more time with Molly. What’s helped me get through that? I try to remember everything that went right. We had her for ten years. We gave her love and attention and time – and a lot of money caring for her, haha (side note: PET INSURANCE IS A GREAT IDEA). But Molly was found in a box in downtown Allentown. She was sick with hookworms. She should have died. But we took her into our home and loved her for ten wonderful years–and for those ten years she loved us and our kids and was with us for our greatest and darkest moments. More time would have been wonderful. But to have a friend like this for so long – and to remember the time you had together – makes a world of difference.

Yes, saying something on Facebook does help: Every time one of my friends posted on FB that they had lost a beloved pet, I said how sorry I was. And, in recent years, with an older dog, it always occurred to me – I’d write that update one day. When the time came, I was floored. I did it just to update people with what was happening in my life. I was blown away at the responses – how kind they were – and how much better they made me feel. When I returned to Harrisburg a day later, I had members, staffers, lobbyists telling me how sorry they were. Someone even mailed me a stuffed dog with a sweet note (I don’t know who you are, but if you’re reading this, thank you so much).

Those messages of support made a world of difference. I remain so touched by their kindness, but I was reminded that losing a pet is largely universal. So many know that pain. Share yours with others and let them be there for you, too.

The absence is louder than any scream: Being home alone has been the worst. Not having Molly in the living room staring at me. Begging to go out. Looking for attention. I can feel her absence like it’s physical. There are no more little noises anymore. No more tinkling of her dog tags. No more claws against the hard wooden floors.

Be prepared for that. I don’t have a solution yet, except time.

The loss of routines: Every morning, I wake up. Molly runs to the bed, pacing, grunting. She’s gotta pee. I let her out. She does her business and runs back to the door, jumping. I feed her. Then I gotta let her out again. For nearly ten years this was our dance, right up until the morning of the day she died. Before we go to bed, we let the dog out. At 4pm, she gets dinner. Every time I go to the kitchen, I check her water dish to refill it as necessary.

And just like that, those routines are gone. Brace yourself. That part is awful. 

Helping the kids: Our kids are 8 and 6. They’ve never known a world without Molly in it. They were, of course, besides themselves – they cried so hard that night. We snuggled with them and told them as appropriately as possible what had happened: She had cancer and had died. Auron, the older one, is more curious: Had she died with her eyes open? How had she died? I answered both of those questions later – without my daughter around.

The night she died we sat on the couch together and spoke about how much we loved her. We told the kids this would hurt – that it would take time – and that they could cry on our shoulders. We let them go late into school the next morning but we did bring them in together – we thought it was better for them to be surrounded by friends. Their teachers and classmates were SO KIND they even made cards. 

Both kids reacted differently. Ayla – my youngest – now walks around with a stuffed German Sheppard that we got her (named Molly, obviously). She brings it to school and says it helps. We got one for Auron too, but I have no idea where it is now – he didn’t really use or need it.

Broadly speaking, my experience with the kids has been this: Let them lead. They want to talk about Molly? Go right ahead. They don’t? Let it go. But just telling them to express their emotions, that death is a part of life, that you love someone so they have no regrets when they are gone and that we were there for them if they needed us – that made a world of difference, I think.

Take the punch: I had an already scheduled appointment with my therapist the other day, and naturally, this is largely what we discussed. I’d been working on trying to be more present and less in my head, and I asked him how to reconcile the pain of grief with that concept. His answer was great: You do it to take the punch. You do it to get stronger, because grief is an non-negotiable part of life.

Take the punch. It was worth every moment. I miss Molly deeply. And will for what I imagine will be the rest of my life. To quote a tweet I once saw: Owning a dog is like borrowing happiness from the future. My family and I are now in our repayment plan, but if you hold to that metaphor, the happiness we borrowed was like an investment. It was repayed countless times over. Dealing with this grief is rough but manageable. We will get there, and we will be dog owners again, both because it’s what we want and I think what Molly would have wanted for us. This house isn’t the same without a four legged friend, and when the grief has passed to a manageable level, we’ll be there again.

Anyway, thanks for reading. I hope this was as helpful for you to read as it was for me to write.

Six ways that humanity once treated mental illness (which would probably kill you today) – Part 2

Hello! On Monday, I published Part 1 of a historical look at the ways in which mental illness was once treated. Here’s Part 2. It’s not any better.

4. Fever therapy

Some general basics here: You don’t just get a fever because your body hates you. Fevers occur when your body has an infection, and your temperature raises to fight off the foreign germ invaders.

Keep this in mind, and allow me to introduce you to Hilda, a patient who was suffering from what the early 20th century referred to as “general paresis of the insane,” (or GPI) caused by advanced syphilis. Hilda was confined to a psychiatric clinic in Austria when she came down with a pretty serious fever. She recovered from the fever…and her psychosis.

How they thought it worked

Hilda’s doctor, Dr. Julius Wagner-Jauregg, attributed Hilda’s sudden recovery to the fever. Using other GPI patients, Wagner-Jauregg began to experiment by injecting patients with a slew of other illnesses, including streptococcal bacteria (strep throat), tuberculin (tuberculosis) and malaria (freakin malaria).

However, for many, the therapy actually worked:

“Patients who previously behaved bizarrely and talked incoherently now were composed and conversed normally with Dr. Wagner-Jauregg. Some patients even appeared cured of their syphilis entirely. Here in the twenty-first century it may not seem like a favorable bargain to trade one awful disease for another, but at least malaria was treatable with quinine, a cheap and abundant extract of tree bark.”

Fever therapy (also known as Pyrotherapy) was used as late as the 1930s, when special machines were constructed to induce a fever.

But, actually….

The therapy did work…for GPI. And GPI only. And it did have the nasty side effect of giving someone whatever deadly illness they were injected with, complete with a 15% chance of…death.

The problem, of course, is that this wasn’t understood. Pyrotherapy (side note: this is the greatest name ever, because it sounds like you are being healed with fire) worked by killing the microorganisms which caused GPI, but there was no such equivalent for other forms of mental illness.

Meanwhile, pyrotherapy was used to treat a variety of different psychiatric disorders, including depression and schizophrenia. New, exciting ways were brought in to treat fevers to, expanding to everything from typhoid to electric blankets. Observations at the time showed that the therapy could work in very limited circumstances, but most of the time, there was no improvement.

As for Wagner-Jueregg? He, too, won a Noble prize. Apparently, they are not as hard to get as one would previously expect!

5. Hydrotherapy

Nothing’s calmer than a nice, relaxing bath to destress you after a long, tough day, right? Well, what about being soaked in icy cold towels and made to stay in a bath overnight?

Wait, what?

How they thought it worked

According to this 2015 Psychology Today article, in older times, mental illness was thought about in “spiritual terms” – and water was seen as an antidote. As a result, water became to be viewed as a common cure to a variety of mental illnesses. This became particularly prominent in the 18th century, when two types of hydrotherapies became prominent:

• The douche (shower), in which a “constant torrent of water could either cool the heat of madness or rouse the melancholic.”
• The balenum (bath), which was just meant to calm someone down.

With the rise of psychiatric hospitals, the practice became more prominent and a variety of different pieces of equipment were developed for the practice, including bath boxes, dunking devices (I don’t think they mean those carnival games) and more.

While this all sounds relatively harmless, in it’s more extreme forms, the therapy could be downright cruel and dangerous. According to one review, in some cases, “A patient could expect a continuous bath treatment to last from several hours to several days, or sometimes even over night.”

But, actually….

The therapy faded from prominence in the early 20th century as other bad ideas replaced this one (insulin shock, electroshock and more).

Here’s the thing though: While forcing someone to do anything against their will is almost always a bad thing, taking a bath can be good for your mental health, so this therapy wasn’t entirely off base! According to this Guardian article, taking a bath can increase your core temperature. This, in turn, is associated with a “moderate but persistent” mood increase.

So, hop on into the tub! Just…don’t strap yourself in. Bad call there.

6. Trephination

Trephination is the fun-filled process by which a hole was cut in someone’s skull. It is one of the oldest forms of therapy, with evidence for the practice dating all the way back to 6500 BCE. Its use wasn’t just confined to mental illness; no no, that would at least limit those who suffered from this God-awful practice. Instead, trepanning was used for a variety of illnesses, including seizures, migraines and head wounds, as well as pain.

Is was used as recently as the Renaissance, around which time one can assume that it began to occur to practitioners that cutting a big ole hole in someone’s skull was not necessarily the greatest practice.

How they thought it worked

Similar to hydrotherapy above, trephination was used because of a different understanding of mental illness. The hole cut in one’s skull would allow for bad spirits to get out, or good spirits to get in. This, in turn, would relieve mental illness.

At the same time, trephination had other uses. Skull discs would be collected and used as good luck charms or amulets, and in ancient Egypt, the scrapings of a skull were used to make potions (hey, why let a good thing go to waste!)

What is even more remarkable is that these operations did not kill everyone on the spot. There is ample evidence that many survived the procedure, as evidenced by skull regrowth among those who had the operation.

But, actually….

Do I really need a “but, actually” section here? Drilling holes in the skulls of people is, generally speaking, a bad practice, m’kay?

Now, that being said, there are exceptions to every rule, and skull-holes has those exceptions as well. In limited instances, such as in the case of brain injury, and specifically epidural and subdural hematomas.
Of course, skull removal is never used for mental illness at this point. Thank God.

Six ways that humanity once treated mental illness (which would probably kill you today) – Part 1

In the course of doing research on mental illness and treatments, I have come across some absolutely wild methods of treating mental illness from older times. Some had roots in science of the moment – others were just really, really bad guesses. Most were very cruel, but in all fairness, it’s easy to say that now.

Anyway, here’s a look at six ways which humanity once treated mental illness. Today is Part 1, and Part 2 will publish Thursday.

1. Electroshock therapy

You may know shock therapy from plays like One Flew Over the Cookoo’s Nest or that episode of Quantum Leap which gave me nightmares for years:

How they thought it worked:

With shock therapy, the premise was simple: They hooked you up to a machine and sent as many as volts as possible into your screaming, aching body. The electrocution would induce a seizure; this, in turn, was thought to improve mental illness like depression and schizophrenia.

The therapy wasn’t usually quite as ugly as portrayed in popular media, but according to Jonathan Sadowsky, who wrote a book on electroshock therapy, it wasn’t too far off: Electroshock therapy was often used in mental hospitals to “control difficult patients and to maintain order on wards.”

Oh, and not for nothing, but electroshock therapy was also used as a way to “cure” homosexuality. Yeah.

But, actually…

The idea behind the practice was sound; it’s the execution of shock therapy that caused the damage. Even in the 1960s, there was ample evidence that electroshock therapy could be successful. However, patients who underwent the practice at the time were often did not give informed consent (agree to the treatment with a full understanding of its potential risks and benefits) and reported the process to be terrifying and painful. Severe memory loss and brain dysfunction often occurred as a result of the treatment.

Thankfully, this practice has been reformed significantly. It’s still used for severely and treatment resistant depression, as well as a few other select disorders. According to the Mayo Clinic, patients are placed under general anesthesia (as opposed to being very awake and very much in pain) and a small electrical current is sent straight to their brain, resulting in a small seizure. And, unlike prior versions, ECT has shown real promise in fighting depression, with success rates as high as 83%.

2. Insulin Shock therapy

Getting electrocuted not enough fun for you? My friend, allow me to introduce you to insulin shock therapy, the process by which patients were intentionally overdosed with insulin and sent into a coma. Yes, that’s right, it’s diabetes…on purpose.

How they thought it worked:

The therapy was first discovered by accident in 1927 by Dr. Manfred Sakel, who injected a morphine-addicted woman with insulin and noticed a remarkable recovery. Said Dr. Sakel:

“My supposition was that some noxious agent weakened the resilience and the metabolism of the nerve cells … a reduction in the energy spending of the cell, that is in invoking a minor or greater hibernation in it, by blocking the cell off with insulin will force it to conserve functional energy and store it to be available for the reinforcement of the cell.”

Over the course of a two month period, schizophrenics were injected with a massive dose of insulin until they slipped into a coma. Patients were selected based on those who had a good prognosis for recovery and were thought to have the physical strength to endure the therapy.

Studies in the 1930s and 40s showed that as many as 70% of people showed improvement with insulin shock.

But, actually…

A paper in 1953 by Dr. Harold Bourne debunked the therapy, noting that any recoveries likely occurred because the patients were already on their way to a recovery. Further studies with randomly selected patients showed that insulin therapy showed absolutely zero difference with medication…except, you know, the self-induced diabetes coma.

The therapy disappeared from the United States by the 1970s.

3. Lobotomies

Not sure what the word “lobotomy” means? Well, let’s look at its origins: “lobe” means part of the brain, and “tomy” is a medical suffix for cutting. So, that means…

…oh. Oh, dear.

Yes, a lobotomy is just that: Removing a piece of the brain in order to make the rest of it function better.

Clearly, the logic here is wanting. Broken arm? Cut it off. Twisted your ankle? Time to amputate!

How they thought it worked:

Back in the day (as recently as the 1950s), lobotomies were used for the treatment of a variety of mental illnesses, including schizophrenia and bipolar disorders (then called manic depression). It was invented in by Dr. Antonio Egas Moniz in 1935. Fun fact: Moniz was awarded to Nobel Prize for Medicine in 1949 for the lobotomy – a move so out of step with reality that there was an unsuccessful effort to revoke the Prize from Moniz.

In the first lobotomies, known as “ice-pick lobotomies” (yes, really):

“As those who watched the procedure described it, a patient would be rendered unconscious by electroshock. Freeman would then take a sharp ice pick-like instrument, insert it above the patient’s eyeball through the orbit of the eye, into the frontal lobes of the brain, moving the instrument back and forth. Then he would do the same thing on the other side of the face.”

In the end, an estimated 50,000 lobotomies were performed in the United States.

But, actually…

According to Dr. Barron Lerner, a medical historian and professor, “The main long-term side effect was mental dullness,” which included damage to a person’s “personality, inhabitations, empathy and ability to function on their own.” Another contemporary source found that a mere 1/3 of people benefitted, while 1/3 had no change, and 1/3 were made worse. So, a cure with a 1:1 chance of doing more harm than good. Neat.

Some patients did show an improvement in their mental illness. But many showed an overall loss in emotions. It got so bad that the Soviet Union – not exactly known as a vanguard of human or civil rights – banned the practice in 1950. Fortunately, as a result of increasing concerns over the operation and the advent of successful anti-psychosis drugs, lobotomies largely fell out of favor in the 1950s.

Religion and suicide

About two weeks ago, I was able to participate in a Jewish Federation event on mental health and stigma. The participants included myself, a psychologist, the head of our local NAMI Chapter and a Rabbi. Much of the information I heard during this presentation was things that I had heard before, but the newest perspective actually came from the Rabbi, who discussed what happens with Jews who do die by suicide.

Apparently, in Judaism (like many other religions), a strict interpretation of suicide views the action as a major sin, and those Jews should not be buried in a Jewish cemetery. Thankfully, this Rabbi believes (like many others) that those who do die by suicide are clearly ill at the time of their death; thus, they should not be “punished” for that action and should be allowed to be buried in a Jewish cemetery.

This entire conversation had me thinking about suicide and religion. Are there differences in suicide rates by religion? What about those with no religion – do they have higher or lower suicide rates? How can religion help or hurt someone’s mental health?

The relationship, as best I can tell, is complicated. According to a 2016 study on the subject:

We found that past suicide attempts were more common among depressed patients with a religious affiliation (OR 2.25, p=.007). Suicide ideation was greater among depressed patients who considered religion more important (Coeff. 1.18, p=.026), and those who attended services more frequently (Coeff. 1.99, p=.001). We conclude that the relationship between religion and suicide risk factors is complex, and can vary among different patient populations.

This study would obviously suggest that religion and suicide are positively correlated. But, as a 2017 article from the American Sociological Association notes, the real relationship is more complicated – and that largely depends on where in the world you are discussing:

A Michigan State University sociologist reports in The Journal of Health and Social Behavior that religious participation affects suicide rates differently around the world, and in Latin America particularly, high religious involvement is associated with low suicide rates.

In contrast, in East Asia, where residents are reportedly more secular, higher levels of religious involvement are connected to higher suicide rates. A one percent increase in religious participation is associated with a one percent increase in suicide rates in East Asia.

Statistics for the United States generally follow with the statistics for Latin America, although the link between religious participation and low suicide rates is not as pronounced in the United States.

An interesting 2017 article from the Huffington Post makes a similar argument but from a reverse perspective: That it is atheists, not religiously affiliated people, who have a “suicide problem.”

When I started this entry, I was curious to see what religions have higher or lower rates of suicide. I now see that it’s not that simple. Religion and suicide are related, and that makes sense, of course. On one hand, religion can give people additional joy, purpose and value. Fear of divine punishment can also serve as a powerful motivator to keep people from killing themselves. However, religion can also alter perspectives and force negative value judgments.

My conclusion: The relationship between religion and suicide is complicated and depends on a variety of factors.

As always, let us know what you have to say in the comments below!

No, you cannot “implant” the idea of suicide

One of the great myths of suicide is that you shouldn’t talk about it with someone (particularly younger people) because doing so may somehow “implant” the idea of killing oneself into someone’s head. That’s categorically, unquestionably not true, and I wanted to take a moment to discuss the idea.

The idea that we can unintentionally encourage suicide by discussing it is a frightening prospect because it leaves us powerless. One of the things that many mental health advocates say (and this certainly includes me!) is that we must discuss suicide and mental health. However, there is a persistent fear that discussing suicide may cause someone to consider attempting the act.

There’s good news though: It’s just not true.

There is ample evidence to back up the notion that discussion of suicide doesn’t increase suicidal ideation or attempts; indeed, thankfully, the opposite is true. According to a 2014 review on just this subject:

None [of the studies reviewed] found a statistically significant increase in suicidal ideation among participants asked about suicidal thoughts. Our findings suggest acknowledging and talking about suicide may in fact reduce, rather than increase suicidal ideation, and may lead to improvements in mental health in treatment-seeking populations. Recurring ethical concerns about asking about suicidality could be relaxed to encourage and improve research into suicidal ideation and related behaviours without negatively affecting the well-being of participants.

This is great news, particularly for anti-suicide and mental health programs, as it means that you can talk about suicide without supposedly putting the idea of suicide into someone’s head.

That doesn’t mean, of course, that suicide and mental health can just be discussed in a willy-nilly sort of way; there must be specific guidelines to these conversations.

According to this article from Psychology Today, these conversations can range from casual to serious. Addressing the issue is important, but it doesn’t have to be done in an ultra-serious way. Asking your child about high-profile suicides in the news, asking their thoughts, inquiring about their feelings and state of mind – these are all positive ways of addressing the subject.

The article also does a good job of explaining what to do if someone you know or love says that they have had thoughts of suicide. It notes that many of us have had those thoughts at some point, and that isn’t inherently dangerous. What is dangerous is if these thoughts are persistent, overwhelming or come with specific plans. That’s when more action may be needed.

So, the summary is this: Talk about suicide with your children or others you care about. Do so in a way that is factual and avoids glamourizing the issue, but in a caring and supportive way. This will not encourage the idea of suicide – indeed, it will help prevent it.

It’s important that we have these conversations with people we love, and do so without fear of “implanting” the idea of suicide. This goes for schools, parents – really, all of us.

Six medically backed treatments for depression – which make absolutely zero sense (part two!)

Earlier in the week, I published part one of this article – six medically backed treatments for depression which make absolutely zero sense. Here’s part two!

Warmth

According to a multiple studies, people suffering from severe depression found relief when their core body temperatures were raised. We’re not talking a fluffy blanket here, either: We’re talking a hardcore warm bath in temperatures reaching 104-degrees Fahrenheit. Incidentally, the more depressed someone was, the more likely they were to find relief, which could offer some hope for people who suffer from treatment-resistant depression.

Another study found that depressed individuals who had their body temperatures raised showed less depressive symptoms than those who had their body temperatures raised, but by a much lower amount. In other words, more heat made someone feel better. And the difference, according to the report’s write-up, was “dramatic” – not a word often used when describing depression treatment!

Does this mean warming up can cure all? No. Of course not. But it does show a promising potential cure, one that needs more study to be truly evaluated. But, there are more cures which are even more effective, such as….

Getting smashed in the head with an electro-magnet (Transcranial Magnetic Stimulation)

Allow me to introduce you to Transcranial Magnetic Stimulation, one of the goofiest (and potentially more effective) treatments for depression that there is.

Transcranial Magnetic Stimulation (TMS) is a type of therapy used for treatment resistant depression. What is it? Well, here:

In a nutshell, it involves being tapped in the head thousands of times (as many as forty over a ten second period) by an electromagenet. The electromagnet is supposed to wack you in the head in a region which corresponds to your brain’s center for mood control. As a result, your depression is supposed to increase.

Yes, this sounds terrible and painful, but it’s not, at all. I actually had TMS and absolutely noticed an improvement – one that decreased six months later, but is still there. Depending on a variety of factors (your own depression, insurance and availability), it’s a significant commitment. I had about 35 sessions over a seven week period. You sit down, get strapped in (again, not as bad as it sounds) and the tapping begins. The magnet hits you about 40 times over a four second period, then it rests for twelve seconds, and the cycle repeats for twenty minutes. Let me emphasize this: THIS IS NOT PAINFUL. I fell asleep repeatedly and texted my way through the other sessions. It’s kind of annoying and does take a session or two to get used to. It is also a time commitment: While you can miss a day or two, you can’t go on vacation in the middle of the session and expect it to still be effective.

Does it work? Yes. It did for me and I’m not crazy (well, I mean, I am, but that’s besides the point): Studies have found TMS having a success rate as high is 58% in terms of lessening symptoms, while other studies found that as 75% of people who had TMS reported that the benefits lasted for at least over a year.

That being said, if you’re looking for a treatment which smacks you less, allow me to direct you to our final item on this list….

Meditation

Breathe in. Breathe out. Focus on your navel. Feel better.

Really.

Meditation has gained a ton of prominence in recent years, and rightfully so: For as little as ten minutes a day, it’s been shown to reduce stress, lengthen your attention span, reduce memory loss and improve sleep, among many other positive changes.

And that works with depression too? Yep.

The most effective type of meditation for beating depression is mindfulness meditation, which is a specific type of meditation in which you sit still, calm down, and focus your mind on the present moment.

In a recent study of people with mild depression, people who underwent mindfulness meditation showed reduced rates of developing full-blown depression when compared to a control group.

Of course, that’s not all. A massive, systematic review of 18,573 citations on mindfulness meditation  showed that mindfulness meditation was moderately effective in treating pain and anxiety.

How does this work? Probably more than just one way. But, according to Dr. John Denninger of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital, Meditation trains the brain to achieve sustained focus, and to return to that focus when negative thinking, emotions, and physical sensations intrude — which happens a lot when you feel stressed and anxious,”

I mean, when you think about this, it makes perfect sense. Meditation can help you calm down, focus your mind and avoid negative thoughts. This isn’t a matter of just sitting still and being chill. Depression changes your way of thinking. Meditation can help make it right again.

Six medically backed treatments for depression – which make absolutely zero sense (part one!)

Depression is, without a doubt, one of the most miserable and common illnesses currently coursing it’s way through the world. And if I have to tell you this, you’re probably one of the lucky ones who has never felt a smothering blanket of pain and sadness squish the life out of you. If that’s the case, congratulations! You are not one of the nearly one in five Americans who are actively suffering from some sort of mental illness.

Depression is widespread and terrible. What’s being done to deal with it? On that front, there’s good news and bad news. With proper treatment, depression can be managed and cured. So, if you are one of the unlucky Americans who suffer from depression, there’s plenty of reason to hope: Therapy and medication can help you recover.

So, does that mean that these are the only options for treatment? Absolutely not.

A friendly reminder: I am a long-time depression sufferer, blogger and writer. So, should you make any changes to your treatment regiment based on the words that you read here? Absolutely not. Hopefully, this article can help you become more aware of a variety of treatments out there. However, do not, under any circumstances, change your medical treatment based on these words. You should never make any treatment changes without talking with a medical professional first. Traditional approaches – such as medication and therapy – unquestionably work – and I know because I take my medication every day.

That being said, there are a lot of ways which can help you fight depression, get healthier and feel better. They may not make sense. They may be counterintuitive. They may make you scratch your head and ask, “What in the world is fish oil?” (See item #2). But, every item mentioned below has serious, medically-backed research which shows that even the most depressed people can find some sort of hope in their own personal hell.

So….

Sunshine

Do you remember being down at some point in your life and someone screaming at you, “Get out of bed and go outside, you’ll feel better!”

They were right.

Depression rates go up in the winter. This is thanks to Seasonal Affective Disorder, which strikes people as a result of a lack of sunlight. It’s also more common as you go further north, as a result of colder temperatures and less sun. Your body’s natural circadian rhythm – your natural clock – gets disrupted when there’s less sun. This makes perfect sense, of course: You see sun, you wake up. You see dark, you sleep. And when that rhythm gets nuked, it can play havoc with your body and your mind.

Additionally, the lack of sun can cause your body’s production of serotonin and melatonin – two chemicals which are linked to a variety of mood disorders, including depression – to go haywire.

But, even if you don’t have SAD (which, not for nothing, is the most perfect acronym of all time), sunshine can help you fight depression. For everything said above about how darkness can cause depression, the inverse is also true: Sunlight can help fight it. Not only does it reset your body’s natural clock back on track and help produce serotonin and melatonin, but it helps stimulate your body’s production of Vitamin D – this, in turn, helps fight depression.

Don’t have the time to go outside? Live in an area made of dark, sad clouds (way to go, Connecticut)? That’s okay: Artificial light can help too. Light boxes (big, shiny boxes which produce a certain type of light) have been shown to be effective in fighting depression.

Fish Oil

Let’s answer this question first: What on Earth is fish oil? Because it sounds…well, it just sounds terrible.

Fish oil can be ingested in two ways: By eating fish, or by taking supplements. The reason it’s so good for you is because it contains Omega-3 fatty acids, and two in particular: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

For years, fish oil has been known to be effective in fighting a variety of ailments, including lowering your blood pressure and cholesterol, increasing heart health and reducing joint pain. But, one of the newly discovered benefits of fish oil? It helps fight depression. There’s no set explanation for how it works, but one theory is that taking fish oil – which is rich in the aforementioned Omega-3s – make it easier for serotonin to get into your cells, thus helping to combat depression.

However it works, there are studies out there which show that it does. A 2008 paper reviewed a series of metanalysis on fish oil and noted that it had a “significant depression effect”, while a 2017 paper found that multiple studies indicated that fish oil is effective in fighting depression.

Like everything in science, more study is needed. But this is real. Numerous papers show that fish oil can help you fight off depression. Of course, it’s not the only effective and goofy thing out there. This leads us to….

Anti Inflammatory Drugs

When you are depressed, your brain gets swollen. You read that right.

In this sense, your brain is like the rest of your body. When you are injured, the injury usually swells up. This is because white blood cells rush to an area to heal it and guard against infection, causing the wound to get bigger.

Depression works in a similar way. According to a study which appeared in JAMA Psychiatry, which found that severe depression can swell your brain by as much as 30%. Now, if this is something which occurs as a symptom of depression, that’s one thing. But the more important question is this: Can inflammation of the brain cause depression?

Yep.

Other studies have found that treatments which increase brain inflammation can cause depressive symptoms like a “loss of appetite, sleep disturbance, loss of pleasure” and more.

So, does that mean that anti-inflammatories can be used to treat depression? Again: Yes. According to a 2016 review of 20 studies, anti-inflammatories improved symptoms of depression. This doesn’t mean that you should run home and start popping Advils, but it does mean that if you’re struggling with depression, you should have a conversation with a medical professional about drugs which reduce inflammation.

But what if fighting depression could be even more simple? As simple as getting warmer?

New postpartum drug highlights continuing divide between the rich and the poor

Let’s start with the good news: For the first time ever, the FDA has approved a drug specifically designed to deal with postpartum depression (PPD). The drug is called Zulresso, and it is produced by Sage Therapeutics.

We know that PPD can be absolutely devastating. According to the article linked above, as many as one in nine women are hit by PPD. So the availability of a clinically successful drug designed specifically for PPD can be a godsend.

Now for the bad news: The cost and time period associated with Zulresso may put it far out of reach of many.

First, the cost: A whopping $34,000. That number might be slightly out of range for…you know, everyone not made of money.

As for it’s method of delivery? That’s another challenge: It has to be administered intravenously, over a 2.5 day period, in a certified clinic. That’s 2.5 days where a woman cannot work, cannot care for her baby (or the rest of her family). And let’s keep in mind, many women simply cannot afford to take 2.5 days off from work, and this is particularly true for hourly workers or those who are economically insecure.

Tragically – and unsurprisingly – women who need this help the most are also most likely to have this drug and its potential benefits out of reach. There are some women who are more likely to experience PPD, and unsurprisingly, in many cases, these are women who are more economically or socially vulnerable. These factors include job loss and a lack of other emotional, familial or financial support.

Simply put, this may mean that this new drug it is not an option for many. We know that tougher economic times – and tougher economic circumstances – lead to an increase in PPD cases. This treatment – both its costs and length of treatment – may be out of reach for many poorer women and their families.

To be clear, I’m not trying to poo-poo the potential success for Zulresso. I am trying to make a broader point though: Many areas of mental health treatment are, sadly, out of reach for the poorest among us. Hopefully, medical advances will continue to improve and make Zulresso’s life-saving benefits available for all women and families in society, regardless of their economic station in life.

The Parkland tragedy continues, as two survivors kill themselves

Originally, this entry focused on Sydney Aiello’s tragic suicide. I finished it early Sunday morning. And by Sunday afternoon, came to the tragic realization that it needed to be updated.

First: Parkland survivor Sydney Aiello died by suicide last week. The young teenager had survived the massacre at Stoneman Douglass High School, which claimed 17 lives.

According to Sydney’s mother, Sydney “struggled with survivor’s guilt and was diagnosed with post-traumatic stress disorder in the year following the tragedy. And while she reportedly never asked for help, she struggled to attend college classes because she was scared of being in a classroom.”

Like all Stoneman students, Sydney was affected by the tragedy. Like far too many, she lost a friend:

Sydney Aiello & Meadow Pollack

Sydney lost her “longtime friend,” Meadow Pollack, in the shooting.

Next: The second victim. On Sunday afternoon, news broke that a second Parkland survivor had killed themselves. It was a sophomore male, and he, like Sydney, shot himself. As I type this entry, much is unknown about this student, including his name. Unfortunately, the notion of a suicide contagion effect is very, very real – and it is highly possible that this is what we are witnessing here.

The ugly truth is that a trauma never ends when the bullets stop firing. There are always long-term after effects. According to a 2018 survey:

  • Nearly 22% of people who had been raped had also attempted suicide at some point in their life.

  • Approximately 23% of people who had experienced a physical assault had also attempted suicide at some point in their life.

  • These rates of suicide attempts increased considerably among people who had experienced multiple incidents of sexual (42.9%) or physical assault (73.5%). They also found that a history of sexual molestation, physical abuse as a child, and neglect as a child were associated with high rates of suicide attempts (17.4% to 23.9%)

  • People with a diagnosis of PTSD are also at greater risk to attempt suicide. Among people who have had a diagnosis of PTSD at some point in their lifetime, approximately 27% have also attempted suicide.

There is no easy, glib solutions here, but there are ways to mitigate suicide risk after a traumatic event. The American Psychiatric Association lists a few helpful ways to deal with a traumatic event, including:

  1. Keeping informed but avoiding over-saturation with an event.
  2. Learning about local resources and sharing that information.
  3. Remembering that you are not alone and talking with family and friends about your experiences.
  4. Remembering that anxiety and depression after an event are normal, and seeking help if this continue or if you become overwhelmed.

There is, as always, a relatively standard thread here: If you endure a traumatic event, seek help. You are not alone, you are not weak or foolish, and you didn’t deserve whatever happened to you. Therapy – or even just talking to someone – can make a powerful difference.

I have a tendency with these blog entries to take smaller events and turn them into larger points. That’s a conscious decision informed by my experience with mental illness. But I want to conclude this entry by making sure we don’t lose sight of Sydney Aiello or the second student, name currently unknown.

It goes without saying: Sydney and others affected by Parkland didn’t deserve what happened to them. It’s a human tragedy. But Sydney and her classmates spent much of their time after the shooting advocating for a better world. I hope that some good comes of this tragedy, and I hope it is done, at least in part, in memory of Sydney, this second student, and all those affected by this tragedy.