3 Unexpected Things Which Are Linked To Mental Illness

We all know that there are some things which correlate positively with mental illness: Stress, negative changes in economics, etc. But it’s more than that – and it’s some areas which you probably wouldn’t expect.

So, here are a three random items – well, seemingly random items – which are correlated with mental illness.

And a reminder straight out of Statistics 101: Correlation does not equal causation. Two items being linked doesn’t mean that one causes the other.

1) Air Pollution

I stumbled across this one while looking at the news, and it really surprised me, but here goes: Air pollution in children is positively correlated with worse psychiatric disorders, according to a study from Cincinnati Children’s Hospital Medical Center. The study also noted that already existing research had already established the connection in adults. So, as if we needed another reason to reduce air pollutions (besides all the asthma and death and climate change), here’s more. And, because life is deeply unfair if you’re poor, the study also found that the worst outcomes were reserved for kids who lived in disadvantaged neighborhoods.

2) Childhood infections

This one is, admittedly, not one I would have expected but when you think about it, it sort of makes sense.

According to a 2018 report, researchers in Denmark found links between certain infections and some mental illnesses, like depression, bipolar and schizophrenia. The theory here is that certain infections can activate the immune system. This, in turn, caused certain mental illnesses to set in.

This wasn’t a small study, either – it tracked 1.1 million Denmark children born over a seven year period.

3) Brain inflammation

I’ve actually discussed this one before, but there appears to be a connection between inflammation and depression. As noted in the link above, there is some research to indicate that anti-inflammatory drugs may be able to help reduce symptoms of depression.

Further research and writings have indicated that it is possible that inflammation is at the core of many physical and mental illnesses. As such, treating brain inflammation may be critical to reducing depression, anxiety and a whole array of other psychiatric disorders.

I’d actually argue that the brain inflammation one is the most interesting here. Why? Because the last article highlights just how much we know now compared to what we thought we knew years ago – and, of course, we will likely repeat that observation in the next ten years as well. What else will we learn? Will we be able to specifically engage in gene therapy to fight off mental illnesses? What kinds of treatments will evolve? It’s a fascinating question.

As always, I’d love to hear your thoughts in the comments below!

Work, Work Hours & Mental Illness

I have frequently discussed the importance of examining other real-life factors, such as economics and housing, as we discuss reducing mental illness and suicides. Well, here’s a great article on why: A new study directly ties shift work and varying hours to depression. From the article:

In particular, the study found, shift workers were 33% more likely to have depression than people who didn’t work nights or irregular schedules.

Shift workers also had a higher chance of developing anxiety, but in this case the difference was too small to rule out the possibility that it was due to chance.

Women appeared particularly vulnerable to the negative mental health effects of shift work, researchers report in the American Journal of Public Health.

Compared to women who worked consistent weekday schedules, women who worked nights or split shifts were 78% more likely to experience adverse mental health outcomes.

The article was based on a report which examined seven studies, totally 28,438 participants. It specifically blamed this increase in depression and anxiety to a disruption of sleep; the connection between a lack of sleep and mental illness has been well documented.

This, obviously, is not the only study which ties work challenges to mental illness – or economic trouble in general. When unemployment increases, so does depression and suicide. Increases in foreclosures and evictions are directly tied to increases in suicides, and states which increased their minimum wages saw slower growth in suicides than states which held their minimum wages even.

This goes back to one of the points I have hit on this blog and in my advocacy over and over again: Mental illness is not always about mental health. It’s myopic to make such an assumption. As we talk about reducing mental illness, we have to talk about increasing the social safety net, about making sure people can get good jobs for fair wages, about giving people a chance to recover from economic hardship. And yes, this unquestionably informs my politics.

The working poor are not more likely to have mental illness or die by suicide than the economically secure, but suicide increases in both groups when there is a change in economic status. We can’t necessarily stop someone’s economic situation from turning south, but we need to at least make sure that everyone has the resources in place to give them a chance to recover.


Stigma, Shame & First Responders

My mental health and legislative worlds frequently come together, but an article and what happened yesterday really made me blink.

First, the good news. At a hearing yesterday, the Pennsylvania House Veterans Affairs & Emergency Preparedness committee moved a bill of mine. HB1459 would give first responders more mental health resources. It would require trauma and mental health training, create a peer to peer mentorship program and mandate the creation of a toll-free hotline for first responders who are struggling with mental health issues.

I feel like legislation like this is more important then ever. Why? Stories like this, which report on the NYPD’s ongoing mental health and suicide crisis, and the unwillingness of some police officers to seek mental health help, despite the fact that they feel the need to do so:

In a new report, the Department of Investigation’s Office of the Inspector General surveyed officers who retired in 2016 and found that 25 percent of them reported going through a period of emotional stress, trauma or substance abuse that caused them to consider getting professional help.

But more than a third of those officers did not end up seeking assistance, according to the report.

Half of them expressed fear that the department would find out about their decision to seek support.

So, what do we do here?

First, there are internal things that I think the NYPD can do. Chief among them? Work to change the culture and attack stigma by sharing stories of successful police officers who have experienced mental illness, sought help, and thrived.

Furthermore, the NYPD must do whatever it can to stress the confidential nature of their programs. According to the report, 50% of people surveyed were worried about the department finding out about their illnesses, 45% of negative labels, and 39% afraid of being put on a modified assignment. As the NYPD notes, an “extremely small number” of officers do wind up having their weapons taken away, but they are given those back upon successful treatment. Treatment is confidential, except in cases where the officer in question may present a danger to themselves or others.

The second is broader: We need cultural change at a society wide level. When we discuss the importance of stigma when it comes to mental health, this is why. Stigma is more than just how people look at the mental ill, its how we look at mental illness within ourselves. Clearly, as cases like this demonstrate, a culture of machismo and an overabundance of self-reliance can kill. For reasons like this, we clearly must do a better job of reminding people that there is no shame in seeking help, and that in many cases, its the only way to lead a happy, healthy and productive life.

How To Support A Friend Who Lost Someone To Suicide

It goes without saying that when someone you care about loses a person they love to suicide, you want to do everything you can to support that person. That being said, survivors of suicide loss endure an array of emotions: Guilt and loss, fear and anger, confusion and resentment.

During that experience, you want to do whatever is necessary to help your friend through their trauma. But you want to do so in a way which is most supportive of them and respects their complex emotional needs.

That’s a tough balancing act. On one hand, you want to be there for them – checking in on them, calling/texting, asking if they need anything. On the other the loss can be exceptionally painful, and you want to respect the other person’s space while still making sure they know you’re there.

Walking that line can be difficult. Here are some tips on how to do it.

1) Have realistic expectations: Your friend is undergoing the worst trauma and pain of their life. You cannot make it all better. All you can do is be supportive and caring. Make sure you remember that in all of your interactions with your friend. When my friend lost her husband, I gave myself two goals: Be there for her, and make her laugh with the occasional terrible joke. If you can make a wounded person smile, even for a moment, you’ve done a good deed.

2) Check for professional advice: The American Foundation for Suicide Prevention has a great blog entry on how you can support someone who suffers a suicide loss, and their tips are extremely valuable. Among their advice: Be patient, don’t attempt to empathize (unless you’ve been through a suicide) and read up on suicide loss. Alternatively, if you have access to one, check with a therapist or other professional to get guidance about how to best approach the situation.

3) Follow their lead: The “how” of talking to someone who lost someone to suicide can be difficult. Follow their lead. If they look like they are looking for humor, engage. If they don’t want to talk, but appreciate your calls, tell them about your day. If they are too depressed to move, wrap an arm around them, bake them a cake and watch TV with them. Take your lead from the person in question and understand how emotionally volatile of a time it is for them.

4) Be explicit with your friend: “I will text you every day to say hello, see how you are doing, and ask if you need anything. If you want me to stop, say the word and I will.” Tell your friend anything and everything you are prepared to do. Be specific: Offer to cook meals or do the laundry. Just make sure the person knows you are there. Even if they don’t seem like they appreciate it, I bet they do.

5) Don’t ask questions: “How did they die? Was it suicide? Were they depressed?” It’s a human impulse, but the answer is absolutely, positively none of your damn business, unless your friend decides to tell you what’s happening. Then, and only then, is it appropriate to ask questions, and even then, use restraint and caution. Remember, your goal is to alleviate your friend’s pain, not get your own curiosity satisfied.

6) Don’t spread rumors: Shut. Up. Keep what you learn in confidence. Don’t discuss anything you haven’t been specifically cleared to discuss. In some cases, your friend may want other people to know. In others, they may desire privacy. Whatever your friend wants, respect it. Remember, it’s not your story to tell.

7) Check with people closer: If you’re confused about how to behave – should you call/text, do they want flowers, should you cook a meal, etc – check in with someone closer. There may be closer friends or family in a less emotionally fragile state, and if that’s the case, you can get some additional guidance. When my friend lost her husband, I texted her best friend to ask if it was alright for me to be regularly texting and checking in. The friend confirmed, and I continued.

8) Don’t stop when the immediate crisis is over: In the immediate aftermath of a suicide, the world swarms. Then the funeral happens, and too many people forget. Don’t be that person. The wounds will last a lifetime – don’t let go of your friend. Don’t stop checking in. The pain will remain – make sure your support does as well.

For those of you with additional experience in this realm, I really welcome your feedback for all of us. If you’ve endured such a loss, what did your friends do right? What did they do wrong? What did you want the world to know that they didn’t?

Thanks for reading. I hope if was helpful.

5 Things Every School Should Have to Help Students with Mental Health

The trends are painfully, tragically clear: When it comes to the declining state of mental health in America, it is our youth which is suffering the most. Rates of depression and anxiety are on the rise in a big way. Suicide rates are increasing across the board, and that trend is hitting our youngest the hardest. Suicide is now the 2nd leading death for those aged 10-34.

Clearly, more needs to be done in terms of helping our youngest battle their mental health demons and become strong, resilient adults. I will not pretend to have all the answers. But I think I have some pretty good ideas on how we can do a better job. To that end, here are 5 things every school needs to help their kids be mentally healthy and strong.

Adequate Psychological Services

The number of counselors which are available in our schools is tragically low. Available statistics recommend that there be one counselor for every 250 students. The actual number is more like 1 counselor to every 482 students. Pay and workforce development have a lot to do with it, but this is also reflective of competing priorities at schools, which are forced to spend more money to deal with other pressing issues. Simply put, we need to actually give schools the money to actually deal with these problems and protect and help our students.

Mental Health Education

I mean this in two ways. First is the obvious: All students should be taught more on mental health, recognizing symptoms of mental illness and what mental illness really is. This should go hand in hand with physical health, as far as I’m concerned.

I’d also argue that kids face more pressures and many are becoming less emotionally resilient. This means that they are less able to cope with the pressures of today, and as a result, becoming more mentally ill – and all this at a time when the pressures upon them are dramatically increasing.

So, what does this mean? We have to teach our kids how to cope, build resiliency and support their friends. I also think we have to teach digital education as much as we teach about other social influences, like peer pressure. This means that kids need to understand that what they see in the digital world isn’t what is happening in the real one.

Ways to Report Problems

Too many kids see problems in their friends but don’t know where to turn, particularly if it means getting a friend in trouble. As such, we need more ways – preferably anonymous or digital – which give kids a safe space to send troubled friends.

In Pennsylvania, we recently unrolled the Safe 2 Say text line. This program, run by the State Attorney General, allows for kids to report when there are threats of violence or mental illness among their friends. Even as early as April, the program was an overwhelming success, stopping violent acts and suicides.

Anti-Stigma Campaigns

Anti-Stigma campaigns which encourage kids to seek help and care for themselves are necessary. Younger generations have done better than older ones have at recognizing that mental illness is serious and treatable, but we still have a long way to go. Multi-media campaigns and speeches featuring ordinary Americans can help to address this stigma, and these kind of public awareness campaigns should be conducted in a culturally appropriate way which allows for students to recognize the severity and treatability of mental illness.

Improved Teacher and Staff Training & Resources

Last – I think we need to do a better job of helping teachers recognize the symptoms of mental illness, and then assisting them in handling it or getting kids help. Teachers are often asked to do quite a bit, but aren’t given the time and resources to handle their overwhelming responsibilities.

I’d also argue that all the training in the world won’t mean a thing if we don’t give teachers the resources to prevent mental illness in the first place, or at least create situations which don’t exacerbate the symptoms of mental illness. What does this mean? Easy. Create manageable class sizes. Allow teachers the space and flexibility to teach in a manner which will engage their kids. Stop with this obsession with standardized testing, and allow for kids to learn at their own pace and subject matter which interests them. I’ve said it a million times and I’ll say it again: All of this stuff is connected. Here are some great examples of how mental illness and education are linked. And if we acknowledge that to be the case, we can try to fix some of the deficiencies within our system.

And, as always, I know I’m missing stuff. But what? I’d love to hear your thoughts. Let us know in the comments below!


More Than Stigma: Shifting the Nature of the Conversation Around Mental Health and Suicide

Advocates for suicide prevention and mental health often talk broadly about “the stigma” which surrounds mental illness and suicide. Many of us – myself included – believe that if we can just get more people talking and thinking of mental illness, if we can have people discussing their issues with depression, anxiety, addiction and more without shame or fear, we can help to put an end to this epidemic. I firmly believe that this is the case.

I also know its not enough.

And that’s where the conversation around public policy, resources and taxation has to come into pay.

I happened to catch a fascinating column on mental health the other day – I obviously can’t find it now, that would be too easy, but the column made a great broad point: Ending mental health stigma is like cutting holes in a wall, but then there’s nowhere to go because our system of mental healthcare is so broken in this country.

Many of us concentrate our efforts on stigma for a couple of reasons. I think it’s one of the most important things that we can do. But let me expand on the second part of that sentence: That we can do. People do need to know it is okay to seek help and to treat themselves. They need to know that these issues are real, powerful and can kill you. But, as any studies have shown, individual conversations are the best way to break mental health stigma. A face to face talk can make a huge difference in that area. That means that, without question, the most important person to ending mental health stigma is you.

Second, it’s the easiest.

Making society-wide change is really hard, of course. Particularly in areas where colossal interest groups are at play. I’m an elected official – theoretically one of the people who makes state-wide decisions in Pennsylvania – and I fully understand just how difficult this can be.

And the simple truth is that we must make systemic changes to help reduce rates of mental illness and suicide.

From a mental health and suicide perspective, there’s an awful lot that needs to be done. This includes increasing access to mental health care, increasing the number of mental health care practitioners and addressing the mental health care practitioner shortage, reducing costs, enforcing parity in insurance care, reducing access to deadly means of suicide and more. And that’s to say nothing about the major societal problems that we face which contribute to mental illness and suicide, including improving housing options, strengthening the social safety net, increasing the minimum wage, making housing more affordable, etc.

Many of us tackle stigma because we can’t get at these issues. And stigma is something we can control.

So, what does that mean? Should you stop talking about mental health stigma? Hell no. Of course it’s vitally important, but it’s important in more ways than you think, because the more you discuss mental health, the more pressure you can bring on policy makers to address the fundamental inequities and gaps in our system which allow for mental illness to run so rampant. Keep fighting.

But make sure you fight in a public policy realm, in addition to addressing individual changes. Tell policy makers and elected officials that you expect them to do more to address rates of mental illness and reduce suicides. These issues require government intervention, and that requires public pressure. Please help make this happen.


Medication is Not Addiction: A response to a misinformed column

I spent way too much time on Sunday on Twitter, joining a chorus of voices who were yelling at David Lazarus, a columnist or the Los Angeles times. Lazarus wrote a column in which he discusses his own experience at trying to withdraw from anti-depressants. The title of the column? “Hi, I’m David. I’m a drug addict.”

Yep. Only went downhill from there.

Ironically, Lazarus discussed important issues like the over prescribing of medication, failure to adequately warn patients about side effects and discontinuation syndrome. These are real, important issues. They merit serious, thoughtful consideration. Instead, Lazarus decided to call millions of Americans (like me) drug addicts. He esoterically wondered “Who am I, really?” about taking anti-depressants. It’s a tragic, misguided view, one which reinforces stigma and will prevent people from getting help they need. And the language used by Lazarus is just appalling. If I’m a drug addict, so is everyone else who uses medication to survive for any other condition.

Really, this is just an ugly article.

I wrote a response which the Los Angeles Times did not accept, citing their policy to not run op-eds in response to other op-eds. Fair enough. My response, then, is below.

Don’t believe crap like what Lazarus decided to spew. Medication can be a vitally important part of any therapeutic regimen. It has saved thousands of lives.

Let’s say you are a diabetic and require insulin to live. One day, a friend tells you to quit insulin. Stunned, you ask why. Your friend responds: “Well, you can’t live without insulin. That makes you a drug addict.”

That’s absurd, right? Taking a prescribed medication in recommended doses doesn’t make you a drug addict. That makes you a responsible adult.

But the above scenario would never really happen, right? No one would ever claim that taking medication to treat diabetes, Parkinson’s or Alzheimer’s would make you a drug addict.

But, apparently, such an understanding does not apply to the millions of Americans who take medication to manage mental illnesses. To Americans like me.

For eighteen years, I’ve been diagnosed with a major depressive and generalized anxiety disorder. I’ve been suicidal. The medication which I take, in conjunction with therapy and lifestyle changes, has saved my life.

About five years ago, I made the decision, as a Pennsylvania State Representative, to start discussing my battles with depression, anxiety and suicidal ideation. I did so in response to the stigma which surrounds mental illness. Depression isn’t a weakness. It can’t be willed away. Taking medication doesn’t say anything about one’s character any more than having heart disease indicates a moral failure.

That’s why I was so disheartened to read Mr. Lazarus’ column: It took serious issues like over-prescribing  and discontinuation syndrome – issues which deserve thoughtful, reflective discussion – and conflated them with drug addiction. To be sure, medication is not a panacea. It often takes months, if not years, to find appropriate medication and dosage. Prescribers sometimes fail to appropriately monitor their patients. Side effects are real and dangerous. All of these issues demand thoughtful consideration and conversation.

However, such problems exist in virtually all areas of medicine, and no one would reasonably or seriously suggest that we should stop prescribing scientifically proven medication to people in need. Yet, that is exactly what some suggest when it comes to mental health.

Mr. Lazarus refers to himself as a “drug addict” for taking anti-depressants. Yet, he also discusses being a diabetic who takes medication for chronic Type 1 diabetes. Strangely, he declines to refer to himself as a “drug addict” for requiring insulin to manage his blood sugar levels. I wonder why.

We should never, ever be so foolish as to conflate appropriate use of anti-depressants with drug addiction. To do so makes people who take anti-depressants to live sound like sound like a caricature of a drug addict, desperate for their next hit of smack…or, as I like to call it, the pills which help me not want to kill myself every morning.

Contrary to what some believe, anti-depressants are not happy pills which whisk you away on a cotton-candy cloud, carrying you to Lollipop Island to float with gumdrops all day long. What they do is help you control symptoms, improve your mood and make other forms of change – like psychological therapy and lifestyle changes – easier to obtain.

Taking medication for mental illness doesn’t change who you are. It allows you to be who you are.

Far too many Americans have ignored their own minds and medical advice, choosing to try and “tough out” spells of depression, to “man up” or ignore these painful and rehabilitating symptoms. Too many Americans have powerful fears that taking anti-depressants makes you weak. This stigma must be crushed and rebutted in the same way intelligent society has pushed back on those who attack vaccines.

Anti-vaxxers and those who deny the positive impact of anti-depressants are flip sides of the same coin: They seek to use pseudoscience and stigma. Science has given us incredible tools which can be used to our great physical and emotional benefit. To ignore those tools, or to somehow wrap their use in shame, serves only to pull us into a darkness which we should have left behind decades ago.

The nearly 1 in 5 Americans who suffer from mental illness – including me – deserve to have our challenges discussed with respect and a comprehensive understanding of mental health treatment options. This discussion is simply incomplete without discussing the importance, effectiveness and risks of medication. No one who takes an anti-depressant is a drug addict, any more than a person who takes Prilosec for heartburn is addicted to not having their chest feel like is on fire.

The facts are stark. Depression rates are skyrocketing, rising sharpest among today’s youth, who have seen nearly 50% increases in rates of depression. 47,000 Americans – and 2,000 in my home state of Pennsylvania – died by suicide last year, an increase of 34% since 1999.

We need serious, sober conversations about mental illness and how to treat it. There are many concerns with anti-depressants. These are valid, serious concerns which must be addressed. But these conversations must occur using words and arguments which shatter stigma and support science. To do otherwise does an incredible disservice to those of us who suffer.


Rural America is in huge trouble when it comes to suicide

This study – and the subsequent reports – paint a stark and brutal picture for rural America. They also paint a devastating picture when it comes to suicide.

First, the study itself, as published by the Journal of the American Medical Association. The study found that suicide rates had increased 41% among those aged 25-64 between 1999-2016. The greatest increase occurred in rural counties.

The abstract of the study attributed the rise to underemployment, poverty, low incomes lack of health insurance and the presence of gun shops. It also noted that less social contact, more single individuals, unmarried individuals and veterans also had higher rates of suicide – and these individuals were more likely to be in rural counties than urban ones.

These numbers are brutal. For the sake of this blog entry, I’ll make two broad comments about addressing these issues, one which deals with public policy and one which deals with our society as a whole.

First and foremost, when it comes to governance. Folks, government needs to do more. We need a more robust, active and flexible government when it comes to preventing mental health, unless we are comfortable with massive spikes in mental illness and suicide. Government needs to do more at providing mental health resources for rural America. We need to make transportation easier, or increase access to mental health help via telemedicine. We need to become more involved in creating a social safety net. And we need to do a better job at limiting access to guns. These are all important things to do. They are also politically difficult. And they still must be done.

Secondly, the broader, societal conversation about this. The study reiterates something which has been discussed before – contentedness leads to a decrease in suicide, and being disconnected from others increases suicidal risk. Rural America, by its very nature, can be socially isolated – and, as such, faces an increased suicide risk.

This speaks to a broader problem. Obviously, there are a slew of governmental and public policy changes I would make if I had the magic wand which would change policy in such a broad way. However, all the pubic policy changes and health insurance in the world will not stop this mental health and suicide crisis we are in. Don’t get me wrong, it can make a major difference, but we can’t truly stop suicides without changing society. Our increased pace of life, less time for actual conversations, economic stress – they are all leading to increases in mental illness and suicides. That’s because human connection and conversation are protective factors – they make us feel better. They make us less likely to die. And I think that’s one of the reasons why urban America does better than rural America when it comes to suicides – urban environments promote more social atmospheres.

As always, this one is above my pay grade. I can make comments about public policy, but changing society is well above what my brain can handle. Your comments and thoughts are appreciated, as always!


The news isn’t completely terrible: 3 Reasons to be hopeful in our ongoing mental health crisis

I’ve written a lot about just how bad things are in the universe of mental health. Rates of depression and anxiety illness are rising, particularly among our youngest and college students, and suicide rates are hitting highs which haven’t been seen since World War II. This, of course, is terrible.

Still, life could be a lot worse when it comes to the mental health universe. Here are three reasons to be hopeful in the long-run.

Stigma is decreasing

According to multiple articles, the stigma which surrounds mental health is slow decreasing, but particularly for those who are younger. Many in a younger generation view seeking therapy and getting help as normal – as such, they don’t hesitate to do so. All of these articles note – correctly – that will still have a long way to go before we can consider stigma to be truly “defeated,” but it is worth noting and celebrating that significant progress has been made. Furthermore, the slew of celebrities who have openly discussed their own struggles has furthered humanized the issue and made others realize that suffering from mental illness doesn’t have to hold you back.

The Affordable Care Act is Helping People Get Treatment

The ACA – or Obamacare – has been subjected to no shortage of controversy. However, some things about it are indisputable. One such example is that more people are getting the mental health treatment that they need and deserve – and that they are getting better. ObamaCare required that all individual and small coverage plans offer mental health care, and that the coverage of mental health be similar to what it was for physical coverage. This alone has helped to increase the amount of plans which offer mental health care. The percentage of young people without health insurance dropped from roughly 22% (2013) to 13% (2016), and since young people were more likely to first experience a mental health challenge, this meant that more people had access to the care that they needed.

There’s more, of course. States which expanded Medicaid saw sharper decreases in mental illness than states which hadn’t, resulting in more care, more treatment and a lower financial burden.

There is no doubt: ObamaCcare has helped those with mental illness.

Social Media Has Tremendous Potential For Good

Alright, so I’ve been a bit harsh on social media in my time as a blogger in the mental health world. Just a bit. But it really isn’t all bad. Social media has the potential to be very helpful – and indeed, has been very good for mental illness…if used properly.

Social media, even if it’s just digital, can help promote a sense of connectedness. Sufferers of various mental illnesses can connect with more people and find the assistance that they so desperately need. If it’s users are mature enough, they can provide goals to aspire to and help to push creativity. By keeping users abreast of social opportunities and events, it can help maintain social relationships.

Indeed, for all of the negative press which social media has gotten on mental illness, there is at least one study (which examines adults, not just college or high school students) which shows that it can be positive and result in less psychological distress.

All kidding aside, I think social media can be good for metnal health…but requires literal mental training that I don’t think we possess as of yet. People have to use social media to supplement their social life, not supplant it. They need to recognize that it’s a curated form of life, not real life. And they need to remember that they have plenty of things to feel joyful and proud about, and to not feel jealous of what others put on their newsfeeds. That can be a real challenge, to say the least!

As always, I’d love to hear your thoughts. What else has been good news in the world of mental illness? Let us know in the comments below!


Means Matters: Why conversations about reducing access is so important – with a very personal example

I came across this very insightful article on three methods of suicide prevention the other day. If this is an area of interest to you, I highly recommend you check it out. Anyway, one of the many things the article discussed was the importance of reducing access to deadly methods (or means) of suicide. The article made some points which I’d barely or never heard. In Sri Lanka, suicide numbers absolutely tanked after common types of pesticides (which were also common suicide methods) were banned. Suicide rates also dropped in England and Wales in the 1960s when domestic gas was switched to a formula with less carbon monoxide, and when more restrictions were placed on sedatives in Australia during the 60s and 70s.

From the article:

Those early observations are backed by a growing body of research that counters the popular misconception that people who attempt suicide once will keep trying, through whatever means necessary. The reality is that those in the grip of a suicidal crisis often can see only one way out—and if that route is barred, they’re unlikely to turn to another, says Jill Harkavy-Friedman, a clinical psychologist and vice president of research at the American Foundation for Suicide Prevention (AFSP) in New York City.

In my legislative career, I was able to get an amendment passed to a bridge reconstruction bill which required that the Pennsylvania Department of Transportation consider adding protecting fencing to suicide hot spots during reconstruction or bridges or other high points. This was done for the exact reasons listed above – means reductions.

It seems as if every community has that place which is known for suicides – in Allentown, my home, it was the 8th Street Bridge. We lost one person every 1-2 months from that location. Then, during reconstruction a few years ago, protective fencing was added – and we haven’t lost a person at that spot since.

This is why there are so many legislative initiatives to reduce gun access for suicidal people via Red Flag laws. I don’t want to get into a debate about gun control, but the science on this issue is clear: Having a gun in a home is more likely to lead to suicides.

For those of you who are lucky enough to not understand, on an emotional level, what it is like to be depressed or suicide, allow me to try to explain. When you’re depressed, you are more than just sad or tired or miserable. Depending on your exact mood or the exact moment, you lose the ability to think clearly. Furthermore, depression isn’t a constant state – like any other emotional feeling, it ebbs and flows. There are moments it is manageable, and then, ten minutes later, you forget your wife, your kids, your loved ones, your career, your successes…you just want to end the pain. And in a bad moment, with the right triggers, yeah, you may grab whatever is easily accessible. If deadly means are available (and guns are the deadliest – 85% of all suicide attempts with a firearm result in a completed suicide), that may be the moment where you end your life.

My worst moment was in college. It was Freshman year, a few weeks back into my 2nd semester. I was a few weeks into anti-depressants for the first time in my life (which can be a moment where suicide risk increases – something I wish I had known then) and had just been rejected by a girl (appropriately on her part, as I wasn’t in a mental state in which I could handle a relationship at the time). The first semester had been a disaster for me – it resulted in an explosion of depression and anxiety attacks, my first time seeing a counselor, and my first experience with anti-depressants.

The night I got rejected by this girl. It was two in the morning or so, and I called my ex-girlfriend (who I was very close with, and in a complicated relationship with), crying. And in my hands, I had a bottle of my new anti-depressants and a glass of water. And I asked her why I shouldn’t end my life then and there.

I feel terrible about that moment. It was such an unfair burden to put on a 16 year old young woman. But she handled it gracefully and like someone with maturity well beyond her years, and she got me to put the pills down, and as I recall, refused to get off the phone with me until I got into bed. I think she actually had the number of our campus safety but couldn’t find it at that moment. And I think I fell asleep with my phone in my bed that night.

The purpose of this story isn’t just to thank my ex (though, as long as I’m on the subject, thanks very much!), but to prove a point. That moment was the worst in my life. That’s the closest I’ve ever come to suicide: Staring at a bottle of polls, and a glass of water, and wondering.

And I can’t help but wonder what would have happened if I’d had a gun. Because getting through that moment – and it was just a moment, a bad one, but not one to be repeated – gave me my life. My wife, my kids, and decades of joy and hope.

Means matter. Access to deadly means matters. And efforts to reduce suicide must incorporate means reduction. Doing so can help get a person through the most difficult moment in their life. And that may save a life.