Morning, everyone, and hope you are having a weekend!
As I continue to build this blog, I’m looking to build other resources with similarly-minded blogs. I’ve found some great ones, and if you have one to add – including your own – please let me know! I’m looking to build a nice Blogroll, and would love to trade links with those of you who are interested!
Any good blogs for me to link to? Please leave your thoughts below.
Have a good one!
Earlier this week, I had the good fortune to attend Pride in the Park, the Lehigh Valley’s annual LGBT festival. I always bring the family and it’s a blast; it’s interesting, has great vendors, good food and is a great time for the kids.
On our way out, I commented to my wife that everyone at the event always seemed so happy, and how relaxing it must be to attendees to be in a place where you know no one cares who you are. My wife corrected me: Everyone cares. Period.
This reminded me of a tragic reality about mental illness in America: If you are a minority, you are more likely to be mentally ill, and less likely to be treated.
Before I go into the statistics, one caviet: “Minorities” is a broader term than you think.
African-Americans
African-Americans make up 13.2% of the U.S. population, and 16% of those have a diagnosable mental illness. However, the disparity is striking. African-Americans are 20% more likely than whites to say they suffer from serious psychological issues. They also feel worse, in terms of sadness, hopelessness and worthlessness, than whites. Stigma-related attitudes are more likely to be held by African-Americans than whites, and cultural competency amoung mental health providers remain a real issue. Perhaps most significant: 15.9% of all African-Americans are uninsured, compared to 11.1% of whites.
LGBT Americans
LGBT Americans are three times as likely to suffer from mental health conditions than the rest of the general population. According to the National Alliance on Mental Illness, much of this is due to “minority stress,” including, “social stigma, discrimination, prejudice, denial of civil and human rights, abuse, harassment, victimization, social exclusion and family rejection.” Suicide is also a major issue within this community, with suicide for LGBTQ Americans aged 10-24 being described as “one of the leading causes of death.” LGBTQ individuals are four times as likely to attempt suicide than the general population, and 38-65% of transgender individuals experience suicidal ideation.
Rural Americans
Clearly, rural Americans are different than some of the other groups here. But, that doesn’t change a central fact: They have similar challenges when it comes to mental health than many other groups. Rural Americans have roughly the same rate of mental illness as the rest of the population. However, poverty is higher in many sections of rural American, and stigma presents a huge cultural barrier to seeking care. Additionally, rural Americans have problems with accessing care due to practitioner shortages and transportation issues.
American Indians
This is astonishing: The suicide rate among males, aged 15-24, who are American Indian or Alaskan Native, are 2-3 times greater than the suicide rate for whites. Additionally, 21% of all Native Americans had a mental illness over the past year, and they experience psychological distress at a rate 1.5 times more than the general population. High levels of poverty, a rural location, poor transportation and low rates of health insurance (33%!!) all lead to low treatment usage.
There is more, but these were just some of the low lights.
I don’t want to necessary explore this from a policy perspective – at least, in this entry. I’d rather approach this from the personal perspective. In this sense, I suppose I am lucky; I’m a white, male, young adult, whose only claim to any sort of minority status is that I am Jewish. That being said, I cannot imagine how difficult it must be – to be a member of one of these communities and have your ability to get and receive care be compounded by factors beyond your control and things that shouldn’t make a difference anyway.
Now, to ignore what I just said: Speaking a a policymaker, it’s pretty clear that there is no one size fits all approach to ending mental health disparities. A ton of factors play a part, including access to care, stigma, availability of practitioners, cultural competency, discrimination and more. Mental illness is a huge problem, and an under discussed one. I suppose that’s why I’m blogging and lending my name to this effort.
We have to do better.
Alright, let me start by admitting that I really debated writing this one. I’m a politician, and a pretty progressive/Democratic one at that, so as you can imagine, I am pretty much diametrically opposed to…err, everything Donald Trump stands for. As a result, the last thing I want to do is to be accused of “bringing politics” into a mental health discussion, something that I legitimately think happens too often. I’m going to do my best to stick with legitimate, reputable sources as I discuss this issue, and try to approach it from the most objective angle possible.
The short answer to this question is yes, the President of the United States can be damaging your mental health. That, of course, depends on a variety of factors.
Let’s start in my favorite place, Twitter:
Well, that was stressful. And yes, there are plenty more. I will say that, in my personal life, I’ve repeatedly joked that this election turned me from an elected official into a therapist: I can’t tell you how many people I’ve spoken with who are suffering from Trump-related anxiety.
In the immediate aftermath of the election, 24/7 crisis lines found themselves overwhelmed with calls from frightened individuals. Then there is this Daily Dot article, which led with the subtitle, “If you’re a liberal with a history of depression or trauma, this presidency could be more damaging than you thought.”
Well, crap.
From the perspective of a therapist, there’s no doubt:
Several patients with histories of sexual abuse and self-image concerns told me that they experienced significant increases in anxiety. One reported that the constant news coverage triggered memories of her past sexual abuse, and another suffered frequent crying spells and difficulty sleeping.
Quoting multiple therapists and psychiatrists, the article notes that many clinical professionals have had patients tell them that they are experiencing additional anxiety, worry and depression as a direct impact of Trump’s rise to the Presidency. This effect is particularly pronounced for members of threatened classes, such as people of color, the LGBT community or other religious minorities, many of whom are already more likely to suffer from mental illness.
Then there is this survey, conducted by the website CareDash. The data below is copied directly from the survey:
Another survey, conducted by the American Psychological Association, found that 52% of Americans believed the 2016 elections were a very or somewhat significant source of stress in their lives.
It seems pretty clear: Yes, Donald Trump has had a negative effect on the nation’s mental health.
So, all of this begs the question: What can you do if you are suffering from Trump Anxiety?
This Lifehacker article and this article from Psychology Today lay it out pretty nicely: Don’t just worry. Channel that worry into something real and tangible.
The elections, and the aftermath, have been extremely stressful to some. If you are one of those people, know you aren’t alone. If you aren’t, I hope this entry gave you some perspective: There are real people who are truly suffering as a direct result of the election and its aftermath.
As always, I’d love your thoughts in the comments below!
For reasons that I will inevitably wind up discussing more in-depth later, this is a topic that I am very interested in. After all, there is no doubt about it: So much of our world is informed by our media, including fiction books. Major pop culture phenomenons – books like Harry Potter and The Hunger Games, for instance – wind up having a major impact on a whole slew of societal attitudes, everything from the names of our children to the hobbies we play.
Of course this extends to serious issues, like mental health. As I sat, thinking about this entry, I came to the realization that I cannot think of too many books I’ve read that explicitly feature stories about characters who feature mental illness – even when the book is potentially about something other than mental illness. This is important from a stigma perspective: I think it is vital that readers hear stories about people with mental illness living a successful life, despite their challenges.
Now, please don’t misunderstand: Just because I haven’t read them doesn’t mean they aren’t out there. A very quick Google search reveals no shortage of books that discuss exactly this topic. And, indeed, many of these books touch of mental illness in a more tangential way.
Two young adult books that I’ve read immediately come to mind. One is Fangirl by Rainbow Rowell, which discusses a young woman moving to college and dealing with a slew of pressures, then finding therapy in her writing. Another, Anthem of a Reluctant Prophet by Joanne Proulx, features a character who clearly is struggling with depression and anxiety, even though it goes unspoken throughout the novel.
I’m coming at this from the perspective of Young Adult novels, which I must confess, I still enjoy (a quick look at my Goodreads page will confirm this!). But, from the perspective of mental illness, there is an important reason for discussing this genre in particular: 50% of all mental illness starts at age 14, and 75% by age 24. If this issue can be addressed early enough – particularly during it’s onset – it can make a big difference.
I suppose my point is this: As best I can tell – and, again, admittedly, I could be wrong, please correct me if I am – it seems like mental illness in fiction is addressed in one of two ways:
Don’t get me wrong, neither of these things are necessarily bad in and of themselves. I’m just having this conversation from a stigma perspective. The first option listed above can be problematic and fail to fully address a characters illness, which can lead to misguided perceptions about the way that mental illness works. The second option can be good, but it, too, can make people think that mental illness is somehow more debilitating than it truly is.
Also, please understand, I’m not criticizing any author or book. Many of the ones that deal with mental illness – directly or indirectly – are powerful, and it’s not possible or fair to be critical of an author simply because they don’t address a particular issue in a way I want to see it done.
That being said, from a stigma perspective, that’s what I’d love to see more of.
Any thoughts to add, or books I am missing? I’d really love to know – if only to read them! Please let us know in the comments.
One of the things I have certainly struggled with in my personal life – and I think one of the things that many people don’t realize – is what depression truly is. I saw this image ages ago in my Facebook feed, and I think it sums it up personally:
This is so, so accurate (except for the Mario Kart part – I got nothing there) and I say this based on more than just a viral image. According to the DSM (Diagnosis & Statistical Manual, the official way in which mental illnesses are diagnosed), the following five symptoms are indicative of a Major Depressive Disorder:
The first item is specifically about depression and feeling sad. The rest are most definitely not. And it’s important to note that everyone experiences depression differently, and at different times. For some, sadness is the overwhelming emotion. For others, it’s complete anhedonia. These emotions are felt in different ways, at different times.
I write about this based on my own experiences. I’ve found that, when I am going through a rough patch, it isn’t often led off by sadness – usually, I start with insomnia and a loss of appetite – I always lose weight when I am depressed. Things usually go downhill from there. Not for nothing, but those two symptoms are often the canaries in the coal mine. I work out a lot so I’m almost always hungry, and if I don’t want to eat, I almost always wonder if something is wrong. It’s amazing, the way depression sneaks up on you like that…it comes out of nowhere and starts to nibble at your mind, before you are even aware of it….
My point is this: It would be foolish to assume that depression is just depression. It can be experienced as an entire series of symptoms, many of which have nothing to do with feeling sad, and all of which can easily be confused with something else. I draw some comfort from this – there is nothing “wrong” with me – well, besides the obvious, haha.
I’m really curious to hear from others. Have you experienced depression in some other way, including those not listed here? Let us know in the comments!
On my drive home today, I was listening to a podcast called Everybody’s Fucked Up, a podcast by two video game developers who have both struggled with mental illness. One of them, Tessa Vanderhart, discussed how one of the best things she discovered in therapy was that it helped teach her that no one who suffers from mental illness is truly alone.
That reminded me of a story from when I first got to college, and when my own depression really exploded. It was the 2nd or 3rd day of school, and I am completely freaking out. I still remember everything about it: It was a gorgeous, late August day. I was sitting on the steps just outside of my dorm, on my oversized cell phone, talking with my Dad. A group of girls walked by, and they were laughing and smiling. I knew one of them from high school, and she waved at me. I sheepishly waved back – my face was obviously tear-stained. I had been balling, homesick, can’t adjust, I am convinced I had no friends, it’s never gonna get any easier, I want to go home, all that good stuff. Anyway, I’m on the phone with my Dad, telling him how I was sure I was the only one who felt this miserable, because, after all, I didn’t see anyone else who was as upset as me. Exasperated, he responded, “Of course you don’t! That’s because they are all in their rooms, crying like you!”
He was right, of course. I later found out that .5% of the kids in my class actually dropped out the first weekend because they just couldn’t handle being away from home, and that says nothing of the kids who were just struggling like me. But, that story actually illuminated a bias that I’ve found still remains when it comes to mental illness: Far too many people think that they are truly the only ones suffering, because they don’t see anyone else.
Nothing, of course, could be further from the truth.
I want to give you two statistics on mental illness and try to personalize them as much as possible. A quick look at the literature shows:
One of the bad things that researchers and politicians have a tendency to do is to talk in the abstract, to talk in big, global numbers, and not give those numbers any context. Sure, 43.8 million Americans sounds like a lot, right? What makes even more of an impact is a personal one – a friend, a colleague, a classmate, a coworker. This is even more important for people who suffer from mental illness – we are more than just a number, and it’s important that we be seen as such.
When you think of mental illness, or when you think of your own mental illness, one of the hardest things to remember, sometimes, is that you aren’t alone. As you sit in your bed crying, or at your desk, wondering how you are going to get through the day, or scrolling through your Facebook newsfeed in a desperate effort to take away your pain, you have to try to remember that you aren’t the one suffering. There are millions upon millions of you – of us – that share your pain at any given moment.
Try to remember that, and try to let that thought give you some comfort – you aren’t the only one.
I think that one of the worst things that I’ve found in dealing with depression is the hopelessness that comes with it. One minute you’re fine, and the next, you’re…not. Medication and therapy help, but depression is a chronic condition. It comes back. And while you can limit it, manage it…it still comes back, and sometimes worse than others.
I’ve said it a million times and I’ll say it again: Professional guidance, and a controlled regimen of therapy and medication, can make all the difference in the world. When it comes to chronic mental illness, the evidence is clear: Treatment works.
But, treatment doesn’t just mean that you rely on medication and/or therapy to get better. To some extent, and I’ve certainly found this in my own life, you have to take control of your own illness. Yes, you may be a victim of a bad roll of the dice, but no one need be depression’s victim. There are things you can do, on your own, to help keep depression away (again, please note, NOT advocating any of the below in place of therapy, medication or any other professional advice that a licensed medical professional gives you…can’t emphasize that enough). Here are a few tips that worked for me, and can hopefully work for you.
Exercise
Here’s a good one with a ton of benefits: Exercise can make a huge, positive difference when it comes to depression. According to the Mayo Clinic, it does so by releasing “feel-good” chemicals, reducing immune system chemicals that can make depression worse and by increasing your body temperature. Better yet, any physical activity can be helpful, so fear not! You don’t have to launch yourself into a massive weight lifting program.
On a personal level, I’ve found the gym to be a savior. Not only does it help you get in shape, feel better and look better, but it makes you feel like you are accomplishing something. All too often, when you are depressed, you want to just lie around and Netflix & Sad. You become depression’s bitch, and that is exactly the time to get up and force yourself to move around. It takes a lot of hard work to overcome this natural inclination to slug-out on the couch, but it is well, well worth it.
Meditation
The evidence is clear: Meditation can help to ease the symptoms of depression, anxiety and stress. It doesn’t have to be long – the article I link to says 2.5 hours a week – but, a bit of meditation goes a long way. What I found somewhat interesting here was that most articles relating to depression and meditation don’t just discuss meditation, but a specific type of meditation – mindfullness meditation. This specific type of meditation is defined as “a technique of meditation in which distracting thoughts and feelings are not ignored but are rather acknowledged and observed nonjudgmentally as they arise to create a detachment from them and gain insight and awareness.”
What is remarkable is that at least one study found that meditation “helped prevent depression recurrence as effectively as maintenance antidepressant medication did.”
Okay, I’ve resisted this all my life. Not “resisted,” really…just, haven’t allowed myself to do it. I’ve come up with excuses, I’ve done it for a few days, I’ve stopped and started and just haven’t been able to sit down and meditate. This blog entry has convinced me…again…of how important meditation can be for depression! Must. Do. It.
Also, try the app Headspace. I’ve used it a couple of times and it seems interesting.
Practice good sleep hygiene
Sleep hygiene? It’s exactly what it sounds like – using healthy practices to help you get some real rest. Sleep and depression have a complex relationship – a lack of sleep can lead to depression, and depression can lead to a lack of sleep, which makes getting a good night’s sleep all the more important. Good sleep hygiene includes:
During some of the particularly rough periods of my depression, I had a REAL hard time sleeping. It was the canary in the coal mine of my symptoms – I couldn’t sleep, and suddenly, there I was again. Sleep hygiene – particularly the routine and screen time part (which I still really need to work on!) – is vitally important, at least to me.
Video Games
I discussed this the other day, but felt it was worth repeating: Video games can help with depression. First, the basics: There are studies which show that MMORPG and other social games can help reduce social anxiety, while puzzlers can reduce stress and anxiety levels. Other apps and video games have also been found to reduce levels of depression.
Of course, video games can have serious negative drawbacks. There is, unfortunately, ample evidence that some are not working and are instead playing video games, and there are real fears that mental health plays a role in this. Video games provide an immersive escape, where there is no judgement, no consequences, and no real failure that cannot be eradicated by reloading the last save file. This, of course, is dangerous when it comes to entering and remaining in the real world.
As I said earlier in the week, I’m a believer that video games can be great – if used in moderation. They provide a nice retreat when necessary and can recharge your batteries – getting you ready to relaunch into the real world.
Anything you want to add? What works best for you? Let us know in the comments!
One way I cope with depression is video games, which some studies have noted can help improve social anxiety, depression and stress levels. I wanted to elaborate on this one a bit.
First: I love video games. And I mean I loooooove video games. I can tie most major periods of my life to some sort of video game. I still remember playing Halo 3 on Xbox live before I went out on my first date with my wife (the guys I was playing with wished me luck when I said why I was leaving for the night). I remember Final Fantasy X before college graduation. Skyrim when my son was first born, too little to move and would curl up on my chest while I slayed dragons. My kids are named Auron and Ayla…bonus points if you can figure out what games those names came from.
I still remember being almost five, coming home from Heather Cohen’s birthday party, and my Dad leading me into our basement, where he gave me the most magical birthday present every: A Nintendo Entertainment System.
Video games have a special place in my heart. As I grew older and began my journey with depression and anxiety, they offered a safe place and a retreat from reality. I can see myself playing Grand Theft Auto 3 when I was going through a rough patch with my girlfriend at the time. During the worst of my anxiety in college, again, it was Final Fantasy X. I still remember being a lonely, awkward middle schooler and just being obsessed with Tie Fighter, because it made me feel good at something. In the Star Wars universe, no one cared that your hair wasn’t stylish, or that your forehead resembled a pepperoni pizza more than any normal persons should. You just shot at the bad guys. End of story.
That being said – that concept of escaping into a video game – is it a good thing?
Personally, I’ve had some experience with MMORPGs, but not a ton. As much as I love video games, I don’t have enough time to truly enjoy them. I’ve played my share of them – Warcraft in particular – but, as a newcomer, always found them to be too intimidating to really get into. However, there’s no question about it – some people get into video games at the expense of real life.
On one hand, there is research with shows that video games can be helpful in reducing stress, anxiety and depressive symptoms. They provide a creative outlet and a safe place to retreat to when the real world can get overwhelming. Of course, that retreat can be toxic, which leads to the concept of video game addiction.
Now, to be clear, though there is no shortage of media reports about video game addiction, it is not yet an officially recognized disorder by any major medical governing body. On an anecdotal level, I suspect that many of us know people who are way, way too into fantasy worlds, but that doesn’t mean they are “addicted,” per se.
I also think it’s worth noting that video games have never been an area free of controversy, and the conversation about whether or not games are addictive have been going on since Space Invaders. So, clearly, this is a conversation that has gone on for quite sometime.
Are video games good or bad for mental health?
Like the answers to most perplexing questions, this one is evolving. Video games have positive benefits on depression and anxiety, as far as I am concerned. I’ve found them to be a safe retreat and a chance to temporarily escape the pressures of the real world. In my opinion…again, just my opinion, not any medical advice…they can be great, but no different than any other hobby. You use them briefly to recharge and recalibrate before launching yourself back into the real world. The challenge, of course, is acknowledging when enough is enough. For some people, that can be more difficult than others.
This is a topic that is near and dear to me: The concept on resilience and mental health.
One of the things that I try to talk with people about when it comes to mental health is the concept that you cannot just “power your way through” it. I mean, when you’re depressed, you can’t just “man up” or “pray it away,” right? If you are depressed, and you cross that magical clinical threshold, you need professional help. This is part of the mantra of countless professionals and experts in this arena – go get help if you need it, and don’t be stupid and think that you can defeat depression on your own.
And yet….
Most estimates say that 1 in 5 Americans experienced a “mental health condition” over the past year. That number is very high – I’d argue higher than most Americans realize. But, as high as it is – it still means that 4 in 5 Americans don’t have a mental health condition. That, obviously, begs this question: Why?
That’s a broader topic than a layman like me can tackle in a 750 word blog entry. There are, of course, countless reasons, including genetics, living situations, access to health care and more. But, for now, there’s one topic I want to explore: The concept of resilience and mental health.
Resilience, as it pertains to mental health, is defined by the American Psychological Association as, “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors. It means ‘bouncing back’ from difficult experiences.” The APA website I link to contains a variety of information on the concept on resilience, including how to build it.
Why do I mention it now? Well, being resilient, as it pertains to mental health, seems an awful lot like “powering through” a difficulty. If someone is resilient, doesn’t that mean that they have the ability to get through a mental health challenge? Is it then possible to “tough it out” and avoid professional help? And, conversely, is someone who just isn’t resilient enough just lacking a fundamental trait?
I think the above paragraph is pretty thought provoking, mainly because it sort of flies in the face of everything that those of us who are on anti-stigma campaigns preach. We tell people to not allow the depression to win – if you are suffering, seek professional help. And yet, if you can just be “resilient” enough, is it possible to get through your mental illness without needing help?
Interestingly, the APA website provides a perfect answer for that question.
The rest of the page has some subheaders, such as “Staying flexible,” “Learning from your past,” and “10 ways to build resilience.” In other words…how to learn it.
Resilience, or the process of basically facing down’s life challenges, is vital to keeping yourself from being overwhelmed and slipping into depression, anxiety or addiction. There’s also this amazing metaphor:
To help summarize several of the main points in this brochure, think of resilience as similar to taking a raft trip down a river.
On a river, you may encounter rapids, turns, slow water and shallows. As in life, the changes you experience affect you differently along the way.
In traveling the river, it helps to have knowledge about it and past experience in dealing with it. Your journey should be guided by a plan, a strategy that you consider likely to work well for you.
The river is life, and resilience is the boat. Sometimes, the river can be so strong that it can overwhelm the strongest craft. Other times, the boat can be leaky or fail to float for any number of reasons.
Here’s the crux of my entry: Resilience is unquestionably important when it comes to mental health. But, it can’t be viewed as some magical skill that just exists or doesn’t, and that’s it. It should be viewed as a critical component to any coping strategy, and a skill that can be both taught and learned. With resilience, someone can get through life. And someone can be taught the resilience to get through life and a mental health challenge…with therapy.
Does this make any sense? I sure hope so. As always, I’d love to hear your thoughts – please comment below and tlel me if you think I am dead on or have lost my mind – more than usual!
When it comes to mental illness, one of the things I have struggles to come to terms with is that it is always there, always lurking, even when it isn’t “active”…sort of like an app on your iPhone.
Alright, some background. In my last blog entry, I discussed how mental illness/depression/anxiety can make it very difficult to relax. I maintain this is at least in part why, on a personal level, I have to be constantly doing something – it is almost impossible for me to “shut off” and not work.
Now, for something completely unrelated: My stupid iPhone. I, like many of you, am completely addicted to the thing – my wife (appropriately) tells me to put it down, my kids will sometimes grab it out of my hands, etc. I’m actually grateful for all of that, but that’s a completely different story. So, my iPhone battery is in a constant state of HALP I AM NOT WORKING, and I find myself constantly shifting it to low-power mode. The other day, while doing so, I saw this:
Of course Facebook & Twitter and destroying my battery. I’m addicted to them.
But…that got me thinking.
If you live with some sort of mental health condition, you probably know exactly what I am talking about, and if not, hopefully this blog entry can be illuminating. Depression, anxiety, addiction, etc., are exhausting, even if you are not actively suffering from them at the time. I’m lucky…therapy, medication and life experience has helped keep my depression and anxiety at bay for the past few months. That being said, as I have stated earlier, you are never fully in the clear. I can’t imagine living a life where that is even possible.
Mental illness is always there. It is always running in the background, draining your battery. Sometimes, it almost feels like there is a ceiling on your joy, on your happiness, one that forces you to lower your standards for what you can and will achieve in terms of personal happiness and relaxation.
Again, please don’t think I am writing this to be whiny or mopey…I’m trying to make a point to those who suffer from mental illness, and to those who don’t: Mental illness is always there, always running in the background…even if it doesn’t seem like it.
This has been one of my personal struggles. I wish I could share some tips or advice on how to deal with being depressed even when you aren’t actively depressed, but I don’t really have any wisdom to share. Do you? Any tips or advice is appreciated – please let us know in the comments!
Mike Schlossberg - Author 