Reimagining Electroconvulsive Therapy

I had the pleasure of attending an event earlier this week in which another local elected official personally discussed his own experiences with anxiety, all in the name of an anti-stigma campaign by our local chapter of the National Alliance for Mental Illness.  One of the speakers at the press conference was a psychiatrist who discussed stigma surrounding mental illness, but he got a little bit more specific: He discussed ECT, or Electroconvulsive Therapy.

Electroconvulsive Therapy was once one of the cruelest treatments for mental illness imaginable.  It’s common use in American began in the 1950s and was largely brought into public view by the film One Flew Over the Cuckoo’s Nest.  It became a controversial treatment option, and with good reason: Patients were often treated against their will and with dangerously high doses.

That being said, that’s no longer the case.  Indeed, to say that the therapy has changed is an understatement.  From the Mayo Clinic:

Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.

The article goes on to note that ECT is used when other treatment – medication and therapy – is less effective.

Is it still risky?  Sure, like any therapy, there is the potential for side effects, including confusion, memory loss and other complications.  That sounds bad, but most of those side effects are also temporary.  That, and let’s be honest: Can you find an effective drug without potentially problematic side effects at this point?  Nope.

How effective is ECT?  Well, according to this article from Psychiatric Times, very: 60-90% of people have a positive response.

If you’ve ever read this blog before, you know that the basic gist of my entire mental health crusade is anti-stigma oriented.  It didn’t really hit me until the press conference I attended how that stigma remains powerful when it comes to specific treatment modalities.  Multiple studies proved that ECT is an effective way of treating depression and mania that is otherwise treatment resistant, but older forms of its operation have convinced many people that it’s a terrifying and dangerous way of trying to rid yourself of depression.  Science has evolved to the point that this is no longer the case, and it is vitally important that we recognize this truth.

How to explain mental illness to your kids

Like the vast majority of parents, my children are the light of my lives.  My son, Auron, is six; my daughter, Ayla is four, turning five in November.  I won’t sit here and wax on and on about how much I love them – I don’t have that kind of time, and you probably don’t have that level of interest.  But, for the sake of this blog entry, please understand that they are one of my main reasons for living, my biggest source of joy and a constant fountain of entertainment, surprise and hilariousness.

So, I suspect many parents can sympathize: Having children when you have depression can add innumerable guilt and sadness to an already debilitating disorder.

When I think about depression in relation to my kids, I think of it from two angles.  First is how it will likely one day affect them.  There is no question that mental illness has a strong genetic component.  Also, as much as it pains me to admit it and as hard as I try to make it otherwise, I suspect that both of my kids will learn some of my behavior and internalize it. Even more unfortunate is that a major source of childhood trauma is having a parent with a mental health disorder, and an expanding body of research has shown that these Adverse Childhood Experiences, or ACEs, can have significant and detrimental effects on the life of a child.

One of the symptoms of depression is guilt, and lemme tell you, this entry is not helping.

Second is how my disorder affects their lives.  As much as I hate to admit it, depression and anxiety have affected my parenting skills.  There’s no doubt that there have been times where it has affected my mood, made me snappier or less willing to do things.  Kids can tell when you are worried or down.  They are like little sponges.  They just know when things are off, and they are far, far more intuitive than most people realize.

So, all of this leads me to the critical question of today’s blog entry: How do you talk to your kids about depression?

Obviously, the answer to this question depends on the age of your child.  The first time it ever came up for me was when my son was about four and happened to walk into the bathroom when I was taking my medication:

“Dad, what are you doing?”

“Taking my pills, buddy.”

“Oh.”  Pause.  “Are you sick?”

Me, internally: Crap.  

Followed by: “Well, Auron, you know how people sometimes get really sad?  Or really scared?”

“Yeah.”

“Well, Daddy sometimes gets really scared or sad for no reason.  These pills help make sure I don’t get too scared or too sad, and they make it easier for me to have a good day.”

“Oh.  I’m gonna go watch Bubble Guppies.”

At that age, I think that was a pretty good way to describe it: Simply, and by relating it to something they already understood.  As my kids have gotten older, I’ve expanded that conversation to talking about it to a stigma perspective.  Whenever we are trying to illustrate something that we think is silly (All boys are better than girls at sports by default, for example), we scream “THAT’S NONSENSE!”  I’ve used that frame to describe how some people don’t think it’s okay to get sad, or get scared, and to try to tell the kids that anyone who is sad or scared should see a Doctor, just like if they had a broken arm.  Do they understand it?  I think so.  I hope so, anyway!

As they get older, it is my hope that the way I have dealt with my mental illness – openly and honestly – will help them recognize the symptoms of it within themselves.  I never want my kids to think that whatever circumstances they may be born with are completely out of their control – I want them to know that they do have the ability to deal with whatever challenges they may face.

I cannot control the mental illness that I have anymore than I can control the weather.  But, just like dealing with a rainy day, I can bring an umbrella.  I can take care of myself by ensuring that I see my therapist when necessary, that I take my daily medication, that I recognize my mistakes and try to learn from them, and by practicing good coping skills.  In that way, I hope I can teach my kids a very critical lesson: You cannot always control the hand that you are dealt, but you can control how to react to it.

As always, I welcome your comments.  How have you dealt with your own mental illness when it comes to your kids?  What have you said – and what have you left unsaid?  Let us know below!

4 ways to stop an anxiety attack

I’ve had a particularly interesting internal debate – well, interesting to me, anyway – about which is worse, depression or anxiety.  I’ve repeatedly come to the conclusion that, at least with the way I have both, I’d rather have depression than anxiety.  Don’t get me wrong – both suck something fierce.  That being said, with depression, if it isn’t too severe, you can still function.  Anxiety, and particularly anxiety attacks makes doing basic tasks next to impossible.

College was the worst for me in that regards.  I would have periodic anxiety attacks, usually brought on by a particular situation.  I developed fears of set events – travelling in buses or planes, for example – that caused me to avoid travelling in general.  Therapy and medication helped get me through, but I still remember how traumatic those events were.  I remember not being able to travel on a bus with my coworkers because I was so, so scared of having an anxiety attack.  Or having a major one while traveling for work that almost caused me to run off of a plane.

Learning how to control my anxiety is what got me through those dark times, and learning how to stop an anxiety attack before it started – or at least how to stop one once it was underway – was immeasurably helpful.  Learning these skills gave me the confidence that I needed to believe that I could survive the worst anxiety attack, and that taught me how to live again.

With that, here’s a few techniques that I’ve successfully used in order to try and head off an anxiety attack before it started, and cool one down when it began.

Oh, and standard disclaimer: I’m not a Doctor or professional. I’m a guy with a blog.  Don’t let my random thoughts stop you from seeking professional, medical advice!

1) Pick a number.  Count to seven.  And keep going.  One of the things I found when I was at my worst was that the brain desperately needed a distraction.  I believe it was a therapist who first made this suggestion to me: Pick a task and run with it.  Pick a random number – 136.  Add 7.  And keep going.  This will, hopefully, distract your brain enough to stop the anxiety attack in its tracks.

2) Breathing Exercises.  There are a ton of variations on this, and there is also ample evidence that anxiety and depression can be ameliorated in the long run with proper breathing techniques.  When I was younger, I found this to be particularly effective, particularly when I first started suffering from anxiety attacks.  I would literally sit there in 8th grade homeroom and say to myself, “There is nothing else but your breath.  Take a deep breath.  Fill your chest as much as possible.  In through your nose and out through your mouth.”

For a more formal exercise, click here.

3) Pick an object.  Any object.  This is related to the first technique.  Getting yourself out of an anxiety attack often means changing the way that you are thinking in order to stop yourself from cycling through panic.  To that end, find an object.  It can be simple or complex.  Stare at that object.  Get lost in it’s texture and colors.  How does it look?  What does it do?  Is it moving?  What are it’s colors?  Rough or smooth? Ask yourself simple questions, and then allow those questions to become more complex.  Remember, the goal here is to get your mind to concentrate on anything other than the panic.

For me, when I was at my worst, the challenge with this was trying to get myself to concentrate on an object, because starting too long at something could make me feel worse.  If that’s the case for you, no problem!  If one object doesn’t work, try picking a different one.  Or, allow yourself to look away for a moment before coming back to the object in question, and starting the cycle over.

4) Call someone.  I found that conversations with others – people I trusted, who wouldn’t judge – could be helpful.  If you allow yourself to get lost in your own mind, you can get yourself into trouble.  To that end, talk to someone you trust and love.  Talk about the anxiety attack.  Talk about the weather.  Do whatever works for you, but just make sure that you can get out of your own head.

As always, these are just suggestions, just my thoughts.  Have better ones?  Let us know in the comments!

4 Video Games that portray mental illness

As I’ve discussed before, I’m a video game nerd.  Hardcore.  And, as someone who is a bit obsessed with eradicating stigma that is related to mental illness, I remain fascinated by public portrayal of depression, anxiety and addiction.

Video games, I believe, are art.  I define art as the ability to make a profound emotional impact on a person.  As such, the portrayal of mental illness in video games – and indeed, humanity – continue to fascinate me, and make me think.  The good news is this: Video games can often describe the human condition in a more thoughtful and complete than many movies and television shows.  That line of thinking inspired this blog entry: How does video games portray mental illness?  How accurate is that portrayal?

Oh, and spoilers below.

Life is Strange: Before the Storm

LifeIsStrange

This one is the prequel to Life is Strange, one of my favorite games, made by Square Enix.  It is a walking simulator  in which you follow Chloe, the main character, as she battles her way through high school and falls in love with Rachel, the previously unseen character who plays a pivotal role in Life is Strange.  

I firmly believe that Chloe is suffering through some major depression symptoms.  Her father has died a few years before and her mother is dating a man who she openly despises and fights with; both of these experiences can lead to depression.  She drinks and does drugs often enough to have a regular dealer to whom she owes money. Her best friend is gone, and not communicating with her at all.  She comes across as angsty, but it’s more than that.  Her quotes, thoughts and actions are often self-destructive and reflect a young woman in pain.

To me, this is more than just a teen being a teen.  She’s miserable, she fights with her mom and her mom’s boyfriend, her family has financial issues, and she is clearly discovering her sexuality.  These are all symptoms that lead my to believe that Chloe is suffering from depression.

What makes the game more relatable is the game’s treatment of Chloe.  In the start of episode one, she is petulant and miserable – not the greatest portrayal.  However, as the game evolves, she becomes a more sympathetic character, and a multi-layered one at that.  You see her hopes, dreams and ability to connect with others.  And, by hearing her thoughts, you can hear all of the truly heartbreaking things she is thinking and saying to herself, about herself.

You intrinsically want Chloe to be better, to have healthier thought patterns and make better decisions.  And, in that sense, I hope that the game can give people a better idea of what it is like to live a life under duress, as Chloe clearly does.

A Night In The Woods

NightInTheWoods

Disclosure: I’m only part way through this one

A Night In The Woods is a platformer. You play as Mae, who has just dropped out of college and returned home.  I’m not very far along this one, but where I’ve gotten to, strange things are happening in her hometown after she reunites with her friends.

The college drop-out part is interesting.  Again, I’m not far in, but thus far, Mae has refused to talk about what happened to her in college, aside from saying that college “didn’t work out” or some variation of that phrase.  She reconnects with old friends, who all have their own battles:

Mae, the protagonist, experiences depression and anxiety, which sometimes create dissociative states during which she becomes completely disconnected from reality. It is implied, though never directly stated, that Gregg has bipolar disorder. His poor impulse control gets him into bad situations, and at times these factors impact his feelings of self worth. Bea and Angus both struggle with the consequences of abusive pasts and their relationships with their families.

As has been noted by Kotaku, the game’s creator’s have both discussed their own battles with mental illness:

The game’s creators have spoken candidly in the past about their own mental health struggles. Scott Benson, who animated and illustrated the game, has type two bipolar disorder. Programmer Alec Holowka runs the Everybody’s Fucked Up podcast, which aims to break through stigma around mental illnesses by interviewing people who have experienced them. (Bethany Hockenberry, the writer of the game, was unable to meet with Kotaku for an interview.)

This game is different than the standard platformer in a few ways, but chief among them is that it allows users to make dialogue choices that affect the game.  This puts you in the driver seat and gives you the perspective of Mae, thus ensuring that you get a first-hand look at what it is like to live a life with depression.

As I said, I’m only a little way into this one, but I’m very curious to learn more.

Please Knock On My Door

Disclosure: I haven’t played this one.

PleaseKnock

This is the portion of the blog entry where the games start getting a touch more obvious.  In Please Knock On My Door:

Please Knock on My Door is a simple game about a person living with depression. The protagonist, a blocky, inky-black character, lives a fairly standard life: Wake up, go to work, come home, repeat. The days are punctuated with mundane tasks like making a sandwich or showering, but each one carries extra weight as it drains — or bolsters — the main character’s mental fortitude.

The game’s art style is simple and stripped down, forcing players to experience the emotions of the game, not be overwhelmed by its graphics, and the focus on simple decisions and how draining they can be gives players the experience of depression, and the added knowledge that each decision made can weigh on a normal human being.  In that sense, it seems to concentrate on giving players the sense of just what a burden living with depression can be.

Depression Quest

Depression Quest

Disclosure: I haven’t played this one either.

Gee, I wonder what this game is about?  From the website:

Depression Quest is an interactive fiction game where you play as someone living with depression. You are given a series of everyday life events and have to attempt to manage your illness, relationships, job, and possible treatment. This game aims to show other sufferers of depression that they are not alone in their feelings, and to illustrate to people who may not understand the illness the depths of what it can do to people.

The game was designed by Zoe Quinn, who faced a slew of death threats for her efforts.  Charming.

As for the game itself: You live the life of someone with depression, making what are relatively mundane decisions about living life.  That being said, in the game, happier decisions are often grayed out, forcing the player to experience life as through someone with depression.  The game is told through a series of text decisions.  In that sense, again, it tries to get the user to experience depression from a first-person perspective.

These are just four, and there are certainly many more.  Any other games you’d like to share?  Let us know in the comments below!

Your smartphone may be making you depressed

I remember catching this story ages ago: A study found that the more time you spend on your iPhone, the more likely you are to be depressed.

Then, yesterday, a friend was kind enough to send me this article about how the University of Berkeley was offering students “counseling” in response to a conservative speaker coming onto campus.  I totally agreed with the article’s premise: That it is absurd to offer counseling for an optional speaker who some students may disagree with, and that such an offer does real harm to the mental health world be further stigmatizing and cheapening the need to get help.  However, there was a passage in the article which really caught my eye:

Researchers have, however, identified reasons to be concerned about the psychological health of teenagers and young adults. In her new book, “iGen,” social psychologist Jean Twenge argues that we may be on the brink of a major mental-health crisis among the generation born between 1995 and 2012, a crisis she links to smartphones and social media.

This made me wonder: Just how true is this statement?  As always, standard disclaimer: I’m not a scientist, just an observer with a real interest in mental health.  That being said, it certainly appears that the answer may be yes.

First, there’s this powerful Atlantic piece, written by Jean Twenge, which makes the case that iPhones are, without a doubt, leading to a “mental health crisis.”  It also argues that smartphones are causing problems at rates previously unheard of in past generational changes:

Psychologically, however, they are more vulnerable than Millennials were: Rates of teen depression and suicide have skyrocketed since 2011. It’s not an exaggeration to describe iGen as being on the brink of the worst mental-health crisis in decades. Much of this deterioration can be traced to their phones.

The articles conclusions are stark and tie directly to smartphones.  It makes the case that teens are going out less, spending less time with friends, showing less independence, dating less, having less sex and driving less than cohorts from previous generations.

So what are they doing with all that time? They are on their phone, in their room, alone and often distressed.

The case here is clear: Screen time makes teens less happy, and more likely to screen for depression.  Seriously, there’s a ton in this article, so if this is an area of interest to you, I highly suggest you read it.  It made me want to set my phone on fire.

Anyway….

Other articles have confirmed the link between smartphones, depression and anxiety.  What is most interesting to me is the nature of this relationship.  Anyone who has ever taken Psych 101 knows that correlation does not equal causation, meaning that just because two things are connected does not mean that one (smartphone use) causes the other (depression or anxiety).  That may be the case, but it may be that depression and/or anxiety actually cause an uptick in smartphone use; personally, I can vouch for this – when I get anxious, I frequently turn to my phone as a crutch or escape from reality.  It also may be a third item, like lack of self-confidence, simultaneously causes both depression and an uptick in smartphone use.

That being said, the Atlantic article I discussed above makes the case that the relationship is linked, and that smartphone use is causing depression.  That conclusion, however, is not uniform, per this meta-analysis:

…the studies examined were correlational, meaning that it is not clear if smartphone use causes symptoms of mental illnesses or if symptoms of mental illness cause greater smartphone use.

As I said above, I’m not a doctor or a scientist, but I do know that smartphones can have a deleterious effect on mental health and social development.  I suspect this is an area that will be the subject of increasing research as time goes on, and I certainly hope that is the case.

Now, go outside!

What you should know if you love someone with depression or anxiety

In the course of my +15 year battle with mental illness, I’ve experienced many emotions that aren’t directly related to the actual depression/anxiety.

One of the most prominent of those is a tremendous feeling of guilt.

I’ll be honest: Loving someone with depression, anxiety or any mental illness sucks.  It just does, and I’ve experienced it from both ends.  You feel so helpless, you don’t know what to do, what to say, you always feel like you are walking on eggshells…it just plain sucks.  And I’ve always felt so bad for my wife and for my kids, who have seen me at some of my worst moments.

I’ve been lucky: I think most of the relationships I’ve had over the course of my life have been healthy ones, and that’s to say nothing of my wonderful wife.  In an effort to figure out how to better help me with my mental illness, she once came with me to my therapist in order to get a better grasp on how to pull me out of an anxiety attack.  This is one of the kindest things I think she ever did for me.

Mental illness is a difficult thing to describe.  It’s hard to convey the hopelessness of depression, the sheer terror of an anxiety attack, the slavery of addiction.  It’s even harder to explain it if you are actively in the throws of it.  When I’ve been at my worst, there have been so many things I’ve wanted to say to the people who love me or care for me, but haven’t been able to find the words.  So here are a few.

First: Don’t think you can make us better.  Suffering from depression has sometimes felt like flinging out a lifeline to someone, anyone, searching for hope before drowning…but it’s still okay.  We don’t expect you to heal us…at least we shouldn’t.  That’s not your job, and even if someone you love does expect that, that’s not fair.  No one should expect you to cure them, to save them.  Love and support is all you can give, and that’s all anyone can reasonably expect of you.

Second: You don’t have to understand.  You don’t have to know everything that we are going through, largely because we may not be able to communicate it at that particular moment.  That can be one of the most difficult things, knowing that someone you love is in pain and not quite being sure why.  As difficult as it can be, let that part go.  Just focus on trying to get someone through that difficult moment.

Third: Your primary job needs to be to get someone through a crisis.  From there, turn to the professionals.  I can’t emphasize this enough.  You may feel incredible guilt and pain at not being able to heal the person you love.  Say it with me, over and over again: It is not your job to fix what is broken.  Support is the only thing anyone can reasonably expect.

Fourth: We’re not always going to be up for talking about it.  But that doesn’t mean we don’t want you there.  Sometimes, sitting there, holding our hand is the best and only thing you can do.

Fifth: Mental illness is not an excuse – ever – for poor treatment.  Understand this.  Mental illness is never an excuse for bad behavior – it may be the reason, but not an excuse.  If someone is making a legitimate effort to find their way out of the darkness, they deserve your love and support.  If they refuse to seek help, it becomes an entirely different matter.

Sixth: Everything you have to offer may not be enough.  Despite your best efforts, despite herculean levels of love, support, care and affection, it may not be enough.  You have to understand that the mental state of the person you love may continue to decline, and that isn’t your fault.  You cannot hold yourself responsible for the declining mental state of someone you love and someone who is ill.

Seventh: Don’t be afraid to reach out for help.  You alone may not be enough to get someone through a crisis, but if someone else is there, don’t hesitate to reach out.  When I’ve had some of my worst moments, my wife connected with my family and friends – if the option is available to you, do the same.

Eigth: Odds are, we’re really, really sorry.  Like I said earlier, I can’t tell you how badly I’ve felt for the lack of control I’ve endured for my own emotions, how that has effected my life and my behavior.  Trust me, it sucks every day to know that my own mental illness may lead to my kids having their own challenges one day.  That being said, if you love someone with mental illness and they’ve experienced these feelings of guilt, I’d encourage you to ask the person you love the same thing my wife has asked me: “So, what are you going to do about it?”  I may not be able to help the way I feel, the disorder I suffer from, but I can control my decision to seek treatment as necessary.  Tell the person you love to get help.  Tell them you love them.  Tell them to use those feelings of guilt as a motivator to be better, for themselves, and for you.

There’s more, but this is just my perspective, my thoughts.  I’d love to hear yours.  Please comment below, from either perspective – that of someone who is mentally ill, or someone who loves someone who is.  What do you wish you knew, or want to communicate?

Anxiety is like living in a box

If you are used to reading this blog, you’ve seen me discuss it before: 1 in 5 Americans suffer from some form of mental illness during a twelve month period.  That number is extraordinarily high, and it means that over sixty million Americans suffer from mental illness’ grasp during any given year.  This is shockingly high and exceptionally tragic.

That being said, here’s a different way of looking at this statistic, one that can be a little but of a head trip for advocates like me who can sometimes drown in the mental health universe: 4 in 5 Americans don’t suffer from mental illness over a one year period. While the world health organization says that 1 in 4 people will suffer from mental illness over the course of their lifetime, that still leaves an exceptionally high number of people who don’t know what it’s like, thank goodness.

Many people understand what mental illness is like.  When I first started talking about my own struggles, I was blown away by how many people said, “Me, too,” or confided that a beloved family member or friend knew exactly what this pain was like.  Even so, describing mental illness can sometimes be a challenge, so allow me to try.

As my life has gone on, I’ve often suffered from some combination of a generalized anxiety disorder, periodic anxiety attacks and a major depressive disorder.  I’d actually make the argument that the anxiety is more dehabilitating than the depression.  That’s because of this simply metaphor: Living with anxiety is like living in a box.  A box that slowly closes.

Allow me to explain.  The kicker about anxiety attacks is that they are often unexpected. While some triggers can make them occur, or can spike a general sense of unease and anxiety, many anxiety attacks occur out of nowhere, for no real reason.  For many – and this was certainly the case for me – there is only one place they don’t occur (without a very good reason): Home.  Home is the safe place.  It’s the place where nothing can go wrong.

So, you’re out at the mall, and bam, anxiety attack.  Or you are out with friends at a party.  Someone gives some backhanded insult, and there you go, down the rabbit hole of anxiety, with no end in sight.  Suddenly, you are miserable.  Stomach churning.  Palms sweating.  Heart rate accelerating.  Breathing difficult.  Hoping no one notices, you retreat to the bathroom, thinking, I need to get out of here.  And you do.  You make up some lame excuse – you’re tired, you have an upset stomach – and out you go.  You’re home.

And then the next time you get invited to a party, you remember.  Remember the pain, the anxiety, and like any normal human, you want to avoid it.  So you don’t go.

So take that situation.  Multiply it by every variable you can think of: The grocery store.  The mall.  School.  Work.  And that’s how anxiety traps you in a box.  It cuts off your life by making sure you engage in avoidance behavior, slowly chopping away joy and vital connections from your world.

Unfortunately, this is all to common among people with anxiety.  They become socially withdrawn, and at it’s most severe, it can lead to agoraphobia, which is when you avoid public situations altogether.

The best way to stop this?  It’s also the hardest: Face your fear and break out of the box. This is different for everyone, and often best done with the help of a therapist.  For me, when I was at my worst, I almost had to retrain myself to engage in social situations – go places by myself, where I was free of judgement, and just relax.  It worked, eventually, but largely because I followed a pretty regimented approach that was set up by my therapist.

As always, I’d love to hear your thoughts below.  Did I get the metaphor right?  Any better, more accurate one that you’d like to share? Let us know in the comments!

Is Donald Trump bad for your mental health? And what can you do about it?

 

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:

  • More than half (59%) of Americans are at least somewhat anxious because of the November election results. The national survey findings mirror an online poll of CareDash newsletter subscribers which found that 55% of respondents are at least somewhat anxious because of the November election results.
  • Nearly three-fourths (71%) of people 18-44 are at least somewhat anxious because of the November election results.
  • Half (50%) of Americans are looking for ways to cope with the negative political environment.
  • Over one-third (39%) of Americans are avoiding social media to reduce their anxiety around the political comments.

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.

  • Ask yourself some key questions about what you can and cannot do.
  • Get active in politics or other social causes – ones that you care about – that will help you reestablish a sense of control in your life.
  • Stop reading the news all the time.  There is a difference between being informed and being obsessed.
  • Connect with others; family, friends and people who, like you, are under serious stress.
  • Exercise!
  • Write down your anxiety.  Don’t just let it be free-floating – write what is troubling you, and use the information you gain from that writing to fight back.

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!

Things you CAN do to fight depression and anxiety

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:

  • Limiting naps.
  • Not drinking caffeine too close to bed.
  • Limiting screen time too close to bed.
  • Having enough exposure to natural light (huh, didn’t know that).
  • Having a set sleep and wake-up routine.

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!

Video games and depression

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.