Six Questions: An interview with Laura Silverman, Author of You Asked for Perfect

Today’s interview is with Laura Silverman, who wrote You Asked For Perfect, the story of a super smart, LGBT teenager who is trying to learn to navigate his life in a high pressure world. From the summary:

Senior Ariel Stone is the perfect college applicant: first chair violinist, dedicated volunteer, active synagogue congregant, and expected valedictorian. And he works hard―really hard―to make his success look effortless. A failed calculus quiz is not part of his plan. Not when he’s number one. Not when his peers can smell weakness like a freshman’s body spray.

Ariel throws himself into studying. His friends will understand if he skips a few plans, and he can sleep when he graduates. But as his grade continues to slide, Ariel realizes he needs help and reluctantly enlists a tutor, his classmate Amir. The two have never gotten along, but Ariel has no other options.

Ariel discovers he may not like calculus, but he does like Amir. Except adding a new relationship to his long list of commitments may just push him past his limit.

1) Do you think that experiencing mental illness is a requirement for any author who deals with this topic?
I don’t think it’s a requirement, but I do think if a writer is ever writing outside of their own personal experience, it should be done with a great amount of both research and empathy.
2) Your book obviously deals with a gay teenager, a group which faces enormous mental health pressures. Can you talk a little about writing a character with mental health challenges from that perspective?
Ariel is a bisexual teen, but his anxiety in the book is related to academic pressure not his sexuality. I wanted to write a book about the extreme academic pressure teens deal with today, as I believe it’s something so many teens experience but is rarely written about.
3) As I type this questions, your book is number one in “Teen & Young Adult Jewish Fiction.” What has your experience been like in terms of the interaction between religion and mental health?
I grew up in a very supportive Jewish community and wanted to reflect that in this novel. Ariel’s Jewish community is a place of comfort and warmth for him. Although services certainly take up more time in his busy schedule, adding additional stress, overall his Jewish community is an incredibly supportive aspect of his life. And his rabbi is actually one of the people who helps him the most throughout the book.
4) Your book addresses many of the societal pressures which teenagers face today. What do you think any of us can do to try to tamp down those pressures?
I think we need to send the message that grades do not define you. There’s so much pressure to excel in school and get into top universities, but while education is important, it should be about the learning experience not about top SAT scores and AP credits.
5) Many of the reviews of You Asked For Perfect note that you seem to perfectly capture what it’s like to be a teenager in a high pressure environment. How did you do that??
I went to one of those high schools! Although my experience wasn’t as intense as my protagonist Ariel, I experienced the exhaustion of taking multiple AP classes, taking extra electives, the pressure to excel, the fear of scoring a low grade. I also did a lot of research for the book. I talked to high achieving students about their experiences and watched documentaries and read books.
6) If you could do it again – anything you’d do differently?
With the book? I wouldn’t change a thing!

Feeling sad? Maybe get a puppy or a kitten

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

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

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

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

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

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

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

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

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

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

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

4. Fever therapy

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

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

How they thought it worked

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

However, for many, the therapy actually worked:

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

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

But, actually….

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

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

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

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

5. Hydrotherapy

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

Wait, what?

How they thought it worked

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

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

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

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

But, actually….

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

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

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

6. Trephination

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

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

How they thought it worked

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

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

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

But, actually….

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

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

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

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

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

1. Electroshock therapy

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

How they thought it worked:

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

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

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

But, actually…

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

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

2. Insulin Shock therapy

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

How they thought it worked:

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

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

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

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

But, actually…

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

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

3. Lobotomies

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

…oh. Oh, dear.

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

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

How they thought it worked:

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

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

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

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

But, actually…

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

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

What is ASMR, and can it help with depression and anxiety?

If you’ve been on the internet long enough, odds are good you’ve heard of or seen ASMR videos. I’ve found them to be a nice, relaxing break, one capable of helping you unwind at the end of the day, similar to relaxing meditation. But, can they help with depression or anxiety? It certainly appears that way.

First, for the uninitiated, let me answer this question: What is ASMR? It stands for “autonomous sensory meridian response.” Per the Google definition, which is pretty accurate as far as I am concerned:

a feeling of well-being combined with a tingling sensation in the scalp and down the back of the neck, as experienced by some people in response to a specific gentle stimulus, often a particular sound.

ASMR recently was seen by hundreds of millions of Americans with this Super Bowl commercial from Michelob:

ASMR can be triggered by a variety of things. For some people, there is nothing that works (like my wife, who wants to throw my iPad out the window when I watch these videos). For others, ASMR triggers include gentle sounds (like tapping or whispering) or demonstrations.

There are a ton of channels and videos on YouTube which are designed to “trigger” ASMR. It’s become an incredibly popular internet trend, one that thousands (if not millions) use to relax and unwind.

From a mental health perspective, here’s a more interesting question: Can ASMR be used to help fight off depression and anxiety?

Well, yeah. Maybe.

ASMR as a formal, intentional genre of videos is relatively new, having only been around since the early 2010s. However, there has been some research done on the subject, and the answer, so far, is yes. According to a study published in 2015, 80% of participants who viewed ASMR said that the viewing had a positive effect on their mood, while another 69% found that their depression symptoms had been improved. Another study showed that ASMR videos can reduce heart-rate and increase skin conductivity, signs of physical and mental relaxation. There are also a slew of internet reports, like this one, of people who have used ASMR to fight depression.

Just to be insanely clear here: ASMR is not a substitution for therapy or medication. Personally, I think it’s a nice distraction, a good way to unwind and temporarily ease the painful symptoms of depression or anxiety. That being said, it’s not a permanent, formal treatment. But, if you’re stressed and looking to relax a bit, ASMR can be helpful. And, even if you’re not – go enjoy it! Millions of people across the world have found themselves finding relaxation and joy with ASMR. Go search for videos and see if there’s anything there you like.

American Teenagers: Depression is our biggest problem

This Pew study. Wow.

PSDT_02.20.19_teens-00-00

According to a new study by the Pew Research Center, a whopping 96% of teens view depression and anxiety as a major or minor problem among their peers, far outpacing literally every other societal problem, including bullying, alcohol, poverty, teen pregnancy and more. And the numbers aren’t even close.

Per the story, it’s even worse than just the graph above:

  • Teens feel this way regardless of whether or not they personally suffer from depression – this means that they are hugely aware of the problem in others, which obviously shows it has a high degree of preeminence.
  • The trend is specific to all teenagers, regardless of “gender, racial and socio-economic lines, with roughly equal shares of teens across demographic groups saying it is a significant issue in their community.”

This makes perfect sense, sadly. As we know from empirical data, rates of mental illness are increasing across the board, but the trend is most visible among American teenagers.

If teenagers across the board are seeing increases in mental illness, what doe that tell us?

I’d argue a broader point, using the graph above: The rise in the first line is a direct result of the rise in every other line.

Again, we know that mental illness is increasing. We also know that mental health isn’t like some contagious virus – you don’t “catch” depression the way you catch a common cold. So, what is it? What is leading to the massive spikes we are seeing in mental illness? My argument is this: It’s not just one thing, but many things. As the graph above and corresponding story makes clear, American teenagers are facing major societal challenges. They are scared, worried and anxious, as a result of a variety of factors, including a more complex society, increasing reliance on technology (at the expense of regular relationships) and the pressures of a rapidly changing and interconnected world.

A problem like this cannot simply be addressed at an individual level. It goes without saying that access to mental health care is incredibly important, and fighting mental health stigma (my favorite issue!) is vital, but we aren’t going to really get at a reduction in mental illness unless we address the societal and cultural problems which have resulted in its increase.

What does that look like? I don’t know all of the answers. But, if you’ve read this blog before, none of what I’m going to say is particularly new. Teenagers – well, hell, and the rest of us – are too addicted to technology. They are spending more times with their phones and less time with each other. This has devastating psychological impacts. The answer is not that simple, of course. But we know that teenagers are spending less time with each other in a variety of ways – less time at parties and social gathers, less time away from adults and less time simply interacting with one another. At the same time, world events and pressures are more available and accessible than they ever have been – thanks, in part, to our lovely phones.

What’s the end result? A generation that is more depressed, more brittle and less resilient.

This isn’t an effort to place blame, but it’s something all of us are responsible for addressing. Teenagers become adults…and, as someone who has suffered from depression and anxiety for my entire life, I don’t want an entire generation of teenagers and young adults to feel that pain. We have to deal with this. Now.

Teens, marijuana and depression

A friend of mine was kind enough to flag this article for me, and it brings up some points that I really think are worth exploring.

As a debate over legalizing marijuana continues across the country – and in Pennsylvania – a new study draws a connection (not a casualtional one, however) between teen marijuana use and depression.

From the NBC report on the study:

Researchers found that cannabis use during the teenage years was associated with a nearly 40 percent bump in the risk of depression and a 50 percent increase in the risk of suicidal thoughts in adulthood, according to the study, published Wednesday in JAMA Psychiatry.

The report does note that this isn’t to say marijuana causes depression (though that may, in fact, be the case). It’s possible that the depression encourages marijuana use, or that a third factor (such as economics, anxiety, stress, etc) cause both the depression and marijuana use.

Still. The study does show a clear connection between marijuana and depression. There’s an irony to that: Some research shows that medical marijuana may actually help alleviate symptoms of depression. This may be a secondary benefit of medical marijuana, which has been shown to relieve pain and stress – two factors which, of course, may lead to someone becoming depressed.

Can these seemingly contradictory findings be reconciled? Sure. It’s possible that the drugs act in such a way which helps those who are already depressed, but affects other aspects of someone’s brain chemistry in those who are not depressed, thus making them so. It’s also important to note that there are major differences in terms of the chemical composition, and effects, of medical and recreational marijuana, thus potentially resulting in different effects.

The causes and effects of marijuana use are not always clear or linear. More research is needed.

Personally, I believe that marijuana needs to be examined and researched like any other drug. I’ll also note a flaming hypocrisy within our current medical and judicial systems: Numerous legal drugs (such as Oxycontin) are obtainable from reputable medical professionals, despite the fact that Oxycontin is more potent and addictive than marijuana.

Our drug policy in America makes no sense. But – and this is a big “but” – we cannot sit here and pretend that legalizing marijuana is the solution to many of our woes. Legalizing marijuana may be preferable to the alternative of prohibition, but that’s not to say that there won’t be significant negative side effects, and this may very well be depression in young people. Marijuana legalization – it’s pros and cons – need real, comprehensive study and thought. It could have major benefits and harm to the mental illness space.

What professions have the highest rates of mental illness?

UPDATE 11:45am: In the interest of transparency, I’m keeping the information below, but please note that the information about farmer’s IS NOT CORRECT. Please see the CDC retraction.

Last week, as part of my real job, I took part on a hearing legislative hearing involving first responders, mental health and their ability to get the care they need. A nice summary of my legislation and other related pieces is here.

Some of my tweets from the hearing are below. When it comes to first responders, the ugly truth is that we are failing them:

As you can see from the tweets above (all of which were gathered from a public hearing), the stress first responders face is absurd. To work in an area where you have a 1/3 chance of showing symptoms of PTSD – and all while helping people and saving lives – that’s a remarkable thing to endure. These folks deserve our help and our praise, and that’s something I’m working on as a Representative.

That being said, it got me thinking: What other professions show high rates of mental illness and suicide?

That information is available. According to a US News article on the subject:

  1. Farmworkers, fishermen, forestry (85 suicides per 100,000).
  2. Construction and mining trades (53).
  3. Installation, maintenance, repair (48).
  4. Factory production workers (35).
  5. Architects and engineers (32).
  6. Police, firefighters and other protective services (31).
  7. Arts, design, entertainment, athletes, media (24).
  8. Computer and mathematics (23).
  9. Transportation and material movers (22).
  10. Corporate managers (20).

Now, those are suicide rates per 100,000. The farmworkers one is so far above the rest of the group that it truly gave me pause, but from a logical perspective, it makes sense. That category of workers obviously is concentrated in rural areas, which have higher rates of suicide. This is for many reasons, including a shortage of mental health care providers and a higher prevalence of guns.

So, why are farmworkers suicide rates so high? Unsurprisingly, there has been a great deal of media coverage about this subject. The job is high stress and success is subject to a variety of factors outside of the farmer’s control, such as the weather and state of international trade.

Looking at a different topic – rates of depression, I found this infographic from MentalHelp.Net.

Which Industries are the Most Affected?

The pattern there is less clear. And what’s even more interesting is that farming is not present anywhere in that information. I don’t understand the disconnect – and, frankly, it doesn’t make any sense to me. If you get it, please let me know in the comments below!

 

 

Climate change – and a potential climate apocalypse – are contributing to depression

The evidence, unfortunately, is clear: Climate change is here, it is accelerating, and it is going to get worse, with potential cataclysmic changes occurring as soon as 2040.

That, obviously, can and will have massive implications on all of our lives. However, as this NBC article notes, one of those negative impacts from a mental health perspective: The depression which comes as a result of “climate grief.”

I didn’t realize this until this article, but the American Psychological Association released a long report on how climate change is affecting mental health. That’s available here. That report, it seems, concentrates largely on the effects of climate change on the mental health of those who are more directly impacted by the negative impacts of climate change, including some of the enhanced hurricanes and extreme weather events. However, it also notes that personal relationships and psychological can be impacted:

Psychological well-being includes positive emotions, a sense of meaning and
purpose, and strong social connections. Although the psychological impacts of
climate change may not be obvious, they are no less serious because they can lead to
disorders, such as depression, antisocial behavior, and suicide. Therefore, these
disorders must be considered impacts of climate change as are disease, hunger,
and other physical health consequences.

I gotta say, personally, I totally get this, and I bet you do too. Worry about the planet’s health has starting permeating some of my worst fears, and particularly in terms of what we are leaving behind for our children. My children.

The NBC article notes that a woman featured in it, who has three very worried children, enrolled in a ten step program (the Good Grief network), which helps people deal with collective societal problems. I like this strategy a lot because it actually involves doing something – not just sitting and waiting.

I will refer again to an earlier entry I wrote in the aftermath of the Tree of Life shooting – how to have hope in a world filled with darkness. One of the specific items I wrote was this: Find what you can control, and do something about it. Is climate change an issue which is important to you? It should be. The question needs to me this then: What can you do about it? As an individual, there are quite a few things. This involves changing what you buy, what you use and how you take care of yourself. This also means connecting with elected officials and becoming a citizen activist.

On this issue, the best advice I can give is this: You aren’t helpless, and you aren’t powerless. If you are worried about climate change, do something.

My most-read blog entries of the year

I have to say, I really enjoyed the blog this year. After letting it go for months, I picked it up again and have consistently tried to create useful and interesting content. It’s also helped me expand my horizons and think about mental health in a different way.

This year also saw the publication of Redemptionan experience which has given me more joy than I ever could have realized – and an experience which was borne of my own depression. Take note, reader: You can get immeasurable joy out of sadness.

That being said, most importantly, I hope what I wrote has helped you.

So, here’s a look at the five blog entries I wrote which seemed to be the most popular. My year in review, if you will.

5) Ties That Bind: Liberals, Conservatives & Mental Health: This is the only “top five” entry which dealt specifically with public policy. It dealt with the challenges facing Democrats/Republicans, urban/rural areas and how mental health remains a huge challenge in all of these sections of the country.

4) Redemption, by Mike Schlossberg, is Almost Available: Alright, this one was blatantly self-promotional 🙂

3) The Tragic Suicides of Kate Spade & Anthony Bourdain: Within a few days, Kate Spade and Anthony Bourdain killed themselves. I wrote this blog entry just after the news broke about Bourdain, largely motivated by a very real fear about the contingent effect when someone does kill themselves. It was my immediate thoughts on what to do and how to help those who are suffering.

2) How To Stay Hopeful in a World Filled With Darkness: This entry was one of the most painful ones I have ever done, and like the one above, it was in the immediate aftermath of a tragedy – specifically the Tree of Life shooting in Pittsburgh. The crux of this entry was how anyone can stay hopeful and optimistic in a world where gloom and doom have become so powerful.

1) How Vacation Can Make You Depressed, and What You Can Do About It: This entry was inspired by my own upcoming vacation – and the depression which often accompanied it. What was most interesting about this one to me is that this one has seen a slow and steady increase in hits after the entry was posted back in late July. It did okay at first, but then the views just grew and grew. I suppose it’s good to know that I’m not the only one who sometimes feels this way.

It has been a wonderful year, and thank you for giving me the opportunity to talk to you. I wish you a happy, peaceful and restorative New Year. See you in 2019!