Are suicides increasing during COVID-19?

It was a frequently used argument during the pandemic, one often used against lockdowns: Suicide rates would increase as a result of social isolation, financial hardships, and more limited access to proper medical care. This fear was repeated by medical professionals and medical health care experts. Even Donald Trump repeated the line at one point, arguing that extensive lockdowns would lead to “thousands” of suicides. So great that he and so many others suddenly care about mental health when they spent years defunding services that would prevent suicide and trying to rip health care away from millions, but that’s a completely different story, so let’s move on, let’s move on.

We’re about four months into some of the various lock-downs and quarantines. The question is obvious: What does the data say? Are suicide rates on the rise?

It seems like its too early to tell. We will only be able to more definitively tell the numbers when the annual suicide numbers come out at the beginning of the year, and even then, it will be extremely difficult to determine the cause of the suicide. However, there is some evidence to indicate that things are not as bad as many of us feared they would be – though that could very, very easily change.

First, let’s look at what data is available and what data has been misleading. At the beginning of the pandemic, a doctor said that his California hospital had seen “a year’s worth of suicide attempts” during a four-week period. That report was utterly debunked: Numbers had barely increased at the hospital in question, and locals reported that they believed the local rate had remained stable in the area.

Apparently, calls to some suicide hotlines have increased. Outreach to suicide prevention text lines has increased as well. However, this may not be a bad thing, as it may be a reflection of people turning to the closest support line to get help. Indeed, if these hotlines are working, the increase in calls may be a good thing. Again, unfortunately, there’s no evidence to say one way or the other.

I couldn’t find any hard data discussing whether or not there was any evidence of suicide rate increases in the United States – if someone has that, please correct me. However, I did find evidence that suicide rates have actually dropped 20% in Germany. This is a preliminary finding, so it is likely too early to draw hard conclusions from it.

There is no question that COVID-19 will cause a massive spike in a wide array of social problems, and suicide would certainly seem to be one of these problems. However, as noted by many articles on the subject, it’s more nuanced than simply saying that “The lockdowns led to more deaths.” The pandemic also ripped apart the economy, threw us into a recession, and maybe a depression. There is clear evidence that down economies lead to higher rates of mental illness and suicide. As such, it is difficult to say that lockdowns lead to suicides. It is much more complex than that.

So, what’s the conclusion? There’s no conclusion. Not yet. Time will tell. But, more importantly, policymakers and the community at large must continue to work to mitigate the economic and social impacts of COVID – particularly on the mentally ill. I’m hoping to be able to work on that one over the summer.

Doom Scrolling: What It Is and Why It’s So Dangerous

I think it was at the height of the George Floyd riots (not protests, riots, and I do mean those two differently) that it really hit me. Dozens of cities were burning across the nation, the fire started by the murder of George Floyd. The kids were in bed, and I could not stop looking at Twitter, loading new tweets, reporting whatever horrendously depressing piece of information I learned to my wife, and then letting the cycle repeat itself over and over and over again.

I slept like crap that night. And for the next three.

Finally, at some point, it hit me: What the hell was I doing? Yes, staying informed is important, but this was insane. No good came of me cycling over and over through the battlefield that our news had become. Twitter was horrendous. Facebook was toxic. I needed to put down the damn phone.

I was Doom Scrolling.

Doom Scrolling is when you are staring at your phone, refreshing a social media feed, consciously or subconsciously looking for more bad news. It usually happens late at night, when you turn on your phone to unwind and relax…and instead become convinced that the world is on fire and that you will never get a peaceful night’s sleep again.

Looking at your iPhone late at night is bad enough for your ability to get some sleep, but Doom Scrolling is pretty much the worst thing you can do with your phone before bed, short of trying to eat the damn thing. But the problem with Doom Scrolling is what it does to your mind: It excites it, it terrifies it, it makes you feel sad and afraid. It also revs up your mind at a time you are trying to slow it down and get some rest.

All of these emotions are obviously not conducive to getting a decent night of sleep, and in turn, you wake up feeling sad, anxious, and depressed. This can turn into a bitter cycle.

Stopping Doom Scrolling is important to your mental health. It is difficult, but we have to find a way to do it.

How? Some thoughts.

  • Physically separate from your phone: Yes, that. It can be hard. It may make you twitch. But put your phone somewhere else. Charge it on the other side of the room. Give it to a supportive partner (who probably hates how much time you spend on it, anyway). Set a hard stop: No more phone use after Xpm. Just…go away from it.
  • Monitor your social media habits otherwise: Doom Scrolling happens because we have developed habits that push us towards using our phones anyway. Doom Scrolling is easier to stop when we monitor our social habits to begin with, then avoid staring at our phones at a moment where our minds are already primed to look for the bad news. We all know what it’s like – disappearing down the Scroll Hole. Looking at your phone for so long that you forgot why you started to begin with. Don’t be that person. Develop the habits to stop looking at your phone so much to begin with.
  • Set a time limit: Say you really do want to look at your phone and watch for the news. Maybe you, like me, enjoy being plugged into society and find value in it. That is a totally understandable reflex, and our phones have been unquestionably helpful at building a more connected world…indeed, many of us never would have become as a way of the problems people of color face at the hands of elements of law enforcement, to begin with, were it not for our phones. So, allow yourself ten minutes. Physically set a timer. Scroll for ten. And when your phone rings, be done.

You’ll notice a theme: Some of the pieces of advice that I give are more physical than psychological. That’s because Doom Scrolling is a reaction to the terror around us. I’ve repeatedly tried to note that individual psychology cannot be separated from the real world, and at moments of terror or anxiety, we all become depressed. Our phones just give that an outlet, hence the Doom Scrolling.

And one more thing. Don’t berate yourself for Doom Scrolling. It happens, and it’s okay. You’re not weak. You’re human and normal. We all want to feel connected, even to a world that feels broken. For better or for worse, our phones give us that opportunity.

How much is Doom Scrolling an issue for you? Have you found any tricks that can help you stop it? Let us know in the comments!

The Depression & Anxiety of Racism

Last week, I wrote a bit about the Black Lives Matters movement and the incredible stress and strain that racism is causing people of color. This is a topic that I really think demands further exploration.

First, I mentioned it last week, but check this article out in more depth. Rates of anxiety and depression spiked, hard, for African & Asian Americans in the aftermath of George Floyd’s murder. Among African Americans, positive screenings for these disorders rose from 36% to 41%, while they increased from 28% to 34% among Asian Americans. Those are all significant increases.

Interestingly enough, it did not increase for members of the Hispanic population. I’d be curious to better understand why that is the case, but that’s for another day.

Tragically, the reason we have this data is because the federal government was attempting to track the impacts of COVID-19 on minority populations, which, as we know, has been hit particularly hard by this pandemic. One tragedy upon another.

If these findings are accurate and representative of the increasing rates of mental illness among the general public, it means that at least two million more people experienced mental illness as the result of the murder of George Floyd. These are horrifying numbers, but they really aren’t all that surprising.

We know, definitively, that external forces can increase rates of mental illness. Depression, anxiety, and suicide all rise in times of economic turmoil and it makes tragic sense that a group of people who are under perpetual attack at an individual and societal level would experience rising rates of mental illness when a horrific video showed a slow-motion murder.

What does this mean? Again, the good news…such as it is…is that we, as a society, are having a larger conversation about systemic racism. I worry that too much of the conversation has focused on police brutality and criminal justice reform. That is important, no question, and its the primary issue in front of us at the moment. However, we cannot lose sight of the impact that centuries of racism have had on countless other areas of life.

One of those must be mental health.

As a white man, I cannot personally understand the impact of racism on mental health. But the literature and personal experience of countless people of color are clear. Racism means lost opportunities. It means personal pain and lives destroyed. It also means the trauma of watching countless people who look and act like you being gunned down by the men and women who are supposed to protect you.

What’s my point of this entry? The article above proves it: Police brutality and systemic racism mean depression. They mean mental health. And as we have a conversation about what Black Lives Matters means, we cannot forget this vitally important component of addressing and ending systemic racism.

COVID-19, Mental Health and Black Lives Matter

Hey, everyone!

First, I apologize. My blog entries have obviously been spotty for the past few months. There is a reason for that: The real world. Simply put, my job as State Representative became too overwhelming. This, along with other responsibilities, made it really difficult for me to blog. I am sorry and I will try to get back into my twice a week habit now.

So, let’s get right to it. Every one of us has been following the murder of George Floyd and the subsequent explosion of the Black Lives Matters movement. If you read my blog, I’m guessing you are at least somewhat progressively orientated. That probably means you are shocked and horrified at the current state of the world, and want to do something to make it better.

As a white man, I can’t sit here and yammer on about what the Black Lives Matter movement means. I represent a district that is about 1/2 minorities and work with dozens of other elected officials who are people of color, and I’ve tried to learn from their experiences to figure out not only how to do my job better, but how to be a better person.

From my perspective, acknowledging those limitations, I’ve come to the conclusion that we scream Black Lives Matter because society has decided for centuries that they don’t. That we scream Black Lives Matter at the top of our lungs because the communities of color have been devastated, destroyed, and degraded for centuries in a way that white people cannot begin to fathom.

To the casual observer, I think it gets too easy to assume that the entire Black Lives Matter movement only revolves around police reform and criminal justice. As best I can tell, that isn’t only the case. Black Lives Matter, at least to me, means that we address all of the systemic inequities in our society. That means addressing countless areas of our public policy, including education, urban planning, economic development, health care access and more.

It also, unquestionably, means mental health. I’ve written on this topic before, but even the briefest of looks at Google shows the enormous disparity facing the minority communities when it comes to mental health. Furthermore, new studies show that that levels of anxiety and depression spiked among the African American population after the murder of George Floyd. As if their burden wasn’t already enough to shoulder.

All this brings me back to COVID. I wrote a line in Redemption that I barely even thought about until a reviewer flagged it: “When civilization collapses, it doesn’t collapse evenly.” COVID has taught us that, hasn’t it? Obviously, civilization isn’t collapsing, but boy has it taken some hits.

And those hits have not been evenly distributed.

Just take a look at how COVID has hit minority communities. The evidence is painfully clear: According to the CDC, minority communities in general – and the African American community specifically – are more likely to contract COVID, be hospitalized as a result of COVID, and die from COVID. This isn’t a result of any genetic challenges. Instead, its a result of systematic discrimination that has resulted in years of poor health care access in general, substandard living conditions and worse health.

When civilization collapses, it won’t collapse evenly.

What’s my point? Pretty obvious. I think most of us agree with the statement that Black Lvies Matter. That means we have to act like it. It means our policy has to reflect those values, and that must be carried out in the way that we discuss all aspects of public policy. Mental health must be part of that equation.

Corona is frightening – here’s how to avoid freaking out

Yeah, I can’t lie, I’ve been stressed about Corona too. As I type this on Saturday morning, 103,739 people have the disease and 3,522 have died. By the time you read this, sadly, both of those numbers will have increased.

Corona is obviously having major ramifications on the world economy, and economists have noted that the potential for this disease to harm our wallets is extremely high. The federal government isn’t exactly doing a bang-up job of instilling confidence in their ability to fight back against this disease, with the President and his staff regularly boasting that the disease is contained when we know that just isn’t true.

An objective look at the facts makes it very likely that the disease is only going to get worse. And, if you have a mental illness, this is likely enough to cause no shortage of panic or anxiety. I had a regularly scheduled appointment with my therapist the other day and asked him if Corona was coming up more often in sessions; he said yes, absolutely.

I certainly can’t blame anyone for being stressed about a potential worldwide pandemic. It is frightening, and even more so if you have a health condition that may make you more prone to becoming ill. That being said, I think that it is important that we keep the coronavirus in perspective and avoid treating it like a death sentence. There are some things we can do to maintain our mental health during this outbreak. Here’s a look.

Focus on what you CAN do

Anxiety – at least to me – is largely about control. I always feel most anxious in situations where I am somehow powerless or helpless, and I know that this is a relatively common theme. Corona is so frightening precisely because it seems as if you have so little control.

Look, that’s not exactly true. There are some things – many things – you can do right now. As noted by governmental officials, you should be:

  • Practice good hygiene. Wash your hands for 2 minutes and multiple times a day, avoid touching your face.
  • Don’t travel to areas with noted outbreaks.
  • Stock up on your emergency kits in the event that there is a disruption of day to day activities.
  • Make plans for you and your family or work in the event that someone gets sick.
  • Research the Coronavirus for symptoms. They appear to be flu-like symptoms.
  • Only get your news from reputable sources. Read something on Twitter? Don’t believe it unless you can confirm it.

And once you do that: Stop. You’re okay. If you are doing everything you can to prevent Corona…well, good! You got this.

Recognize that anxiety has a use

This Lifehacker article on the subject absolutely nails it: Anxiety serves an evolutionary purpose. Yes, anxiety disorders are clearly not helpful, but remember, the purpose of anxiety is to keep you on your toes for any perceived threat. A bit of anxiety over a global pandemic is not a bad thing! It helps ensure that you are keeping informed of developments about the virus and that you don’t take this disorder too lightly.

When you’re feeling anxious, don’t try to suppress it. Try to logic your way through it. Ask yourself:

  • What is the threat? Is there any immediate threat?
  • Are you doing what you can to prevent and prepare for Corona?
  • What do the authorities recommend that you do right now?
  • Do you have an emergency plan?

If you’ve answered these questions satisfactorily, then you’re probably more prepared than the vast majority of society to deal with Corona. Congrats!

Limit your news intake

Throw CNN and Foxnews out the window.

Okay, don’t do that. But remember, the purpose of many news stations isn’t just to keep you informed. It’s to panic you so you need to constantly be turning the news on. These guys profit off of your fear, and yes, they have their use, but don’t sit there, staring at CNN, waiting for the next BREAKING NEWS ALERT (“Wolf Blitzer is coughing, what does this mean!?!?!”). Watch the news at regular intervals, certainly. Stay informed. But at some point, turn the damn TV off.

Of course, there are more tips, and I’d love to hear whatever your recommendations are for staying calm during a viral outbreak. Any tips you want to share with us? Leave them in the comments below!

 

Landmines and Ballerinas: How to cope with a lack of sleep when you’ve got mental health issues

For a lot of reasons, I slept like hell last night. For me, that’s dangerous. To be clear, all of us need a good amount of sleep in order to function the next day – I need at least five hours, I’d say, to be able to fire on all cylinders.

However, and this goes without saying, there is a huge connection between mental health and sleep. A lack of sleep can hurt your mental health, and mental health challenges can hurt your ability to get sleep. I know that both of these items are true for me, and I also know that on nights where I barely sleep (like three hours or less), I can barely function. As I said to my wife today, it feels like my head is filled with landmines and ballerinas that are blowing up those landmines. I absolutely cannot think straight. Of course, that may make this blog entry kind of interesting, so if I write out CHEEEEEEESE or something with no context, just bear with me.

Anyway. If you are like me, this can be a real challenge. A lack of sleep fires every one of my depression and anxiety genes, and I feel like I lack the coping and logic skills to get those emotions back in the bottle. My head feels like it’s filled with fog and sand.

How do I deal with this? I’m not quite sure yet, to be honest. But, broadly speaking, here are some thoughts.

Treat it as a sick day

Look, when you don’t sleep, you feel like crap, right? Take it for what it is: It’s a sick day. I’m not saying curl up in bed and take the day off from work – that may not be an option – but what I am saying is you should go easy on yourself. It’s not as if you somehow asked for mental health problems or to sleep like crap. Give yourself a break, and don’t hold yourself to the same standards that you may do on an otherwise normal day.

Ask yourself what you can do

One of the more impactful moments of my life came about a year after my son was born and when my wife was pregnant with our daughter. I was much, much heavier – 31 pounds or so, depending on the day. And I was upset. I’d really let myself go. And I was complaining about it to my wife, but the complaints weren’t action-oriented. They were just me bitching. And she said the line to me:

“So, what are you going to do about it?”

I don’t know about you, but on days where I’m struggling for one reason or another, I always feel better when I ask myself that question. Look, everyone has bad days. But if they become a pattern,  you have to ask yourself that question. What are you going to do about it? And that’s a key question, because yeah, things may suck at the moment, but if you can say to yourself, “Yes, I can barely think straight and am probably less coordinated now than I am when I’ve had a few drinks, but what can I do to make sure I take care of myself?”

Nap…but…

According to sleep.org, a nap the next day can potentially be helpful, as it can help ease the impact of having trouble sleeping. However, timing is key: Early to mid-afternoon is best, as this decreases the chances of your naping hurting your ability to sleep later that night.

Ultimately, these are just some broad thoughts, and I’d be really curious to hear yours…particularly considering I’m about to go face first into my keyboard. Any advice would be appreciated!

 

The Difference Between Being Sad & Depressed

As someone who has a lifelong period of depression, I think the above question is one that I ponder on a somewhat regular basis – certainly more often than I wish I did. It’s sad, but it’s necessary, and it’s something I have to consider.

If you’ve stumbled across this blog entry, you may be asking yourself the same question. What, exactly, is the difference between being sad and actually being depressed?

First, the standard disclaimer: I’m not a doctor, therapist or anyone with any real training. Just a guy with a lifetime of experience at dealing with these issues and their related public policy implications.

That being said, this is an important question. It can determine a lot of next steps: Do I need to see a therapist? How seriously should I be taking my mood? Do I need to adjust my medication?

Some broad thoughts:

Length of time

Of all the factors below, I think I’d argue that this is the key difference. Depression – when it’s clinical – is something that lasts for more than just a few minutes or days. It lasts for weeks and it is relatively relenting. Indeed, some of the things listed below really aren’t the biggest problem if they are brief or intermittent. But, if the symptoms last for two weeks or more, you start to cross the threshold into something being clinically wrong.

The reason behind your mood

The reason behind your mood is a key issue. If there’s a clearcut reason (stress at work, sick family member, that sort of thing), of course, you are going to be down. Indeed, the DSM-V diagnosis for depression has a specific exception for bereavement. However, if the depression or mood feels disproportionate to the situation, or you can’t quite pinpoint what’s making you so sad, there may be something deeper going on.

Functionality

Everyone gets sad. But how the sadness affects your ability to function, and over an extended period of time, is the real key here. If you are sad, can you function? Can you still go to work? Are you too impaired or altered to be able to do your regular responsibilities?

Physical symptoms

Generally speaking, sadness doesn’t come with physical symptoms. Depression, however, often does. You lose appetite. You get an upset stomach or a major headache. You get sick. If this is something that’s happening to you, and you feel the sickness with a degree of intensity, well, there may be something more serious going on.

As you can probably see from the nuance I use above…there’s no easy answer here. I wish there was. But that’s the bitch about mood disorders. There’s no blood test. There’s no magic diagnosis. Yes, there are screenings, and therapists who can help you find your way (thank God), but there is often more nuance in this question than is preferable.

As always, I welcome and appreciate your comments. Anything to add? Where’d I go wrong? Let us know in the comments below.

 

The Availability Heuristic and You

Alright, you’ve read this blog before, right? So, what do I hate more than almost anything else, despite the fact that I just can’t stop checking it? Yes, social media. I’ve written over and over and over about how evil it is and how much harm it can cause and blah, blah, blah…

(Okay, yes, I know it isn’t necessarily THAT bad, and that it does have many positive benefits, but people should use it with caution)

Anyway, I had an interesting conversation the other day about how terrible things are in the world and how all it seems like you hear is bad news. My friend and I were discussing this, and he specifically mentioned the Availability Heuristic.

For those of you who didn’t take Psych 101, in the most simple terms possible, the Availability Heuristic is the notion that what you see is what you get. Your mind, when thinking of things, thinks of the loudest or most recent things that it sees.

And this, in turn, can really lead to depression. Particularly in a social media-heavy world.

Think about it: You sign onto social media, and what do you see? TRUMP SETS THINGS ON FIRE! DEMOCRATS SET BABIES ON FIRE!

I mean, I’m kidding…a little. But as you scroll, you get more and more depressed. We’re exposed to a good chunk of statistics and information that other generations couldn’t even fathom. This can warp our perception of the world and alter our moods and feelings.

Given the reality of the Availability Heuristic, I am convinced that this is part of why we have so much trouble in the universe today. We see and think of things that are only immediately available and memorable. And that’s the bad news.

I mention this because I think this is an interesting way of framing the conversation of social media. There’s a set, cognitive bias for why we think and feel the way we do, and the better we understand this, the more sense all of our minds will make. Remember, it’s not just you. Cognitive biases like these exist to poke us in the head and make us see things a certain way. They have their evolutionary benefits to be sure, but sometimes, they can run amok.

So, short of throwing your phone out the window, what can you do if you do find yourself getting depressed by the evening news and your Twitter feed? Remind yourself of this fundamental truth: The bad news is sticking in your brain more than the good. This is normal – even healthy to an extent – but it isn’t as bad as it seems.

LGBT Marriage Equality Saved Lives

I’ve written extensively on the connection which society forces upon people who are LGBT and have a mental illness. To be clear, there is nothing inherently mentally ill about anyone who is LGBT: It is the societal pressures and discrimination faced by people who are gay or transgender which can give them a mental illness. This is a tragedy and a sin that we must address at a societal level.

If you’ve read this blog long enough, you know that one of the items I regularly harp on is the connection between mental illness and public policy. That connection was first driven home for me in a 2015 study which showed that members of the LGBTQ population had higher rates of mental illness and addiction in states where marriage equality wasn’t the law of the land than in states where it was legal. To be clear, this may be a classic case of correlation not equalling causation, as there may have been other reasons which LGBTQ people had better mental health in these states. However, it would certainly imply that there is a connection between mental illness and discrimination – a finding which was picked up in other countries, like Australia and New Zealand.

Finding that study was a critical moment for me, at least in terms of how I viewed mental health and public policy. Not only does public policy influence mental health, but it influences it in ways which we may not expect.

Well, here’s more proof: As noted in this Upworthy story, suicide attempts by LGBT youth dropped in states that legalized gay marriage and didn’t drop in states that didn’t. Similar findings were replicated in other countries that embraced marriage equality.

Again, the findings aren’t necessarily causational, but they would seem to pretty strongly imply a connection between societal stigma. Countless other studies have proven that treating any typically discriminated group with love, acceptance, and support can reduce their suicide rates. The legalization of gay marriage can make a massive difference here, as it ended a societally-enforced piece of discrimination.

Public policy and mental health matter, and matter deeply. We can, and should, examine all aspects of public policy through a mental health prism, as this connection exists in dozens of public policy spheres – everything from transportation to minimum wage to licensure laws and more.

New study: 13 Reasons Why did not cause an increase in suicides, and may have done some good

I’ve written repeatedly about Netflix’s 13 Reasons Why, and usually in a pretty damning light. Like others (who are far more informed and educated than I am), I’ve expressed my real concern that the show has unintentionally glamorized suicide, and there has been evidence to suggest that it actually led to an increase in suicides.

However, a new study shows that this may not be the case, and, in fact, that 13 Reasons Why may have done some good.

First, a review. 13 Reasons Why tells the story of Hannah Baker, a teenage girl who dies by suicide and leaves behind tapes for people to listen to, explaining why she died and their role in her demise. The show was criticized by many for glamorizing suicide and presenting it as a possible choice, and Netflix eventually removed the three-minute, highly graphic scene in which Hannah dies.

Of course, that removal came after being viewed millions of times, and at least one report directly tied the show to a rise in suicides.

However, a new study came to the opposite conclusion:

But a recent reanalysis of the data by Dan Romer, research director of the Annenberg Public Policy Center at the University of Pennsylvania, found no evidence of an increase in suicides for boys, and (like the original study) an insignificant increase for girls. Romer adjusted the data to factor in trends like an overall increase in adolescent suicides since 2007.

That’s important. But it’s not as important as this finding:

But when Romer conducted a study on 13 Reasons Why’s effects on self-harm, published last April, he found that teens who watched the entire second season of the show were less likely to purposely injure themselves or seriously consider suicide, even when compared with those who did not watch the show. He said that this could be because of the Papageno effect, which occurs when stories that portray people overcoming their suicidal crisis end up reducing suicide rates. The effect is named for a character in Mozart’s opera The Magic Flute who considered suicide until his friends showed him a different way to solve his problems.

The second season of 13 Reasons Why features a character who is depressed and considers suicide – but survives. This is important, and it feeds in with a larger theme in the mental health universe: We have to share stories of hope, of survival, and of seeking help successfully.

Part of the reason that so many (myself included) thought 13 Reasons Why was so damning, as portrayed, is because it features a character dying by suicide in a graphic manner. This can create copycat scenarios. However, the good news is that the Papageno Effect is real and has been repeatedly backed up by science. This is great news: If you can show someone finding hope, you can inspire others to do the same.

I appreciated this alternative perspective of 13 Reasons Why, and I appreciated the hope that it could potentially inspire in others. It also reinvigorates what I have said for ages: Share your story. It’s why I’m so passionate about sharing mine.

You can save a life.