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.

Another Study Ties Higher Minimum Wage with Reduced Suicides

I’ve written about it before: Economics and suicide are tied. To be clear, that’s not to say that poor people are more likely to die by suicide; by and large, suicide crosses economic boundaries. What is more likely to be associated with increases or decreases in suicide rates is a change in economic status: An increase leads to lowered suicide rates, while a decrease leads to higher rates.

And that brings us to this study, published in the Journal of Epidemiology & Community Health. The study examined 25 years of economic and suicide rates in all fifty states and Washington, D.C. From the results of the study:

The effect of a US$1 increase in the minimum wage ranged from a 3.4% decrease (95% CI 0.4 to 6.4) to a 5.9% decrease (95% CI 1.4 to 10.2) in the suicide rate among adults aged 18–64 years with a high school education or less. We detected significant effect modification by unemployment rate, with the largest effects of minimum wage on reducing suicides observed at higher unemployment levels.

In other words, an increase in the minimum wage can save lives.

This study was picked up in numerous major media outlets, including CNN and NPR. As the CNN story noted, if you assume that the data from this story is accurate, an increase of $2 could have saved upwards of 40,000 lives between 2009-2015.

This study shows many things, but there are two, in particular, I want to focus on.

First: It challenges the idea that suicide is exclusively related to mental health, or at least adds a qualifier and a modifier to that idea. I think that when most people think of suicide, they think that a person who dies by suicide must be mentally ill. That makes sense, of course, and it’s a perfectly logical conclusion to reach. However, it’s not completely supported by the evidence. If depression was the only thing that mattered when it came to a suicide attempt, the minimum wage wouldn’t make a difference unless you assume that economic status is tied directly to mental health.

What this shows, again, is that suicide is not simply a matter of mental illness.

And that leads me to my second point: Everything is connected. Mental health is deeply connected to economics, and if we can ensure a robust social safety net, fair wages and equal opportunity, we can reduce suicides and save lives. This study proves it – again – and it isn’t even the first to make the argument that work and work hours are tied to minimum wage.

As public policymakers, we have a job to address major problems (like the massive spike in suicides) in a manner that is holistic and comprehensive. That means not only improving access to mental health care but reducing the causes of suicide.

That means increasing the minimum wage.

Why Words Matter – Even If It’s Not You

 

As some of you may have seen in the news or on my Facebook page, we had quite the day this past Friday. Governor Wolf was in town, holding the first of what will be many mental health roundtables. He announced the kick-off of Reach Out PA: Your Mental Health Matters on Thursday. It’s an overall, comprehensive effort to reform and improve Pennsylvania’s mental health system. It’s fantastic and desperately needed.

At the Governor’s Press Conference on Thursday, the Governor said:

“For those struggling with their mental health, we have one message: your mental health matters and it’s okay to reach out for help. We are stepping up our efforts to ensure every Pennsylvanian can access mental health care and more agencies can respond to the challenges facing Pennsylvanians struggling with their mental health. The act of reaching out for help – or to help – can make a huge difference for someone struggling.”

I opened the roundtable with this:

Obviously, I’ve discussed my depression and anxiety before. I haven’t quite gotten that intimate with how close I came to a suicide attempt, so that was a bit new.

I actually wasn’t even planning on doing that until a few hours before the event, when it hit me: I was going back to the place where I had seriously considered ending my life, standing with the Governor, my Congresswoman, friends, colleagues, and advocates, with the goal of saving lives.

(Random side note: I actually tagged my ex-girlfriend on Facebook for saving my life. We’re certainly on good terms, but I can’t imagine how weird that must have been – she looks at her phone and goes, “Wait, who tagged me? Why did that happen?)

I have to say – on a personal level – how much it meant to share that story. At the table with me was the Governor, my Congresswoman (Susan Wild, who has become a dear, dear friend) and Dr. Rachel Levine (PA Secretary of Health). Dr. Levine is brilliant and one of my favorite cabinet members with the Governor. She’s also a pioneer, serving as one of the highest-ranking transgender government officials in the United States. I cannot imagine how many kids and adults look at her and draw hope from her success and competence.

Congresswoman Wild is an advocate for mental health in and of her own right after she lost her life partner, Kerry Acker, to suicide. And Tom Wolf is truly one of the most recent people I’ve ever met in this job.

To be able to share that story – with those fine people, and everyone else in the room – that was meaningful. It gave meaning to what I had endured.

So, away from myself now. What the Governor has said about mental health, what others in his cabinet have said…it matters deeply. It matters because the Governor is lending his personal credibility and institutional strength to a push for better mental health access.

Public policy, public statements, and stigma are all interwoven. By doing events like this, there are people out there who are recognizing what the Governor is doing. At least some people will be touched by his words, by all of our words. And hopefully, they will be more likely to get the help they need and deserve.

Look, this system needs investment. Massive investment. We need more workers, more funding and less stigma. That all ties together. I hope and pray this was the start of a more comprehensive effort.

But I know that hearing someone as important, well known and well-liked as the Governor say that it is okay to ask for help – that matters. And it should matter if you say it, too.

“People who conquered depression and/or anxiety, what’s the #1 factor that helps you?”

As some of my prior entries have indicated, I’m a big fan of Reddit. If you use it the right way it can be hilarious, inspirational and adorable.

One of the more popular subreddits – and certainly one of my favorites – is AskReddit. In AskReddit, users can post a question to the Reddit community. Some of the questions are serious: “Why can’t you sleep tonight?” Some are hilarious: “You’re being interrogated and so far you’ve held strong. What song do they play on repeat that breaks you?”

And then there’s moments like these:

This was truly interesting. The top responses are largely along the lines of answers you might expect: Sleeping well at night, keep busy, stay away from social media (irony, right?), stop overthinking, etc.

I answered this question (surprise!), but I took my answer in a different direction. Here’s what I said:

I’m gonna spin this one on its head a bit. I think it’s important to address this answer to those of us who haven’t conquered depression or anxiety, and who never will.

Depression for some is a temporary condition as a result of a variety of factors, including social or cultural experiences, genetics, your upbringing or traumatic events. For people like this, time, therapy and/or medication – as well as lifestyle changes – can result in permanently defeating depression, and never seeing it again.

For other individuals – and people like me – it’s a permanent, chronic condition. Personally, I’m lucky – my ups are relatively long and my downs are manageable. For now. But, for people who will never truly rid themselves of depression or anxiety – who will experience it all their lives – it’s important to realize that this may be your world. Some people are cursed with physical disabilities which dramatically alter their lives and the way they experience it. For others, like us, it’s a mental disability.

What’s the #1 factor that helped me? I honestly think that one of them is this knowledge. The idea that I will never, truly be rid of depression. Why has this helped? It takes the pressure off. It makes me realize that I can lead a good life, even if this is always who I’ll be. That the “black dog” – as Churchill called it – will be a constant companion and challenge.

Second: To an extent, I have power over it. No, I don’t think I’ll ever be rid of depression. I don’t think I’ll ever be rid of the sinking feeling in my chest, the tension at the base of my neck, the imposture syndrome, the constant fear of losing everything and everyone I love. But I do have control. If I seize it, there are things I can do. That means self-care – therapy, medication, writing, working out being a type-A personality, etc. I accept that it has ruined other parts of my life, but strove to make me better in a variety of others.

Third: Accepting the positives of depression. It has made me constantly force myself to do something to improve myself, my life or those around me. It has made me tougher. It has given me a perspective and sense of empathy which I could never have imagined. And it has dramatically and positively impacted my career (I’m a State Representative in Pennsylvania, where I work largely on mental health issues – I also write and blog on the topic).

Yeah, leave it to a politician to not answer the question and answer it at the same time………..

My answer was long enough and pretty self-explanatory, but it’s worth noting again: Some people don’t “conquer” depression. They just learn to live with it, how to manage its ups and downs. I think that’s me. Once I accepted that – once I stopped kicking myself for feeling the way I did – it let go a lot of stress.

That being said, I don’t want to make it seem like my answer to the question was somehow crapping on the other ones. Less time on the internet, sleeping right, etc. – those are REALLY GOOD WAYS of beating depression. I just think that, for some of us, the idea of “conquering” depression is a bridge too far, sadly.

But that doesn’t mean it gets to run our life!

 

Will new three-digit Suicide Prevention Hotline lead to a surge in calls?

As you may have seen last week, the FCC voted to formally approve the regulatory process which would take the Suicide Prevention Hotline number (currently 1-800-273-8255) and turn it into a three-digit number, 9-8-8. It will take at least a year for the new line to go live.

For many reasons, this is a big deal in the suicide prevention world, and a wonderful development which will save lives. I can think of two reasons why this is so important off the top of my head. First is obvious: It’s an easy number to remember, like 911. Most people haven’t remembered the suicide prevention hotline number (I always have to Google it when I do blog entries like this, and I’m very in tune with the mental health world), and that’s an extra step. When someone is in crisis, you want to make it as easy as possible to get help. For the same reasons, means reductions matters when it comes to preventing suicide.

Second is the cultural statement: Suicide prevention matters. We all know 911 and understand the importance behind needing to call for help as soon as possible. With suicide numbers continuing to rise unabated, having a three digit number is a statement of priorities. It’s our way of saying, “Yes, this is important – really important. So important that we’re going to elevate the ease of getting help.”

But, that’s not to say that issues may not emerge as a result of this very significant and important change. As noted by this article from Pew Trusts, the new number will likely lead to a surge in calls. That’s good if it helps more people get help, but it can only help people get more help if the hotlines are prepared.

As noted by the article, there is not one massive hotline, per se, but a series of local hotlines, and many of them are “woefully underfunded.” Waiting periods and being bounced to a less local line are already occurrences which occur, and this surge in calls may make things worse. Furthermore, some states are in better shape then others. Six states (Georgia, Arizona, Colorado, New Mexico, New York and Utah) have made substantial investments and improvements in their suicide prevention hotlines, centralizing and standardizing systems while also expanding them. These states will be better prepared for the change over, but others may not.

What’s the solution here? The shift to 988 is great – but only if these lines are adequately funded. State and national governments have to expand funding, and they have to do it now. Pennsylvania and the rest of the nation have been utterly devastated by the opioid crisis which has taken more than 70,000 from us in 2017. As a result, we invested tens of millions of dollars in prevention and treatment. Suicide took 47,000 from us in the same time period, and hasn’t seen anywhere near the same levels of investment.

We need to invest the money here, too.