A More Preventative Mental Health Model

I caught this article in USA Today and it introduced a fascinating concept – one I hadn’t heard of.

Many of you are likely familiar with the National Suicide Prevention Hotline, which has been used to stave off countless crises and has likely saved thousands of lives. Of course, calling this number is what you do at your worst moment – when you are at the bottom of the barrel and feel as if you might hurt yourself because you have nowhere else to turn.

What if there was a way to reach a person before it hit that crisis point?

Introducing the “warm line” from the Mental Health Association of San Francisco. From the article:

Unlike a hotline for those in immediate crisis, warmlines provide early intervention with emotional support that can prevent a crisis – and a more costly 911 call or ER visit. The lines are typically free, confidential peer-support services staffed by volunteers or paid employees who have experienced mental health conditions themselves.

In other words – someone can call, get support, talk to someone, and get access to more resources, thus potentially preventing a more expensive and serious crisis.

This is a great idea, and according to article, a wildly popular one. But, does it work? Will it cut down on arrests, suicides or other mental illnesses? According to one analysis, yes.

Here’s the real reason this appeals to me: It’s a paradigm shift. It’s so much more than just a band-aid or a cure for someone in a crisis. Don’t misunderstand – that’s incredibly helpful, and necessary. But what if we can stop someone from getting sick in the first place?

If you stop a physical illness before it gets infected, you save money, time, pain and lives. Hopefully, programs like this can help push in more into that sort of space when it comes to how we discuss, treat and cure mental illness. It’s why we should try to teach mental health in schools. It’s why physicians should conduct mental health screenings on routine exams. It’s why mental health first aid should be taught alongside physical health first aid.

We can stop these problems before they start.

How To Give Thanks When You Aren’t Sure How

My understanding of Thanksgiving has always been to try and take a step backwards and find the things for which I am grateful: Family, friends, food and safety. It’s a moment where you are supposed to be filled with gratitude.

Of course, if depression is clouding up your life, that can be a difficult experience – to put it mildly.

One of the worst things about depression is that it not only makes you feel sad, but it staves your sense of joy. When you are depressed, you cannot enjoy things. You cannot find the things to be grateful for – your mind is just clouded with sadness and pain. That, of course, is awful on every level.

According to an article from Psychology Today, gratitude can make you feel better:

Scientists say that these techniques shift our thinking from negative outcomes to positive ones, elicit a surge of feel good hormones like dopamine, serotonin and oxytocin, and build enduring personal connections.

Another article, this one from Harvard, notes that there is actual science behind this concept, and that multiple experiments have shown that individuals who actually took the time to decide, discuss or write down things that they were grateful for actually felt better and more optimistic about their lives after doing so.

All of this being said – I’ve been there. I get it. When you are in a hole so deep that you cannot see any light, writing down things for which you are grateful can be a challenge…to put it mildly.

If that’s where you are right now, it’s okay. Don’t feel bad, don’t feel guilty and don’t beat yourself up. That’s a pain which millions of others can share with you.

Instead, my advice to you is this: Try to take a step backwards.

If you are reading this, you’re in better shape than large swaths of humanity. You’re able to read and access the internet. Hopefully, you’re at home now, safe and secure, able to access the basic necessities of life. I hope you are warm and comfortable. You’re able to eat and drink whenever you want. I mean, according to the World Health Organization, 785 million people don’t even have access to basic drinking water service. If you are reading this, that almost certainly isn’t you.

Folks, one of the hardest things to remember – particularly if you are one of the 1 in 5 Americans who has a mental illness – is just how lucky you truly are. Start at the basics, and I mean the basics. The food in your stomach. The clothing on your back. And try to remember that there are billions who aren’t as lucky as all of us are.

Whatever our struggles, whatever your pain, I guarantee you are more fortunate than hundreds of millions. Start from there. Use that as the building block and move upwards. Concentrate on the gratitude and joy you’ve gotten from the smallest moments: The quick laugh with a coworker who likes you. The likes on your Facebook status. You can find joy in even the smallest of moments, and sometimes, that’s enough.

To be clear: I’m not an idiot and I’m not pollyanic. A Facebook like or a shared smile with a stranger will not cure your depression. It will not make you whole. But it may take away your pain, if only for a moment. It may help you regain a sense of control over your own mind, something that is absolutely critical when we are battling our own demons. To that end, try to balance your pain-filled moments with the good ones. Write down what you are grateful for. You may be surprised with how it makes you feel.

Happy Thanksgiving, everyone. I hope you are able to celebrate and enjoy it!

 

Do you have a puppy folder?

I had a couple of rougher moments over the past weekend. No real reason, just work and stress – the standard stuff, really. I will admit that I was surprised by how intense it was, but these things happen.

Anyway, I was talking with my wife and trying to snap myself out of it, and with a laugh, I pulled up this video.

The background: I was speaking at an event announcing the moving of the Da Vinci Science Center into downtown Allentown (a big deal, locally!). I was surrounded by elected officials, major developers, local residents, the works. And the microphone just went, “Nahh, f&ck you, I ain’t working.” So we have massive feedback, followed by the microphone just straight up falling as I tried to speak. I know it sound stressful, but honestly, it was hilarious for me, and if you watched the clip, you can see I handled it just by laughing at myself. It wound up being really funny (side note: When faced with an embarrassing situation, just lean into it).

Anyway, whenever I watch this clip, I always get a chuckle. And that’s sort of the point of this entry.

On Monday, I spoke about the need to develop specific tactics which can help you fight back against your anxiety. Things that would temporarily distract you from where your head was swirling off to in order to break the cycle of anxiety and get you out of an attack.

This entry is more or less the companion entry for depression. My suggestion: Have a puppy folder. Have a folder (digital or physical) which you watch that features adorable videos which always cheer you up or make you laugh. It can be movie bloopers, cute pictures of puppies, whatever.

By the way, I do mean, literally, have an actual folder. As you probably know, when you go down the rabbit hole of depression, it can be extremely difficult to pull yourself back out, or to do anything which has even the slightest bit of self-care involved. That’s why I say you should have an actual folder, a one-stop shopping sort of place: When it comes to self-care in your darkest moments, you need to make it as easy as possible for yourself.

To be clear, this isn’t a long-term strategy. It’s a tactic, and there’s a difference. If you find yourself having these dark moments more frequently, if they turn to thoughts of self-harm, or if you start to lose productivity and the ability to function, you need to do more than just watch funny videos: You probably need to see a therapist.

That being said, everyone has down moments. The tactic of a puppy folder can help you break the cycle. It can feel good and give you a moment of joy, and that moment can turn into the foundation for getting yourself out of a rougher moment.

Any videos, pictures or websites which you use on a regular basis to get yourself out of that darkness? Let us know in the comments below!

 

4 Tactics to Stop A Panic Attack In Its Tracks

Ah, panic attacks.

Last week, I wrote about the difference between panic attacks and anxiety attacks. They are both nightmares, of course, but I’d argue that panic attacks are the more intense, nightmarish ones. I consider myself deeply lucky that I haven’t had either in years, but I still remember the pain: The feeling that my bowels were going to turn to liquid, the heart racing, the desperate desire to escape and sensation that you are going to crawl out of your own skin at any moment.

Defeating panic attacks takes quite a bit – often some combination of therapy, medication or tranquilizers. It takes planning, effort, and strategy. However, there are also tactics which I think you can use in order to defeat or slow a panic attack. Yes, I mean tactics: Specific things which you can do in order to feel more powerful and regain control over your own body and mind.

Here are 4 of them:

Pick a Number. Add By 7. Repeat.

My anxiety was out of control in college, particularly senior year. That time period ultimately resulted in a medication adjustment, increased therapy and the development of a series of tactics with my therapist to stop an panic attack. And this one worked, a lot.

When you have a panic attack, your mind just whirls out of control. The key – as exemplified by this effort and others – is to stop it from doing so. To that end, you have to distract yourself.

So, ask yourself? What’s 1,054 + 7? And then another 7? And then another? Get bored? Subtract by 8 now. Just keep going. Take all of that mental energy you are feeling and put it elsewhere. Do whatever you can to break the chain of anxiety which has wrapped its way around your neck.

Notice Stuff

I actually got this one from a LifeHacker article, and it apparently came from BoJack Horesman. Specifically, two characters are talking, and one starts having a panic attack. The other asks him to notice the things which are giving her anxiety, and then start noticing and describing the more mundane things. Chairs. Tables. Lamps.

I think this one works similar to my example above, but with a different basic idea: You try to distract yourself by immersing yourself in another activity. This, of course, can be impossible to do when your mind feels broken, but it is absolutely worth the effort. With this tactic, you try to lose yourself in something else. You find a detailed object and go DEEP. What color is it? What do you think it feels like? When was it made and who do you think made it?

Allow your mind to run away from itself.

Guided Visualization

Guided Visualization is just what it sounds like – you use it to escape your own mind. Either through an audio or visual file, you follow the narrator on a journey. It often involves breathing deeply and relaxing.

Thanks to YouTube, there are no shortage of examples. Even better is that many of them are highly specific to panic attacks.

I’ll say this: These were hard for me when I had bad ones. When they were on their way out or just starting, my wife could often give me a visualization scenario that worked, but as the panic heated up, it became even harder to focus on visualization. Everyone is different, of course, and I hope this works better for you than it did for me.

Understand What’s Happening

Yes, I understand that this one sounds utterly ridiculous, but if you are capable of thinking logically (big if – big big if), this may be helpful. On a biological level, a panic attack is a misfiring of your body’s flight or fight response. Your brain perceives a threat when none exists. As such, you have to try to trick your brain into coming back to reality.

Difficult as it can be, try to take a step back, something akin to mindfulness. Say to yourself: “This is just a misfiring of the neurons of my brain. Nothing is wrong. There is no threat. I am safe.”

If you can understand what is going on – that there is no threat – you may be able to get yourself out of the attack.

As always, I welcome your advise. And also, please understand, much of what I wrote will not work for everyone. Or maybe anyone, I don’t know. But these things did help me – and I hope they can help you, you too.

 

Why We Need More Articles That Get Specific to YOU on Mental Illness

I’ve been relieved to see that more and more people are discussing mental illness lately. When done right, this is a good thing – people become more aware of the breadth and depth of the mental health crisis we have, and hopefully more likely to seek help themselves or encourage their loved ones to do the same.

As long as the topic is approached with sensitivity and empathy, there is no such thing as a “bad” mental health article. Some articles, however, can have more of an impact than others.

Which ones are those? The ones which focus on you or your loved ones.

Consider, for a moment, these articles which focus on specific professionals:

Or these articles, which concentrate on age groups:

Or these racially or location-focused articles:

If you reviewed all of these headlines and identified with any of them, you felt a moment of empathy. You probably felt a touch of happiness at being mentioned in a story like this. If you fell into any of the groups noted above, I bet you were a little more likely to click on the article and read more, and from there, maybe you found a useful piece of information. Maybe you found something that made you think of someone you loved. Maybe you filed a scrap of information away for later.

Either way, stigma and mental health campaigns work best when they are targeted at the person with someone that they recognize. Often times, in the work of mental health planning, you will hear conversations about the need for culturally competent campaigns – meaning campaigns where it’s people of varying ethnic and racial backgrounds.

I’ll take that one step further by point to the above. There’s no question that cultural competence in every area – including mental health conversations – is very important. However, it’s not the only one. We also need to have these conversations where the reader can look at someone and recognize them because of their job, their age group, their location, and that’s why these stories are so important.

Generalities aren’t enough. The more specific we can get – the more targeted we can be in our efforts to discus mental illness and stigma and suicide – the better our campaigns can be.

The American Public Gets It: Stigma Is Real, and We Need To Do More

CBS News ran this fascinating poll on mental illness. I’d argue that there aren’t many surprises in the poll, but I got two key takeaways.

First, to summarize the findings:

  • 51% of Americans say that people living with a mental illness face “a lot” of stigma and discrimination – 31% say “some.”
  • 38% of people say that mental illness stigma has gotten better, 22% say worse, and the rest say that it hasn’t changed.
  • 66% of people say that mental illness is a very serious public health problem – 28% say somewhat serious.
  • People do believe that mental illness is a real medical condition (79%). Roughly 2/3 of those polled also said that virtually anyone can get a mental illness and most people who are treated right can lead productive lives.
  • A mere 12% of people say that services for the mentally ill are adequate – but 49% said they are not.
  • A whopping 77% of people say that celebrities speaking about mental illness are doing a good thing – only 18% said no.
  • 73% of Americans know someone diagnosed with a mental health disorder (I guarantee that number is higher and people just hid their own mental illnesses), while 58% said that they had a family member who sought care for mental health (again, I’m sure that number is higher).

So, here’s what I got out of this. First, those support numbers are just overwhelming. 66% of people think mental illness is a “very serious” public health problem. 28% say it is at least “somewhat serious.” That’s 95% of the American public who think that mental illness is at least somewhat serious. That is not a small number! The key question is this: What does that translate to? Are people willing to dedicate more time and money to mental health care? Or is this simply a, “Gee, that sucks…moving right along” sort of things?

At the bare minimum, it is good to know that people understand just what a major problem mental illness is.

Second, the stigma questions got me thinking: What if the stigma is all self imposed? I mean, take a look again at that top finding. 51% of people think individuals with mental illness face “a lot” of stigma, while 35% say they face “some” stigma. That is not a small number. But if that many people think stigma is so real, what’s really the problem here? People who acknowledge stigma is real must also have stigma-inducing thoughts, right? Or, what if the stigma is just the fear of being stigmatized? Or self-stigma? I’ve always thought that self-stigma is a bigger problem then actual stigma.

The findings, in my mind, mean that we have to rethink our traditional definition of mental health stigma, because I don’t think that a traditional understanding of, “People with mental illness sure do face a lot of stigma” is enough.

But, as always, I ask: What do you think? What are your thoughts on this poll? Let us know in the comments!

How Gun Control Can Help Stop Suicides

When people who oppose gun control don’t want to say, “Hey, yeah, I think that we should allow ordinary citizens to own ballistic weapons without so much as a background check,” they don’t do that. Instead, they say, “We shouldn’t focus on gun control – we should focus on mental health.” It’s a lovely political pivot from a group of people who don’t want to actually focus on things which will stop gun deaths.

Related: They then do less than nothing to help people with mental illness.

I’ve attacked that argument before, but now I’d like to add to it: Gun control measures – and specifically Red Flag laws – can help stop suicides.

What is a “Red Flag Law”?

A “Red Flag Law” – also known as an Emergency Risk Protective Order – is a formal court proceeding. They vary from state to state but have the same characteristics: If a person is making threats or found to be a danger to themselves or others, someone (such as a family member or police officer) can petition the Court to have an individual’s guns temporarily removed from their possession. They’ve been promulgated as an effort to stop mass shootings, but the data thus far shows that they are more beneficial in the fight against suicide.

Limiting Access To Deadly Means Stops Suicide

Multiple studies and historical experience have proved it – if you limit someone’s access to the means of suicide, you can reduce suicides. And that is precisely why Red Flag laws are so important for reducing suicides. If crafted appropriately, a red flag law can result in the removal of a gun from someone who may hurt themselves with it.

So, yes. Here’s an area where we can help mental illness – but it’s via sane gun control measures.

Red flag laws are relatively new, so the research on them is somewhat limited. But, from what’s available, they work. For example, take a look at the experience of states like Indiana and Connecticut, which enacted red flag laws relatively recently:

“In Indiana, after the enactment of the law [in 2005], we saw a 7.5 percent decrease in firearms suicides in the 10 years that followed,” Kivisto said. “We didn’t see any notable increase or decrease in non-firearms suicide.”

“And so when we looked at it from 2007 and beyond [in Connecticut], [gun suicides] decreased by 13.7 percent,” Kivisto said.

This furthers the idea that access to deadly means can help control for suicide.

Suicide is a massive societal problem, one which belies simple solutions, involves multiple areas of public policy and will require significant investment to truly tackle. That being said, some small laws can make a big difference, and reducing access to suicidal means can do just that.

The Mental Health of our LGBTQ Friends

We celebrated National Coming Out Day last Friday, and it gave me a few things to think about. As we all know, this world is hard enough. The times we live in are more interconnected, more stressful and more difficult than they ever have been, and I do think that the current state of our world is adding to our rising rates of mental illness and suicide.

So, imagine being someone who so many in society say is wrong.

I’m a straight, white man. This comes with many societal advantages. And let me be clear, I cannot imagine how difficult it must be to be a sexual orientation that is different.

But numbers don’t lie: It’s a harder life. A quick look at the statistics:

  • 28% of all LGBTQ youth said they felt depressed most of the time (in the past 30 days), compared to 12% of non-LGBTQ youth.
  • When compared to non-LGBTQ youth, LGBTQ youth are:
    • Twice as likely to feel suicidal.
    • Four times as likely to attempt suicide.
  • Over the course of their lifetime, 30-60% of LGBTQ people deal with depression – 1.5 – 2.5 times as straight individuals.
  • These issues are largely impacted by perceived support and social stigma.

So, what can we do to help individuals who identify as LGBTQ? A few things. First, remember, all language counts. If you show bias towards one group, individuals are far more likely to perceive you as biased towards another. Don’t be that person who uses bias and then jumps in with, “But I have a gay friend!” Don’t show bias in your language. Don’t use derogatory terms to discuss anyone. Language counts. Language reinforces stigma and stereotypes. Use appropriate pronouns. Use language that is kind and respectful. And just…don’t be an ass.

Second: Show your support. You don’t know who is struggling or who is desperate for someone to talk to. One study which was bouncing its way around my Facebook feed showed that an LGBT individual who found a supportive adult could see their risk of suicide drop by 40%. Be that one person. And be so explicitly. Yeah, post something to your Facebook page about how you support LGBT people and you’re a safe person to come out to. Is it gonna get anyone to come out to you? Maybe. But, more importantly, someone who is LGBTQ will see it, and will appreciate it. They will know that you value them as a person. That you believe in their dignity and basic human rights.

Third: Support policies which humanize LGBTQ people. In most places in Pennsylvania, you can be fired or evicted for being gay. That’s madness, and laws matter: When gay marriage was equal in only some states, studies showed that LGBTQ people had better mental health and lower rates of addiction when they lived in states where gay marriage was legal. Again: PUBLIC POLICY MATTERS. It makes a difference! Support your LGBT friends by supporting candidates for office who support human dignity for all.

Others who are better versed in this subject have written about it, and I encourage you to read more about how to help millions of Americans feel loved and safe. I can’t imagine how hard it must be to be a minority in America – particularly today, given that the President is a racist, xenophobic monster who stirs up hatred at anyone he can find. That being said, I remain convinced – now more than ever – that this is the moment to show our friends – all of our friends – the love and respect they deserve. Be that person. Be one of the people who tells our friends that they are loved. You may save a life.

The Hope and Sadness: Out Of The Darkness Walk

With one exception, I’ve had the honor of speaking at every Out Of The Darkness walk which has occurred in the Lehigh Valley in the time I’ve been a State Representative. Since I began publicly discussing my struggles with depression, anxiety and suicidal ideation, my role has expanded, and I’ve MCed the event for the past few years. I came back from this year’s event a few minutes ago, and I wanted to discuss it.

First and foremost: Man. It’s really, really tough. People walk around with shirts and team shirts and mottos and anti-suicide tattoos and teams of people and you just feel their pain. There are sweet dogs everywhere.

I always have a tough time – particularly during the Honor Bead ceremony, where you introduce family members and attempt survivors – and that just breaks you. You read these stories out loud of people with life and love and potential, and they are gone. This year, I had the honor of reading the Honor Bead ceremony with Congresswoman Susan Wild, someone I’m proud to call a friend. As many of you likely read, Congresswoman Wild lost her long-term partner, Kerry, to suicide, and has lead a very public fight for suicide prevention and mental illness. I cannot imagine how hard it was for her.

And I’m not gonna lie, I feel terrible feeling emotional. I’ve struggled with depression, and I have been suicidal, but I’ve never attempted suicide. I’ve lost people I’ve known, but never a dear friend or someone I love. And you walk around this event – people come with shirts and signs of their loved ones – and you can’t even imagine their pain.

Please understand, I am not looking for comfort here. I get why it’s hard. I just don’t think my pain compares to those who walk for someone they love. And I don’t expect it to, either.

The one story I don’t think I’ll ever forget was this:

That…yeah. It was hard.

Here’s the dichotomy of the event though, and I suppose it’s more a reflection on the dichotomy of the human experience. It was still, for all the sadness and grief, a beautiful event.

First of all, they raised over $115,000. YAY!!! Oh, you can go here to donate. And you should.

Second of all. It’s not all sadness. It was stories of hope. People who survived and turned their life around. An army vet who survived addiction and multiple attempts to stand on that stage in honor of the 22 veterans who die by suicide every single day. People who walk to remember, and who find each other. I kept watching people talk to Congresswoman Wild and say thank you. But there was a real feeling of community there.

As I said in my brief remarks, everyone who attended and walked was brave. We all know what a prominent issue suicide is: 47,000 died in 2017, and more than 1.4 million attempts. And yet, still. Silence and stigma. Every step that was taken, every dollar raised – that’s a little crack in the darkness. I’ll take that.

So, despite the sadness and pain of an event like this, you have to find hope. It can be a struggle. It can be emotionally and physically draining. But it was such a beautiful event to participate in. People found hope, found each other. And found an awful lot of puppies. Seriously, that really helped. The puppies.

I won’t lie and say I’m fine – it was a hard event to run. Speaking personally, there’s a sense of burden there. You want to do the best job you can, and you want to let people know that those of us in power are listening. And that we share their pain and want to help alleviate it.

As always, thanks for reading. Please leave any thoughts below!

3 Unexpected Things Which Are Linked To Mental Illness

We all know that there are some things which correlate positively with mental illness: Stress, negative changes in economics, etc. But it’s more than that – and it’s some areas which you probably wouldn’t expect.

So, here are a three random items – well, seemingly random items – which are correlated with mental illness.

And a reminder straight out of Statistics 101: Correlation does not equal causation. Two items being linked doesn’t mean that one causes the other.

1) Air Pollution

I stumbled across this one while looking at the news, and it really surprised me, but here goes: Air pollution in children is positively correlated with worse psychiatric disorders, according to a study from Cincinnati Children’s Hospital Medical Center. The study also noted that already existing research had already established the connection in adults. So, as if we needed another reason to reduce air pollutions (besides all the asthma and death and climate change), here’s more. And, because life is deeply unfair if you’re poor, the study also found that the worst outcomes were reserved for kids who lived in disadvantaged neighborhoods.

2) Childhood infections

This one is, admittedly, not one I would have expected but when you think about it, it sort of makes sense.

According to a 2018 report, researchers in Denmark found links between certain infections and some mental illnesses, like depression, bipolar and schizophrenia. The theory here is that certain infections can activate the immune system. This, in turn, caused certain mental illnesses to set in.

This wasn’t a small study, either – it tracked 1.1 million Denmark children born over a seven year period.

3) Brain inflammation

I’ve actually discussed this one before, but there appears to be a connection between inflammation and depression. As noted in the link above, there is some research to indicate that anti-inflammatory drugs may be able to help reduce symptoms of depression.

Further research and writings have indicated that it is possible that inflammation is at the core of many physical and mental illnesses. As such, treating brain inflammation may be critical to reducing depression, anxiety and a whole array of other psychiatric disorders.

I’d actually argue that the brain inflammation one is the most interesting here. Why? Because the last article highlights just how much we know now compared to what we thought we knew years ago – and, of course, we will likely repeat that observation in the next ten years as well. What else will we learn? Will we be able to specifically engage in gene therapy to fight off mental illnesses? What kinds of treatments will evolve? It’s a fascinating question.

As always, I’d love to hear your thoughts in the comments below!