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!

 

Post Traumatic Growth

In the course of discussing mental illness, I’ve written quite a bit about PTSD and its devastating impacts. If you have had the misfortune of experiencing some sort of traumatic event, you don’t need me to tell you just how much this can negatively impact your life, because you live it every day. PTSD isn’t a small problem: According to available statistics, 1 in 13 people will develop PTSD at some point in their lives.

However, I don’t want to talk about PTSD today. I want to talk about a different concept: Post Traumatic Growth.

I’ve been thinking a lot about this one of late – mainly because I want to know what circumstances make it possible. PTSD, or Post Traumatic Stress Disorder, is the concept of showing positive growth or change after a devastating event. It is basically the idea that you can turn a negative into an incredible positive and come out stronger in the aftermath of suffering.

According to this article from the American Psychological Association, PTG is different than resilience, which is the factor that determines if you can recovery from a traumatic event. One inventory holds that these five factors determine if you experience PTG:

  • Appreciation of life.
  • Relationships with others.
  • New possibilities in life.
  • Personal strength.
  • Spiritual change.

How we measure PTG isn’t as important to me as determining how to encourage someone to experience it, and I think this is an important question for people who suffer a traumatic event – how can they not only get through it, but grow from it?

According to the article, some people are predisposed to experience PTG. There are also a variety of other factors, including the type of trauma, the circumstances and the age of the individual in question (being 8 or younger decreases the chances of PTG). Furthermore, people who are more open to new experiences and extroverted are more likely to experience PTG. One study also found that there may be genetic connections to PTG, with individuals who had certain variations of the gene RGS2 being found as more likely to experience PTG.

As I’ve said repeatedly, I’m no doctor or therapist – I just play one on this blog. However, being able to show post traumatic growth strikes me as an incredibly difficult thing, one which requires a ton of support and therapy to prove. I would think that there is a real connection to optimism and resilience – to the notion that you can find light in the darkness. For many, a traumatic event – such as an assault or accident – proves to be too much to ever recover from.

However, I’d also hope that knowing that PTG is possible – indeed, achievable – can give people a new appreciation on life, on trauma, and even on depression. I mean, look at the article above, or just search for the subject. The internet is replete with examples of people finding light in the darkness, of using a traumatic experience to grow and change and become better people. Knowing that this is out there – that there are people who’s lives have been made better by trauma – that should inspire hope in all of us who are suffering.

Folks, I’m grateful for my depression and anxiety. It gave my career purpose and meaning and allowed me to use my experiences to make the world a better place. And, I suppose, that’s the best way I can look at what otherwise could have been a crippling illness.

Any thoughts on the concept of PTG that you want to share with us? As always, leave them below!

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!

 

What is the difference between an anxiety attack and a panic attack?

Having had both, I feel like I’m overqualified to write this article, but as I was discussing this issue with someone the other day, I realized something: As careful as I like to be in my language – particularly when discussing mental health and mental illness – I had goofed. There is a difference between the two, and an important one at that.

What is it? From what I can tell and what I’ve researched, it seems to me that panic attacks are the dramatically more painful experiences, the ones which make it feel like your chest is going to explode out of your body.

There are a ton of similarities, of course. Both come with painful physical symptoms, including chest pain, difficulty breathing, dizziness, upset stomach and other fun things. Both come with an overwhelming sense of fear.

However, anxiety attacks are more characterized by worry and distress. Panic attacks are the ones where you feel as if you have to escape from wherever you are, right now. They often come out of nowhere, whereas anxiety attacks are usually caused by some stress or worry.

It this a distinction without a difference? I’d say no. Panic attacks – if experienced repeatedly – can be beyond debilitating. They can safely be described as “intense and disruptive.” Anxiety attacks can as well, but I’d argue that they are less frightening, and perhaps less painful.

Why does this matter? Because words matter. There’s a reason that there have been so many efforts to watch how we discuss suicide. Phrasing things one way or the other can have implications. It can also affect treatment – anxiety and panic are two different things. Indeed, the notion of an anxiety attack isn’t even a diagnosable illness, but a panic disorder absolutely is.

I’d also add that we need to make sure we don’t confuse these two things because how we discuss them can alter how others respond to them. Panic implies immediate danger and something to be deeply worried about right now. Anxiety, at least to me, implies an ongoing and persistent fear and worry.

Does this make sense to you? Please let me know your thoughts, and if you think this is the right idea or not.

The Best Way To Help Veterans With Mental Illness

Today is Veterans Day, the day of the year in which we are supposed to remind ourselves about the importance of the veterans who have served all of us. It’s a solemn day…one which most people know better by the kind of sales they can get and if they get the day off or not.

As an elected official, I’ve certainly been to my share of Veterans Day events, and had three leading up to today. That being said, they are events which always leave me feeling inadequate. Why? I never served in the military, and while I don’t believe that is necessary to be a good public servant, I do always worry about talking to veterans and thinking that they must think I don’t understand what they have been through. That’s me projecting, to an extent, but of course, I don’t understand what they have been through, the things they have seen.

As a politician, I’ve always said that I want to be judged by my actions, not my words. And when it comes to taking care of our veterans, far too many of our actions come up short. This goes double when it comes to mental illness. A brief look at the facts reveals:

These numbers are unacceptable. Those who give so much for us should receive even more in return. That being said, for the vast majority of us, our options are limited. Let me pose this question, then, if you’d like to learn more about how to help our vets: What can you do to help veterans who are suffering from a mental illness?

Here are a few thoughts.

Understand what you don’t understand

One of the things I have realized in my time in government and the mental health universe is that you will not understand everything – and that’s okay. You don’t have to understand what it was like to serve. You don’t have to actually have experienced someone else’s pain to understand that it exists. Not being a veteran doesn’t disqualify you from this conversation, but it does require extra effort. Read up on the specific challenges which veterans face. Learn more about what they need and how you can help. This broader prospective will put you in a better position to help those who need it.

Support groups who support vets

While the need is great, the response has been as well. Numerous organizations do a fantastic job of taking care of our veterans. If you can afford to do so, please contribute to these organizations, because while the passion is there, the funding often is not.

Read up on veteran-specific mental health issues

Part of understanding veterans issues is learning more about them. PTSD and TBI (traumatic brain injury) are both tragically common for veterans. If this is something you want to learn more about, read up on these two devastating diseases, and learn more about how you can help.

Talk about it, and find others who know more

The best way to address and reduce stigma is to talk about it – but to do so in a way which is inclusive. Discussing mental illness is important, but talking about it from the perspective of a veteran even more so. Make sure to be inclusive when discussing mental illness and stigma, and make sure to rely on other voices (like veterans) who may have more experience than you.

I know I missed a lot here – as usual, I’d love your thoughts. Do I have a goo handle on this? What am I missing? Fill us in in in the comments section!

When To Take A Step Back

I’ve written a lot about the importance of trying to push through your mental illness. To clarify, I don’t mean “power through” or “man up” or any of those other absolutely ridiculous cliches. By that, I suppose I more mean “don’t surrender.” As someone who constantly feels like they are being chased by anxiety/depression – and that they will nip my heels and catch me one day – I think one of the hardest things is knowing when to stop moving.

What do I mean by that? Well, if you suffer from this stuff, you probably know. You’re exhausted – words aren’t making any sense anymore – and your brain is just fighting back against every productive impulse you have. All you want to do in the world is build a big old blanket fort, watch Netflix, eat all of the ice cream, and go to sleep.

But you can’t. Because you are so scared that, once you slow down and surrender…even if it’s just for one moment…it will catch up with you. And once it has you in its grips, you lose. It’s over.

Now, if you are someone who isn’t depressed or anxious…or at least, has a better handle on it than I clearly do…you are looking at me right now like I’m saying 2 + 2 = 5. Because non Type-A people, and people without a mental illness, don’t suffer like this. They can take their foot off the pedal without feeling guilt or fear.

I suppose, then, that this is an entry for those of you who know what I’m talking about. Because the truth is that there are moments where you simply must take your foot off the pedal and slow down.

When do you hit that point? I bet you know. I bet you know somewhere, in your heart of hearts, when it is time to back off.

When you hit that point – and the guilt or fear starts to set in – I have two points for you to consider.

First – stop. An hour playing video games doesn’t mean that you will lose your career. No human being, ever, has made it in this world without self care, be them type A, B, X, Y or Z. Every event is not vitally important. Every assignment does not have to be done RIGHT STAT NOW, because even if it is necessary for your career, a career which holds that must sway over you is not that important.

Second, let me flip it around. People like me – and maybe you – who are obsessed with productivity need to stop conflating working non-stop and productivity. Microsoft Japan just tried a four day work week and the result was…a 40% increase in productivity. It’s almost like working smarter is better than harder.

Also. Your demons will find you, or they won’t. But taking a break never killed anyone. But it probably will help kill your demons.

Alright. That’s it. I’m out. I need to eat me some ice cream.

How Politics Helps Keep Me Sane – And How It May For You, Too

 

So, I’ve written extensively about mental health, depression, my book, etc. But, if you’ve followed this blog for long enough, you’ve probably seen me allude to my full-time career. I want to talk about it for a second – and talk about why I think that getting involved politics and governance is actually really good for your mental health.

My full time job is to serve as a Pennsylvania State Representative, where I work for 65,000 people who live in the City of Allentown and South Whitehall Township. I’m a Democrat, and involved in a slew of issues, but mainly working in education and mental health.

One of the more common things I get when I discuss my long-time issues with anxiety & depression is, “IN YOUR LINE OF WORK!?!?!”

I mean, yeah. To quote Finley Peter Dunne, Politics Ain’t Beanbag. And there are times where the hard parts of this job – the negative mailers, the nasty comments – they get to you. They weigh on you. And when you combine the normal stresses of this abnormal job with a mental illness, it can be ugly. I should note something here: If I hadn’t had years of therapy, and medication, I’d never be able to cope with the stresses and requirements of this job. I’d have never been able to hold it, and I hope do well at it, as I hope I have.

That being said, I firmly believe that politics has been good for me and my mental health, and if you are similar at all to me, you may feel the same.

Why? A few reasons.

First and foremost, politics & government gives me a chance to make a difference. I firmly believe that, with my type of depression, I feel worst when I am hopeless, helpless, and out of control. That includes a variety of things in my life, including the health of my loved ones or the state of the planet around me. Being in government, I firmly believe, is one of the most noble and powerful callings that there is. It also gives you a modicum control over one of the most powerful entities in the country. As a result, this job let’s me have a say in the direction of resources and state authority towards what I believe to be just pursuits. That acknowledgement, alone, is often enough to help combat the helplessness I feel as a citizen of a country and planet for which that I am deeply worried.

Second, it gives my mental illness meaning. On those bad days – where I’m sitting with my hands in my head, plagued by some very silly demons – I can’t help but wonder, Why me? Yes, there’s that tendency to stew in your own sad juices if you have some sort of mental illness. Being in government and politics – helping people – is the perfect antidote for that self-indulgent question, because I know I’ve helped people by telling my own story.

To be clear, government isn’t required to find meaning. But I get to be someone who is part of a good story – how mental illness is being viewed by our society, and how those views are evolving. I’ll take that.

Third, I can speak with authority. One of the biggest challenges we have in government is people don’t believe us. Much of that we bring upon ourselves, so I get that. However, it’s hard for people to ignore you when you speak on an issue which personally affects you in a deeply personal way. As humans, we are built to better understand stories – personal stories – and when I tell mine, I think that people are inclined to listen. I can speak with authority on this issue. Honestly, that helps me sleep at night.

There’s more, of course, but I’d say those are the biggest reasons I’ve found government to be helpful to me when it comes to dealing with my own depression. This is just me – your mental illness may have helped motivate your career choice, and if that’s the case, I’d genuinely love to hear it.

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!