Category: mental illness

The next time there’s a high profile suicide, don’t just tweet a phone number. Do this instead.

As part of my legislative work, I just finished reading a technical package from the Centers for Disease Control. The topic was suicide. It was some pretty heavy reading. At the same time, it was informative for many reasons, as it included a wide array of programs that people in government and the non-profit world can enact in order to reduce suicides.

Something, in particular, was highly instructive about the packet. It contained a wide array of information dealing with numerous public policy areas. But let me talk about the first chapter in terms of specific recommendations about suicide reduction. What do you think it was? Was it access to mental health care? The need for more research into better drugs? Controlling access to means of suicide?

Nope. It was economic supports.

Suicide rises in times of economic strife. The connection is clear. So, the first two specific recommendations within the packet:

  • Strengthening household financial security via programs like unemployment benefits, temporary assistance and livable wages.
  • Enacting programs that reduce foreclosure risk.

The report went on to note that ample evidence exists showing that stronger social safety net programs can reduce the risk of suicide.

Other areas of this report also showed the strong demonstration between public policy, public health and reducing suicides rates. Various sectors of our society are critically important as well, of course, but government can be – and should be – a primary actor when it comes to suicide reduction.

Let me go back to the title of this blog entry. Like many others, when there is a high-profile suicide, I’ll tweet out the “thoughts and prayers” line, as well as information on the National Suicide Prevention Hotline. That’s good, and it’s helpful. But it’s not enough. I want to start treating suicide in public the way we treat gun violence. It’s not enough to tweet support. We have to demand action from our policy makers:

Look, I’m a flaming progressive, so this may just be my political orientation, but I think we need more common sense gun reform measures in the worst way – things like red flag laws (which would allow for a temporary removal of weapons from people who are a danger to others or themselves), universal background checks and more. And I’m glad now that, whenever we have yet another tragic shooting, it’s not just “thoughts and prayers” but “thoughts, prayers and CAN WE PLEASE ACTUALLY DO SOMETHING ABOUT THIS.”

I want to take this mantra and apply it to mental health and suicides. Let’s stop pretending that suicides are a problem of an individual or their family. They aren’t. They are a societal, communial and governmental problem. We need to do more at the societal level to address mental health and suicide, and that means doing more than just working to improve mental health. If we can acknowledge that, we can make a change.

So, I say to you, dear reader: Don’t just tweet the suicide hotline numbers. Demand that policy makers make the changes necessary to save lives.

Science Fiction and Mental Health:The Lost Opportunity

In the course of writing my book, I made an assumption – one which I would ultimately find to be incorrect: That mental illness and science fiction would be very popular subgenres. They are not. I’ve been surprised by this. In fact, thus far, I’ve only been able to find one other book which intermixes mental health, science fiction and young adult – Portals by Kristy Acevedo. That’s a REALLY great book, by the way – if you liked Redemption, you’ll like Portals – Kristy Acevedo was kind enough to do a blog interview with me. That’s here.

I thought the two genres would go much better together. The reason? The sheer freedom of it. I’ve written two books now – Tweets and Consequences (which was a non-fiction look at social media, politicians and epic failures) and Redemption. Obviously non-fiction is a little bit more limiting. But, even fiction can be very constraining. If you write a regular YA book, for example, you are limited by the realities of the genre. For example, It’s not a good or consistent book if your YA character suddenly grows wings and flies away.

Science fiction and fantasy, of course, are different. All bets are off. You set up your world, it’s limits, and then you go from there. In Redemption, I created a Lord of the Flies-like world – on a space ship – and we were off to the races. The extremes of the world in Redemption allow me to explore the mental illness of the main character, Ash. Clearly, it’s science fiction, but the constraints of the world are still pretty similar to this one. As such, I get the opportunity to explore mental illness in a whole new light, but one that is simultaneously interesting/entertaining (at least, I hope!) and relevant to the reader.

Portals does a similar exploration – it creates a fantasy world with aliens from the future who are trying to save the world. The main character has debilitating anxiety issues, and the extreme stress of the world has major impacts on her mental health, her limits, and what she learns about herself and those around her.

But again, I’ve been surprised. I haven’t seen a ton of interaction between these subjects, and that, in my estimation, is a lost opportunity. Science fiction allows you to break traditional boundaries. I’ve actually always thought that the best science fiction just takes advantage of the weird elements it creates. Star Wars isn’t about space, it’s about good vs. evil. Star Trek (which one reviewer on the Amazon page was kind enough to compare Redemption to!) isn’t about the damn United Federation of Plants, it is about social justice and an exploration of the galaxy and the human psyche. It seems like mental illness and it’s related topics would be a perfect fit for this universe, but alas, unless I have been mistaken, this is not a topic which has seen much interaction.

Am I wrong? I’d love to be wrong. If I am wrong, please correct me – leave your best book recommendations in the comments below!

TMS Update

Well, as I type this I am 10 sessions into the 30 session Transcranial Magnetic Stimulation sessions. 1/3 of the way there. Woohoo!

How’s it going so far? Well…maybe better? Honestly, yeah, starting at the beginning of the 2nd week, it did start to feel like I was feeling a bit better, but let me define what I mean. Birds did not start singing. The sky is not the bluest it has ever been. Depression is still there. Life is not perfect.

But, to some extent, I have to say, it does feel like things have gotten a bit better. My life hasn’t dramatically improved, but there does seem to be a bit less…pressure. Like, the ceiling of depression which pressured down on me seems a bit lighter. That’s the best way I think I can put it.

To be clear, this may be placebo. The readings that the Doctor gave me showed that depression probably wouldn’t start to improve until week four. When I mentioned this to him, he said some people did feel better in week two, but for many it was longer, and it is certainly possible that this is just placebo. So I guess we will see!

Some other notes:

  • For me, there are no side effects. Even the slight headaches that during the treatment have become more tolerable. I haven’t taken a Tylenol before a treatment since it started, and my head has not hurt a soon as the treatment has ended.
  • You really do build a resistance to the minor pain caused by the treatment. Of the ten times I’ve had it, I’ve fallen asleep three of them, which is kind of funny.
  • I went through the math in my head the other day. As I said in the last entry on this subject, the magnet taps your head for four seconds, then rests for twelve. During the four seconds in which you get tapped with the magnet, it makes contact 40 times. A session is twenty minutes, so you get tapped 3,200 times a session. Multiply that by the 30 sessions, and congratulations, you’re getting smacked by a magnet 96,000 time over six weeks!

Only 64,000 taps to go!

The futility of gratitude – and why it’s so important

I had an interesting realization in therapy the other day, and it led to this blog entry. Stay with me for a second.

My therapist and I were talking about trying to change my mindset from both a depression and anxiety perspective. I think a great deal of anxiety comes from a fear of “not being able to handle” any given situation – be that going to school, work, travel, whatever. I’m not quite sure what “not being able to handle” means, save for turning into a blubbering ball of sad and fear, but whatever. Now, by and large, that’s a silly fear. There’s no such thing – not really – as “not being able to handle” something. Sure, there are some life events and experiences that go better than others, but short of dying, you get through life.

This sort of fear in stressful situations can manifest itself in many ways. One of them is that it causes a shift in mindset. You no longer engage in new experiences to enjoy them or learn from them – instead, you do so in order to say “I survived” them. This mindset can be damning for so many reasons. You start an experience not looking to enjoy it, but to get through it. This kind of bunker-mentality can absolutely destroy your ability to get any joy. To try new things. To adventure or gain new experience. Indeed, it makes you afraid, and it makes you far less willing to be adventurous. You live in a constant state of looking over your shoulder, wondering when the anxiety attack will hit. Wondering when you will get cripplingly sad. Wondering what goes wrong next.

This way of thinking, of living – survival versus gratitude – can be absolutely crippling. And it leads me to the point of today’s entry: I don’t want to just survive. I want to thrive. I want to learn and to live. Don’t you?

How do you do that? Hahaha, yeah come on, you know I don’t have an answer. I only have a piece of one. That’s this: Try to change the way you approach new situations. Approach them from a perspective of gratitude and gaining new experience. Instead of entering an anxiety-provoking situation from the perspective of, “Oh, God, how am I gonna get through this?” ask yourself, “Okay, what can I learn from this?” or better yet, “How can I be grateful for this experience?”

Now, I titled this entry, “The futility of gratitude” because I am not an idiot. When you are depressed or anxious and someone tells you to “Be grateful,” you probably want to punch that person in the face. Grateful? For the crippling fear and sadness? That’s madness.

But, that’s exactly why it’s so important.

The only way to break anxiety and depression is to change the way you think. The way you process thoughts and emotions. And the only way to do that is to shift your mindset. So, just try this. Try, every now and then, asking yourself this question: “How am I learning from this new and difficult situation?” or “What can whatever I am experiencing right now teach me so I don’t encounter these problems in the future?” Fear is only crippling is it denies you the chance to grow, to learn. And there’s no such thing as an experience you can’t handle.

So, try to ask yourself that. Try to ask yourself what you can be grateful for. What you can learn. Shift your mind, and maybe you can shift your emotions too.

“A woodpecker on steroids” – My experience, so far, with Transcranial Magnetic Stimulation

So, for the first time in my multi-decade battle with depression, I’m trying a new type of therapy (other than talking and taking pills). It’s Transcranial Magnetic Stimulation (TMS), and I’ve written about it before.

Here’s the basic gist of how it works:

Transcranial magnetic stimulation (TMS) is a method whereby an electromagnet placed on a scalp transmits magnetic pulses or waves to a small portion of the brain. Repetitive transcranial magnetic stimulation (rTMS) delivered at a low frequency (once per second) has been shown to reduce the reactivity or excitability of the part of the brain stimulated and other brain regions functionally connected to the region stimulated.

I started it Monday, and it is time intensive – not so much in how long you have to sit there (my sessions are only twenty minutes), but in terms of how long you have to do it – for me, it’s six weeks, five days a week. I had to wait until vacation was over and for a break in my calendar to make it happen.

As for how it works: Honestly, it’s not hard. You sit there. You get yourself into a nice and comfy chair and they adjust a couple of things by your head. The right side of your head is lined up with a pad to keep your head still. The left side of your head is where the action is at – a magnet, enclosed in some equipment, is aligned in the right spot. It’s desired location is your frontal cortex, which is the area of your brain where depression apparently can be adjusted. They send one magnetic pulse into your head, and if your hand twitches, they have the right spot.

Once they have the right spot, they save the settings and that’s where you sit. If it’s aligned right, you may feel a little discomfort or pressure during the actual treatment. The actual treatment consists of your head being tapped with a magnet (not directly, but through padding) for four seconds, followed by a rest of twelve seconds. That continues for twenty minutes.

Is it painful? No. The first alignment can be – if it’s misaligned, it hits a nerve and OUCH. It just stings for a few seconds. They readjust, and then it’s fine. Now, is it comfortable? Nah. But you do build a resistance to it. I had a headache and took Tylenol the first three days. By days four and five I barely noticed. They also give you earplugs. Those are optional, but if a Doctor gives you ear plugs, use them, okay?

It’s a strange experience, described to me by the nurse as being hit by a woodpecker on steroids. I love that description, and it’s accurate. I mean, you’re basically getting tapped by a magnet or roughly 30 times over four seconds. It’s weird, but not painful. I’ll putz on my phone, close my eyes and chill, whatever. Honestly, its not that bad. The session ends and you go back to work. There are no after effects, except for maybe a slight headache that Tylenol can bop right out. You can drive, think, function, etc. I’ve left therapy sessions where I’ve been more disoriented.

When am I supposed to see results? The literature I read said week four. They said they thought they had seen some people get more depressed as the placebo effect wore away in week two. I’m hoping I don’t go through that, because I have no illusions that this will work until at least week four.

So, one week down, five to go. Here’s to hoping.

As always, I’d love to hear your thoughts and experiences, and as the process goes on I’ll share more, including some pics. Let us know about your TMS experiences below!

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SIDE NOTE: First, again, I’m not a doctor or medical professional – I’m a damn politician and writer. I’m certainly doing my best to write an accurate description, but if you have any questions or concerns, please contact a medical professional. Second, this probably goes without saying, but I’m going through this treatment like any other normal person and paying with my insurance. I am not receiving any compensation or consideration whatsoever for sharing my experiences.

The incredibly sweet tribute to a mental health hero in Zelda: Breath of the Wild

I’ve written about video games before, but never quite like this.

Yesterday, I was watching this video on Zelda: Breath of the Wild (awesome game, by the way). In the course of watching, I came across this:

For those of you who don’t watch the video, here’s the basic gist: Link, the game’s hero, walks to the edge of a Proxim Bridge in the game. He is confronted by a character named Brigo, who stops you from jumping off of the bridge and says things to get you to stay put. He even offers to stay with you to keep you company.

Okay, kind of random, right? Brigo is likely inspired by Kevin Briggs:

Kevin Briggs.jpg

Briggs is a fascinating man: He spent decades working for the California Highway Patrol, which he retired from in 2013. During much of that time, he patrolled the Golden Gate Bridge, and by his estimates, stopped over 200 people from jumping to their death.

This is a truly kind tribute to a man who clearly deserves it.

If you want to watch the entire scene, it’s below:

What does peace feel like to you?

I’ve written before about my relatively desperate attempts to meditate. I phrase it that way because it seems like, no matter what happens, my efforts fade away. Then I’m reminded of how important meditation can be for depression at a later date. I start again, I start again, and the cycle continues.

The good news – well, at least for me – is that I am in a cycle now where I am actually meditating. While I haven’t noticed a change in thinking yet, I will say that I always feel better and more peaceful in the immediate aftermath of a meditation session. And, that sense of peace is what I want to discuss in this entry, because I had a genuinely interesting realization while meditating the other day.

The meditation I practice – which, from what I’ve read, is the best kind for a depressed or anxious person to engage in – is mindfulness meditation. It’s a little complicated to explain – mainly because I don’t understand it and I kinda suck at – but the basics is focusing on nothing – and, in so doing, improving your focus.

Like I said, I’m terrible at it. My mind moves at a million miles an hour and I can’t shut it off. That’s one of the many reasons I am meditating: To try to relax and improve my focus.

So, the other day, I’m meditating. I have been sticking with five minute sessions – YouTube videos – and doing so because if I do longer I fall asleep. Anyway, I’m almost done. That realization is met with a degree of happiness and sadness. Happiness because I can get back to work. Sadness because I am at peace. And then I realize something: I’m at peace. Meditating is nice, and when I can actually concentrate enough to do it right, it fills me with peace.

That, then, triggers a question: What does peace feel like to me? There’s an easy answer, too: A fullness. A fullness in my chest which crowds out any negative feelings.

So, here’s my suggestion: Find what peace feels like to you. Because if you do, you can recognize the feeling when you actually experience it. And maybe, from there, learn how to keep it with you, even if it’s only just an extra moment or two.

Anyway, that’s something to think about: What does peace feel like to you? Let us know in the comments below!

How vacation can make you depressed, and what to do about it

One of the issues I have had with my depression is traveling. I go to Harrisburg very frequently as part of my job, and many of those are overnight – I’m probably away from home something like 40-50 nights a year (easily the worst part of my job, and that has nothing to do with depression!). It was hard to get used to. That being said, at this point, I’ve spent so much time in Harrisburg, it’s almost like a second home. I have the same hotel (and usually the same few rooms), same basic routine, and it’s made life relatively easy.
Now, traveling to a new place, particularly when I am alone, remains a struggle. A new routine, a new city, make life very hard. For me, that happens from time to time, usually as part of a convention or hearing. I have found that it’s best for me to keep the same basic routine. I try to be back in my hotel room by 8-9, putz around for a bit, go to sleep by 11 and wake up early enough to get to the gym. Having a standard routine no matter where I go is really helpful, as it gives me a sense of comfort and normalcy, no matter where I am.
While I know I’m not the only one with travel anxiety, the idea that others could share my periodic troubles on family vacations were new to me. But, to my surprise, when I googled “vacation depression,” I found a ton!
Anyway, after doing some research, here are the best tips that I could find, along with some of my own thoughts.
  • First, and this is just me stalking, stick to your routine. Get up around the same time. Keep a normal bedtimes. Try to keep at least one meal you eat similar to what you’d eat at home. A sense of routine can avoid a shock to your body.
  • Go easy on yourself. Remember that vacations aren’t about expectations or THINGS I HAVE TO MUST DO RIGHT NOW NOW NOW – they are about relaxing, unwinding and a break from the stresses of normal life. If you suffer from depression, this may mean that you still suffer – and that’s okay. That’s who you are. Give yourself permission to be in pain and don’t berate yourself for it.
  • Choose a vacation that matches your personality. Placing pressure on yourself to go on a vacation you think you’re “supposed” to go on will only add to the depression you’re feeling. Instead, select a destination that will allow you to get what you want out of the vacation. Going somewhere you can’t fully enjoy or a place that makes you feel inadequate will only make your depression worse (via WikiHow)
  • Avoid comparing yourself to others. Many people with depression fall into the trap of comparing others’ vacations to theirs. You may look at the vacationers around you and wonder why you’re not enjoying yourself as much as they are. Placing pressure on yourself to enjoy what you think you should can make you feel worse. Instead, realize you probably aren’t seeing the bigger picture (via WikiHow)

There’s more out there, and if you have any tips, I’d love to hear them. Leave them in the comments below!

Public spaces and depression may be related!?!?!

So this article popped up in my newsfeed and it blew me away:

In what is perhaps the first scientific study of the effects of public spaces on mental health, a non-profit group in Philadelphia cleaned up trash-filled vacant lots and “greened up” others, primarily in low-income areas, and found that residents reported feeling happier.

The results of the study?

They found that residents of areas that had either the greening or trash removal projects reported a decrease in feelings of depression by about 40 percent. In neighborhoods below the poverty line, the drop was 70 percent. Researchers also found reductions in feelings of worthlessness, hopelessness and overall poor mental health.

What? What?

That being said, the outcomes of this study are very much inline with a perspective I developed after reading Lost Connections by Johanna Hari. I wrote about my feelings on the book here, and while I did have some major concerns with portions of the book, it really opened my eyes to an often unexplored dimension of depression: The social and community one. If everything around us is falling apart, too stressful, too ugly (and I mean that in more ways than one), we’ll be depressed. This study would seem to be a validation of Hari’s theory.

This isn’t the first study which would seem to tie physical environment – and access to a good, healthy, clean environment – to depression. A 2018 study showed that levels of depression for residents at British care homes could be predicted based on whether or not they had easy access to the outdoors, and there is also ample evidence which shows a connection between a physical environment and mental illness.

In a sense, this is an extension of the famed Broken Window theory of urban planning. That theory, in essence, is this: Small neglect (like an unrepaired broken window) leads to larger and larger crimes. The reverse can also be true: Cleaning one section of a neighborhood can lead to the cleaning of others.

My conclusion here is not one that I haven’t said before: More research is needed. But this study is a powerful incentive which captures yet another positive benefit of neighborhood revitalization – it may ease the symptoms of depression.

This is how depression & sleep trouble are related

For me, there have always been two markers that are my “canary in a coal mine” when it comes to depression – the two factors that tell me I’m depressed even when I may not realize it right away. First is eating. Some people eat more, some stop. I’m the later. I drop weight when I am depressed.

The second, and the one I wanted to write about today, is insomnia. Simply put, when I get depressed, I have a huge problem sleeping. When I get to sleep, I usually stay asleep, but the challenge for me is that I can’t sleep when I’m depressed. I’ve never been exactly sure why. Maybe it’s because I cannot shut my mind off, or maybe it’s because there’s some unresolved conflict that is prohibiting me from sleep.

Unfortunately, I’m not the only one who gets these issues. Even more unfortunately is this: When you are depressed, you can’t sleep. And not sleeping may mean more depression.

Alright, first, the evidence. Sleep and depression are strongly connected, and it’s not just me saying that. This comes straight from the DSM-V (Diagnostic & Statistical Manual):

Insomnia (inability to get to sleep or difficulty staying asleep) or hypersomnia (sleeping too much) nearly every day

So, one of the formal criteria for diagnosing a depressive episode or illness is the above. Unfortunately, it’s a two-way street, as not getting enough sleep – or getting a poor quality of sleep – can lead to depression. From The Sleep Foundation:

The link between sleep and mood has been seen over and over by researchers and doctors. For example, people with insomnia have greater levels of depression and anxiety than those who sleep normally. They are 10 times as likely to have clinical depression and 17 times as likely to have clinical anxiety. The more a person experiences insomnia and the more frequently they wake at night as a result, the higher the chances of developing depression.

There’s so much irony in the discussion about depression and sleep it’s ridiculous. What always frustrated me the most, however, was this: When you can’t sleep, and you are having prolonged trouble sleeping, all you can think about is how YOU CAN’T SLEEP, and this will worry you/frustrate you/depress you. This, in turn, will worry/frustrate/depress you even more, and then – you guessed it – you can’t sleep! It creates a vicious lack of sleep cycle.

Do I have any magic cure? No. Heck no. While there is plenty of advice on how to sleep when you can’t, I’ve found that everyone’s experiences are deeply personal. Related to that, I can tell a story about how I broke through my sleep issues when I was depressed. There was a period where I wouldn’t be able to sleep for 3-5 days a week. Not until 3am or so, only to become a sleepy zombie the next day and not be able to sleep at all the following night, and thus, the cycle continues.

One night, I’m in Harrisburg for session. I can’t sleep, it’s 2am and I am miserable. And I remembered something my therapist said a week or so before about how he had patients who had broken through their anxiety and phobias when they accepted the worst. And as I laid there, I said to myself, “You know what? Screw it. I’m done. I’m not gonna sleep, I’m gonna have the worst day of my life tomorrow, and then when I drive back to Allentown, I’m gonna crash the car. It’s over and I accept!!”

I slept that night.

It was an interesting moment for me, so if I have any piece of advice, it is this: When you accept the worst, you can get where you need to be.

Any thoughts, tricks or tips are appreciated! Leave them below!