Category: mental illness

OP-ED: Massacres, gun safety & mental health

The Morning Call, which is my local newspaper, recently published this op-ed that I wrote, following up on the Parkland massacre.  I’m publishing it here because it does touch on mental health, but specifically from the perspective of violence and publish policy.  First, remember, someone who is mentally ill is far more likely to be the victim of violence, rather than the perpetrator.  Second, I’m tired of hearing about, in the aftermath of these shootings, how we must repair our mental health system and then the only things that are done is funding cuts.

Anyway, read on for more.  I hope you find this useful

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Seventeen dead students and teachers.

Fifty-eight dead concert goers.

Forty-nine dead club attendees.

Twenty-seven dead students and teachers.

These are some of the worst gun massacres in the history of the United States. And they have all occurred within the past five years.

We have reached the point in our society where kindergarteners are being trained how to cower in the event that an armed gunman barges in on their class. Teachers are now being lauded for laying down their lives for their students. There is serious conversation about whether or not school staff, including administrators, teachers and janitors, should walk around school with guns locked and loaded.

We have hit this low point in our society. But we aren’t powerless. We aren’t lambs being led to the slaughter. We are the United States of America. The country that beat the Nazis can surely be the country that stops senseless bloodshed in sacred public places.

We need real gun safety, and we need it now.

•First: Reinstate the assault weapons ban that was in effect from 1994-2004. It is harder for a 19-year-old to purchase Sudafed than an assault weapon. More to the point, the 1994 ban worked. According to one analysis, gun massacres and deaths from assault weapons tripled since the expiration of the assault weapons ban. Military-style weapons are responsible for almost every one of these crimes, and we can do something about it.

•Second, close the loophole that allows for individuals to purchase firearms without being subjected to a background check. If you want to buy a gun, you should always be subjected to a background check, and right now, you can legally purchase certain types of guns at certain types of sales without doing so. This massive loophole allows for terrorists or convicted felons to have access to firearms.

•Third, enact state Senate Bill 501, which would bar individuals who have a protection from abuse order from owning firearms and make it easier to take weapons away from those convicted of domestic assault. Many of the perpetrators of our worst massacres have been convicted of this heinous crime, and no one who beats an intimate partner should have access to a firearm.

It’s also vitally important that we discuss mental health. We frequently hear in this country that there is a need to improve our mental health system to prevent these types of massacres, despite the fact that someone with mentally illness is significantly more likely to be a victim of a crime than a perpetrator of one.

Indeed, opponents of gun safety often shake their heads, offer their “thoughts and prayers” and pledge to deal with our mental health system. That is followed immediately by … absolutely nothing, except attempts to repeal Obamacare and Medicaid expansion, both of which would fundamentally devastate our mental health system by cutting off funding, preventive care and hospital beds.

If you are opposed to gun safety measures, and want to improve our mental health care system, it’s not enough to say words that sound good. You have to stand for something.

Here are some suggestions. First, address the rising shortage of psychiatrists and psychologists by increasing reimbursement rates and Medicaid/Medicare slots for mental health care. Second, increase funding to critical and crisis care treatments, allowing for the creation of additional hospital beds to treat those experiencing a mental health crisis. Third, increase the reach of programs like the nurse family partnership and pre-K education, which have been proven to dramatically decrease mental illness.

Each and every one of us — from the most ill homeless person to the president of the United States — is never more than one moment away from a mental health crisis and running headlong into a system that doesn’t care about us. One in 5 American adults suffer from mental illness; 1 in 20 suffer from an illness so debilitating that they can no longer work. If you don’t care about the mentally ill, fine, but remember, this could be you or someone you love in a heartbeat.

There is no single solution to stopping gun violence, and individual and familial responsibility has an enormous role to play in ending this bloodshed. Background checks and banning the sale of military-style weapons won’t stop every massacre; after all, all of our laws and police activity don’t stop every crime. But our law enforcement — and the laws they enforce — do save countless lives and stop innumerable crimes every day.

We aren’t powerless. There are solutions. American ingenuity and know-how can save thousands of lives, and the only way to guarantee that the problem only gets worse is to do nothing.

All of us have an obligation to each other to make the world a better place, and we should be tired of living in a society which allows for over 13,000 gun deaths every year, including 17 dead children and adults on the floor of the freshman building of Marjory Stoneman Douglas High School in Parkland, Fla..

Mike Schlossberg of Allentown is state representative from the 132nd District.

The Lost Connections by Johann Hari

I mentioned this book in my entry the other day and I really wanted to discuss it more.  Hari is a journalist who openly discusses his own battles with depression and anxiety as a young man.  He, like many of us, was put on anti-depressants.  Like many of us, he found success with anti-depressants, only to find their effectiveness waning.  He goes on to discuss nine different types of depression and anxiety, ways to reconnect and the various social causes of psychological illness.  This book opened my eyes in a lot of ways.  Much of what was said rang completely true.  At the same time, I found myself incredibly angry at some of the arguments Hari makes.

Let me do the angry part first, because I think that made more of an impact, at least in my mind, because it’s more dangerous.

Hari basically argues that anti-depressants are effective only in the short-term, and only then for a placebo effect.  This argument is partially – but only partially – supported by science.  I will say that it really made me do some research and I was dismayed at what I found. The record of anti-depressants in terms of long-term effectiveness is not a positive one.  The link above is actually for a Google search, not a specific article, and I’d encourage you to do your own research.

What’s my problem, then?  Easy: Hari completely dismisses the biological causes of depression, issues that legitimately may require depression to address.  While much research needs to be done on the specific biological components of depression, it is clear that there is a biological component. To dismiss that – and to thus dismiss biologically based treatments – is problematic and pseudo-scientific.  I have real issues with that, and I think that Hari is being disingenuous at best – and dangerous at worst – with this type of advocacy.

But.

Hari makes other, very persuasive arguments – ones that ring true, in my mind.  The one that hit me the most was these: The social element of mental illness.  Hari goes through a series of arguments about how our society is making us sicker: We have lost our connections to each other as we are busier and get more absorbed in our various electronic devices.  We are bombarded by “junk values,” that encourage materialism over intrinsic values and real connection to people.  We live in a sick world – last week’s news from Parkland is a great example – that make us depressed.

This much really made sense to me, and if this advice was taken by all of us, could be transformative.  Society’s obligation to deal with the mentally ill has to do with much more than just treating biological and psychological causes of mental illness – we have to address the social ones as well.

Anyway, is the book worth the read? In my opinion, yeah.  I think you have to read it with an entire shaker of salt, and keep in mind that some of what Hari says isn’t supported by science.  But much of it is, and hopefully, you can read between the lines, find the things that work for you and go from there.

Depressed? Try volunteering

I caught this article on Motherboard and it really, really got me thinking.  The article itself is certainly worth the read, but I’ll try to summarize the points and add my own spin on it.

The article notes that volunteering helps with depression.  This happens a few different ways:

  • First, there are mental and physical benefits to volunteering.  Volunteering can lower blood pressure, reduce the risk of hypertension and make you physically feel better.  This happens, in part, by noting that oxytocin (feel good brain chemical) gets released when you regularly volunteer.
  • Volunteering helps you keep things in perspective.  It gets much harder to be depressed when you are working with someone much less fortunate than you.  I’ve always found this to be a helpful strategy, to be honest: On moments when you are depressed, compare yourself to someone who has it worse than you.
  • Volunteering gives you social connections and social interaction, a challenge for people who are depressed.

It’s actually the second point that I want to talk about more than anything else, because that’s something I’ve always found to be powerful: Volunteering gets you out of your own head.  Let me point back to a blog entry I made some time ago about depression and rumination: Thinking obsessively about yourself, and your own problems, can be tied very strongly to depression.

That’s where volunteering can come in.  Not only are you exposed to people in legitimately worse situations than you, but it can help you out of your own head, as it is much harder to think about yourself when you are trying to help others.  Sometimes, your brain needs that extra kick in the butt to stop the thoughts of yourself.  And that’s where volunteering can come in.  According to the article, there is no volunteering that is better than others – doing good means feeling good.

I do want to add one clarification here, however: I’ve made volunteering sound like a selfish exercise designed to the volunteer feel better. That’s not the attitude that you should have when you go to do good. Don’t get me wrong, there is nothing wrong with volunteering because you want to feel better and are hoping to build some social connections and make a difference.  But I would remind you that the only way to truly reap the benefits of volunteering is to do so by approaching it from an ultimately selfless perspective.  Go somewhere with the hope of doing good, and the rest of it will fall into place.

As always, I am curious to hear your perspective.  What good experiences have you had with volunteering in the hopes that it will help control depression?  How about negative ones?  I know I’ve felt both ways when volunteering, and I’m curious to hear other perspectives.  Let us know your thoughts in the comments!

Facebook to enhance efforts to stop suicide

I’ve written before about how bad social media can be for your health.  It can be terrible for anyone, but particularly young people.  Unfortunately, there is research which shows that social media may be contributing to a rise in teenage suicides, and that it is almost  certainly contributing to increased depression and anxiety among teenagers.  Those findings are even stronger for woman then men, and teenage women have also seen a higher increase in teenage suicide (please keep in mind, correlation does not equal causation).

There’s some good news on the horizon: It seems that Facebook is unveiling new tools to catch users who may be at risk of attempting suicide.  According to Facebook’s website, it will be doing three things:

  • Using pattern recognition to detect posts or live videos where someone might be expressing thoughts of suicide, and to help respond to reports faster
  • Improving how we identify appropriate first responders
  • Dedicating more reviewers from our Community Operations team to review reports of suicide or self harm

As noted by the Washington Post, Facebook will be using artificial intelligence to scan posts and comments for suicidal potential, allowing posts to be found sooner and addressed to authorities:

Facebook said that it will use pattern recognition to scan all posts and comments for certain phrases to identify whether someone needs help. Its reviewers may call first responders. It will also apply artificial intelligence to prioritize user reports of a potential suicide. The company said phrases such as “Are you ok?” or  “Can I help?” can be signals that a report needs to be addressed quickly.

n the case of live video, users can report the video and contact a helpline to seek aid for their friend. Facebook will also provide broadcasters with the option to contact a helpline or another friend.

This…well, this is actually great.  I have repeatedly come down pretty hard on technology in terms of it’s impact on mental health, but this is unquestionably a good thing.  What’s most interesting to me is that Facebook is using artificial intelligence to try to reduce suicides; technology causes a problem, and technology is then used to limit said problem.

There are, of course, limits to the effectiveness of this new initiative.  Yes, it can potentially catch a person in crisis and stop them from hurting themselves.  But it won’t do anything to stop a person from reaching that point.  Social media can still do enormous harm individuals from a mental health perspective, and that’s why it is so important that anyone using social media do so responsibly and in a manner which ensures that they won’t make themselves more depressed.

Still, it’s good to see Facebook acknowledge this issue and try to do something to fix it.

Why talking about mental illness helps

I’d almost make the argument that the thing that makes the most sense about depression is that it doesn’t make any sense at all.

Like, none.

Understand that this is just my perspective, but hear me out on this one.  Depression, anxiety, mental illness, the works, they make no damn sense.  I mean, isn’t one of the things that makes us human the ability to control our own thoughts and act independently?  “I think, therefore, I am?” and all that?

Which is why having a mind that works against you so darn frustrating.

Call me crazy here…okay, don’t, I do that enough on my own…but I think that one of the reasons that depression is so frustrating, confusing and mystifying is that it goes against the very thing that makes us human: Our ability to think.  Humans are fundamentally logical and emotional creatures, right?  I firmly believe that there is a piece of our own minds will always believe that it is in control.

Of course, that isn’t the case.

Even now, even as someone who has been living with depression for years and doing so in a very public forum – it still makes no sense to me.  How is it that people who are so successful, loved and popular can still suffer so?  And I ask myself this question despite the fact that I am someone who has depression.

So, that brings me back to the crux of this blog entry: Why I think that talking about depression/mental illness in an open, honest and public manner helps, and why I always encourage others to do the same.

I think it helps us make sense.

I firmly believe that the idea that we aren’t in complete control of our emotions and thoughts is a truly alien one, something that most of us struggle with on some base level.  To that extent, I think that talking about mental illness helps.  It helps us process what’s going on in our brain and make sense of the thoughts and feelings that we are experiencing.

I obviously don’t have all the answers to mental illness – if I did, I’d be a lot richer, and at least a little bit happier.  But I would suggest this: If you are one of the people suffering in silence, do what you can to change that perspective.  Talk about it.  You may not have access to a supportive network of family or friends, but I think you’d be surprised at the amount of online support groups that you can participate in – anonymously or not.  Even the act of sitting there, and formulating your feelings, can help process your emotions and make a positive difference in your life.

And, on a personal note: I’ve found that this blog has helped my advocacy tremendously, and not just because it gives someone else a chance to read my thoughts.  By putting “pen to paper,” so to speak, it gives me a chance to organize my thoughts, examine my feelings and reevaluate the way I handle my own recovery.  It’s also helped me to rethink some of my public advocacy, in particular the portions related to stigma – it’s not just stigma that matters, but self-stigma.  

As always, I’d love to hear your thoughts.  Am I onto something here?  Let us know in the comments, and have a wonderful day!

Mental health and the holidays

Gobble gobble!

Now that the obligatory greeting is out of the way, here’s another: Happy Thanksgiving!  I hope that, for whatever struggles you are currently enduring, you are able to find a way to be grateful for all that you do have.

The holidays can be a stressful time, particularly for those who suffer from mental health issues.  This interesting article from Healthline notes two very accurate reasons for depression during this time period:

  • Social isolation, particularly during the holiday season, and particular if you actually don’t have the opportunity to spend time with friends and family.
  • Grieving.  The holidays can be very difficult for those who have lost someone, even more so if that death is a recent one.  After all, since the holidays are usually associated with spending time with people you love.  As such, the loss of those who you are close with can make the pain of the holidays feel virtually unbearable.

This story from a 2014 Huffington Post article adds some additional insight:

  • People tend to set unrealistic expectations for their social interaction and what they can accomplish during the Holidays (pro-tip: You aren’t Martha Stewart).
  • People try to do too much.
  • “Comparing your insides to someone else’s outsides,” particularly thanks to social media (YES this a thousand times!).

That being said, I may as well take this opportunity to dispel a suicide-related myth: Contrary to popular belief, suicides do not increase during the holidays.  In fact, they actually decrease.

On a personal level, I was always relatively okay during the holidaus, even at my most depressed points, though there were some rough patches.  Thanksgiving and Christmas were always nice, but, randomly, what always got me was the 4th of July.  It’s supposed to be a fun, relaxed holiday, but somehow, I always spent it alone, or frequently with people who I didn’t really like and made me feel alone.  There’s something about holidays that can just make you feel like a loser…like, you are supposed to be having fun and aren’t.  Isn’t that the worst?

So, how do you survive?  Some thoughts:

  • First and foremost, don’t even think about talking about Donald Trump.
  • Stay.  The.  Hell.  Off.  Of.  Facebook.  Seriously.  As I’ve discussed previously, social media can be really bad for your mental health, and this can be particularly true for moments when you are already vulnerable from a mental health perspective.  For your own sanity, limit your time on social media.  It will be way, way too easy to, as the note above says, “compare your insides to someone else’s outsides.”
  • It’s Thanksgiving.  Try to be as thankful as you can be.  That’s easier said, than done, of course.  But, to the extent that you are able, think about it.  If you are reading this blog, you have internet access, which is better than the more than three billion people who don’t have internet access. That likely means you live in the developed world, which means you have access to food, clean drinking water, modern sanitation systems and decent medical care.  It’s not much, but try to remember – odds are, you have it better than billions of people across the planet.  That has to count for something.  Challenge yourself to shift your perspective; yeah, you have the racist uncle sitting two seats down, and he’s had one to many Coors, but odds are still better you have it better than billions.
  • Remember – if you are able – actually relax!  The holidays were designed for unwinding.  Need a break?  Take it.  The damn turkey can wait.  You’re more important.
  • If you are someone (like me) who values routine, don’t let the holidays knock you off of it.  I’m still going to the gym.  I’m still gonna go to sleep and wake up at my usual times.  I’d recommend the same for anyone else.

This isn’t much – and it may be woefully inadequate for what you are facing, that I completely understand – but hopefully these little tips can help make your holiday a little better.

Happy holidays, readers!  I am thankful for many things in my life, and that certainly includes those of you who keep coming back to read what I have to say.  I hope you have a great holiday season, and a very happy Thanksgiving!

You probably need an escape

The more I think about it, the more convinced I’ve become of this idea: If I didn’t have an escape, I’d go absolutely, positively out of my mind.

As I’ve said before, I’m an elected official. It’s not a low-stress job.  No matter what anyone tells you, by and large, it’s a pretty grueling gig: Long hours, lots of stress, important decisions, and often a sense of helplessness that is not conducive to people with depression.  Now, just to be clear: I love it.  It gives me a change to change lives and advocate for the issues that I care about.  I knew what I was getting into when I got this job, and I am not complaining, because this job is absolutely amazing.

But, loving a job and having it drive you nuts at the same time can certainly occur at the same time, and my experiences operates as proof.

So, going back to the challenges of my job: I know I’m not alone.  No matter who you are, and no matter what you do, odds are decent that you get stressed out at work, life or with your family.  For people who are more likely to get depressed or anxious, this goes double, and we know that chronic stress can lead to depression.

And that, of course, is why you need an escape.

It doesn’t have to be a literal, physical escape.  For physical, emotional, job-related or financial reasons, a physical escape is often impossible.  Between my family, job and trying to pay off student loans, a regular vacation isn’t an option for me, and I suspect this is the case for the vast majority of you as well.

So, that brings me to my central question: What is your escape?  Where can you go to lose yourself, even if it’s only for a few hours?

Personally, I have two answers to that question.  The first is the one that sort of inspired me to create this blog in the first place: My writing.  I have found tremendous peace in my writing, and a sense of purpose as well.  As I’ve noted before, I have a Young Adult Dystopian thriller coming out, one which features a main character that also battles depression and anxiety.  At moments where my job feels fruitless, I can find solace and inspiration in the idea that this book can potentially do the same things I seek to do every day in public policy: Improve people’s lives.

Second, my not so guilty pleasure: Video games.  We just bought a Switch and I have been obsessed with Mario Odyssey.  I also just, finally, downloaded Civilization VI and am intrigued, to say the least.

Video games, of course, are easier than writing, which requires more work but a bigger payoff.

Anyway, my main point is this: You need an escape.  A mental place where you can go – a hobby where you can lose yourself and hit that perfect state of flow – if only to recharge.  Remember, an escape isn’t really an escape.  The word “reprieve” may make more sense here – or perhaps “recharge.”  Make sure you can find a place that you can go and get your bearings again.  It’s an invaluable part of self-care.

What anti-stigma really means

Call this one a brilliant thought that I had in the shower the other day.

There are plenty of anti-stigma campaigns related to mental health.  In many cases, the goal of these campaigns is simple, noble and necessary: to defeat “mental health challenges in the workplace and at home.”  This is vitally important work.

There’s good news related to that though.  In many areas, anti-stigma campaigns have already done their job.  For example, a poll taken in my home state of Pennsylvania (March 2017) shows high levels of comfort in terms of working with someone with a mental illness, a vast improvement over previous levels.  While there is still a long way to go, this poll shows significant movement in the area of mental illness.

I was thinking about this poll the other day, and it had me thinking: What does anti-stigma really mean?  Obviously we need to continue to work on critical areas like discrimination and access to healthcare, but I’d argue there’s more than that.

My argument is this: The most powerful sense of stigma is self-stigma.

Consider this 2012 article, which describes self-stigma as when “patients agree with and internalize social stereotypes,” resulting in:

•Patients often think that their illness is a sign of character weakness or incompetence.
•Patients develop feelings of low self-esteem and become less willing to seek or adhere to treatment.
• Patients anticipate that they will be discriminated against, and to protect themselves they limit their social interactions and fail to pursue work and housing opportunities.

As a result, patients find themselves less willing to seek treatment and social support, leading to lower rates of recovery.

This realization has had me rethinking how I approach the notion of anti-stigma campaigns.  Of course they should be focused on ensuring that all of society views people with mental illness not as sick freaks who are weak, but as real people suffering from real disorders that can be treated like any physical illness.  I want to push society to a place where all of us – those with mental illness and those without – view people who are suffering from a mental illness the same way that someone views a cancer patient.  No one who suffers from a mental illness should do so in fear, shame or silence.  They should talk about their therapy appointments the same way a cancer patient discusses chemo or someone with a broken leg discusses physical therapy.

I suppose, then, that what I am saying is this: Anti-stigma campaigns shouldn’t just address societal stigma.  They should address self-stigma as well.

As always, I welcome your thoughts – am I onto something here?  More importantly, have you found any anti-stigma campaigns that fulfill what I am describing?  Let me know what in the comments!

How to look at social media and not want to throw your phone out a window

As I’ve written before, social media can be really, really, really bad for your mental health.  This is for a variety of reasons, including:

  • It inspires unrealistic comparisons between yourself and others.
  • It creates unrealistic and unhealthy expectations of how someone should be living their life.
  • It can lead to increased feelings of isolation.
  • It can inspire jealousy.

All of this, and more, are why I am going to be paying particular attention to research and experiences as they pertain to social media and mental health.  I swear, it’s almost like we need a primer on how to teach people to use social media at this point.  I’m looking at my kids – they are 6 and almost 5 – and terrified of the day that I will have to relent, give them a phone, and allow them to be exposed to the world that isn’t real.

Let me go back to what I just said: A primer.  Seriously, we need that when we go on social media!  The world that appears in our newsfeed can be so fake, so overwhelming and so depressing, that I think it’s important that we keep a few things in mind when we use Facebook, Twitter, Instagram and more.  Some initial thoughts:

First, and most importantly: THIS.  IS.  NOT.  THE.  REAL.  WORLD.  Say it with me now: “Social media is not the real world.”  That happy, smiling family?  Probably upset as often as you.  That sweet looking couple?  They have struggles, too.  Social media allows for a very biased view of the world, where everyone looks shiny and happy and pretty.  It is so, so important to keep in mind that there is very little about social media that is real.  People choose to present a biased picture of themselves, one in which they seem perfect, even if they aren’t.  If you can keep that in mind while scrolling through your newsfeed, odds are good that you won’t be quite as miserable while you scroll.

Second, approach social media with a Dale Carnegie perspective.  I took a Dale Carnegie course about a decade ago and it changed my life.  One of the most important lessons I learned was this: No one wants to hear about you.  In the course of public discourse, instead of focusing obsessively on yourself, focus on other people and how you can make them feel good.  To that end, when you are on Facebook and Instagram, don’t scroll through your feed looking for likes and clicks on your own content.  Instead, approach social media from the prospective of how you can make someone else happy.  Like other people’s comments.  Try to be joyful and happy for their accomplishments.  Instead of comparing yourself to others, try to just be happy for other people.

And yes, I know that is easier said than done.

Third, stop comparing yourself.  Yes, this is directly related to item #1: If you use social media and think, “Why aren’t I having as good a time as Jimmy is?” you are going to make yourself depressed.  If you use it and think “Well, good for them, they are having fun!” you’ll be fine.  Remember, in this instance, treat social media like the real world: Do you run around, comparing yourself to random people that you see on the street?  I hope not.

Anything else to add?  Let us know in the comments!

The importance of telling your story

This is a bit of a different entry: Partially standard, but also partially self-promotional.  Fair warning!

As I’ve discussed before, I made a very conscious decision, about three years ago, to tell my story about my experiences with anxiety and depression.  I made this decision because I thought it was important to put a face to these two largely misunderstood and under-discussed disorders, and because I realized that doing so would help fight the stigma that still surrounds both of these illnesses.  A good friend of mine also told me that going public would change my career in a very dramatic way – he was completely right, in ways that I totally failed to anticipate.

Three years later, this public conversation has evolved into something more.  I’ve always enjoyed writing, but had basically given up the art of writing fiction.  That changed around 2015, when, during one of my down periods, I decided to try it again, remembering the joy and therapeutic value I got from it.  Reading Fan Girl by Rainbow Rowell at around the same time certainly helped remind me!

That, in essence, was the start of Redemption, my fiction book that will be premiering in the first half of 2017.  I’ll have more to say as the book gets closer to release.  The basic plot is this: A group of young adults find themselves transported onto a spaceship, and they have to save the world. What makes this one a bit different is the main character, who suffers from anxiety and depression. Sounds familiar, right?

If you are interested, I discuss the book, my own battles and the importance of telling your story in this podcast with my friend Kim Plyler of Sahl Communications.

Obviously I wrote this book to tell a story, and I think it’s an important one: Depression and anxiety are real, they are treatable, but they don’t have to stop you from doing important things and living/enjoying your life.  I discuss all that and more in the podcast, and I hope it’s something you can listen to!