Category: Uncategorized

Ties that bind: Liberals, conservatives and mental health

It’s not much of an exaggeration to say that there are some…umm, slight…differences between liberals and conservatives in America today. I continue to believe – perhaps naively – that the things which unite us are bigger than the things that divide us.

One of those things, without a doubt, is mental health.

First, speaking in generalities: Liberals tend to want government to do more, conservatives tend to want governments to do less. This is a very broad statement and there is a lot of room for nuance within it, but I think that’s pretty accurate. Looking at that from a mental health perspective, that tends to translate into liberals wanting government to do more (even if it means raising tax rates), conservatives want them to do less.

I have a theory: That’s not completely accurate, because conservative areas need as much help as liberal areas when it comes to this.

Let me approach this from a different perspective: Urban vs. rural. Again, broadly speaking, but urban areas tend to be more liberal, rural ones more conservative. But – and this is important – rural areas really, really struggle when it comes to mental health. Suicide rates are higher in rural areas than urban areas. This is for any reasons, including an increased prevalence of firearms and a lack of access to health care practitioners.

At the same time, urban areas – which have high levels of poverty and minorities – also really struggle in these areas. Urban areas with high levels of poverty have significantly higher rates of mental illness. Unfortunately, poverty makes mental illness worse, and the mentally ill are more likely to be pushed into poverty and lose access to health insurance and care – thus creating a viscous cycle.

Here’s my theory: These can be united. While I represent an urban area, I don’t want anyone to suffer or struggle, no matter what they look like or where they live, and I am sure that the vast majority of conservatives feel the same. We all care about the people we represent, and I’m hoping that, over the next couple of years, I can find more people to work with in order to bridge the gap between liberals and conservatives/urban and rural areas. I’m hoping that we can use mental health to do that, and in so doing, help all of the people we represent.

 

 

 

Six Questions with Leslie Stella, author of Permanent Record

I gotta say – one of the most fun things about this blog, at least to me, is learning how other authors approach depression, and the unique spins that they give on the issue. Last week’s interview, for example, dealt with cyber-bullying and self-harm. This one’s is with Leslie Stella, author of Permanent Record, who deals with racism, terrorism and a post 9/11 world.

From the description:

Being yourself can be such a bad idea. For sixteen-year-old Badi Hessamizadeh, life is a series of humiliations. After withdrawing from public school under mysterious circumstances, Badi enters Magnificat Academy. To make things “easier,” his dad has even given him a new name: Bud Hess. Grappling with his Iranian-American identity, clinical depression, bullying, and a barely bottled rage, Bud is an outcast who copes by resorting to small revenges and covert acts of defiance, but the pressures of his home life, plummeting grades, and the unrequited affection of his new friend, Nikki, prime him for a more dangerous revolution. Strange letters to the editor begin to appear in Magnificat’s newspaper, hinting that some tragedy will befall the school. Suspicion falls on Bud, and he and Nikki struggle to uncover the real culprit and clear Bud’s name. Permanent Record explodes with dark humor, emotional depth, and a powerful look at the ways the bullied fight back.

Your book not only deals with depression, but it also deals with some very heavy societal issues—racial identity and terrorism. What inspired you to address this subject?

I wanted to explore several themes: 1) bullying, and the fine line between standing up for yourself and taking revenge, 2) the relationship between mental health, outsider status, and bullying, and 3) how a teen targeted for his racial identity might retaliate. Funneling these three concerns into the experience of one protagonist made for a gripping story, one in which readers must wrestle with themselves about whether the protagonist is justified in his actions.

As noted in your book’s description, your main character, an Iranian American, is pressured by his family to hide his identity. This is a common issue faced by many teens. How do you think this impacts someone’s mental health?

Ignoring the interplay between mental health and outsider status is a sure way to court disaster, either for the outsider himself or society. Sublimating one’s identity (whether it’s racial, gender-based, or any other facet that contributes to the makeup of a person) always backfires; you cannot grow as a human being if you deny those very facets that make you whole.

How can authors approach subjects like this with authenticity, even if it isn’t their lived experience?

Speaking for myself, if I wrote about only my own experiences, I would subject my readership to a never-ending glut of books about office work. The purpose of literature is to transport the reader—and that usually means transporting the author as well. It’s called imagination and research. Use them! They are your friends.

In Permanent Record, the protagonist’s Persian background was based on a family that my family was close to when I was in high school. My sister dated one of the brothers, and I worked for the parents for several years at a store they owned. I learned so much about Persian culture from them, including the dynamics within the family and what is expected of the children—especially the difference between expectations of the daughters versus the sons.

The book was written in 2013, but, unfortunately, many of its themes seem more relevant than ever. If you had to write the book again now, with Donald Trump as president, what would be the same, and what would be different?

Like so many things, terrorism begins at home. The ritual of school violence in our country is a brand of home-grown terrorism that our society has decided it will tolerate. If I had written Permanent Record today, with Donald Trump as president, I would likely have the covert displays of racism present as overt. People aren’t any different today than they were previously; it’s that they feel free to parade their prejudices and hatred more openly.

In looking at this book, it seems to me that it can apply to two groups: Members of the “majority” community who are looking to get a better understanding of what life is like to those who are minorities, or members of the minority community, like Badi, who are looking for a character to identify with. Did you have one of these audiences in mind more than the other?

 Why must these two great tastes be mutually exclusive? In the Reese’s Peanut Butter Cup of fiction, the writer’s job is to hold a mirror up to the world so that we can see not only ourselves but everyone else as well.

In a social media friendly world, what’s the role of books—like yours—in terms of addressing mental health and the stigma which surrounds it?

People usually feel alone when they struggle with their mental health, and social media exacerbates this: “Gee, everyone else on Facebook seems so happy; their children pose readily with handmade signs, while I’m taking pictures of squirrels ransacking my birdfeeder.” At the same time, I’m not a fan of people using social media as a substitute for therapy. A book, however, can delve deep into these problems in a way that is personal and intimate and three-dimensional, which is something a tweet or post can never do. I don’t think I’m alone in saying I relate better to complex fictional characters better than I do with most real-live people with whom I have human contact. So in that sense, I hope Badi’s struggles with depression inform readers about the complexities of mental health and the many options for treatment out there.

 

 

 

A strange gender gap: Men, women and writing about depression

As part of my marketing efforts for Redemption, I’ve been reaching out to other author’s in similar book categories, which means other Young Adult books which deal with mental health, depression and anxiety. These efforts are how you’ve seen some of the other Six Question entries.

The other day, I noticed something strange:

Let me give some backup here to that tweet: I just went back through my notes on other authors. I identified 115 authors who also had books in this category. Of those 115, only 18 were men; 89 were female, and another 8 either had names that could have been either gender or used initials (which often than not, means they are a woman – see J.K. Rowling, who went with her initials because her publishers were trying to disguise the fact that she’s a woman).

Anyway, that difference is massive: 115 authors, and a mere 16% are men!

What the hell is going on here?

This is just a hunch, but I think what I’ve found is a microcosm of society as a whole: Women are much more willing to discuss mental illness and emotions than men. According to research, both men and women are more likely to be viewed more negatively when they suffer from “gender atypical” mental health disorders. Additionally, according to a 2015 study, men are more likely to have negative attitudes towards health seeking, which results in a less significant uptake in using mental health services.

This blows me away. I mean, it shouldn’t – none of this is surprising, and intuitively, I think most of us recognize that women are more comfortable seeking help and discussing emotional topics than men.

There are so, so many issues facing women today. I’m so glad that, as a member of the human race, we are doing a better job at discussing vitally important issues like women’s equality and safety. But I think one of the things we don’t do a good enough job of – and my above observation would seem to back up this assertion – is discussing how these gender stereotypes also hurt men.

Please, please do not misunderstand me here – I am not saying, “Boohoo, but what about the white man, life is so hard for us, we are so discriminated against!” That simply isn’t true, and it is abundantly clear that other minorities and women have much, much tougher obstacles to overcomes than any white man does. It is also apparent that we, as a society, must do a better job at creating a more level playing field and changing our culture as it pertains to women and minorities.

But, I think it’s important to note that men can also be the victims of gender stereotyping and expectations – and clearly, this is one such example. What I would hope this observation would make us realize is that we must do a better job of working towards true equality in society – and men have many, many ways to benefit from achieving that ideal as well.

How the Center for the Disease Control says we can stop suicide

Yesterday, I wrote a little bit about a really insightful technical package offered by the Centers for Disease Control. It’s a long document, but for those of you who care about how we can stop suicide and are looking for ideas (if you are involved in the government or not!), I think it’s a great read.

I don’t want to get insanely in-depth into what sort of recommendations were contained in the document. But I do think it’s worth reviewing the broad outlines of it, just in case you don’t have time to read a 60 page governmental white paper. Broadly speaking, it broke down it’s recommended solutions into a few categories:

  • Strengthening Economic Supports: This one was the topic of my entry yesterday, and I’d argue the most important for both suicide and protecting vulnerable people in our society. This specifically deals with making sure that people who may be at risk for suicide as a result of economic conditions have access to the services that they need to recover, and includes items like robust unemployment benefits, medical benefits, foreclosure assistance and more.
  • Strengthen Access & Delivery of Suicide Care: Here’s where things start to align with what I think most people would expect. This includes the obvious systemic changes needed to be made to our mental health system, including improvements to the insurance system (parity between physical and mental health), reducing provider shortages (a huge issue of mine which, unfortunately, largely needs to be dealt with at the federal level), and broader changes to the mental health care system in order to better address mental illness and suicide prevention.
  • Create Protective Environments: Here’s where what I’ll call “stop-gap” methods really come into play. This includes means reduction (guns are  huge issue here, but this also includes restricting access to suicide hotspots) and improving organizational/social systems to promote protective environments (particularly in at risk locations) and addressing excess alcohol use (which is connected to suicide).
  • Promoting Connectedness: Thanks to phones and technology, we are more connected than ever before. Except we’re not. And as social connectedness breakdown, suicide rates will continue to increase. This specific approach recommends addressing suicide by establishing peer norm programs and engaging in increased community engagement activities.
  • Teaching Coping & Problem Solving Skills: One of the keys to surviving any bout of mental illness – and I’ve written about it before – is building resilience, or an ability to cope. This includes creating social/emotional learning programs and addressing parenting and family relation skills.
  • Identify and Support People at Risk: This includes training gatekeepers, improving crisis intervention and broad-based treatment for people at risk of suicide.
  • Postvention: The aftermath of a suicide attempt can have a dramatic impact on both the victim and those around them. This section of the report deals with postvention for those who were close with a suicide victim and addresses safe reporting/messaging in the aftermath of a suicide.

This is really comprehensive, and again, worth a read. If you have any thoughts or questions, I’d love to hear them! Leave your questions or comments in the section 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.

Redemption and me, live on TV

(Hey, if my titles rhyme more often, will I get more views?)

Anyway, morning, everyone!

As the title said, the good people at WFMZ were kind enough to interview me on Saturday. The topic was Redemption, and here’s the interview.

A sincere thanks to WFMZ for the interview. As always, if you want to purchase the book, you can get it directly from me or on Amazon.

Enjoy!

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!

Depression is on the rise; here are some guesses about why

The news about depression is – well, depressing. According to the most recent information, major depression is on the rise, and that spike is particularly acute among teens and young adults. Meanwhile, a new CDC report shows that suicide is at a twenty year high, having jumped more than 25% across America since 1999. In more than half the states, that rate has increased 30%; in my home state of Pennsylvania, it’s up 34%.

These numbers are not acceptable, they are not healthy, and they are not sustainable. The ugly truth is that we live in a world that seems broken, and we have an obligation to repair it.

Before we can do that, however, we have to ask ourselves this very important question: Why? Why are rates of depression and suicide spiking like this? There are a lot of people smarter than me who have given there reasons, and those are incorporated into my post below.

Please note my usual disclaimer: I’m not a doctor, scientist or researcher. I have some evidence in some of these cases, but by and large, this is all just a gut feeling.

1) The world is more interconnected, and we know how terrible some things are

As this article perfectly demonstrates, the world is more connected than ever before. There are 2.5 billion smartphones in the world. Half of all adults on the planet have access to these devices that can instantaneously connect us with anyone, anywhere, or give us access to news in any corner of the globe.

Ahh, let’s look through our phones, shall we? Check out Twitter. Oh, I see the President is yelling at ::insert race-based insult here::. Right, what else? Thousands of children who are being separated from their parents and may never see them again. Super. What else? Hmm, border patrol is randomly asking people for their papers. Lovely.

Oh, and that’s just America, and that’s just today.

It’s difficult to look at the news and not be depressed, and feel an overwhelming sense of doom. If you are lucky enough to live a life of relative comfort, how do you avoid an overwhelming sense of guilt and shame? My kids are currently sitting on the couch, eating a healthy breakfast and playing a game for the Nintendo Switch I got them yesterday. Thousands of children in America – asylum seekers who fled their homes – will never see their parents again. How do you deal with that guilt? That disconnect?

The world may not, really, be getting worse. But thanks to the availability of information and news, it sure does feel like it is.

2) Technology and social media are bad replacements for real connections

Yes, My favorite topic: Writing about how technology is killing us all.

Seriously, as I have discussed previously, the increasing prevalence of technology and social media are poor replacements for the real connection that we all need and crave. How many times have you turned to the comfort of the soft blue light of the device in your pocket, only to come up empty when it didn’t fill a gap in your heart? In this fantastic article in The Atlantic, Jean Twenge persuasively argues that social media and technology is making our generation less comfortable and more depressed. I completely agree, and I think – and hope – that we realize this more and more in the years to come.

3) We’re busier and feeling the pressure of life more

Of the three causes that I’ve written about, this is arguably the one least supported by the evidence and most supported by a gut feeling. But, if you’re reading this now, I suspect you know exactly what I am talking about, because you feel it too: The pressure. Today, I must go here. I must do this. I must pay the bills. I must make sure that my perfect children remain perfect, walk 10,000 steps, eat all of the right foods, tweet something good, oh, God, the house is a mess, and have I eaten any trans-fats today? CRAP.

You know what I mean here. The pace of life seems to be caught in a constant phase of acceleration. There’s no down time. No rest. And that, combined with the pressure of the real world, leads to more broken minds.

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I don’t know – I could completely off here, but I would genuinely love to hear your thoughts. Where do you think I am right? Where am I wrong? Give us your thoughts in the comments below!