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!

 

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

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

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

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

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

Or these articles, which concentrate on age groups:

Or these racially or location-focused articles:

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

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

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

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

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

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

First, to summarize the findings:

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

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

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

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

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

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

How Gun Control Can Help Stop Suicides

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

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

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

What is a “Red Flag Law”?

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

Limiting Access To Deadly Means Stops Suicide

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

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

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

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

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

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

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

The Mental Health of our LGBTQ Friends

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

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

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

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

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

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

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

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

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

The Hope and Sadness: Out Of The Darkness Walk

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

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

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

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

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

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

That…yeah. It was hard.

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

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

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

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

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

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

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

3 Unexpected Things Which Are Linked To Mental Illness

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

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

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

1) Air Pollution

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

2) Childhood infections

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

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

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

3) Brain inflammation

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

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

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

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

Work, Work Hours & Mental Illness

I have frequently discussed the importance of examining other real-life factors, such as economics and housing, as we discuss reducing mental illness and suicides. Well, here’s a great article on why: A new study directly ties shift work and varying hours to depression. From the article:

In particular, the study found, shift workers were 33% more likely to have depression than people who didn’t work nights or irregular schedules.

Shift workers also had a higher chance of developing anxiety, but in this case the difference was too small to rule out the possibility that it was due to chance.

Women appeared particularly vulnerable to the negative mental health effects of shift work, researchers report in the American Journal of Public Health.

Compared to women who worked consistent weekday schedules, women who worked nights or split shifts were 78% more likely to experience adverse mental health outcomes.

The article was based on a report which examined seven studies, totally 28,438 participants. It specifically blamed this increase in depression and anxiety to a disruption of sleep; the connection between a lack of sleep and mental illness has been well documented.

This, obviously, is not the only study which ties work challenges to mental illness – or economic trouble in general. When unemployment increases, so does depression and suicide. Increases in foreclosures and evictions are directly tied to increases in suicides, and states which increased their minimum wages saw slower growth in suicides than states which held their minimum wages even.

This goes back to one of the points I have hit on this blog and in my advocacy over and over again: Mental illness is not always about mental health. It’s myopic to make such an assumption. As we talk about reducing mental illness, we have to talk about increasing the social safety net, about making sure people can get good jobs for fair wages, about giving people a chance to recover from economic hardship. And yes, this unquestionably informs my politics.

The working poor are not more likely to have mental illness or die by suicide than the economically secure, but suicide increases in both groups when there is a change in economic status. We can’t necessarily stop someone’s economic situation from turning south, but we need to at least make sure that everyone has the resources in place to give them a chance to recover.

 

Stigma, Shame & First Responders

My mental health and legislative worlds frequently come together, but an article and what happened yesterday really made me blink.

First, the good news. At a hearing yesterday, the Pennsylvania House Veterans Affairs & Emergency Preparedness committee moved a bill of mine. HB1459 would give first responders more mental health resources. It would require trauma and mental health training, create a peer to peer mentorship program and mandate the creation of a toll-free hotline for first responders who are struggling with mental health issues.

I feel like legislation like this is more important then ever. Why? Stories like this, which report on the NYPD’s ongoing mental health and suicide crisis, and the unwillingness of some police officers to seek mental health help, despite the fact that they feel the need to do so:

In a new report, the Department of Investigation’s Office of the Inspector General surveyed officers who retired in 2016 and found that 25 percent of them reported going through a period of emotional stress, trauma or substance abuse that caused them to consider getting professional help.

But more than a third of those officers did not end up seeking assistance, according to the report.

Half of them expressed fear that the department would find out about their decision to seek support.

So, what do we do here?

First, there are internal things that I think the NYPD can do. Chief among them? Work to change the culture and attack stigma by sharing stories of successful police officers who have experienced mental illness, sought help, and thrived.

Furthermore, the NYPD must do whatever it can to stress the confidential nature of their programs. According to the report, 50% of people surveyed were worried about the department finding out about their illnesses, 45% of negative labels, and 39% afraid of being put on a modified assignment. As the NYPD notes, an “extremely small number” of officers do wind up having their weapons taken away, but they are given those back upon successful treatment. Treatment is confidential, except in cases where the officer in question may present a danger to themselves or others.

The second is broader: We need cultural change at a society wide level. When we discuss the importance of stigma when it comes to mental health, this is why. Stigma is more than just how people look at the mental ill, its how we look at mental illness within ourselves. Clearly, as cases like this demonstrate, a culture of machismo and an overabundance of self-reliance can kill. For reasons like this, we clearly must do a better job of reminding people that there is no shame in seeking help, and that in many cases, its the only way to lead a happy, healthy and productive life.

More Than Stigma: Shifting the Nature of the Conversation Around Mental Health and Suicide

Advocates for suicide prevention and mental health often talk broadly about “the stigma” which surrounds mental illness and suicide. Many of us – myself included – believe that if we can just get more people talking and thinking of mental illness, if we can have people discussing their issues with depression, anxiety, addiction and more without shame or fear, we can help to put an end to this epidemic. I firmly believe that this is the case.

I also know its not enough.

And that’s where the conversation around public policy, resources and taxation has to come into pay.

I happened to catch a fascinating column on mental health the other day – I obviously can’t find it now, that would be too easy, but the column made a great broad point: Ending mental health stigma is like cutting holes in a wall, but then there’s nowhere to go because our system of mental healthcare is so broken in this country.

Many of us concentrate our efforts on stigma for a couple of reasons. I think it’s one of the most important things that we can do. But let me expand on the second part of that sentence: That we can do. People do need to know it is okay to seek help and to treat themselves. They need to know that these issues are real, powerful and can kill you. But, as any studies have shown, individual conversations are the best way to break mental health stigma. A face to face talk can make a huge difference in that area. That means that, without question, the most important person to ending mental health stigma is you.

Second, it’s the easiest.

Making society-wide change is really hard, of course. Particularly in areas where colossal interest groups are at play. I’m an elected official – theoretically one of the people who makes state-wide decisions in Pennsylvania – and I fully understand just how difficult this can be.

And the simple truth is that we must make systemic changes to help reduce rates of mental illness and suicide.

From a mental health and suicide perspective, there’s an awful lot that needs to be done. This includes increasing access to mental health care, increasing the number of mental health care practitioners and addressing the mental health care practitioner shortage, reducing costs, enforcing parity in insurance care, reducing access to deadly means of suicide and more. And that’s to say nothing about the major societal problems that we face which contribute to mental illness and suicide, including improving housing options, strengthening the social safety net, increasing the minimum wage, making housing more affordable, etc.

Many of us tackle stigma because we can’t get at these issues. And stigma is something we can control.

So, what does that mean? Should you stop talking about mental health stigma? Hell no. Of course it’s vitally important, but it’s important in more ways than you think, because the more you discuss mental health, the more pressure you can bring on policy makers to address the fundamental inequities and gaps in our system which allow for mental illness to run so rampant. Keep fighting.

But make sure you fight in a public policy realm, in addition to addressing individual changes. Tell policy makers and elected officials that you expect them to do more to address rates of mental illness and reduce suicides. These issues require government intervention, and that requires public pressure. Please help make this happen.