Tag: depression

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!

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!

What recovery means

People who have recovered from addictions to alcohol and drugs are often very, very cautious with how they describe their recovery, and that’s for good reason: Relapses are, tragically, all too frequent.

It didn’t dawn on me until much, much later in my life that the same applies for people living with depression.

First, a look at some broad facts: According to one study, ” at least 50% of those who recover from a first episode of depression having one or more additional episodes in their lifetime, and approximately 80% of those with a history of two episodes having another recurrence.”

In other words, sadly, the more depressive episodes you have, the more likely you are to have another one in the future.

Making this personal: The worst depressive episode I’ve had in my life, and the most extended, was my freshman year of college.  Therapy and medication helped me learn to live again, but I had a pretty hard-core relapse my senior year, and then another one a little after grad school.  Periodic ups and downs followed, but I’d say those were the three worst “episodes” of my life, with the most dehabilitating consequences.  As I got older, the intensity of these episodes began to wane, as I became better at recognizing depression for what it was, coping with it’s symptoms and seeking additional help as appropriate.

That’s not to say they went away.  They didn’t.

I’m bringing this up to make a point: Recovery is not an end state.  It’s not a destination.  For most, it’s a journey.  For some, they’re lucky: One episode of mental illness, one bout with addiction, and they are done.  You lucky, lucky sons of…sigh, anyway….

For most who have ever suffered – depression, anxiety, addiction, whatever – a relapse could always be just around the corner.  This means that you can never let your guard down, because you’re never really, truly “done” with mental illness.

Is this a bad thing?  Well, I’d be a heck of a lot happier if I never had to worry about this again.  But the specific reason I am bringing this up is to remind people who suffer that recover is not the end state – it’s a perpetual one – and that relapses are okay.  They are part of the disease with which you suffer and not endemic of any internal weakness.  Recurrences shouldn’t be dealt with via self-flagellation and scolding – they should be treated as a natural flare up of a disorder that can be dehabilitating without treatment.  Don’t yell at yourself.  Don’t hate yourself.  And don’t think that your any recovery must be permanent or you are failing.

Recovery is a journey.  Not a destination.

Shhhhhhhh and listen

I have always found that, when depressed, one of the most difficult things for me to do is to shut up and actually listen to others.  This makes sense, of course: When you get depressed, you have a hard time escaping your own head.  After all, depression and rumination are linked; that is to say that when you are depressed, you are more likely to think about yourself.  Your problems.  Your issues.  Your concerns.  Doing so makes you more self-absorbed, which, in the case of many people (me for sure!), can make you feel incredibly guilty and like a burden to your loved ones.

I also want to tie this back to the current political environment in which we find ourselves.  Last week, I went on this FB rant:

tl;dr – I listened and learned something.

I find that there is a big connection with how self-centered I feel and how depressed I am, and that the more I focus on the needs of others, the better shape I’ll be in.  I suspect this feeling is universal – indeed, there is evidence to show that is the case.

On an intuitive level, this makes all the sense in the world.  Thinking of other people makes you more likely to get out of your own head, less likely to ruminate, and more likely to break the cycle of destructive thoughts that are bouncing around in your own brain.  It can be hard.  Really, really hard.  I remember my therapist once telling me that avoiding people and allowing yourself to retreat in to a corner is the absolute worst thing you can do when you are depressed.

He was right, as far as I am concerned.  I think trying to think of others and actively engage with other people when you are down can be next to impossible, given the mood of a depressed person.  That also makes it all the more important that you try and break through and change your focus…get out of your own head.

Now, this is all well and good, but it doesn’t answer the question…how you gonna do it?  How can you break that cycle and start engaging with other people well all you want to do is grab your iPad and dive into a blanket fort?

A few thoughts on that:

  • Most social interaction is casual and almost thoughtless – that is, it lacks conscious effort.  When you are down, you have to actively make yourself talk to someone else.  Get up.  Get out of the chair.  Go find the spouse you’ve been ignoring because you are trapped in your own head.  The kid you were letting watch too much TV.  Talk to them.  As them how they are doing.  Try to start a conversation and hook yourself in.  Make a conscious effort to do something real.
  • Can’t leave the house, or don’t want to?  Pick up the phone.  Don’t text!  No texting!  And don’t send a FB message!  Call someone…you know, like phones used to be used.  Start talking with a real voice.  Engage in that human connection that I think far too many of us have delegated to texting and messages.
  • Read a book.  Alright, this one is slightly different than the first two.  But, staring at your phone, mindlessly scrolling your way through your Facebook newsfeed, isn’t going to help yourself.  Instead, try to break the cycle by getting lost in someone else’s life.  See if you feel better on the other side.

There is more – so much more – but I want to hear from you.  How do you get out of your own head when you are depressed?  Let us know in the comments!

When depressed is caused by nothing at all

I have an interesting question for those of you out there who suffer from depression: What do you do when your depression is caused by nothing at all?

There are times – and I suspect that this is for everyone, not just folks who have depression problems – where I get depressed for no reason.  At least, none that I can think of.  I remember my therapist once telling me that there was always something lurking around in the back of my mind somewhere.  That depression is almost never caused by “nothing.”  I suspect that he is right, and that makes it even more frustrating.

I’d argue that this can often be worse than feeling miserable for reasons that you can identify.  Obviously, that depends on the reason you are down, but if there is a reason behind a depression or sadness issue…well, then you can actually deal with it.  When there’s no reason, it’s harder to grasp.  In instances like these, fighting depression is like pushing smoke.  It just can’t be done.

On instances like this, I come back to a conversation I had in a psychology class when I was in college:

glass-half-full.jpg

Ahh, yes, the glass half full.  But, this one comes with a different spin.

I once had a Muhlenberg professor describe mental illness as a combination of genetics and environmental factors.  This is a vast oversimplification, of course, but hear me out.  Let’s say that the water already in the glass is your genetic predisposition to depression.  Additional water gets poured in as a result of environmental factors and other stressors, and when the glass overflows, bam, you are depressed.

In this metaphor, people who aren’t predisposed to depression are less likely to be depressed, but that’s because they have less water in the glass to begin with.  Those people can still get depression, but it’s gonna take a heck of a lot more water (life stressors) to get them there.  For others who have a history of depression or a genetic predisposition, it only takes a little bit of water to get the glass overflowing.

I agree with my psychologist – it’s never really nothing.  It’s always something – maybe something you don’t want it to be, maybe something you are ashamed or embarrassed by, but there is usually something bouncing around in your head which is going to push you over the edge into a depressive funk.

So, here’s my advice: When it’s nothing at all – when you are depressed, but have no idea why, try to ask yourself what’s truly on your mind.  Work?  Family?  School?  As best you can, within your own head, ask yourself those questions.  Create a judgement free zone and allow your heart and your head to tell you what’s really up.  I hope this doesn’t come across as new-agey mumbo-jumbo, but as helpful advice.  Sometimes, the best way to get yourself feeling better is to ask yourself the right question – even if you don’t really want to know the answer.

I hope this is helpful, and as always, I’d love to hear your thoughts – for this one more than most!

The difference between being sad and being depressed

Here’s one that came up yesterday when I was just having a conversation yesterday: How can you tell this difference between being sad and having a diagnosable depression problem?

I mean, everyone gets sad at some point, duh.  Life has moments of pain.  But, what is the difference?  Because it is a crucial one – and it can be difficult to tell for people who are in recovery from depression or who have other mental health issues.

Now, in the course of writing this entry, not to my surprise, I discovered that there is a loooooooooot of other content on this topic.

An ABC news article on the subject summarizes it nicely:

Depression causes problems with regard to a person’s functioning. And the symptoms of depression typically last at least two weeks or longer. Sadness is one the of the symptoms of depression, but with depression you have more than just sadness.

You have other symptoms as well, and the diagnosis requires that you have not only sadness for two weeks or longer, but also some of these other associated symptoms that I was talking about earlier such as lost of interest, and inability to sleep at night, trouble with your weight and your appetite, as well as feeling guilty, having trouble concentrating, and having suicidal thoughts.

That’s a pretty succinct summary.

But….

Okay, I’ll bring in my own personal experience here, and note that it isn’t quite as black and white as this.

First, the above symptoms aren’t quite as clearcut as noted above.  Some hypotheticals:

  • I couldn’t sleep for a couple of nights in a row – is it just the coffee, or something more?
  • I haven’t enjoyed my video games for a week or so – do I need a new game, or am I starting to get depressed?
  • My weight has been off – is it the ice cream, or something worse?

More often than not, these symptoms don’t approach with the force of a tidal wave.  They start slow, and then get worse and worse.  In times when I’ve relapsed, I’ve looked back and thought, “Wow, that got bad…and I didn’t notice it before.”  It’s sort of like the frog and boiling water metaphor.  You feel fine one day, then turn around the next week, realize you have been really struggling, and didn’t even realize that you were in a bad place.

Early detection for depression – well, for anything, certainly – is absolutely critical.  Which is why this is an important question to be answered.  Am I sad, or is it something more?  Do I need to make an appointment with my therapist?  Adjust my medication?  What do I need to do right now to stop this from being getting worse?

I’d also say that this question is better answerable from an outside source.  At times where I have skidded into a depressive phase, more often than not, it’s been my wife who has noticed it and given me a gentle prodding or two about seeming off.  Others – family or friends – are often much better at telling when we are suffering than we are ourselves.

Here’s my point: Telling the difference between sadness and depression isn’t always easy.  It isn’t a flow-chart like exercise that lends itself to a simple interpretation.  It’s a complicated question – more complicated than it would appear, certainly – and can be even more complicated to answer.

As always, I welcome your thoughts and advice.  Any experiences with answering this question that you’d like to share?  Let us know in the comments below!

Reimagining Electroconvulsive Therapy

I had the pleasure of attending an event earlier this week in which another local elected official personally discussed his own experiences with anxiety, all in the name of an anti-stigma campaign by our local chapter of the National Alliance for Mental Illness.  One of the speakers at the press conference was a psychiatrist who discussed stigma surrounding mental illness, but he got a little bit more specific: He discussed ECT, or Electroconvulsive Therapy.

Electroconvulsive Therapy was once one of the cruelest treatments for mental illness imaginable.  It’s common use in American began in the 1950s and was largely brought into public view by the film One Flew Over the Cuckoo’s Nest.  It became a controversial treatment option, and with good reason: Patients were often treated against their will and with dangerously high doses.

That being said, that’s no longer the case.  Indeed, to say that the therapy has changed is an understatement.  From the Mayo Clinic:

Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.

The article goes on to note that ECT is used when other treatment – medication and therapy – is less effective.

Is it still risky?  Sure, like any therapy, there is the potential for side effects, including confusion, memory loss and other complications.  That sounds bad, but most of those side effects are also temporary.  That, and let’s be honest: Can you find an effective drug without potentially problematic side effects at this point?  Nope.

How effective is ECT?  Well, according to this article from Psychiatric Times, very: 60-90% of people have a positive response.

If you’ve ever read this blog before, you know that the basic gist of my entire mental health crusade is anti-stigma oriented.  It didn’t really hit me until the press conference I attended how that stigma remains powerful when it comes to specific treatment modalities.  Multiple studies proved that ECT is an effective way of treating depression and mania that is otherwise treatment resistant, but older forms of its operation have convinced many people that it’s a terrifying and dangerous way of trying to rid yourself of depression.  Science has evolved to the point that this is no longer the case, and it is vitally important that we recognize this truth.