Climate change – and a potential climate apocalypse – are contributing to depression

The evidence, unfortunately, is clear: Climate change is here, it is accelerating, and it is going to get worse, with potential cataclysmic changes occurring as soon as 2040.

That, obviously, can and will have massive implications on all of our lives. However, as this NBC article notes, one of those negative impacts from a mental health perspective: The depression which comes as a result of “climate grief.”

I didn’t realize this until this article, but the American Psychological Association released a long report on how climate change is affecting mental health. That’s available here. That report, it seems, concentrates largely on the effects of climate change on the mental health of those who are more directly impacted by the negative impacts of climate change, including some of the enhanced hurricanes and extreme weather events. However, it also notes that personal relationships and psychological can be impacted:

Psychological well-being includes positive emotions, a sense of meaning and
purpose, and strong social connections. Although the psychological impacts of
climate change may not be obvious, they are no less serious because they can lead to
disorders, such as depression, antisocial behavior, and suicide. Therefore, these
disorders must be considered impacts of climate change as are disease, hunger,
and other physical health consequences.

I gotta say, personally, I totally get this, and I bet you do too. Worry about the planet’s health has starting permeating some of my worst fears, and particularly in terms of what we are leaving behind for our children. My children.

The NBC article notes that a woman featured in it, who has three very worried children, enrolled in a ten step program (the Good Grief network), which helps people deal with collective societal problems. I like this strategy a lot because it actually involves doing something – not just sitting and waiting.

I will refer again to an earlier entry I wrote in the aftermath of the Tree of Life shooting – how to have hope in a world filled with darkness. One of the specific items I wrote was this: Find what you can control, and do something about it. Is climate change an issue which is important to you? It should be. The question needs to me this then: What can you do about it? As an individual, there are quite a few things. This involves changing what you buy, what you use and how you take care of yourself. This also means connecting with elected officials and becoming a citizen activist.

On this issue, the best advice I can give is this: You aren’t helpless, and you aren’t powerless. If you are worried about climate change, do something.

My most-read blog entries of the year

I have to say, I really enjoyed the blog this year. After letting it go for months, I picked it up again and have consistently tried to create useful and interesting content. It’s also helped me expand my horizons and think about mental health in a different way.

This year also saw the publication of Redemptionan experience which has given me more joy than I ever could have realized – and an experience which was borne of my own depression. Take note, reader: You can get immeasurable joy out of sadness.

That being said, most importantly, I hope what I wrote has helped you.

So, here’s a look at the five blog entries I wrote which seemed to be the most popular. My year in review, if you will.

5) Ties That Bind: Liberals, Conservatives & Mental Health: This is the only “top five” entry which dealt specifically with public policy. It dealt with the challenges facing Democrats/Republicans, urban/rural areas and how mental health remains a huge challenge in all of these sections of the country.

4) Redemption, by Mike Schlossberg, is Almost Available: Alright, this one was blatantly self-promotional 🙂

3) The Tragic Suicides of Kate Spade & Anthony Bourdain: Within a few days, Kate Spade and Anthony Bourdain killed themselves. I wrote this blog entry just after the news broke about Bourdain, largely motivated by a very real fear about the contingent effect when someone does kill themselves. It was my immediate thoughts on what to do and how to help those who are suffering.

2) How To Stay Hopeful in a World Filled With Darkness: This entry was one of the most painful ones I have ever done, and like the one above, it was in the immediate aftermath of a tragedy – specifically the Tree of Life shooting in Pittsburgh. The crux of this entry was how anyone can stay hopeful and optimistic in a world where gloom and doom have become so powerful.

1) How Vacation Can Make You Depressed, and What You Can Do About It: This entry was inspired by my own upcoming vacation – and the depression which often accompanied it. What was most interesting about this one to me is that this one has seen a slow and steady increase in hits after the entry was posted back in late July. It did okay at first, but then the views just grew and grew. I suppose it’s good to know that I’m not the only one who sometimes feels this way.

It has been a wonderful year, and thank you for giving me the opportunity to talk to you. I wish you a happy, peaceful and restorative New Year. See you in 2019!

Highly recommended mental health reading

As the year comes to an end, I find myself staring at my Goodreads page. I had a pretty good year for reading! Looks like I read 28 books when I wanted to read 20 – I’ll take it!

But, that’s not what I am writing about today, at least, not specifically. I wanted to pass along the books I have read in the mental health genre, both fictional and non-fictional. Some authors just do a remarkably good job of dealing with this realm, and it’s my honor to make a few recommendations. So, without further ado:

Fiction

  • The Summer The World Ended, Matthew Cox: A fantastic book about a young girl who experiences a traumatic loss and has her entire life uprooted. The book takes a close look at trauma, PTSD and more (which I can’t get into without spoiling).
  • Consider and Contribute, Kristy Acevedo: This was the only other book I could find which simultaneously dealt with a young adult, science fiction and mental illness! In the book, portals open, with aliens advising that Earth residents jump in them because the world is about to end. The book follows a young girl with major anxiety challenges and her struggles to deal with the new world. I also interviewed the author, Kristy Acevedo, here.
  • The Memory of Light, Francisco Stork: One of my favorites. It follows a young girl who survives a suicide attempt and her way back into the light. Stork was kind enough to answer an interview from me as well.

Non-Fiction

  • Lost Connections, Johann Hari: A controversial book which I had some issues with. Nonetheless, it offers some interesting insight into the ideas of social, societal and cultural causes behind depression and mental illness in general.
  • How To Break Up With Your Phone, Catherine Price: Okay, this isn’t exactly a mental health book, per se, but I think it is. It helps people learn how to stay away from their phones, and all the benefits that can bring. I also interviewed Price on the blog a few months ago.

And, of course, if you want one more book, allow me to suggest Redemption, my young adult, science fiction tale of depression, anxiety and saving the world.

Any other books to add? Please let us know in the comments. Have a WONDERFUL new year!

Mental Heath & The Holidays

This entry originally appeared in November 2017, and for Thanksgiving, but I think the lessons certainly still apply. To all who celebrate, Merry Christmas, and Happy 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!

Two major mental health trends, with one unifying theme

Two articles jumped out at me over this weekend. The first was this extremely long and in-depth look at a major suicide study done decades ago, which showed that even the occasional letter from a therapist can get someone through a crisis and significantly reduce suicide rates. The second touches on the topic you’ve all heard me discuss many times before: The rise of depression and suicide in young adults, and the potential role that smart phones may play.

The commonality here is obvious: The importance of relationships in stopping a mental health crisis and maintaining happy lives.

The Huffington Post article tracks the work of Dr. Jerome Motto, who engaged in a massive suicide study. His team tracked tracked mentally ill patients and found that sending letters to them could dramatically reduce suicide attempts, a study that, according to the article, has been backed up by other, similar studies, including this one by Gregory Carter:

Gregory Carter, who ran a psychiatry service in New South Wales, Australia, orchestrated a study in which Motto’s words were typed onto a postcard illustrated with a cartoon dog clutching an envelope in its mouth. The notes were sent eight times over the course of 12 months to patients who were among the hardest to treat. The majority had histories of trauma, including rape and molestation. Some had made repeated suicide attempts. But Carter found there was a 50 percent reduction in attempts by those who received the postcards. When he checked in on the study’s participants five years later, the letters’ effects were still strong. And the cost per patient was a little over $11.

Meanwhile, the USA Today article I noted above places at least some of the blame of the rise in depression among teenagers and young adults on cell phones:

San Diego State University psychologist Jean Twenge sees a direct link between how much time teens spend on smartphones and troubling signs of mental health distress.

In her 2017 book “iGen,” she cited national health surveys and other statistics to argue that a generation of teens have turned to smartphones as their preferred social outlet, and teens who spend the most time on their screens are more likely to be unhappy.

“What you get is a fundamental shift in how teens spend their leisure time,” Twenge told USA TODAY. “They are spending less time sleeping, less time with their friends face to face. … It is not something that happened to their parents. It is not something that happens as a world event.”

There’s a common connection here, and it’s pretty obvious: People – all of us – need each other.

The simple fact is this: iPhones and social media are build on the premise of building a further connection between people, and while that’s certainly possible, I’d argue that they really just keep us apart. I’m just as guilty of this as anyone else, but when we use our phones instead of talking to people face to face, we’re not building anything. It may increase our surface knowledge of someone’s life, but it’s not a substitute for a real interaction. It’s like heaving sugar for dinner instead of a healthy meal – it may fill you up, but there’s nutritious about what you are eating, and eventually, it rots you from the inside.

The article about sending letters to suicidal people backs up this point, in my opinion. People can, apparently, be brought back from the brink by hearing from someone who truly cares. I will not presume to imagine what is going through the mind of someone who is at the point of a suicide attempt. But from what I’ve read – and what I’ve experienced when I was close to that point – suicide isn’t really about dying, per se. It’s about someone wanting to stop their pain. To know that they have a reason to hope. So, if you get an authentic person sending a real message – hey, how are you doing, I’m thinking about you and I care about you – can that fill a void? Can that bring a person back from the edge? Dr. Motto’s research, and that of others, would certainly seem to imply that the answer to that question is yes.

It seems to me that these two articles detailing the rise in suicide and depression have someone in common – humans are losing their innate ability to connect with others, and doing so can solve many of our mental health issues.

As always, I welcome your thoughts. Let us know your thoughts in the comments below!

Depression rates by state, and what one state is doing about it

USA Today has run a fascinating and eye opening article on the state by state depression rates throughout the country.

First, here’s the basics (sorry, tried to get this as an infographic but having trouble getting the link to load):

Depression By State.png

 

The bluer the state, the higher the rate of depression. Leading the pack, sadly, is Utah, which has 3,977.6 cases of depression for every 100,000 people. At the bottom is New Jersey, with 2,353.3 cases. My state, Pennsylvania, is in the lower half of the country, with depression rates of 2,881.8.

The USA Today article largely focuses on the very high rates of depression in the Mountain West region of the country, which, as you can see, are very high. The article discusses the damning role of stigma, lack of access to health care, the rural natural of many of these states and high levels of gun ownership, which, unfortunately, often lead to suicide.

The article blames much of the rise of depression in this region on its self-reliant culture, particularly in terms of how it affects men. That’s one of the reasons why articles like this are so important: They can hep shatter the stigma which surrounds depression, and particularly by using personal stories of men who have suffered and sought help.

To Utah’s credit, they have done a variety of things to address their rising rates of depression and heavy rates of suicide. This includes:

  • Development of a smartphone app which can provide counseling.
  • Requiring students to take classes on life skills, mental health and substance abuse.
  • Creation of a suicide prevention research coordinator.

The App is widely known within mental health circles and has saved lives. The requirement that student take courses in life skills is interesting, particularly if it teaches things like resilience and coping skills. I know – it seems difficult to imagine that classes are now needed in this area – but the world has changed. It has evolved. And these classes are now, apparently, painfully, necessary.

This article makes a broader point: Depression, suicide and mental illness are rising. We, in the public policy arena, must address these changes for our society to have any hope of evolving and surviving. The world seems to have become a darker place. We have to be the ones who give it light.

Your smartphone can tell if you’re depressed

person using phonwYou know how I’ve written about how social media and phones can cause depression? Well, it turns out, your phone can also tell if you are depressed.

The study, from the University of Stanford, shows that face and speech software on your phone can detect depression based on your facial expressions and speech patterns:

The researchers fed video footage of depressed and non-depressed people into a machine-learning model that was trained to learn from a combination of signals: facial expressions, voice tone, and spoken words. The data was collected from interviews in which a patient spoke to an avatar controlled by a physician.

In testing, it was able to detect whether someone was depressed more than 80% of the time. The research was led by Fei-Fei Li, a prominent AI expert who recently returned to Stanford from Google.

The article did caution that, due to the way the study was conducted, the therapeutic applications aren’t clear. According to David Sontag, an assistant professor at MIT:

…that the training data was gathered during an interview with a real clinician, albeit one behind an avatar, so it isn’t clear if the diagnosis could be entirely automated. “The line of work is interesting,” he says,“but it’s not yet clear to me how it’ll be used clinically.”

I have two thoughts about this type of treatment. First, this is fascinating – and this type of technology be helpful in terms of closing the gap between those who have access to treatment and those who don’t. In addition to studies like the one above, Stanford has also developed apps which can be used to treat depression – and which apparently work. I’ve touched on this topic in previous entries as well: Apps which treat depression can work.

In other words, apps and automated programs can help to treat depression. That’s fascinating to me – I never would have believed that depression could be treated without a live, human person, but apparently it can work.

On the other hand, there are some rather frightening potential applications of this sort of treatment. First is privacy: I am sure that any app working right now is operating with the strictest of privacy measures and data safeguards, but as we have seen repeatedly, data hacks and breaches occur with relative consistency. This has some very serious implications for something like text therapy or therapy which occurs over a device, because it begs the question: What data is recorded, and how could it potentially be accessed? I mean, I’m pretty open about the fact that I receive treatment, but even I wouldn’t want the items I discuss with my therapist broadcasted to the whole word. Is that possible with these apps? I don’t know, and it may not be. But there are real privacy and technological concerns which must be addressed when it comes to therapy delivered electronically.

Second: Can someone be diagnosed against their will? I don’t think so. Not yet, anyway. Later down the line, programs like the one discussed above may also have issues with consent. It seems to me that the Stanford program is not yet ready to be used in a public or even therapeutic setting. But, when it is, will people be able to use it on others without their consent? That…that’s kind of a scary thought.

These are questions which are only somewhat hypothetical. Technology is clearly advancing, and I can only hope privacy and ethical safeguards can advance with it.

Let us know your thoughts in the comments below!

Symptoms of depression in others

I’ve written a lot about how to deal with depression if you’re the one suffering, but there’s one topic that I realized I haven’t touched on a ton: How can you recognize when someone you know or love is depressed? That can be a challenge: The symptoms may be subtle, or they may be screamingly obvious. But recognizing that someone is suffering is the first step towards getting them the help that they may need.

So, what are the signs of depression in someone else? There’s the obvious: They seem down. They express negative emotions or feelings about themselves. But spotting depression isn’t always that easy, sadly. Here’s a few thoughts on how you can keep an eye out for when someone is down:

  • Lack of energy: The person you know or love just doesn’t seem to want to do anything anymore.
  • Social withdrawal: They don’t want to spend time with their friends, go to work or do anything other than lie in bed/stay at home and watch TV.
  • Changes in appetite: This can go either way – someone suddenly stops eating or is eating all the time.
  • Tired and/or lacking energy: Okay, yeah, we’re all busy and constantly sleepy, but if someone is complaining to you about wanting to do nothing but sleep – or not being able to get any sleep – that’s a problem.
  • Reckless behavior: People with depression will often do anything to escape their own heads. This may involve behavior which unnecessarily puts them in some sort of risk. That may involve increased use of alcohol or drugs or other dangerous activities.
  • Attention problems: People with depression may have a hard time focusing on work or school. If you see your friend having a bigger problem than usual paying attention, that may be a sign that they are in trouble.

Two additional things about the symptoms noted above. First, there has to be a baseline. Someone may seem like they are withdrawing from the world when the truth is that they are just a homebody – you have to have something to judge their behavior against, and it has to represent a change from the norm.

Second, these changes can be subtle. People with depression are often good – too good – at hiding their symptoms (trust me). This is for a variety of reasons – they don’t want to be a burden, they think it’s just “all in their head,” etc. As a friend or a loved one, this can make your life difficult, but it requires you to keep an eye out for behavior. This is particularly important when someone you know has been depressed in the past, or is likely to slip into a depressive spell again. My poor wife has a series of symptoms which she is constantly on the lookout for, and if you have someone you love who has suffered, you know exactly what I am talking about.

As always, I welcome your thoughts and comments! Anything I missed here? Please let us know in the comments below!

Suicide rates are on the rise

Bad news, per a press release from the American Foundation for Suicide Prevention. The CDC has released it’s 2017 mortality report on suicide and found that 47,173 Americans killed themselves – an increase of 3.7% over the 44,965 Americans who killed themselves in 2016.

The suicide rate is at a 50 year peak, an astonishingly high number, and one which is actually contributing to a decrease in the life expectancy of the average American. Suicide is the currently 10th leading cause of death in America.

The American Foundation for Suicide Prevention says that five things need to change in order to comprehensively address suicide reduction:

  1. Cultural attitudes about help seeking and overall awareness about mental health conditions.
  2. Access to affordable mental health care.
  3. Training for primary care physicians to screen for mental health and suicide risks.
  4. Reducing access to lethal means of suicide.
  5. Better data collection.

I’d add this, based on other research that I’d seen: We need a stronger social safety net. This means that we need a more activist government that can provide a social and financial backstop for people who are in need of it. Studies have shown that suicide rates are lower in areas where there is a stronger social safety net, but that connection seems to be particularly strong when there is good access to health care and housing assistance.

This is a harder one to advocate for, to be honest, and I think there are two reasons behind that.

First, the concept of a “stronger social safety net” is broader and more abstract. The five points noted above are relatively clear-cut, and the connection between them and suicide reduction is clear. I think that connection is weaker when it comes to improving the social safety net, but it doesn’t mean that the two aren’t connected.

Second – and maybe this is just in my head – is a political concern: A stronger social safety net requires more government intervention and funding. That, of course, is a much broader and more political statement, one which slants more towards the progressive end of the ideological spectrum. And that gets difficult for non-partisan organizations which typically fight for stronger mental health services.

I think that’s a long term challenge for the mental health community. Again, I’m a Democrat and pretty progressive, so I’m biased, but I do think that the research bears this out: A more progressive political orientation is better for individuals with mental health challenges and to reduce the scourge of suicide.

That is NOT to say that Republicans or conservatives don’t care about mental health or suicide reduction – nothing could be further from the truth, and I have very proudly worked with Republicans and conservatives on mental health and suicide reduction legislation. But, it is a challenge. The simple truth is that making improvements in these areas requires more government intervention.

Anyway, as always, I’m curious to hear your thoughts – do you agree or disagree with me? Let us know in the comments below!

An in-depth look at worldwide suicide

The Economist has an absolutely fascinating and thought provoking look at suicide trends across the world. The most interesting item in the article is the graph above, which shows two things. First, suicide worldwide is declining. Second, the United States is the exception – we’re the only place in the western world where suicide is increasing, which is terribly upsetting.

The article is well worth reading, but it is a long one. I’ll try to summarize some of the trends it notes.

First, and most importantly: Suicide rates are down 38% from 1994. That’s fantastic news. But, of course, those decreases haven’t occurred evenly across all subgroups.

In China and India, significantly less women are killing themselves. This is attributed to public policy changes – and changes in culture – which have given women more freedom and independence. As gender norms have changed, women have gained more control over their lives, thus leading to lowered suicide rates. In other words, gender equality can save lives.

Increased urbanization is helping with this as well, as rural suicide rates are higher than urban ones – a trend which seems to be relatively constant across the word.

In Russia, cultural and political changes contributed to massive spike in suicides among middle aged men. That number, though still high when compared to the rest of the world, is now at half of its peak in the 1990s. This is attributable to a few things. First, the article notes that men have learned how to live in Russia’s new society and economy, having more success at getting a job and earning a living. Unemployment and economic upheaval leads to suicide, so as more men get jobs, they are less likely to kill themselves, and this is a constant across the world, in all cultures.

Additionally, studies have noted that suicide rates are tied with health care access. In countries where the unemployed still had access to health care, suicide rates did not increase during recessions – something that was not true in countries where health care was harder to come by.

Alcohol is also linked to suicide – alcohol consumption and suicide rates move together, though the article was unclear about whether or not one caused the other or a third factor moved both.

Suicide rates are higher among the elderly than they are the young or middle-aged population. As health care and poverty improves among this group, suicide rates fall.

The article also notes that means reduction – be it with guns, poison or gas – can have a major effect on suicides. The impulse to kill oneself is often fleeting, and reducing access to deadly weapons can absolutely reduce suicides.

What are the broad, global conclusions of this article? The one thing that I get out of it – more than anything else – is that public policy can have a major, major impact on suicide. Efforts to enhance economic security, increase access to health care, spread economic freedom and enhance gender equality plays a big role in reducing suicides. These are important factors which must be taken into account for any mental health conversation.