As someone who now works with people experiencing depression, anxiety, addiction and a range of other issues, and being a person who has experienced my own battle with depression, I have my own unique perspective.
Reflecting on his experience at a preview session from the Health Promotion Agency’s National Depression Initiative, Phillip shared his own common and unique experience of depression and anxiety.
Philip talked about his objections to the idea that depression is “an illness, not a weakness” because, in his view, the causes of depression and anxiety are often social factors – and that these problems (and other mental health concerns) need a “social model” rather than a medical one.
Firstly, like Philip, I can see why someone would classify anxiety or depression as “an illness, not a weakness”. I agree that no mental health problem comes about as the result of a weakness of character and that anyone, anywhere, at any time, can experience these kinds of problems (and indeed, one in five New Zealand’s do in their lifetime).
I think that experiences like depression and anxiety get called “illnesses” as a way of signaling the vast difference between someone when they feel mentally “well”, compared to when they don’t. Indeed, most of the diagnostic criteria for mental “illnesses” include the fact that the symptoms either cause significant distress to a person, or significant impairment in their day-to-day functioning.
So my take is that “illness” is perhaps used as an inadequate shorthand for “not functioning in the way that I do when I’m feeling whole, connected, supported, complete and satisfied with my life – I’m struggling, help!”
But I agree too, that “illness” also does not feel like quite the right term. Philip suggests that depression, anxiety, and other mental health concerns can be valid emotional responses when a person is struggling with the state of their life. As both a therapist and a person who has experienced significant depression, I completely agree.
Philip goes on to suggest that rather than a medical model, we need a “social model” of mental illness. The thing is, that is exactly what we have and use in mainstream mental health. We base most modern, evidence-based mental health intervention on what is called the “bio-psycho-social” model of mental illness. I’ll break this down briefly, with examples.
The Biopsychosocial Perspective
The “bio” part of the model refers to the fact that we are pretty sure that some mental health problems have a genetic component. Now, this doesn’t mean that if you have a particular gene you are guaranteed to get a particular disorder, rather than your brain chemistry might just be a little bit more vulnerable to developing one, given the right life circumstances. It’s a bit like heart disease. Two people can have the same healthy (or not so healthy) diet. One, who has a particular genetic marker in their family, may have a heart attack; while the other goes on to live a long life with no heart problems.
It’s a bit like heart disease. Two people can have the same healthy (or not so healthy) diet. One, who has a particular genetic marker in their family, may have a heart attack; while the other goes on to live a long life with no heart problems.
“Bio” also refers to the fact that experiences like anxiety and depression do affect your physical body just as much as your mental health. In terms of treatment, many people will find that particular medications help (others don’t, and that’s okay too). We also know things, like getting enough sleep and exercising a little, can help people manage these problems too.
The “psycho” part refers to your internal functioning – your mind, mental and emotional experience. When I was growing up, I learned particular ways to think about and manage my emotional experiences, that didn’t really serve me so well as an adult. For example, thinking “negative” emotions like sadness or anger are a bad thing and should not be experienced or expressed…that’s a pretty common right across Kiwi culture, I think.
Part of my recovery involved learning a different way of understanding and managing my emotions. This is generally where therapy can be the most helpful and can heap other benefits as well.
The last is the “social” part of the model. This is the acknowledgment of the idea that crappy life experiences or a not-so-great situation can significantly contribute to mental health concerns.
Again, treatment often involves helping someone to get themselves into a better or more stable environment, and connecting to good support. I’ve had many clients realize they needed to do things like end relationships, quit a job or move house, as I did myself, to help improve their mental health.
Now, our mental health system is far from perfect. There is a massive shortage of resource and funding, as well as an ongoing battle with stigma and discrimination, amongst other issues. But, for better or worse, that’s a super short summary of the model that the majority of mainstream mental health support services are based on.
So given that we are supposed to be acknowledging, integrating and working with all the parts of a person and their situation – why is it that the message is still out there in the media that mental health problems are a medical, not a social issue? Is it short-hand, a simplified way of raising awareness that mental health problems are common, and not a character flaw?
Or is it is lack of understanding as to how mental health problems develop, and how we treat them? I’m really not sure on this one – but I’d love to find out.
Want to Help Your Teens? Make Their Lives Predictable
Establishing consistent routines at home for your teen may generate pushback, but it could also set him or her up for future success.
Researchers at the University of Georgia found teens with more family routines during adolescence had higher rates of college enrollment and were less likely to use alcohol in young adulthood, among other positive outcomes.
The findings were published recently in the Journal of Adolescent Health.
“If we’re going to make a difference in our lives and in our family members’ lives, we have to make a difference in the everyday,” said lead author Allen Barton, an assistant research scientist at the Center from the Family Research and the UGA College of Family and Consumer Sciences. “Routines play an important role in making that happen.”
Researchers analyzed data collected from more than 500 rural African American teens beginning when they were 16 and continuing until they were 21.
The teens whose primary caregivers reported more family routines – such as regular meal times, consistent bedtimes and afterschool schedules – reported less alcohol use, greater self-control and emotional well-being and higher rates of college enrollment in young adulthood.
Researchers also analyzed biological samples from the teens and found that those with more family routines during adolescence showed lower levels of epinephrine, a stress hormone.
The benefits of family routines generally persisted even after the researchers took other factors into account such as levels of supportive parenting, household chaos and socioeconomic status.
Routine, consistency and predictability, the research suggested, are powerful influences on a teen’s life.
“We often lose sight of the mundane aspects of life, but if we can get control of the mundane or the everyday parts of life, then I think we can have a major impact on some bigger things,” Barton said. “These findings highlight how you structure your teen’s home environment really matters.”
The research has important implications for family-centered interventions, Barton said, including focusing more attention on increasing predictability and positive routines at home.
“The big takeaway is to help your child navigate the teen years, make their lives predictable,” Barton said. “There has been a lot of research about the importance of routines for healthy development with young kids. These results are some of the first to show that even with teens, it appears routines are similarly powerful.”
The paper, “The profundity of the everyday: Family routines in adolescence predict development in young adulthood,” is available at https://www.sciencedirect.com/science/article/pii/S1054139X18304130?via%3Dihub
Additional authors are Gene H. Brody, Tianyi Yu, Steven M. Kogan and Katherine B. Ehrlich from the University of Georgia and Edith Chen from Northwestern University.
Strong Committed Relationships Can Buffer Military Suicides
Can being in a strong committed relationship reduce the risk of suicide? Researchers at Michigan State University believe so, especially among members of the National Guard.
Suicide rates for members of the military are disproportionally higher than for civilians, and around the holidays the number of reported suicides often increases, for service members and civilians alike. What’s more alarming is the risk of suicide among National Guard and reserve members is even greater than the risk among active duty members.
When returning from a deployment, National Guard members in particular are expected to immediately jump back into their civilian lives, which many find difficult to do, especially after combat missions. Some suffer from post-traumatic stress disorder, depression or high anxiety in the months following their return. These mental health conditions are considered at-risk symptoms for higher rates of suicide.
The researchers wanted to know what factors can buffer suicide risk, specifically the role that a strong intimate relationship plays. They discovered that when the severity of mental health symptoms increase, better relationship satisfaction reduces the risk of suicide.
“A strong relationship provides a critical sense of belonging and motivation for living – the stronger a relationship, the more of a buffer it affords to prevent suicides,” said Adrian Blow, family studies professor, and lead author. “If the relationship is satisfying and going well, the lower the risk. National Guard members don’t typically have the same type of support system full-time soldiers receive upon returning home, so it’s important that the family and relationships they return to are as satisfying and strong as possible.”
The researchers surveyed 712 National Guard members who lived in Michigan, had been deployed to Iraq or Afghanistan between 2010-2013 and reported being in a committed relationship. The study measured three main variables – mental health symptoms, suicide risk and relationship satisfaction – each on a separate ranking scale. The soldiers were asked questions such as how enjoyable the relationship is, if they ever thought about or attempted suicide, how often they have been bothered by symptoms of depressive disorder, etc.
Results showed significant associations between each of the mental health variables (PTSD, depression and anxiety) and suicide risk, indicating that higher symptoms were predictive of greater risk.
However, once couple satisfaction and its interaction with mental health was factored in, the association between mental health symptoms and suicide risk was changed. Specifically, for those with higher couple satisfaction, the increased symptoms of PTSD, depression and anxiety were no longer a risk for suicide.
“Our findings show that more needs to be done to enhance the quality of relationships to improve the satisfaction level and through this decrease the suicide risk,” Blow said. “Having a partner who understands your symptoms may help the service member feel understood and valued. There are family support programs available, but we need to do more to enhance relationships post deployment. Relationships do not get enough consideration in the role they play in preventing military suicides, and I would love to see more attention devoted to this issue.”
Other co-authors included Adam Farero from MSU; Heather Walters and Marcia Valenstein from University of Michigan; and Dara Ganoczy from the Veterans Health Administration. The study was funded by the Veterans Administration. The study was published in the official journal of the American Association of Suicidology.
The Joy of Giving Lasts Longer Than the Joy of Getting
The happiness we feel after a particular event or activity diminishes each time we experience that event, a phenomenon known as hedonic adaptation. But giving to others may be the exception to this rule, according to new research from the University of Chicago Booth School of Business.
In the paper, “People Are Slow to Adapt to the Warm Glow of Giving,” forthcoming in Psychological Science, Chicago Booth Associate Professor Ed O’Brien and Northwestern University Kellogg School of Management’s PhD candidate Samantha Kassirer found that participants’ happiness did not decline, or declined much slower, if they repeatedly bestowed gifts on others versus repeatedly receiving those same gifts themselves.
“If you want to sustain happiness over time, past research tells us that we need to take a break from what we’re currently consuming and experience something new. Our research reveals that the kind of thing may matter more than assumed: Repeated giving, even in identical ways to identical others, may continue to feel relatively fresh and relatively pleasurable the more that we do it,” O’Brien explains.
The researchers conducted two studies. In one experiment, university student participants received $5 every day for 5 days; they were required to spend the money on the exact same thing each time. The researchers randomly assigned participants to spend the money either on themselves or on someone else, such as by leaving money in a tip jar at the same café or making an online donation to the same charity every day. The participants reflected on their spending experience and overall happiness at the end of each day.
The data, from a total of 96 participants, showed a clear pattern: Participants started off with similar levels of self-reported happiness and those who spent money on themselves reported a steady decline in happiness over the 5-day period. But happiness did not seem to fade for those who gave their money to someone else. The joy from giving for the fifth time in a row was just as strong as it was at the start.
O’Brien and Kassirer then conducted a second experiment online, which allowed them to keep the tasks consistent across participants. In this experiment, 502 participants played 10 rounds of a word puzzle game. They won five cents per round, which they either kept or donated to a charity of their choice. After each round, participants disclosed the degree to which winning made them feel happy, elated, and joyful.
Again, the self-reported happiness of those who gave their winnings away declined far more slowly than did the happiness reported by those who kept their winnings.
Further analyses ruled out some potential alternative explanations, such as the possibility that participants who gave to others had to think longer and harder about what to give, which could promote higher happiness.
“We considered many such possibilities, and measured over a dozen of them,” says O’Brien. “None of them could explain our results; there were very few incidental differences between ‘get’ and ‘give’ conditions, and the key difference in happiness remained unchanged when controlling for these other variables in the analyses.”
Adaptation to happiness-inducing experiences can be functional to the extent that it motivates us to pursue and acquire new resources. Why doesn’t this also happen with the happiness we feel when we give?
The researchers note that when people focus on an outcome, such as getting paid, they can easily compare outcomes, which diminishes their sensitivity to each experience. When people focus on an action, such as donating to a charity, they may focus less on comparison and instead experience each act of giving as a unique happiness-inducing event.
We may also be slower to adapt to happiness generated by giving because giving to others helps us maintain our prosocial reputation, reinforcing our sense of social connection and belonging.
These findings raise some interesting questions for future research – for example, would these findings hold if people were giving or receiving larger amounts of money? Or to giving to friends versus strangers?
The researchers have also considered looking beyond giving or receiving monetary rewards, since prosocial behavior includes a wide range of experiences.
“Right now we’re testing repeated conversation and social experiences, which also may get better rather than worse over time,” O’Brien explains.
Music: The Secret to Mental Health and Balance While Aging
No matter where you travel, you’ll notice one universal truth — music has a very particular and powerful hold on us all. Cultures everywhere make and love music. This has been the case throughout history. We have used music to relax, communicate and celebrate — the human brain is hard-wired to react to music. According to Kimberly Sena Moore, a neurologic music therapist, “Your brain lights up like a Christmas tree when you listen to music.”
The magic of music goes much further than entertainment — there a surprising number of health benefits for the elderly, and there is a lot of evidence to support the fact that music is a secret weapon when it comes to maintaining optimal mental health and balance in our old age.
Boost Memory by Learning to Play an Instrument
If you want to ensure your memory is strong well into your winter years, consider picking up an instrument. Regardless of what you prefer to play, the act of learning how to play will sharpen your memory recall. This is because the process of learning and playing an instrument requires a great number of complex tasks, such as reading musical notes and knowing where to place your fingers. In time, this expands your working memory capacity and your ability to multiprocess without feeling overloaded. You will also be able to remember information for longer periods.
Music Can Act as a Stress Reliever
Coping with stress can become more difficult as we get older. We have less resilience to it, and it can affect us differently, which is stressful in and of itself. On top of changes in response to stress, we can experience changes in triggers as the years go by, so it is important we all find a way to cope.
There have been many studies to show music has a notable (and positive) effect on our stress and blood pressure levels. In fact, this is the case even if we’re not conscious. One study involving surgery patients found the use of music before an operation reduced stress levels to an even greater degree than anti-anxiety medication. The act of singing sends small vibrations throughout the body, which lowers cortisol (the stress hormone) levels and releases endorphins, thereby helping to keep you calm and collected in trying times.
Music Can Reduce Falls in the Elderly
Remarkably, studies show when the elderly exercise while listening to music, it helps them maintain balance and reduce the risk of falling. Falling is a huge concern for those over the age of 65, and music might well be the answer. According to a 2011 Swiss study, where participants were trained to walk and perform certain movements in time to music, they experienced 54% fewer falls when compared to the control group. The study also found that walking speed and stride length increased as a result.
A Good Drum Beat Can Kickstart Brain Function
The brain instinctively syncs to a rhythm. Because of this, therapists use drumming to get through to patients with severe dementia who don’t normally respond to external stimulus. When dementia patients hear music, you can detect a noticeable shift. They show more of an interest in their surroundings, they clap to the beat or even sing. This is because music can stimulate many parts of the brain simultaneously. Music which was popular when the patient was between the ages of 18 and 25 generally gets the most positive response.
Music Can Soothe Physical and Emotional Pain
Swedish researchers have found your favourite music can be a great pain reliever, as it can distract us and boost positive emotions. Interestingly, by evoking nostalgia, music can help us get through the pain, both physical and emotional.
Music Can Combat Depression and Boost Happiness
A serotonin imbalance in the brain causes depression. When you listen to music, you experience a boost in serotonin, so music can be used as a tool to combat depression in the elderly. Doctors claim the simple act of singing can release oxytocin, providing a significant mood booster. So while music alone may never entirely relieve the symptoms brought about by depression, it can certainly do its bit to enhance wellbeing.
Music Provides Opportunities for Social Interaction
Music can provide an essential source for social contact, which promotes interaction and a sense of belonging. This is increasingly important as we age. By incorporating music therapy and joining a choir, the opportunities to socialise and collaborate let us make new friendships and create new bonds.
Music Can Improve Quality and Quantity of Sleep
Many seniors don’t get as much sleep as they need, which can cause serious medical issues in time. Lack of sleep has been shown to have a profound and negative impact on mental health and wellbeing. A 2009 meta-analysis found music can improve the quality and quantity of sleep. Of course, the benefits may not happen overnight. But if you persist, in as little as three weeks, you should notice a pay off from this relaxation technique. Some of these include falling asleep faster and remaining asleep for longer.
The Mind-Body Connection
One of the most important things I learned from my experience of depression was how closely linked my physical and mental well-being are. In the thick of it, I remember many days of trying to figure out why I felt so low. I talked through with my therapist all the various stressors which could have been affecting me that day. This included all my thoughts and feelings, and possible resolutions to my troubles. Only to figure out later on that I hadn’t had enough sleep the night before…and when I got enough sleep the next night, my mood was hugely improved.
It’s still true if I don’t sleep well, I’ll invariably feel a bit low the next day. Not to the extent that I’m depressed, but I definitely notice being more irritable and sensitive to things which wouldn’t normally bother me that much. Being sick is another example of when not feeling great physically affects my emotional resilience and makes everything else that much harder. On one occasion, when I was horribly sick and sleep deprived, I burst into tears because I dropped my toast, butter side down, on the kitchen floor!
And who hasn’t heard of the phenomenon of being “hangry” ie: getting so hungry you start getting angry. I’m sure this is a regular for me coming up to lunchtime at work.
The Mind-Body Connection
It seems so obvious now, the mind-body connection is important, but it took me such a long time to figure it out. For the longest time, I didn’t realise every little fluctuation in my level of happiness didn’t necessarily indicate anything major going wrong other than my body trying to say, “take care of me, please!” Of course, sometimes there are other things going on when you’re feeling down. But I guess I found it useful to realise that my physical health is connected to my emotional well-being, too.
Now that I’m working as a therapist, I’ve noticed this theme with clients as well. Whenever someone says to me they are having a bad day, the first thing I ask about is how they’ve slept, whether they’ve eaten, or if they are sick at the moment. Of course, the answer is not always this simple but I’ve been surprised at the number of people who will say, “Actually, I didn’t sleep at all last night…and now you mention it, no wonder I’m feeling a bit crappy today.”
Separating Mind and Body
These days we are very good at separating mind and body. Our mind – our thoughts, perspectives, moods, and emotions – almost seems like a completely different thing to our physical experience of the world.
These days, it’s essential to think about our physical and mental well-being as interconnected and it’s equally important to take care of both. I’m not one to preach about what this might mean for you. I’d be the last person to advocate that everyone should stick to any particular health regime – I’m firmly from the school of doing whatever works for you!
But I think what it boils down to is a little self-care (and for me personally, a healthy dose of balance) is good for both body and mind. I find noticing the effect of one on the other is helpful in understanding my experience of the world.
What are your thoughts on the mind-body connection?
The Power of Language and Labels
A while ago I posted a meme which said, “Better to have lost in love than to live with a psycho for the rest of your life.”
I liked it, of course, otherwise, I wouldn’t have posted it. Eleven others did too, some commenting on Facebook, “Amen to that,” and “Definitely!!”
Then this: “Hate it. It’s beat up on people with mental illness time again. Ever had the amazing person you love tell you that they just can’t deal with your mental illness anymore? Our society is totally phobic about people with mental illness having intimate relationships.”
Woah, that came a bit out of the blue. I hadn’t made the link between “person with a mental illness” and “psycho”, otherwise I wouldn’t have posted it. It didn’t say, “Better to have lost in love than to live with a person with a mental illness for the rest of your life.” I had linked “psycho” with the often weird, unspoken assumptions people make when in relationships, which have kept me out of long-term relationships all my life.
It made me think, though. Suppose it had read, “Better to have lost in love than to live with an idiot for the rest of your life.” Would that have been a slight against people experiencing unique learning function?
Probably a more accurate meme would have been, “Better to have lost in love than to live with an arsehole for the rest of your life.” But that’s not what the image said.
For the record, I have had someone I loved tell me he couldn’t cope with my unique physical function anymore. It was hard to hear, but ultimately he was the one who lost out. And I know intuitively many would-be lovers haven’t even gone there — again, their loss and my gain, because why would I want to be with anyone so closed-minded?
The power we let labels have over us can be overwhelming. If I had a dollar for every time a person called someone a “spaz” in my presence, I’d be wealthy. If I got offended because “spaz” is a shortened version of “spastic”, which is one of my diagnoses, and I got another dollar for that, well — I’d be angrily living in the Bahamas.
I think the evolution of language — and the generalization of words like, “gay,” “spaz,” “idiot” and “psycho” — creates the opportunity for them to lose their charge and liberate us from their stigma. By allowing them to continue having power over us, though, we re-traumatize ourselves every time we hear them. Words are symbols and they change meaning over time and in different contexts.
I celebrate that “gay” means “not for me” rather than “fag”; that “spaz” means “over-reacting”, not “crippled”; that “idiot” means “unthinking”, not “retarded”; and that “psycho” means “someone with weird, unspoken assumptions”, not “a crazy person”.
By letting words change meaning for us, we are redefining diversity and creating social change. It’s not a case of, “Sticks and stones will break my bones but words will never hurt me.” It’s recognizing that, unless someone is looking directly at us menacingly, calling us gay, spaz, idiot or psycho, we’re not in their minds — they’ve moved on.
Maybe it’s useful for us to move on with them?
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