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Marvelously Ordinary

Amy and I had a chance to visit yesterday after a full time the past three weeks for both of us with work, travel and family.  What was especially nice was the fact that we didn’t have to talk about depression.  Both of our husbands are in good places now and the darkness of the past months has dissipated.  So we talked of knitting and festivals, of Rome sights and gall bladder clubs, of children and mutual friends, of huckleberry bushes and what we were having for dinner.  It was very normal, very mundane, and very appreciated.  We wish the same for all of you out there dealing with a depressed loved one. 

 -Bernadette

It’s just not that simple.

On the subject of thoughtless things people say…

I often see supposedly inspirational blog posts, bumper stickers, posters, etc that exhort us to simply choose to be happy. I suppose there may be people out there for whom a happy outlook on life vs. a sad outlook on life is, in some way, an issue of “mind over matter.”

But that hasn’t been my experience. Nor has it been the norm for many, many people I know who struggle with one form or another of depression and other brain illnesses.

April of “Finding Beauty in Spite of Myself” discusses this topic beautifully in her post today, Happiness is a Choice?  Thanks, April, for sharing your perspective and for striking a blow against the ignorance the general public holds regarding issues of mental health.

-Amy

The Crazy Priority of Mental Health

Back in 1963 the Community Mental Health Act was passed. The bill was one of the boldest attempts to deal with mental health.  It moved people out of inpatient psychiatric hospitals and put them back in the community where mental health centers and other programs were to make help for the mentally ill affordable and readily available to all.

Let’s see how we’ve done in the past 50 years in putting the action into this act.

  • Up to 30 percent of homeless people are thought to be seriously mentally ill.  That’s five times the rate in the general population.
  • Approximately 10 percent of US homicides are committed by untreated severely mentally ill people.
  • Chances that a perpetrator of a mass shooting displayed signs of mental illness prior to the crime: 1 in 2
  • Between 1998 and 2006, the number of mentally ill people incarcerated in federal, state, and local prisons and jails more than quadrupled to 1,264,300.
  • The percentage of inmates with mental health problems in 2004 were 44.8% in federal prisons, 56.2% in state prisons and 64.2% in local jails.  Since 2006, mental-illness rates in some county jails have increased by another 50 percent.
  • For every $2,000 to $3,000 per year spent on treating the mentally ill, $50,000 is saved on incarceration costs.
  • Prisoners with mental illness cost the nation an average of nearly $9 billion a year.
  • In 1955, there was one psychiatric bed for every 300 Americans. In 2010, there was one psychiatric bed for every 7,100 Americans—the same ratio as in 1850.(You heard me right – 1850.)
  • Severe mental disorders cost the nation $193.2 billion annually in lost earnings

The Associated Press wrote the following in regard to the Community Mental Health Act of 1963:

Kennedy said when he signed the bill that the legislation to build 1,500 centers would mean the population of those living in state mental hospitals — at that time more than 500,000 people — could be cut in half. In a special message to Congress earlier that year, he said the idea was to successfully and quickly treat patients in their own communities and then return them to “a useful place in society.”

But only half of the proposed centers were ever built, and those were never fully funded. [emphasis added]

Meanwhile, about 90 percent of beds have been cut at state hospitals, according to Paul Appelbaum, a Columbia University psychiatry professor and expert in how the law affects the practice of medicine. In many cases, several mental health experts said, that has left nowhere for the sickest people to turn, so they end up homeless, abusing substances or in prison. The three largest mental health providers in the nation today are jails: Cook County in Illinois, Los Angeles County and Rikers Island in New York.

The Community Health Act of 1963 was not able to accomplish much because we as a nation have some pretty crazy priorities and those priorities seldom include the mentally ill.  We should be ashamed of ourselves.

– Bernadette

Sources include National Coalition for the Homeless, NMH Hunger and Homelessness Survey7; the US conference of Mayors “Inmate Mental Health”; and the National Institute of Mental Health.

Be careful what you say.

Earlier this week I was at a conference for church educators, in the company of about 100 very kind, caring people. I had the opportunity to attend five different workshops, led by different presenters, and to have lunch with people I’ve never met before but with whom I may be working in the future. I’m quite certain that none of the people there would knowingly do or say anything hurtful.

And yet there were three separate comments, made by three different people over the two days, that made me cringe:

“My husband is a rabid Tarheels fan. I mean, seriously – he needs therapy.” Ouch.

A narrative read by one presenter included the words, “It was a rough bus trip. Before I got where I was going I was desperate for an antidepressant.” Ouch.

Another presenter, jokingly describing a co-worker: “He’s a little OCD, so we had to do everything just perfectly.” Ouch.

These types of off-hand comments, meant to be funny, are out there everywhere. They’re so pervasive in our culture that even people whose life work includes caring for and ministering to others drop them in conversation regularly.

I’m aware that I’m probably over-sensitve due to over-exposure to issues relating to mental health.

But wouldn’t it be a wonderful world if everyone, everywhere could just guard their tongues?

-Amy

Young, gay, and depressed

Struggling with sexual identity is a difficult challenge. Although our society has become more accepting of gays and lesbians, it still has a long way to go. When it comes to depression, being a member of the LGBT community is not a ticket to ease in dealing with it.

Depression accounts for between 20 and 35 percent of all suicide deaths each year and number more than death from motor vehicle accidents. But statistics are even worse for the lesbian, gay, bisexual and transgender people.

For example, we know that adolescence is a difficult time but for those in the LGBT community, it can be especially challenging. Attitudes toward differentness, cultural stigmas, and increasing bullying, teasing and physical violence lead to more LGBT youth finding the teenage years most difficult and creating a rise in depression.

A 2009 survey of more than 7,000 LGBT middle school and high school students between the ages of 13 and 21 found that, because of their sexuality, in the previous year 8 in 10 had been verbally harassed at school, 4 in 10 had been physically harassed and 1 in 5 had been physically assaulted. Six in ten felt unsafe in school. And depression lurks around the corner.

Often there is also the component of how parents respond to their teen. If a negative reaction takes place on learning their teen is gay, often the response is throwing the child out of the house or the child running away. Because of this, it is important for parents to foster healthy, positive and supportive environments for their child. They need to talk openly about any difficulties the child might be having, always watchful of signs of bullying and taking immediate action should any hint of something occur.

LGBT youth themselves can seek help through an online resource e- The It Gets Better Project – which has become a worldwide movement in which a cross section of individuals share their stories of overcoming bullying and harassment and depression, letting kids know that things do get better.

Being gay and depressed is difficult. However with understanding parents, good teachers, supportive friends and excellent resources, it can be a time of great growth.

-Bernadette

Mentally ill people are not the problem.

I’m in Rome and enjoying the sites, learning about depression in a place where people think there is none and this morning I came across this. I don’t know where it comes from so apologies for not giving appropriate credit. I do, however, think what it says is important for people to hear again and again.

Mentally ill people are not the problem.
Inaccessible, unaffordable health care is the problem.
Stigma is the problem.
Lack of treatment is the problem.
Lack of understanding is the problem.
Not taking people seriously is the problem.
Lack of honest conversation and open dialogue is the problem.
Using jails as a housing facility for mentally ill persons is a problem.

Do you understand me?
Mentally ill people are NOT the problem.

Amen to whoever wrote this.

– Bernadette

Just Don’t Think About It

“Just don’t think about it.”

If you kept track of how many times a depressed person or a caregiver of a depressed person heard this, you would be dealing in the millions. People who have not had to deal with depression in their lives often think that if depression is pushed out of the mind, a cure occurs. Ah, if life could be so easy!

Depression is not something you can turn on and off easily. You can’t just think happy thoughts and have it disappear. Depression imbues your being and even when you are feeling somewhat good, it is still in the background. When someone says “Just don’t think about it,” it only reinforces the fact that depression is there, waiting, waiting, waiting.

Remember the old story about someone who comes up to a friend and says, “I will give you five hundred dollars if you don’t think about purple elephants for ten minutes.” Of course, it is impossible and the friend loses the five hundred dollars.

So it is for the depressed person and for the caregiver. Asking them to not think about this monster that has invaded their lives, is asking them not to be on guard for what that monster can do. They have to make sure medicine is taken, doctor appointments kept, exercises done, crises averted, tears wiped. They laugh and enjoy each other too when times are good, but even then, in the distant background is the fact that depression could once again rear its ugly head.

So the next time you find those words on the tip of your tongue, pause, and remember that it is indeed easier to say that than to do it.

-Bernadette

We’re both recovering.

After nearly 18 months of a downhill slide, my husband’s depression is lifting, in a big way. This recovery has everything to do with a new career path he’s chosen, for which he’ll begin training in just under a week.

I’m noticing the changes daily. Singing around the house. Tackling tasks he hates with good humor. Enthusiastically digging into a project he’s put off for months. Handling business details, career change details, and financial details with energy and efficiency. Honestly, it’s like he’s someone I haven’t seen for years.

It’s good timing. Between the wrench of moving our oldest and youngest away for school and the rapidly descending SAD season, I don’t have a lot of emotional reserves. I’m finding that the relief due to his major change in mood has allowed me some much-needed emotional down time. For at least a while I’ve been able to stop being the tough one, the together one, the responsible one.

In the past I’ve had a hard time trusting this type of turnaround. A giant dip in the depression roller coaster is so often just around the corner. But I’m taking it differently this time. I don’t know if it’s because of how thoroughly he’s improved, or if it’s a sign of how completely exhausted I was.

Either way, I’m enjoying the change.

-Amy

Depression in the Workplace

Depression is in the workplace whether we choose to recognize that fact or not. It is expressed in negativity, in skipped days of work, in behavior that seems totally out of character and out of place.

According to the Work Place Health Promotion of the Centers for Disease Control and Prevention, in a three month period patients with depression miss an average of 4.8 workdays and suffer 11.5 days of reduced productivity. That is over 200 million lost workdays each year at a cost to employers of $17 to $44 billion. That is not a problem to be ignored.

But what, practically speaking, can employers and co-workers do to help?

Companies can offer education, support groups and other classes for people with depression or the employees who live and work with a depressed person. Amy and I were invited by Hallmark, a Kansas City corporation, to do a program for interested workers, on living with someone with depression. It was done during the lunch hour and incentives were offered for participation. From that program, requests were made for a support group which meets once a month, again during the lunch hour, and offers continuing support. It’s not difficult to offer support to your employees. An employer just has to make the decision that the education will make a difference not only in individual lives but in the company’s well being.

Next, managers and employees should be trained to recognize the signs and symptoms of depression such as tardiness, complaints of fatigue, reduction in work output or quality, safety problems or accidents, and changes in attitude. Such monitoring may lead to early identification and then referral to treatment and screening services.

Fostering good communication and a safe atmosphere to vent is an often overlooked but much needed in the work environment. Too often we fall into complacency, thinking that we are communicating but in reality we are instead approaching situations from our own agenda, not really listening, carrying pre-formed opinions. Good communication allows us to really see and hear what each person is saying and, if needed, feel their pain.

Depression in the workplace doesn’t have to be a bad thing. It can be an opportunity for co-workers to be of support in the work community and to be a kinder, more understanding person in the rest of his or her world.

-Bernadette

A Lecture from Mom

Saying you are capable of recovering is not the same as saying it’s your fault. You are depressed and you are not choosing to stay that way, not choosing to have your life lived under this dark cloud.

Maybe it would help to think of your disorder as a natural disaster. Sometimes there is a definite cause for a disaster but just as often there isn’t. The disasters just happen and cause damage and ruin lives.

It is not a country’s fault if it’s struck by a natural disaster. That would be an awful thing to say or think. But it is still that country’s job to clean up the mess. The country and its allies band together to repair what was damaged and to replace what was lost.

It’s the same way that you and your support network fight back against your disorder and if you don’t have the emotional and material resources to start that clean up yet, that’s not your fault. But you have to believe that it can be done. You can feel better than you do. You can take the steps you need to take. You can make the choice to exercise. You can make the choice to eat well. You can make the choice to seek therapy. You can make the choice to take your medication religious. It is one choice and that one choice leads to another. You might not be ready for that step now, but remember that you are capable of making a choice to start on the road to recovery even if you are not ready for it yet.

Never blame yourself for your illness. Just believe you can take that first baby step. One day you will.

-Bernadette