Sadness of Depression

The Mighty is an online community for people facing serious health conditions—and it offers a lively platform for sufferers of mental illnesses to share their experiences. According to The Mighty’s Who We Are page: “We’re creating a safe platform for our community to tell their stories, connect with others and raise support for the causes they believe in. We are stronger when we face adversity together, and we know it.”

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Read a recent post, “What the Sadness of Depression Really Feels Like”:

Imagine you wake up in the morning and you feel as though, overnight, your heart has sunk into the pit of your stomach and stayed there, throbbing, until it becomes a dull but persistent ache that has spread to your entire body. Maybe it’s raining and you have a dentist appointment later that day, or maybe it’s a warm sunny day and you have plans to spend it in your favorite place with your best friends: it doesn’t matter. The entire world looks ominous through the lens of the depression. Whatever lurks beyond the door of the bedroom doesn’t feel safe. Sitting up and swinging your feet out of bed feels insurmountable, not because of the mind-numbing fatigue you feel but because it just hurts inside. Just pushing yourself up to turn off your alarm makes your insides clench with discomfort and fear.

Combatting Soldier Suicides

The suicide rate in the U.S. military is out of control. During some periods, more active soldiers have taken their own lives than been killed in combat. U.S. military suicides hit a record 349 in 2012, although they declined to 265 in 2015. It’s even worse when the soldiers become vets. A Department of Veteran’s Affairs report in 2012 showed that 22 veterans a day were killing themselves—almost one an hour.

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Memorial Day candle vigil march at Bagram Airfield, Afghanistan, May 26, 2014. Staff Sgt. Evelyn Chavez/Air Force/Department of Defense

New research published in JAMA Psychiatry, the journal of the American Medical Association, is providing further guidance for effective suicide prevention in the military. The study found that 60 percent of U.S. army suicides occurred among soldiers who had not yet been deployed to combat roles. In general the study highlighted the importance of transitional periods for suicide prevention efforts.

The JAMA researchers also found female soldiers were more likely to attempt suicide than their male counterparts. A 2015 Veterans Administration study showed that female military veterans commit suicide at nearly six times the rate of women in the general population—and 12 times the rate if the women are between the ages of 18 to 29.

The Christian Science Monitor and NBC News covered the JAMA study here and here.

The Monitor cited a 2015 report by the U.S. Office of Inspector General criticizing bureaucratic inefficiency in the Pentagon’s suicide prevention efforts:

The Defense Suicide Prevention Office lacked clear processes for planning, directing, guiding, and resourcing to effectively develop and integrate the Suicide Prevention Program within the DoD. We recommend the Defense Suicide Prevention Office provide an implementation strategy to adapt Department of Defense applicable evidence-based suicide prevention research findings into standard practices across the Department.

[If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741.]

“In the Deepest Depths”

Trenni Kusnierek, a reporter/anchor for Comcast Sportsnet New England, is using her public profile to raise awareness about mental illness and depression—sharing her own experiences.

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This is an excerpt from a Boston Globe profile:

It’s hard to articulate what it’s like in the deepest depths. But the best way I can explain it is you almost feel like you are separate from yourself. You don’t feel like you are physically inhabiting that space in the moment. That’s an awful feeling. No matter what anyone says to you in that moment, how much they love you, how great you are, that you have a great life…none of it, your brain cannot process it or register it. …I’d do anything to be a super-chill hippie. That would be my ideal life.

Check out “The Trenni Kusnierek You Don’t Know,” the piece in Milwaukee Magazine where she first spoke about her depression and how she realized it was important to talk about it publicly.

Alarm in Britain Over Student Depression

There has been a disturbing rise in mental ill-health among university students in Britain. Eighty percent of the 54 universities responding to a survey reported observing a “noticeable increase in complex mental health crises” among their student populations in 2015 compared to 2014.

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In the survey conducted by AMOSSHE, a student services organization, 90 percent of the schools reported working on critical/serious incidents with the police and/or coroner during 2015; two thirds noted that they had worked on three or more such incidents in 2015. Nearly half of the schools reported one or more student death in 2015 involving suicide or suspected suicide.

At one institution—the University of York—24 percent of students seeking support from the Open Door counseling center presented with depression. Eighteen percent of Open Door users reported having suicidal or self-harm thoughts nearly every other day. In the period from January 1 to February 8 this year, ambulances were called to respond to 12 cases of self-harm or suicide attempts involving York’s students.

In response, Vice Chancellor Koen Lamberts commissioned a task force to consider actions that the university could take to better support students with mental health problems. The task force submitted its report in March—which cites the AMOSSHE survey results—and in early May York’s University Executive Board agreed to implement its recommendations.

Read the full York report and recommendations here.

The main findings: the severity of mental ill-health among students at UK universities has been increasing and continues to rise; and there are serious gaps in mental health provision, with delayed and inappropriate support for students in need of care. In a 2013 National Union of Students survey cited in the report, nearly eight in ten respondents indicated that they had experienced mental health difficulties over the previous year.

The recommendations: take immediate steps to improve University support for student mental health; and ensure a high-level and coordinated approach to improve mental health services for students. Among the eight required actions to implement the recommendations: ensuring support for “first contact” staff providing crisis support for students; improving the capacity of academic departments to identify and support students whose health and personal circumstances give cause for concern; strengthening university governance structures for student welfare; developing and implementing a new Student Mental Health Policy.

Here’s the report’s Executive Summary:

1. The prevalence and severity of mental ill-health among students at UK universities has been increasing and continues to rise. Evidence comes from national data on students reporting a mental health condition at the time of admission, student wellbeing surveys, suicide data and sector-wide evidence from student support services.

2. The prevalence and severity of mental ill-health among students at the University of York has been increasing and continues to rise. Evidence comes from a range of sources, including Open Door, Health Centre and ambulance call-out data. We were also provided with soft information pointing to a heightened sense of pessimism in the wider student community.

3. NHS mental health services are regularly failing to meet the needs of vulnerable people including students. While the government has made improving mental health services a priority, mental health services are struggling from the combined impact of rising demand and chronic underinvestment. Evidence comes from a variety of sources, including NHS England. Within the higher education sector, evidence from the leaders of student services points to serious gaps in mental health provision, with delayed and inappropriate NHS support for students in need of care.

4. These shortfalls in NHS mental health provision are evident at the University of York. They have been exacerbated by additional pressures in York and N Yorkshire, including the sudden closure of Bootham Park hospital in autumn 2015 along with other mental health provision. While the data are incomplete, they suggest those living in York, including York students, face particular difficulties in accessing early interventions (e.g. psychological therapies), crisis intervention and both inpatient and outpatient care.

5. The higher education sector recognises that student wellbeing is the foundation of learning and future success. A university experience that is enriching and fulfilling depends on positive mental health and access to support during periods of mental ill-health. A range of frameworks, good practice guides and online resources are now available to enable universities to improve their policies and practices.

6. Our recommendations are framed by the twin pressures we have identified: increasing, and increasingly complex, mental health difficulties among students at a time of increasing gaps in NHS provision. They are framed, too, by an appreciation that the University needs to give much greater priority to the mental health and wellbeing of students.

7. We make two overarching recommendations: to (i) take immediate steps to improve University support for student mental health and (ii) ensure a high-level and coordinated approach to improve mental health services for students in York and N Yorkshire.

8. Our Action Plan is designed to deliver these objectives within the next 12 months. It includes 8 areas of internal action to improve University policies and provision and 3 areas of external action to drive forward improvements in local mental health services for students.

The York report received wide attention in the British media: BBC News, Independent, Times Higher Education, York Vision.

“While Rome Burns”

A leading psychiatrist says the 24 percent increase in the U.S. suicide rate is “shocking” and “chilling,” and is blasting the government for failing to respond to America’s mental healthcare crisis as a national emergency.

Jeffrey Lieberman sounds his alarm in a commentary published on May 13 by Medscape called “While Rome Burns: Addressing Rising Suicide Rates.” He is chairman of the Department of Psychiatry at Columbia University, and director of the Department of Psychiatry at the New York State Psychiatric Institute. His commentary was prompted by a new report by the National Center for Health Statistics showing spikes in suicide rates between 1999 and 2014.

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Read the full text and watch a video of his remarks here.

Extracts of Lieberman’s commentary:

The death rate by suicide and by other forms of passive self-destructive behavior are all related to mental disorders. We know that 90 percent of individuals who take their life by suicide have pre-existing mental disorders and that major causes or antecedents are mood disorders, psychosis, posttraumatic stress disorder, or substance abuse. This is a problem that has long been known and has suffered from inadequate attention, stigma, and underfunding (both in terms of clinical care services as well as biomedical research). And this problem continues to worsen, as reflected by the shocking statistics, with continued inactivity on the part of government policies, legislation, and funding priorities.

… [I]f you look at the response in terms of any type of action being taken from a policy or healthcare initiative standpoint, nothing is being done. To put this into context economically, these are major public health problems, the most egregious manifestations of which are these recent statistics on suicide and declining longevity in that age group due to self-harming behaviors related to mental disorders. Yet, the amount of money that is being spent on studying them has not changed, and it is an inadequate amount in terms of the overall federal budget.

It’s hard to understand why these rates, which are really the tips of the iceberg of an overall chronically failed mental healthcare policy in this country, have not risen to the level of a national emergency, like Zika virus, Ebola, or AIDS years before.

I can only think that the reason is that there is a stigma attached to mental illness. It relates to drug abuse and the conflation of things that are not medical conditions and may relate to failings in moral character or behaviors that are sinful. I’m speculating egregiously, but I just can’t understand the basis for viewing these statistics with dismay, shock, and concern and then having inaction. We’ve seen this with other cases before. We’ve seen it with civilian massacres and mass violent incidents, which usually result in cries of rage and indignation and a rush to do something to not let this happen again, and then devolve into partisan political arguments and parochial concerns, finally leading to nothing being done.

I urge you to not just read up on these latest developments but to express your concern in a way that might be influential, either through the media, to your governmental representatives, or in any way that you can, so that services and funding priorities are brought in line with these public health concerns.