Maria Fabrizio for NPR
by Sasa Woodruff
“Ryan ‘China’ McCarney has played sports his entire life, but sometimes he has to force himself to show up on the field to play pick-up soccer with his friends.
“‘I’m dreading and I’m anticipating the worst. But I do it anyway. And then, it’s a euphoric sensation when you’re done with it because you end up having a great time,’ says McCarney.
“McCarney was just 22 when he had his first panic attack. As a college and professional baseball player, he says getting help was stigmatized. It took him six years to get professional support. He still struggles with depression and social anxiety, but says exercising helps him — especially when it’s with his teammates.”
by Jane Eleey, for The Inquirer
“Loneliness may have the same impact on mortality as smoking 15 cigarettes a day, making it even more dangerous to health than obesity. Recent nationwide studies highlight the close relationship between social isolation and loneliness and serious health problems — memory loss, depression, self-neglect, changes in blood pressure, medication errors, decline in functional status, poor management of everyday living tasks — as well as greater mortality.
“Social ties provide support during illness, encourage people to maintain better health habits, and have positive effects on the immune system. Isolation from others contributes heavily to illness burden and premature death in at-risk populations.”
“I grew up thinking of my grandfather as a drunk. His spiral into self-destruction left a legacy of bitterness and addiction that will haunt our family for generations to come. But only recently have I begun to realize how much of that legacy is rooted in the war.” – Adam Linehan
Photo illustration by Jesse Draxler
by Adam Linehan
“My friend Paul Critchlow fought in Vietnam, earning a Purple Heart and a Bronze Star with valor. Then he returned home to Omaha, Neb., and nobody wanted to talk about it. So he did what many combat vets did after the war: He kept his head down and drove on, built a career, raised a family, avoided anything that reminded him of Vietnam, compartmentalized the trauma, drank heavily and abused drugs. He did as his old coach once advised after he broke his leg playing college football: “You’ve got to play above the pain, Critchlow.” It was a productive approach.
“He eventually landed on Wall Street and rose to become head of communications for Merrill Lynch. But then one morning in 1994, he woke up and couldn’t get out of bed. As hard as he tried, he couldn’t find the will to move. The doctors told him he had clinical depression. In Critchlow’s mind, however, it was much more specific than that: a hill in the Central Highlands of Vietnam that the Army numbered 102. Many of his close comrades died there during the battle in which he was wounded. He blamed himself.
“There were fewer than 200 American soldiers on Hill 102 when it came under siege by the entire Second North Vietnamese Army Division on the afternoon of Aug. 19, 1969. Critchlow was a 23-year-old forward observer for Charlie Company, responsible for calling in airstrikes and artillery barrages. As the Vietnamese troops advanced farther up the hill, the grunts dug in along the perimeter shouted over the radio to Critchlow for more and more bombs. The battle raged through the evening, and once it got dark, Critchlow lay on his back in a roofless French plantation house and used a strobe light to guide an AC-47 Spooky gunship to its targets. Just before midnight, a lone figure appeared in Critchlow’s periphery. He was armed with a rocket-propelled-grenade launcher, and Critchlow knew he was an NVA soldier by the shape of his helmet. The explosion lifted Critchlow off the ground, and suddenly he was immersed in brilliant white light, spinning slowly through the air, certain he was dead. Five hours later, he was tossed onto a helicopter packed with bodies, and bullets pierced the fuselage as the bird lifted off the ground. Critchlow begged God not to let him die after all he had just survived. He prayed to go home. But as soon as he got there, he wanted to turn back around. He felt as if he had abandoned his men. ‘By putting myself in harm’s way, I left them behind,’ he recalled thinking after waking up in a hospital in Danang.”
This New York Times Magazine long read (below) is so important to gain insight into what warriors grapple with after returning from hostile actions in other nations.
I was convinced the deaths of my friends in combat were my fault. It took me years to realize this feeling had a name: survivor guilt.
Capital Area Behavioral Health Collaborative (CABHC) is reintroducing a Peer Support scholarship initiative. CABHC will cover the cost to enroll in the Peer Support training class and have secured slots at each training session in Lebanon, PA. Qualified individuals who are interested in applying to receive a scholarship to attend the 10-day Peer Support training class in Lebanon, PA, should visit www.cabhc.org. Please see attached flyer for more information. Thank you.
There are many medications that can be used to treat mood disorders. But finding the right one can be a lengthy process, and the choice can be more complicated than you might imagine. Just because a particular drug worked for a friend doesn’t mean it will work for you. Psychiatrists and doctors who prescribe antidepressants choose a particular drug and dosage based on many factors, including the following:
- Diagnosis. Certain drugs are a better choice for specific symptoms and types of depression. For example, an antidepressant that makes you sleepy may be better when insomnia is an issue. The severity of your illness or the presence of anxiety, obsessions, or compulsions may also dictate the choice of one drug over another.
- Side effects. You may first want to choose a drug based on which side effect you most want to avoid. Medications vary in the likelihood they will cause such problems as sexual effects, weight gain, or sedation.
- Age. As you age, your body tends to break down drugs more slowly. Thus, older people may need a lower dose. For children, only a few medications have been studied carefully.
- Health. If you have certain health problems, it’s best to avoid certain drugs. For example, your doctor will want to consider factors such as heart disease or neurological illnesses when recommending a drug. For this reason, it’s important to discuss medical problems with a primary care doctor or psychiatrist before starting an antidepressant.
- Medications, supplements, and diet. When combined with certain drugs or substances, antidepressants may not work as well, or they may have worrisome or dangerous side effects. For example, combining an SSRI or another antidepressant with the herbal remedy St. John’s wort can boost serotonin to dangerous and, in rare cases, fatal levels. Mixing St. John’s wort with other drugs—including certain drugs to control HIV infection, cancer medications, and birth control pills—might lower their effectiveness. Women receiving tamoxifen for breast cancer should take an antidepressant that does not interfere with tamoxifen’s effectiveness. Eating certain foods, such as aged cheeses and cured meats, while taking an MAOI can cause a dangerous rise in blood pressure.
- Alcohol or drugs. Alcohol and other substances can cause depression and make antidepressants less effective. Doctors often treat alcohol or drug addiction first if they believe either is causing the depression. In many instances, simultaneous treatment for addiction and depression is warranted.
- Personal and family mental health and medication history. If you or a member of your family has had a good response to a medication in the past, that information may guide your choice. Depending on the nature and course of your depression (for example, if your depression is long-lasting or difficult to treat), you may need a higher dose or a combination of drugs. This may also be true if an antidepressant has stopped working for you, which may occur after you’ve used it for some time or after you’ve stopped and restarted treatment with it.
- Cost. Since all antidepressants are roughly equivalent in their effectiveness, you won’t lose anything by trying a generic version first.
- Your preference. Once you have learned as much as you can about the treatment options, your doctor will want to know what approach makes most sense given your lifestyle, your interests, and your judgment.
For more on diagnosing and finding the right treatment on the different types of depression, read Understanding Depression, a Special Health Report from Harvard Medical School.
SOURCE: Harvard Medical School
“The formula for what makes a community livable isn’t particularly complex. For the most part, the features and needs are fairly simple.
“But living in a place that, say, requires having a car for every errand or outing can be a difficult place to live if you don’t have a car or can’t drive.
“Living in a place without access to outdoor spaces, good schools and healthy food isn’t very livable, especially for young families.
“Living in a community that isn’t safe, or offers few activities, can be isolating for people regardless of age.
“On the other hand, a community that includes all of the features pictured in our “In a Livable Community” handout can be great — for people of all ages!”
AND people with a disability!
Aging in Place Technology Watch and GreatCall have published a new white paper about initiatives to fight social isolation — a few of the points are excerpted here:
What has changed in the past two years? First, the research. Once the correlation between social isolation and poorer health outcomes was made, the volume of research spiked. From its pre-correlation measurement in the 1996 UCLA Loneliness Scale, a number of other surveys have been released that include correlation with health care costs, economic status, and lifestyle preferences. In late 2017, research from AARP’s Public Policy Institute concluded that socially isolated older adults cost the U.S. health system an additional $6.7 billion in health-related spending. Newer research from the National Institute on Aging is focusing on the connections between loneliness, long viewed as a predictor of cognitive decline, and other health risks, including: high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.
Social isolation – is this a worsening 21st century phenomenon? Is social isolation more of a problem today than in the past. And, what is the prognosis for the future? The recent AARP report zeroed in on the key predictors of loneliness, sometimes referred to as “perceived social isolation.” Living situations and marital status may provide a clue to societal changes that result in social isolation and loneliness. In 2018, the Administration for Community Living (ACL) released its survey profile of older Americans (age 65+). It showed that while only 14 percent of the 65+ population lives alone, almost half (45 percent) of women aged 75+ live by themselves. According to Pew Research, among those 65 and older, the divorce rate has tripled since 1990.
A top predictor of loneliness is size and quality of one’s social network. To assess these elements and their connection to loneliness, the AARP respondents were asked for both the number of people in their lives who have been supportive in the past year and the number with whom they can discuss matters of personal importance. From the study: “As expected, as one’s social network increases, loneliness decreases. Also as expected, as physical isolation decreases (the factor which included items such as disability status, number of hours spent alone and household size), so does loneliness.”
Health limitations can exacerbate social isolation. While loneliness and social isolation are emerging as public health issues, less has been published about the health issues that may lead to social isolation: mobility limitations, depression, cognitive impairment and hearing loss. In another study, older adults with mobility impairments were more likely to report being isolated from friends. These surveys underscore the fact that elderly people are the most likely to experience social isolation and its related health effects. According to a UK study, those who provide care — including family caregivers such as children or spouses — are also known to experience loneliness in their roles and would benefit from greater societal appreciation and possible interventions such as respite care.
Untreated hearing loss contributes to social isolation. According to government statistics, among adults aged 70 and older with hearing loss who could benefit from hearing aids, fewer than 30% have ever used them. Denial and unreimbursed cost ($2400/ear) are factors, and delay in acquiring them can worsen the isolation. Hearing aids today also offer features that include fall detection, smartphone integration, and AI capabilities. Moving forward, Medicare Advantage plans are beginning to contribute to a portion of the cost. Audiologists play a role in managing user expectations and training an individual to adjust to the change from little or no sound to the noisy environment of stores, restaurants, office buildings and streets.
“Connection Is a Core Human Need, But We Are Terrible at It | No person is an island, and we need healthy relationships to thrive” – Medium
Illustration: Hélène Desplechin/Getty Images
by Brianna Weist
“In his book Lost Connections, Johann Hari talks about his decades of work in the fields of trauma and mental health and why he believes that the root of almost everything we suffer through is a severed connection we never figured out how to repair.
“At one point, Hari talks about an obesity clinic where patients who were overweight to the point of medical crisis were put on a supervised liquid diet in an effort to try to save their lives. The treatment worked, and many of the patients walked out of the clinic hundreds of pounds lighter and with a new lease on life—at first. What happened later was a side effect no doctor predicted. Some of the patients gained back all the weight and then some. Others endured psychotic breaks and one died by suicide.
“After looking into why many of these patients had such adverse emotional reactions, the doctors discovered something important:” Continue reading this article at Medium; click here.
by Robert Weisman
“WOBURN — Scanning recent police reports from the Massachusetts communities under her jurisdiction, Middlesex District Attorney Marian Ryan was alarmed to spot what she called a ‘tragic spike’ in suicides.
“Fifty-two county residents had taken their lives in the first half of this year, a toll up almost two-thirds from last year. She knew that plenty of young people battle anxiety but was surprised to learn the residents’ average age was 46. A quarter were over 60.
“‘The numbers are dramatically higher than we’ve seen in the past,’ Ryan said. Although it’s impossible to pinpoint one cause, ‘loneliness is definitely a factor,’ she said. ‘“Many older people are feeling disconnected from other folks in their communities.’”