Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

Medals and Mental Illness: Olympic Athlete Sparks A Dialogue

Today's guest post comes from Julie Maier. Julie has a master’s degree in social work and is currently a PhD student in the Kinesiology Department at the University of Maryland (Physical Cultural Studies focus).  Her research interests focus on the intersection of mental health, gender, sexuality, and the body. If you'd like to get in touch, she can be reached at jmaier@umd.edu

Olympic season brings with it a plethora of news stories focused on some of the best athletes in the world.  In addition to factual accounts of Olympians’ performances, human-interest stories and sensationalized gossip pervade the print and online media.  Indeed, one would have to bury his or her head in the snow to avoid hearing about athletes during this time of year.  While many Olympic-centered articles are seemingly trivial, some stand out as having the potential to create a more socially just world.  For example, an Olympian came out describing his struggles with something that remains relegated to doctors’ offices or psychology classrooms: mental illness.  Though athletes’ discussion of mental health can be seen as a way to de-stigmatize this issue, the overall impact is dependent upon informed reporting that does not perpetuate misconceptions about various forms of distress.

  Upon winning the gold medal in the 1,000 meter men’s speed skating event in Sochi, the news reports that followed not only detailed the Dutch athlete Stefan Groothuis’ Olympic win, but his disclosure of his battle with depression.  According to Reuters, Groothuis had struggled with depression for years, which hindered not only his training, but his overall ability to enjoy life.  Casert, in an article by the Associated Press, noted that Groothius’ depression brought him to the point of contemplating suicide.  By opening up about mental illness, Groothius joins a handful of professional athletes who, through the years, have come out as living with particular forms of distress such as depression, borderline personality disorder, bipolar disorder, and obsessive compulsive disorder.

The significance of such attention to mental health issues cannot be overstated.  Though progress undoubtedly is being made to reduce the stigmatization of those who live with mental illness, there is still a long way to go.  For instance, in a 2014 article published in Psychiatry Services, Dr. Jennifer Stuber and colleagues found that negative attitudes towards people with mental illness were prevalent amongst the lay public, as well as some mental health providers.  Participants indicated being particularly afraid of individuals with schizophrenia due to the misperception that such people are inherently dangerous.  Additionally, over two-thirds of the general public and almost one half of mental health practitioners in the study reported not wanting somebody with schizophrenia to marry into their family.  Such stereotypes contribute to an environment in which those suffering from mental health conditions are subject to discrimination, marginalization, and various forms of abuse.  Greater openness about mental health may help to educate the general public about a topic that frequently arises only in light of sensationalized tragedies such as mass shootings, and then quickly disappears, sending the message that those with mental illness are a threat to public safety, and mental health is only appropriate to discuss when lives have been taken.

The fact that professional athletes are stepping out and talking about their experiences with distress is of particular importance.  In the realm of sport, a traditionally (and still!) masculine domain, mental illness is too often equated with weakness.  In fact, historian Dr. Roberta Park (2012) noted that sport was used as a way to toughen up men returning from war who were suffering from what we might now consider a form of post-traumatic stress disorder (PTSD). The idea that mental illness is a form of weakness or an excuse can be seen in many of the responses to NBA player Royce White’s coming out as having obsessive compulsive disorder and generalized anxiety disorder (GAD) in 2012, which included death threats.  Such negative reactions, however, only reaffirm the importance of celebrated athletes speaking up about mental health.

Although self-disclosure is of course not enough in and of itself to drastically change the lives of those living with depression, schizophrenia, or the like, it can have a positive impact on the discourse surrounding mental health.  This is dependent upon the way journalists and others craft and frame the athletes’, and other public figures’, stories.  For example, one headline pertaining to Groothius announced that “Groothuis gold ends years of misery, depression,” while another boasted that “Stefan Groothuis overcomes depression and wins Olympic gold.”  Such framing may perpetuate the misconception that most mental illnesses can be overcome, never to return, as opposed to an ongoing condition whose severity may ebb and flow throughout one’s life--something that can be managed, though never fully cured.  This is not to discount Groothuis’ experience; perhaps he has indeed ‘overcome’ depression. However, for many suffering from depression—particularly, major depressive disorder—they may never be fortunate enough to be totally free from depression (see psychiatrist Peter Kramer’s widely cited book, Against Depression, for more on this).  With that said, the aforementioned headlines may make people with depression who have struggled for years to recover feel further marginalized, while perhaps sending the message that mental illness is temporary.

Additional conversation surrounding mental health is desperately needed, and stories such as Groothius’ help to chip away at the deep-seated misunderstanding and stereotyping pertaining to mental illness.  Hopefully one day athletes coming out with their stories of depression will be a non-issue, but until then, such disclosures are vital for the health of all.

"Call Me Crazy": Lifetime's New Movie That Champions Hope and Resilience Around Mental Illness

*Warning: it was difficult to write this post without including a few small spoilers, but I hope you'll watch the whole film anyway.

On Saturday April 20th, Lifetime debuted "Call Me Crazy: A Five Film".  The film (which boasts a star-studded cast and director list) includes five short stories that examine the impact of mental illness from various perspectives.  Each story is named after the main character: "Lucy", "Grace", "Allison", "Eddie", and "Maggie".

In the first story, we are introduced to Lucy (played by Brittany Snow).  Lucy, a law student, has recently been admitted to a psychiatric institution after experiencing a schizophrenic episode.  She is struggling to see how she can live a "normal" life that includes relationships and a career.  Her clinician encourages her to finish law school because she has insight into something very few people understand (mental illness)- so who knows how many people she could help?

In "Grace", we meet a daughter who has been living with a bipolar mother for her entire life.  Grace is played beautifully by Sarah Hyland from "Modern Family"- I loved seeing her in a dramatic role.  We see the "highs" and "lows" of her mother's condition.  We also see the devastating impact that it has on Grace's life when it is not treated.  Grace often plays the role of caretaker- making sure her mother is safe.  We see her struggle to have her own life aside from her mother's illness.

"Allison" offers the viewers a twist.  She plays Lucy's younger sister.  So we step back from Lucy's view and we see how mental illness has affected her entire family.  Allison's childhood, her sense of safety, her relationship with her parents- were all changed as a result of her sister's illness.  She has bottled up a lot of anger and finds it difficult to support her sister through her recovery.

"Eddie" introduces the only male main character.  He is suffering from severe depression.  He has withdrawn from his wife and his friends.  He has stopped receiving help from his therapist.  We watch his wife intervene after discovering that he may be thinking about suicide.

Finally, "Maggie" introduces topics that (unfortunately) are all too common these days- post traumatic stress disorder (PTSD) and military sexual trauma among our returning veterans.  Maggie (played by Jennifer Hudson) was victimized during her time in the Army and its lasting impacts are threatening her ability to have a healthy relationship with her family.  Here we get another update on Lucy- she is now a lawyer and is representing Maggie in court.

While each story stands on its own, Lucy's story is woven throughout "Allison" and "Maggie" as well.  I really liked this strategy.  Not only because I became invested in her character during the first story...but also because seeing her evolve over time helped to demonstrate some key themes from this film- hope and resilience.

As Lucy says to Maggie: "I am living proof". [Of what?] "That there is hope".  In court, Lucy reminds Maggie's judge that having mental illness does not mean that you are a bad person or a bad mother.  She also reminds him about the importance of social support, "it is nearly impossible to get well alone".  Even though we see all of these characters at their lowest point- there is still hope that they can feel better, have strong relationships, and contribute positively to the world.

It seems fitting that Brittany Snow's character delivers these messages about hope and resilience, as she is a strong advocate for them in real life.  Together with the Jed Foundation and MTV, she founded Love is Louder.  Love is Louder is an inclusive movement that amplifies messages of love and support to combat negative messages resulting from bullying, loneliness, and stigma.  She has also publicly shared her own battles with anorexia, depression, and self harm.

As a health educator, I highly recommend this film as a resource for discussing mental illness, suicide, stigma, social support, and help-seeking.  Since each story is approximately 20 minutes, they can be broken down into segments or watched all together.  This film is a great example of Entertainment Education, which is an area of public health that acknowledges the strong impact that television and movies play in educating the public about health issues.

If you or someone you know is struggling with a mental illness, please reach out:
National Suicide Prevention Lifeline (1-800-273-8255)

"Girls" Tackles OCD: What I Hope IS NOT Happening In Our Emergency Departments

This afternoon I had the pleasure of having some downtime- so I used it to catch up on the three recent "Girls" episodes sitting on my DVR.  Having avoided spoilers, I was surprised and saddened to see Hannah (Lena Dunham) being consumed by Obsessive Compulsive Disorder (OCD).  We learn that she had a serious bout with the condition once before- in high school.  It was so serious that she sought professional help and medication at that time.  Flash forward to her post-college life and we see her plagued again...perhaps triggered by the stress of a recent break-up and a looming book deadline.

While there are several disturbing issues in the most recent episode "On All Fours" (you can see the comments in Alan Sepinwall's review for those details), I want to focus specifically on Hannah's trip to the local emergency department (ED).

I was very upset watching this scene and I'll tell you why:

We know that emergency room providers are key gatekeepers for those who are suicidal and/or suffering from mental illness.  Research tells us that 1 in 10 suicides are by people seen in an emergency department within 2 months of dying.  Acknowledging the importance of this gatekeeper role, leadership organizations in suicide prevention have created a variety of toolkits and resources to educate and train emergency department personnel to identify patient warning signs and assess their risk.

In "On All Fours", Hannah visits the ED after obsessively sticking a Q-tip in her ear, getting it stuck, and experiencing pain.  After lying to her parents by saying she has "12-15 good friends" to accompany her to the ED, she goes alone.  The scene opens with the doctor telling her, "Well, you must be feeling pretty silly."

As the doctor examines her injured ear, Hannah says:

"I've just been having a little trouble with my mental state."
"I have a lot of anxiety and I didn't think stress was affecting me but it actually is."
"I'm not saying this was an accident, but I was just trying to clean myself out."

At no point does the doctor respond to any of these statements.  He is all business, telling her to follow-up with a specialist if she is still experiencing pain in a few days.  As Hannah lays down so he can put antibiotic drops in her ear, she pleads with him to look at her other ear.  He snaps at her "there is nothing wrong with the other one."  Hannah cries on the bed because it (the drops? her situation?) hurts so bad.

He discharges her and she walks home alone.  In just a t-shirt and no pants.

Now I'm not saying that Hannah was acutely suicidal or verbalized such a threat in the ED.  However, I am saying that she made several clear statements about her mental health that should have been treated with concern and respect by a competent medical provider.  Her demeanor and her appearance deserved a kind ear, a social worker's visit, someone to ask if she was all right.

These recent episodes have been applauded for their accurate portrayal of OCD.  I hope that a future episode will show a portrayal of a caring and skilled provider using the public health prevention and education tools that are available to assist someone in desperate need of help.

For any readers that may need help:




Facebook Revisited: Does the Platform Help or Hurt Users (or Both)?

The benefits and challenges of social media for public health are a frequent topic on Pop Health.  For example, I've explored the influence of these platforms on emergency response, increasing the number of organ donors, and health activism.  However, one of the debates that I hear the most among public health colleagues relates to Facebook.

Does it isolate users?  Does it connect users?  Does it do both?

Earlier this year, my colleague Elana Premack Sandler explored this debate as it relates to loneliness.  Inspired by a feature in the Atlantic Magazine, Elana asks key questions like, "Is Facebook part of the separating or part of the congregating?"  She also mentions concerns about how Facebook (and other social media platforms) affect our social skills and therefore our friendships.

I thought of Elana's writing as I read a new post on the Atlantic website today, "Are Your Facebook Friends Stressing You Out?  (Yes.)".  This post highlights a new report out from the University of Edinburgh Business School.  The report caught my eye because it identified a very specific cause of stress for Facebook users.  The more groups of "friends" a user had (e.g., family, real life friends, co-workers, etc), the more anxiety they had because there was a greater chance of offending someone with their posts.  The report stated that the greatest anxiety came from adding parents or employers as Facebook "friends".  As Megan Garber writes so eloquently in her Atlantic post, the stress comes from Facebook forcing users to "conduct our digital lives with singular identities".  The way we speak or act around family or friends or co-workers must jive on Facebook, or we run the risk of offending someone.  I'm sure many of us saw this conflict a few weeks ago when political and election posts ran rampant on Facebook!

The anxiety described above is interesting, because ideally what we would hope is that Facebook provides a source of social support to users.  Social support occurs when one is cared for by others (via emotional, tangible, or informational support).  The presence or absence of social support is a factor related to public health issues, such as suicide.    

So after reading through the various posts/articles, what do I think about my opening questions about Facebook?

Does it isolate users?  Does it connect users?  Does it do both?

I think it does both.  I have seen it do both.  For example:

Isolation:  I have spoken to friends and colleagues who feel terrible about themselves or their lives after scrolling through their Facebook news feed.  A friend with chronic illness feels isolated hearing about the latest vacation or new job taken by her "friends".  A friend suffering from infertility can't bear one more picture of a "friend" and their newborn.  I think much of this results from the "whitewash" that many of us put on Facebook.  We often paint a picture for our Facebook friends, full of engagements and babies and fun events.  

Connection:  Earlier this year I watched a suicide intervention unfold on Facebook via the comment section under a post.  A friend of a friend posted a suicidal message on their Facebook wall.  Within minutes, "friends" reached out in the comments.  However, not only did they "speak" to the person, but they interacted with each other and followed up in real life.  One comment read, "Did someone go to his house?"  The next comment read, "I went to his house and I called his parents".  After he was taken to the hospital, a comment was posted to inform all the friends that he was safe.  As a public health practitioner that worked in suicide prevention for years, I was amazed with what I saw. 

So what can we do to reduce the isolation/anxiety and increase the connection?  You can certainly start by exerting your control over your Facebook account.  For example:

  • Create a policy about "groups of friends" that you accept into your circle.  I know lots of people that do not accept requests from co-workers or parents.  They make it clear to the individual that it is nothing personal, they just have minimal friends with which they share intimate information.
  • Use the privacy settings!  You can control who can see your posts.
  • Find and use the unfriend button!  I have done this frequently.  If someone posts messages that are offensive or disrespectful regarding something that I've posted- I get rid of them quickly.
  • Take a break from Facebook.  If you realize that Facebook is making you feel bad about yourself, take a break or disable your account.  Use that time to connect with your in real life (IRL) friends or family.
Tell me what you think!  
  • Does Facebook isolate and stress us?  
  • Does Facebook connect us?
  • What other strategies can help to reduce the isolation and increase the connection on Facebook or other social media platforms?
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