Mental Health Awareness Month Focuses On Solutions.

Shortly after the coronavirus first began to spread across the United States, public health officials expressed concern that mental health conditions such as anxiety and depression would soon be on the rise as well.

Read stories at Living with Mental Health Conditions from NAMI.

Their concern was so great that in New York, Governor Andrew Cuomo announced plans to establish a free mental health service that allowed anyone needing counseling to speak to a medical professional about the stresses caused by the COVID-19 outbreak.

Two months later, the effects of a spike in cases of anxiety and depression caused by the coronavirus is still being felt, which is why the selection of May for Mental Health Awareness Month carries as much meaning now as it ever has.

As it is every year, the goal during Mental Health Awareness Month is to “fight stigma, provide support, educate the public, and advocate for policies that support people with mental illness and their families.”

Sponsored by the National Alliance on Mental Health (NAMI), the program also seeks to draw attention to suicide, and it does so through the “You Are Not Alone” campaign, which features real-life stories told by real-life sufferers of depression.

The NAMI website contains hundreds of personal stories that detail people’s trials and tribulations with depression. It also offers advice on how best to deal with anxiety and depression, which affects millions of people in the U.S. alone each year.

In 2018, for example, one of every five adults in the U.S. suffered from some form of mental illness and one of every 25 adults in the country suffered from some form of “serious” mental illness, according to a government study.

Another study showed that in 2016, nearly eight million youths between the ages of 6 and 17 experienced a mental health disorder, while another showed that more than nine million people struggled with both mental illness and substance abuse at the same time.

And like the coronavirus, mental illness does not discriminate. It affects people of all races and nationalities, with members of the gay, lesbian and bisexual community accounting for more than 37-percent of its sufferers.

Unlike the cold or flu, though, symptoms of mental illness are not always identifiable. What is typical behavior for one person may be a sign something is wrong with another, but the most common signs to look out for include:

• Feeling excessively sad or low
• Strong feelings of irritability or anger
• Decreased desire to socialize with friends or family
• A strong desire to sleep all day or not get up in the morning

The good news is that solutions for all these problems can easily be found. In fact, in accordance with Mental Health Awareness Month, Mental Health America has created the #4Mind4Body Challenge.

It’s designed to improve people’s overall health and well-being through small lifestyle changes that include eating better, sleeping longer and avoiding many of the habits and practices that can increase depression and anxiety.

For more on the #4Mind4Body Challenge, check out the MHA website at mhanational.org.

The US was on the upswing for a while. Between 1959 and 2014, life expectancy for Americans, which is the average length of time we are expected to live, increased by nearly ten years, from 69.9 years to 78.9 years. But something started happening in the 1980s, and the increase slowed considerably. By 2010, it plateaued.

Between 2010 and 2017, death rates for people aged 25 to 64 increased in nearly every state.

Then in 2014, life expectancy in America began reversing, and by 2017, the latest year for statistics, life expectancy in the US had decreased for three straight years to 78.6 years. Our decline persisted despite the fact that the US spends more dollars per capita on health care than any other industrialized nation.

The findings of a comprehensive study that explored the nature of life expectancy in America as well as possible causes for its decline were released at the end of November and published in the Journal of the American Medical Association (JAMA).

For the study, the researchers reviewed more than a half-century of data from the US Mortality Database and the US Centers for Disease Control and Prevention’s WONDER database. That’s an integrated information and communication system for public health practitioners and researchers.

One key finding of the study was that adults ages 25 to 64, or working-age Americans, saw the largest increase in death rates, a rise of six percent. The increase in death rate in this age group was seen in nearly every state in the US.

According to the study, the death rate in working-age Americans from all causes increased from 328.5 deaths per 100,000 people in 2010 to 348.2 deaths per 100,000 people in 2017. The statistics showed this increase occurred across all racial and ethnic groups.

Dr. Steven Woolf, one of the study’s authors, noted this increase in mortality was driven, in part, by “deaths of despair.” Those include deaths from drug overdoses, which reflect the opioid crisis in this country, as well as those from alcohol abuse and suicide.

Men sit passed out in a park where heroin users gather to shoot up in the Bronx borough of New York, May 4, 2018.

The study found that between 1999 and 2017, fatal drug overdoses by working-age Americans increased by 386.5 percent. Deaths linked to alcohol use, including those from chronic liver disease and cirrhosis of the liver, rose 40.6 percent during those years. And suicide rates by that population rose 38.3 percent.

The study also pointed to health conditions such as diabetes, high blood pressure and heart disease as other causes for the death rate increase. It noted that these conditions are exacerbated by unhealthy behaviors such as smoking, being overweight or obese, eating a high-fat diet and living a sedentary lifestyle, problems that are rampant in our society.

And these problems impacted the death rates for working-age Americans. For example, deaths in this age group linked to obesity increased 114 percent between 1999 and 2017. The majority of American adults, about 71 percent, are overweight or obese. And obesity increases the risk for cancer, diabetes, heart disease and other chronic conditions.

Deaths related to high blood pressure increased by 78.9 percent in the 25 to 64 age group during the same time period. And about 80 percent of American adults don’t meet the physical activity guidelines. If we don’t manage chronic conditions better and change our unhealthy behaviors, our life expectancy will continue to decline.

And according to the new study’s findings, the increase in working-age death rates coincided with major shifts in the US economy dating back to the 1970s and 1980s. It was during those years that the US started to lose manufacturing jobs, and the middle class began to shrink, Dr. Woolf noted.

These loses hit certain areas of the country harder than others, and that is reflected in the statistics. The Ohio Valley, which includes Ohio, West Virginia, Indiana and Kentucky, is part of the  nation’s “Rust Belt.” This area was highly stressed economically with the closing of steel mills and auto plants.

The Ohio Valley, as well as northern New England, which includes New Hampshire, Maine and Vermont, experienced the largest relative increases in working-age mortality rates in the US. Both of these areas were hit hard by the opioid crisis and by declines in their economies

Dr. Woolf said it’s noteworthy that the largest increases were seen in these areas. The people living there have gone through long periods of economic stress, which can lead to a set of consequences that can affect health in many ways.

People struggling financially are more likely to turn to drugs, alcohol or suicide, he said. In addition, they may not be able to afford routine or emergency medical care, prescription medications or healthy food. And they are less likely to effectively manage chronic conditions such as diabetes and high blood pressure. These factors can lead to increases in mortality rates.

It’s pretty clear that reversing the downward trend in life expectancy will take a combined effort on the individual, community and national levels. As individuals, we must commit to changing unhealthy behaviors and eat healthier, exercise more and pay closer attention to our overall health. And we need to put our pride aside and seek help for substance abuse disorders.

Communities must work harder to increase local access to health education and services. And as a nation, we must continue to focus on battling the opioid crisis, tackling the obesity epidemic and increasing economic opportunities, especially in distressed areas. There’s a lot more to be done, but these steps are a good starting point. After all, our lives depend on our action.

The United States is in a suicide crisis. America’s rate of suicide, now its 10^th leading cause of death overall, has increased by more than 33 percent since 1999. That was among the findings of a US Centers for Disease Control and Prevention National Center for Health Statistics research study. The results of the study were released in June.

The worst thing you can do for someone dealing with suicide or expressing suicidal thoughts is remain quiet. Speak up, reach out, learn the best way to offer support.

The Center for Health Statistics’ research discovered that suicide among Americans ages 15 to 64 rose from 10.5 per 100,000 people in 1999 to 14 per 100,000 in 2017, the most recent year with available data. That number represents the highest suicide rate in the US since World War II.

Federal data released in October showed that suicide rates are climbing in nearly every state and across age groups and ethnicities. The suicide rate for young Americans ages 10 to 24 increased 56 percent from 2007 to 2017. It’s at its highest rate this century. Suicides by active-duty military and veterans are also on the rise.

According to one study, 10 million Americans seriously considered suicide in 2018. That certainly sounds like a crisis to me.

All of these studies confirm that suicide is a significant public health problem. The CDC also reports that on average, 129 Americans die by suicide each day. Suicide claims 47,000 lives each year. That number is probably much higher considering not all suicides are reported. Men die by suicide three and a half times more often than women, but women are more likely to attempt suicide.

It’s also been determined that 90 percent of people who died by suicide had a diagnosable mental health condition at the time of their death. And if it’s diagnosable, it’s most likely treatable. Suicide affects us financially as well. It costs this nation at least $69 billion per year in medical costs and lost work productivity.

Suicide is an equal opportunity problem. Anyone can be at risk, and those risk factors are varied. They include depression, substance abuse disorder, mental health disorder or a family history of such disorders. Other risk factors include previous attempted suicide, a family history of suicide, a history of physical or sexual abuse, the presence of guns in the home or an experience with a painful medical illness.

The reasons people die by suicide are complex. In general, they react to, think, and make decisions differently than people who are not suicidal. One researcher suggests there are six main reasons people kill themselves.

In many cases, people who attempt suicide or succeed at it are depressed, which typically comes with a pervasive sense of suffering, as well as a belief that their situation is hopeless. Some people who commit suicide are psychotic, some are impulsive, some are crying out for help, and others have a philosophical desire to die. This desire can develop when people have a painful, terminal illness.

Whatever the cause, it’s imperative to know the warning signs for suicide, especially if you or a loved one has any of the risk factors. Most people who take their lives by suicide show one or more warning signs in the way they talk and behave.

Be alert if someone you know starts talking about killing themselves, or about feeling hopeless or having no reason to live. Other verbal warning signs include talking about being a burden to others, feeling trapped or being in unbearable pain.

Certain behaviors may be warning signs as well, especially if they are linked to a painful event, loss or major change. These behaviors include increased use of drugs or alcohol, looking for methods to end their life, withdrawing from activities and becoming isolated socially, visiting or calling people to say goodbye and giving away prized possessions.

Preventing suicide is the goal, and help is available. If you or a loved one is contemplating suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line.  For crisis support in Spanish, call 1-888-628-9454.

In emergencies, call 911 or seek care from a local hospital or mental health provider. Today, many hospitals and mental health providers have redesigned their practices to include research-backed tools for determining a patient’s risk for suicide. These providers then use proven interventions to prevent suicide and initiate the patient’s recovery.

Victims may appear happy when in fact they’re not

In the days just prior to the moment in which she took her own life, world renowned fashion designer Kate Spade was described as happy, jovial and in good spirits by friends and family members.

Three days later, friends and associates of Anthony Bourdain were saying the same thing after the celebrity chef took his own life while he was on location in France shooting an episode of his CNN TV show, Anthony Bourdain, Parts Unknown.

Mental health experts weren’t surprised to hear that. It’s not unusual they say for suicide victims to mask their true emotions all while displaying a completely different set of feelings while they’re with family and friends.

Many with suicidal thoughts simply do not want to burden their friends or family members with their darkest feelings. Others refuse to share those thoughts out of fear they won’t be taken seriously and will be see as simply seeking attention.

But attention is precisely what anyone experiencing suicidal thoughts needs, and as the recent deaths of Spade and Bourdain suggest, anyone from any walk of life can develop and eventually act on his or her suicidal tendencies.

Simply put, suicidal tendencies do not discriminate. Suicide is the second-leading cause of death among people aged 10 to 24, but people 85 and older have the highest suicide rate among all adults.

Some members of the population are, however, more prone to falling prey to suicidal tendencies. For example, it has long been known that members of the Native American and Alaskan Native communities are more prone to suicide.

The same goes for members of the LGBTQ+ community, and according to a 2016 report by the United States Department of Veterans Affairs in which the records of 55 million veterans were analyzed, 20 veterans take their lives each day.

But suicide is not a problem only for those suffering from depression, such as Spade. In 2016, more than half of the nearly 45,000 suicide victims in the United States had not been previously diagnosed with a mental illness, according to the U.S. Centers for Disease Control and Prevention (CDC).

That’s one reason clinicians are convinced that many potential suicide cases can be prevented, and why most of those clinicians believe that by simply paying attention, friends and family members can do the most to prevent a suicide from happening.

In particular, it’s important to look for significant behavioral changes such as a sudden desire to withdrawal from or avoid social activities involving family and friends, decreases in activity levels and increases in anxiety, agitation or restlessness.

The reason, according to Dr. Dan Reidenberg, executive director of the Suicide Awareness Voices of Education (SAVE), is that suicide is not something that someone typically attempts on a spur of the moment basis.

“It’s not as if one morning someone wakes up and says, Today is the day I’m going to do this,” Dr. Reidenberg told ABC News shortly after Spade died.  “It happens over time and falls on a continuum.”

Dr. Reidenberg added that simply being available to talk to someone who may be contemplating suicide can change that person’s plans and that letting someone know you are always there for them can save a life as well.

The National Institute for Mental Health (NIMH) provides several tips for helping someone who may be contemplating suicide that also apply to anyone who may be going through a crisis that could lead to such thoughts.

They include asking the person if they are thinking about suicide. That may seem to be a rather blunt approach, but studies show that asking someone if they are contemplating suicide does not increase the risk of it happening.

It is also wise for those around someone who may be displaying suicidal tendencies to rid their environment of anything that might be used to commit suicide, such as guns, knives and drugs.

Finally, encouraging someone to seek professional help, be it from a volunteer at a crisis center, a doctor or a spiritual advisor clergyman, can go a long way toward preventing a suicide as well.

It’s also important to remember that, should the crisis pass, it’s wise to continue to keep tabs on a person who may have expressed suicidal thoughts. After all, that person may seem to be happy, jovial and in good spirits, when in fact they are not.