This space has been pretty quiet but I just wanted to throw out a reference to some interesting information. There’s a developing sub-field in psychology that studies people’s beliefs about emotions. What we believe about emotions– whether they are good or bad, whether we can voluntarily change feelings, differing cultural beliefs about emotions– all these things have an impact on our mental health and our relationships with each other.
When you see that phrase you may think of monetary gain from being good to others, if you are a product of Western Culture. But it turns out that there’s another side.
I’m just now reading an article on the web site of the UC Berkeley Center for Greater Good on research that shows the physical benefits of being a compassionate person, someone who spends time helping others. Not only does becoming more compassionate reduce anxiety and depression, it reduces inflammation and can lead to a longer lifespan.
I’m not going to attempt to gild the lily; the article is packed with references to research that shows the benefits of being compassionate, of trying to learn how to be more compassionate. It’s just that I’ve read so much about people feeling anxious and depressed, and about how there’s such a tremendous lack of professional care for these widespread problems, that I’m always looking for DIY hacks that will help people heal themselves. This is one where you can do it if you’re already doing OK or you can do it if you’re feeling bad. No matter what your baseline is, you’re going to go up. And I never heard of any negative side effects of too much compassion, and you don’t have to do it daily for two or three weeks for the effects to kick in. But it’s true you might get addicted to being a compassionate person.
If you go to Youtube and do a search for Alcoholics Anonymous, you’ll find a lot of interesting videos ranging from the recovery stories of famous people (“famous anonymous” ???) to debunking videos about how A.A. is a cult and why it doesn’t work. But a friend recently tipped me off to an interesting fifteen minute video about a study with multiple authors, one at Harvard and one at Stanford (my apologies to the other authors), that did what is called a Cochrane review. What this involves is doing a literature search of multiple large data bases to get multiple studies on the subject you’re interested in and doing a meta-analysis, a study of the studies. Their conclusion: Alcoholics Anonymous works, and works better than other competing forms of professional treatment.
This is encouraging. When we consider that 140,000 people die from alcohol-related causes annually in the U.S., it’s nice to know that there’s something that can reduce that toll. Also, considering that the health care system is having a long and painful struggle with the fact that professional treatment is still not easily available despite parity laws , it’s especially encouraging that it’s possible to find A. A. meetings all over the country as well as all over the world, with 123,000 meetings and recovery resources in 180 countries. What’s really encouraging to me is that it’s help that’s provided on a donation basis, because most people who find themselves in need of alcohol recovery are often short on funds. As a former employee of the Haight Ashbury Free Clinic, that warms my heart. It’s also nice to know that A. A. literature is available in many languages. The web site for A. A. in Los Angeles lists meetings in ten different languages. Given that A. A. is totally grass roots, this is going to vary widely from place to place, but there are now many A. A. meetings online. So access for people with different languages and mobility issues may be better than in professional treatment. A friend I talked to about this blog post cynically observed that nobody will trumpet this fact from the mountaintop “because nobody can make any money off it.” Quite probably true, but the word about good free stuff tends to spread. Now that you know, dear reader, feel free to steer people toward A. A. meetings if you think it would help. They may give you pushback so don’t work too hard, but feel free to get the word out.
The twelve step, twelve tradition model has been applied to other problems, with the existence of everything from Gamblers Anonymous to Emotions Anonymous . I haven’t done any background research on whether or not there are equivalent studies on these other peer-led grassroots programs. But given the appalling lack of behavioral health options in the U.S., it’s certainly food for thought. And a ray of hope.
This is just a quick post because so many people are interested in using melatonin for sleep, but it’s not regulated so you don’t know how much you’re getting. The products evaluated were advertised as for children, so accuracy in labeling seems a pretty strong ethical issue to me. The article reports more than 27,000 pediatric emergency room/clinic visits over a nine year period. I’ve had so many times when I run across interesting stuff from credible sources but don’t bookmark it or save it, and in this case I thought others might want to know also. In one case, a product advertised as having melatonin had none, but had CBD in it. Personal opinion– there’s nothing wrong with either melatonin or CBD, but there’s a lot wrong with inaccurate and misleading labeling on products people use for health reasons. Especially when giving them to children.
This space has been silent for quite some time for a variety of reasons But with the arrival of the mid-winter blues, the holiday season and so on, I was struck by a good piece on NPR about suicidality at the holidays and how to help. By the way, the small white dot in the middle of the photo is someone coming out of the darkness.
The thing that inspired me to post was the basic idea I’m using for my headline. To give a little professional background, I started in this field working as a peer counselor with what I later found out was a very high-risk population. If you read up on suicide rates, number are typically given in the number of completed suicides per 100,000. In our population the rate was typically around one per hundred annually. Working in San Francisco, it was pretty typical to have people who reported wanting to jump off the Golden Gate Bride or to throw themselves in front of a BART train. We learned to ask some simple questions like “How often do you take BART?” or “Do you know which bus goes to the Golden Gate Bridge?” Most of our clients did not own cars and relied on public transportation. Sometimes clients would get a little cranky at being asked questions like this, but we learned to to take it in stride. In nearly twenty years of working with this population we never once had a client who jumped off the bridge (that we found out about) or in front of a BART train. We learned not to panic when working with this extremely high risk population. When someone irritably answered the question about knowing which bus went to the bridge by saying, “I can find out in a heartbeat If I want to go there, you moron!” A counselor would calmly reply, “I know you can. I just need to know if I should be calling the 5150 squad right now before you leave. I don’t want you to die.” Or words to that effect.
The point simply is this: Anyone, not just a trained professional, can be of tremendous help when someone is feeling suicidal. The article linked above has lots of great tips and links to lots of great resources, whether you are the one feeling like you wish your life would end or whether it’s someone you know. I’m reminded of a story I read a few years ago about how the city of Seattle put on a public health campaign to teach as many people as possible to do CPR. The result? They actually identified cases where someone fell down dead on the sidewalk (remember CPR is only used when there’s no heartbeat or respiration) and were saved from a passerby knowing CPR. Well, the good news is that if you do any or several of the interventions outlined in the NPR article, it’s not as desperate as that– but you could still be saving a life. I had a client at one time who shot himself in the head– and survived with a miraculous lack of serious impairments. At the time I met him, he was no longer suicidal and was successfully coping with a lot of stuff. You never know how far people are going to bounce back up. But to show a different side of the coin, I’ve also met people who reported suicidal ideation off and on for years, but had never made an attempt.
So don’t be afraid to ask, don’t be afraid to engage. Coming back to my experience with the very high risk population at my first job, we had a lot of socially isolated people, but in every case of a completed suicide there were always people in their lives who said “If only I had known, I would have tried to help.” Always. So if you’re the one wishing your life would end, reach out to people. If you even slightly suspect someone in your life feels like this, reach out to them. Please.
I looked for photos relating to this subject, but too many were too grim. Remember– recovery happens!
Guns are used five percent of suicide attempts yet result in about fifty percent of suicide deaths. Add to that the fact that of all gun deaths in the U.S., more than half are suicides. Research shows a modest reduction in gun suicides when mental health services are increased, and laws that allow removing guns from the possession of people with mental health crises can also be helpful, along with strict laws to prevent children from having access to guns. To the extent that it has been studied, reducing gun suicides does not result in increasing suicide by other methods. The author in this JAMA article suggests that gun safety and mental health are partners, not rivals, in reducing suicide deaths. I didn’t locate the reference for this post, but I remember hearing of a study of people who survived near-fatal attempts; a significant percentage of these survivors said that they had considered suicide for less than five minutes before attempting it. Clearly, anything that reduces the lethality of such an impulsive behavior is desirable.
At one time I was working with a population that included a significant number of gun owners, a number of whom were depressed. I’ll always remember the one who, in a moment of crisis, took the firing pin out of his pistol and threw it into the dark, weedy backyard of his rural home. These men would not have considered getting rid of their guns, but they were open to discussing ways to prevent impulsively killing themselves, like getting all the bullets out of the house. One who still lived in the family home had support in keeping all weapons in a gun safe, with his dad keeping the key. This is just a quick reminder that while political discourse may proceed by sound bites and polarized presentation of opinions, real world solutions that are adequately resourced and actually help are far more complex.
Remember to check in with anyone you know any time you feel it would help about whether or not they’re thinking about self harm. The 988 national number is up and running for suicide crisis intervention. There is hope. I once had the incredible privilege of working with a client who survived shooting himself in the head– who wasn’t even depressed by the time I knew him; he was in for other issues. Recovery happens!
This space has been dormant for a long time because when I first started, I made a commitment to myself to post things that I felt were original content, and my reading/thinking for this space has been distracted and directed to other projects. But I just ran across something from one of my favorite web sites, the UC Berkeley Center for Greater Good, in which an author asserts that anxiety isn’t the problem– it’s how we deal with it. There’s a really great interview with an author who wrote a book about the upside of anxiety and I just wanted to pass it along. Here’s just one quick quote from the interview: “When you think about anxiety as this information that you need to pay attention to, you also realize that it means that you’re still hopeful about that future.”
The author is very emphatic that we benefit from drawing a clear distinction between anxiety and anxiety disorders. I find that to be so important. I can’t promise that I’m going to read her book, but I like the point of view. In previous posts I have pointed out that there is definitely a level of anxiety that is actually helpful, so I was more or less primed for someone else to come out with a book about exactly that idea.
P.S. I did a web search for images using the word “anxiety” and all that came up was stuff about anxiety disorders and the negative aspect of anxiety, so I pulled from personal photo files for an image that may seem tangential.
I’ve been seeing a lot of stuff about the trend for people to take the month of January off from consuming alcohol. There’s an interesting term, sober curious about people who want to look at their relationship with alcohol, and NPR just ran a piece on some of the aspects of the whole Drynuary project and what it may bring out for people. Some of the most interesting articles I ran across doing a little preliminary reading included stuff about how annoying people can be doing the whole Drynuary thing– making it more about virtue signaling and basically giving other people a hard time for a month instead of quietly doing their own thing.
Then, of course, there are the various hints that you may have an alcohol use disorder if you think it would be a good idea to take a month off from drinking. Call me a contrarian, but I would like to suggest that it’s just as likely for you to have an alcohol use disorder if you don’t want to take a month off from drinking. Think of it this way– who would you worry about more: a person who thinks it would be a good idea to go dry for a month, or a person who thinks they can’t possibly go dry for a month? Feel welcome to disagree with my point of view.
So we don’t necessarily want to lean too heavily into “maybe I have a problem” signaling, either. How many of us have had periods where we were diligent about going to the gym, avoiding sugar, fried foods, being vegan on Mondays or other self-imposed health improvement projects, only to realize somewhere down the line that we’d fallen off the sugar wagon or the meat wagon and we couldn’t even say exactly when it happened? There have been studies of people’s drinking habits after they did the Drynuary thing; a significant number of people end up drinking noticeably less six or eight months down the line. This suggests that when people re-think their relationship with alcohol by going on hiatus for a month, they decide to drink less and end up drinking less. Not what you’d expect from somebody with a problem; more someone who is just generally taking care of their health.
So, is Drynuary a good idea or a bad idea? I’m definitely with those who say that it’s a bad idea of you’re mainly about virtue signaling and giving other people a hard time for their boozy ways. I can get backup from what some would consider an unlikely source: “Why sit with a long face in places where there is drinking, sighing about the good old days. If it is a happy occasion, try to increase the pleasure of those there; if a business occasion, go and attend to your business enthusiastically. If you are with a person who wants to eat in a bar, by all means go along. Let your friends know they are not to change their habits on your account.” Alcoholics Anonymous, 4th ed. P.102 Yep, that’s right. The A. A. book gives that advice to people who have quit drinking. In other places it is suggested that the non-drinker not be a nag, a killjoy, a wet blanket. And that’s for people who are presumably intending to stop drinking for good, although A. A. is famous for the “One day at a time” slogan. The book also says “. . .not one drinker in a thousand likes to be told anything about alcohol by one who hates it.” (p. 103) And for someone who’s just on hiatus for a month, it would be sort of like badmouthing a lover you’ve broken up with when you’re not sure the split is permanent. So nix on the virtue signaling.
Just FYI, the NIH guidelines for safe drinking are a lot lower than many people think. They define moderate drinking as one drink a day for women and two drinks a day for men, and a drink is twelve ounces of beer at five percent alcohol, five ounces of wine at twelve percent alcohol, or a one and a half ounce shot of spirits at 40% alcohol. I was surprised to learn that in studies of alcohol use only about 70% of Americans say they had a drink of alcohol in the last year. I can’t find a reference to embed, but I remember being at a webinar on traumatic brain injury (TBI) and hearing that something like half of all the civilian TBI is caused by a fall while intoxicated. Everyone has heard of alcohol-related brain damage, but they don’t usually think of it as being the result of falls after drinking. Granted, most of the falls come to people who drink a lot, but if someone just happens to have a couple too many on a Saturday night, that’s a real risk factor– and if you do Drynuary that’s reducing your personal risk by at least one twelfth, right? And presumably throughout the year if you’re one of the people who continue with lower use patterns afterward. So dialing it back can be a successful change strategy. Just check yourself to see what February first looks like.
There’s not a catchy name for it yet, but maybe we need something like Healthuary, where we look at all our behaviors and focus on wellness. There’s Mental Health Month, which is the same as National Physical Fitness and Sports Month (May). I would prefer each to get their own month, but that’s how it is. How about good relationship month? Helping others month? National Eat Your Vegetables Month is June. Don’t wait! Eat your vegetables today. But no virtue signaling please.
Everyone knows that time in nature is good for you, but there’s actual research that shows it. A heart surgeon discovered that his patients who went to hospital rooms facing trees healed faster than those that went to rooms on the side of the hospital that faced the parking structure. I’ve been a fan of the healing power of nature all my life, but the article linked at the beginning of this post is peppered with references to different studies that demonstrate how it can lower blood pressure and stress hormones and the effects last for days after the last exposure to it. There are people who theorize that because we evolved to be in nature all day every day of our lives that we naturally (see what I did there) feel better when we get back to our green shoots and roots. Other research shows that the beach or the plains or any natural environment can help; it doesn’t have to be the forest. Every little bit helps, apparently. If you’re in a totally urban environment, get a house plant. Go to the nearest park. If you can’t make the park, look at pictures or nature videos. Doctor’s orders.
In reports of a recent study researchers found that alcohol consumption increased chances of atrial fibrillation. Although previous studies hinted at this, the study reported in the New York Times was more rigorous in that it had participants wear recording devices that actually measured heart performance and blood alcohol levels. There have been other reports that alcohol consumption is good for heart health, but this one seems to be an important caveat. Does this mean we should all quit drinking immediately? Not exactly. The study involved people who had already reported having a-fib and looked at their alcohol consumption. So if you’ve never had a diagnosis of a-fib you’re not under the gun to lay off the sauce. But a couple of drinks in this study population tripled their chances of having an episode within the next few hours so if you have had the diagnosis it’s quite a wake up call. What’s interesting about this study is that it suggests that moderate alcohol consumption affects the electrical functioning of the heart. Two or three drinks didn’t used to be considered risky, but now there’s clearly a population for which this is the case. We’ve known for a long time that excessive alcohol use is bad for the heart, but this suggests the bar for risk is lower than previously thought. For those who have been intending to cut their consumption already, look at the bright side– it’s a motivator, right? But no recent bad news about chocolate, at least . . .
jamesmatter 