Living Well This time of year, I'm extra attentive to my family.
Thanksgiving has come and gone. Here in the U.S., the holiday season has wrapped up and the new year is underway. The excitement of the season is behind us...
Now, it's time for life to return to its usual tempo... Back to work and school... Back to paying bills and running errands... The change from the dark, stillness of winter into the bright, buzzing of spring seems so far away...
For one in four Americans, this time of year is emotionally difficult.
Seasonal affective disorder ("SAD") is a mild depression that comes on as the season shifts into colder and darker months. Those affected by SAD usually start to feel better once spring arrives and the days get longer.
However, sometimes the depression is deeper and darker. This is a major depressive disorder. And anyone can be a victim. Common symptoms include persistent sadness, overwhelming anxiety, and difficulty concentrating. They can also include thoughts of self-harm and suicide. Oftentimes, people will stay in bed all day with very little social interaction. This is when help is needed.
I (Thomas Carroll) have made a career in health care research – from designing employee health benefit programs to consulting for hospitals and managed care organizations to running health care services research at two large investment banks. I am an avid reader of health care journals, and one of my favorites is Health Affairs.
In the November 2021 issue, an article caught my eye. Health care executive Nora Super wrote a piece titled "Opening Up About My Struggle With Recurring Depression."
Super was the chief lobbyist for AARP during the design of the Affordable Care Act. She spent time at the Department of Health and Human Services – the federal agency that runs Medicare and Medicaid. She was also appointed the executive director of the White House Conference on Aging under President Obama.
Despite being a well-educated health care executive and consumer, she opened up about having four major depressive episodes in her life between 2005 and 2021. Each of her episodes required intervention beyond therapy and prescription drugs. Her story struck a chord with me...
Several members of my family have struggled with depression, SAD, and debilitating bouts of anxiety. A friend of mine recently ended his life because of his illness. Make no mistake, this is an illness and something to be taken seriously. It's not someone being selfish or taking the "easy" way out. Nothing about mental illness is easy.
As Super, my family, and countless sufferers undoubtedly know, mental health is often overlooked and stigmatized in our country.
Super calls for four necessary actions to happen...
1. The stigma of mental illness needs fixing. The pandemic exposed the prevalence of anxiety and depression in the U.S., illustrating the vastness of the problem. However, there are cultural, social, and economic barriers to people receiving care – for instance, some lack access to quality care, and others think asking for help will make their problems worse.
2. Access to good, affordable mental health services need to increase. Many health plans do not offer robust mental health coverage (despite the Mental Health Parity Act of 2008). These services often are paid for "out of pocket," limiting who can afford them.
3. Robust alternatives need to be available. When nothing else works, the system needs to develop innovative solutions and pay for the ones we already have available. Electroconvulsive therapy – or ECT – and some psychedelic drugs – such as LSD, ketamine, and psilocybin – are studied alternatives that can provide relief to some who don't respond to other forms of treatment.
4. "Social prescribing" needs to be better explored. This is prevalent in the U.K. and Europe. The concept allows doctors and other health care providers to refer patients to a range of non-clinical services. For example, joining a group that fixes up homes for people who are poor or homeless. Social prescribing offers direction and purpose to people who are feeling useless.
The questions below are adapted from a depression test. Think back over the last two weeks and then ask yourself these questions:
- Do you have little interest or pleasure in doing things?
- Do you feel bad about yourself or feel that you are a failure?
- Do you have trouble concentrating on things such as watching TV or reading the newspaper?
- Do you have thoughts that your family would be better off if you were dead?
This stuff is real, and this time of year is often when it rears its ugly head. So if you answered "yes" to any of these questions, please reach out to a mental health professional today.
We really want it to be a HAPPY New Year for everyone.
Here's to our health, wealth, and a great retirement,
Thomas Carroll with Dr. David Eifrig
January 20, 2022