Benefits of Summer: Supporting Your Mental Health all Summer Long!

We’re in the middle of summer and for many people, it’s their favorite time of year. Of course, there’s a lot to love about summer. It can be a great time to really work on strengthening mental health, too! There are a lot of benefits to summer when it comes to mental health.

Everyone knows vitamin D is good for you. It’s why so many things are fortified with it. Just 20-30 minutes of sun exposure can help boost your natural vitamin D production. Not only is it good for your bones, but it can also help with energy levels.

Another benefit of summer is that being outside soaking up that vitamin D encourages us to get more physical activity in. The warmer weather helps, too! With the nice weather, it can be hard to not want to go outside for many people. There are a lot of fun things we can do outside to help get us moving. For example, a lot of people love to hike, play sports (like tennis or volleyball), go for walks, or ride their bikes. All of these things keep us moving which helps release endorphins. Endorphins naturally raise our mood and help to keep us feeling great throughout the day. Exercise or movement during the day also helps many people sleep better at night, allowing us to be well rested the next day. Of course, remember to use sunscreen and sun protection while outside!

It does have to be noted that summer can be a stressful time for some people. For children and teens, summer comes with a disruption of their routines. While there are many benefits of summer for these age groups, there can also be social isolation. It’s important to keep children and teens in a routine as similar to their school year one as possible. This is especially important for younger children. Keeping to a wake and sleep schedule can also help make the transition back to school less difficult!

Parents can also have a hard time! Being faced with more child care difficulties during summer can be stressful. School often functions as a safe place children can be while parents work. Without school, parents are now responsible for finding care for their children during the work hours. This can be especially difficult for parents on a tighter budget or who don’t have family or friends who can help out with childcare.

Not only that, but summer comes with an expectation to spend more money. There are vacations, events, and outdoor activities that take up so much of people’s days. These things very often cost money, and for some families, the investment could be substantial. This extra financial stress can make it difficult for parents who are trying to juggle everything.

So how can we capitalize on all the benefits of summer without the drawbacks? It can be easy to get overwhelmed by the potential problems that summer can bring, which can cause us to isolate and stay indoors. This makes it difficult to get the good out of summer!

One thing that’s especially important for adults is to not spend their paid (or even unpaid) vacation time catching up on chores or projects around the house. Allotting some time for these things can be important, of course, but also try and make sure to carve out some time to unwind and do something that isn’t productive or checking things off a list. This can be especially restorative, even if it’s just a day or two.

As mentioned earlier in the post, keeping children and teens to a routine is important. Not just sticking to their normal wake and sleep times, but making sure there is some structure to the day, too. Younger children will benefit from having set play times and socialization time. If it’s in the budget, arranging for summer camps or other day programs can help fill this need for children. Older teens could benefit from socialization times being set and even possibly summer jobs. This can be especially helpful for teens who need deadlines to help stick to a routine. With a summer job, this can help ease the tension between teens and parents over outings teens may want to attend that cost money, too.

Another one of the benefits of summer is that the days are longer! Of course this means more daylight time to be outside and do fun things. However, some people also use longer days to stay awake later. It’s important for adults, too, to stick to their normal sleep cycles. Try to go to bed as close to your normal sleep time as possible, even if that’s only shortly after sundown. Making sure you get enough sleep is incredibly important!

Sometimes it can seem like there’s a party or event every weekend. And this can come with pressure to attend. However, it’s important not to overbook yourself. You don’t have to say yes to every invitation, especially if you’re starting to feel stressed about it. Make sure to schedule out some time every week to relax without the pressure of an event or thing to go to.

One thing that can be especially difficult for people is the end of summer. August and September bring with them the realization that routines are going back to normal, the weather is going to cool, and the days will get shorter. This can be very difficult for people, especially if they traditionally experience depression with a seasonal pattern in winter (Seasonal Affective Disorder or SAD).

Something that can help is to plan fun things to do throughout the fall. It doesn’t have to be big or extravagant but having activities to look forward to during the fall can help ease some of the summer ending blues. Think about hiking or walking while the weather is dry, doing more indoor activities like attending museums, or planning fun stay-in nights for the family. Something as simple as a monthly movie and take out night can help ease some of the sadness that comes from losing summer.

There are many benefits of summer to consider at this half-way mark of the season. Here’s to supporting your mental health all year long, however!

Resources:

Strengthening Mental Health in Summer

https://www.child-focus.org/news/how-summer-can-affect-our-mental-health

Five Self-Care Tips to Maintain Mental Health During the Summer

https://www.flexpsychology.ca/think-flexibly-blog/sunlight-and-serotonin-the-mental-health-benefits-of-summer

15 Activities for Your Summer Self-Care Checklist

Mental Health Benefits of Summer

Supporting your child’s mental health during the summer

July 26, 2024August 8, 2024

Disability Pride Month: A Primer

July 1st marked the beginning of Disability Pride Month. This commemorates the passing of the Americans with Disabilities Act (ADA) on July 26th, 1990. So what is Disability Pride and why is it important? Even in today’s society, it’s hard to imagine why anyone would be proud to be considered as having a disability. However, that’s exactly why Disability Pride Month exists and why Disability Pride is so important.

Disability Pride comes from the Disability Rights movement. On March 12, 1990, there was a protest of over 1000 individuals who marched from the White House to the Capitol Building. Once there, about 80 wheelchair users crawled up the steps of the building to showcase how inaccessible many public buildings were to those who have limited mobility or use mobility aids. That July, President George Bush signed the ADA into law in order to protect the rights of those with disabilities and ensure that public spaces would be accessible to as many people as possible.

The Disability Rights Movement

The Disability Rights movement has fueled a lot of these pushes for change and advancement for accessibility. The argument is that disability is not something shameful that should be hidden away from society. It should be accommodated in all spaces. Those with disabilities deserve the chance to live their lives in the same way as ablebodied individuals.

Disability rights pushes for the adoption of the social model of disability versus the medical model. According to the medical model of disability, disabilities are caused by faulty biology and should be fixed or cured in some way. However, the social model argues that disability is caused by three main barriers. These barriers are institutional (laws), environment (non-accessible spaces), and attitudinal (beliefs about disability which contribute to the other two). These barriers can only be dismantled through societal change, which is fueled by education and awareness. Physical differences do not need to be cured but need to be accommodated.

This movement argues that individuals should be given as many tools as possible to live as independently as they can. This includes having equal access to education and employment, which includes fair pay. For example, in the US, it is legal to pay those with intellectual disabilities less than minimum wage, which impacts their ability to be financially independent. Another example of lack of rights for those with disabilities is that many individuals who are on disability benefits cannot get married.

Because of the strict rules surrounding how much money these individuals are allowed to have, marrying a partner (even if that partner is also on benefits) disqualifies them from receiving benefits any longer, even if their partner does not make enough money to support two or more people. This also means they are limited in how many assets they can have, including savings. How can people with disabilities be considered to have equal rights or access if they do not have the ability to marry?

Disability Pride

This all feeds into why Disability Pride is so important. The historical stigma about disability may have lessened, but there is still a large amount of stigma present. This not only fuels societal inequalities but also impacts how disabled individuals feel about themselves and how much they may or may not advocate for their needs and rights as a result. Of course, being disabled is not the end all be all of a person’s identity, but it does influence how someone navigates the world. More importantly, it influences how the world interacts with disabled people.

Disability pride serves to educate people on how society causes disability for many people and what we can do to make changes and encourages a push for accommodations and societal changes, like universal design. Universal design encourages spaces and products to be as accessible to as many people as possible regardless of size, (dis)ability, or age. Spaces and products should be able to meet the needs of everyone who intends to use them.

The Disability Pride Flag

Due to the movement of pushing for Disability Pride, Ann Magill (a writer with cerebral palsy) developed the Disability Pride flag. She wanted it to represent the disability community as much as possible. Originally, the colors were bold and bright and the stripes were in a lightning design to describe the barriers disabled people have to navigate around. However, after feedback from the community, she made changes to accommodate those who were having their disabilities triggered by how the flag appeared on screens.

The colors were made to be more muted and the stripes were straightened in order to make the flag more accessible. The original design was reported as triggering migraines, seizures, and being difficult for those with sensory based conditions. The color brightness change also helped those with colorblindness. Some of the stripes were reordered in order to provide more visual contrast between the colors, which also was an accommodation made for color blindness.

So what do the colors mean?

Black/charcoal background: Represents the mourning and rage of the disability community due to mistreatment, abuse, and the violence that results in the ableist discrimination and death of disabled people around the world
The stripes represent cutting through the darkness and isolation and barriers
Green: Sensory disabilities (Deaf/HoH, Blind/Low-Vision, lack of smell/taste, other sensory based disabilities)
Blue: Psychiatric disabilities (Anxiety, Depression, other mental and mood disorders)
White: Invisible disabilities or not yet diagnosed.
Gold: Cognitive and intellectual disabilities, along with other forms of ND
Red: Physical disabilities

Supporting the Disability Community

What can we do to help support the disability community? The biggest thing is to listen! Individuals with disabilities know what they need best and they should be allowed to voice their needs and concerns and have them listened to. Support the movement! Ask how you can help in your local community to push for more accessibility, especially for public events which are often inaccessible even in 2024.

Support someone’s identity. Many people are taught that we should always use person-first language (a person with disabilities) as opposed to identity-first language (disabled person). However, a large amount of the community prefers identity-first language. The belief is that many disabilities cannot be separated from the life experiences of the person. The best way to know for certain is to ask! Ask how someone prefers to have their disability referred to and follow their lead!

Don’t ask invasive questions about their disability but definitely ask about their experiences if they’re open to talking about them. Many people, disabled or not, do not want to discuss the intimate details of their health. Unless knowing information is critical to accessibility accommodations or for safety, there is no need to ask.

Remember that not all disabilities are visible! You cannot tell by looking at someone if they are disabled or not. If someone identifies themselves as having a disability, never respond with “But you don’t look sick”. And especially not with “You don’t look disabled”. Someone’s age, size, or any other physical characteristics cannot always clue you into whether or not they have a disability.

And learn as much as you can. Try to consume media and content made by disabled people.

Hopefully this article has helped give you a head start into understanding the Disability Rights movement and Disability Pride!

Resources

Here’s What the Disability Pride Flag Represents

What is Disability Pride?

https://butyoudontlooksick.com

https://diversity.ldeo.columbia.edu/heritage-months/disability-pride

https://www.pbs.org/articles/disability-pride-month-and-the-disability-rights-movement

https://universaldesign.ie/about-universal-design

https://en.wikipedia.org/wiki/Disability_Pride_Month#

https://en.wikipedia.org/wiki/Disability_rights_movement#

https://en.wikipedia.org/wiki/Social_model_of_disability

July 19, 2024August 8, 2024

When Worrying Takes Over: Generalized Anxiety Disorder

Our next post for Mental Health Awareness Month, which was in May, is going to focus on generalized anxiety disorder, or GAD. On our socials, we covered these topics during May and these blog posts are part of that series, expanding on those topics and giving more information. According to WHO, 4% of the global population experience an anxiety disorder. And NIMH reports that 20% of adults in the US have an anxiety disorder. There are many different kinds of anxiety disorders but GAD is the most common. However, there is concern that GAD is actually underdiagnosed because of societal stigma and lack of education about anxiety disorders. Due to the fact that many symptoms of generalized anxiety disorder feel primarily physical as opposed to purely psychological, many people mistake their symptoms for signs of a physical ailment.

It generally develops in adulthood, around age 30, but it is common across all age groups, including children. It’s diagnosed twice as often in women and people assigned female at birth, though at this time it’s unclear why. Some research suggests that societal factors could play a role in this.

Risk factors for developing generalized anxiety disorder include: experiencing child abuse or trauma, having a chronic illness, living with a lot of stress, and substance use (such as: alcohol, nicotine, caffeine, and recreational drugs). It often co-occurs with other mental health disorders, such as major depressive disorder, or MDD, which we described in a previous post.

Symptoms of Generalized Anxiety Disorder

There are many symptoms of GAD to look out for. If any of these symptoms interfere with your daily life or relationships, it could be time to seek out a diagnosis and treatment. Symptoms must be present for at least 6 months:

Worry excessively about everyday things
Have trouble controlling their worries or feelings of nervousness
Know that they worry much more than they should
Feel restless and have trouble relaxing
Have a hard time concentrating
Startle easily
Have trouble falling asleep or staying asleep
Tire easily or feel tired all the time
Have headaches, muscle aches, stomachaches, or unexplained pains
Have a hard time swallowing
Tremble or twitch
Feel irritable or “on edge”
Sweat a lot, feel lightheaded, or feel out of breath
Have to go to the bathroom frequently
Children and teens are more likely to worry about school performance and the health of loved ones

Treatment

Generalized anxiety disorder is very treatable, even in chronic cases. However, it is important to seek out treatment as soon as possible to ensure the best outcome. There are a variety of treatments including medications, therapy, and some complementary additions someone can use to help their GAD along with other treatments. Medications, such as SSRIs, SNRIs, and buspirone are commonly prescribed to help treat GAD. Benzodiazepines were once a common treatment but are no longer generally recommended due to concerns about dependency and limited long-term effectiveness. CBT and ACT are common forms of therapy used, often in conjunction with medication, to treat GAD.

There are also complementary changes someone can make that can be added to the above treatments. For example, some lifestyle changes like limiting caffeine and nicotine, can help reduce anxiety symptoms. Mindfulness like meditation and journaling are also often recommended. Getting enough sleep, exercise, and joining support groups for those also experiencing anxiety are commonly added as recommendations to traditional treatments.

With proper treatment, many people go on to be able to return to their normal routines and regain functioning and quality of life. The earlier the treatment, the more quickly someone can return to their lives and the more effective treatments are likely to be.

Resources:

https://my.clevelandclinic.org/health/diseases/23940-generalized-anxiety-disorder-gad

https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad#part_6119

https://www.ncbi.nlm.nih.gov/books/NBK441870

https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders

July 12, 2024August 8, 2024

All About MDD: Major Depression Disorder

May was Mental Health Awareness Month and in honor of that, we shared information on our socials during May about various mental health topics. This series of blog posts is an expansion on those social media posts. Our last post was about compassion fatigue and why self-care and mental health is so important as a clinician. This post is about major depression disorder, more commonly just referred to as depression.

MDD is one of the most common mental health disorders in the world and one of the leading causes of disability globally. 3.8% of the global population and 29% of Americans experience depression at least once in their lives. 18% of Americans are currently experiencing depression. This disorder has been most commonly associated in adults in the past but more recently has been acknowledged in children. Depression is also proportionally higher in the LGBTQIA+ population than the general population.

While women and people assigned female at birth are 50% more likely to be treated for depression than men and people assigned male at birth, it’s unclear if this is due to genetic differences (meaning that depression is more common in one group or the other biologically) or societal differences. Men and people assigned male at birth are less likely to seek treatment for mental health disorders, primarily due to societal stigma, which may be skewing data in this area.

There is some data that suggests that depression could be genetic, with people who have at least one biological relative with depression being at higher risk than those who don’t. Those who have experienced trauma or stress as children are also more likely to develop depression as adults. Substance use (alcohol, drugs) has also been linked to higher rates of depression. Some physical illnesses, such as diabetes, are also associated with higher risk for developing depression.

Symptoms of Depression

In order to be diagnosed with depression, an individual must have five or more of the following symptoms:

Sadness, hopelessness, emptiness
Fatigue
Feeling restless or lethargic
Sleep issues (sleeping too much or too little)
Appetite changes which can contribute to weight gain or loss
Anxiety or irritability
Difficulty concentrating
Feeling guilty, ashamed, or like a burden
Social isolation
Lack of pleasure in doing things (anhedonia)
Thoughts of dying or attempting suicide

Some people may only have five of the symptoms while others could have many more. The important part is that these symptoms must be present most days for at least two weeks for the person to qualify for a depression diagnosis. Other possibilities must also be ruled out, such as vitamin deficiencies or a physical illness.

Most people go to their primary physician first at the onset of symptoms, especially for sleep disturbances and fatigue. This could be because of lack of education about mental health disorders such as depression or because of the stigma that is attached to depression. Physicians can help but usually their understanding of psychiatric treatments are limited in comparison to psychiatrists.

The majority of people experience major depression disorder once with many experiencing recurring episodes of depression. The more episodes of major depression disorder someone experiences, the more likely it is that the depression will be more chronic in nature. With proper treatment, most people start to feel better within a few weeks to three months. For most, MDD can go into remission in about 6 to 9 months. Without treatment, however, symptoms can last months or years and could be more severe than for those who are getting medication and/or therapy for their depression. This is one of the many reasons early diagnosis and treatment are so important. It can help avoid someone’s life being so impacted by depression that they become disabled or attempt (/complete) suicide.

An important thing to note is that depression and grief are not the same thing. Grief, which can come with sadness, is a natural response to loss. However, they can co-occur, which can prolong symptoms of grief and make them more severe. Accurate diagnosis is crucial in this area in order to make sure someone gets the proper treatment most likely to help them.

Treatment Options for Major Depression Disorder

Major depression disorder is very treatable in most people and there are a variety of of treatment approaches that are available:

Treatments include a variety of medications that can be tried (SSRIs, SNRIs, TCAs, MAOIs, etc)
Various forms of talk therapy are also available for treating MDD (CBT, family therapy, interpersonal therapy, etc)
For treatment resistant depression, brain stimulation therapies exist that can help severe MDD (ECT, rTMS, VNS)
Esketamine is a newer, FDA approved treatment for MDD that has not responded to other forms of treatment.
A combination approach is usually the most effective way of treating MDD (therapy plus medication, for example)

When trying medications it is important to remember that it can take at least 6-8 weeks to feel the full benefits of a medication. If side effects are intolerable, discuss with your doctor before discontinuing treatment.

Along with these traditional treatments, a variety of self-care activities can be done in conjunction (not instead of) to help alleviate symptoms more quickly or avoid a recurrence of a depressive episode:

Regular exercise
Eating nutritious and balanced meals
Mindfulness, such as journaling or meditation
Spending more time in nature
Remaining connected with your social circle and confiding in trusted people
Setting realistic goals
Break down tasks into smaller steps
Avoid using substances such as alcohol and drugs not prescribed to you

Self-care is incredibly important when treating depression, especially in those who have recurrent depressive episodes. While it can be difficult to get into a self-care routine while depressed, it can be crucial to helping shorten the depressive episode. It’s especially important for staving off future episodes.

Ending mental health stigma is an important step in ensuring that people are more likely to seek help for their depression sooner rather than later, which can help with achieving the ideal prognoses. The more we discuss mental health and educate others about it, the more likely people are to seek help in a timely manner and get back to being able to live their lives more fully again.

Resources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/major-depression

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Depression

https://www.ncbi.nlm.nih.gov/books/NBK559078

https://www.nimh.nih.gov/health/topics/depression

https://www.psychiatry.org/patients-families/depression/what-is-depression

https://www.samhsa.gov/mental-health/depression

https://www.who.int/news-room/fact-sheets/detail/depression

July 5, 2024July 5, 2024

The Importance of Clinician Mental Health

An image with a teal background and white text. The text reads "Clinician Mental Health". There is a flower wreath and inside of it is a calandar, watch, and the sillhouette of a human head with a lightbulb growing out of it.

The topic of clinician mental health came to us when May was Mental Health Awareness Month and we shared information on our socials about various mental health topics. This is an expansion on those posts to give more information about things of note related to mental health.

Mental Health Awareness Month is usually focused on raising awareness of different mental health disorders, the type of help available, and trying to reduce the stigma attached to mental health disorders. While this is partially aimed at educating the general public it can also be a way of encouraging people to seek out the mental health care they need.

One important group we often fail to mention in these conversations is that of the helping professionals, or mental health practitioners. Those who work in the mental health field need to be just as aware of their mental health and needs as anyone else. This allows us to do our jobs for longer and do them better. It also lets us get the most out of our profession and everyday lives. Not taking care of our mental health can lead to things like burnout and compassion fatigue. Focusing on clinician mental health can help avoid both of these concerns.

Compassion Fatigue

Burnout and compassion fatigue can look very similar. Burnout usually comes from overwork and low job satisfaction while compassion fatigue is more associated with vicarious or secondary trauma. Compassion fatigue usually comes on suddenly while burnout occurs slowly over time. When thinking about the differences in their symptoms, burnout usually involves resentment towards the job or coworkers, and can feel like wanting or needing a new job or a different job. Compassion fatigue involves self-contempt, as opposed to contempt of others and it can feel like you’re not working hard enough or doing enough to help others. It can also leave you feeling like the therapeutic relationship is uneven, with you giving much more to your work and clients than you receive in job satisfaction.

Despite these differences, they do have some overlap of symptoms. Both involve feelings of job satisfaction, bringing “work home” (an inability to stop thinking about work during off-hours), mental and physical exhaustion, headaches, trouble sleeping, poor eating habits, depression, and anxiety.

Certain clinicians are more likely to develop compassion fatigue. If you work with victims of trauma often, if your caseload is made up primarily of severely depressed clients, or if you work heavily with grief and bereavement, you’re at higher risk of developing compassion fatigue.

The first step to avoiding burnout or compassion fatigue is to be aware of how you’re feeling. Being able to notice changes in how you approach work or others can be one of the early signs that you may need to take extra care of yourself or change how you approach your professional life. If you, or others around you, notice any of those symptoms becoming a problem for you, then it’s time to step back and evaluate your work load and your self-care routine. These are important aspects of promoting clinician mental health.

Self-Care

We all know that self-care is important for many of our clients. However, it’s just as important for those who work in the mental health field. This is critically important when it comes to being able to not just do our jobs, but to do them well.

There are a lot of different things you can do to take care of yourself both before and after developing compassion fatigue or burnout:

Consider getting therapy if this is heavily impacting your day to day; we all know how important therapy is for our clients and it can be just as important for us, too. This is especially true if you find yourself “bringing work home with you” a lot.
Take regular days off and vacations, if possible, in order to relax and decompress from your work. While work will still be there when you get back, this can be a good way to reset yourself and give yourself more mental resources in order to tackle your caseload efficiently.
Consider a smaller case load, if needed, or changing the types of clients you see. Sometimes it really is that we’ve reached a point where our caseload is hurting us more than we’re helping others.
Try bringing mindfulness into your every day, such as meditation or journaling. This can also be a great way to catch the signs of compassion fatigue before it starts to impact you.
Exercising regularly and making sure to eat a nutritious diet can also help as it’s easier to tackle the day when you’re taking care of yourself physically, too
Make sure to get enough sleep regularly.
Make time for things that bring you joy.
Spend some more time in nature.
Make sure to stay connected to your support system – compassion fatigue can sometimes make us want to isolate and this can make things worse.
Engage in hobbies you love or find a new one – games, books, movies, gardening, anything that brings you a sense of peace or you’ve been curious about trying.
Practice gratitude, both for the things around you and for yourself and what you bring to the world.

Prioritizing self-care can be hard, especially for the types of people who are so drawn to helping in the first place. It can be easy to feel guilty or compare ourselves to others, even more so if we have clients who are unable to engage in self-care themselves. It’s deeply important that we practice self-care, however, because this is how we can better take care of ourselves. And others, too. You need to take care of yourself before you can fully take care of others. Like we’re always told on planes, you need to put your oxygen mask on first before helping someone else put on theirs. It’s not selfish, it just ensures that we’re best able to provide that help to someone else.

Mental health care is incredibly important, not just for our clients, but for us, too. It’s especially important because we are tasked with listening to the worries of others. If we cannot keep ourselves healthy, it becomes much more difficult to do this day in and day out. Clinician mental health is something we should make sure we make time for and focus on.

Curious if you’re at risk for compassion fatigue? Take the Professional Quality of Life test developed to measure compassion fatigue AND compassion satisfaction.

Resources:

https://compassionfatigue.org/index.html

https://www.goodtherapy.org/blog/the-cost-of-caring-10-ways-to-prevent-compassion-fatigue-0209167

https://positivepsychology.com/self-care-therapists

https://www.samhsa.gov/blog/mental-health-awareness-month-time-self-care

June 28, 2024July 5, 2024

Men’s Mental Health

By: Kerry Moran

June is Men’s Mental Health Awareness Month and we decided to bring you a blog post about this. Here we detail some of the statistics, potential reasoning behind those statistics, and what can be done to help. Men’s mental health is an important topic in the mental health world and yet is severely misunderstood.

Many people in the United States are diagnosed with a mental illness every year. However, women are diagnosed almost twice as often as men with depression and other mental health disorders. It can be easy to look at that and think that women are just more prone to mental illness. Despite that, men make up almost 80% of all suicides each year, making them 4x as likely to complete suicide. Why is that, if they’re not being diagnosed at a higher rate than women?

There are many things to consider when it comes to this statistic. At least 1 in 10 men experience depression, but less than half seek treatment. This means that while women have higher rates of diagnosis, there are many men going undiagnosed every year. Men also make up 10% of bulimia and anorexia diagnoses and 35% of binge eating diagnoses each year. However, we also know that men are less likely to seek care, which means these figures could be higher.

A blue image with gold text that reads "Why do men fall through the cracks?" There is a silhouette of a man along with gold and blue details.

Why Does Men’s Mental Health Fall Through the Cracks?

So why do men so often fall through the cracks? Societal stigma against mental illness cannot be ignored. It’s what keeps so many people, regardless of gender, from seeking mental health care. Until this is something we eliminate as a society, there will always be people who go untreated for mental illness. We also have very strict societal ideas about what men should be and how they should act. This includes being non-emotional, that anger is an acceptable solution to many problems, that heavy drinking is normal. And, of course, that men shouldn’t cry. These factors not only contribute to why men don’t seek mental health care but also actively harm their mental health.

We don’t socialize men to be able to recognize their feelings or discuss them. This means they’re more likely to lack the verbiage to be able to clearly say that they need help. Sometimes, as a society, we can downplay when someone says they’re not feeling well if it doesn’t seem serious. It’s likely that because of the lack of socioemotional education for men that they have a hard time expressing just how seriously unwell they’re feeling. On the outside, it can look like they’re just having a bad day. However, inside, they could be very seriously depressed.

They’re also not socialized to have these types of conversations with each other. Often, we showcase that men should have relationships with other men based on shared hobbies. This makes it difficult to “ruin the fun” and bring up something difficult during what is supposed to be a low-key outing. They’re also not encouraged to ask other people, especially men, about how they’re feeling. This can lead to the false sense that men don’t suffer. Or, that they don’t recognize the suffering of others. Neither of these things are true.

Mental health affects men in many different areas of their lives, which could then contribute to worsening mental health. For example, it can affect their work lives and make their jobs difficult or cause lower productivity or job satisfaction. It can result in problems in romantic or platonic relationships, which can contribute to loneliness in men. It can also affect their families who may experience the brunt of some of the symptoms that many men experience.

There is also the issue that men’s symptoms, especially for depression, most often present as physical. For example, they often report headaches, digestive issues, fatigue, or general aches and pains as opposed to low mood. This means they’re more likely to seek help for what they perceive as a physical ailment from a doctor than reach out to a mental health professional for depression. They also often have a difficult time distinguishing depression from stress, as they present very similarly in men, and often have similar causes (relationship problems, work issues, family dynamics, etc.).

We also see that men are more likely to self-medicate when they’re depressed or anxious. This means they turn to drugs and alcohol more often. Unfortunately, it is considered societally normal for men to use alcohol to deal with stress or difficulties, which can encourage this behavior but also means that depression is going unnoticed. We see it as a man just trying to unwind from a hard day as opposed to a man experiencing depression. Even worse, these methods of self-medicating often make the problem worse, causing a vicious cycle.

Not only this, but physicians and mental health care providers are also less likely to realize the severity of symptoms in men. This is partially due to how gender differences play into presentation of symptoms but also due to inherent bias that all of us carry with us in our everyday lives. There is an unspoken understanding that men just don’t experience depression as often and so when they seek help, they are more likely to be dismissed as the problem being less severe than it actually is. Often, men are blamed for their own symptoms by society, with a focus being on their attitudes about mental health and masculinity (which are all influenced by the cultures in which they live).

We do not focus on addressing these societal issues and instead focus on how those experiencing mental illness should do better. Especially paired with how their symptoms are often different, these men who do seek care often do not get the level of care they need. In fact, almost half of all men who died by suicide sought mental health care in the year before completing suicide. Clearly, there is something missing in how health care professionals, including mental health professionals, are being trained in this particular area.

Barriers for Men of Color

Men of color have even more barriers to mental health care than their white counterparts. Indigenous men have the highest rates of suicide of all demographics and are more likely to report feelings of hopelessness, for example. Racism and racial trauma adds an extra stressor to the lives of men of color that contributes to poor mental health. Racial biases still exist in the health field, which could also contribute to a reluctance on the part of men of color to reach out for help from a predominantly white pool of health professionals.

Not only that, but historically, white medical professionals have used Black individuals for experimentation, often against their will and without their knowledge, harming their health permanently or killing them. This has contributed to lack of trust in the medical field. We also have to consider the impact that lack of resources have on men of color’s ability to even seek care. Many men of color live in areas with low density of mental health practitioners, heavily limiting their access. Many also cannot afford mental health care, which further causes impediments in seeking help for mental illness.

How does depression often present in men? We associate depression with low mood and excessive sleeping or eating, feelings of hopelessness, or other things that we associate with people being “sad”. However, we have seen that men often exhibit other symptoms when depressed:

Escapist behavior: spending more time at work, spending more time on hobbies such as sports.
Physical symptoms: muscle aches or pain, fatigue, headaches, nausea and other GI complaints.
Self-medicating by heavy use of alcohol or drugs.
Abusive behavior such as violence, controlling behavior, or emotional manipulation.
Anger, irritability, or aggressiveness that seems to not line up with expectations for the situation.
Risky behavior: use of illicit drugs, reckless driving (such as speeding), many sexual encounters.
Noticeable changes in mood or appetite.
Difficulty concentrating.
Feeling restless or on edge and an inability to relax.

So what can we do? One of the things we have to work on as a society is how we approach mental health stigma. While many strides have been made in this area, not enough has been done to address the stigma specifically aimed at men. We also have to, as a society, work to address how we see masculinity and the way we expect men to behave.

Our current gender roles are actively contributing to men’s poor mental health and their deaths. While these are big tasks, smaller tasks we can do is work on how health professionals are trained. We need to make them more able to recognize symptoms of depression in men. And to be able to meet men where they are to work with them towards better mental health. We need more access to mental health care, especially for men of color. We also need to encourage people to check in on their male friends and be prepared to have difficult conversations.

There are two organizations that are working on addressing men’s mental health and how people can have these conversations with men in their lives. They are Man Therapy and Movember. Man Therapy approaches men’s mental health with humor in the hopes of destigmatizing access and encouraging men to reach out for help. They also offer resources to help men recognize their symptoms and to recognize if a friend could be struggling. Movember also works towards this and has resources to help men talk to other men about mental help, including ALEC and R U Okay? Movember is working on releasing an online education program called Men in Mind . This is for mental health professionals to help them be better equipped to help male clients.

Men’s mental health is something we need to talk more about. And we need to work towards the end of stigmatization and approaching men with a focus on their unique needs. Men are dying at incredible rates from preventable mental health consequences. There is more we could be doing as a society and mental health professionals to address this.

Resources:

https://www.aamc.org/news/men-and-mental-health-what-are-we-missing

https://adaa.org/find-help/by-demographics/mens-mental-health

https://online.hpu.edu/blog/the-importance-of-mens-mental-health-awareness

https://www.medicalnewstoday.com/articles/mens-mental-health-man-up-is-not-the-answer

https://mhanational.org/infographic-mental-health-men

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444121

June 27, 2024July 8, 2024

The Importance of LGBTQIA+ Affirming Care

With June being Pride Month, there are many things to celebrate. However, it is also important to consider the importance of LGBTQIA+ affirming care, not only in our actual work but also in how we interact with people daily. Our previous post was a quick primer on identities and terms common in the LGBTQIA+ community. This post felt like a natural progression from the previous one.

While there are many good things about being part of a community as rich and diverse as the LGBTQIA+ community, we also cannot ignore the statistics that are available that show the impact of prejudice, bias, and bigotry on the lives of many people. This is why affirming care for these individuals is so important. It is important to remember that there is no inherent link between being LGBTQIA+ and having a mental illness but that it is the way that the world treats individuals in this community that contributes to mental illness. This is where the importance of LGBTQIA+ affirming care comes in.

Statistics

According to a 2022 survey by SAMHSA (Substance Abuse and Mental Health Services Association), LGBTQIA+ adults are more likely to use substances, experience mental health disorders, and experience serious thoughts of suicide.

The Trevor Project Shows us Why LGBTQIA+ Affirming Care is Needed

The Trevor Project also releases a survey every year that asks thousands of LGBTQIA+ youth about their experiences. It covers many topics, including experiences with mental health, abuse and bias, and what their home and school (or work) lives are like. Their most recent 2023 survey is an incredibly detailed look into what it is like to experience the world in the United States as an LGBTQIA+ youth. According to the Trevor Project:

41% of LGBTQ young people seriously considered attempting suicide in the past year.
56% of LGBTQ young people who wanted mental health care in the past year were not able to get it.
At least some of those 56% of LGTBQ young people stated that one of the reasons they could not access care was because of a lack of LGBTQIA+ affirming care providers.
Transgender and nonbinary young people who reported that all of the people they live with respect their pronouns reported lower rates of attempting suicide, however fewer than 40% of LGBTQ young people found their home to be LGBTQ-affirming.
Roughly half of transgender and nonbinary young people found their school to be gender-affirming, and those who did reported lower rates of attempting suicide, however a majority of LGBTQ young people reported being verbally harassed at school because people thought they were LGBTQ.
Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation.
Nearly 2 in 3 LGBTQ young people said that hearing about potential state or local laws banning people from discussing LGBTQ people at school made their mental health a lot worse.

NAMI

NAMI (the National Alliance on Mental Illness) gives some insight to some of these statistics. According to them there are a variety of reasons that individuals in this community are more likely to experience mental illness. These include:

Coming out – This is an experience that can be either positive or negative for people. If coming out was voluntary, it is more likely to be positive, however it can still come with some negative ramifications depending on how those around them react. If someone is outed (having their identity told to others without their consent), it can often be a negative and traumatizing experience.
Rejection – Many LGBTQIA+ plus, especially youth and young adults, experience rejection from loved ones upon coming out (or being outed). They can also be rejected by peers and are more likely to experience bias and prejudice at work or in school.
Trauma – Unfortunately, due to the way many in our society still treat those who are LGBTQIA+, many individuals end up experiencing trauma throughout their lives, especially as adolescents.

Extra Risks for LGBTQIA+ Individuals

They also discuss some risks that LGBTQIA+ individuals are more likely to experience as a result of their identities, such as:

Homelessness – LGBTQIA+ youth have an estimated 120% higher risk of experiencing homelessness in comparison to their non-LGBTQIA+ peers. This is especially high for Black and Indigenous youth.
Suicide – As we saw from the Trevor Project’s survey, 41% of LGBTQIA+ youth have had serious thoughts of suicide. Suicide completion is also high in this group as a result of their experiences.
Inadequate mental health care – the Trevor Project noted that 56% of LGBTQIA+ youth who wanted mental health care could not access it due to a variety of factors. However, it is also important to note that not all mental health practitioners are informed in this type of work and may accidentally contribute to some of the distress their clients may face or end up providing substandard care (either due to ignorance or to their own biases).

While many of the statistics available focus on youth, we have to remember that adults, especially older adults, also face difficulties. According to SAGE, 53% of older adults who identify as LGBTQIA+ experience loneliness and they are twice as likely to live alone in comparison to non-LGBTQIA+ peers. We know that loneliness can contribute to mental illness, especially depression.

What We Can Do

These statistics are distressing, but what can we do about them? As people, just showing kindness and understanding can go a long way to changing someone’s day or even life. When we keep in mind our language and how we talk about different groups of people, we take into consideration the impact we have on other people every day. But what about as clinicians?

Don’t assume someone’s gender or sexual orientation. If you’re able to have your own intake forms, look into making sure they are as inclusive as possible. If you work for a group practice that has the same forms for everyone, advocate for the LGBTQOA+ community by approaching whoever is in charge of the forms and suggesting more inclusive language and changes to them. It can be the best way to set up a safe environment almost immediately before a client even meets with you. Also remember to include a third gender option of your forms, if you ask for a client’s gender.

Provide a space for them that makes them feel safe. There are many ways you can do this both during intake and going forward. It’s not appropriate to ask about medical transitioning unless the individual brings it up first as medical transition can be an especially sensitive topic for many people. You wouldn’t ask a cisgender person details about their genitals and you shouldn’t ask a transgender individual about this, either.

Make sure to use their pronouns; a good way to know them is to have this included on your intake form or to make a point of asking every client during the first appointment what their pronouns are. It’s important to ask all clients because there is no way to know just by looking at someone what their gender or pronouns are.

Don’t use their deadname if it is still their legal name; giving an option for a chosen name on your intake form alongside the legal name can help you know how best to refer to your clients.

Learn how they want to refer to their partners. Understand the most up to date terms to avoid using outdated, now offensive words to describe identities.

Be prepared with resources that are tailored for LGBTQIA+ individuals. For example:

There are many more than these, however! Look for ones local to you, as well, as sometimes having local communities can be more helpful than online ones.

The way we come prepared to handle the needs of clients who may be different than us can make a world of difference for how much they’re able to get out of the care they come to us for. Focusing on LGBTQIA+ affirming care can make a world of difference for individuals in this community and can greatly improve their quality of life.

Resources:

https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQ

https://www.sageusa.org/news-posts/startling-mental-health-statistics-among-lgbtq-are-a-wake-up-call

https://www.samhsa.gov/newsroom/press-announcements/20230613/samhsa-releases-new-data-lesbian-gay-bisexual-behavioral-health

https://www.thetrevorproject.org/survey-2023

June 21, 2024July 8, 2024

A Primer in LGBTQIA Identities and Terms

With it being June, and thus Pride Month, we decided to follow up on our previous post about the history of Pride Month with a post serving as a quick primer to some LGBTQIA+ identities and common terms to be familiar with. This is by no means a comprehensive list! Those who want to learn more should check out the resources we’ve listed at the bottom of this blog post. There are a lot more terms explained throughout those websites which could serve to be even more helpful.

It’s important to be able to understand some of the more basic aspects of the LGBTQIA+ community as it can help when trying to work with clients in that community or even to help support or understand loved ones in your life. Everyday we come into contact with those who are part of this community, whether we know it or not, and the way we speak about these concepts and terms can make a huge impact on others. The more understanding we have, even if just basic, is critical in providing the care and support people need.

One important thing that must be understood before getting into the terms in general is that sex, gender, and sexuality are all very different and separate from each other. While many people use these terms interchangeably, especially sex and gender, they should be understood as completely different concepts that all play a role in how we interact with the world and how the world interacts with us.

Sexual orientation specifically refers to an individual’s sexual desire towards another person (or lack thereof). Sex is based on characteristics assigned by the medical community and society, usually based on genitals, to categorize individuals into primarily binary categories. Also known as the sex assigned at birth. Gender, on the other hand, is a social construction that categorizes individuals into male, female, or a third category. Socially considered to be based on external appearances or qualities (hair length, clothing choice, voice and mannerisms, etc), though there is no true defined set of characteristics that belong to any one gender or gender expression.

There are many common acronyms that are used to describe the LGBTQIA+ community and the acronyms have gotten progressively more and more inclusive over time. LGBT was the most common acronym, first coming into conversation about sex, sexuality, and gender in the 90s. However, since then, as the spectrum of gender and sexuality are being better understood and more discussed, we have added onto that acronym to reflect that. It is important to understand that no one acronym can ever fully represent the full scope of identities for this group, which is why we often see a “+” at the end. The acronyms LGBTQQIAA, 2SLGBTQQIAA, and SOGIE also exist, along with many others

Two Spirit, Lesbian, Gay, Bisexual, Trans, Queer, Questioning, Intersex, Asexual, Aromantic are the agreed upon most common understanding of the letters in the longest common form of the acronym (2SLGBTQQIAA). SOGIE stands for Sexual Orientation, Gender Identity and Expression. Some claim the second A stands for Ally, many argue that Allies should not be considered part of the acronym (even though they are important to the community and do good work) and that it stands for Aromantic or that a second A does not need to be included. However, there is no one consensus on this matter and it depends on individual interpretation.

Ally – Someone who does not identify as part of the LGBTQIA+ community but is supportive of the group, often advocating for their rights and providing safe, inclusive areas for various people.
Aromantic – An individual who does not experience romantic attraction and does not need or want romantic relationships. These individuals often find fulfillment in other types of relationships, such as friendships and families, and do not find that anything is missing due to a lack of romantic relationships. May identify as sexual orientation, as well. Sometimes shortened to Aro.
Asexual – An individual who does not experience sexual attraction, or only experiences sexual attraction under very specific circumstances. They may identify any kind of romantic attraction (or lack thereof) along with this identity (such as: gay-romantic, bi-romantic, etc). Often shortened to Ace. This is not the same as celibacy, which refers to an active decision to refrain from sexual activity regardless of sexual attraction.
Bisexual – Someone who is sexually attracted to people of their own gender and people of other genders. Typically in the past, this was understood to mean someone who was attracted only to men and women, but as understanding of gender spectrums have evolved, so has the understanding of this term. While some individuals may have a specific set of genders they are attracted to, others may have many.
Cis(gender) – An individual who identifies with the gender they were assigned at birth that coincides with the social or cultural understanding of the sex assigned at birth (often based on sex characteristics).
Cisnormativity – An oppressive belief and assumption that everyone identifies, or should identify, with the gender or sex they were assigned at birth. Often excludes the considerations and needs of trans people and gender non-conforming individuals.
Deadname – A name an individual no longer uses to identify. This is often a legal name given at birth. Referring to someone by their deadname (deadnaming someone) is often considered rude or hurtful, depending on the intention behind it. It is important to respect someone’s lived or chosen name even if it differs from their legal name as not everyone can afford to legally change their name.
Gay – A man who is attracted to other men. In the past, this was referred to as homosexual or homophile. While some men still refer to themselves this way, more commonly now it is considered a medicalized term that was created to pathologize men who were attracted to men.
Gender affirming (care, surgery) – Health care (both mental and physical) that includes therapy, medications, and surgery to affirm and meet the needs of trans individuals.
Gender dysphoria – Distress felt by a trans individual due to incongruencies in gender identity and physical characteristics or others’ perceptions of them. For example, a transwoman may feel gender dysphoria due to having a deeper voice than she would be comfortable with.
Gender euphoria -The joy a trans individual can feel from gender affirming experiences, such as being able to wear their hair how they like, receiving gender affirming care, or being able to dress how they wish. This is something that many are pushing to be the focus of trans care (such as, how can we promote more gender euphoria in trans individuals) as opposed to gender dysphoria, which only focuses on the struggles of being trans.
Gender non-conforming – An individual who may or may not be trans who presents in a way that does not conform with traditional gender expectations for their gender assigned at birth. Often, this is seen in how someone physically presents but can also be how they define their social role, as well.
Heteronormativity – An oppressive belief or assumption that everyone identifies as heterosexual (or straight). This often ignores the lived realities of many people who do not identify this way and can also put individuals in a difficult position about self-disclosing their sexual or romantic orientation.
Intersex – An individual who is born with “ambiguous” sex characteristics. This can be seen as having genitals or other physical sex characteristics that do not conform with stereotypical expectations of “male” or “female”, could be a combination of chromosomes that do not fit expectations, or hormone levels that do not “match” the idea of what “males” or “females” should have. Individuals can have any combination of these attributes, as well. Often, individuals are assigned a sex or gender based on “best guess” practices as infants, with many going through unnecessary and often harmful surgical procedures to have their bodies conform to societal and medical categories, often for the comfort of the parents or doctors. Intersex individuals were referred to as hermaphrodites in the past, a term that is now considered outdated and harmful.
Lesbian – A woman who identifies as loving or being sexually attracted to other women. In the past, this was referred to as homosexual or homophile.
Misgendering- Referring to someone as being a gender that they do not identify with. Sometimes this is done because we assume gender based on how someone looks (assuming that someone with short hair, no visible breasts, and a deep or ambiguous voice is a man), other times this is done intentionally (such as when someone purposefully refers to someone they know is a transwoman as “sir”). This can be very upsetting for trans individuals and can contribute to dysphoria.
Non-binary – Someone who identifies as neither a woman or a man. This could be someone who identifies as a third gender or no gender. Often uses any number of pronouns (including pronouns that match their sex assigned at birth or don’t, or could be a combination of pronouns).
Pansexual – An individual who identifies as being sexually attracted to many different genders. Some people use this interchangeably with bisexual while others feel it is completely separate.
Queer – An umbrella term for any number of different identities. In the past, this was seen exclusively as an offensive term whereas now with the younger generations the idea has been that they have taken back the term. It is only appropriate to use this term if you identify as LGBTQIA+ and it is not appropriate to use it haphazardly for individuals, as not everyone is okay with this label.
Questioning – A term for someone who is still questioning their sexual orientation or gender identity. This being included in the acronym allows space for those who may still not be sure of where they are in their journey with their identity without forcing them to make a choice they may not identify with later.
Trans(gender) – An individual who does not identify as the sex they were assigned at birth. This is an umbrella term for anyone who fits into this category, though we often see it applied more frequently to transmen and transwomen. A trans person may or may not be out, may or may not have socially transitioned in every aspect of their lives, and may or may not have medically transitioned. There is no one or right way to be trans.
Transition – The process of someone coming to publicly present as their gender. This can be done slowly, by socially transitioning in stages (such as to close loved ones and then to work and then to public in general), or it can be done all at once depending on the individual’s comfort level. It can involve appearance changes (or not), pronoun or name changes (or not), and could involve hormone treatments or surgeries (but does not have to). People transition in their own way and at their own pace.
Two Spirit – A gender identity specific to Indigenous peoples in North America. There are many different ways this can be defined and they are culturally determined by specific Nations and their history. Often, these individuals serve important social roles in their communities.

Resources:

https://www.aecf.org/blog/lgbtq-definitions

https://www.lgbtqiahealtheducation.org/wp-content/uploads/2020/10/Glossary-2020.08.30.pdf

https://lgbtqia.ucdavis.edu/educated/glossary#g

https://whatsonqueerbc.com/woq-bc-stories/what-does-the-acronym-mean

June 14, 2024July 9, 2024

June is Pride Month

It’s officially June and June 1 was the beginning of Pride Month (which is different from LGBTQIA+ history month)! Pride Month is a celebration during June worldwide for the LGBTQIA+ community. More specifically, June 28th is the anniversary of the Stonewall Inn riots. This sparked a change in how the queer community advocated for their rights and why we celebrate Pride month today. While many Pride events focus on the celebration, it is important to remember that Pride has a rich history of political activism. The riots at the Stonewall Inn are the most famous and were monumental for the queer community they were not the beginning of queer activism in the US, which has a history going back to at least 1926.

protesters holding signs at Stonewall Riot supporting LGBTQIA+

Pride Month: Before and After Stonewall

1926 was when the Society for Human Rights was founded by Henry Gerber. He was an US army soldier who had been inspired by the queer community and organizations advocating for their rights in Germany. He wanted to bring something like that to the US and push for rights and advocacy here. Its focus was on bringing awareness to the needs of the LGBTQIA+ community.

In the 1950s, the Mattachine Society was founded with the aim of advocating for gay rights and for the repealing of anti-gay laws. There was concern that they were demanding too much and not gaining enough so they changed tactics. They appealed to the community to adapt as much as possible to mainstream society and ideals. The hope was that they would appeal to the heterosexual community and be more accepted. The message they wanted to send to the heterosexual population was that they were “normal” and “just like them”.

Also in the 1950s, the Daughters of Bilitis were founded. This was an organization similar to the Mattachine Society but was aimed at the lesbian community. At first, they were primarily concerned with having safe places where lesbians could meet and spend time together. Over time, they also started working towards supporting married lesbians and mothers and giving educational talks to the heterosexual community. They worked to spread awareness and understanding of lesbian causes and concerns and became more focused on lesbian feminism and politics as time went on. This organization no longer exists, however.

In 1966, in San Francisco, there was a riot in a restaurant called the Compton Cafeteria. When a police officer attempted to arrest a drag queen (as it was illegal at the time to wear gender non-conforming clothing), she fought back and this sparked the other queer patrons in the restaurant to fight back against the police, as well. Much like the Mattachine Society, this organization no longer exists.

We also have organizations that started in the wake of the Stonewall Inn riots. In the 1970s, the Sisters of Perpetual Indulgence were founded. This organization started with drag queens who used nun’s habits in their performances. Eventually, it evolved into a drag organization that brings attention to queer issues while wearing drag versions of nun’s clothing. They bring awareness to issues such as discrimination and oppression of queer people, especially when linked to religious hypocrisy. They also focus on safe sex education and about the dangers of drug use. The group also raises money for AIDs organizations and other important causes within the LGBTQIA+ community.

Also in the 1970s we saw the beginning of STAR (Street Transvestite Action Revolutionaries). It was founded by Marsha P. Johnson and Sylvia Rivera, two people who are famous in the queer community today, who took part in the Stonewall Inn riots. While the organization only lasted 3 years, it was organized to provide housing and support to homeless queer youth. It made a huge difference in the lives of many homeless LGBTQIA+ youth in New York City for the brief time it was running.

LGBTQIA+ advocates in Stonewall Inn Riots

The Stonewall Inn Riots

It is important to remember that the Stonewall Inn riots are rightly famous. They marked a significant turning point in how queer advocacy organizations approached queer causes and the many needs of the LGBTQIA+ community and other overlapping causes.

In the 1960’s there were still laws that targeted the LGBTQIA+ community, especially gay men and gender non-conforming individuals. These laws affected many different areas of people’s lives. One law was that it was illegal to serve alcohol to those who were part of the queer community. This meant that many bars and clubs were not an option for most people. There were few places to meet other LGBTQIA+ individuals that were safe.

While there were bars and clubs that specifically catered to gay men and lesbians and allowed gender non-conforming folks to attend, as well, depending on the venue, these establishments were often owned by the Mafia. Police would do frequent raids on known or suspected gay bars and arrest anyone who didn’t have ID or were wearing clothing that didn’t align with their gender assigned at birth. These bars being owned by the Mafia did often provide some protection as they often paid police off to reduce the frequency of raids or for tips when a raid was incoming.

The Stonewall Inn was a well-known bar run by a Mafia family that catered exclusively to the queer community. On June 28th, 1969, there was an unexpected police raid on the Stonewall Inn that the Mafia had not been tipped off about. During this raid, the police were being overly forceful and were seen to hit patrons with their clubs. A crowd had begun to accumulate around the bar made up of patrons, neighborhood residents, and customers from nearby clubs and bars.

As a woman was being forced into a police vehicle for arrest, she called out to the crowd asking why they weren’t doing anything to help (most say Stormé DeLarverie was the woman in question). This pushed the crowd into action who started throwing things at police and fighting back, rioting against the unfair treatment they had been forced to endure for years. The rioting continued for five more nights in the neighborhood as the queer community demanded equal rights and the ability to live authentically as themselves.

On June 28th, 1970, on the one year anniversary of the Stonewall Riots, the first Pride parade was held to commemorate the ongoing struggle for equal rights for queer folk. However, many of these early Pride events and the organizations that came up after Stonewall did not include people of color or transpeople in their organizing, despite the pivotal role they had played in much of the fight for equal rights.

LGBTQ+ equal rights advocating for pride today and tomorrow

Pride Month Today and Tomorrow

Today, Pride is celebrated all throughout the month of June and is celebrated globally. All over the world, one can find a Pride event to attend during June to celebrate the queer community. There are concerns for many in the queer community about the large sponsorship and presence of corporations during these events. They are concerned with the commodification of Pride. This could be taking attention away from not only the political roots of Pride. And also from the continuing work that still needs to be done advocating for the LGBTQIA+ community. There is also concern about the heavy police presence at many of the larger Pride events. Because of continued oppression and marginalization of queer individuals, especially individuals of color, this has been questioned.

Celebrating and acknowledging the strides made for equality is important and very much needed. But there is also still a lot of work to be done. The queer community is rich with political activism and celebration. Stonewall may not have been the first instance of LGBTQIA+ resistance and activism. But it was the first to be covered globally and sparked an international movement for LGBTQIA+ rights and equality.

Resources:

https://www.britannica.com/story/why-is-pride-month-celebrated-in-june

https://www.history.com/topics/gay-rights/pride-month

https://www.loc.gov/lgbt-pride-month/about

https://www.them.us/story/the-complete-history-of-pride

https://www.them.us/story/queer-elders-stonewall-riots-50

https://www.them.us/story/queer-history-beyond-stonewall

https://en.wikipedia.org/wiki/Pride_Month

https://en.wikipedia.org/wiki/Stonewall_riots

April 8, 2024July 9, 2024

Bipolar Disorder Overview

According to the World Health Organization (WHO), 1 in 8 people in the world currently live with a mental health disorder. This equals out to 970 million people. As of 2019, of those 970 million people in the world, 40 million had bipolar disorder.

Bipolar disorder is a mental health disorder characterized by extreme highs and lows (it was previously known as manic-depressive disorder). These highs and lows often come in cycles of depression or mania. But they sometimes can be seen as a “mixed state” in which symptoms of both are present. Mania in adults is characterized by high, euphoric moods, increases in energy, decreases in appetite and sleep, and can sometimes also include thoughts of grandeur, delusions, and at the most extreme, hallucinations.

Children are more likely to exhibit irritability and emotional outbursts than these more well-known highs. Hypomania is a less severe form of mania that can affect many people with bipolar disorder. Depression in bipolar individuals can be seen as very low mood, low energy, and feelings of hopelessness. Bipolar disorder has a high rate of suicide completion, with one in every five people with the disorder completing suicide. This highlights the importance of treatment for individuals with this disorder.

The misdiagnosis rate is unfortunately high, which delays proper treatment. Women and female presenting persons are more likely to be misdiagnosed with depression and men and male presenting persons are more likely to be misdiagnosed with schizophrenia. Bipolar affects these groups in equal rates.

Typical onset of this disorder is found in adulthood, however it can occur in adolescence and early childhood. There does seem to be a genetic component to this disorder, as it is more common in individuals who have at least one parent with unipolar depression (major depressive disorder) or bipolar disorder. Individuals with an immediate family member who has bipolar disorder are also more likely to develop it sooner in life.

Bipolar Disorder Types

There are three types of bipolar disorder based on how cycles present. No type is more or less “severe” than the other in terms of the challenges someone may face and the types are not determined by impact on a person’s life but on types of symptoms.

Bipolar I typically presents with manic symptoms that last at least a week. These manic symptoms can also result in the need for emergency care depending on severity. Depression in bipolar I typically lasts at least two weeks.

Bipolar II is characterized by episodes of hypomania and depression. These hypomanic episodes can be less severe than traditional mania and usually do not require emergency medical attention. Depressive cycles tend to be more common with bipolar II.

Cyclothemia, or cyclothemic disorder, is a disorder that involves cycling between hypomania and depressive episodes. These episodes are usually shorter than in bipolar I or II.

Treatment

Typically, we see the use of mood stabilizers and anti-depressants used as the first line treatment for this disorder. Lithium is the most well-known mood stabilizer and was the first one developed as an effective treatment for bipolar. However, many more are now available. SSRI’s and SNRI’s are also commonly used in combination with mood stabilizers. Atypical antipsychotics are often used along with these other medications. According to WHO, 9 in 10 patients are happy with their treatment plan and medications.

Therapy is also part of an effective treatment plan for bipolar. Through therapy, clients are able to learn how to address troubling thoughts, identify potential triggers for cycling and signs a depressive or manic cycle may be coming, and how to change their behaviors. Therapy can also be a way of providing support and education to bipolar clients and their families.

My Story

I was diagnosed with bipolar II when I was 12 years old, though it’s very likely I developed it much earlier. Bipolar is considered a progressive disorder and developing it so early meant it was likely my symptoms would be severe. Progression is associated with more frequent episodes, more difficulty in treatment, more severe episodes, and a higher likelihood of suicide attempt and completion.

Treatment was difficult at first for me. I tried many medications that did not work well for my case. My age was a complicating factor in this, of course, as many medications at the time (2002) were not approved for use in children. I reacted poorly to the medications that were available to me and eventually I stopped treatment.

My adolescence was, understandably, difficult. I often experienced rapid cycling, which is categorized as four or more cycles within a year. My depressive symptoms were very severe, resulting often in difficulty in functioning socially and in school.

According to all odds, it was likely only going to get worse. Many bipolar patients experience disability from their disorder. However, in my early 20’s, I went back to trying medications. It took a few years to find an effective treatment regimen. Some medications had side effects I couldn’t tolerate and others didn’t make a difference in my depressive symptoms. After some time I was able to find something that worked for me.

Combining an effective medication schedule with therapy allowed me to gain the skills I needed to achieve a normal level of functioning. These skills were recognizing when a cycle may be coming so that I could take steps to try and prevent it from being too severe, learning how to combat the thoughts and feelings that came with depression and could sometimes lengthen my depressive cycles, and learning when to reach out for more help. Learning when a medication had reached its limit to help me and I needed more support in that area was crucial for my treatment success.

Despite the odds stacked against me with my early onset and severity of symptoms, I was able to achieve a level of functioning that has allowed me to thrive as an adult. I was able to continue working and then eventually attended college and am on my way to a graduate program. Bipolar disorder can be a scary diagnosis, but with proper treatment and education on the disorder, it is possible to have a high quality of life and, more importantly, a full life that is characterized by achieving one’s goals, having good friends, and seeing one’s dreams through.