Tuesday, January 28, 2014

Let's talk about ... mental health and hockey

As hockey fans, players, and supporters, we always feel like we're part of a big family.

But when it comes to mental illnesses, it can feel like you're battling things all alone.

If you're on Twitter or social media, you might have noticed the tag "#BellLetsTalk" and wondered what it is. It's a day to raise awareness via social media to start conversations about mental health. But Bell's effort is not just limited to today, it's every day - a "multi-year charitable program dedicated to mental health", focusing on four pillars: anti-stigma; care & awareness; workplace health; and research.

Four mental-health tragedies rocked the hockey community in 2011. Tom Cavanagh had been diagnosed with schizophrenia; he jumped to his death off a parking garage in January. In May, Derek Boogaard was found dead from an accidental drug and alcohol overdose; his autopsy revealed he suffered from chronic traumatic encephalopathy. Rick Rypien and Wade Belak, both of whom had been struggling with depression issues for a few years, both committed suicide in late August of that year. Sixteen hockey players, both male and female, across various levels of the sport, from collegiate to NHL, have killed themselves since the late 1960s.

Mental health issues are very common, and they are not limited to just depression. It's very important to remember that as dialogues continue to increase about mental health. In fact, depression can be one sign of a much larger larger mental health issue.

Asperger's syndrome. Autism. Eating disorders. Anxiety disorders. Season affective disorder. Obsessive-compulsive behavior. Eating disorders. Substance abuse. Bipolar disorder. ADHS/ADD. Post-traumatic stress disorders. Social anxiety. Phobias. Tourette's. Stuttering. Separation anxiety. Erectile dysfunction. Insomnia. Sleepwalking. Hoarding. Panic attacks. Parkinson's disease.

What do these all have in common? They're all considered mental disorders. So why are some of them - like erectile dysfunction - so "easy" to discuss (hello, Viagra and other "male enhancement" medication TV commercials!), while many of the others are seen as shameful, not to be discussed?

For as much as we know about the brain, there is so much we don't know, so much we have yet to be discovered. We also don't know how all the chemicals and additives that are so prevalent in our society will influence us long-term, yet we continue to use and consume them.
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I'm not going to put a time frame on when it occurred, but I'll share the following from my retail experiences. One day, we were joking with a customer at check-out about the upcoming holidays. The woman's face suddenly crumpled, and it was clear she was trying extremely hard not to burst into tears in front of us.

In talking with the woman, I found out it was approaching the one-year anniversary of her daughter's death by suicide. Nobody should have to bury their kids first, and like any death, the first anniversary was the toughest, and she was suffering more because nobody was acknowledging it.

She just wanted to be able to talk to somebody, anybody, about her beautiful, smart daughter that she had lost; and nobody wanted to talk about it, because the idea of depression and suicide seems too shameful. She was further burdened because her other child was also suffering from depression, and she was living with the daily fear that her son might take the same route his sister had.

"Why won't anybody talk with me about her?" she asked, gazing at her daughter's picture on her phone. Her daughter had hid the full extent of her depression, too, until the day she took her own life. And here she was, crying on a stranger's shoulder, the only person willing to listen to her story.

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Depression seems to be one of the toughest mental disorders to talk about, despite how pervasive it is in society. Statistically, it is believed that one out of ten Americans is dealing with depression at any time - and 80% of those suffering from clinical depression receive neither diagnosis nor treatment for it.

If you've never dealt with depression personally, it can be hard to understand. The most common reaction to it is, "Snap out of it!"

If only it could be so easy to simply turn it off.

Somebody with mild depression may not even realize they have it, dismissing the onset of symptoms as just feeling a bit under the weather or excusing it as feeling tired.

Depression is not textbook. Not everybody with depression spends their days moping in dark rooms, although there are certainly plenty of people who do. People with depression can be quite functional, throwing themselves into work and then losing themselves in an activity that keeps them from thinking or feeling too much.

I dealt with it when I first moved to Chicago. I'd heard of seasonal affective disorder (SAD), but I didn't recognize it for what it was. Chicago is bleary and grey for much of the winter, from around Halloween until nearly May; and the days are shorter than I was used to from anyplace else I'd lived.

I was heading to work when it was barely light, and the sun had set nearly an hour before I headed home. Winters made me feel like a vampire, and my solution was to plunge into MMORPG gaming. I'd get up, go to work, come home, log on, get lost in a make-believe world for several hours, go to bed, rinse/repeat. I hardly went out to be sociable unless I could figure out a way to do it on the way home from work; I was cranky, and easily irritated over the stupidest things. I was turning insomniac, and was grinding by on barely five hours' worth of sleep a night. What took me so long to realize I was suffering depression was that I never "felt" depressed; I just simply felt like I was too sapped of energy to do much that required what seemed like a lot of effort.

What broke me out of depression was the scale. One day, I got on the scale, sat down at cried at the number I saw there, realized how much weight I'd gained in a couple years, and figured out pretty quickly that it was related to mindless eating while lost in the blur of work/gaming/sleep.

It was that moment that changed my health - both physical and mental - for the better. I went through my cabinets and threw out anything vaguely "junky". I started eating better; broke - then ended - my soda habit; and I signed up for the gym. I eventually quit the hard-core gaming cold turkey, and felt better for it. It's taken several years of discipline, but 125 pounds lost later, I can't begin to tell you what a different person I feel like now versus ten years ago. Better health, better diet, exercising - these things all help, not just physically, but mentally.

Going to my doctor for help with the depression also led eventually to the discovery of a sleep apnea issue. I was sleeping and exhausted all the time, and at first, I thought it was just depression-related. It finally reached a tipping point when I lacked any focus to function properly, even after sleeping a weekend away. I decided it was time to be re-tested for sleep apnea - and found out that it was a major problem. I had corrective surgery for sleep apnea several years ago, and I cannot even begin to tell you what a difference that it made in my life, being able to sleep properly and begin to feel normal once again.

I was "lucky"; my depression was mild to some other people's depression I've witnessed in my life. I'm thankful I was able to recognize signs within myself and get treatment; and in doing so, made changes in my life that made me a healthier person overall.

A few years ago, somebody I knew through the local theater scene chose to take their own life. Those of us who knew him knew he was prone to mood swings and could be quite "dark" at times, but mostly, he was very, very good about hiding his mood. He was funny and charming, and if he noticed you were in a funk, he would try to find a way to bring a smile to your face. Despite his dark patches and brooding, however, his death still shocked those that knew him.

What was particularly horrible about his death was the very public way he chose to go. Whether he thought about it long in advance, or whether it was just a sudden decision as he stood on the train platform, I guess we won't know; but there's little doubt that the people who witnessed it have to have been traumatized by it.

People will talk about those who suffer from depression or other mental illnesses, but it affects so many more people than just the person who's directly suffering from it.

To start with, there's the most obvious: depression and other mental-health issues cost the U.S. economy nearly $100 billion in lost work days, medical expenditures, lost productivity, and various other costs. That's huge!

Here's the positive part: up to 80% of those treated for depression show an improvement in six weeks or less of beginning medication or other treatment. So, while we may not fully understand what causes or starts depression episodes, it is very responsive to treatment.

The challenge is getting somebody who is suffering from mental disorders to get treatment. Denial often goes hand-in-hand with depression or other mental issues, even when the problem is obvious as a giant neon-green elephant.

Some mental health issues, like autism, can manifest in very visible, hard-to-ignore ways. A friend of mine has a son with autism; she keeps a blog about the ongoing battle that is Life With Autism and their current goal of saving enough money to get a service dog for her son. It is not a pretty journey: is their daily struggle to deal with the unpredictability of autism, the tantrums, mood swings, dealing with the mental health system, and what happens when life throws you a curve ball of epic proportions.

TV's 60 Minutes recently had a pair of stories related to this same issue: Nowhere to go: Mentally ill youth in crisis and its follow-up story, The stigma of raising a mentally ill child.

Mental health issues don't go away if they're ignored. Asking for help is not a sign of weakness; it is a sign of strength, of admitting that you need help.

People who are dealing with them need help, and they need to know somebody cares about them. If somebody is displaying behavior that concerns you, do something about it. You can save a life by speaking up. If you don't know how to deal with it, talk to a hotline or counseling center; they can help you figure out what you need to do.

If you need help yourself, remember there's always somebody out there to listen. Maybe you don't know somebody personally, but there's lots of hotlines, and counseling groups, and sometimes, even just random kind strangers who can lend you an ear, and maybe a shoulder to cry upon, or a much-needed hug.

Some resources:

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