SKAGIT PUBLISHING A supplement to the Skagit Valley Herald and Anacortes American • Sunday, December 20, 2020
DEPRESSION / ANXIETY
LIFE’S BASIC NEEDS
SUICIDE / SELF-HARM
SOMEONE TO TALK TO
Asking for ”Helps” Isn’t a Four-Letter Word! No judgment. No pressure. Just resources for help.
ALCOHOL / DRUG OVER-USE
SkagitHelps.org For You, For a Friend
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Skagit Valley Herald
WHERE TO GET HELP w Call 211 or visit nsbhaso.org to learn about resources in the region including counseling, support groups and digital programs.
w Mental Health Referral Service for Children and Teens, a free Seattle Children’s Hospital program, provides referrals for those 17 and younger. For more information, call 833-303-5437, MondayFriday, 8 a.m.-5 p.m.
w Volunteers of America Western Washington crisis hotline at 1-800-584-3578 or info page at imhurting. org.
w The Brigid Collins Family Support Center Parenting Academy, offers free online seminars and one-on-one coaching sessions using video chat. For more information, visit parenting-academy.org.
w Washington Listens hotline at 1-833-681-0211 9 a.m.-9 p.m. Monday through Friday and 9 a.m.-6 p.m. Saturdays and Sunday, plus resources and tips at walistens.org. w State Department of Health coronavirus and mental health info page: coronavirus.wa.gov/youand-your-family/mentaland-emotional-well-being.
w Weekly webinars from the Washington State University College of Nursing’s Peer Workforce Alliance: peerworkforcealliance.org/ covidwebinarsaccess.
w Northwest Washington Narcotics Anonymous 24hour helpline at 360-6473234 or website for info and digital meetings lists at nwwana.org.
w Guidance from the Centers for Disease Control and Prevention: cdc.gov/ coronavirus/2019-ncov/ daily-life-coping/managingstress-anxiety.html.
w National Alliance on Mental Illness info line at 1-800950-6264, Monday-Friday, 7 a.m. to 3 p.m., or info page at namiskagit.org.
w Alcoholics Anonymous of Skagit Valley hotline at 360-734-1688 or website for info and digital meetings list at district4aa.weebly.com.
w Substance Abuse and Mental Health Services Administration 24-hour Disaster Distress Helpline: 1-800-985-5990.
Sunday, December 20, 2020 - 3
Skagit Valley Herald
focus on skagit county
Law enforcement finds another approach By KERA WANIELISTA @Kera_SVH Throughout Skagit County, officials believe jail may not be the best place for those in the midst of a mental health crises. In September, the Sheriff’s Office launched a program that pairs deputies with professionals from Compass Health in an attempt to peacefully resolve issues stemming from mental health crises so that a trip to jail doesn’t become necessary. “I feel like over the years we (law enforcement) have really failed people with mental and substance abuse issues,” Sheriff’s Office Chief of Field Services Chris Baldwin said. In the past, when deputies responded to a person in crisis, they have given out a phone number and encouraged the person to get connected with services. Less than a third of people would make the call, Compass Health Program Manager Marla Johns said. Recognizing that system wasn’t working, the Sheriff’s Office began partnering in January with Compass Health to find alternatives. Now, a person experienced in mental health care can meet a deputy on the scene and use their training to try to calm the subject and avoid a situation where the deputy may have to use force. “This is a way for us to get the most services to the most people,” said Sheriff’s Office detective Anne Weed, who partnered with Johns to develop the program. Since its launch, the teams have responded to an average of 119 calls a month, Johns said. Originally funded for six months, the program is expanding with an additional two deputies on the team. “We’re not at the end, we’re just at the beginning,” Johns said. The Sheriff’s Office is not the only law enforcement agency in the county taking steps to reach out to those in need. The Mount Vernon Police Department has had an embedded social worker as part of its team since 2017.
photo by edgar sierra
The Skagit County Sheriff’s Office launched a program that pairs deputies with professionals from Compass Health in an attempt to peacefully resolve issues stemming from mental health crises so that a trip to jail doesn’t become necessary.
“(She) most often works with people who are without homes, and many of the people she comes into contact with are in need of resources,” Mount Vernon police Sgt. Brent Thompson said in a column in the Skagit Valley Herald. “This may be the result of a recent job loss or may be related to a mental health illness or a substance use disorder.” The embedded social worker, Erin Von Fempe, has helped many navigate the sometimes complex world of accessing services for housing, mental health, substance abuse and employment, Thompson said. She’s helped many keep out — or get out — of the criminal justice system. “I truly believe she is a difference
maker in Mount Vernon,” Thompson said. This year saw the start of Community Court, an alternative justice program designed to meet the needs of those committing low-level crimes before they commit higher-level ones. “When you don’t address the underlying issues, that leads to recidivism,” said Skagit County District Court Commissioner Jenifer Howson, who adjudicates over Community Court. Through Community Court, those facing charges such as theft, trespassing and possession of drug paraphernalia can get connected to services that can lead to their charges being dismissed and help them get back on the right path.
In order to have their charges dismissed, those participating must follow certain guidelines, including staying out of trouble, completing any necessary drug or mental health evaluations and treatments, and completing community service hours. Community Court operates through Skagit County District Court as well as Anacortes and Mount Vernon municipal courts, with plans to expand into other cities. “Meeting those basic needs and connecting them with services that help the underlying issue is a better way,” Mount Vernon Mayor Jill Boudreau said. “It’s more effective. It does help reduce crime. It does help a human become better.”
You have what it takes to help someone in crisis
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To register online for a QPR course, use a QR code reader app or open your phone's camera and hold it over the image to the left. Or visit http://bit.ly/CommunityQPR
"I think the biggest thing I didn't realize prior to the course was that asking directly if someone is contemplating suicide is the right thing to do. That was huge (thank you!)" - QPR Participant
Upcoming FREE QPR trainings:
QPR teaches you: The warning signs for suicide How to listen and offer support Resources for yourself and others Three steps you can take to help someone in crisis
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For questions, or to schedule a group training, contact Alice.Michaelson@UnitedGeneral.org or call 360-854-7150
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Sunday, December 20, 2020 - 5
Skagit Valley Herald
focus on skagit county
Pandemic has had wide-ranging effects By KIMBERLY CAUVEL @Kimberly_SVH Parents turned into workfrom-home teachers, children kept home from their friends, health care workers donning full-body protective gear, hospitality workers suddenly unemployed, families facing the loss of loved ones. No one has been untouched by the stress of the COVID-19 pandemic. That has made emotions including anxiety, anger, fear, frustration, grief, loneliness and sadness common, from the state’s first Stay Home, Stay Healthy order in March through the most recent spike in COVID-19 cases. State and Skagit County mental health experts say those feelings are normal in the face of the pandemic. “Emotions are absolutely normal and expected during this time,” Keri L. Waterland, director of the Division of Behavioral Health and Recovery that operates under the state’s Healthcare Authority, told the Skagit Valley Herald. “Whatever you are feeling right now is OK and there is nothing wrong with you.” According to weekly U.S. Census Bureau data, the number of adults in the state reporting feelings of depression and anxiety is on the rise. The onset now of dreary weather and holiday stress will compound the mental health challenges brought on by the pandemic. “It’s only sort-of light for eight hours a day,” Compass Health Chief Medical Officer Dr. Camis Milam said. “You add that ... and coping skills are now overwhelmed by this chronic anxiety that everybody is living with because of COVID.”
The psychology around disasters, from pandemics to major earthquakes, suggests more despair is ahead. “The rest of 2020 and early 2021 will likely be defined by experiencing the disillusionment phase (following disasters) ... The risk of suicide, depression, hopelessness, and substance use historically are at their highest during this phase of any disaster,” a state Department of Health report says. This “emotional fallout of the pandemic,” as some have
called it, has meant a dramatic increase in demand for services, the majority of which are now offered through video calls. The good news is that those services are available — just a phone or video call away — and many are turning to them for help. The North Sound Behavioral Health Organization that serves Skagit and surrounding counties reports that calls to the area crisis line (1-800584-3578) have doubled over the past six months, to about
4,000. One of the providers that connects with callers through that crisis line, Compass Health, has seen an increase in telehealth visits from 500 per month before the pandemic to more than 5,000 per month. Milam said Compass Health has also seen an increase in new clients. “A lot of the increase that we’re seeing are folks that are not traditionally consumers of mental health care, but with all the things that have happened they are starting to feel over-
whelmed,” she said. The state’s Healthcare Authority said the telemedicine visits it has logged — the majority of which are for behavioral health services — grew from 2,000 per week in April to 65,000 per week in September. Representatives of Skagit Regional Health said it is seeing an increase in those seeking help who never before reported experiencing behavioral health issues. “It has me quite alarmed,” Chief Medical Officer Dr. Connie Davis said. Health care providers including Skagit Regional and state agencies that collect health care data also say overdose deaths, suicide attempts and reports of domestic violence have increased during the pandemic. Brandon Foister and Amy Pereira said as of September Compass Health’s crisis responses — focused on helping those experiencing overdose, suicidal thoughts and domestic conflict — were up about 13% compared to 2019. In an effort to help prevent crisis situations from developing, the state in July launched an additional phone program, Washington Listens, as another way for Washington residents to seek support during pandemic related stress. Dr. Kira Mauseth, co-lead of the state’s behavioral health strike team, said natural responses to disaster-related stress include becoming forgetful and distracted or having trouble tracking details. It’s normal to be on edge due to fear and uncertainty while changes outside our control play out around us. “Not a single brain is immune to that,” Mauseth said.
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Skagit Valley Herald
focus on skagit county
Progress being made on new treatment facility By BRANDON STONE @Brandon_SVH Skagit County broke ground this year on a new mental health treatment facility. Ken Hansen, director of county Facilities Management, said the project is on schedule for completion by late July 2021. The 16-bed evaluation and treatment center will provide acute, short-term mental health care, offering stabilization and connections to longer-term treatment. Patients will generally be brought to the facility by law enforcement after experiencing a mental health crisis and will work with staff to plan for future care. The project represents a first step in replacing the 141-bed long-term inpatient facility on the grounds of the former Northern State Hospital with several smaller facilities embedded in the community. The Northern State facility is set to close in 2023, requiring replacements in the North Sound region — Whatcom, Skagit, Island, San Juan and Snohomish counties. With only a few years left until services there end, Skagit County is behind on finding suitable replacements, county Commissioner Lisa Janicki said at the groundbreaking ceremony in October. “It does seem that so much should have been done long ago, but you can’t look back,” she said. “You just have to start.” The $10 million project is funded mostly with allocations from the state, an effort spearheaded by state Sen. Keith Wagoner, R-Sedro-Woolley, and state Rep. Carolyn Eslick, R-Sultan. Wagoner has said the state
OLIVER HAMLIN / SKAGIT PUBLISHING
Crews work on construction of a new mental health treatment facility on Highway 20 west of Sedro-Woolley on Dec. 15.
The project represents a first step in replacing the 141-bed long-term inpatient facility on the grounds of the former Northern State Hospital with several smaller facilities embedded in the community. Legislature’s support for the project is a recognition that community-based mental health treatment is preferable to large, isolated institutions, because it keeps patients near friends and families, which helps with their recovery.
“In general, we’re trying to put more facilities at the local level,” Wagoner said. “Clearly, what we’ve done with large state institutions did not work.” Hansen said construction has progressed on schedule. Crews have installed the foun-
dation and utility hook-ups to the site in Sedro-Woolley, along Highway 20 east of PeaceHealth United General Medical Center. The county has yet to select a health care provider for the facility, and will likely send out
a request for qualifications soon. The provider will likely have some input on certain design elements, so Hansen said there are advantages to finding a partner sooner than later. Eventually, the county hopes to expand on the campus, adding a 16-bed substance abuse treatment facility and developing the site into a central location for behavioral health care, county Commissioner Ken Dahlstedt said in a previous interview.
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Skagit Valley Herald
HOW YOU CAN HELP VETERANS EVERY DAY By SHELLEY MACDERMID WADSWORTH Guest Columnist As the nation celebrates our 17 million living veterans, it is also important to know that the number of these heroes who are ending their own lives prematurely is rising. In the general population, suicide is the 10th most common cause of death, but among veterans with PTSD, it’s fourth. Among veterans younger than 35, it’s second. Suicide rates are also rising among
And more than half of service members who attempt or complete suicide had been seen within those 90 days by a medical, mental health or social service professional. Almost one-third communicated a potential for self-harm. It’s not only medical professionals who can help a veteran who is dealing with despair and contemplating death by suicide. You can also help.
A ‘GOOD CATCH’
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members of the military. Since 2017, rates for active-duty service members have been above those of civilians. The same is true for National Guard service members since 2015 and nonactive veterans for the past decade. I’m a researcher who studies risk and resilience in military and veteran families. I can tell you that the single most common stressor for those who attempt or complete suicide is a serious relationship difficulty with an intimate partner or someone else within the previous 90 days.
Some recent studies have suggested that a complex array of factors combine to lead a person to contemplate death by suicide. And many things contribute to the feelings of despair that veterans experience. In addition to post-traumatic stress disorder, other mental health problems and medical challenges, veterans also face unemployment, bereavement and parenting issues. It is easy to understand how veterans might feel overwhelmed and desperate. Through my work, I’ve heard firsthand the stories of service members and veterans who had decided to take their own lives but did not. Often I’ve observed that it was a “good catch” that did it: a friend or family member answered a call at an odd hour; noticed the person seemed “off” and asked careful questions; stayed with them while summoning professional help; or checked in with them so they wouldn’t feel isolated. Families, friends, neighbors and colleagues all may have opportunities to make these catches.
Peer support programs may also help. Alcoholics Anonymous and Narcotics Anonymous are effective alone or in combination with clinical treatment for substance use disorders. Results regarding mental health problems such as depression are more mixed, but a consistent finding is that peer support can help promote compliance with treatment, communication with clinicians, improved coping and self-care, and increased feelings of hope and self-efficacy. Studies suggest that peer support can also help people during transition times, particularly when they are leaving military service to return to civilian life. Veterans themselves are taking action. In the Department of Veterans Affairs, peer facilitators are key to a new “whole health” approach. American Legion members also offer support aimed at preventing suicide. Across the country, veterans treatment courts routinely include mentors to boost the success of clients.
PEER SUPPORT IS OUT THERE
Not all peers have to be veterans. Sometimes the strongest connections are with those who have had different challenges and who also can therefore relate — like a family member’s addiction, or one’s own disability or mental health problem. Many peer networks can help, including the National Alliance on Mental Illness, the American Cancer Society and the Alzheimer’s Association. Even though they may
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not focus specifically on suicide, they help reduce isolation, increase social connections, and support coping and self-care. We can all help to prevent death by suicide. And joining a peer support program or training to make ourselves ready aren’t the only ways. Simply being more attentive as a friend, family member, neighbor or colleague can help.
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It is normal for a person to feel awkward when talking to someone contemplating death by suicide. Learning is a great way to prepare. For example, “Question, Persuade, Refer (QPR)” is evidence-based training that can help anyone recognize early warning signs of suicide, learn ways to offer hope and encouragement, and connect with help. If you or anyone of your loved ones are in need of help, call the National Suicide Prevention Lifeline at 800-2738255 or text 838255. You can also get help at the Veterans Crisis Line and the Military Crisis Line.
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Skagit Valley Herald
IN PANDEMIC ERA’S ISOLATION, MEANING OF ‘SELF-CARE’ EVOLVES By ANNE D’INNOCENZIO and SOPHIA ROSENBAUM Associated Press
T
by. No longer are worries about longevity and fears of mortality mere hypotheticals. They are 2020’s reality. It is that daunting reality that has skyrocketed the importance of “me” time: stress-baking the latest viral creation, tending to a garden, learning a new skill, getting dressed like you’re going out just to feel some semblance of normalcy. “People are social beings. And while the social fabric has been torn down, and you can’t be a normal social person, you have been more focused on yourself,” said Rod Little, CEO of Edgewell Personal Care, which makes Schick and Bull Dog products. “It’s beautifying for longevity, as opposed to how I look in the office tomorrow.” It’s also a way to mitigate the feeling that life is careening forward haphazardly in so many ways. That’s true for Tonya Speaks, a 43-year-old wardrobe coach from Fort Mill, South Carolina. Before the pandemic, she was always zipping to and from business meetings. BEING KIND TO ONE’S SELF FEELS Now, the mother of two teenagers exercises reguESPECIALLY IMPORTANT DURING THE larly and opts for luxurious PANDEMIC, WHERE EVERY baths at night instead of quick showers in the ASPECT OF HUMAN LIFE morning. She’s happier HAS BEEN IMPACTED AND doing so. “Taking care of myself,” THERE IS LITTLE CONTROL Speaks said, “is one way OVER WHAT’S NEXT. for me to have control.” hese days, with a pandemic raging, this is what life can look like: Staring at your face on Zoom for hours instead of occasionally glimpsing it in the mirror. Living out the days in loungewear. Wearing minimal makeup because no one sees much of you. Considering an investment in home exercise equipment because gyms are closed or restricted. The pandemic has forced people to spend more time with themselves than ever. Along the way, it has reshaped and broadened the way many think about and prioritize how they treat themselves — what has come to be called self-care. The pandemic-era incarnation of selfcare isn’t about buying a signature outfit, wearing a trendy shade of lipstick or getting a perfect haircut. It has, for many, put the purpose and meaning of life front and center, reconfiguring priorities and needs as the virus-inflected months drift
BEYOND THE ‘LIPSTICK INDEX’
Self-care isn’t a new fad. The difference is that pre-pandemic, it could fall by the wayside if a to-do list got crowded. Now, eight months into the new reality, it is a priority. After all, the thinking goes: If we’re not taking care of ourselves, how can we do jobs, parent children, care for loved ones? For those who have the means — and that’s no small caveat during this pandemic — feeling good can mean looking good. And the widespread isolation has produced new trends in beauty and clothing. Companies like Signet Jewelers and Blue Nile are seeing a surge in sales of earrings, which are visible on video calls and when people are out wearing face masks. Department stores like Kohl’s and Macy’s are expanding casual clothing offerings as more people stay close to home. But when it comes to consumer products, the pandemic is pushing makeup aside as people gravitate towards skin care products. The virus is even turning the “lipstick index” upside down. Typically, lipstick sales skyrocket when the economy gets rough because it is an inexpensive way to feel good. But during the pandemic, makeup sales have been rocky, and sales of skincare products are up. In fact, 70% of con-
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Community Wellness is our Priority.
Tamia Prescott sanitizes a cosmetic display Nov. 19, 2020, at an Ulta beauty store on Chicago’s Magnificent Mile. AP Photo Charles Rex Arbogast sumers scaled back their use of makeup this year, according to the NPD Group Inc., a market research firm. As a result, skincare has eclipsed makeup as the top category in the beauty industry’s market share from January through August. “This is a wellness revolution,” said Esi Eggleston Bracey, chief operating officer of Unilever North America’s personal care and beauty division.
A DEEPER IMPORTANCE
How deep does this run? Is all the pandemic self-care working, or are people are just going through haphazard motions? One psychologist compares it to a roller coaster — up on some days, down on others. “Some days, you have a great day when you did all the things you wanted to do. You got up on time, you made a salad.
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Skagit Valley Herald
And then the next day, it’s Cheetos for lunch,” said Dr. Vaile Wright, a senior director at the American Psychological Association. Being kind to one’s self feels especially important during the pandemic, where every aspect of human life has been impacted and there is little control over what’s next. That level of uncertainty is unnerving, Wright said, and further depletes already limited energy levels. Self-care, of course, is only one dimension of coping during stressful times. Surveys have shown a sharp increase in anxiety disorders. Many therapists are reporting upticks in referrals and increases in caseloads. Virtual mental health services are booming — another form of self-care, in a more medical sense. “Having a toolbox of coping skills is really critical,” Wright said. She highlights other types of self-care like meditation, journaling and organizing — each of which has its own culture and committed practitioners. “We have a tendency to isolate emotionally,” Wright said. “It is really important that people don’t do that.” Ultimately, “self-care” contains as many definitions as there are people who take care of themselves — a Google search of the term will show you that. The World Health Organization takes an expansive view, describing it as a “broad concept” that includes hygiene, lifestyle, social habits, income levels and cultural beliefs — and, in the best cases, can “strengthen national institutions” to encourage a society’s overall health. As the world navigates a web of unknowns that sometimes feels like the Upside Down in “Stranger Things,” there is one thing that people can do something about: themselves. For all the horror the pandemic has brought, it has also revealed things that matter. And from the way people have reacted through this year, it seems clear that, in all the forms it takes, self-care matters — particularly right now, particularly with so many unknowns still ahead.
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COOLING STRESS TIPS:
HOW TO FILL UP YOUR EMOTIONAL BANK ACCOUNT By JUDI LIGHT HOPSON Tribune News Service (TNS) Do you feel anxious when your checking account gets low? Most of us do. Our bank statements and incoming bills can cause a rise in anxiety. But, do you realize your emotional “bank account” can plunge as well? Too much stress, too many problems, too many demands on you can drain the life right out of you. When we’re stressed out, many of us tend to overeat. We might also overspend, watch too much TV, and stay on social media for hours. We’re trying to fill our spirit because the emptiness gets to be too much. That’s why it pays to guard your emotional bank account. How? You’ll need to make some “deposits.” Every person has his or her way of doing that. But, it’s better to choose actions that are healthy in the long run. Also, choose actions that are relatively easy to do. Once you get the idea, you can keep adding to the list.
HERE ARE SOME STRATEGIES TO FILL UP YOUR BRAIN AND SPIRIT WITH GOOD FEELINGS: •
Do what feels soothing to your senses. You might read a few pages in a good book, soak in a tub, or listen to music when you cook dinner.
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Take a long nap when you get a chance. You might want to stretch out and relax on a Saturday afternoon. If you’re sleep deprived, this will feel like a gift to yourself.
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Watch a few of your favorite movies. This is a healthy form of escape. You might select a movie you enjoyed in high school. Or, you might choose a Disney movie you loved as a child.
•
Forgive a couple of people who’ve hurt you. This really paves the way to let go of negative emotions. The purpose of forgiveness is to clear your own brain from psychological pain.
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“I recently got on a ‘forgiveness’ kick,” says a financial adviser we’ll call Anna. “I decided to focus on tackling big goals I want to reach. For instance, I need to lose 25 pounds. So, to add energy to my get-in-shape willpower, I decided to let go of all bad thoughts.” Anna says she forgave her ex-husband, the woman he cheated with, and her ex-business partner who flubbed a couple of great financial opportunities for their company. “I’m a financial adviser, and I know my divorce and past business partner cost me a lot of money,” says Anna. “But, I’m making up for it all. I’ve got a good business sense of how to invest, and I’ll eventually be back on top!” Imagine going out to seize the day by having good emotions literally pouring out of you. These days happen when we’re dwelling on what’s right in our lives. “I have clients who are still grieving over lost love that died 10 years ago,” says a psychologist we’ll call Jack. “They are literally buried alive in bad thoughts. These thoughts all produce bad feelings. They can easily cause physical illness.” Jack helps those he counsels by helping them plan their good experiences. Each client is asked to keep a journal. “We spend a lot of time focusing on what memories and activities felt good in the past,” says Jack. “Some people bury all their past joy when one bad thing happens. I go in and help excavate their buried happy memories, hopes, and dreams. I help them slowly bring them back to life.” Jack concludes: “We each can easily make deposits into our emotional reserves. And, it usually costs little, if any, money.”
DocTalk: Managing Your Mental Health
January 14, 2021 | 12:00 - 1:00 p.m. | Paul Hammer, MD
DocTalk: Healthy Sleep Habits
January 20, 2021 | 1:00 - 1:30 p.m. | Robert Reyna, MD
10 - Sunday, December 20, 2020
Skagit Valley Herald
PEOPLE WITH DEPRESSION FARE WORSE IN HEART HEALTH STUDY AMERICAN HEART ASSOCIATION NEWS
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eart disease and depression are interwoven, and a new study is helping unravel that connection by linking depression with poorer scores on seven important measures of heart health. The research included more than 4,000 people taking part in a national survey who had been screened for depression using a basic questionnaire. Participants were evaluated for weight, smoking, diet, physical activity, blood sugar, cholesterol and high blood pressure — measures known as the American Heart Association’s Life Simple 7. After adjusting for factors such as age, race and income, the researchers found people with symptoms of severe depression were 3.1 times more likely to have worse cardiovascular health than people without depression. People with mild-to-moderate depression were 1.4 times more likely.
Lead researcher Dr. Brent Medoff said the study shows a clear link between depression and poor heart health, although it can’t explain what’s behind the connection. “Whether it’s because they’re depressed and they don’t want to move around, or they’re not taking care of themselves, or they’re unable to get medication, (these) are things that we have to look for in other research,” said Medoff, a resident physician at the University of Pittsburgh Medical Center. The research, presented this month at the AHA’s virtual Scientific Sessions conference, is considered preliminary until published in a peer-reviewed journal. Dr. Christopher Celano, associate director of the Cardiac Psychiatry Research Program at Massachusetts
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General Hospital, said zeroing in on the root causes of the relationship between depression and heart disease offers fresh details on a complicated interaction. He was not involved in the new research. It’s a two-way street, studies suggest. People with depression are more likely to develop heart disease. And
“DEPRESSION AND DEPRESSIVE SYMPTOMS ARE NOT JUST IN THE BRAIN. YOUR BRAIN IS CONNECTED TO EVERY OTHER PART OF YOUR BODY. WE KNOW MORE AND MORE THAT THESE CONNECTIONS BETWEEN THE BRAIN AND THE REST OF THE BODY GO BOTH WAYS. SO THINGS THAT HAPPEN IN YOUR BODY CAN AFFECT HOW YOU THINK AND FEEL.”
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people with heart disease can experience depression. In fact, research suggests 15% to 30% of people with cardiovascular disease have depression — a rate two to three times higher than the general population. Celano said some of the connection is probably behavioral. People who are depressed are more likely to smoke, less likely to be active and tend to have a less healthy diet. But depression also has a physical side. It affects the nervous system in ways that can raise blood pressure and heart rate. It affects blood platelets, which can increase the risk of clotting. It’s also been associated with inflammation, which is linked to many diseases. “Depression and depressive symptoms are not just in the brain,” Celano said. “Your brain is
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Skagit Valley Herald connected to every other part of your body. We know more and more that these connections between the brain and the rest of the body go both ways. So things that happen in your body can affect how you think and feel. And changes in your brain can affect many different parts of your body, including your heart.” Debra Moser, a professor and assistant dean at the University of Kentucky College of Nursing in Lexington, said the new study shows that health care professionals need to do a better job of managing depression.
“Basically, this evidence says we really need to start assessing people for depressive symptoms,” said Moser, who was not involved in the study. The U.S. Preventive Services Task Force in 2016 recommended depression screening for the general population, with an emphasis on people with cardiovascular disease. And an AHA advisory in 2008 recommended screening for depression in people with coronary heart disease. Screenings can be done easily with the same nine-item questionnaire used in the study, said Moser, who is actively researching depression in car-
diac patients. People also can watch for warning signs in themselves and loved ones. “People who really lose interest in what they used to do, and really kind of just feel down and depressed and don’t engage in anything they used to like, should begin to worry that they’re suffering from depressive symptoms that need to be managed,” she said. Medications, talk therapy and exercise can help, Moser and Celano said. People having depressive symptoms should speak with their primary care physician about getting a refer-
ral to a psychiatrist or other mental health professional, Celano said. That is “critical. And this is regardless of whether you have heart disease or not.” Medoff said with less stigma these days attached to mental health treatment, better communication can make for better overall health. “I think it’s going to be really important for patients to feel comfortable coming to their physicians and saying, ‘Hey, I feel I haven’t been able to do these things. I feel down,’ and for the physician to say, ‘OK, well, I think these are connected.’”
SEASONAL AFFECTIVE DISORDER MARK SKRIEN Guest columnist
Recently, people set their clocks back to Central Standard Time from Central Daylight Saving Time. This annual occurrence allows more daylight hours during the spring and summer. At about the same time, some sufferers of Seasonal Affective Disorder began to experience symptoms of depression that can last throughout the fall and winter months. Seasonal Affective Disorder (SAD) is a mood disorder associated with episodes of depression related to variations of light. The amount of sunlight that people experience during the spring and summer is greater than in the late fall and winter. It is thought that if sunlight affects the hibernation and other seasonal activities of animals, it may also affect humans. A theory is that when the daylight decreases, it may change our biological rhythms, causing an individual’s “biological clock” to be different than their daily schedules. Symptoms of SAD are: depression (including excessive eating and sleeping), weight gain, loss of energy, decreased activity, general sadness, and craving for sugary and starchy foods. Some sufferers are described as sluggish and lethargic. These symptoms can impact marriages, other relationships, and work-related activities. Most SAD symptoms subside in spring as daylight hours begin to stretch by a few minutes each day. The most difficult months for SAD sufferers are January and February.
The most common theory about the cause of the disorder is the increased level of melatonin, a sleep-related hormone secreted by the brain. In the dark, it is produced at increased levels. When the days are shorter and darker, the production of the hormone increases, thus giving the body messages about sleeping, slowing down, i.e. messages that are similar to the symptoms of SAD. Seasonal Affective Disorder should not be confused with “holiday blues,” although they share some of the same symptoms including sadness, weight gain, and lower energy. The latter is the result of increased stress during the holiday season. Phototherapy or bright light therapy suppresses the brain’s production of melatonin, thus informing the body not to go to a sleep mode. Many individuals respond well to phototherapy. A phototherapy light box uses white fluorescent lights and a metal reflector. The person turns the light on and sits in front of the light for a period of time (about a half hour) each day. Bright light therapy has proven to effectively reduce the intensity of the SAD symptoms. Antidepressant medication and brief therapy for support can also be effective treatments for some sufferers of SAD. A mental health professional can correctly diagnose and offer suggestions for treatment of Seasonal Affective Disorder.
Ask your local pharmacist how to support your mental health in these times of isolation, grief, and anxiety.
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12 - Sunday, December 20, 2020
Skagit Valley Herald
WORK THROUGH CHANGE THIS HOLIDAY SEASON By CARRIE HADERLIE The Sheridan Press
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or a healthy person under stress, for someone coping with the fallout from a worldwide pandemic and its impacts on day-to-day life, there is room for tears. “There is also room for laughter,” said Alicia Clark, a clinical psychologist and owner of Big Horn Psychological Services. “For some reason, in the day of 24/7 news that seems to want to draw people’s attention through gravitas, and in the era of political correctness, people are afraid to laugh anymore. Laughing at oneself or the overwhelming saga of life is a wonderful skill. Laughter is good, when it is about genuinely funny things that we can all appreciate about being human.” This holiday season, Clark recommended several ways to manage stress or feelings of sadness or disappointment. CONSIDER YOUR PERSONALITY in trying to find the best way forward. A one-size-fits-all approach for creating meaning will not work for everyone. Holiday music and decorations might be uplifting for some people, but others might struggle with outwardlyfocused holiday trappings. “If people can embrace that this is going to be different and hard, that can help, because if they try to ignore it, it makes them depressed. They are not allowing themselves to grieve or get frustrated,” Clark said. CONSIDER RESILIENCE. It’s OK to be down about not seeing your family, but find intentionality and meaning by looking inward, Clark said. “I would encourage you to be very reflective,” Clark said. “Realistically, there isn’t going to be a year like this one again, so find a sense of the beauty in overcoming the struggle.” That could come from a hobby, or taking up painting or poetry. It may come from faith, or time spent in worship. It can come from honoring your friendships and family relationships, even from a distance.
EMBRACE CHANGE, however hard.“If you can say, ‘Here is my challenging 2020 Christmas,’ you can begin to move forward,” Clark said. “Some people just really hate the change. I am one of those. It is not an easy thing to realize that change is a part of life, and definitely a part of this year.” PRACTICE GRATITUDE. Gratitude is not a feeling, but an attitude or a perspective. To practice gratitude, deliberately focus on the things you are grateful for, and then put weight or value into the thought by either expression or action. Following those actions, the feeling of appreciation occurs, which combats depression or self-pity. However, if someone around you feels hopeless, it’s not a good idea to say there is nothing to be hopeless about — a hopeless person can always think of discouraging things. The more helpful perspective is: “I may feel hopeless right now, but in the middle of this, I’m drawing to mind the things I’m so thankful for. I have this person in my life; I have this job; I have my health; I have these muscles; I get to enjoy this food; I can enjoy this painting; I love the look of the stars tonight,” Clark said. Even being grateful for life’s challenges can be healthy, Clark said, because sometimes they help you appreciate other things more. HELP OTHERS. “It is not an ideal year, but when you can do things for others and push yourself through, if you have that capacity, it is really going to help,” Clark said. Simple acts of kindness like standing on the street corner in your nuclear family and singing Christmas carols or leaving groceries outside for
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someone who is in quarantine are both examples. Helping others can get your mind off your own sadness. If you’re struggling with depression, anxiety, substance abuse or other mental health issues, get help. “I would not hesitate to get help,” Clark said. “The holiday season is a high-suicide time, and this year alcoholism and depression have gone significantly higher. It really does help to be proactive in saying, ‘This Christmas might be tougher than normal. I better get help, even if it is just a few sessions to have someone you really can talk to.’ That can be a real game changer for some people, and I would honestly do that now before the holidays.”
“REALISTICALLY, THERE ISN’T GOING TO BE A YEAR LIKE THIS ONE AGAIN, SO FIND A SENSE OF THE BEAUTY IN OVERCOMING THE STRUGGLE.”
Check out our Health Page featured in Wednesday’s paper!
Sunday, December 20, 2020 - 13
Skagit Valley Herald
MAYO PSYCHOLOGIST DISCUSSES COVID-19, HOLIDAY STRESS By RYAN PATTERSON Leader-Telegram Staff
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ith COVID-19 cases at an all-time high in the country, gatherings and celebrations in 2020 will look different than in previous years. Many will not happen, while others will take place over computers instead of in-person as public health precautions. With the holiday season underway, Craig Sawchuk, clinical psychologist and co-chair of the Integrated Behavioral Health Division at Mayo Clinic in Rochester, provided guidelines for navigating decisions and conversations with loved ones in the weeks and months ahead. Sawchuk laid out five tips to think about when determining travel plans for the holidays: make a decision based upon your values; have the conversation early about what you decided; don’t turn your decision into a debate; be flexible and open to doing holiday activities differently; and be realistically optimistic for the present and future. When informing people of your decision not to gather with them, for example, use simple, declarative messaging such as. “I love you, we want to
“TO AID ONE’S MENTAL HEALTH, HAVE SOME SENSE OF POSITIVITY WHILE STILL ACCEPTING THE SIGNIFICANT LOSSES FOR SO MANY PEOPLE THIS YEAR.”
spend time with you, and we’re choosing to stay at home,” Sawchuk said. Sawchuk said the best course of action is the “broken record routine” of a brief statement that clearly explains what you are doing without over-explaining why you are doing it. “If you’ve made this decision and it’s based upon your values, it really is not a debate,” Sawchuk said. Ideally, people can amicably agree to disagree. If that is not possible, suggest talking again after the holidays. When talking about decisions with a spouse or partner that lives in the same household, people should communicate and be on the same page regarding what they decide. Sawchuk also said the only thing you can control is what you say and how you say it. You can’t control how others interpret what you say, so choosing words carefully is crucial. If conversations could result in you causing or receiving guilt, ask, “Is it more important to be right, or is the relationship more important?” Sawchuk said. Ideally, relationships have a strong enough history to overcome current difficulties. If you are physically separated, reach out early and try to figure out how to keep any traditions going virtually. Other options include sending care packages and writing letters to loved ones. “We’re adaptable; that’s the nature of being human,” Sawchuk said. To aid one’s mental health, have some sense of positivity while still accepting the significant losses for so many people this year.
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“Be optimistic but not deluded,” Sawchuk said. If a person is grieving the death of a friend or family member, the first step is accepting how difficult this year has been. “It really is OK to not be OK,” Sawchuk said. “It’s normal to not really feel normal at this time … It’s been hard, and we have to acknowledge that it’s been hard, but maintain that optimism. Just imagine how good these get-togethers are going to be once we’re able to get back to living life normal.” There are fewer events to look forward to, like holiday celebrations, weddings and graduations, but some sense of optimism is vital in the months to come. “We will get to the other side of this, but we also are taking a lot of hits along the way,” Sawchuk said. “We will get through this. Sometimes we don’t actually know exactly how we will, but we’ve gotta trust that we are adaptable and we will get to the other side … Maybe we’ll celebrate twice as hard in 2021.”
A BIG
oxu2.3” kADySPACE than9.75”
to our health-care professionals
We salute the courage and dedication of health-care workers who continue to bravely serve our community during the pandemic. Your contributions are invaluable and we want to acknowledge them in a big way!
14 - Sunday, December 20, 2020
Skagit Valley Herald
CONNECTING TO NATURE IS GOOD FOR KIDS — BUT THEY MAY NEED HELP COPING WITH A PLANET IN PERIL By LOUISE CHAWLA, University of Colorado Boulder
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s an environmental psychologist who works to improve young people’s access to nature, I recently completed a review that brings two bodies of research together: one on connecting children and adolescents with nature, and the second on supporting healthy coping when they realize they are part of a planet in peril. My review shows that children and adolescents benefit from living near nature and having adults in their lives who encourage free play and outdoor discovery. When they feel connected to nature, they are more likely to report good health and a sense of well-being, more likely to get high scores for creative thinking, and more inclined to show cooperative, helping behaviors.
They are also more likely to say they are taking action to conserve nature, such as by feeding birds, saving energy and recycling. On the flip side, lack of access to nature has adverse effects. For example, COVID-19 restrictions on travel and social gathering led more people to visit parks to escape stress and move freely. But some families don’t have safe, attractive parks nearby, or their local parks are so heavily used that it’s hard to maintain safe distances. Under these conditions, city families stuck indoors reported mounting stress and deteriorating behavior in their children. My research literature review also shows that feeling connected with
When family, friends and teachers listen sympathetically and offer support, young people are more likely to feel hopeful that people’s actions can make a positive difference. Opportunities to envision a promising future, plan pathways to get there and have hands-on experiences of working toward this goal also build hope.
2. ENCOURAGE TIME OUTDOORS IN NATURE
Free time in nature and opportunities to develop comfort and confidence in nature are positive experiences in themselves; and by boosting well-being, providing time in nature can contribute to young people’s resilience.
3. BUILD COMMUNITY WITH OTHERS WHO CARE FOR NATURE
Meeting other people who love and care for nature affirms young people’s own feelings of connection and shows them they’re not alone in working for a better world. Learning
maybe them or their son or nephew is going to have to experience the end of the world.” Children who worry about the environment are likely to report that they are doing what they can to protect nature, but they almost always report individual actions like riding their bike to school or saving energy at home. Knowing that climate change and biodiversity loss are bigger problems than they can solve themselves can affect their mental health. Fortunately, the research also shows some key ways adults can help children and teens work through these feelings and maintain hope that they — in alliance with others — can address environmental problems constructively.
individual actions that add up to making a difference, or joining collective efforts to improve the environment, simultaneously demonstrate a sense of connection with nature and commitment to its care.
METRO WELLBEING
1. CREATE SAFE OPPORTUNITIES TO SHARE EMOTIONS
nature can bring difficult emotions as well as happiness and well-being. When young people are asked about their hopes and fears for the future, many describe environmental breakdown. For example, when a doctoral student I supervised asked 50 10- to 11-year-olds in Denver what the future would be like, almost three-quarters shared dystopic views: “Everything will die out, and there will be less trees and less plants, and there will be less nature. It just won’t be such a great Earth anymore.” “I feel sad because the animals are going to die.” “I feel sad because when I die I am probably gonna have a grandson or a great-grandson by then and
4. EMPOWER THEIR IDEAS
It’s important to treat young people as partners in addressing environmental problems in their families, schools, communities and cities. A boy who was part of a group of children who created climate action proposals for his city in the Mountain West summarized the benefits. After they presented their ideas to their city council and got approval to launch a tree-planting campaign, he noted, “There’s something about it … getting together, creating projects, knowing each other, working together.” Research is clear: Children and young people need free time to connect with nature, but it’s also important to support them when they struggle with the consequences of feeling part of a natural world that is currently at risk. This article is republished from The Conversation under a Creative Commons license.
Friendship house
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is a hand up not just a handout…. The Friendship House offers residents a variety of programs aimed at assisting residents finding their path to self-sufficiency. With community partners we offer a variety of workshops dealing with financial literacy, job search skills and healthy lifestyles among other topics.
www.skagitfriendshiphouse.org
Join the Checkup Challenge to make sure every aspect of your health is covered. Check all the boxes for you and those you care about: Get preventive screenings Make sure medications are getting refilled Get new health issues diagnosed Get a flu vaccination and any needed immunizations Check developmental skills (for children) Stay physically and mentally active (especially for older adults) For a complete checkup checklist by age group, visit peacehealth.org/challenge
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Asking for Isn’t a Four-Letter Word! The Help You Want. The Resources You Need.
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