Mental Illness’ Storm

                                    “Every storm runs out of rain.” – Maya Angelou

 

                  I have always found Maya Angelou to be inspiring. Her poem, And Still I Rise is one of my favorite poems. I always included it when I taught high school special education English classes. I discovered that my students could relate to her words, especially when I showed them a video of her reciting And Still I Rise. It was inspiring to watch them relate to the poem.

                  The above quote from Maya Angelou really strikes me as I consider my own mental health. The storm could represent my depression and anxiety. There are times when the darkness of depression’s storm is very thick. I am soaked by my depression and left dripping with the pain it causes. When I think of a storm, I see dark clouds and pouring rain. It feels dreary. Can you see the image of a storm? That is what depression is like. Depression and other mental illnesses are storms that run through our lives. 

                  Angelou’s statement indicates that storms do not last forever. The rain runs out. Does that happen with depression? I think it does. Even the deepest depression will lift at least somewhat at times. Usually, that lifting of the depression is a result of treatment. That treatment is different for each of us. For me only TMS (transcranial magnetic stimulation) and esketamine lift my depression. These two treatments cause the storm to run out of rain. For others, it might be medication that lifts the storm. Others might find relief from ECT or psilocybin.

Whatever treatment works for us, we must trust in its ability to stop the rain. Angelou says, “Every storm runs out of rain.” Yes, depression lifts. It runs out of its force in our lives. That does not mean it doesn’t return. Storms come and go. Weather exists in patterns. The same is true for mental illness. Depression often has patterns. There are times when it pops up in our lives. For some of us it pops up more than others. I think Angelou is saying we need to believe that things will get better. We must believe that we can get through depression or other mental illnesses by relying on our treatment and support systems. This is not an easy task. When we are in the eye of the storm, it seems impossible to escape. The rain and the darkness are intense. At these times we feel trapped. We are soaked in the pain of the mental illness. If you have never experienced depression, think about being trapped in a storm. You are soaked and surrounded by darkness. You are lying in mud so thick that you cannot get up. Wind blows intensely around you. Can you feel it? Does this image let you know what depression and other mental illnesses are like? 

                  But anyone who has studied weather knows that Angelou is right. Storms run their course. They end. Depression can lift. It is difficult to get out of the storm, but it is possible. We need to trust our treatment. We need to trust our support systems. We need to trust the strength we carry within ourselves. It may not seem possible, but we possess the strength to allow mental illness to ease. Notice I didn’t say disappear. Depression and other mental health disorders are illnesses. So, they are not going to disappear just because a storm has passed, but they can ease up and allow us to heal. If we think about episodes of depression as a storm, we can understand that it will run its course. There will be an easing of symptoms. What we do with the times in between storms is important for our healing. We need to use this time to build our coping strategies and develop our support systems. That is how we make future storms easier to survive. This involves work. It is not easy to live with a mental illness. We can make it a little easier if we have something positive to focus on. That something could be Angelou’s quote. She gives us that reminder that storms end.

                  I am not trying to simplify living with mental illness. It sucks. That does not mean life is without hope. We can get through the storms. We can trust our treatment and support systems and heal. Remember: “Every storm runs out of rain.”

 

 

                  

 

 

 

Veterans and Mental Health

                  Since it is Memorial Day, I thought now would be an ideal time to discuss the mental health needs of our veterans. These individuals have unique needs that need to be addressed. Through their service they have earned the best care possible. Really everyone deserves high quality mental health care, but I think sometimes our veterans get overlooked.

                  There have been many veterans in my family. My grandfather was a lifelong Navy man. He served in World War II, Korea, Vietnam, and during peacetimes. My father served in the Air Force during Vietnam. I have a cousin who served in the Army and was stationed in Afghanistan. In addition, several of my great uncles served during World War II. I do not know how any of them were impacted from a mental health standpoint. I can’t ask any of them about this except my cousin,as he is the only one still with us. Many families have relatives who served in the military. It is my hope that these individuals are provided with mental health care if they need it.

                  Military personnel and veterans face many challenges to their mental health. Perhaps the most recognized is post-traumatic stress disorder (PTSD). It is one of the most common mental health conditions among veterans. PTSD in veterans can be a result of combat exposure, military sexual trauma, or other life-threatening experiences. Some symptoms include flashbacks, nightmares, hypervigilance, emotional numbness, and irritability. 

Depression is another common mental health disorder facing veterans. The depression can be a result of service-related experiences or difficulties adjusting when they return home. Depression can co-occur with PTSD or substance use issues. Symptoms include persistent sadness, loss of interest in activities, sleep and appetite changes, and thoughts death or suicide. 

                  Anxiety disorders are also common in veterans. These disorders include generalized anxiety disorder, panic disorder, and social anxiety. Deployment and military demands can lead to anxiety disorders in active military personnel. 

                  Traumatic brain injuries (TBI) can affect active military personnel and veterans. These can be caused by blast exposures, falls, or accidents during service. These can result in cognitive impairments, mood disorders, and behavioral changes.

                  It is not uncommon for alcohol or drugs to be used to cope with the emotional pain or sleep disorders faced by veterans and active personnel. Substance abuse disorders lead to risk of addiction, accidents, and homelessness. 

                  Military sexual trauma (MST) includes sexual harassment and assault during service. This can affect both women and men. MST can lead to PTSD, depression, and trust issues. 

                  Suicide risk is higher in the veteran population than in the general population. There are several risk factors including PTSD, depression, chronic pain, access to firearms, and a sense of isolation.

                  Veterans can be faced with adjustment disorders. These can be a result of difficulty adapting to civilian life, loss of identity or purpose, and issues related to employment or family reintegration. All these issues can cause distress.

                  Relationship and family issues can also cause distress. Military service can strain relationships. It is not uncommon for veterans to struggle with communication, intimacy, or parenting after deployment.

                  How can we support the mental health needs of our veterans? There are several things we can work on  to ensure they get the care they need and deserve. First, veterans need access to culturally competent mental health professionals who are familiar with military culture. Veterans need access to peer support groups to reduce isolation. Since veterans often have co-existing conditions, comprehensive treatment programs are necessary. Veterans need access to suicide prevention resources. Family therapy can be beneficial for veterans and their families as they reintegrate into civilian life. Finally, veterans need continuity of care during the transition from active duty to civilian life. 

                  A quote from Major General Mark Graham emphasizes the need to provide mental health care for veterans:               

                  “We must make it a sign of strength to reach out for mental health care.”

                  This Memorial Day as we enjoy a day off with picnics and parades, let’s take a moment to remember why this day is a holiday. It is not about BBQs and sitting in the sun. It is about honoring all the individuals who have served our country in the military. They put their lives on the line and many of them lost their lives. The least we can do is ensure that all veterans and active-duty military personnel have access to high-quality mental health care. 

 

Healthcare Professionals and Mental Health

I had another post planned for today, but then I realized there is more I need to share for Mental Health Awareness Month. So, today I want to address the role of healthcare professionals in treating and caring for people who live with mental illness. I have experienced several healthcare professionals who understand mental illness and are empathetic. Unfortunately, I have also experienced those who don’t understand and allow that lack of understanding to affect how they treat patients. 

I have shared my story of the painful experience I had. (Turning Hurtful Words Into Healing) It is hard to believe it has been eight years. Even though it has been that long, at times it still affects me. An interaction that provider never gave a second thought scarred me. I know I am not the only one. People with mental illness are misunderstood and mistreated often. I think it is happening less. At least that is what I would like to believe. 

I don’t know what the training programs for doctors and other healthcare professionals are teaching their students. My research indicates that most non-psychiatric doctors take one psychology course in medical school and do a 4-8 week psychiatric rotation. That doesn’t seem like enough. The training for physician’s assistants and nurse practitioners appears to be about the same, one course and a 4–6-week rotation. I wish mental health was a larger part of the curriculum for healthcare professionals. Mental health and physical health are tied together. They affect each other. My understanding of that connection has strengthened over the past two years. 

My mental health was not in a good place when I was diagnosed with stage 4 breast cancer. I could not have faced my cancer diagnosis without also addressing my mental health. I needed my mental health team as much as I needed my oncologist while I fought cancer. I needed my oncologist to understand my mental health needs so she could better treat me. Thankfully, she understood. There were some chemo days when my anxiety was high. My oncologist was empathetic and gave me Ativan to help me get through the anxiety. She never doubted that my experience was real. My oncologist respected my mental health and as a result was better able to treat me as a whole person. 

What about primary care providers? They see a wide variety of patients. I am sure not a day goes by where they don’t see a patient with a mental illness. They may be seeing that patient for some other reason, but daily a patient enters their exam room who has some type of mental illness. How they treat these patients is important. I know my primary care provider not only understands mental illness, but she is also empathetic. That is important and I am grateful.  Patients need to know they can trust their provider. We need to know that our mental health needs will be taken seriously. We also need to know a physical symptom won’t be ignored because we have a mental illness. Physical symptoms are not in our head just because we have a diagnosed mental health disorder. 

I have had the privilege of giving talks to psychiatric nurse practitioner students. They listened with open minds and curiosity as I shared my lived experience. I would like to speak to medical students and students in physician assistant and general nurse practitioner programs. I think hearing from a person with lived mental illness experience would be valuable to them. I also think it would be beneficial to talk to those already in healthcare professions. It would give them a refresher on what it is like for a patient to live with mental illness. Hearing my experience or the experience of others with mental health disorders might encourage practitioners to learn more about mental health. It might even change how they approach their patients. Maybe it could help that physician’s assistant who mistreated me.  Since it has been eight years, I hope she has already figured out that she needs to be more empathetic. Sadly, unless we make purposeful efforts to provide healthcare professionals with a better understanding of mental health there will be providers like the one I experienced.

If you are a healthcare provider or healthcare instructor, you can reach out if you would like me to speak to your group. You can email me at ginacapobiancoauthor@gmail.com.

 

 

Depression and Alcohol

                 Today is a special day for me. It marks 23 years of sobriety. I haven’t had a drink since May 2002. It hasn’t been easy. At times it has been very hard to remain sober. For me drinking wasn’t a social thing. Drinking was a way of self-medicating. It is how I learned to cope with depression early on. I started drinking in high school to numb the pain depression caused. If I drank enough, I wouldn’t feel the depression. Most of the time I just passed out. When I started drinking my depression was still undiagnosed. I wasn’t seeing a therapist. I was a lost high school kid. Drinking followed me in varying degrees until I was 29 years old. At that point I couldn’t hide it anymore. It was making my depression worse. I needed help. I found that help in the psychologist I started seeing In May of 2002. Dr. K helped me quit drinking. Through the years he has been there when depression has brought the urge to drink back. Even today, 23 years later, there are times when that urge creeps back. Luckily, I now have coping skills and support to get me through those times.

                  I would like to explore how depression and alcohol lead to serious issues. Alcohol is a depressant. So, while its initial effects might be to reduce anxiety or emotional pain, that effect does not last. When this effect wears off, the mood is usually worse. In my case this led to increased drinking to relieve my mood. It is not uncommon for people with depression or anxiety to try to self-medicate with alcohol.  Increased drinking worsens mood. It leads to increased feelings of sadness, hopelessness, and fatigue. Alcohol disrupts the brain’s chemical balance, which is already impaired in individuals with depression. Alcohol use and depression can reinforce each other creating a vicious cycle. Even though depression can provide a temporary easing of depressive symptoms, it almost always worsens things in the bigger picture. If drinking is involved with depression, a mental health professional needs to address both issues. 

                  Alcohol can also lead to suicidal ideation. This can be a result of a lowering of inhibitions while under the influence of alcohol. There is evidence that a number of suicide attempts involve alcohol use. Looking back, I recognize that several of my suicidal behaviors occurred while I was drinking to ease the pain of my depression. I am lucky that I managed to get through those times. I am also lucky that I have learned how alcohol negatively impacted me. 

                  How can someone address struggles with alcohol and depression. The first thing is to recognize there is an issue. This is not easy. Our minds try to deny it. We need to reach out for help. That help will look different for everyone. For me working with a psychologist was the answer I needed. If you do not have a psychologist or therapist, make an appointment with your primary care provider. Share your concerns and what you are dealing with your provider. This provider can refer you to a mental health professional who can help. Another option is to go to an AA (Alcoholics Anonymous) meeting. A simple internet search can help you locate a meeting or click on the link.  You can find a sponsor at one of these meetings who can help you with the alcohol issues. If depression or other mood issues are involved, you should still seek out the assistance of therapist or psychologist. 

                  Reaching out for help is difficult. I drank for years before I reached out for help. It took me hitting really low before I reached out. To this day I am grateful I reached out. I needed a push to get me to reach out. For some reason at this point in my life I decided to listen. The coping skills I have developed as a result have saved my life. I know reaching out is difficult. It is hard to admit when we are struggling. Often, we do not want to admit when we have a problem, but we need to. Depression and alcoholism are not going to go away on their own. Professional help is necessary and effective.

                  If you feel that you are in crisis, please reach out to the 988 helpline or go to the nearest emergency room. If you have been drinking, take an Uber/Lyft or ask someone to take you. Don’t drive.

                  Depression and alcohol are a terrible mix. On their own they can destroy a life. Combined they can have devasting effects. I am one of the lucky ones. I was given the help to stop drinking, While I continue to deal with depression, I am in a much better place. I have the mental health support from an amazing team to get me through the touch times. I am proud of my 23 years of sobriety. Even though it hasn’t always been easy, I have made it this far. Again, please reach out for help if you are struggling. There is help and there is hope.

 

Art and Depression

                 I have shared a lot about how writing has carried me through my depression. Writing is my go-to coping strategy when I am struggling. It provides an outlet for all that gets trapped in my head. As much as writing helps me sometimes it is not enough. Other times I feel I need something different. It is not that writing is not working. It is more that I just need other outlets at times. I have discovered art as a secondary outlet when I am struggling. Usually when I lean into art, I find that painting soothes me. I enjoy paint pouring and painting on canvas with acrylic paint. 

I am not the most artistic person, but I enjoy the act of getting paint on the canvas.  When I am working with paint I feel a sense of calm. Paint pouring is especially soothing because I can watch the paint flow on the canvas. I like to mix different colors in my paint pours. There is something in the swirling colors as I move the canvas around that just feels healing. I also like the feel of the paint on my hands. I don’t know what it is about the feel of paint on my hands that is so soothing. It just relaxes me. 

I have mentioned before that I am being  treated with esketamine. During this treatment I experience a dissociation during which I “see” colors. Most often it is shades of purple emerging from a black background. I believe that the purple is an indication of healing. It is emerging from the darkness of my depression. I have created a few paint pours using shades of purple to represent what I experience during treatment. When I do this, it allows me to share my experience with others. I think combining my experience with depression and treatment with art is positive practice. It allows me to make my depression more concrete. 

Sometimes I see other colors emerge during treatment. I painted a mandala to represent these colors. Just painting what is in my head soothes me. One thing I like to do is combine my writing with painting. I have written poems to go with several of my paintings. This links two of my coping strategies, writing and art. Sometimes I put a poem on the painting. Other times I scan a painting and then print a poem on the back. When I combine my art and writing in this way, I can share the creations with others. I like to share my art and writing with people who are important on my journey.

Another way I like to incorporate art is by pouring paint on glass vases. Doing this creates beautiful pieces. Watching the paint drip down the vase is soothing. It is a feeling I need when I am struggling with my depression. It also helps when I am anxious. Pouring the paint and watching it flow also calms my anxiety. I am not sure I can explain how it happens. I just know it works. 

I found a quote by Winston Churchill, who battled depression, that I think captures how I feel. “Painting is a pastime, a therapy, and a life-saver for me.” Painting is healing for me just as writing is healing for me. I know that I can turn to writing and painting when I am struggling. I encourage others to try these activities. You don’t have to have the talent of the great artists. I surely don’t, but I enjoy creating art anyway. Find an artform that you enjoy. A trip to a craft store can provide a vast array of possibilities. If you are struggling with depression or anxiety, art might just provide a bit of relief.

 

 

 

Mental Health Screenings

                  In my last post I mentioned taking mental health screenings as a part of Mental Health Awareness Month. Today I would like to further discuss mental health screenings. What is a mental health screening? A mental health screening evaluates a person’s mental well-being using a standard set of questions to identify potential signs of mental health disorders. They are intended to provide for early detection. These screenings help health care providers understand a person’s mood, thinking, behavior, and memory. 

                  These screenings are usually questionnaires and can be given in a primary care provider’s office. The questionnaires include general mental health screenings, depression screenings, anxiety screenings, PTSD screenings, substance abuse screenings, and eating disorder screenings. The Patient Health Questionnaire (PHQ-9) is often used to screen for depression. Two other common screenings include the Generalized Anxiety Disorder Scale (GAD-7) and the Mood Disorder Questionnaire (MDQ). These screening tools allow the primary care provider or other provider to know if there are symptoms of a mental health disorder. When used regularly, for instance as part of a yearly physical exam, mental health concerns can be identified early. When identified early, mental health conditions often have better outcomes. 

                  These screenings are a valuable part of a yearly physical examination but should also be used if a person is exhibiting symptoms such as sadness or excessive worry. Screenings should also be used when there are major changes in personality or eating habits and if dramatic mood swings are present. A primary care provider can gain a better picture of a patient’s mental health by using one of these screenings.

                  Mental health screenings are also available online. Mental Health America offers online screening tools that an individual can take. If one of these tools indicate that you may be experiencing a mental health issue it is important that you share this information with your doctor or a therapist, who can provider further screening and evaluation. This can lead to treatment if necessary.  

When used as a part of a yearly physical it is important that the provider discuss the results with the patient. Too often providers see the results and just add it to the patient’s file. I would recommend that if you fill out a screening tool you ask the provider to review the results with you. This is important to ensure that the provider is not overlooking the screening tool. Unfortunately, I have experienced providers who overlook results. Luckily, in my case, I have mental health providers who are well aware of where my mental health is, and I don’t need to rely on a primary care provider for mental health care. But for many people the primary care provider is the only one they have who can catch any issues. So, do not be afraid to ask the provider for the results of any mental health screening you take. These tools are only useful if we review the results.

Being aware of the status of our mental health is vital to our well-being. We cannot take our mental health for granted. As with any health issue, early detection is crucial. If your primary care provider does not give you a mental health screening, ask for one. Take the initiative. Screenings make a major difference in mental health care. 

Mental Health Awareness Month 2025

                 It is Mental Health Awareness Month. The theme this year is “Turn Awareness into Action”. What a great theme! For those of you who have been reading my blog or those of you who are aware of mental health and the needs it presents it is time to take the next step. It doesn’t have to be a big step. Just a small step will make a difference. It is time to move from awareness into action.

                  Allow me to provide a little background before we discuss taking action. Mental Health Awareness Month was started by Mental Health America (MHA) in 1949. You read that correctly. 1949! That is over 75 years ago It makes me wonder why we are not in a better place with mental health. We need to do better raising awareness. In 1949 the purpose of this month was to raise awareness of mental health conditions and the importance of well-being. That continues to be the purpose.

 

                  The goals of Mental Health Awareness Month are:

1.        To reduce the stigma surrounding mental illness.

2.        Encourage open conversations about mental health.

3.        Promote mental wellness and preventive care.

4.        Educate the public on signs, symptoms, and support systems.

5.        Advocate for better access to mental health services.

 

                  So, what can we do to take action regarding mental health? Those of you reading this blog are acting by reading and increasing your knowledge about mental illness. Maybe an action step for you would be to share this blog with someone, or even multiple people. That would bring mental health awareness to others. It would also help me in my action as a mental illness blogger because it would grow this blog. Even one share by each of you reading this blog would help.

                  Maybe you can bring mental health up in a conversation. Tell others what you know or have learned about mental health. You could encourage your workplace to build mental health awareness into their structure. Mental wellness programs are vital in the workplace. Maybe you could encourage your employer to start a program. 

                  You can share personal stories or share the stories of others (with their permission) in conversations or on social media. Sharing our stories is an amazing way to raise awareness about mental health. You will be surprised at how many people can relate to your story and have stories of their own. If you don’t have a story to share, you could share a post from my blog that you found interesting or important. 

                  A simple way to raise awareness is to wear green, which is the official color of mental health awareness. Don’t forget to tell people why you are wearing green.

                  You can attend local events, webinars, or workshops. NAMI Greater Los Angeles County has its NAMI Walks this Saturday, May 10 at LA Historic Park. You could attend, raise money, or support a walker by donating to their efforts. I will be there. If you want to support my efforts, you can donate here: Gina's NAMI Walk Page. Donating can be difficult, and a lot of people have supported my efforts to raise money for another cause that is dear to me, breast cancer research. So, I am not publicizing my efforts anywhere other than here. I will be helping at the NAMI Long Beach/Whittier table. You might also find me at the NAMI Glendale table, where the chapbook we created as a part of our Writing as a Healing Tool Writers’ Group last year will be available.

                  That reminds me of another way you can get involved. Join a group or attend a workshop/class. We are doing the writers’ group again. There is still time to join this free group NAMI Glendale Writers' Group Registration.  NAMI offers great classes and programs. Check out your local NAMI chapter’s website for information. 

                  Mental health awareness involves taking care of our own mental health. Another way you can promote awareness is to take a mental health screening. It is important to be aware of your own mental health. Your primary care provider should have a screening tool available. Mental Health America offers free screening tools. You may find that your mental health could use attention. It doesn’t necessarily mean you have a mental health disorder. You might just benefit from some self-care. The more aware we are of our mental health, the better we can address our needs. Mental health awareness involves taking care of our own mental health. 

                  Advocating for policies that improve mental health services and access is another way to raise awareness. There are many advocacy needs. NAMI does important work in this area. Considering things going on in our government, advocacy is important. For instance, we need people to speak out against the cuts that are being made by the Trump administration to mental health services in K-12 public education. These cuts will prevent our young people from getting the mental health assistance they so desperately need. I hope to write a post soon to address this issue.

This month I will try to raise awareness about mental health both on my blog and in my interactions with others. I encourage you to try to do at least one thing to raise awareness. Maybe you can share that one thing in the comments section of this post. 

Thank you for reading my blog. You are helping me do my part to raise awareness and turn that awareness into action. 

Depression – A Blanket of Pain

                  Today I would like to explore a metaphor that I thought about as I was coming out of esketamine treatment today. The effects of esketamine left me thinking about the feeling of a blanket. Maybe I was cold or just looking for a little comfort. Either way I thought about how depression sometimes blankets me. At times depression can be a blanket, heavy and encompassing. This contradicts the image a blanket often conjures up for people. That image of lying on a sofa on a rainy day, curled up, warm and cozy, under a blanket. Depression is nothing like that comfortable image. At least it is not for me.

                  Depression feels like a blanket is covering me from head to toe. It is a heavy blanket, much like a weighted blanket, but without the benefits attributed to weighted blankets. Depression’s blanket is just heavy. It is a weight bearing down on me. This weight prevents me from moving much. It keeps me paralyzed in my bed. I feel like I cannot lift depression’s blanket on my own. Its heaviness traps me in the darkness. 

                  Often, I am alone with this blanket of depression. Many people are. Depression is a lonely illness. Sometimes we are wrapped in that blanket and have no one to help us push the blanket to the floor. That is when the blanket, the depression, is in control. We need someone to reach out and offer a hand to pull the blanket off us.

                  I like to think about the blanket that waits for me on my couch. It is warm and soft. I like to lie under it and read. That is what a blanket should be. It should illicit feelings of comfort. Instead, I have this image of the blanket I know so well. It is dark, of course it is dark just like depression. From an outside perspective the blanket looks harmless. But I know its plan for me. It will wrap me in the darkness, drag my mood down. I have learned to fear the blanket of depression. I know it will hurt me and I will struggle under its weight. So, I reach for the light. I find that light in my mental health team, in my treatment, and in getting involved in life. It is not easy to reach out, but it is necessary. It is the only way to strip that blanket of depression of its strength.

                  As I mentioned at the start of this post, I felt the presence of a blanket as I was emerging form the effects of esketamine today. I can never be sure what the images I “see” during esketamine mean. My mind is working on healing. It conjures up images and feelings. There are usually colors, bright colors welcoming me. Today’s blanket meant something. Maybe it means comfort is coming my way. Maybe the heaviness of depression’s blanket was floating away on one of the colorful clouds that lift me during treatment. That would mean I am healing. I thinking I am healing. There is still a long way to go, and I know there will be ups and downs. The depression will emerge and recess at its own will, but I am making strides in the right direction. The esketamine is working. Therapy is working. Conversations with my mental health team are lifting me. Grounding myself in my senses is working. The blanket of depression is losing some of its heaviness. It may be happening slowly, but it is happening.