The Implications of AI on Mental Health

                 I have been intrigued by some of the uses of AI (Artificial Intelligence). I became more intrigued when I heard that it can be used for mental health. Despite my intrigue, I was skeptical. What I found indicates that there are positives and negatives to the use of AI with mental health. It seems that even though there are some positive possibilities, AI cannot replace the human aspect of mental health support. Let’s take a look at some of the positives and negatives.

                  We first need to ensure that if AI is going to be used to support individuals with mental illness, the integration of AI needs to follow ethics, be transparent, and have human oversight. AI should not be used in isolation for mental health support. The people who use AI in this way, need to understand the risks and limitations of its use. Mental health safeguards need to be in place. Ethical guidelines need to be followed. In addition, data needs to be protected. While I have not researched the specifics, AI does collect data. So, using it for mental health would include allowing your information to be collected. 

                  One positive implication of AI on mental health is improved access. There are AI chatbots and digital therapists that can provide 24/7 emotional support and early intervention. This can be useful in areas where services are scarce or where receiving services is stigmatized. These AI tools can track moods, help a person practice CBT techniques, and allow a person to receive crisis resources quickly. While these sound great, I am hesitant to support the use of AI chatbots and digital therapists. I would rather a person call the 988 lifeline. I just do not think a computer or AI can replace a human. It certainly cannot replace a human psychiatrist, psychologist, or therapist. In a mental health emergency, I would rather rely on a human than a computer. 988 provides the human connection that AI cannot.

                  Another positive mental health implication that is listed for AI is the ability to detect signs of depression, anxiety, or suicidal ideation early. AI can analyze speech, facial expressions, and social media activity. This analysis would allow it to detect warning signs early. Again, while this seems like a positive, I do not think I would want anyone relying on this. There are AI-assisted tools that mental health providers can utilize to identify at-risk individuals and to personalize treatment. These tools include Mindstrong, Ellipsis Health, and general screening/monitoring platforms that continuously monitor biomarkers, texts, and usage. Please note that I do not have specific information on these tools, and I am not endorsing them. I am simply noting that they exist. I would much rather these tools be used by a provider than having an individual with a mental illness rely on AI by themselves. 

                  There are noted negative implications of the use of AI for mental health. First, it can lead to an overreliance on AI companions, which would lead to a reduction in interaction. The lack of human interaction could potentially worsen symptoms. It might increase loneliness and increase social anxiety. If a person is relying on AI companions, such as AI “friends” or “therapists”, a sense of false intimacy may develop. There is no genuine empathy with AI, which can negatively impact a person with a mental illness. 

                  Another negative implication involves privacy and trust. Mental health data that is input into AI can be misused or leaked. An individual using an AI program for mental health does not know where their data is being stored or who has access to it. I would not want my personal mental health data out there in cyberspace being used in ways I did not intend for it to be used. 

                  A third negative implication is the possibility of misinterpretation of cultural or linguistic expressions of distress. This can lead to the neglect of some vulnerable groups. It can lead to misclassification of disorders and biased diagnoses. 

                  Finally, reliance on AI leads to a person being exposed to continuous curated content. In other words, too much exposure to social media platforms that utilize AI. There is a lot of research available about the overuse of social media. Too much social media or other internet content is not healthy for anyone. 

                  When used correctly by mental health professionals as a supportive tool AI can have positive implications for mental health. The key is that human connection and empathy need to remain at the core. I realize that not everyone has access to mental health care, or they might be in area where that service is stigmatized. As I mentioned earlier, I think 988 is a better alternative to AI. Yes, humans can make mistakes just like AI, but I would rather place my trust in a trained human than an AI program relying on algorithms. 

                  The use of AI is not going away. In fact, it will likely grow. I do believe that AI has a role in our society. I use it for research. However, when I use AI, I am aware that it is just a tool. I think in the realm of mental health, this tool is best utilized as a support used by mental health professionals as part of their treatment tools. Mental health is an area that is rooted in human connection. While AI can be helpful, I caution against allowing it to replace human support. 

 

My Old Self Wouldn’t Recognize Me

“…reading old journal entries and I know her, but she doesn’t know me.”

 

A social media friend posted this quote the other day.  It made me think about my long-time journal work. I have more old journals than I can count. So, I took some time to think about the writings that have carried me through so much over the years.  As I reflected, I realized how much I have grown through my journaling practice. 

My early journaling practice started when I was a teenager. I wrote poems in red spiral notebooks. I still have those notebooks. It was not traditional journaling, but it served the purpose of journaling for me. While I am not comfortable going back and reading those journals at this point in my life, I remember the ideas and tone of the content. Depression had entered my life. I was struggling. Everything I wrote was an acknowledgement of that struggle. The pain ran deep. At that time, I only saw darkness and my poems reflected that. Death was a frequent theme. It was a painful time and my journals, those red spiral notebooks, carried that pain. 

If the girl I was then could see the woman I am today, she would have difficulty recognizing me. Yes, depression is still a part of my life, but my world is much less dark overall. Sure, there are moments the girl I was then would recognize, but I have learned to cope with the depression.

As I moved on from my teenage years, I continued writing. At some points I found myself journaling more than others. I remember all those years and all those journals. There were so many words written about living with depression and anxiety. My journals were a place of escape, a place to find a haven for my thoughts. The younger me who wrote those words would not believe that I now write about more than my pain. My writing about depression has turned into a healing practice. 

This is not to say that I do not still feel the pain and darkness of depression. I do, but I have learned to use my writing as more than just an escape. My younger self likely would not understand because writing, journaling, was her escape. I have found that writing is healing. Perhaps, in a way, it was then, too. I just did not know it 

 Now, when I journal, I explore what I am experiencing. I go beyond the darkness of depression. I ask depression questions. Sometimes the answers find their way into other writings like this blog and my books. I have learned that by sharing my writing I am not only helping myself, but I can help others. 

I journal every day. It is a part of my healing toolbox. Maybe I should I write a letter to my teenage self. I could comfort her in a way I was not comforted then. I think earlier versions of myself would be amazed at the way journaling and writing in general, have carried me through difficult times. She would never have thought the words she scribbled in the many journals would have allowed me to evolve into the woman I am today. I have lived with depression. I have written about my depression on what may be near thousands of pages. That is hard for even present day me to believe. 

Journaling is powerful. I have written about journaling on this blog in the past (The Practice of Journaling). I share pieces of my journal with my mental health team in different ways. The poems I have written in my journals have made their way into all five of the books I have written. I have had conversations with others about depression and mental illness in general. This has happened because I picked up a pen almost 40 years ago and began journaling. 

As we journal, we transform along with our words. I have transformed. The younger me, from my teenage years to even a few years ago, would not recognize me today. I am aware of her. I know that I am the me I am today, because my younger self fought through the pain of depression, chronicled that pain on the pages of my journals, and created a practice that provided a safe space to process my struggle. For that I am grateful. 

A Letter to My Depressed Self

Dear Depressed Self

                  I am writing to you from a moment where all is not dark. I know you will find it difficult to believe that is possible, but it is. You will experience times when the darkness lifts. I know you spend a lot of time feeling as if everything is shrouded in darkness. You often feel life is not worth living. It is difficult to engage in life and you do not want to even get out of bed. That is depression. It is a part of you, but it does not define you.

Depression has been a constant companion for so much of your life. You will get better. I promise you this. Do you remember when the depression was so constant that ending your life was a common thought? You have overcome that even though those thoughts still creep into your mind. I know the depression still wanders in and grips you. Fortunately, you have excellent mental health care. You have a team determined to help you. I know you are aware of how important this team is in your life. 

On the days when the depression has released its grip on you, you are able to see that life is valuable and worth living. You realize how often depression has lied to you over the past four decades. It is really hard to understand how much depression has darkened your view of life, but deep down you know that you are not your depression.

The important thing is that you are making progress. You are winning the battle with depression. Even on the days when it does not seem that depression will ever leave you alone, there is hope. Sometimes you just need to talk to someone on your team. Other times you need esketamine treatment. Whatever it is, you have support to carry you through the darkness. Don’t get discouraged. You have this amazing support system. You need only reach out and they are there. 

I want you to remember that what you feel is real and not real at the same time. It is real in the sense that you are feeling it. Depression is not in your imagination. It is as painful as you experience. But it is not real in the sense that it lies to you. When it tells you that life is not worth living or that life won’t improve, it is lying. Depression feeds off its lies. At times you feel hopeless. I get it. That feeling will return at times. It is a part of the illness that is depression. 

Depression does get better. Sure, there will be ups and downs. Remember, you have an illness. You require treatment, which you thankfully have access to. You are strong. You have overcome so much. Depression has been hard on you, but you have fought back. I am proud of you for all your efforts. I know there will be times when the depression seems in control. There will be times when you need to step back and rely on your mental health team. That is okay. Keep fighting. Focus on the positives and remember that depression is not in control. Talk back to it. Trust that you will heal. 

Sincerely,

Your Healing Self

 

Note to Readers:

While I wrote this letter to myself, if you are living with depression, this letter is to you as well.  We share the diagnosis of depression. We have had similar experiences. Although, each of our experiences are also unique. My intent in sharing this letter is to remind all of us that we can fight depression. We can live meaningful lives with this illness. Sometimes we just need reminders that it gets better.  If you need help, please reach out to a mental health provider, a primary care provider, or 988.

Lemonading

When life gives you lemons, make lemonade.

                  The other day I was scrolling social media, which is something I find myself doing too much of lately. Anyway, I came across a word I had never heard. It sounded made up and it probably is. The word is “lemonading”. The definition given on the post was “turning a negative situation into something positive, empowering, or creatively fruitful.” I immediately thought of the mental health and physical health aspects of the definition of this new word.

                  A quick internet search revealed that as would be expected this comes from the saying “When life gives you lemons, make lemonade.” At its essence it means turning something bad into something good. Lemonading is the idea of growing from negative experiences. We can learn from a setback. We can use rejection, failure, or pain as motivation. We can reframe negative experiences in a constructive manner. When we do these things, we are lemonading. 

                  When we are lemonading we are doing several positive things. One thing is boosting resilience. In doing this, we are not allowing ourselves to remain discouraged even when we face difficulties. Lemonading leads to shifts in mindset. Instead of focusing on the negative we are pushing ourselves towards optimism. We also incorporate problem-solving. This can build creativity. We are pushing ourselves to find new ideas or ways to move forward. All these things can lead to improvements in mental health. 

                  How does lemonading improve mental health? I doubt there is much research on this with respect to the term lemonading since it is such a new word. I think the benefits are fairly obvious, though. When we focus on the positive it helps us to feel better. We see the world in positive light when we are lemonading. While this is not going to cure mental illness, it might help to lift mood. It is part of the process of restructuring our thoughts or using self-talk to change our thoughts. For example, maybe we are struggling with our depression. Our thoughts are dark. If we attempt to use the practice of lemonading, we might try to find one thing that is positive. Maybe it is as simple as noticing the sun shining in a blue sky and focusing on that. Thoughts of a bright sun might remind us of a time when we did something fun in the sun. These thoughts can serve as a distraction for a bit. This is not going to make the depression go away, but it might make it a little easier to cope with. 

                  Another way a person with a mental illness might engage in lemonading is getting involved in raising awareness about mental illness. Let me share an example from my own life. I have lived with mental illness for nearly 40 years. It is painful. It is difficult. How do I engage in lemonading? I started sharing my story. I used my writing, which has always held my pain, to creatively share my experiences with depression and anxiety. This led to several positives. I published and sold my books. I gave talks and read from my books at bookstores and coffee shops. I discovered an awareness and advocacy group, NAMI, that changed my life. Through NAMI I have been able to continue sharing my story, teach others, and raise awareness about mental illness. While the word is new to me, I have been lemonading. I shifted the negative aspects of my mental illness into positives by reaching out to others. I continue to engage in lemonading. I am active member of NAMI. I also continue to write and share my story. This blog is an example of my lemonading. I have experienced creativity and growth in the face of the negatives of mental illness. 

                  Another example of lemonading is when people who have been struck by an illness start fundraising for a cure. Think of the countless number of charity walks that are held each year. My breast cancer diagnosis has led me to raise money for breast cancer research. In fact, I am planning another fundraiser now. NAMI Walks take place all over the country to raise money for mental illness. People who have lost loved ones to suicide often get involved in raising money for and awareness about suicide. There are walks and other fundraisers to help individuals with autism. The examples are countless. I think it is a part of human nature to want to help when surrounded by negatives. In this way lemonading has been around for long time. 

                  There are so many examples of lemonading in the world. I wish we saw them more frequently. Too often we are focused on the negative, but there is lemonading going on all around us. Can you think of any examples? Share them in the comments.

                                                       

I Pressed On

                I read somewhere that if you rearrange the letters in the word “depression” it says, “I pressed on.” As I thought about it, I began to think about my lifelong battle with depression. It has been a struggle. Starting in my early teens, depression has dragged me down and made my life difficult. Almost 40 years after depression first reared its ugly head, I am still here. Do I struggle at times? Yes. Is depression still present in my life? Yes, but I am still here. I pressed on with living despite the painful darkness of depression. 

                  It has not been easy to press on. Many times, I have been on the verge of giving up on life. I have needed help to crawl back from the edge of suicidal thoughts. Even though the urge has been intense at times, I have not given up on life. I have fought depression with everything I have. Of course, I recognize that this fight would not have been possible without the people who have stood beside me. I have a mental health team that is always poised to lift me out of the darkness. They are always there to listen and empathize. This team provides the treatment I require to continue to my battle. I am not able to press on without them. 

                  What does it mean to press on? I think it means to make an effort even when everything around you is telling you that you can’t or that it is not worth it. Sometimes this requires wearing blinders. I needed to fake that I am okay at times. This is no easy feat. It requires lying to myself. When the depression is bad and I still need to function in the world, I must tell myself that I do not feel the darkness encompassing me. I need to wear a fake smile. Sometimes I need to put my head down and go to work or interact with others when inside I am gripped by a feeling of worthlessness. To be honest I do not know exactly how I have done this. I tell myself bills need to be paid. I tell myself no one can know how I really feel. In other words, I just press on. 

Depression is an illness. That is just a fact. I live with an illness. It is a major part of my life. Depression drags me down, but I also step on it. There is something inside of me that fights this illness. I need help from my psychiatrist, psychologist, two psychiatric nurse practitioners and a few friends/family. That seems like a lot of people, but that is what it takes to press on. I need their support and treatment. Anyone with an illness needs those.

My cancer battle has taught me to have more respect for the fact that my depression is an illness. As I fought cancer, I needed a lot of support and treatment. If it is okay to need support and treatment for cancer, then it must be okay to need those for other illnesses, including depression. 

                  I am not the same person I was when depression first inflicted me. I have grown in my understanding of my illness. Depression does not scare me the way it used to. Sure, I still get overwhelmed by it at times, but I now know I can fight it. I have support and coping strategies to guide me as I press on. 

                  Depression can tear a person down. It makes life a challenge. Depression can also teach us how to move forward. That will to move forward is born out of necessity.  I will always battle depression, but I can still press on. 

Just Be

                  There is a Styx song titled, “Just Be”.  It is one of my favorites of their songs. It has a mellow feel, while still being a rock song. The concept behind the words “just be” remind me that sometimes we need to sit with ourselves and let the world happen around us. As someone with depression and anxiety, this is an important concept for me. 

                  What does it mean to “just be”? I think it means embracing a moment. It means letting go of what is in our minds. Depression and anxiety can really get my mind going on what seems like a never-ending loop. In these moments it is difficult to be still and to quiet my mind. I have several strategies at my disposal to try to cope in these situations. I use strategies such as self-hypnosis, listening to a hypnosis recording my psychologist made for me, listening to music, walking, writing/journaling, and creating art. One thing all these strategies have in common is they allow me to “just be”. I attempt to escape whatever is hounding me at the time by delving into one of these strategies. When I am doing this, I try to allow my mind to focus on just being present rather than the thoughts or pains I am experiencing. In a way I am allowing myself to “just be.”

                  There is a line in the song that I relate to, 

 

“You close your eyes 

But the sleep won't come.” 

 

I often struggle with my thoughts when I go to bed at night. Depression and anxiety like to relive the day or anything that has been difficult. They like to provide a running commentary that keeps me from being able to relax and sleep. Can anyone relate to this? I know I am not alone in this experience. As I lie there, I struggle to just be, but I know I need to find a way to let go and just be. 

By definition, just being is existing without striving, performing, or fixing. It sounds simple, right? As I have described it is not always easy. My nighttime experience is an example of how it can be difficult to let go of the expectations the world and we, ourselves, place on us. Our minds want to revisit everything. It is as if in revisiting we can fix things. But what if we could fix things by letting go and just being? 

One way we can just be is to sit in stillness with no goal in mind. Maybe we look out a window or sit on a park bench. We can notice a tree or feel the air. We can notice any sensations that might fall upon us. If we focus on noticing, we can learn to not try to manage the moment and to just be. We should observe, but not analyze. If we see the petals on a flower, let them be just petals. Notice their color and take those colors in. If we have a feeling as we are sitting in the stillness, let that feeling be a feeling without trying to analyze it or fix it. This is not easy, but with practice we can learn to sit in the stillness even if just for a couple moments.

I mentioned walking as a coping strategy I use. One way we can improve our ability to just be while walking is walk without a destination in mind. In this way we just allow our feet to guide us. We walk without an end destination in mind. This may be easier in park, beach, forest, or residential area. As we walk, we want to just move through space. Again, we can notice our surroundings, but we do not want to think too much about them. Let whatever we come across, just be what it is. Perhaps we walk by an oak tree. Notice that oak tree, acknowledge it, and move on with our walk. 

There is a lot of information available about breathwork. But if we are trying to just be, we should just let ourselves breathe naturally. We do not have to practice deep breathing in these moments. We can save that work for another time. If we are trying to just be, we should merely notice our breath and let ourselves breathe. 

Silence is often an uncomfortable place for those of us with mental illness. If we are trying to just be, we want to notice silence. We can listen for the silence between noises. In this way we are allowing silence to be a presence rather than an absence. If we can reach that point, we are closer to just being. We are also taking the focus off our thoughts and placing it on the silence. 

I read about another way to just be. The recommendation was to drop the narrator. It said to let the narrator gently fade away. This struck me as very difficult. My depression and anxiety fuel the narrator in my head. I can see the benefit of letting this narrator fade away. For me, I think some self-talk would be necessary to guide this narrator away. It likely will not be an easy task, but I can try. The potential benefits make it worth the effort. 

While looking for information on just being, I found a practice called “The Here, Now, This” Practice. It can be done in 30 seconds or stretched out longer. We can do this while sitting, while walking, or while lying in bed. There is no specified position. Our eyes can be open or closed. The first step is to silently say, “I am here.” We should feel where our bodies are. Notice any contact points, such as the floor, a chair, or a bed. Then we let that be enough. We are here. The second step is to silently say, “It is now.” Do not pay attention to a clock. We should let go of the past or the future. The key is to notice the exact moment we are in. Just the breath, the light, and the sound.  In this moment there is nothing else. We are in the now. The third step is to silently say, “This is what is happening.” There is no judgment, no good or bad. Let whatever is happening just be. It could be a thought, a noise, a mood, a tightness, or an ease. Acknowledge it and let it be. Remember that you do not need to fix or change anything. We are in the now.

For me the practice of just being is a work in progress. I am doing my best to make daily efforts to allow myself to just be. I am not always successful, but in the moments that I am, it is worth the effort. Give it a try. Allow yourself to just be, even if only for a moment. 

 

                  

Complimenting Others

                 Yesterday I visited my mother at the assisted living facility where she is now living.  It seems like a very welcoming place. While I hate seeing my mom lose her independence, I am pleased that this facility seems to offer great care. The environment is very positive. I saw a sign on a wall that caught my attention. I thought I would share it here. The sign said, “What If We Began Flinging Compliments Around with Wild Abandon?” I love this idea. There is so much negativity in our world right now. I wonder what would happen if each of us made an effort to give a couple compliments each day.

                  What is a compliment? By definition, a compliment is “a polite expression of praise or admiration.”  Sounds simple enough. How do we get in the habit of giving compliments? First, it is important to be observant. We should interact with others with the intention of noticing positives. It is not about looks, although you could compliment someone’s style or efforts to make positive body changes. We should notice a person’s insight, dedication, humor, and kindness. Also, we should notice the way a person interacts with others and the efforts they make to be kind, helpful, and caring.

                  We should be sincere when we compliment someone. While flattery is okay at times, it should not be the basis of compliments. When we compliment someone, it should be about something we truly admire. We do not need to exaggerate. All we need to do is make a sincere observation. 

                  A compliment is more sincere when it is specific. I think it means more when a compliment is specific rather than just a generality. Think for moment. Is there a specific compliment you could give someone in your life today? 

                  Compliments can be said aloud. They can be written notes, texts, or emails. How would you feel if you received a note, text, or email with a compliment? How would you feel if someone said something complimentary to you? Chances are it would bring a smile to your face and make you feel good about yourself. When others notice something positive about us, it gives us a lift. 

                  This is mental health blog. So, where is the mental health tie-in to compliments? I just said it. A compliment can make a person feel good about themselves. That good feeling can increase our self-esteem. It can also lift our mood. I am not saying compliments can heal mental illness, but they can give a bit of relief to the symptoms. Compliments give a little lift. Compliments can bring a smile to our faces. Compliments can make us pause and notice that there are positives in our life. They can also let us know that other people appreciate us. Anything positive that makes us feel good is helpful when we live with mental illness.

                  I would like to issue a challenge. Let’s all try to give two compliments a day for a week. That will start a habit of giving compliments and making others feel good. This could be contagious. When we receive a compliment, we may be more likely to give a compliment to someone else. When that happens, we are doing our part to bring a bit of positivity into this world that is often full of negativity. Two compliments a day. That is all I am asking. I am starting today. Will you join me in flinging compliments with wild abandon?