Category: Mental Health

Pro-Sanity Sundays: Running round the world

Kevin Carr crosses the finish line of his round-the-world run, 621 days and 26 countries of ultramarathoning. Photo courtesy of

Kevin Carr crosses the finish line of his round-the-world run, 621 days and 26 countries of ultramarathoning. Photo courtesy of

Kevin Carr of England, 34, has set a new world record for fastest run around the world—and he did it to raise awareness of, and money for, the fight against mental illness.

“I have loved endurance sport all my life, but I almost had a very short life,” he writes on his website, “At 19 I was incredibly lucky to survive a very serious suicide attempt. I’ve had to fight depression and anxiety all my adult life, but I’m determined not to let an illness or any stigma wrongly associated with it ever hold me back.”

Nothing held Mr. Carr back—not bears, heatstroke, pain, subfreezing and 100 degree-plus temperatures, or the flu. Some things slowed him down a bit, but he ran 16,300 miles through 26 countries in 621 days, breaking the previous record by hours. And he did it pushing a cart that held all of his gear. It weighed up to 100 pounds.

“By running around the world (one of the toughest things, both physically and mentally one could ever ask of the human body) I aim to provide a very real demonstration that: ‘An ill mind is in no way a weak mind.’ I hope to inspire others, especially people who are where I was.”

Mr. Carr crossed his finish line in Dartmoor National Park in the south of England at 1:35 p.m. EST on Thursday, April 9.

If you want to support his charities, go to his website,, for links to giving to SANE and the British Red Cross.

Worry Less Weekend: Do You Know What Day it Is?

If taxes give you this feeling, read on for help. Image courtesy of

If taxes give you this feeling, read on for help. Image courtesy of

Do you know what today is?

It’s the last Sunday before April 15, is what it is. Your federal tax return, and probably your state return, are due in three days. Three. Days.

If you’ve got this handled, you can stop reading now. But if you’re one of those people for whom tax season is a major source of stress– even depression and anxiety– read on for some tips from the IRS on how not to pull your hair out.

  1. Don’t procrastinate (any longer). You could snatch defeat from the jaws of victory and wait even longer to open that file of receipts… but don’t. Start now. Right this minute.
  2. Visit the IRS website. It may be counterintuitive, but avoidance is not going to help. In your heart, you know this. Go to, which is chock-full of useful and easy-to-use info. Click on “File Your Tax Return” to get great options.
  3. Use Free File. If you made $60,000 or less, you can do your taxes online for free—no need to buy any packaged software. Check it out at
  4. Don’t panic if you can’t pay. If you think you owe but don’t have the dough, file your return anyway. Send as much of a payment as you can manage now to avoid (or lessen) penalties and interest. According to the IRS, more than three-quarters of taxpayers eligible for a payment plan (called an “Installment Agreement”) can apply using the web-based Online Payment Agreement application available at Just type “Online Payment Agreement” in the search box. And if you’re in that last quarter, you can still contact the IRS to discuss payment options.
  5. Request an extension of time to file—but pay on time. You can get an extension of time to file till Oct. 15, but any taxes due are still due Wednesday. See number 2, above.

Most of the information in this post came right from IRS Tax Tip 2012-50, “Six Tips for Reducing Tax-Time Stress.” Nevertheless, I’m not a tax advisor and I don’t speak for the IRS.  But if you’re stressing about the April 15 date of doom—don’t. Take some action, any action, like going to and reading about how to get started.  You’ll feel better.


Pro-sanity Sundays: Why the Germanwings tragedy matters to you

img-handsNew events have pushed the deliberate downing of the Germanwings flight off the front pages.  Maybe now you’re wrapped up in the Iranian nuclear negotiations, or engaged in the whittling of the Final Four to the Victorious One. That’s normal. But before you shake your head one last time over the actions of co-pilot Andreas Lubitz, consider this:

Suicide is the tenth leading cause of death in the United States.  For young people ages 15 to 34, it is the second leading cause of death.  According to the Director of the National Institutes of Mental Health, Thomas Insel, M.D., mental illness is not the only cause of suicide. “There are many types of individuals at risk for suicide,” he wrote in a recent blog post. You might know one. You might be one.

There is help.  The National Suicide Prevention Lifeline—1-800-273-TALK—can connect you to local resources, whether you are suicidal or just worried about someone else. There will be a caring individual on the other end of the line, 24 hours a day, 7 days a week.

Don’t suffer alone or allow a friend to do so. Connect, and live.

Pro-sanity Sundays: Cheer up with some vitamin D

Courtesy of, Oxford  students enjoy warmer-than-usual weather.

Courtesy of, Oxford students enjoy warmer-than-usual weather.

Feeling a little perky with the advent of some spring sun, however weak?  It’s probably not your imagination.  A new study from Oregon State University suggests there is a relationship between low levels of vitamin D and depression in otherwise healthy young women.

You make your own vitamin D when your skin is exposed to sunlight, although vitamin D is also found in some foods. When sunlight is scarcer, as it is in winter, vitamin D levels tend to decrease. When the days get sunnier and longer in spring, vitamin D levels tend to increase. Year-round, the recommended daily allowance of vitamin D is 600 I.U. per day. There’s no established vitamin D level for mental health.

The study followed 185 undergraduate women aged 18-15 through four weeks of normal activity, checking vitamin D blood levels at the beginning and the end of the period and with weekly web surveys of mood and activity.  Result?  Young women with lower levels of vitamin D were more likely to have clinically significant depressive symptoms.  The results were consistent even when researchers took into account other possible explanations, such as time of year, exercise and time spent outside.

Lead author David Kerr, an associate professor in OSU’s School of Psychological Science, said the study was prompted in part because there is a widely held belief that vitamin D and depression are connected.  This study did not conclusively show that vitamin D levels cause depression, researchers said.  A clinical trial examining whether vitamin D supplements might help prevent or relieve depression is the next logical step, Kerr said.

In the meantime, your entire skin surface is a vitamin D factory, so roll up those sleeves and go for a walk.  With sunscreen, of course.

Ode to Billie Joe: Suicide Rate Much Higher for Rural Youth

Bobbie Gentry’s 1967 country song tells the story of a boy who mysteriously “jumped off the Tallahatchie Bridge.” Even today, suicide still accounts for about 1 in 10 deaths among teenagers. Although national rates of youth suicide have decreased since 1991, a study published this week in JAMA Pediatrics reveals the disparities between rural and urban youth suicide mortality.

According to the study, the suicide rate for male youths in rural counties (almost 20 per 100,000) is almost double the rate of male youths in the most urban counties (about 10 per 100,000). While rural suicides have been more common since at least the 1990s, the gap between rural and urban suicides has only widened with time, at least for males. Regardless of where one lives, youth suicides by firearms have decreased, while suicides by other methods like hanging have increased.

It is difficult to pinpoint exactly why rural youths are committing more suicides. The study’s senior author Dr. John Campo believes accessibility may be a major problem, as “it’s especially difficult to receive psychotherapy in a rural area” (Source: OSU press release). There may also be cultural issues at play; when there is more stigmatization surrounding mental illness, people may be less inclined to seek help, according to the press release. Identifying the reasons behind these tragic statistics should be the next aim for public health policymakers and healthcare professionals.

Photo credit: Victor Reynolds via Flickr

Got cabin fever?

Feeling like this is your house?  Hang on, spring really is coming.

Feeling like this is your house? Hang on, spring really is coming.

The people who write this blog are located in north-central North Carolina, which has lately experienced a lot of snow.

This isn’t normal.

Of course, other regions of the United States are experiencing record-setting snow this year.  A representative of the normally hardy Bostonians used words like “desperate,” “hammered” and “drained” in a New York Times op-ed to describe their reaction to their Alpine accumulations.

One of the consequences of this kind of weather is that people have to stay indoors more than usual.  They get what’s known as “cabin fever.”

It’s not a precise term, but if you’re having it, you might be “irritable, unmotivated, and lethargic” according to WebMD, or feeling “dissatisfaction at home, restlessness, boredom, irritability, and needing to break routine” according to a 1984 paper in the Journal of Social Psychology.  (That one comes from the University of Minnesota, where presumably they know from cabin fever.  They definitely know from snow.)

If you’re hemmed in by a mountain of fluffy or crunchy white stuff and haven’t been out of the house in days, you might be a bit grumpy—understandably so.  WebMD suggests:

  • Don’t overdose on the news
  • Use a relaxation technique to unwind
  • Limit your intake of alcohol
  • Maintain contact with your friends
  • Exercise regularly

And if your grump persists, or starts intensifying, see a doctor.

The National Institute of Mental Health differentiates between cabin fever and depression.  Their excellent article on depression begins with the acknowledgement that “Everyone occasionally feels blue or sad.  But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you.  Depression is a common but serious illness.”

We’ll talk about depression in more depth in a future post.

Pro-sanity Sundays: Bipolar people’s press

The cover of the latest issue of bp magazine, written by and for people with bipolar disorder.

The cover of the latest issue of bp magazine, written by and for people with bipolar disorder.

A magazine for people with bipolar disorder is celebrating its 10th anniversary with an issue in mailboxes now.

bp magazine is a glossy quarterly with the tagline “hope and harmony for people with bipolar.”  Leaving off the “disorder” reflects the shortened version often used by people who have the condition—but it could also be an assertion that the condition doesn’t always have to “disorder” one’s life.

Formerly known as “manic depression,” bipolar disorder is characterized by extremes of energy, inspiration, grandiose thinking and behavior (mania or the highs) and opposite extremes of lethargy, poor self-concept and withdrawal (depression, or the lows).  The changes in mood typically repeat and can last for hours, days, weeks or months.  Lithium used to be the standard treatment, but the last 20 years have brought major advances in understanding the disorder and in treatments for it.

Issues of bp typically provide a cover story of a notable person who has bipolar, news of research advances in treatments for bipolar, letters and comments from an active online community of readers with bipolar (and their support people), tips and professional advice for coping with the many problems bipolar can cause, reviews of books about the condition, and columns from survivors.

Members of the bp staff took the opportunity of the 10th anniversary issue to comment on their jobs, using words like “powerful.”

“It’s the personal stories told in these pages that I think are so inspiring,” wrote news editor Paul Forsyth.  “They play a vital part in ‘normalizing’ mental illness, and it’s uplifting to read how people whose lives had often spiraled into destruction and despair can reclaim their futures and tell their stories with such dignity, courage, and in many cases, even humor.”

For more information on bp, go to

The Battle Within: PTSD alters the body’s response to stress

Post-Traumatic Stress Disorder (PTSD) can arise in people after they have experienced a traumatic event, such as being in combat or suffering physical or sexual abuse. It can be a debilitating psychological condition, as symptoms – which include intrusive flashbacks of the trauma, chronic hyperarousal, and avoidance behaviors – greatly decrease a patient’s quality of life. But how does this illness actually affect the body during stress?

To answer this question, researchers used an experimental technique called the Trier Social Stress Test. In this study, currently in press at Psychoneuroendocrinology, both healthy females and those with PTSD completed the task. Participants were asked to prepare a speech, deliver it in front of a panel of stoic judges, and then perform mental arithmetic out loud, being careful not to make any mistakes. This task might seem nightmarish to many readers, but it is frequently used as a reliable way to induce stress. While all PTSD participants reported much greater psychological distress than their healthy counterparts, some of these patients’ biological stress responses – as measured by cortisol levels – were actually lower than normal throughout the task.

Why is it that PTSD would cause blunted cortisol release in some patients but not others? Although the authors’ data could not provide any definitive answers, the study suggests that there may be a subtype of PTSD patients in which stress hormones are particularly dysfunctional. This subgroup had overall greater symptom severity and different patterns of cortisol-related gene expression. Knowledge of distinct PTSD subgroups may help inform individually-tailored pharmacotherapy treatments – eventually giving patients a better chance not just to survive, but to thrive as well.

Pro-sanity Sundays: iTherapy?

photo of iPad2Online cognitive behavioral therapy for depression could become a “useful strategy to reduce suicidal ideation,” according to a pair of Australian researchers.


Their study, which appeared in the January 2015 Journal of Affective Disorders, followed the progress of 484 depressed patients who were prescribed internet cognitive behavioral therapy (iCBT).  More than half (56.8 %) finished all six iCBT lessons.  At the study’s outset, half of the patients had suicidal ideation (the visualization of or actual plans for a suicide attempt, which is considered a danger signal for suicide); at the completion of the study, only 27% had it.  The prevalence of major depression went from 71% at the outset to 28% at completion.


The authors, Louise Mewton and Gavin Andrews, note that iCBT is “a strategy which can be implemented on a large scale without enacting major structural change at the societal level.” The patient data were de-identified, but more than half of the referring clinicians were based in rural areas of Australia (55.6%) and almost half were general practitioners (45.2%).  This implies that iCBT therapy could be practical and effective in situations where there is a dearth of mental health specialists, or where patient transportation is an issue.


The study was “practice-based”; that is, data from an established practice were analyzed.  The gold standard in the medical field is a randomized double-blind clinical trial, and the authors advocate for iCBT to be so tested.  But the Mewton and Andrews report is an indication that rural and underserved mental health patients may soon have another way to access badly-needed treatment.

Art and Nature: “Awe”-some for health!

When it hits you – your eyes widen and a tingle runs down your spine – you’ve encountered something that fills you with wonder and awe. It might be from gazing at the Milky Way on a camping trip, admiring the passionate brush strokes of Van Gogh, or attending a church service to worship a higher power. However it happens, experiencing the emotion of awe may not just be awesome; it may also be good for your health.

A recent paper published in the journal Emotion found that positive emotions – and especially awe – were associated with lower levels of IL-6, a marker for inflammation. Proinflammatory cytokines like IL-6 are normally important when the body is exposed to infection or injury, as they help the body to heal. However, chronic levels of inflammation are implicated in the progression of diseases such as diabetes, cardiovascular disease, and certain types of cancer.

While stress can increase the body’s level of inflammation, this study suggests that positive emotions like awe can act as a counterbalance. This study supports previous research that has shown that other positive psychological processes – such as finding value in one’s life and making meaningful social connections – are associated with gene expression profiles indicative of lower levels of inflammation. Because positive emotions may prompt us to explore and connect with others, they may help us identify resources that help protect us against adversity. So get going and see the world, for both your mind and your body.

Image credit: Robert Couse-Baker via Flickr