TUESDAY, JUNE 2, 2020

Alexandria, VA - More than 88,000 additional people have developed anxiety or depression as a result of the COVID-19 pandemic, according to new data released today by Mental Health America (MHA) from its online screening program.

In addition, more than 21,000 depression screeners reported thinking of suicide or self-harm on more than half the days – a number that suggests a coming wave of mental impacts that could be of epidemic proportions.

In May 2020, more than 211,000 people took a free, anonymous online mental health screen at www.mhascreening.org. The results from those screenings continued the upward trends in mental health conditions observed by MHA – and confirmed by recent analysis from the U.S. Census Bureau – since the start of the COVID-19 pandemic.

“Our May screening numbers were unprecedented,” commented MHA President and CEO Paul Gionfriddo. “And what is most troubling,” he added, “is that the numbers – consistent with the numbers from the U.S. Government’s Census Bureau - demonstrate not only that there is not yet any relief from the mental health impacts of the pandemic, but that the impacts actually seem to be spreading and accelerating.”

Gionfriddo also emphasized on the suicidal/self-harm ideation numbers. “These numbers are just so striking. When you consider that a total 45,000 to 50,000 Americans die by suicide every year and nearly half that number reported suicidal or self-harm thinking in just May alone, this has to be a wake-up call to policymakers to act now to prevent this,” he said.

“There are three options immediately available to federal policymakers – pass the 988 legislation already approved by the Senate, pass the funding for the mental health block grants and other safety net mental health providers and services already approved by the House, and work together to make mental health screening the norm for the entire population to find new cases of mental illnesses as soon as they emerge.”

Since the beginning of the pandemic:

·       There have been at least 88,405 additional positive depression and anxiety screening results over what had been expected (using November 2019-January 2020 average as a baseline).
 
·       There have been 54,093 additional moderate to severe depression and more than 34,312 additional moderate to severe anxiety screening results from late February through the end of May.
 
·       The per day number of anxiety screenings completed in May was 370% higher than in January, before coronavirus stress began. The per day number of depression screens was 394% higher in May than in January.
 
·       These impacts on mental health are more pronounced in young people (<25): roughly 9 in 10 are screening with moderate-to-severe depression, and 8 in 10 are screening with moderate-to-severe anxiety.
 
·       “Loneliness and isolation” is cited by the greatest percent of moderate to severe depression (73%) and anxiety (62%) screeners as contributing to mental health problems “right now.”
 
·       In May 2020, 21,165 depression screeners reported thinking of suicide or self-harm on more than half of days to nearly every day, with 11,894 reporting these thoughts nearly every day.
 
·       Special populations are also experiencing high anxiety and depression, including LGBTQ, caregivers, students, veterans/active duty, and people with chronic health conditions.
 
·       This isn’t just affecting people with anxiety and depression, but other mental health conditions, too. Among all psychosis screeners in May, more than 16,000 were at risk of psychosis, and the percentage at risk (73%) also increased.

MHA has had an online screening program since 2014. People who come to the website can screen anonymously and for free, using the same evidence-based mental health screening tools that are used by most clinicians. Over five million people have taken a mental health screen in the last 5 years. More than 300,000 took an anxiety screening in 2018 and 2019 alone. Most people who take a screen have never been diagnosed with a mental health condition.

MHA will continue to monitor its screening data and report out details in the coming weeks and months. To take a mental health screen, visit www.mhascreening.org. MHA offers customized resources to everyone who takes a mental health screen, based on the screen taken, severity of the result, age of the individual, and other factors.

More information:
COVID-19 and Mental Health: What We Are Learning from www.mhascreening.org

Source: https://www.mhanational.org/mental-health-america-releases-may-2020-screening-data-88000-have-anxiety-or-depression-and-results 

Dr. Giuseppe (Bepi) Raviola, director of mental health at Partners In Health, put together a list of key practices to maintain good mental and emotional health for those asked to stay at home in efforts to prevent further spread of the novel coronavirus, or COVID-19. 
 
As we enter this new and unprecedented phase of the pandemic, we are inundated with guidelines about how to keep ourselves and our families healthy and virus-free. Yet a key item on the list—social distancing—poses unprecedented challenges to our mental and emotional well being, and requires consideration. The risk may be especially high for our children, who are suddenly cut off from school and friends.
 
How do we as individuals and parents cope without driving ourselves and each other crazy?
 
It’s a question that mental health professionals such as myself are being asked multiple times a day and that urgently needs addressing. This introduction and list was written with the help of people with whom I work, trying to gain steady emotional footing in this strange new scenario we together are in:
 
Top 10 Practices:
 
         1) Social distancing does not mean emotional distancing; use technology to connect widely;
 
         2) Clear routines and schedule, seven days a week, at home—don’t go overboard;

         3) Exercise and physical activity, daily if possible;
 
         4) Learning and intellectual engagement—books, reading, limited internet;
 
         5) Positive family time—working to counter negativity;
 
         6) Alone time, outside if possible, but inside too; but remember, don’t isolate;
 
         7) Focused meditation and relaxation;
 
         8) Remember the things that you really enjoy doing, that you can do in this situation, and find a way to do them;
 
         9) Limit exposure to TV and internet news; choose small windows and then find ways to cleanse yourself of it;

         10) Bathe daily, if possible, to reinforce the feeling of cleanliness.
 
 
Remember:
 
*Things will get better eventually, and back to normal; the world is not collapsing (don’t go “catastrophic”).
 
*Most people are good, and people are going to persevere and help each other.
 
*You’re tough, you’ve overcome challenges before; this is a new one.
 
 *This is a particularly strange and unprecedented situation; humor helps once in a while.

*If having obsessive or compulsive thoughts related to the virus, or the broader uncertainty, wash your hands once, and then remind yourself that anxiety is normal in this scenario. But the mind also can also play tricks on us. Try to breathe and move the internal discussion on.
 
*Live in the moment, think about today, less about the next three days, even less about next week; limit thinking about the next few months or years, for now.

From:https://www.pih.org/article/10-mental-health-tips-coronavirus-social-distancing?fbclid=IwAR3IHX7fKqNxTbcnBsP4b3gs3Rw1Tn42idWYUJYoDD1A50xSUi32NmjoiQA

What Is the Best Diet for Mental Health?
 
New research is exploring the connection between the foods we eat and our feelings of depression, anxiety, and happiness.
BY KIRA M. NEWMAN | SEPTEMBER 18, 2019
            
Should you eat an apple—or a bag of Oreos? Go to McDonald’s—or the vegetarian restaurant on the corner?
 
When we make these everyday food choices, many of us think first of our physical health and appearance. But there’s another factor we may want to consider in picking foods: their impact on our mental health.
 
A growing body of research is discovering that food doesn’t just affect our waistline but also our moods, emotions, and even longer-term conditions like depression. Which makes sense, after all. Our brains are physical entities, running on the energy that we put into our bodies, affected by shifts in our hormones, blood sugar levels, and many other biological processes.
 
Although there are many unanswered questions, the research to date can give us some guidance when we’re hunting for an afternoon snack. What we know so far can be summed up, more or less, as this: Whole-food diets heavy on the fruits, vegetables, and unprocessed protein can lift our moods and protect us from depression, while too much junk food and sugar may put our mental health at risk.
 
One-third of adults in America eat fast food on a given day. Many of us see French fries and chocolate cake as treats to cheer us up when we’re feeling down. But perhaps our perspective on food needs an update. With a few simple dietary changes, you might be able to improve both your mind and your mood.
Can your diet protect you from depression?
 
A paper published this year in Psychosomatic Medicine offers one of the most up-to-date snapshots of diet and mental health—specifically, how diet might play a role in depression.
 
The research team scoured academic journals for experiments that had asked people to change their diets and had measured the effects. In all, they found 16 studies with nearly 46,000 participants from the United States, Australia, and Europe, ranging from ages 21 to 85.
 
The experiments were quite diverse, prescribing a variety of diets to boost nutrient intake, reduce fat intake, or encourage weight loss. One group went on a vegan diet, while others restricted calories; many people loaded up on fruits and vegetables while avoiding meat and processed foods. Some people attended nutrition classes together, while others got personalized counseling or simply took home a set of guidelines. They followed the diet for anywhere from a couple weeks to a few years.
            


The results? Overall, adopting a healthier diet did lead to reduced symptoms of depression—less hopelessness, trouble sleeping, and disconnection from others—compared to engaging in other self-improvement activities or going about life as usual.
 
“Including more non-processed foods, more whole foods—fruits, vegetables—is very beneficial in terms of your psychological well-being, particularly mood,” says Joseph Firth, the lead author of the paper and a research fellow at Western Sydney University.
 
But the results got more interesting when the researchers started to dig into the details, to see for whom and under what conditions our diet might keep the bad feelings at bay.
 
Who benefits most from a healthy diet?
 
First off, diet programs tended to work better for women. Why? Besides differences in hormones and metabolism, Firth conjectured, women seem to be in a better position to benefit. They’re more likely to be depressed, and, he says, they might have more discipline at following diets than men.
 
Also, the diet programs worked better if a dietary professional administered them—probably because the recommendations were sounder and the participants (believing in the dietitian’s authority) were more apt to follow them, Firth says. An earlier review of diet studies came to a similar conclusion.
 
One of the strongest studies in the collection suggested that diet could help people who were right in the midst of a major depressive episode. Researchers recruited 67 depressed people with poor diets, half of whom were instructed to follow a healthy, Mediterranean-style diet favoring whole grains, fruit and vegetables, legumes, low-fat dairy, nuts, fish, lean red meat, chicken, eggs, and olive oil while reducing sweets, refined grains, fried and fast food, processed meats, and sugary drinks. Across 12 weeks, they attended seven sessions with a dietitian who helped them set diet goals and stay motivated; they also received recipes, meal plans, and a hamper of food.
 
The other half attended sessions on a similar schedule. But rather than getting diet advice, they simply spent time with a research assistant who was trained to be supportive of them—talking about topics they were interested in, like sports and hobbies, or playing games with them for an hour.
             
 
Despite how beneficial social interaction is, the diet group fared better than the social support group. After 12 weeks, they had reduced their depression and anxiety more—and they were about four times more likely to experience a remission from their depression. The more they improved their diet, the more their depression lifted.

 
What about anxiety? In that particular study, anxiety did go down—but on average, across all 16 studies, healthier diets didn’t seem to make people less anxious. That actually strengthens the case that diet can directly affect depression, says Firth. If the results were simply due to people feeling proud and accomplished with their new healthy habits, you would expect them to feel better all around, including less anxious. The fact that only their symptoms of depression shifted means that something deeper may be going on. 


What could that be? We don’t know for sure yet, but there are a variety of biological processes that seem to be both influenced by diet and involved in mental health. It’s possible that certain diets may increase inflammation and oxidative stress, and disrupt our mitochondrial function and neuron production, in ways that could put us at risk for psychological problems. Our gut microbiome—the colony of microorganisms in our intestines that is increasingly being studied as a contributor to mental health—may interact with many of these processes. 
 
Also, says Firth, following a diet can bring us a sense of self-esteem and self-efficacy, as well as potential weight loss—which can influence our minds, too.
But there are still a lot of unknowns. As Professor Almudena Sanchez-Villegas of the University of Las Palmas de Gran Canaria points out, the findings from diet experiments are not consistent. Many of the diet programs in Firth’s review didn’t help alleviate depression, nor did a newer one that also included multivitamins. Researchers have much more to explore.
 
Can your diet make you happy?
 
It’s one thing to say that our diet might protect us from depression and other mental health issues. But could the foods we eat actually move the needle toward more positive emotions and happiness?
 
In a 2017 experiment published in PLoS ONE, researchers recruited 171 young adults with a diet low in fruits and vegetables, which meant three or fewer servings per day. These 18 to 25 year olds were split into groups: One got a basket of carrots, apples, and kiwi or oranges and was told to eat an extra serving of fruit and an extra serving of vegetables per day; another didn’t change what they ate.
Every day for two weeks, they answered questions about their feelings, mood, and happiness. At the beginning and the end of the experiment, they also filled out surveys about their anxiety and depression.
 
The diet group only managed to add one extra serving of fruit and vegetables to their daily diet. But that made a difference: Compared to everyone else, they had more energy, curiosity, creativity, and motivation; and they felt more engaged and purposeful in their lives overall—a greater sense of flourishing.
 
Surprisingly, though, the diet didn’t seem to change their mood or their feelings of depression and anxiety. That might be because the experiment was so short, the authors believe; while diet can give us a positive boost pretty quickly, it’s possible that mental health problems take longer to show up.
 
“The accumulation of factors such as low vitality, reduced motivation, and poorer socio-emotional flourishing may precipitate the development of psychological ill-being over time,” write researcher Tamlin S. Conner and her colleagues.
Similarly, in a short pilot study from 2011, a Mediterranean diet seemed to boost people’s feelings of contentment—but didn’t improve their depression or anxiety.
 
Twenty-five women were surveyed on their feelings of depression, anxiety, anger, calm, and contentment. Some continued eating as usual for 10 days, while the rest adopted a Mediterranean diet (this time with no red meat). After another round of surveys, the researchers found that the women on the Mediterranean diet felt more content. “The nutrients consumed in everyday diets are important for individuals’ mood,” write Laura McMillan and her colleagues.

 
Of course, this was a very small study—and the women may have simply felt satisfied about doing something good for their health. Indeed, in a few other studies, a healthy diet didn’t make people happier. For example, following a Mediterranean diet for 12 weeks didn’t seem to boost people’s mood, well-being, or sense of self-efficacy compared to receiving social support.
 
Despite how catchy it sounds, it might be too early to say that any particular diet is going to bring us happiness.
 
Eating for well-being
 
So, how should all this research inform our grocery list?
Most researchers are only willing to say that diet does seem to influence our mental health in some way, although they’re not sure exactly how. “There’s no real evidence to suggest that one diet works better than another,” says Firth.

However, the big picture is reasonably clear: Try to get enough fruits and vegetables—and avoid junk food.
Supporting that perspective, one paper reviewed the results of another 16 studies and found no differences between two relatively healthy diets. People who were eating a typical Western diet of fast food, salty snacks, desserts, and soft drinks became more depressed over time. But eating a classic healthy diet high in fruit and vegetables, seafood, and whole grains or a more Mediterranean diet—which includes lots of olive oil and more legumes, meat, dairy, and alcohol—both seemed to protect against depression.
 
Since many of the research findings are stronger for women, Firth does have one further tip. “If you’re female, then you will benefit from adopting a healthier diet in general and you don’t need to worry about what type of specific diet you’re adopting,” he says. “If you’re a man and you’re not overweight, probably don’t bother.”
 
In other words, at least as far as our mental health goes, we can stop obsessing about having a perfectly consistent diet—or whether we should go paleo or keto—and instead focus on cultivating healthy but sustainable eating habits. 
 
That’s the area where Firth wants to see more research, too, to figure out how to help people make lifestyle changes that last.
 
“It’s more important to actually stick to any healthy diet than it is to try and go for some aspirational perfect one that’s ultimately unfeasible or disgusting for you to stick to,” he says.
​
From: greatergood.berkeley.edu/article/item/what_is_the_best_diet_for_mental_health

​Seasonal affective disorder: It’s more than winter blues
 
Julia Haskins
The Nation's Health February/March 2019, 49 (1) 24;
 
Winter can be a difficult season to get through. The days are shorter and colder, and you’re more likely to spend more time indoors. You may not take part in the same activities you would when it’s warm and sunny outside. While plenty of people get down during the darker months, some people go through a more serious form of the winter blues called seasonal affective disorder.
 
Seasonal affective disorder is a type of depression that comes around the same time each year, usually beginning in autumn and ending in spring. Winter is usually the toughest season for people to get through.
 
It’s not so much the cold weather as the lack of light that makes the disorder so hard to deal with, says Jill RachBeisel, MD, vice chair of clinical affairs in the Department of Psychiatry at the University of Maryland School of Medicine. The amount of light we get can affect our waking and sleeping cycles and our mood.
 
“Seasonal affective disorder is not something to just brush off and tough out,” she says.
 
The disorder mostly affects women and young adults and people who live in high latitudes, meaning that they live far from the equator where there is less sunlight. People who have family members with depression or a history of depression themselves are also more likely to have it. But the disorder can affect anyone, regardless of age, gender, location or genes. That’s why when winter rolls around, it’s important to recognize signs and symptoms and get help if you need it. People with seasonal affective disorder may feel tired, sad or irritable. They may lose interest in their favorite activities and withdraw from friends and family. Hunger, weight gain and difficulty sleeping are also typical.
 
Some people also go through the disorder during the summer, although it’s much less common then. People with summertime seasonal affective disorder may feel restless or angry and can also have weight loss, less appetite and problems sleeping.
 
There are three main types of treatment for seasonal affective disorder, RachBeisel says: light therapy, psychotherapy and medication. A mental health professional might recommend one of these treatments or a combination.
 
Light therapy involves a box that gives off a bright light that you sit in front of for about 15 to 30 minutes every day. If you use light therapy early in the fall, you may be able to reduce symptoms of seasonal affective disorder or prevent it altogether, RachBeisel says.
 
Antidepressants and psychotherapy have also shown to be effective treatments for the disorder. A therapist can help you talk through feelings of sadness or hopelessness and can help you find solutions to stay active and connected to the people around you when you’re depressed, RachBeisel says.
 
Even though scientists don’t know exactly what causes seasonal affective disorder, light plays a big role in treatment.
 
“Getting as much exposure as you can during your daily activities is really important,” RachBeisel says.
 
She encourages people with the disorder to go outside as much as possible to take in natural light. Even if it’s cold, a short walk outside during your lunch break can help you feel better. At home, arrange your furniture or position yourself so that you can take in light from the window, she suggests. And for some people, getting natural light is helpful enough that light therapy may not be necessary.

Some signs and symptoms of seasonal affective disorder may just feel like normal parts of going through a rough patch during the winter. But if you’re concerned that you have more than just a case of the winter blues, speak to a mental health professional about what you’re feeling. Some mental health problems can even get worse with seasonal affective disorder, RachBeisel says.
 
Symptoms of the disorder do generally lift when spring comes, but it’s important to take care of yourself in the meantime. Remember that it’s temporary and there are brighter days ahead.
 
Enjoy winter a little more
 
Even with seasonal affective disorder, you can find ways to get through the more difficult months and have fun doing it. Though you may have to adapt some activities for winter weather, you can still enjoy them. To make the season a little more bearable, try these ideas to keep you active, healthy and happy:

• Invite some friends over for a potluck with healthy comfort foods.
• Bundle up and take a brisk walk around your neighborhood with a friend.
• Roll out your yoga mat for some stretching.
• Surround yourself with nice things at home, like bright flowers or cozy blankets.

                  
Copyright The Nation’s Health, American Public Health Association
thenationshealth.aphapublications.org/content/49/1/24

Today is World Mental Health Day!

"There’s no need to suffer in silence - share how you’re feeling, ask how someone is doing and listen for the answer. Be willing to ask for help when you need it and know that we are all in this together." #WMHD

Together we can end the stigma - today and every day.

Today is World Suicide Prevention Day, 2019.  Suicide is a leading cause of death in the United States, and suicide rates have have been on the rise over the past two decades.  Raising awareness, offering support, and knowing what do in if you or somebody you know is having suicidal thoughts is key to preventing suicide.  There is always hope!

The following offers information about how you can help yourself or a loved one in a suicidal crisis:

Are You Feeling Suicidal?
 
How to Deal with Suicidal Thoughts and Feelings and Overcome the Pain
 
You’re not alone; many of us have had suicidal thoughts at some point in our lives. Feeling suicidal is not a character defect, and it doesn’t mean that you are crazy, or weak, or flawed. It only means that you have more pain than you can cope with right now. This pain seems overwhelming and permanent at the moment. But with time and support, you can overcome your problems and the pain and suicidal feelings will pass.
 
I’m having suicidal thoughts, what do I need to know?
 
No matter how much pain you’re experiencing right now, you’re not alone. Some of the finest, most admired, needed, and talented people have been where you are now. Many of us have thought about taking our own lives when we’ve felt overwhelmed by depression and devoid of all hope. But the pain of depression can be treated and hope can be renewed. No matter what your situation, there are people who need you, places where you can make a difference, and experiences that can remind you that life is worth living. It takes real courage to face death and step back from the brink. You can use that courage to face life, to learn coping skills for overcoming depression, and for finding the strength to keep going. Remember:

1. Your emotions are not fixed – they are constantly changing. How you feel today may not be the same as how you felt yesterday or how you’ll feel tomorrow or next week.
2. Your absence would create grief and anguish in the lives of friends and loved ones.
3. There are many things you can still accomplish in your life.
4. There are sights, sounds, and experiences in life that have the ability to delight and lift you – and that you would miss.
5. Your ability to experience pleasurable emotions is equal to your ability to experience distressing emotions.

 
Why do I feel suicidal?
 
Many kinds of emotional pain can lead to thoughts of suicide. The reasons for this pain are unique to each one of us, and the ability to cope with the pain differs from person to person. We are all different. There are, however, some common causes that may lead us to experience suicidal thoughts and feelings.
 
Why suicide can seem like the only option
If you are unable to think of solutions other than suicide, it is not that other solutions don’t exist, but rather that you are currently unable to see them. The intense emotional pain that you’re experiencing right now can distort your thinking so it becomes harder to see possible solutions to problems, or to connect with those who can offer support. Therapists, counselors, friends or loved ones can help you to see solutions that otherwise may not be apparent to you. Give them a chance to help.
 
A suicidal crisis is almost always temporary
Although it might seem as if your pain and unhappiness will never end, it is important to realize that crises are usually temporary. Solutions are often found, feelings change, unexpected positive events occur. Remember: suicide is a permanent solution to a temporary problem. Give yourself the time necessary for things to change and the pain to subside.
 
Even problems that seem hopeless have solutions
Mental health conditions such as depression, schizophrenia, and bipolar disorder are all treatable with changes in lifestyle, therapy, and medication. Most people whoseek help can improve their situation and recover. Even if you have received treatment for a disorder before, or if you’ve already made attempts to solve your problems, know that it’s often necessary to try different approaches before finding the right solution or combination of solutions. When medication is prescribed, for example, finding the right dosage often requires an ongoing process of adjustment. Don’t give up before you’ve found the solution that works for you. Virtually all problems can be treated or resolved.
 
Take these immediate actions
 
Step #1: Promise not to do anything right now
Even though you’re in a lot of pain right now, give yourself some distance between thoughts and action. Make a promise to yourself: “I will wait 24 hours and won’t do anything drastic during that time.” Or, wait a week.
Thoughts and actions are two different things—your suicidal thoughts do not have to become a reality. There is no deadline, no one’s pushing you to act on these thoughts immediately. Wait. Wait and put some distance between your suicidal thoughts and suicidal action.
 
Step #2: Avoid drugs and alcohol
Suicidal thoughts can become even stronger if you have taken drugs or alcohol. It is important to not use nonprescription drugs or alcohol when you feel hopeless or are thinking about suicide.
 
Step #3: Make your home safe
Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms. If you are unable to do so, go to a place where you can feel safe. If you are thinking of taking an overdose, give your medicines to someone who can return them to you one day at a time as you need them.
 
Step #4: Don’t keep these suicidal feelings to yourself
Many of us have found that the first step to coping with suicidal thoughts and feelings is to share them with someone we trust. It may be a family member, friend, therapist, member of the clergy, teacher, family doctor, coach, or an experienced counselor at the end of a helpline. Find someone you trust and let them know how bad things are. Don’t let fear, shame, or embarrassment prevent you from seeking help. And if the first person you reach out to doesn’t seem to understand, try someone else. Just talking about how you got to this point in your life can release a lot of the pressure that’s building up and help you find a way to cope.
 
Step #5: Take hope – people DO get through this
Even people who feel as badly as you are feeling now manage to survive these feelings. Take hope in this. There is a very good chance that you are going to live through these feelings, no matter how much self-loathing, hopelessness, or isolation you are currently experiencing. Just give yourself the time needed and don’t try to go it alone.
 
Reaching out for help
 
Even if it doesn’t feel like it right now, there are many people who want to support you during this difficult time. Reach out to someone. Do it now. If you promised yourself 24 hours or a week in step #1 above, use that time to tell someone what’s going on with you. Talk to someone who won’t try to argue about how you feel, judge you, or tell you to just “snap out of it.” Find someone who will simply listen and be there for you.
It doesn’t matter who it is, as long as it’s someone you trust and who is likely to listen with compassion and acceptance.
 
How to talk to someone about your suicidal thoughts
Even when you’ve decided who you can trust to talk to, admitting your suicidal thoughts to another person can be difficult.

• Tell the person exactly what you are telling yourself. If you have a suicide plan, explain it to them.
• Phrases such as, ‘I can’t take it anymore’ or ‘I’m done’ are vague and do not illustrate how serious things really are. Tell the person you trust that you are thinking about suicide.
• If it is too difficult for you to talk about, try writing it down and handing a note to the person you trust. Or send them an email or text and sit with them while they read it.

 
What if you don’t feel understood?
If the first person you reached out to doesn’t seem to understand, tell someone else or call a suicide crisis helpline. Don’t let a bad experience stop you from finding someone who can help.
 
If you don’t know who to turn to:
In the U.S.– Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the National Hopeline Network at 1-800-SUICIDE (1-800-784-2433).
In the UK and Ireland– Call the Samaritans at 116 123
In Australia– Call Lifeline Australia at 13 11 14
In other countries– Visit IASP or Suicide.org to find a helpline in your country.
 
How to cope with suicidal thoughts
Remember that while it may seem as if these suicidal thoughts and feelings will never end, this is never a permanent condition. You WILL feel better again. In the meantime, there are some ways to help cope with your suicidal thoughts and feelings.
If You Have Suicidal Thoughts and Feelings

Things to do:

Talk with someone every day, preferably face to face. Though you feel like withdrawing, ask trusted friends and acquaintances to spend time with you. Or continue to call a crisis helpline and talk about your feelings.

Make a safety plan. Develop a set of steps that you can follow during a suicidal crisis. It should include contact numbers for your doctor or therapist, as well as friends and family members who will help in an emergency.

Make a written schedule for yourself every day and stick to it, no matter what. Keep a regular routine as much as possible, even when your feelings seem out of control.

Get out in the sun or into nature for at least 30 minutes a day.

Exercise as vigorously as is safe for you. To get the most benefit, aim for 30 minutes of exercise per day. But you can start small. Three 10-minute bursts of activity can have a positive effect on mood.

Make time for things that bring you joy. Even if very few things bring you pleasure at the moment, force yourself to do the things you used to enjoy.

Remember your personal goals. You may have always wanted to travel to a particular place, read a specific book, own a pet, move to another place, learn a new hobby, volunteer, go back to school, or start a family. Write your personal goals down.

Things to avoid:

Being alone. Solitude can make suicidal thoughts even worse. Visit a friend, or family member, or pick up the phone and call a crisis helpline.

Alcohol and drugs. Drugs and alcohol can increase depression, hamper your problem-solving ability, and can make you act impulsively.

Doing things that make you feel worse. Listening to sad music, looking at certain photographs, reading old letters, or visiting a loved one’s grave can all increase negative feelings.

Thinking about suicide and other negative thoughts. Try not to become preoccupied with suicidal thoughts as this can make them even stronger. Don’t think and rethink negative thoughts. Find a distraction. Giving yourself a break from suicidal thoughts can help, even if it’s for a short time.
 

Recovering from suicidal thoughts
Even if your suicidal thoughts and feelings have subsided, get help for yourself. Experiencing that sort of emotional pain is itself a traumatizing experience. Finding a support group or therapist can be very helpful in decreasing the chances that you will feel suicidal again in the future. You can get help and referrals from your doctor or from the organizations listed in our Recommended reading section.
 
5 steps to recovery

1. Identify triggers or situations that lead to feelings of despair or generate suicidal thoughts, such as an anniversary of a loss, alcohol, or stress from relationships. Find ways to avoid these places, people, or situations.
2. Take care of yourself. Eat right, don’t skip meals, and get plenty of sleep. Exercise is also key: it releases endorphins, relieves stress, and promotes emotional well-being.
3. Build your support network. Surround yourself with positive influences and people who make you feel good about yourself. The more you’re invested in other people and your community, the more you have to lose—which will help you stay positive and on the recovery track.
4. Develop new activities and interests. Find new hobbies, volunteer activities, or work that gives you a sense of meaning and purpose. When you’re doing things you find fulfilling, you’ll feel better about yourself and feelings of despair are less likely to return.
5. Learn to deal with stress in a healthy way. Find healthy ways to keep your stress levels in check, including exercising, meditating, using sensory strategies to relax, practicing simple breathing exercises, and challenging self-defeating thoughts.

 
Suicide crisis lines in the U.S.:
National Suicide Prevention Lifeline at 1-800-273-8255 or IMAlive at 1-800-784-2433.
The Trevor Project offers suicide prevention services for LGBTQ youth at 1-866-488-7386.
SAMHSA’s National Helpline offers referrals for substance abuse and mental health treatment at 1-800-662-4357.
Suicide crisis lines worldwide:
In the UK and Ireland: Call Samaritans UK at 116 123.
In Australia: Call Lifeline Australia at 13 11 14.
In Canada: Call Crisis Services Canada at 1-833-456-4566.
In other countries: Find a helpline near you at Befrienders Worldwide, IASP, or International Suicide Hotlines.
 
Authors: Jaelline Jaffe, Ph.D., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: June 2019

From: https://www.helpguide.org/articles/suicide-prevention/are-you-feeling-suicidal.htm

You have probably heard of the brain chemical called Serotonin, often referred to as the "happiness chemical" because it is known to contribute to feelings of happiness and wellbeing. In fact, the most commonly prescribed antidepressants are meant to increase the amount of Serotonin in our brains. While these medications can provide great benefits, did you know there are also proven ways to increase our brain's Serotonin levels without medication? Check out some of these ideas!

Serotonin is a neurotransmitter, or chemical messenger, that’s involved in many processes throughout your body, from regulating your mood to promoting smooth digestion.
 
It’s also known for:
 
-promoting good sleep by helping regulate circadian rhythms
-helping regulate appetite
-promoting learning and memory
-helping promote positive feelings and pro-social behavior
 
If you have low serotonin, you might:
 
-feel anxious, low, or depressed
-feel irritable or aggressive
-have sleep issues or feel fatigued
-feel impulsive
-have a decreased appetite
-experience nausea and digestive issues
-crave sweets and carbohydrate-rich foods
 
Read on to learn about different ways to increase serotonin naturally.

1. Food

 
You can’t directly get serotonin from food, but you can get tryptophan, an amino acid that’s converted to serotonin in your brain. Tryptophan is found primarily in high-protein foods, including turkey and salmon.
But it’s not as simple as eating tryptophan-rich foods, thanks to something called the blood-brain barrier. This is a protective sheath around your brain that controls what goes in and out of your brain.
 
In a nutshell, tryptophan-rich foods are usually even higher in other amino acids. Because they’re more abundant, these other amino acids are more likely than tryptophan to cross the blood-brain barrier.
 
But there may be a way to hack the system. Research suggests that eating carbs along with foods high in tryptophan may help more tryptophan make it into your brain.
 
Try consuming tryptophan-rich food with 25 to 30 grams of carbohydrates.
 
 
Here are some snack ideas to get you started:
 
-whole-wheat bread with turkey or cheese
-oatmeal with a handful of nuts
-salmon with brown rice
-plums or pineapple with your favorite crackers
-pretzel sticks with peanut butter and a glass of milk
 
 
 
     2. Exercise
 
Exercising triggers the release of tryptophan into your blood. It can also decrease the amount of other amino acids. This creates an ideal environment for more tryptophan to reach your brain.
 
Aerobic exercise, at a level you’re comfortable with, seems to have the most effect, so dig out your old roller skates or try a dance class. The goal is to get your heart rate up.
 
Other good aerobic exercises include:
 
swimming
bicycling
brisk walking
jogging
light hiking
 

1. Bright light

 
Research suggests that serotonin tends to be lower after winter and higher in summer and fall. Serotonin’s known impact on mood helps support a link between this finding and the occurrence of seasonal affective disorder and mental health concerns linked to the seasons.
Spending time in the sunshine appears to help increase serotonin levels, and research exploring this idea suggests your skin may be able to synthesize serotonin.
 
To maximize these potential benefits, aim to:
 
-spend at least 10 to 15 minutes outside each day
-take your physical activity outside to help increase the serotonin boost brought on by exercise — just don’t forget to wear sunscreen if you’ll be out for longer than 15 minutes
-If you live in a rainy climate, have a hard time getting outside, or have a high risk for skin cancer, you can still increase serotonin with bright light exposure from a light therapy box. 
If you have bipolar disorder, talk to your therapist before trying a light box. Using one incorrectly or for too long has triggered mania in some people.
 
4. Supplements
 
Some dietary supplements may help to jumpstart the production and release of serotonin by increasing tryptophan.
Before trying a new supplement, check in with your healthcare provider. Make sure to tell them if you also take:
 
-prescription medication
-over-the-counter medication
-vitamins and supplements
-herbal remedies
 
Choose supplements made by a manufacturer that is known and can be researched for reports on their quality and purity of products. Research suggests these supplements could help increase serotonin and reduce symptoms of depression:
 
Pure tryptophan
Tryptophan supplements contain much more tryptophan than food sources, making it possibly more likely to reach your brain. A small 2006 study suggests tryptophan supplements can have an antidepressant effect in women, though more research is needed. 
 
SAMe (S-adenosyl-L-methionine)
SAMe appears to help increase serotonin and may improve depression symptoms, but don’t take it with any other supplements or medications that increase serotonin, including certain antidepressants and antipsychotics.

5-HTP
This supplement can easily enter your brain and produce serotonin. A small 2013 study suggests it worked as effectively as antidepressants for those with early symptoms of depression. But other research on 5-HTP for increasing serotonin and reducing symptoms of depression has yielded mixed results. 
 
 
 
Probiotics
 
Research suggests getting more probiotics in your diet may increase tryptophan in your blood, helping more of it to reach your brain. You can take probiotic supplements, available online, or eat probiotic-rich foods, such as yogurt, and fermented foods, such as kimchi or sauerkraut.
 
Use caution when trying these supplements if you already take medication that increases serotonin. This includes several types of antidepressants.
 
Too much serotonin could cause serotonin syndrome, a serious condition that can be life-threatening without treatment. 
 
If you want to try replacing antidepressants with supplements, work with your healthcare provider to come up with a plan to safely taper off antidepressants for at least two weeks first. Abruptly stopping can have serious consequences.
 
5. Massage
 
Massage therapy helps increase serotonin and dopamine, another mood-related neurotransmitter. It also helps to decrease cortisol, a hormone your body produces when stressed.
While you can see a licensed massage therapist, this might not be necessary. One 2004 study looked at 84 pregnant women with depression. Women who received 20 minutes of massage therapy from a partner twice a week said they felt less anxious and depressed and had higher serotonin levels after 16 weeks.
Try swapping 20 minutes of massage with a partner, family member, or friend.
 
 
6. Mood induction
 
Too little serotonin can negatively impact your mood, but could a good mood could help increase serotonin levels? Some research suggests yes.
Thinking about something that makes you feel good can help increase serotonin in your brain, which can help promote an improved mood in general.
 
Try:
-visualizing a happy moment from your memory
-thinking about a positive experience you had with a loved ones
-looking at photos of things that make you happy, such as your pet, a favorite place, or close friends
 
Keep in mind that moods are complex, and it’s not always that easy to change your mood. But sometimes just engaging in the process of trying to direct your thoughts toward a positive place can help.
 
When to seek help
 
If you’re looking to increase serotonin to improve mood-related symptoms, including those of depression, these methods may not be enough.
Some people simply have lower serotonin levels due to their brain chemistry, and there isn’t much you can do about this on your own. In addition, mood disorders involve a complex mix of brain chemistry, environment, genetics, and other factors.
If you find that your symptoms are starting to impact your day-to-day life, consider reaching out for support from a therapist. 
Depending on your symptoms, you may be prescribed a selective serotonin re-uptake inhibitor (SSRI) or another type of antidepressant. SSRIs help keep your brain from reabsorbing the serotonin that’s released. This leaves more available for use in your brain.
Keep in mind that you may only need to take SSRIs for a few months. For many people, SSRIs can help them get to a place where they can make the most out of treatment and learn how to effectively manage their condition.
The bottom line:
Serotonin is an important neurotransmitter, affecting everything from your mood to your bowel movements. If you’re looking to boost your serotonin, there are a few things you can try on your own. However, don’t hesitate to reach out for help if these tips aren’t cutting it.

Source: 
https://www.healthline.com/health/how-to-increase-serotonin?fbclid=IwAR1mMTwrf3Tr2KOENDyxo55eGdnxJ7vggKjjr00W_h1G85h7IGPRI3d9Irk​

Sleep deprivation can affect your mental health
Harvard Health Publishing
 
Updated: March 18, 2019; Published: July, 2009
 
Sleep and mental health are closely connected. Sleep deprivation affects your psychological state and mental health. And those with mental health problems are more likely to have insomnia or other sleep disorders.
 
Americans are notoriously sleep deprived, but those with psychiatric conditions are even more likely to be yawning or groggy during the day. Chronic sleep problems affect 50% to 80% of patients in a typical psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. Sleep problems are particularly common in patients with anxiety, depression, bipolar disorder, and attention deficit hyperactivity disorder (ADHD).
 
Traditionally, clinicians treating patients with psychiatric disorders have viewed insomnia and other sleep disorders as symptoms. But studies in both adults and children suggest that sleep problems may raise risk for, and even directly contribute to, the development of some psychiatric disorders. This research has clinical application, because treating a sleep disorder may also help alleviate symptoms of a co-occurring mental health problem.
 
The brain basis of a mutual relationship between sleep and mental health is not yet completely understood. But neuroimaging and neurochemistry studies suggest that a good night's sleep helps foster both mental and emotional resilience, while chronic sleep deprivation sets the stage for negative thinking and emotional vulnerability.
 
Key points

• Sleep problems are more likely to affect patients with psychiatric disorders than people in the general population.
• Sleep problems may increase risk for developing particular mental illnesses, as well as result from such disorders.
• Treating the sleep disorder may help alleviate symptoms of the mental health problem. 

How sleep affects mental health
 
Every 90 minutes, a normal sleeper cycles between two major categories of sleep — although the length of time spent in one or the other changes as sleep progresses.
During "quiet" sleep, a person progresses through four stages of increasingly deep sleep. Body temperature drops, muscles relax, and heart rate and breathing slow. The deepest stage of quiet sleep produces physiological changes that help boost immune system functioning.
 
The other sleep category, REM (rapid eye movement) sleep, is the period when people dream. Body temperature, blood pressure, heart rate, and breathing increase to levels measured when people are awake. Studies report that REM sleep enhances learning and memory, and contributes to emotional health — in complex ways.
Although scientists are still trying to tease apart all the mechanisms, they've discovered that sleep disruption — which affects levels of neurotransmitters and stress hormones, among other things — wreaks havoc in the brain, impairing thinking and emotional regulation. In this way, insomnia may amplify the effects of psychiatric disorders, and vice versa.
 
Psychological effects of sleep deprivation
 
More than 70 types of sleep disorders exist. The most common problems are insomnia (difficulty falling or staying asleep), obstructive sleep apnea (disordered breathing that causes multiple awakenings), various movement syndromes (unpleasant sensations that prompt night fidgeting), and narcolepsy (extreme sleepiness or falling asleep suddenly during the day).
 
Type of sleep disorder, prevalence, and impact vary by psychiatric diagnosis. But the overlap between sleep disorders and various psychiatric problems is so great that researchers have long suspected both types of problems may have common biological roots.
 
Depression. Studies using different methods and populations estimate that 65% to 90% of adult patients with major depression, and about 90% of children with this disorder, experience some kind of sleep problem. Most patients with depression have insomnia, but about one in five suffer from obstructive sleep apnea.
 
Insomnia and other sleep problems also increase the risk of developing depression. A longitudinal study of about 1,000 adults ages 21 to 30 enrolled in a Michigan health maintenance organization found that, compared with normal sleepers, those who reported a history of insomnia during an interview in 1989 were four times as likely to develop major depression by the time of a second interview three years later. And two longitudinal studies in young people — one involving 300 pairs of young twins, and another including 1,014 teenagers — found that sleep problems developed before major depression did.
 
Insomnia and other sleep problems affect outcomes for patients with depression. Studies report that depressed patients who continue to experience insomnia are less likely to respond to treatment than those without sleep problems. Even patients whose mood improves with antidepressant therapy are more at risk for a relapse of depression later on. Depressed patients who experience insomnia or other sleep disturbances are more likely to think about suicide and die by suicide than depressed patients who are able to sleep normally.
 
Bipolar disorder. Studies in different populations report that 69% to 99% of patients experience insomnia or report less need for sleep during a manic episode of bipolar disorder. In bipolar depression, however, studies report that 23% to 78% of patients sleep excessively (hypersomnia), while others may experience insomnia or restless sleep.
 
Longitudinal studies suggest that insomnia and other sleep problems worsen before an episode of mania or bipolar depression, and lack of sleep can trigger mania. Sleep problems also adversely affect mood and contribute to relapse.

Anxiety disorders. Sleep problems affect more than 50% of adult patients with generalized anxiety disorder, are common in those with post-traumatic stress disorder (PTSD), and may occur in panic disorder, obsessive-compulsive disorder, and phobias. They are also common in children and adolescents. One sleep laboratory study found that youngsters with an anxiety disorder took longer to fall asleep, and slept less deeply, when compared with a control group of healthy children.
 
Insomnia may also be a risk factor for developing an anxiety disorder, but not as much as it is for major depression. In the longitudinal study of teenagers mentioned earlier, for example, sleep problems preceded anxiety disorders 27% of the time, while they preceded depression 69% of the time.
But insomnia can worsen the symptoms of anxiety disorders or prevent recovery. Sleep disruptions in PTSD, for example, may contribute to a retention of negative emotional memories and prevent patients from benefiting from fear-extinguishing therapies.
 
ADHD. Various sleep problems affect 25% to 50% of children with ADHD. Typical problems include difficulty falling asleep, shorter sleep duration, and restless slumber. The symptoms of ADHD and sleeping difficulties overlap so much it may be difficult to tease them apart. Sleep-disordered breathing affects up to 25% of children with ADHD, and restless legs syndrome or periodic limb movement disorder, which also disrupt sleep, combined affect up to 36%. And children with these sleeping disorders may become hyperactive, inattentive, and emotionally unstable — even when they do not meet the diagnostic criteria for ADHD.
 
Sleep and mental health lifestyle changes
 
In some respects, the treatment recommended for the most common sleep problem, insomnia, is the same for all patients, regardless of whether they also suffer from psychiatric disorders. The fundamentals are a combination of lifestyle changes, behavioral strategies, psychotherapy, and drugs if necessary.
 
Lifestyle changes. Most people know that caffeine contributes to sleeplessness, but so can alcohol and nicotine. Alcohol initially depresses the nervous system, which helps some people fall asleep, but the effects wear off in a few hours and people wake up. Nicotine is a stimulant, which speeds heart rate and thinking. Giving up these substances is best, but avoiding them before bedtime is another option.
 
Physical activity. Regular aerobic activity helps people fall asleep faster, spend more time in deep sleep, and awaken less often during the night.
 
Sleep hygiene. Many experts believe that people learn insomnia, and can learn how to sleep better. Good "sleep hygiene" is the term often used to include tips like maintaining a regular sleep-and-wake schedule, using the bedroom only for sleeping or sex, and keeping the bedroom dark and free of distractions like the computer or television. Some experts also recommend sleep retraining: staying awake longer in order to ensure sleep is more restful.
 
Relaxation techniques. Meditation, guided imagery, deep breathing exercises, and progressive muscle relaxation (alternately tensing and releasing muscles) can counter anxiety and racing thoughts.
 
Cognitive behavioral therapy.Because people with insomnia tend to become preoccupied with not falling asleep, cognitive behavioral techniques help them to change negative expectations and try to build more confidence that they can have a good night's sleep. These techniques can also help to change the "blame game" of attributing every personal problem during the day on lack of sleep.