Dr. Dawn, The Suicide Prevention Pharmacist

In the past few months I have heard and read about some possible link between hormonal contraceptives (a type of birth control) and depression.  Today I would like to explore that in a little more detail. 

I did a quick internet search on the topic, and there are a variety of articles out there that suggest that there is a link between hormonal contraceptives and depression.  However, I can not necessarily vouch for the quality of the information that is being presented, because I am not sure how much of this comes from reputable sources.   That being said, there may be some valid evidence of this link, but we can also think about it from a more theoretical viewpoint.

What are hormonal contraceptives, after all?  Well, they contain some combination of estrogen and/or progesterone hormones.  We also know that hormonal changes may be a cause of depression.  So, from a basic standpoint, it makes sense that taking hormones could lead to hormonal changes.  In turn, these hormonal changes could factor into a depression.  Besides the basic idea of hormonal changes, hormonal contraceptives may also affect the body in other ways that might lead to a depression.  So, regardless of any clinical data, it makes sense to me to at least consider the fact that taking hormonal contraceptives could lead to a depression.  Taking it even further, hormonal contraceptives may also interact with other vitamins, medicines, etc., and that could cause issues as well.  The different possible scenarios really start to add up.

What do you think?  Do you believe there could be a link between hormonal contraceptives and depression?  Do you need to see more hard clinical evidence?  Have you ever experienced someone who seemed to have depression after being on hormonal contraceptives?  Overall, I think it is important to research this topic in more depth.

As I write this post, I have finished my first week at a new job.  This job is unique for me in that I have joined a company that is literally starting from scratch.  As you can imagine, this provides for some challenges and some exciting opportunities as we start to build and grow. 

Even though this new job has come with the luxury of gradually easing into it so far, starting something new can be overwhelming and exhausting.  For me, it signifies a whole new routine, and that has taken a lot for my brain to process.  Honestly, figuring out what to take for lunch and what to pack have required a lot of energy.  It sounds like these should be relatively simple tasks, but it has shown me how much effort can go into changing routines. 

For someone touched by depression in some way, it is no doubt an overwhelming experience when it happens.  Habits and routines are changed, and it can definitely be exhausting.  And, for the most part, the changes are not welcome.  Change can be tough even if it is a positive change, so the changes that depression brings can be devastating.

I think it is important to realize that like a diagnosis of heart disease or cancer, a diagnosis of depression can be overwhelming to all affected.  This likely can lead to anxiety and exhaustion as everyone tries to figure out their “new normal”.  Overall, no matter what the diagnosis, we need to be empathetic to all people facing these changes.  And, in general, we should be kind to everyone, because we usually do not know the struggles or changes that everyone is facing in their lives.

How about you?  What changes have you experienced as the result of a personal diagnosis or diagnosis of someone you know?  Was it overwhelming at first?  Did it get easier over time?  My hope is that we can always try to be more understanding of how change affects people.

Currently in my church we have been talking about the “wilderness” in our lives.   Each week, a story from the Bible is used to illustrate a different wilderness that people faced and how they went through it.  Today I want to touch on both the wilderness in my life and how depression could be considered a wilderness.

Depending on who you ask, wilderness can mean many things to many people.  Basically, I have thought about wilderness mostly as something that happens outdoors.  But, there is a deeper meaning, one that can involve a range of emotions and experiences.  Wilderness can be a time of great uncertainty and anxiety.  It can also be a time of confusion.  On the other hand, wilderness can represent a time of great opportunity and positive change.  It can also be a time of growth.  Overall, what sticks out to me is how uncertain the wilderness can be – it’s getting comfortable with being uncomfortable, and I think for most of us that is a big challenge.

In my own life, wilderness is definitely happening.  I have some uncertainty about my career, my finances, and my health, and that is only the first three that I thought of while writing this.  And, I wonder – has there ever been a time in my life that was completely certain?  Is wilderness always present in our lives?

I also think that depression must be a particular type of wilderness.  I can only imagine how uncertain and anxious a depression must be, and it almost has to be uncomfortable.  I think that the wilderness of depression has to be tougher than the wilderness that many of us face, and it comes with even more challenges that I would not know how to describe here.

Have you ever thought about the “wilderness” in your life?  What uncertainties are you currently facing?  Have you always had times of uncertainty in your life?   

Today I had the opportunity to visit a mental health exhibit at a nearby science center, and I wanted to highlight some key takeaways and reminders that came up for me.  Here you go:

1.The exhibit had an interactive display about trying to have a conversation when you are also hearing voices in your head – I have done this exercise before, but every time it still gets to me.  This is a very vivid example of how mental illness can make even basic situations extremely challenging.  A simple and yet powerful way to help you understand what it might be like to live with a serious mental illness.

2.People visiting the exhibit where given the opportunity to write on a card about their own personal story, and reading some of the cards created a range of emotions.  Some were hopeful, others were sad, but all of them shared a real slice of humanity.

3.The history of how mental illness and treatment were viewed was appalling.  Not only was some of the physical treatments absolutely barbaric, but one of the things that truly disgusted me was that mentally ill people were put on display as entertainment for people.  Revolting.  We have come a long way, but there is still a very long way to go.

4.The exhibit had stories of resilience and hope and recovery.  Even though mental illness has been associated with many negative things, it is important to understand that there is always hope and a brighter future ahead.

As the mental health momentum continues, I suspect we will see more public exhibitions, conversations, forums, etc. available to discuss this important topic.  I hope that everyone will get the chance to take part in these activities as they continue to grow, because they all help to educate and advocate for positive mental health for all.

Today I want to highlight another organization that is tied to mental health – This is My Brave.  Most of today’s information comes from their website, www.thisismybrave.org

This Is My Brave shares that storytelling saves lives.  Their mission is the following: to end the stigma surrounding mental health issues by sharing personal stories of individuals living successful, full lives despite mental illness through poetry, essay, and original music, on stage in front of a live audience, through stories submitted and published to our blog, and via our YouTube channel. 

This Is My Brave was started in 2013 and 2014, so it has not been around all that long, but it has already produced over 50 unique shows in the United States.  In 2017, This Is My Brave went international, with shows in Australia as well.  Although the number of shows has increased, This Is My Brave notes that they are doing this one person and one story at a time.

Personally, I have been to a This Is My Brave show, and it was amazing.  The stories are so personal, and the performances are moving.  I support This Is My Brave and the work they are doing to end the stigma surrounding mental health issues, and I encourage you to catch a live show and check out their online content.  The more stories the better in my opinion, and the more we talk about mental health the less stigma there will be.  I look forward to seeing this organization continue to grow.

How about you?  Have you heard of This Is My Brave?  If not, are you interested in learning more?  If you have heard of them, have you seen or viewed any of the performances?  What did you think?  Have you considered being a performer yourself?  What story could you share with others?

As I write this entry, I am about to make a decision that will change the life of me and my family.  You could argue that it really won’t be that big of a change, but this time around has had me more scared and afraid than ever.  Why? 

The big reason for me now is that I have a family to think about, and for much of my life that has not been the case.  Decisions that I made only affected me, and I had a lot more confidence in that.  Now, the decisions I make affect 3 people, and potentially more in the future.  What if this change is a mistake?  What if this new change is worse than what we have now?  What if this change doesn’t work out and I don’t have back up plan?  It is one thing to bring myself down, but it is another to bring down others with me. 

Again, this is likely small potatoes for me, but it has me thinking about depression and how this might be a constant feeling.  If someone is depressed, are they thinking about how they might be bringing down others?  Are they worried about someone around them “catching” what they have?  I sincerely hope not, but I imagine it is possible.

Of course, all I have done so far is look at the downside of things.  If I stopped a little to really think about the change, there is the potential for great opportunity and growth and good things.  You may not think about it in relation to depression, but somehow there may be a way to find some opportunities and good things that await you after a struggle with it.  I could be totally off base here, but at least I know in my change that there are some potential benefits that make the uncertainty a little bit easier for me.

Within the last week of writing this entry I had the chance to spend a good part of an afternoon advocating for mental health at my state capitol.  I have done this before, and every time it feels very empowering and meaningful.  Today, I want to share a few things I have learned that has helped to make my advocacy feel more impactful.

First, sharing your personal story is huge.  You do not have to go into a lot of details, and it is important to keep it short, but a story typically is going to resonate more with people than facts or numbers.  Next, while some stories can be heartbreaking, it is important to try to put a positive spin on it.  People are usually not motivated by what is wrong.  People are motivated by things that have worked or helped other people.  Possible solutions are also encouraging here.

After sharing your story and highlighting possible solutions or helpful ideas, it is important to have an ask.  What do you want?  What would you like to see?  After all, a main reason for advocating is to ask for changes or improvements.  Another helpful tip is that if you feel like it, offer yourself as a contact or resource if additional questions or information is requested.

Overall, advocacy it not a one size fits all approach.  Every person can advocate differently, and the tips I have mentioned here are a few that I have found to make sense and work for me.  They are not hard and fast rules, but I hope that you will at least find some of them helpful.

How about you?  Are you an advocate for mental health?  If so, how do you advocate?  Do you use the same tactics I have mentioned here?  Do you use other strategies?  If you feel so inclined, feel free to leave your ideas in the comments section.