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Tuesday, September 12, 2023

Superlative of Note

There are a great many superlatives. We each likely became aware of them in those terms back in high school. The ballotting was intense for such descriptions as "most likely to succeed" and "class clown" or "cutest couple." The yearbooks of yesteryear are littered with those accolades. I remember a comedian once claiming to have been voted "most likely to." That is funny. In reality, it is likely many of us were that undetermined and unpredicted in those years. 

The news recently brought us a troubling superlative "most depressed." There has been a focus on the challenges of mental health. I have touched on mental health in The Latest AMA Guides and Psychiatric Impairment (September 2014), The United States of Xanax (July 2017), Risks for Attorneys (June 2019), Here We Go Again (February 2019), and Mental Health (September 2023). It is fair to say that emotional challenges are present in workers' compensation. Some would say they are becoming more forefront. 

But, US News reported that West Virginia has the "most depressed" county in America. The coverage makes clear that depression is widespread in this country. And, there are indications that it is getting more prevalent generally. But, the thoughts as regards Logan County, West Virginia are both intriguing and troubling. 

There is discussion in that article of the weather and references to the volume of sunshine that residents experience. There are mentions of the local labor market and the challenges caused by those who destroyed the coal mining industry. Yes, with each cause celeb, there will be victors and vanquished. The economics, lack of jobs, and perhaps even isolation at least bear mention. The overall health is described in terms of the persistence and prevalence of chronic illnesses there such as diabetes and obesity. Yes, they label obesity as a disease. See Disease or Choice (March 2023). 

This country is going to have to get over the failures of models past. See The BMI Conundrum (August 2022). There is room to consider that our population includes many body styles, shapes, and forms. I myself have experienced body issues. That is real, and Madison Avenue and others have rammed that down our collective gullet for many years. See I Know Victoria's Secret (Jax, 2022). That singer provides a stinging rebuke. Know this (whoever and wherever you are), You are not alone in body issues. 

That said, of the diseases (if you buy that label) that afflict us, this fat issue is likely the easiest to attack. Get up, get out, and walk today. Do 100 steps, and 101 tomorrow. If you walk one step further each day, by the end of the month you will be out of your neighborhood. By the end of next year, you could literally be half the person you used to be. And, every walker I know brags about the peace they experience getting out and walking daily. It is renewing and calming. 

But to the depression, the numbers are staggering. "An estimated 32% of adults in Logan County, West Virginia, have been diagnosed with depression." There are vast numbers of people who have symptoms or complaints, and yet they are not eager to obtain care. There are stigmas attached, and there is resistance. Many believe they can make it back to sufficiency and balance unassisted. That reticence is troubling. A population of people who will not seek any help. Know this, whoever and wherever you are, there are many who suffer in silence. You are not alone.

Those who will accept care are nonetheless disinclined from therapy with a psychiatrist. That may be in part due to the limited population of psychiatrists available. The article is clear that there are few providers in the therapy or counseling realms in that area. They celebrate some recent expansion of capacity but lament that the community has been slow on the uptake so far. 

The corollary is as troubling. Having gotten over the impediment of declining care, many seem to be interested instead in alternative care. They want a pill. They want Mama's Little Helper (Rolling Stones, Decca, 1966). Let us all just take a pill and the world will be right. Don't get me wrong, I am a big fan of following doctor's orders. I have no qualms with the pharmacy business. 

But, in a similar vein to all the masses who think that drugs are a magic bullet for weight loss, there are those who think a pill is a magic bullet for mental health challenges. But, as the article mentions, there are impacts on us from weather, activity level, and more. Is it possible that getting out in the sunshine for a walk might have an ancillary benefit for those with depression? Is it possible that diet, surroundings, and personal circumstances might matter to mental health? Could someone around you benefit merely from the opportunity to be heard, that chance to vent?

Yes, I know, it is hard. It is hard to get off the couch. It is hard to be seen walking down the street. I know. I have no form (I do run more smoothly than Phoebe Buffay, but not by much). Getting up and getting out is an everyday challenge. The most avid dread it, resist it, but everyone likes finishing that walk or run. There is accomplishment, endorphins, and more. Starting is hard, but finishing is great. 

How did this country get to such a feeling of depression? Where is this weight of circumstance from? Why are so many feeling emotional symptoms and yet so resistant to seeking any care? Who convinced us that the answer to every problem lies in some chemical habit? There are so many questions and unfortunately few competent attempts at answers. Mental health is a crisis of today. It is manifesting uniquely and is insidious. What are you doing to impact it?

If you are struggling with challenges and need help, dial 988. Remember September is Awareness Month (September 2022). If you are not, look around you and see if there are people who might benefit from a kind word, a little interaction, or a quick 15-minute walk on a coffee break. If you know someone who may need more, why not take a moment to speak with them about their feelings and the raft of resources that do exist, the treatment options that surround us?