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Pandemic, winter may add up to mental health crisis in Clark County

Columbian - 11/15/2020

Nov. 15--RIDGEFIELD -- London Bruns' parents don't know exactly how to say what they want to say, but they mean to keep talking. Talking to the media, fellow parents, school groups, friends, strangers -- anyone who will listen to their concerns about depression, suicide and the upcoming winter.

"If it could happen to our daughter -- the kid who had everything -- it could happen to anyone," said Heather Wendling.

She and her husband, John Bruns, figure they'll never understand why their artistic, athletic, cheerful and popular 13-year-old daughter, a student at View Ridge Middle School, died by suicide in late September. They saw no hint of trouble other than some disrupted sleep in recent months. London's death remains an unanswered question and a baffling shock, they said.

"There are no words to describe it. Even if you get an answer, it'll never be good enough," John Bruns said.

While there's no way to know whether the coronavirus pandemic had anything to do with London's death, her parents view the upcoming winter with both dread and dedication. So do mental health professionals who have struggled to comfort a world in health crisis -- and now expect cold, dark weather to intensify the anxiety, isolation and loss.

Warning signs of suicide

Source: National Institute of Mental Health

Talking about:

-- Wanting to die

-- Great guilt or shame

-- Being a burden to others

Feeling:

-- Empty, hopeless, trapped or having no reason to live

-- Extremely sad, more anxious, agitated or full of rage

-- Unbearable emotional or physical pain

Changing behavior, such as:

-- Making a plan or researching ways to die

-- Withdrawing from friends, saying goodbye, giving away important items, or making a will

-- Taking dangerous risks such as driving extremely fast

-- Displaying extreme mood swings

-- Eating or sleeping more or less

-- Using drugs or alcohol more often

What to do:

-- Do not leave the person alone

-- Remove any firearms, alcohol, drugs, or sharp objects that could be used in a suicide attempt

-- Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

"People with mental illness are doing a dive, for so many reasons," said Kim Schneiderman, executive director of mental health peer-support agency NAMI Southwest Washington. "But the 'normies' (people without mental illness) are also going to be impacted, in a way that's very unique to our time. ... We really want to try to stave off what's happening or it will come crashing down on us very shortly."

NAMI is eager to sign up people ages 18 to 35 who are living with a mental health disorder and willing to talk to middle and high schoolers about it.

"Kids listen better to other kids or younger people," Schneiderman said. "Helping them understand ... it can and will get better if they reach out for help."

Also needed are parents like Bruns and Wendling, who can speak to their peers and to educators about warning signs and strategies. NAMI provides the evidence-based training for all speakers in its "Ending the Silence" project, Schneiderman said.

"We were too late," said John Bruns. "We want to encourage everyone else to reach out, get help, make a connection."

Mental health and other help

--Clark County Mental Health Crisis Services, available 24/7, call 800-626-8137.

--Clark County Teen Talk, "non-judgmental support for teens, by teens." Call 360-397-2428, text 360-984-0936, visit www.ccteentalk.clark.wa.gov.

--Washington Listens, anonymous non-clinical line for anyone who is sad, anxious, stressed because of the virus. Compassionate listening, referrals for help. Call 1-833-681-0211 or visit www.walistens.org.

--Clark County Regional Support Network, www.clark.wa.gov/community-services/mental-health-providers

--NAMI Southwest Washington, peer support, guidance, resources: www.namiswwwa.org or 360-695-2823.

--Ridgefield School District'sFamily Resource Center, exhaustive list of local resources: www.ridgefieldsd.org, click on Family Resource Center.

--Forefront, public suicide prevention effort by the University of Washington School of Social Work: www.intheforefront.org.

--How Right Now, Centers for Disease Control's interactive guide to identifying, coping, getting help with this year's complicated and difficult feelings: www.howrightnow.org.

SAD combination

Science has confirmed what many people feel every year: Dark days can be depressing.

"This is the time of year when many people get depressed," said George Keepers, the chief of psychiatry at Oregon Health & Science University in Portland.

Seasonal affective disorder, known as SAD, is a type of major depression that's linked to winter's shorter daylight hours. The signs and symptoms line up with classic signatures of depression: persistent low feelings and unhappy thoughts, low energy, weight gain or loss, disrupted sleep and difficulty concentrating. Another specific SAD sign is the tendency to withdraw or "hibernate."

According to the National Institute of Mental Health, SAD increases as you move away from Earth's sunny equator and toward the dimmer poles; one study found that 1 percent of Floridans suffer from SAD while 9 percent of Alaskans do. There's no study specific to the Pacific Northwest, but some local health experts have said they assume nearly everyone in this cloudy region suffers from some level of SAD.

Fortunately, Keepers said, there's a ready-made solution to winter SADness: morning light or its equivalent.

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"We've learned how to treat (Seasonal Affective Disorder) very effectively with bright light that mimics the intensity of sunlight in the early morning," he said. More intensive treatments and medications can help too. But in high-SADness Alaska, Keepers said, the first thing you hear when you call the community mental health clinic is a recorded suggestion that, before anything else, you try light therapy for two weeks.

Proper light therapy involves a "light box" that cranks out 10,000 lux (a standard measurement of brightness) emphasizing morning's white-blue rays and filtering out harmful ultraviolet rays. Experts recommend 20 to 30 minutes of exposure every morning. Light therapy can harm skin or cause other side effects, so talk to your doctor first.

Slaps in the face

Given annual SADness plus the once-in-a-lifetime coronavirus pandemic, everyone's got a reason to feel stressed and depressed this winter.

People who already struggle with mental health challenges are struggling harder, Schneiderman said.

"They've lost their groups, their doctors, their therapists, their friends," she said. "They've lost their routines. They've lost the place where they go have coffee. They've lost it all -- all the very things we tell them they need to have in their lives. It's been a real slap in the face.

"Everything is virtual now, and not everyone responds well to that. They stop taking medications, they go back to their addictions, which throws their families into chaos. They may be locked into residences with people who may not have realized how sick they are," she said.

The pandemic is also testing the mental health of people who have never been tested before -- all those so-called "normies" whose normalcy has been upended by everything from canceled family gatherings and erased holiday hopes to lost incomes and fear of illness. While hard data isn't in yet, Keepers said, it does seem that the pandemic has given rise to more depression, family troubles and substance abuse.

"If you look at the data, it shows that people who can least afford not to work are out of work," he said. "In past recessions, when people are out of work, the suicide rate goes up."

Ethnic minorities "are subject to more social stressors to begin with, and they appear to be more at risk for complications and a higher mortality rate with COVID," Keepers said. "In many places, those groups don't have the same access to medical care. That makes the situation much more anxious for them."

Another really stressed-out group, he said, is parents working from home while simultaneously caring for children. If they do have day care, he added, all it takes is a case of the sniffles for the child to be sent home.

"Another group is the elderly," Keepers said. "Elderly folks who are isolated are very vulnerable in this circumstance." People who normally look to family, friends or aides to help with mobility, basic self-care or household tasks -- not to mention companionship -- are having more trouble both with daily life and with loneliness, he said. They're more prone to accidents and hunger as well as despair, he said.

"Being by yourself for such a long period of time is really hard on people," he said. "We are a social species and we need contact with each other. We evolved as tribes of people living together, not as hermits in caves. But that's what we're doing now."

Reach out, dig in

While some kids love doing school from home, View Ridge School Counselor Jenny Berry said, others have found pandemic isolation really tough.

It's imperative for schools to provide resources on mental health and crisis intervention, Berry said, but reaching out is hard when nobody's in the building. View Ridge has both sent home and posted online suicide-prevention resources developed for both teens and parents by Forefront, a project of the University of Washington School of Social Work.

"Suicide is the second leading cause of death in ages 10-34," Schneiderman wrote in an email. "We need to get ahead of it. I spoke with a lady yesterday that has had four friends lose their children to suicide and her daughter made an attempt before they got her help."

Pandemic uncertainty about life and the future is especially hard on young people, according to Forefront. At the same time, fewer adults are watching out for their well being.

"There is more pressure on parents and guardians to fulfill the support roles that are usually shared with schools, coaches and youth workers," Forefront's website states.

"Kids don't talk about it. They just do it," Schneiderman said. "We need to teach the kids that they are not alone and the adults in their lives how to comfortably talk to them about it."

Even small actions can help, according to Forefront's website. Check in with your child every day. Ask questions and listen carefully. Even just 15 minutes of uninterrupted daily attention "will do wonders" for your relationship and your kids' certainty that they're loved, according to Forefront.

John Bruns and Heather Wendling said they have been comforted by all the love and support they've received from the school community, friends and complete strangers who've heard the news.

"Each day gets a little better," Bruns said.

When they're feeling ready, they plan to undergo training to become NAMI presenters and give back some of that support and guidance.

"Reach out and ask different questions," he said. "It may be awkward, but dig into your kid's life like never before. How's school? How are your friends? Is everything OK in your world?"

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