From the Jackson Hole News & Guide Column Sound Mind

This last week some of the results from the Mental Wellbeing Survey, a component of the Behavioral Health Needs Assessment, were reviewed and discussed in a town hall forum. Much of the information from the survey is not surprising given what is going on in our community and with the fallout of the pandemic.

The results show that many of us have a strong sense of community and many have struggled with mental health at some point and some level. Increased feelings of loneliness and increased alcohol use may be among the consequences. So, what does that mean for our overall community health?

Social determinants of health are “economic and social conditions that influence individual and group differences in health status. They are the health-promoting factors found in one’s living and working conditions, rather than individual risk factors that influence the risk for a disease, or vulnerability to disease or injury.”

Looking at the underlying issues outside of just medical care related to health in various populations can shed light on solutions. Some common examples include education, income, employment, food insecurity, housing, health services and social isolation.

Locally, there has been a great deal of focus on housing and economic stability related to being determinants of health. That makes sense. We all know there is a large income disparity and housing issue at play.

However, one area that has also been identified as a factor but gets less attention is social isolation or loneliness. While we continue to have that small-town feel, our population is also growing and filled with people who are new to the area and people who are working several jobs to make ends meet. In addition, many of our friends have moved away. The pandemic has made social connection more of a struggle, and individuals may also find themselves isolated by stress, cultural and language barriers, and busy schedules.

It has been identified as a social determinant of health in our community through various needs assessment and is also an issue that more people than you would expect, are reporting. As you might guess, this is reported in even higher numbers by marginalized populations.

Social connection is an important part of overall wellness and can combat loneliness. Connection is the experience of feeling accepted or close to others. It can create a sense of self value and belonging and is an important part of interpersonal health.

Brene Brown has a great definition for social connection: “Connection is the energy that exists between people when they feel seen, heard and valued; when they can give and receive without judgment; and when they derive sustenance and strength from the relationship.”

Is this important for community well-being? The research shows that there is not only a correlation but a strong correlation between levels of social connectivity and physical/mental well-being.

Loneliness and low social connectivity increase the risks in the following ways:

• Increased illness.
• Increased aggressive thoughts and actions.
• Slower recovery.
• Higher levels of anxiety.
• Higher levels of depression.
• Developing unhealthy habits such as smoking, substance abuse and eating disorders.
• Increased negative self-thoughts.
• Suicide.

Benefits of high social connectivity include these:

• Increased longevity.
• Stronger resistance to illness.
• Increased emotional regulation.
• Increased mental and physical wellness.
• Increased empathy.
• Higher levels of self-esteem.

Does this mean that we should all have a lot of friends or attend frequent social events? Not so much. As it turns out, the quality of the connection is much more important than the quantity. Levels of isolation and loneliness were on the rise before the pandemic.

Everyone feels lonely from time to time. It is when it begins to affect your ability to function or goes on for an extended amount of time that it becomes problematic and can lead to depression.

Signs that you may be struggling might include the following:

• Increased illness
• Sleep disturbances.
• Depression.
• Increased anxiety.
• Increased negative thoughts.
• Increased defensiveness, negative self-thoughts and antisocial behavior.
• Short temper, decreased impulse control.

What are some ways to connect if you or someone you know are feeling lonely?

The benefits of connection are about quality, so you don’t have to go out to where there are a lot of people (which is a good thing right now). There is a difference between being alone and being lonely. Someone can be surrounded by people and still feel lonely. Reaching out to even just one person will make a difference. Something as simple as calling and reconnecting with someone or reaching out for lunch, coffee or a walk. Get to know someone by asking questions and listen to answers. That helps if you are the one feeling isolated or if someone else is feeling disconnected. Take notice of the people around you. Get to know them and what is going on with them, share stories. In addition to helping them it will also make you feel more connected.

If you notice some patterns or are worried about yourself or someone else, reach out for help. It is easy with everything going on to feel isolated and withdrawn. One of the most amazing qualities of this community is how open, helpful and accepting we can all be when someone is struggling.

From the Jackson Hole News & Guide Column Sound Mind

One positive thing that has come out of the pandemic: Not only are we more OK with being not OK, but we are also taking time to reconnect with others and have real conversations.

So many social interactions are nothing more than polite conversation, but as we emerge from our COVID isolations, conversations are about real connection. I know that things were a bit awkward at first, but now many find themselves asking the question “How are you doing?” and responding with real conversations.

So what do we do when the answer to the question is honest and lets us know someone is struggling? Where do you go from there and what can you do to help?

Depression is more common than you would think and does not discriminate. It affects people of all ages, genders and socioeconomics. Before the pandemic, depression was on the rise, especially in lower-income areas. The impact of the pandemic on mental health is still climbing. The ripples of depression are felt not only by the individuals but also by their families, friends and employers. Depression can make even simple daily tasks feel impossible. Suicide and addiction can be devastating consequences. Fortunately, prevention and treatment options are out there, and the more we talk about depression the more we need to learn to recognize and respond.

Depression is more than just the blues or being sad. Clinical depression is a mood disorder in which feelings of sadness, loss, anger or frustration interfere with everyday life for a longer period. Common symptoms include:

• Low or irritable mood most of the time
• A loss of pleasure in usual activities
• Trouble sleeping or sleeping too much
• A big change in appetite, often with weight gain or loss
• Tiredness and lack of energy
• Feelings of worthlessness, self-hate and guilt
• Difficulty concentrating
• Unusually slow or fast movements
• Lack of activity and avoiding usual activities
• Feeling hopeless or helpless
• Repeated thoughts of death or suicide

Deep in the symptoms of depression for those who struggle can be a lack of motivation, energy or insight enabling someone to reach out for help on their own. What can you do when you suspect someone you know is depressed or thinking of suicide, or when it feels like you are trying but nothing seems to make a difference?

Just be there, listen and let them know you care. At times you may not feel your presence is wanted. But don’t underestimate showing up; just being there for someone and listening with empathy can show a person that she is not alone and that someone does care. There can be a great deal of guilt and shame involved in deep depression. Allowing someone to just talk about what they are going through can be so helpful. It is OK for someone to feel sad; don’t feel like you must solve all their problems or cheer them up. A lot of people are not comfortable sitting with sadness and think it must be avoided. The truth is, emotions are part of life and even a healthy response to life stressors.

Ask the question: “Are you having thoughts of suicide?” One of the biggest misconceptions regarding suicide is that if you ask the question that you may be planting the idea. The reality is that by asking the question, you are showing support and concern. Don’t dismiss or minimize (“It is really not that bad”) the person’s comments and ask direct questions.

• Talk to the person about your concern. Ask if he or she has been thinking about suicide or has a plan for how to do it. Having a plan indicates a higher risk of suicide.
• Seek help. Contact the person’s doctor, mental health provider or other health care professional. Let other family members or close friends know what’s going on.
• Call a suicide hotline number. In the United States you can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to talk to a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line. You can also call Jackson Hole Community Counseling Center at 733-2046. Better yet, make the call together.
• Make sure the person is safe. If possible, eliminate access to any means used to attempt suicide. For example, remove or lock up firearms, other weapons and medications.
• Call 911 if the person is in danger of self-harm or suicide. Make sure someone stays with that person.

Be genuine. You don’t need to walk on eggshells or inadvertently make the person feel like a burden or a problem. Be genuine and voice your concerns about the person. Try not to get into the “fix it” mode. You may not be able to solve all their problems, but the most important thing is your presence and understanding, showing empathy, and making a connection. Avoid judgment. The inability to “snap out of it” is true depression. Depression is not just being sad, it is an illness, so it’s no different from telling someone with another physical ailment to “buck up.” In fact, most who are suffering from severe depression have already tried this approach and may already feel like a failure for not being able.

Reach out and provide social opportunities. Ask them to help you out with a project or something that will include them but not call attention to their depression and make them feel embarrassed or like a burden. Invite them to contribute to your life in some way, even if it’s as small as asking you to go see a movie that you wanted to see.

These are just a few suggestions for supporting those you care about. Be patient with them and yourself, educate yourself and others on depression and resources in our community. Helping people get the treatment they need may take time and many different approaches but can make a difference.

From the Jackson Hole News & Guide Column Sound Mind

While this pandemic has been devastating in so many ways there is one positive that has come out of it. More people are talking about mental health.

While awareness has been on the rise over the last few years, the stigma attached to mental health issues has remained high — and has been a barrier to healing. In fact, I think this is the top subject I hear people talking about. We have been focused on dealing with the physical side of COVID and many of us are also struggling with the emotional long-haul.

I recently read an article in The New York Times by Adam Grant that hits the nail on the head (“There’s a Name for the Blah You’re Feeling: It’s Called Languishing”). He talks about moving past the panic of the early pandemic into the various stages of stress and worries and exhaustion-burn out to languish or a “sense of stagnation and emptiness. It feels as if you’re muddling through your days, looking at your life through a foggy windshield. And it might be the dominant emotion of 2021.”

We have come to a place where it is almost like we are in a waiting pattern or going through the daily motions in the space between depression and thriving. It is the space where we wander on autopilot, and, according to Grant, “is the neglected middle child of mental health.” I tend to think he may be right. Operating in this space can lead to indifference and dull the conscious response to attend to mental health needs.

Each day we all deal with many pressures and responsibilities from jobs and kids to whatever else is competing for attention in our lives. We tend to live hectic lives and, as a result, mental health is pushed to the back of the priority line. I think many of us have done this throughout the pandemic, saying to ourselves that “I just need to make it to ______________ (fill in the blank).”

As spring hits many of us have been able to get away and reset. The good news is that now is the perfect time to focus on a few basic mental wellness practices that can prioritize your overall mental health. This is exactly the right time to make some time and prioritize your mental health before it gets to be something more serious and difficult to deal with.

• Pay attention to how and what you are eating and drinking, get enough sleep and try to get some exercise each day. If your sleep is off (too much binge-watching Netflix?), evaluate your sleep hygiene practice and see if there are some habits you can change. It is amazing how much of a role sleep and nutrition play in how we feel mentally as well as physically.
• Be aware of how you are feeling and doing. Notice patterns and be honest with yourself. How many times have you answered “I’m great, I’m fine” or something similar when, in reality, you are really struggling?
• Give yourself some dedicated down time. Focus on one small project or goal and dedicate some of this down time to completing. Celebrate success. A sense of purpose and progress is a great countermeasure to the blahs.
• Manage your stress levels. If you find yourself spinning on worry or beating yourself up for something that happened in the past, it may be an indicator that you need to work on your mindfulness skills. Practice some mindful exercises with breathing or meditating. There are plenty of great mindfulness exercise apps that you can give a try or schedule during your day. MyStrength.com has a great series and is free with the code: jhcommunity.

Whatever you decide to do, make it a priority to pay attention to your mental health. It is not something that many of us are taught to do. We push it to the bottom of the list. Thinking that we will get to it “some day” or when we have more time. We all know it is not good to put off wellness checks for our health, or to delay getting that physical issue taken care of. Why not prioritize your mental health the same way?

From the Jackson Hole News & Guide Column Sound Mind

Day 9,050 of 2020.

If we look back on the year, it’s not hard to notice all the stressful events that have occurred. Fires, natural disasters, climate change, policing issues, racial issues riots, the election … oh, and let’s not forget all of this during a global pandemic.

In addition to all the above, we here in Jackson have also dealt with one of our busiest summers ever.

Summer stresss, with staffing issues and traffic, has been exacerbated by stress about the pandemic.

So many of us have mentioned how this prolonged state of stress is affecting us. I like to call it COVID brain. I’ve noticed increased levels of stress, memory difficulties, a hard time focusing on simple tasks, irritability, less patience and empathy, sleep issues and feeling generally overwhelmed.

In conversations with others, this is not a unique experience: Many are experiencing similar symptoms. It’s no surprise that with everything going on we are all feeling an increased level of stress and anxiety.

A good example of how this is affecting us can be noted through responses on social media. As many of the issues heat up it feels like the overall environment is becoming more and more divisive and negative. Politics and values always have people on both sides with differing views. Actual debates and discussing the issues is a healthy part of the process.

However, allowing anger to fuel disagreements rather than respectfully disagreeing, feeds the negativity. Social media shows us people are passionate about many of the current issues on both sides, and yet the debate many times becomes more about character and name-calling rather than the facts in the discussion.

So where do we go from here?

Taking care of your mental health related to the overall stress is an important piece, and this includes your physical health — getting plenty of sleep, exercise, eating healthy, limiting alcohol and tobacco — and decreasing screen time and avoiding toxic conversations. Try to find some time to relax and recharge practicing mindfulness, gratitude and empathy, and maintain routines, connect with others and do something for someone else. Remember, this is a marathon, not a sprint.

Related to discussing the issues, here are some suggestions that may work well as reminders when debating contested stories in the news and especially on social media.

Avoid defensiveness: Our natural reaction to conflict can be to become defensive. This is not helpful in working through conflict productively and will not help you make a valid argument.

Research: Explore the facts of the issue from a reliable source. Include more than one source to form your own opinion.

Try to understand both sides of the issue, which can allow you to make your own argument stronger.

Argue the merits and the facts of the situation rather than just emotional responses.

Ask questions to explore the other side.

When you’re stating your own opinion or case, keep in mind that not everyone thinks the same as you and everyone is allowed their own opinion. Listen to the argument with intent to understand rather than to respond.

Avoid allowing disagreement to turn to anger, hate or name-calling. Try not to engage in this behavior or conversation. If necessary, walk away.

Keep in mind that conflict debates, discussions and stress reactions are all normal right now. There can be no progress without some sort of conflict to induce change. However, it’s not the conflict itself that is the problem, but the ways in which we choose to engage in the conversation or to their stress.

Tensions are high and everyone is feeling overwhelmed, anxious and stressed with a lot of uncertainty. Know what is the normal reaction for you to stressful situations so that you are aware when things are getting out of the normal range.

Luckily, there are so many local resources available to help navigate the stressful times.

Consider practicing mindfulness every day using tools highlighted by Becoming Jackson Hole’s 100 Acts of Mindfulness or on MyStrength.com. (Use access code jhcommunity.)

If you notice things are feeling out of control, it may be time to seek professional help or support. Family and friends can be a huge support system, as can clergy. In addition, there are many affordable options for seeking mental health support including Mental Health JH (collaboration with private practitioners and nonprofit partners) as well as the Jackson Hole Community Counseling Center.

From the Jackson Hole News & Guide Column Sound Mind

As emotions go, guilt and shame seem to be universal across cultures, socioeconomics and demographic. While there is an important function to these emotions, they can also be extremely uncomfortable to deal with for a person.

Guilt is a feeling of responsibility (real or imaginary) or remorse for some offense, crime or wrongdoing.

Shame is the uncomfortable feeling that stems from the perception of something dishonorable, improper, unintelligent, committed by self or others.

Though the feelings of shame and guilt are often seen as the same thing, there are important differences between the two.

While the emotions can feel similar, shame has a strong relationship to bullying, depression, anxiety, body image issues, suicide, addiction and aggression. Guilt, on the other hand, has a connection with empathy and understanding other points of view.

Guilt is what we feel when we have made a mistake, an error or done something wrong. This is linked to one’s behavior that alerts us of an inconsistency between our behavior and our values. For example, “I did something bad” or “I made a mistake.”

The connection to empathy stems from feelings of remorse and the wish to make corrections or repairs, or ask forgiveness. Feeling guilt and then making amends is what allows us to learn from our mistakes, view a situation through another perspective and move on.

On the other hand, shame becomes more of an internal focus on self-image or worth. It becomes a belief such as “I am bad” rather than “I did something bad.”

Research shows that problems begin when shame becomes attached to a person’s self-image or sense of self-worth. While most of us have experienced shame at one time or another, it is the dysfunctional processing and accumulation of shame that can lead to eating disorders, domestic violence, substance abuse, social phobias, aggression, bullying, sexual offenses and other problems.

It might be a situation, either real or imagined, that may elicit shame. Shame is felt when we feel we are being perceived as inadequate because of our abilities, appearance or intelligence.

One response to shame can be to attack others as a defense mechanism. To avoid feeling shame, one may show contempt toward another person to shift the shame on them. Transferring shame to another person is a typical self-protective behavior in narcissists and bullies.

Regardless of the trigger, when shame is experienced the damage to self-worth can be toxic. Shame can elicit emotions such as jealousy, anger, rage and anxiety. In addition it can also lead to feeling isolated, sad, depressed, worthless or lonely as a result.

When shame results in self-attack, it can be overwhelming, and damaging to self-worth and self-esteem.

Brené Brown has done extensive research and written several books on shame. She suggests that shame requires examination through curiosity rather than judgment. Shame, if not processed functionally, can become accumulative. That means that it can build on previous memories when we experienced it and can influence our reactions and behaviors.

One such reaction to shame can be to “save face” to avoid the emotion. Another reaction may be to withdraw or hide from emotion. This can lead to behaviors that exacerbate shame such as addiction, harsh and self-critical thoughts or compulsive behaviors. See sidebar for some ideas on healthy ways to combat shame.

In the end, guilt and shame happen and are crucial for social development. These emotions keep people from acting entirely in self interest and keep us in line with our values and moral code. These emotions provide opportunities to learn and grow. When repairs are made after a mistake and one is open for self-forgiveness, it can be a powerful experience for growth and connection.