The Situation of Depression

From Gallup (09/28/10):

Residents of Gulf Coast-facing counties experienced a decline in their overall emotional health, as measured by the Gallup-Healthways Emotional Health Index, in the 15 weeks after the onset of the BP oil spill. Those living in inland counties in the same Gulf of Mexico states showed no such drops in emotional health in the oil spill’s aftermath.

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From The Associated Press:

A Gallup survey released Tuesday of almost 2,600 coastal residents showed that depression cases are up more than 25 percent since an explosion killed 11 people and unleashed a three-month gusher of crude into the Gulf in April that ruined many livelihoods. The conclusions were consistent with trends seen in smaller studies and witnessed by mental health workers.

People just aren’t as happy as they used to be despite palm trees and warm weather. A “well-being index” included in the Gallup study said many coastal residents are stressed out, worried and sad more often than people living inland, an indication that the spill’s emotional toll lingers even if most of the oil has vanished from view.

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The Gallup survey was conducted in 25 Gulf-front counties from Texas east to Florida over eight months before and after the spill, ending Aug. 6. People reported 25.6 percent more depression diagnoses after then spill than before it, although the study didn’t conclude the additional cases were tied directly to the oil.

The survey said people along the Gulf reported feeling sad, worried and stressed after the spill, while people living inland reported less over the same period. More than 40 percent of people in coastal areas reported feeling stress after the BP geyser blew, a 15 percent increase from before.

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[A]n earlier study conducted in 13 counties and parishes with a total population of 1.9 million showed that 13 percent of coastal adults from Louisiana to Florida suffered probable serious mental illnesses after the spill.

The level of mental illness was similar to that seen six months after Hurricane Katrina decimated the coast five years ago, and experts aren’t yet seeing any improvement in mental health five months after the oil crisis began. Before Katrina, a study by the National Institute of Mental Health said only 6 percent of area residents had likely mental illnesses.

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Steve Barrileaux, a psychologist at the Gulfport center, said some of the problems leading to mental health issues are obvious, like the loss of work by a person who rented chairs on the beach. Others are more subtle.

Many people are deeply worried about the environment, for instance, or lament the lost moments they would have spent fishing recreationally with loved ones. Others are still afraid to eat seafood, even on the coast where livelihoods depend on it.

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To read the article in its entirety, click here.  For a sample of related Situationist posts, see “Some Situational Effects of the BP Gulf Disaster,” “The Situation of Mental Illness,” “Inequality and the Unequal Situation of Mental and Physical Health,” “The Situational Consequences of Uncertainty,” “The Disturbing Mental Health Situation of Returning Soldiers.”

The Depressing Effects of Racial Discrimination

From Cornell News Service, here is a news release regarding fascinating research on the effects of racial discrimination.

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Many studies have shown that experiencing chronic racial discrimination chips away at the mental health of African-Americans.

But a new Cornell study sheds light on precisely how – and to what effect – chronic racial discrimination erodes mental health.

The study found blacks may, in general, have poorer mental health as a result of two mechanisms: First, chronic exposure to racial discrimination leads to more experiences of daily discrimination and, second, it also results in an accumulation of daily negative events across various domains of life, from family and friends to health and finances. The combination of these mechanisms, reports Anthony Ong, assistant professor of human development in the College of Human Ecology at Cornell, places blacks at greater risk for daily symptoms of depression, anxiety and negative moods.

“As a result, African-Americans experience high levels of chronic stress. And individuals who are exposed to more daily stress end up having fewer resources to cope with them,” said Ong.

The study, one of the first to look at the underlying mechanisms through which racial discrimination operates to affect the daily mental health of African-Americans, was conducted with Cornell graduate student Thomas Fuller-Rowell and Anthony Burrow, assistant professor of psychology at Loyola University-Chicago; it is published in the June issue of the Journal of Personality and Social Psychology (96:6).

The researchers examined the ways that chronic discrimination exerts a direct influence on daily mental health and an indirect influence through daily stress (i.e., daily racial discrimination and negative events) by analyzing daily questionnaires from 174 African-Americans for 14 days. Participants answered questions daily about the frequency of racially stressful encounters, mental health symptoms, mood and stressors across life domains.

“What we found was that it is the daily discrimination and daily stress that are driving the psychological distress,” Ong said.

The authors noted that racial discrimination in this country “is a ubiquitous experience in the lives of African-Americans,” citing various studies that reported that between half to three-quarters of black respondents report experiencing racial discrimination. They also cite a 2003 review of 32 studies that found a positive link between perceptions of racial discrimination and mental illness in all but one of the studies.

Based on the new study, Ong emphasized that the tendency for serious stressors, such as racial discrimination, to expand and generate additional stressors – a process called stress proliferation – requires that interventions cast a wide net.

“It is not enough that interventions target one problem,” Ong noted, “even if it appears to be a serious stressor, when there might be multiple hardships and demands that are instrumental in structuring people’s daily lives. Chronic exposure to racial discrimination provides a poignant illustration of the proliferation of stress stemming from repeated discriminatory experiences.”

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To read a sample of related Situationist posts, see “The Situation of Racial Health Disparities,” and “The Physical Pains of Discrimination.”

The Disturbing Mental Health Situation of Returning Soldiers

The military conflicts in Iraq and Afghanistan have led to over 4,700 deaths of U.S. soldiers (in addition to over 1.2 million deaths of Iraqi and Afghan people) and tens of thousands of physical injuries to U.S. soldiers. As we know too well, some of those injuries are catastrophic.

The mental health of returning soldiers has received much less attention, no doubt in part because those injuries are less apparent, because many people still view mental illness as less serious than physical illness, and because of choice myth in the context of mental illness: there is a common presumption that mental illness reflects a weak will (as opposed to biological impairment) of the person and that it can be corrected by the person, if the person so chooses.

Given the horrific conditions of warfare, however, perhaps the mental illness of soldiers will receive more credibility. New revelations about the number of veterans attempting suicide will certainly draw attention to the issue: although the Veterans Health Administration recently claimed that 800 veterans are attempting suicide each year, newly-uncovered e-mails from government officials indicate the actual number of veterans attempting suicide each year is closer to 12,000.

Just released data about the number of soldiers who have returned, and will return, from Iraq and Afghanistan with very serious mental health-related problems should also raise public consciousness. A new study by the RAND Corporation entitled “Invisible Wounds of War,” indicates a truly jaw-dropping figure: 1 out of every 5 returning soldiers–or about 300,000 total soldiers to date–suffers from either post-traumatic stress disorder or major depression. Below we excerpt an article by Lizette Alvarez of the International Herald Tribune on this topic.

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One in five service members who have returned from Iraq or Afghanistan report symptoms of post-traumatic stress disorder or major depression, but little more than half of them have sought mental health treatment, according to an independent study of United States troops.

The service members and veterans who reported these symptoms represented about 19 percent of the 1.6 million service members who have deployed to war in the last five years, a figure consistent with the most recent findings by military researchers. A 2007 survey of combat army soldiers who had been home for several months found that 17 percent of active-duty troops and 25 percent of reservists had screened positive for symptoms of stress disorder.

The study, released on Thursday by the RAND Corporation, reported that about 19 percent of the troops said they might have experienced a traumatic brain injury, usually the result of powerful roadside bombs, yet a majority of those troops had never been evaluated for such an injury.

The 500-page study is the first exhaustive, private analysis of the psychological and cognitive injuries suffered by service members. The study sought to determine the prevalence of these injuries, gaps in treatment and the costs of treating, or failing to treat, the conditions.

RAND researchers conducted a telephone survey from last August to January 2008 with 1,965 service members, reservists and veterans who had deployed to Iraq or Afghanistan in the last five years. Some respondents had deployed more than once. The researchers also gathered data from focus groups. The survey was conducted in 24 communities with high concentrations of service members, reservists and veterans.

The Defense Department said that it was heartened that the data reflected its own findings on the prevalence of mental injuries, and that the study helped highlight the hurdles the military faces in helping veterans.

“We’re on a long journey, and we’ve come a long way, but we’ve got a long way to go,” said Colonel Loree Sutton of the army, head of the new Defense Center of Excellence for Psychological Health and Traumatic Brain Injury.

Lisa Jaycox, a senior behavioral scientist at RAND and a co-author of the new study, “Invisible Wounds of War,” said the findings also served to underscore the barriers, some of them self-imposed, that troops face in getting help. War veterans say they are often reluctant to seek treatment, in part out of fear that their medical information will be used to derail their careers. Commanders typically have access to a service member’s military medical records.

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For the rest of the article, click here. To access “Invisible Wounds of War,” click here. For related Situationist posts on the military conflicts in Iraq and Afghanistan, see The Situation of Soldiers, “Our Soldiers, Their Children: The Lasting Impact of the War in Iraq,” “The Situation of a “Volunteer” Army,” “From Heavens to Hells to Heroes – Part I,” and “Looking for the Evil Actor.” For related Situationist posts on mental health, see “The Situation of Racial Health Disparities” and “Guilty or Not Guilty? Law & Mind Meet Hamlet.”