Gathered at the ‘Let’s Taco-Bout It’ LAHS Key Club event Feb. 9 at SALA are, from left, Emily Xu, Lilly Viteva, Sean Lo, Morrie Pongratz, Angel Meng, Jessica Strong, Adrian Koo and Lucia Rodin. Photo by Maire O’Neill/losalamosreporter.com

Key Club members make cotton candy at the ‘Let’s Taco-Bout It’ Feb. 9 at SALA. Photo by Maire O’Neill/losalamosreporter.com

Magdalena Karlick of Los Alamos JJAB speaks at the ‘Let’s Taco-Bout Mental Health event. Photo by Maire O’Neill/losalamosreporter.com

LAHS Key Club members reach out to the audience at the beginning of their event. Photo by David Hampton

BY MAIRE O’NEILL
maire@losalamosreporter.com

More than 40 people, both teens and adults, attended the Key Club Feb. 9 ‘Let’s Taco-Bout It’ event at SALA Event Center where they heard from Magdalena Karlick of Los Alamos JJAB and Jessica Strong, whose “day job” is the Los Alamos County Social Services Manager, about youth mental health issues and how to help.

Strong was there to share from her years of experience as a friend and ally of people with mental health needs, sharing what she wished she would have known about mental health when she was younger.

She told those present that one in six teens will experience a mental health disorder in any given year.

“Some 50 percent of teens will report some symptoms in any given year. It doesn’t mean you have a diagnosis, it just means you have some symptoms. Half of all mental health diagnosed conditions are before age 14, but most people between the ages of 15 and 40 experience an average delay of 1 1/2 years between the symptoms and getting to treatment. That’s due to a lot of factors including access to mental health treatment, access to health insurance coverage. That varies a lot by diagnosis. For someone with bi-polar disorder the average delay is closer to 10 years,” Strong said.

Jessica Strong speaks to young people at the Key Club event at SALA. Photo by Maire O’Neill/losalamosreporter.com

She noted that the more people that receive information when they’re in high school, “the better outcomes we hope people will have.”  When she asked which mental illness has the highest fatality rate, many people guessed depression, but the answer was eating disorders.

“Eating disorders is one of the hardest ones to treat because while there are a lot of really good treatments for some of the other mental health disorders, eating is necessary to life so for someone who has an eating disorder it can be really, really hard,” Strong said. “We talk a lot about physical and mental health as if they are two separate things. Your brain is connected to your body; it’s all actually connected and there’s definitely good mental health and there’s worsening mental health. And they exist along a really big spectrum.”

Strong stressed that just because someone is experiencing bad mental health doesn’t mean they’re going to have it for life.

“Just because there may be some negative mental health things happening – you might not even get a diagnosis – but if you do get a diagnosis, there may be things that help you get better,” she said. “The reason we talk about mental health is because it impacts all of the emotions we talked about earlier [during Magdalena Karlick’s talk]. When we are talking about a mental health diagnosis, we are talking about when it starts impacting lots of different facets of your everyday life. When Magdalena was mentioning what anxiety feels like and we could all name times when we felt anxious, there are times when that anxiety becomes more and more persistent and it becomes more and more things throughout our day and then those days turn into weeks and suddenly we might meet the definition for a diagnosis. We might need to get some type of help.”

Strong said that is true for all of the mental health disorders.

“Somebody who is restricting food intake may be dieting. It may never become an eating disorder… or it might when it begins impacting daily activities over a long period of time. People experiencing some form of sadness or not wanting to get out of bed, that is very normal. Suddenly when it is happening more and more frequently, for longer periods of time, that is when we would call it depression,” she said.

Strong said that makes it really hard sometimes to get any diagnosis and very hard to get any kind of treatment.

“Even though mental health is part of our whole body, it’s the only health disorder for which there’s no real blood test. You can’t go to the doctor and get any type of blood test or anything, there’s no MRI, there’s no CAT scan, these are all self-reported behaviors. Some people may not want to share all of their behaviors or symptoms that they’re experiencing. They may not have a doctor or somebody they can talk to about these things or a trusted person, and that’s why it sometimes takes a year, or a year and a half on average to get adequate treatment,” she said.

What causes mental health disorders? Turns out a lot of things cause it, Strong said.

“There may be a genetic component, if there’s a history of depression in a family or substance abuse disorders in a family. Some mental health disorders may be attributed to learned behavior. For example, with substance disorders there may not be another component but you may learn from people in your family that when there’s a stressful situation, alcohol may relieve some sense of that stressful feeling and that it turns into an addiction,” she said. “Or if you have a family member exhibiting behaviors of a phobia – a fear of flying, a fear of spiders or snakes or something like that, you may learn to be afraid of snakes or spiders if there’s no genetic component.”

Strong said some disorders are a result of trauma – from people who have experienced war, violence, or traumatic events, that can often then lead to diagnoses of anxiety or depression or other mental health diagnoses.

“There are people who live in chronic stress, whether that is chronic lack of income, chronic racism, chronic stress related to whatever it might be… There could be an environmental component with people who have lived through wars or other natural disasters, like hurricanes, earthquakes, etc. that can lead to increased diagnoses of mental health,” she said. “We know there’s a hormonal component to it, and we know that it can also be tied to physical health changes. For example, post-partum depression, post-partum anxiety, post-partum psychosis – all related to the change in hormones after someone gives birth.”

She noted that people who are over the age of 60 who have a heart attack or stroke are at a sudden increase in risk of developing depression, and that with people who have had a recurrence of cancer their rates of anxiety and depression also go up.

“”We know there is a whole confluence of things that may impact where someone falls along that spectrum. Some people can live with chronic stress and never develop any mental health disorder and other people are much more sensitive to it. We don’t really have all of the puzzle pieces figured out just yet. There’s a lot that goes into it,” Strong said. “What I want to point out is, there are nine factors that are considered important to the diagnosis of depression, and to meet the clinical diagnosis of depression, you can have any five of those things (just mentioned). If you are experiencing five of nine symptoms, the person you are seeing – the therapist, the doctor or whoever, could diagnose you with depression.”

Somebody could have the first five and somebody else could have the last five.

“The only one they would have in common would be one of them, which is why it makes it really tricky. If you are only reporting a couple of symptoms and you are reporting completely different symptoms, you might end up with wildly different diagnoses. That makes it very tricky to get a diagnosis and get a treatment that works, because it is so variable.” Strong said. ” …You don’t need to know the nine symptoms, what you need to know is what to be on the lookout for with a friend or a loved one or yourself.”

She listed the big five symptoms as experiencing the following:

Emotional Roller Coaster
Increasing Isolation
Absence of Self-Care
Hopelessness
Suicidal Thoughts

“If you have noticed these changes happening for a period of a couple of weeks and they don’t seem to be getting better, we want you to get help. I am trained as a trainer in Mental Health First Aid, and trained as a trainer in suicide prevention, and opioid overdose response and a bunch of other things and there are lots of trainings with a bunch of acronyms, but this is what is key. If somebody is experiencing emotional volatility, a bunch of changing emotions – a lot… Not normal teenage hormones – nothing like that, but if they’re really quick to anger, really quick to cry, really quick to storm away and slam doors, really quick to show frustration, that rollercoaster is happening a lot. Having trouble regulating emotions is one of the hallmarks of a lot of mental health diagnoses,” Strong said.

She emphasized thar if you’re worried about someone’s emotional state, you don’t need to diagnose them, but that it is one datapoint leading to the belief that “something might be going on here.”

“The second big one is increase in increase in isolation. No matter what the diagnosis is, someone who is becoming increasingly isolated, on a spectrum, not someone who is shy and introverted or for the last weekend, they just wanted to stay at home and catch up on stuff. Increasingly isolated – missing social events, missing school, missing work, a greater period of time over a period of weeks. They never want to come out. They never want to have people over. They never respond to the text messages or whatever. They’re increasingly isolating themselves and that should be another red flag that something is changing and we might want to be additionally concerned,” Strong said,

The third thing she mentioned was the absence of self-care.

“You can see how these things all become tied together. People will tend to, when a mental health issue is in the process of developing, stop showering or bathing, stop brushing their teeth, stop doing their hair or nails, stop caring about what they’re going to wear and they will wear the same thing because they are kind of ‘bed-rotting’ for want of a better word. The absence of self-care is another huge sign,” Strong said.

Strong said an increased feeling of hopelessness may be present in a number of different ways.

“You might hear, ‘I just don’t see why I would go on. I just don’t see why we’re making plans for the future,’ for example. There will be a marked change in that person’s personality that comes across as that lack of hope. That’s usually a really big warning,” she said.” And the last one is obvious, I hope. If the person starts talking about thoughts of suicide, thoughts of killing themselves, thought of not wanting to be here physically anymore – these are the ones that we want to be on the lookout for.”

Strong said any of these are really serious warning signs that somebody is needing help.

“I have been in positions lots of times – where I knew something was wrong, where I’m thinking. ‘What do I do? Do I call 911?’ If they are having thoughts of suicide, yes call 911,” she said.

If a friend just isn’t coming out, they’re missing a bunch of classes, they’re going to drop out, what do you do?

“Even though I’m a trainer and there could be lots of other acronyms to teach you, right now I put the big four up here, because what people need if they are experiencing a mental health crisis, is someone to listen without judgment. I’m just as guilty of this, but sometimes when somebody says something is going wrong, it’s very easy to jump into problem solving – Have you tried this, have you tried that? Really what we want to do first is be able to listen without judgment to what it is they may be experiencing, what may be causing them to exhibit these warning signs.  We want to be just present and show empathy as actually the first step.” Strong said. “To be present without judgment is a huge ask because for somebody who’s experiencing symptoms of depression or OCD – it may not be easy to be with somebody. So be present with the person and not jumping to problem-solving. There are definitely resources. There are definitely ways we want to get them connected, however, we are not in a position to diagnose, we just want to be with the person so that we can help get them to that next step for getting help.”

She advised the student wherever they are next year to find out where the local social services department is located because we they do have all the resources to get people connected.

“Help may be talking to a doctor. Most people are a little wary of jumping straight to a therapist. There are often long wait times to get in to a therapist, which is really unfortunate, but be able to be with somebody and listen to them and build that trust and rapport to get them connected to additional help,” Strong advised.

The last thing she said is that with a lot of mental health symptoms that people may be experiencing there is no one magic answer.

“There is no one kind of cure, and even though I have been doing this kind of work for more than 20 years, and there have been a ton of improvements, it can still be really hard. Somebody who has five symptoms of depression because of postpartum related to hormones after a pregnancy and somebody who has a totally different set of symptoms related to Seasonal Affective Disorder, a totally different form of depression, may not respond to the same types of treatment,” Strong said. “There’s talk therapy, art therapy, music therapy, medications – there’s a whole constellation of things. Some things take six to eight weeks of daily medication before they start to kick in. Others are once a month injectable shots that they have to go to the hospital to receive. Others may need rehab or detox or residential facilities. It’s a whole gamut of things. What often happens is that people will say, ‘I tried that treatment and it didn’t work’. So part of teaching all this is that the way to be a really good support person is to offer that hope to people.”

“We’re just at the beginning of research. But being able to provide support, to provide hope to people, and especially for people experiencing hopelessness, that really goes a long way. Remaining connected, being that friend, helping give them that support even if there’s no one answer or one cure, really keeps people from far worse health problems.” Strong said.