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Tag: Depression

  • Tired of what she says is oppression, woman in Zimbabwe challenges a law banning sex toys

    Tired of what she says is oppression, woman in Zimbabwe challenges a law banning sex toys

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    HARARE, Zimbabwe — Sitabile Dewa was content with her sex life when she was married, but after her divorce, she found her prospects for erotic pleasure rather bleak.

    In socially conservative Zimbabwe, divorced women and single mothers are often cast as undesirable partners for men, and in her frustration Dewa decided she wanted to use sex toys.

    The problem is sex toys are against the law in Zimbabwe.

    “I should not be deprived of self-exploration and indulgence in self-gratification,” said Dewa, 35.

    Part of Zimbabwe’s “censorship and entertainments control” law makes the importation or possession of sex toys illegal as they are deemed “indecent” or “obscene” and harmful to public morals. Owning sex toys can put a woman in prison.

    Dewa said the law is “archaic” and is challenging part of it in court on the basis that it is repressive and infringes on her freedom. She filed court papers in March suing the Zimbabwe government and seeking to have parts of the law repealed. The court is considering her case.

    Her bold, open references to masturbation and women’s sexuality are bound to make many Zimbabweans uncomfortable.

    But her crusade is significant, say women’s rights campaigners, as part of a broader challenge to the nation’s patriarchal outlook, where women’s choices on a range of other issues that affect them and their bodies — including contraception, marriage and even what they wear — are scrutinized and often limited.

    Dewa is a women’s rights activist herself, and says she applied her own life experience in her stand against the ban on sex toys.

    Proof that the law is actively enforced came last year when two women were arrested over sex toys.

    One of them was running an online business selling sex aids to women and offering advice on their use. She spent two weeks in detention and was sentenced to six years in jail or 640 hours of unpaid community work.

    The thing that appears to rile authorities the most on the sex toy issue is the sidelining of men, said Debra Mwase, a programs manager with Katswe Sistahood, a Zimbabwean group lobbying for women’s rights. Sexually liberated women frighten the men who dominate Zimbabwe’s political, social and cultural spaces, she said.

    “Sex is not really seen as a thing for women,” Mwase said. “Sex is for men to enjoy. For women, it is still framed as essential only for childbearing.”

    “Sex without a man becomes a threat,” she added.

    Dewa boils it down to this: “These laws would have been repealed a long time ago if the majority of users were men,” she said.

    Also significant is Zimbabwe’s history. While untangling the effects colonialism might have had on women’s rights in sub-Saharan Africa today, multiple studies have shown that African women were far more sexually expressive before European laws, culture and religion were imposed.

    Prominent Ugandan academic Sylvia Ramale wrote in the introduction to a book she edited titled “African Sexualities” that pre-colonial African women were “relatively unrestrained” when it came to their sexuality. For one thing, they wore revealing clothing, Ramale said.

    But colonialism and the foreign religion it carried with it “stressed the impurity and inherent sin associated with women’s bodies,” she said.

    Mwase quips at what she sees as a great irony now in Zimbabwe, which has been independent and free of the oppression of white minority rule for 43 years and yet retains laws like the one that deals with sex toys, which is a carryover from colonial times.

    “African societies still vigorously enforce values and laws long ditched by those who brought them here. It is in Europe where women now freely wear less clothing and are sexually liberal, just like we were doing more than a century ago,” she said.

    Dewa’s campaign for access to sex toys falls into the bigger picture in Zimbabwe of women being “tired of oppression,” and is clearly forward-thinking, she said. But there has recently been evidence of a throwback to the past that might also be welcome.

    Some parts of a pre-colonial southern African tradition known as “Chinamwari” are being revived, in which young women gather for sex education sessions overseen by older women from their families or community.

    Advice on anything from foreplay to sexual positions to sexual and reproductive health is handed out, giving Chinamwari a risqué reputation but also the potential to empower young women.

    In modern-day Zimbabwe, Chinamwari meetings are advertised on the internet. But they also now come with guarantees of secrecy, largely because of the prevailing attitudes toward sex and backlash from some men uncomfortable with the thought of women being too good at it.

    ___

    More Associated Press Africa news: https://apnews.com/hub/africa

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  • Why A Full Dopamine Detox Isn’t Possible & What To Do Instead

    Why A Full Dopamine Detox Isn’t Possible & What To Do Instead

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    The name dopamine detox implies that these behaviors are the only source of dopamine, and thus cutting them out will somehow rid you of the feel-good neurotransmitter—but that’s not the full picture. 

    It’s important to note that Sepah has clarified in past interviews that this term was not intended to be taken literally but unfortunately has been by many. 

    Experts clarify that the goal of this practice isn’t to rid your life of dopamine but to change your relationship with it. “Dopamine is a neurotransmitter that plays a crucial role in the way the brain functions. It is impossible to ‘detox’ or rid the brain entirely of dopamine,” says neuropsychologist Sanam Hafeez, Ph.D. She notes that it’s more about practicing self-regulation than detoxification. 

    To be fair, high levels of dopamine have been linked to impulse-control issues and a hypercompetitive attitude. However, lower dopamine levels aren’t the answer either; these have been associated with a lack of motivation.

    Regardless, does cutting out your vices for a short period of time really do anything? According to a 2021 study, the dopamine detox method can be helpful in reducing impulsive behaviors, thus contributing to an overall healthier state of mind. 

    I doubt many people would be surprised to learn that spending time away from social media or limiting the use of recreational drugs would benefit your mental health, but nevertheless, the specific perks are quite motivating. Hafeez says that reducing the amount of time you spend on activities that overstimulate the brain leads to many benefits, including: 

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    Hannah Frye

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  • “ADHD and OCD: My Codependent Frenemies”

    “ADHD and OCD: My Codependent Frenemies”

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    On the surface, ADHD and OCD are seemingly impossible bedfellows. “Messy,” “hyperactive,” and “scatterbrained” are just a few common synonyms for the former, while the latter is frequently associated with being exceedingly clean, uptight, and meticulous. (While some of these assumptions about these disorders are accurate for some people, they cannot be generalized or applied to everyone.)

    Yet, that’s precisely the combination I have. Research shows that up to 30% of people with ADHD also have OCD.

    In my reality, ADHD and OCD are codependent frenemies that sometimes help balance each other, even as they egg on one another.

    OCD and ADHD Feed Off Each Other

    My OCD diagnosis came first, and it never quite felt like the whole picture. I had trouble focusing, which is a common struggle in OCD that stems from difficulty managing compulsive symptoms. Still, it didn’t explain the day-to-day distractibility I experienced. It also didn’t explain my childhood issues with school or my impulsivity. When my psychiatrist added the ADHD diagnosis, it all suddenly made sense.

    OCD and ADHD both think they are helpful. ADHD knows you need more dopamine, but it fails to differentiate between healthy and unhealthy sources. OCD wants to relieve anxiety; it just tends to do so in maladaptive ways.

    [Get This Free Download: How Are Symptoms of OCD Different from ADHD?]

    Converse to its stereotype, ADHD also brings hyperfocus – a curious combination with OCD, as “obsessive” is right in the name. For ADHD brains, obsessions are a way to get the stimulation your brain thinks it needs. For OCD, obsessions are a catalyst for the compulsion part of the disorder. The two frequently exacerbate each other for me; this was especially true before I understood that I have both.

    The interplay might go something like this: I have an obsessive thought that creates anxiety. So I perform a compulsive action or thought to make it better. Making it better gives relief, and relief makes dopamine. Therefore, the compulsion not only relieves the anxiety temporarily but also activates my brain. Trying to avoid a compulsion, on the other hand, produces a hefty dose of adrenaline while dopamine and serotonin perform an endless dance in my brain.

    OCD exploits the poor impulse control of ADHD. It is so much easier to “give in” to a compulsion for that quick relief.

    As a kid, ADHD contributed to feelings of shame. I felt like I was lazy and could not do anything right. I felt like a failure and understood that I was not “living up to my potential.” OCD feeds on shame; its what-ifs led me farther into this spiral. What if my obsessions and intrusive thoughts meant that I was a terrible person? And what if, as a horrible person, I was truly lazy?

    [Read: The Truth About Obsessive-Compulsive Disorder]

    While “I have OCD” is accurate, it doesn’t mean that the disorder rules everything that I think about and do. For instance, I am not neat and orderly, and germs don’t bother me beyond what feels rational. Those aren’t my particular flavors of OCD. So while it’s true that OCD and ADHD have functional and physiological differences, there is room in my brain for both.

    OCD tends to resemble a game of whack-a-mole, with new worries and obsessions popping up just as others begin to feel manageable. ADHD means I can always find new ideas to turn into intrusive thoughts.

    Uncertainty fuels OCD, and ADHD produces a lot of uncertainty. For example, it’s challenging to reassure yourself that you locked the car when you have forgotten to do so many times before.

    OCD and ADHD: Too Intertwined to Tease Apart

    However, I suspect ADHD works to keep OCD in check in some ways. For example, people with comorbid ADHD and OCD are more likely to experience mainly thought-based compulsions, which I find less disruptive than any physical compulsions I experience. Sometimes, the distractability of ADHD smooths the roughest edges of my OCD.

    I also think ADHD makes OCD therapy more successful for me. Having a breakthrough, figuring something out, and relieving shame all bring the jolt of dopamine my brain craves. So, in some ways, their coexistence led me to more effective treatment.

    It would be great if neurodivergence and symptoms of mental conditions could fit nicely into individual columns. If only we could say, “this compulsion clangs around in the OCD bucket,” “that quirk lines the bottom of the ADHD basket,” and “that neurosis fits in the wider anxiety container.” But it’s rarely that easy. While OCD and ADHD are opposites in some ways, they are also too intertwined to tease apart.

    OCD and ADHD Together: Next Steps


    CELEBRATING 25 YEARS OF ADDITUDE
    Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitude’s mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

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    Nathaly Pesantez

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  • How To Stop Ruminating For Good With 13 Expert-Backed Tips

    How To Stop Ruminating For Good With 13 Expert-Backed Tips

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    Of course, reflective and/or deliberate rumination are not always bad, and can even help you learn from the things you’ve experienced. But as licensed psychotherapist Babita Spinelli, L.P. tells mindbodygreen, when rumination turns intrusive or brooding, you can think of it like “being on a hamster wheel of a negative thought patterns, creating anxiety, phobias, OCD, and depression.”

    And from there, according to neuroscientist Tara Swart, M.D., Ph.D., rumination can actually lead to self-fulfilling prophecies, in which we subconsciously confirm and repeat the same negative thoughts and feelings over and over again. “The more we ruminate on these thoughts, the more we embed brain pathways that hold these as true,” Swart previously told mindbodygreen.

    As you might imagine, a nasty rumination habit can take a major toll on your mental health. One 2020 analysis2 of existing rumination research has shown that ruminating can lead to worsened mental health issues, including anxiety, depression, psychosis, insomnia, and impulsive behaviors.

    It’s also been found to magnify and prolong both bad moods and the body’s stress response, negatively impact problem-solving, and even interfere with therapy and psychological interventions.

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    Sarah Regan

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  • The Real Reason ADHD Medication Supply Is Lagging Demand

    The Real Reason ADHD Medication Supply Is Lagging Demand

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    June 13, 2023

    Whoever says the Adderall shortage is over is living on a different planet. I have dozens of patients who rely on Adderall and who panic every month. Whenever it’s time to refill their prescriptions, the drama begins: Where can I find the medication I need?

    This uncertainty is causing extreme hardship for many of my patients. While stimulant medication is not exactly like insulin (you won’t likely die without it), it is like eyeglasses. Without your glasses, your execution of everything suffers. You go about your day making mistakes, bumping into things, risking getting fired because suddenly you’re incompetent. I wish the Adderall shortage were over, but up here in the Boston area at least, it is as bad as it’s ever been.

    I can’t figure out why. It’s not as if Adderall is like truffles; we don’t need special pigs to root it out from the ground. Production is not limited by the availability of its components. It’s easily synthesized. So why is there a limit on how much stimulant medication can be produced and marketed? Why are my patients suffering unnecessarily?

    [Read: Adderall Shortage Persists as Opioid Settlement Triggers Pharmacy Constraints]

    Why Are We Punishing ADHD Patients?

    If limiting the production of Adderall is part of an effort to reduce or prevent the reselling or other misuse of the drug, that simply makes no sense. It’s just plain stupid. It’s like trying to reduce car theft by limiting the manufacture of cars.

    It’s difficult for me not to believe this is a misguided attempt to avoid another oxycontin debacle. But limiting the manufacture of Adderall to prevent Adderall abuse only succeeds in punishing the patients who really need the drug.

    To blame the Adderall shortage, as the FDA commissioner recently did, on improper or aggressive diagnosis of ADHD and improper or aggressive prescription of stimulant medication is to penalize the many for the mistakes of a few. Unless a doctor is intentionally over-diagnosing to make a profit — which does happen, unfortunately, but not nearly often enough to create a shortage of Adderall — then we ought to have enough of a supply to meet the needs of all people diagnosed with ADHD.

    [Download: ADHD Medications – Comparison Chart of Stimulants & Nonstimulants]

    There is a shortage of Adderall because, for some reason, the manufacturing quotas set by the Drug Enforcement Administration (DEA) are not keeping up with demand. It’s good news that the demand is high because that means more people are getting diagnosed. Not too long ago, it was hard to find a doctor who knew enough to diagnose and treat ADHD.

    Now that we’re diagnosing and treating more people with ADHD, especially adults, we ought to be able to prescribe for them the medications they need to live more productive, fulfilled lives.

    ADHD Medication Shortage: Next Steps


    CELEBRATING 25 YEARS OF ADDITUDE
    Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitude’s mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

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    Nicole Kear

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  • New Research Explores How Probiotics Can Impact Depression

    New Research Explores How Probiotics Can Impact Depression

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    Symptoms of depression can be debilitating. They include apathy, guilt, hopelessness, changes in body weight, insomnia, and irritability. While these symptoms tend to be the primary focus of treatment, there’s also a long list of cognitive symptoms, such as difficulty concentrating, indecisiveness, and memory issues.

    A new study shows that a popular supplement may help with the cognitive issues associated with depression. This randomized controlled trial including over 40 patients showed that high-dose probiotic supplementation for four weeks significantly enhanced memory and affected brain mechanisms underlying depression-based cognitive issues.

    Results showed that people in the probiotic group have improved hippocampal function (the part of the brain in charge of emotion and memory) at the end of the study period.

    As lead author Else Schneider, Ph.D., explained in an interview: “It supports our hypothesis that the hippocampus is the main structure that benefits from probiotics, and that’s why we only see improvement in the episodic memory and not in other cognitive domains, which are less hippocampus-dependent.”

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    Gretchen Lidicker, M.S.

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  • “I’m Still Recovering from ‘Hyperfocus Burnout.’ It’s Been Six Years.”

    “I’m Still Recovering from ‘Hyperfocus Burnout.’ It’s Been Six Years.”

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    In my first full-time job after finishing my master’s degree, I was put in charge a long-running project that was already years behind schedule. With strict, unrealistic timelines and insufficient resources, the project was mine to save.

    I’ve always been a high achiever, so I dove right in. Despite the pressure and all the givens, I found the work highly engaging and rewarding – the perfect combination for hyperfocus.

    Intense weeks turned into months. The longer I hyperfocused on the project and the more I accomplished, the more important my work became to me. It was all or nothing.

    I kept up the pace for a year and a half. Then, with almost no warning, I broke.

    I know what you’re thinking; it’s a classic case of burnout, right? Not exactly. You see, that burnout episode happened six years ago — and I’m still recovering from it.

    Burnout by Another Name

    Years after that episode, with a new job and an objectively manageable workload, I am still only able to work about 20 hours a week. I’m also highly sensitive to day-to-day work stress; some hard days can trigger depressive episodes and significant fatigue.

    [Read: Rising from the Burnout — an ADHD Recovery Kit]

    I finally sought help recently, and I found a therapist who specializes in ADHD. I told her my story and, I read what I could on burnout between our sessions to try to make sense of what I went through (and the effects I’m still experiencing). The more I learned, and the more I explored my burnout during therapy, the more I realized that traditional, commonly understood concepts of burnout failed to capture my experience.

    What I went through, I realized, was a form of burnout that I believe affects many of us with ADHD: I call it “hyperfocus burnout.”

    Digging Deeper on Hyperfocus Burnout

    The World Health Organization (WHO) describes burnout as the result of chronic workplace stress that has not been successfully managed. Here’s how the dimensions of burnout match up to my burnout experience:

    • feelings of energy depletion or exhaustion (Yep)
    • increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job (Not really)
    • a sense of ineffectiveness and lack of accomplishment (Nope)

    As stressful and demanding as leading that project was, I kept going back every day, eager to see it through. I wasn’t mentally distant from my stressor — I was engaged with it. It was all I thought about, day and night. I didn’t feel a sense of ineffectiveness or a lack of accomplishment on the job. It was just the opposite; my job was its own reward, and my productivity and effectiveness increased over time, fueling a positive feedback loop.

    [Read: Hyperfocus — a Blessing and a Curse]

    In my mind, there was nothing to escape or recover from. Sure, I wanted things to calm down, but burnout never showed up on my radar (though others in my life could see it). That’s why it’s typical approaches — like taking breaks, reframing, and increasing rewards – wouldn’t have worked on me.

    A dimension of my experience that I didn’t see reflected in my research was my intense and increasing fear of falling short on my job. As time went on, my perceived consequences for failure worsened and became unrealistic. By the end, what started as “it will be a bad look” turned into the existential “this project could end my career and leave my wife and I destitute.” I won’t deny that these irrational fears also kept me hyperfocused on my work.

    Day to day, when I wasn’t working, I just felt exhausted. I’d have trouble focusing, I was forgetful, and I found it almost impossible to muster the energy required to start day-to-day tasks like cooking and cleaning. All other aspects of my life, including things I truly enjoyed, started to fade away.  Once I started working again, that exhaustion faded away, or at least I didn’t notice it.

    When I did break, it was sudden — as if the branch that I had been perched on all this time had suddenly snapped, leaving me broken on the ground. From one day to the next, I could barely get out of bed. My mind was foggy, my memory was non-existent, and I couldn’t make coherent sentences, let alone work. That extreme state lasted for the next five weeks. I then spent the next five years clawing my way back, only to still be half of my former self; I worked part time and struggled to keep up with the demands of life. The effects of traditional burnout, meanwhile, apparently resolve after a few months.

    Hyperfocus Burnout vs. Traditional Burnout

    With the help of my therapist, here’s where I landed: Traditional burnout is triggered by a mismatch between time, demands, resources, and rewards. Symptoms occur on a spectrum and increase over time as pressure and lack of reward increase.

    Hyperfocus burnout, on the other hand, is triggered only by an overabundance of pressure or demands, particularly on a high-focus activity.

    In traditional burnout, there are efforts to detach and turn away from an unsustainable situation. In hyperfocus burnout, we engage and turn into the unsustainable situation. We push through until the situation ends or we break.

    My therapist, who has seen her fair share of clients with ADHD who have burned out like I have, says those who reach their hyperfocus breaking point push themselves past their limits due to a strong sense of responsibility and a failure to recognize the mental and physiological strain that is accumulating to an inevitable peak.

    Hyperfocus, ultimately, is just another problem with attentional shifting that characterizes ADHD. It’s why many of us will forget to eat or go the bathroom when absorbed in a task. When unchecked, hyperfocus can cause us to sacrifice many life functions in the pursuit of a particularly salient goal.

    Traditional burnout, it seems, is a protective mechanism that helps a person recognize when they’re reaching their limit and are close to breaking. That mechanism failed, in my case, because of my ADHD and attention regulation challenges.

    Recovering from Hyperfocus Burnout

    There is another element to my story: Though I was diagnosed with ADHD as a child, I had gone without treatment for most of my adult life, as I had enough strategies to keep the “traditional” inattentive symptoms at bay. My therapist strongly encouraged me to start taking ADHD medication, and I’m glad she did. Medication has reduced my emotional ADHD symptoms (symptoms I hadn’t even been aware were part of ADHD). My existential fear of failure disappeared almost overnight. Stimulant medication reduced my anxiety and increased my resilience to stress; it was much more effective than the SSRI I had previously been prescribed.

    All in all, starting medication allowed me to increase my working hours longer than I have in years, without sacrificing the rest of my life. Now I’m also better able to recognize instances of unhelpful hyperfocus, and I’m much more likely to disengage and use coping strategies — something I struggled to do before. Still, medication is not a fail-safe; I have to be careful about slipping back into old patterns.

    I wish I knew then what I know about extreme hyperfocus. I wish I knew that it could turn into a positive feedback cycle that gets harder to escape the longer you’re in it. I wish I knew that relentless hyperfocus would break me and result in a very long and painful recovery. Maybe if I had this information, I would have listened to my wife and friends; maybe I could have helped my manager realize that I was in serious trouble, even though I was still very effective at my job and not showing the traditional (dare I say, neurotypical) signs of burnout. Maybe I could have prevented my hyperfocus burnout.

    Extreme Burnout and ADHD Hyperfocus: Next Steps

    This piece was a joint effort between Matt and his psychologist, Dr. Petra Hoggarth. Based in Christchurch, New Zealand, Dr. Hoggarth specializes in adult ADHD assessment and therapy.


    CELEBRATING 25 YEARS OF ADDITUDE
    Since 1998, ADDitude has worked to provide ADHD education and guidance through webinars, newsletters, community engagement, and its groundbreaking magazine. To support ADDitude’s mission, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

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    Nathaly Pesantez

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  • How To Forgive Yourself: 10 Steps For Releasing Guilt & Moving On

    How To Forgive Yourself: 10 Steps For Releasing Guilt & Moving On

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    According to a 2018 study2 published in the journal PLOS One, researchers define self-forgiveness as “a positive attitudinal shift in the feelings, actions, and beliefs about the self, following a self-perceived transgression or wrongdoing committed by the self.” They also note that forgiving yourself can help “restore a positive sense of the self and safeguard [your] overall well-being against the toxic effects of guilt, shame and regret.”

    The antithesis of self-forgiveness, meanwhile, usually involves denial and/or berating yourself, according to therapist and relationship expert Ken Page, LCSW. As he tells mindbodygreen, “There’s this constant tendency to think we have to be perfect. It’s a self-protective mechanism, because when we’re not perfect, there are consequences, and that’s a scary thing.”

    When you foster your ability to recognize and accept your imperfection, however, “that is literally one of the greatest skills of life,” Page says, adding, “And a side benefit of that is when we learn to do it for ourselves, we learn how to forgive other people, too.”

    Ultimately, as licensed marriage and family therapist Jessi Leader, LMFT, previously told mindbodygreen, forgiving yourself comes down to getting curious and exploring why whatever happened, happened—and further, processing the feelings associated with the hurt.

    Self-forgiveness, she says, isn’t so much about letting go, but rather “having a better relationship with this part of you.”

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    Sarah Regan

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  • Afghan sisters who defied family and the Taliban to sing

    Afghan sisters who defied family and the Taliban to sing

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    Islamabad — In 2010, two Afghan sisters rebelled against their family’s wishes and their country’s traditions by not only singing, but singing in public, even posting videos of their music online. Singing and dancing are largely taboo in Afghanistan‘s deeply conservative society, for men and women. The pair were reprimanded lightly by a local court, but it didn’t stop them.

    Khushi Mehtab, who’s now 32, and her younger sister Asma Ayar, 28, kept performing at local shows and posting their videos, and they gained significant popularity.

    afghan-sisters.jpg
    Afghan refugee sisters Khushi Mehtab, left and Asma Ayar, 28, practice their music in the one-room apartment they share with their younger brother in Islamabad, Pakistan, as they speak with CBS News in mid-May, 2023.

    CBS News


    But just as they were rising to fame in Afghanistan, the U.S.-backed government collapsed and the Taliban took back control of the country in August 2021.

    “We were banished”

    “I couldn’t believe how suddenly everything collapsed and changed 360 degrees,” Ayar told CBS News. “The next day, we saw the Taliban patrolling the streets. We tried to hide our instruments but there was no one to help us. On the third day after Kabul was captured, Taliban forces knocked on the door and took my 18-year-old brother. They knew about our profession and told him that we should go to the police station and repent.” 

    “I separated myself from my family and got to the airport to escape. Amid the chaos, a Taliban guard stopped me and stuck the barrel of his gun into my forehead,” said Mehtab. “At the time, I thought, ‘I’m a singer, which is sinful to the Taliban, they will surely shoot me,’ but luckily he got distracted with another person. I ran toward the airstrip but didn’t manage to catch an evacuation flight.”

    “We were banished from our inner family circle for our choice of making music. The [previous] court ruled in our favor, but now the Taliban and some family members were against us, so we dumped our musical instruments,” she said. “It was liking throwing away our dreams.”


    Education activist Malala Yousafzai on the Taliban banning women from universities

    04:23

    The sisters hid out in the northern city of Mazar-e-Sharif for about four months until they finally managed to escape across the border into neighboring Pakistan, where we met them living in rented one-room apartment with their brother, who’s now 20.

    They reached out to everyone they knew in the country for help but found only further threats.

    “At one point, a Pakistani girl offered us shelter, which we accepted, but we came to understand that she was trying to exploit us as sex workers, so we escaped from there as well,” Asma told CBS News.

    Nightmares and depression

    Qais Ayar, the women’s brother, said Asma has struggled to sleep since they fled their country. Nightmares keep her awake.

    afghan-siblings.jpg
    Afghan refugees Asma and Qais Ayar stand in the apartment they share with their older sister in Islamabad, Pakistan, in mid-May, 2023.

    CBS News


    He said he and his sisters were turned back twice at the border by Pakistani border police, who handed them over to Taliban officials, before they made it into the country.

    Qais said his sisters have been so traumatized by their ordeal that they’re both now taking antidepressants.

    “I went to a doctor, begged him not to charge,” Mehtab said. “I’m grateful to him for giving me medicine.”

    “I dedicated my life to the art of singing, but I lost everything,” said Asma. “First, I was exiled by my family, then in 2021, I was forced into exile from my homeland by the Taliban… Life has become meaningless for me and my sister. I don’t know how long I will be alive without a clear fate and destiny. Americans helped us for 20 years, but in the end, the U.S. left us and my country to the Taliban.”

    “The Taliban is responsible for our current mental state,” added her older sister. “One day, when the Taliban is destroyed, our minds and nerves will calm down, and I will continue my art.”


    If you or a loved one is struggling or in crisis, help is available. You can call or text 988 or to chat online, go to 988Lifeline.org.


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  • “The Personal Mottos That Transformed My ADHD Life”

    “The Personal Mottos That Transformed My ADHD Life”

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    I never thought I’d have a life-changing revelation in the cereal aisle at Walmart, but that’s exactly what happened. As I tried to decide which breakfast option to buy, my thoughts went something like this:

    I don’t know what to get.

    I really want Cinnamon Toast Crunch.

    But I can’t get that. I should get the Special K.

    Shoulds and musts are instilled in us from the time we are very little. Some of these rules are valuable. Others are more arbitrary, but they still end up governing our lives as rules. In this case, I had made a rule dictating which cereals I can and can’t buy.

    That’s when it hit me.

    Wait, there are no rules! I can buy what I want. I can do what I want!

    ADHD Motto #1: There Are No Rules

    My Walmart moment may not seem like a big deal, but it was an epiphany to me. You see, growing up, my parents taught me very specific ways of doing just about everything. From folding towels to emptying the dishwasher, everything had to be completed a certain way, which was both helpful and harmful. It wasn’t until I was diagnosed with ADHD as an adult that I understood why I struggled so much to keep up with my everyone else’s rules and norms.

    [Read: My 25 Rules for Life — a Practical Cure for ADHD Shame and Stagnation]

    Living — or trying to live — by rules set by neurotypical brains is one of the most frustrating aspects of living with ADHD. Worse than that, we don’t always recognize what’s happening — that we’re beating ourselves up for stumbling over rules that don’t work for our neurodivergent brains.

    After that Walmart moment, and with an understanding of how my brain works, I constantly remind myself that there are no rules. There is no “right” way to do a thing. There’s only the way that works for me.

    How many trash cans should I have in my office? There are no rules — as many as I need. Do I have to fold my clothes before putting them away? No. There are no rules.

    ADHD Motto #2: Anything Worth Doing is Worth Doing Poorly

    Hold on, perfectionists — stay with me here.

    My second motto came from a post I saw on social media, which reads in part: “Anything worth doing is worth doing poorly… because doing it poorly is better than not doing it.”

    [Read: Intention Deficit Disorder — Why ADHD Minds Struggle to Meet Goals with Action]

    I don’t have to tell you that getting things started is immensely difficult for ADHD brains. There’s overwhelm, for one, and then there’s fear of failure, all of which can keep us at a standstill, perpetuating the cycle of exhaustion we tend to create.

    But this motto gave me permission to do what I can and forget about the big finish line. To me, this motto helped me see that getting 10% of a task done is better than getting none of it done.

    Maybe I absolutely cannot bring myself to do all the dishes — but I can do the glasses, only. Laundry is exhausting — but I can focus on folding just my shorts. No, I cannot write a 40-page paper right now, but I can jot down some ideas. By giving myself permission to do a little at a time, I actually reduced my stress and increased my productivity.

    Adopting the Two Mottos for Your Life

    These mottos have helped me practice self-compassion and affirm my own neurodiversity.

    Embracing the fact there are no rules, and that anything worth doing is worth doing poorly, helped me adapt and learn to accept things as they happen, not as someone else says they should.

    But in my own work helping adults with ADHD, I hear a few concerns when I share these mottos with my clients. Mostly, my clients worry that they’ll spin out of control if they become too self-compassionate — that being hard on themselves is the only thing keeping their lives in check. I’ve been there, and I know that this black-and-white form of thinking keeps us trapped.

    Start with these four steps to work toward living with more self-compassion. Perhaps you’ll use these mottos or develop a few of your own:

    1. Watch for patterns. Which tasks do you frequently struggle to get done? Where do you find the most resistance and hot spots in your life?
    2. Troubleshoot with your brain in mind. Time to get creative. Do you struggle to put away your clothes? I’ve seen some people replace their hangers with S-hooks, or even install a pegboard in their Does trash pile up on your desk? Move your trash can within arm’s reach.
    3. Break down daunting tasks. Think smaller steps and remember my second motto. If breaking down a big task is difficult in itself, use a tool like Magic ToDo – GoblinTools to break it down for you. (Seriously, it’s fantastic.)
    4. Remember, there’s always tomorrow. There will be days when we can’t get everything (or anything) done. Those are the days when we need to talk to ourselves as we would to our best friend. We didn’t get everything done that we wanted to, and that’s OK — we can try again

    Personal Mottos for ADHD: Next Steps


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  • “The 3 Vital Keys of Our Happy ADHD Marriage”

    “The 3 Vital Keys of Our Happy ADHD Marriage”

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    The day before our wedding, the entire city of Sydney became blanketed by heavy red dust. I woke up coughing, I could taste dirt in my mouth, and my bedroom was filled with a rusty glow.“Of course the bloody apocalypse would happen the day before my wedding,” I thought to myself. “I bet my fiancé has been raptured while I was left behind!”

    Catastrophizing is normal for me. It’s part anxiety, part comedic coping mechanism. When my fiancé woke to the dust, he just wondered where it came from and thought about washing the car.Though we both have ADHD and had been diagnosed as adults, our general outlook and ways of functioning are wildly different. We are chalk and cheese; I’m the hyperactive type and he’s the inattentive type, which makes for an interesting union, to say the least. But we continue to make it work after all these years (14 and counting at the time of writing). It all comes down to three vital keys.

    Key #1: Never Go to Sleep Angry

    A lot happens when two adults share a life — and a condition that causes countless frustrations. We’re both forgetful, albeit in different ways. He immediately forgets about his keys if he sets them down. While I can remember where my keys are, I don’t always remember what time it is, even if I’ve just checked, or where I am when I’m driving, even on a familiar route.

    [Get This Free Download: Manage ADHD’s Impact on Your Relationship]

    We also struggle in social settings. In our early days especially, my husband — who had lots of trouble reading facial expressions, keeping up with fast-paced conversation, and even stringing a sentence together — would often withdraw from others. While he was unable to tell when people were making fun of him, I was acutely aware of others’ mocking undertones and uncomfortable shifts in the conversation, all of which set my rejection sensitive dysphoria (RSD) and anxiety into overdrive. I felt the need to overcompensate during lulls in conversation and fill the silence with inappropriate babbling and outrageous antics. I’d drink alcohol to try to manage my intense social anxiety, but all it did was make me even more intense, hyperactive, and hypersensitive.

    It can be tempting to cast blame when our individual challenges invariably come up and affect both of us. But no matter what our day has been like, we agreed from the very beginning of our marriage that we would never go to sleep angry at each other.

    This doesn’t mean that we have long conversations into the night to reach resolve. It simply means that we’ve made the choice to push past shame and blame to say we love each other, no matter what. All hurts and misunderstandings do not change how much we love one another.

    Key #2: Always Be Willing to Learn — and to Let Things Go

    Learning about our unique ways of functioning has been so helpful in our marriage. We do our best to help each other in our respective trouble spots in day-to-day living. That has meant learning to let the little things go.

    [Read: Yeah, We Both Have ADHD — and It’s a Marriage Made in Heaven!?]

    There is one clutter-free, easy-access key holder in our home. Sometimes, my husband’s keys don’t make it to the took and land on a nearby table — where they’re bound to end up under a pile of mail. If I see his keys on the table, I put them in the key hook rather than give him a hard time for forgetting. And life runs a little more smoothly for both of us that day.

    In social settings, my husband has worked hard to pick up on signs that my social anxiety is kicking in. He checks in with me and firmly puts his hand on my shoulder or back to ground me. He reminds me to take a walk or remove myself from the stressful situation. More often than not, these strategies ease me back to present. When they don’t work, he doesn’t push it. But later, we reflect on what happened and how we can both try to do things differently next time. Then, we move on.

    Key #3: Never Stop Laughing Together

    The benefits of laughter and of having a sense of humor are well-known. Somehow, throughout our marriage, we’ve had an innate ability to find joy in the hardest of circumstances. Laughter is our reset button. (That’s why it’s hard for us to go to bed angry at each other.) We have literally laughed in the middle of heated arguments (usually at how ridiculous we are behaving), the result being instant tension and stress relief.

    Our Personal Key: Don’t Say The ‘D’ Word

    Many Ds have been unearthed in our relationship: diagnosis, depression, deficit, disorder, dysfunction, dysregulation, dyscalculia, and the list goes on. But we decided from the beginning that one particular ‘D’ word was never going to be on the table: Divorce.

    That word is not hidden up the back of the junk drawer, waiting to be pulled out and thrown into an argument like a gaslit weapon. Sure, there are painful spaces in our relationship that cause us to withdraw, defend, attack, or drag up the muddy waters of the past. But we vowed until death — not diagnosis — do us part.

    With both of us wired as fighters, we are willing to “never say die.” We’ll do everything to fight for our marriage, including holding firm to our keys (the kind we’ll never lose) and even looking for new ones. It’s hard work, but we know that our diagnoses are not a marriage death sentence. They do not define us negatively. They are what make us so strong and loving.

    Happy Marriage Rules for ADHD Couples: Next Steps


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  • Personal Hygiene Tips for ADHD Brains (and Bodies)

    Personal Hygiene Tips for ADHD Brains (and Bodies)

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    Three years ago, I launched the @domesticblisters TikTok channel to serve a neurodiverse audience. Short videos on the channel present strategies for accomplishing daily care tasks. For all the ADHD information swirling around social media, very little addresses how the simple tasks of living are sometimes the hardest for us. Cleaning, doing dishes, folding piles of laundry — these tasks are simple for most people but tend to paralyze some of us with executive functioning problems. Perhaps more difficult than the struggle to stay on top of these tasks is the immense shame we feel when we’re unable to do the things we see our peers accomplish with ease.

    In my experience, this kind of shame tends to spike when we struggle with personal hygiene. How could we be so incapable? Our differences in executive functioning can create significant hurdles when it comes to the daily demands of living. And that makes hygiene routines our common kryptonite.

    [Download: Free Guide to Health & Fitness: Lifestyle Changes for Adults with ADHD]

    The ADHD brain often struggles to transform multiple mundane steps into a routine that works. So instead of forcing on yourself neurotypical routines that are doomed from the start, try adapting your daily hygiene rituals with the following four approaches:

    Personal Hygiene Hacks for ADHD Brains

    1. Rather than trying to adhere to a strict schedule and setting for brushing your teeth, build in flexibility so that you can care for your teeth whenever the thought strikes you. Place a toothbrush and toothpaste in multiple locations: by your kitchen sink, in your shower, in your guest bathroom, and even in your car. Because of the way ADHD motivation systems work, you are most likely to think about brushing your teeth while headed out the door (Oh no! My breath stinks!) or when randomly prompted by the sight of your toothbrush (I’m already here, so I might as well!). You might also consider keeping deodorant and a hairbrush or comb in these places.
    2. If showering is too boring, try getting a waterproof speaker. A good podcast or audiobook that you save for the shower can suddenly transform an onerous chore into a decadent treat. Also, a fancy hair towel or a high-powered blow dryer can reduce time spent on your wet hair.
    3. If showering aggravates your sensory aversion, consider changing your environment to mitigate this. For instance, turning on a space heater before a shower will prevent that awful cold shock you feel when exiting the tub or shower. Using a soft and gentle towel also typically helps.
    4. Create a hygiene kit for the days you skip a shower or bath. You deserve to be clean and comfortable; there is more than one way to get that done. A little bag with deodorant, dry shampoo, body wipes, and mouthwash can be kept in multiple locations in your home and car.

    Maintaining good hygiene is important to your health, so get creative and find what works for your unique brain.

    How to Keep House While Drowning – with ADHD: Next Steps

    KC Davis, LPC, is a licensed professional therapist and the author of How to Keep House While Drowning.


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    Melanie Wachsman

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  • “Stop Chasing Others’ Approval: On Twice Exceptionality and Living Life for Me”

    “Stop Chasing Others’ Approval: On Twice Exceptionality and Living Life for Me”

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    “You’re going to do great things!”
    “You have so much potential!”
    “You’re so talented. I see great things in your future!”
    So many people in my life have directed various versions of these well-meaning yet anxiety-inducing, expectation-laden comments to me during every phase of my academic career. As a gifted child, I felt as though I could succeed and, at the same time, as if I had to… or I would be letting everyone down.This black-and-white way of thinking did get me to check off a list of great accomplishments:

    • first in my family to graduate college, go on to complete a masters, and start a doctoral program
    • a successful career
    • financially independent since age 18

    But hidden in these accomplishments are the many, many struggles and failures I encountered along the way:

    • flunking out my freshman year of college
    • being asked to resign from a job for an error in judgment I made
    • flunking out of my Ph.D. program due to being unable to complete assignments
    • piling on credit card debt

    I eventually learned that my setbacks — so confusing and contrary to my successes — were actually due to undiagnosed and unmanaged ADHD. I was twice exceptional (or 2e) all this time, and I had no idea.

    [Read: I Grew Up Gifted and Autistic — and Suffered the Burnout of Twice Exceptionality]

    My undergraduate transcript is a wonderful example of my interest-based nervous system. I had As and Bs in classes within my major, but failed yoga (which likely had to do with my impulsive, oppositional streak).

    Perspective Shift: From Never Enough to Good Enough

    At the age of 29, I came to the realization that my life is my own, and while the approval of others is nice, I would never feel content if I continued to chase it. I made the conscious decision to let go of “greatness” as defined by others and to start experiencing life as it came to me.

    Letting go of greatness freed me up to be content with where I am currently, instead of always trying to do more or be better. I still have personal and professional goals, but these goals are now based on my values rather than the values of other people.

    My shift from “not good enough” to “good enough” has changed my self-view from lazy, unmotivated, and stubborn to efficient, understanding, and passionate.

    [Read: “Twice Exceptional Is a Cruel Double-Edged Sword”]

    Now I am:

    • enrolled in a doctoral program to advance MY learning and knowledge
    • in a job I can see myself in long-term, with opportunities to advance or switch it up, if I choose
    • writing this blog from a house that I own after paying down my debt

    I don’t believe any of this would’ve been possible if I hadn’t made the choice to live life for me, instead of an image I could never realistically attain. I’ve found a specialty I love and a life that finally feels sustainable.

    How to Live for Yourself

    If you are 2e like me, or if you see yourself in my story, start living life for you with these steps:

    1. Clearly identify your current values. Your personal values will come to define and frame everything else you do in life.
    2. Set at least one goal for each value. They can be as broad or as specific as you like. For example, if you value family, how will you commit to spending more time with them?
    3. Let go of the constant pursuit of greatness. If you are always thinking of where you could or should be, it only robs you of the ability to appreciate who and where you are now.
    4. Foster self-compassion. You are a multi-faceted person. Your worth is not directly measured by your productivity or your achievements.

    2e and How to Live for Yourself: Next Steps


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  • Loneliness is an ‘epidemic’ that costs billions and leads to bad health outcomes and even death

    Loneliness is an ‘epidemic’ that costs billions and leads to bad health outcomes and even death

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    Loneliness is more than a bad feeling. It’s as deadly as smoking up to 15 cigarettes a day and is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death, according to an advisory by the U.S. Surgeon General.

    The mortality impact of being socially disconnected is greater than that of obesity and physical inactivity, U.S. Surgeon General Vivek Murthy said in an 81-page report called “Our Epidemic of Loneliness and Isolation.”

    Social isolation among older adults alone accounts for about $6.7 billion in excess Medicare spending a year, largely due to increased hospital and nursing facility spending, the report said. 

    Read: Depression, isolation, loss of purpose: Could retirement be bad for your mental health?

    Loneliness and isolation also are connected with lower academic achievement and worse performance at work. In the U.S., stress-related absenteeism attributed to loneliness costs employers an estimated $154 billion annually, according to the report.

    “Given the profound consequences of loneliness and isolation, we have an opportunity, and an obligation, to make the same investments in addressing social connection that we have made in addressing tobacco use, obesity, and the addiction crisis,” the report said. Still, no federal funding or programming will be provided to combat the issue.

    Essentially, social connection is a significant predictor of longevity and better physical, cognitive, and mental health, while social isolation and loneliness are significant predictors of premature death and poor health, the report said.

    Read: Americans are lonelier than ever—and that’s bad for your health

    The Surgeon General’s advisory is intended as a public statement that calls the people’s attention to an urgent public health issue and provides recommendations for how it should be addressed. Advisories are reserved for significant public health challenges that require the nation’s immediate awareness and action, the report said.

    “Each of us can start now, in our own lives, by strengthening our connections and relationships. Our individual relationships are an untapped resource—a source of healing hiding in plain sight. They can help us live healthier, more productive, and more fulfilled lives,” the report said. “Answer that phone call from a friend. Make time to share a meal. Listen without the distraction of your phone. Perform an act of service. Express yourself authentically. The keys to human connection are simple, but extraordinarily powerful.”

    Americans have become less connected to houses of worship, community organizations and their own families and have reported an increase in feelings of loneliness. The number of single households has also doubled over the last 60 years.

    About half of U.S. adults report experiencing loneliness, with some of the highest rates among young adults. People cut their circles of friends during the Covid-19 pandemic and reduced time spent with those friends, according to the report. 

    Read: ‘When we retire, we lose a lot.’ How to avoid retirement shock.

    Americans spent about 20 minutes a day in person with friends in 2020, down from 60 minutes daily nearly two decades earlier. Among young people, ages 15 to 24, time spent in-person with friends has reduced by nearly 70% over almost two decades, from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020, the report said. 

    Technology has made loneliness worse. People who used social media for two hours or more daily were more than twice as likely to report feeling socially isolated than those who used such technology for less than 30 minutes a day, according to the report.

    Murthy called on technology companies, employers, community-based organizations, parents and individuals to tackle the problem. 

    “We are called to build a movement to mend the social fabric of our nation. It will take all of us…working together to destigmatize loneliness and change our cultural and policy response to it.

    It will require reimagining the structures, policies, and programs that shape a community to best support the development of healthy relationships,” Murthy said. 

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  • Fetterman returns to the Senate following treatment for clinical depression | CNN Politics

    Fetterman returns to the Senate following treatment for clinical depression | CNN Politics

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    CNN
     — 

    Sen. John Fetterman has returned to the Senate after receiving treatment for clinical depression at Walter Reed National Military Medical Center. The Pennsylvania Democrat began inpatient treatment in February and was discharged at the end of March.

    “It’s great to be back,” he told reporters as he arrived at the Capitol Monday afternoon. He did not answer questions.

    “I want everyone to know that depression is treatable, and treatment works,” Fetterman said in a statement after his release. “This isn’t about politics — right now there are people who are suffering with depression in red counties and blue counties. If you need help, please get help.” His office had said he would return to Washington, DC, when the Senate came back into session on April 17 following a two-week recess.

    While Fetterman had dealt with “depression off and on throughout his life, it only became severe in recent weeks,” his chief of staff said in February, announcing that the senator had decided to seek treatment.

    Fetterman, a 53-year-old freshman senator who was elected in November of last year, suffered a stroke ahead of the the May 2022 Democratic Senate primary in Pennsylvania, which he went on to win.

    Lawmakers on both sides of the aisle expressed support for the Pennsylvania Democrat as he underwent treatment for clinical depression – and Fetterman’s decision to seek treatment opened up a broader conversation on Capitol Hill about mental health.

    Sen. Elizabeth Warren, a Massachusetts Democrat, CNN’s Lauren Fox that Fetterman “saved lives” by being public about getting help for his depression.

    “I think John Fetterman saved lives by being a prominent person who stepped up and said he had a problem with mental health issues and he would seek treatment in a very visible and public way,” Warren said.

    Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide and Crisis Lifeline, or visit the hotline’s website.

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  • Transgender adults brace for treatment cutoffs in Missouri

    Transgender adults brace for treatment cutoffs in Missouri

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    Ellie Bridgman spent her Thursday night shift at a local gas station in Union, Missouri, planning for the day she’ll lose access to gender-affirming treatments the transgender and nonbinary 23-year-old credits with making “life worth living.”

    A first-of-its-kind emergency rule introduced this week by Missouri’s Republican Attorney General Andrew Bailey will impose numerous restrictions on both adults and children before they can receive puberty-blocking drugs, hormones or surgeries “for the purpose of transitioning gender.”

    Transgender rights advocates have vowed to challenge the rule in court before it takes effect April 27. But promises of swift legal action have done little to ease the worries of trans Missourians like Bridgman who say it may be time to flee the state.

    Before gender-affirming medical treatments can be provided by physicians, the regulation requires people to have experienced an “intense pattern” of documented gender dysphoria for three years and to have received at least 15 hourly sessions with a therapist over at least 18 months. Patients also would first have to be screened for autism and “social media addiction,” and any psychiatric symptoms from mental health issues would have to be treated and resolved.

    Some individuals will be allowed to maintain their prescriptions while they promptly receive the required assessments.

    Bridgman, who uses she/they pronouns, is autistic and has depression. She said she sees only two options: move across the country, away from all her friends and family, to a state that protects access to gender-affirming care, or accept the serious health risks that could come with illegally buying hormones online.

    She headed to a pharmacy Friday afternoon to pay out of pocket for all her remaining refills.

    “Placing restrictions on transitioning for people with depression is just a way for them to completely bar us from transitioning at all,” Bridgman said. “For lots of trans people, dysphoria is the cause of depression. You can’t treat the depression without treating the underlying dysphoria.”

    Before Bridgman started hormone replacement therapy last summer, she said “life felt meaningless” and suicidal thoughts crowded her head. Gender-affirming care was her “last chance at life,” she said.

    The regulation comes as Republican lawmakers across the country, including in Missouri, have advanced hundreds of measures aimed at nearly every facet of transgender existence, with a particular emphasis on health care.

    At least 13 states have enacted laws restricting or banning gender-affirming care for minors. Bills await action from governors in Montana, North Dakota and neighboring Kansas, and nearly two dozen other states are considering legislation to restrict or ban care.

    National groups advocating for LGBTQ+ rights contend the Missouri regulation — based on a state law against deceptive and unfair business practices — goes further than most restrictions enacted elsewhere.

    Three states have imposed restrictions on gender-affirming care via regulation or administrative order, but Missouri’s regulation is the only one that also limits treatments for adults.

    Cathy Renna, a spokesperson for the National LGBTQ Task Force, said the rule demonstrates how Republicans are now successfully broadening the scope of gender-affirming care restrictions beyond minors, which advocates had been warning about for months.

    “When they see one thing work in one state, they’ll try to replicate it in another,” Renna warned.

    Bailey’s restriction comes after a former employee at a transgender youth clinic in St. Louis alleged that physicians at the Washington University Transgender Center were rushing to provide treatment without appropriate patient assessment.

    Bailey said he is investigating the clinic but has not yet issued a report. The claims of mistreatment have been disputed by others, including another former employee and patients. Neither Bailey nor the university responded to phone and email messages seeking comment.

    Dr. Meredithe McNamara, an assistant professor of pediatrics specializing in adolescent medicine at the Yale School of Medicine, said evidence widely supports maintaining access to hormone therapy and other gender-affirming care.

    As part of a consent process, Bailey’s rule requires that patients be shown materials containing nearly two dozen specific statements raising concerns about gender-affirming treatments — a practice doctors like McNamara have denounced as a form of conversion therapy.

    “There is no evidence that shows that psychotherapy as the only treatment is effective,” she said.

    Stacy Cay, an autistic trans woman in Kansas City, has been stockpiling vials of injectable estrogen in anticipation of restrictions. The 30-year-old comedian and model realized she only required a small dose and has saved up enough estrogen to last about a year. When that runs out, she will have to travel across state lines to fill prescriptions or consider moving elsewhere.

    Cay said her persistent depression will cut off her access to hormones under the regulation and that her autism diagnosis could complicate her path to receiving future care. While the regulation does not specify whether autism disqualifies a person for gender-affirming care, it does mandate an assessment.

    A 2020 study from natural sciences journal Nature Communications estimated that transgender and gender-diverse people, or those whose gender expressions do not conform to gender norms, are 3-6 times more likely to be autistic compared to cisgender people. They were also more likely to have other developmental and psychiatric conditions, including depression.

    “They know a lot of us are autistic, and it’s part of their strategy to paint us as unstable — that we can’t be trusted to make our own medical decisions,” Cay said.

    Attorneys from Lambda Legal and the American Civil Liberties Union say they plan to challenge the new rule in court.

    Missouri falls under the 8th U.S. Circuit Court of Appeals — the same court that upheld a preliminary injunction last year preventing Arkansas from enforcing a first-in-the-nation ban on trans children receiving gender-affirming treatments. Federal judges have also blocked enforcement of a similar law in Alabama.

    Republican legislators leading Missouri’s effort to ban gender-affirming treatments for minors said Friday that they have no plans to expand their legislation to include adults.

    Separate bills passed by the Missouri House and Senate would ban treatments for children younger than 18 but would impose no restrictions for adults who are covered by private insurance or willing to pay for their own health care.

    “I believe it is detrimental to a person’s body, probably even their psyche, to go through treatments like that,” said state Sen. Mike Moon, lead sponsor of the Senate legislation. “Adults have the opportunity to make decisions such as these.”

    ___

    Schoenbaum reported from Raleigh, North Carolina, and Lieb reported from Jefferson City. Associated Press editor Jeff McMillan contributed from Scranton, Pennsylvania.

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  • City: Schwarzenegger repaired utility trench, not a pothole

    City: Schwarzenegger repaired utility trench, not a pothole

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    The “giant pothole” that Arnold Schwarzenegger filled on a street in his Los Angeles neighborhood was actually a trench dug for utility work

    LOS ANGELES — The “giant pothole” that Arnold Schwarzenegger said he recently filled on a street in his Los Angeles neighborhood was actually a trench that had been dug for utility work, according to the city.

    Southern California Gas Co. had covered the trench with temporary asphalt that was to be replaced with a permanent surface, the Los Angeles Department of Public Works said in a statement.

    “We have notified the Gas Company of the issue and the need for them to maintain the site pavement until their permanent paving is constructed,” the statement said.

    After months of heavy rains that have turned roads into tire-popping swiss cheese for many commuters, Schwarzenegger struck a chord when he released a video of himself and a crew filling a depression on a street with packaged asphalt patch.

    “Today, after the whole neighborhood has been upset about this giant pothole that’s been screwing up cars and bicycles for weeks, I went out with my team and fixed it,” he wrote on Twitter. “I always say, let’s not complain, let’s do something about it. Here you go.”

    A passing motorist paused to thank the actor, who also filled another smaller hole.

    SoCal Gas said in a statement that an upgrade of a pipeline system there was completed on Jan. 26 but rain delayed permanent paving, which is usually done in about 30 days. The utility’s crews returned to the site on Wednesday, a day after Schwarzenegger posted his video, and leveled off the patch he’d completed to make it stronger. It expects to finish permanent paving of the site on Tuesday.

    “Teamwork. Happy to help speed this up, and thanks to the crew for pumping up my fix,” the former governor tweeted Friday.

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  • Attorney: Mom of Virginia boy who shot teacher was depressed

    Attorney: Mom of Virginia boy who shot teacher was depressed

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    NEWPORT NEWS, Va. — The mother of a 6-year-old Virginia boy who shot and wounded his teacher had a series of miscarriages and post-partum depression in the year before the shooting, her attorney said Friday, after she was arraigned on charges of child neglect and failing to secure the handgun her son used in the shooting.

    Police say the boy fired a single shot at his first-grade teacher, Abigail Zwerner, on Jan. 6, striking her in the left hand and chest. She spent two weeks in the hospital and has had four surgeries since the shooting.

    The Associated Press is not identifying the mother to shield the identity of her son. A grand jury indicted the mother this week, and she was released on a $5,000 bond after turning herself in Thursday.

    The 25-year-old woman appeared somber and stood with her hands clasped behind her back as the two charges against her were read in Newport News Circuit Court. She did not speak except to say “no, sir” in response to a question from the judge. After the hearing, she quickly walked away from a scrum of reporters and TV cameras without commenting.

    Her attorney, James Ellenson, said his client wants to reach a plea agreement with prosecutors and hopes they will consider what he called “mitigating circumstances.” He cited a number of miscarriages the woman had, including one following an ectopic pregnancy that resulted in a hospital stay in January 2022. An ectopic pregnancy occurs when a pregnancy develops outside the uterus, often in a fallopian tube. Ellenson said the miscarriages resulted in post-partum depression.

    “We’re looking forward to working collaboratively with the Commonwealth’s Attorney’s Office to resolve the charges,” Ellenson said, adding that he is hoping for “something that is fair, something that is just.”

    Ellenson has requested a trial before a judge instead of a jury. A trial date of Aug. 15 has been set.

    The felony neglect charge is punishable by up to five years in prison. The misdemeanor charge of recklessly storing a firearm is punishable by up to one year in jail.

    Ellenson has said the mother believed her gun, which was legally purchased, was secured on a top shelf in her closet and had a trigger lock. It is unclear how the boy got the gun and was able to take it to school on the day of the shooting.

    Zwerner filed a $40 million lawsuit against the school system last week, accusing school officials of gross negligence and of ignoring multiple warnings from teachers and others in the hours before the shooting that the boy had a gun.

    The city prosecutor’s office said Tuesday that it is investigating whether the “actions or omissions” of any school employees could lead to criminal charges.

    Ellenson said the boy has an “acute disability” and was under a care plan that included his mother, father or grandfather accompanying him to class every day. The week of the shooting was the first when a parent was not in class with him.

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  • Sen. Fetterman opens up about ‘downward spiral’ before receiving treatment for depression | CNN Politics

    Sen. Fetterman opens up about ‘downward spiral’ before receiving treatment for depression | CNN Politics

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    CNN
    CNN
     — 

    Pennsylvania Sen. John Fetterman opened up about his struggle with depression during a candid interview with CBS News that was taped during his stay at Walter Reed National Military Medical Center.

    “I had stopped leaving my bed. I had stopped eating. I was dropping weight. I had stopped engaging … most things that I love in my life,” Fetterman told CBS’ Jane Pauley.

    The Pennsylvania Democrat said he had never attempted to harm himself but that he was “indifferent” about his life. “If the doctor said, ‘Gee, you have 18 months to live,’ I’d be like, ‘Yeah. OK, well, that’s how things go,’” he said.

    Fetterman, whose win helped cement Democrats’ 51-49 Senate majority last fall, was discharged last week from Walter Reed, where he had been treated for his depression.

    He had suffered a stroke last year during the days ahead of the primary. When he returned to the campaign trail, Fetterman often struggled to communicate with lingering auditory processing issues, relying on assistance through devices with closed captioning to converse and answer questions.

    The same auditory processing issues impacted him in his early days in the Senate. And when he struggled with substantial weight loss and a loss of appetite, he was diagnosed with clinical depression, and later was admitted to Walter Reed for treatment.

    “I was at a Democratic retreat, and many of my colleagues were coming up to me and asking, ‘Why aren’t you eating?’” Fetterman recalled during the interview.

    But following his discharge from Walter Reed, Fetterman said in a statement, “I want everyone to know that depression is treatable, and treatment works.”

    “This isn’t about politics — right now there are people who are suffering with depression in red counties and blue counties. If you need help, please get help,” he said.

    Fetterman is expected to return to the Senate the week of April 17, but he told CBS that his immediate plans include taking his son “to the restaurant that we were supposed to go (to) during his birthday but couldn’t because I had checked myself in for depression.”

    “And being the kind of dad, the kind of husband, the kind of senator that Pennsylvania truly deserves.”

    Editor’s note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide and Crisis Lifeline, or visit the hotline’s website.

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  • Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

    Lawmakers who struggle and have struggled with mental health see power in ‘telling the story’ | CNN Politics

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    Editor’s Note: If you or a loved one are facing mental health issues or substance abuse disorders, call The Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 or visit SAMHSA’s website for treatment referral and information services.



    CNN
     — 

    In the spring of 2019, Democratic Sen. Tina Smith of Minnesota was busy putting the finishing touches on a bill that sought to expand mental health care access for kids in schools.

    But she couldn’t shake the feeling she was being less than honest about just how personal the issue of mental health was for her.

    Smith was on the precipice of an election. She had no obligation to open up about her own depression that she says happened twice – once in college and once as a young mom. But in May 2019, on the floor of the US Senate, Smith, delivered a speech about mental health and admitted, “The other reason I want to focus on mental health care while I’m here is that I’m one of them.”

    “I remember being nervous,” Smith recalled of delivering the speech. “I was concerned that people would think that I was trying to like make it be about myself, but once I got beyond that, and I realized that there was power in me telling the story – me particularly being a United States senator, somebody who supposedly has everything all together all the time, then it started to feel really interesting, and I could see right away the value of it.”

    The National Alliance on Mental Illness estimates that one in five adults in the US – nearly 53 million Americans – experience mental illness every year. The Centers for Disease Control and Prevention reports more than 50% of Americans will experience mental illness in their lifetime. But for politicians – often far away from home, under high levels of stress and pressure, all risk factors for mental illnesses like depression and anxiety – talking about their own mental health is still a relatively rare admission.

    It’s why in February when Pennsylvania Sen. John Fetterman announced he was seeking inpatient treatment for clinical depression, lawmakers on both sides of the aisle celebrated not only his decision, but his transparency.

    “It’s tough in politics, there’s a lot of scrutiny, you’re clearly in the public eye a lot. There are consequences to the things you say and talk about, but I think in a circumstance like this, it helps the conversation,” Senate Republican Whip John Thune said. “It helps people realize and understand the impact that this disease has on people across the country.”

    Years after coming forward with her own experience, Smith said she doesn’t have any regrets. In light of the Fetterman news, she feels even more the importance to share.

    “I think that every time a somebody like John or me is open about their own experiences with mental illness or you know, mental health challenges, it just breaks down that wall a little bit more about people saying, ‘Oh, it’s possible to be open and honest and not have the whole world come crashing down on you,’” Smith said.

    It’s been decades since Smith experienced depression, but she said she still remembers so much about that time.

    “I thought I was just off,” Smith said. “Something is wrong with me. I’m not with it. I’m not doing well enough and then you start to sort of blame yourself, and I was sort of in that cycle,” Smith said.

    It was her roommate in college who first suggested she talk to someone. Reluctantly, Smith took herself over to student health services and started talking to a counselor. She said she started to feel better and eventually noticed her depression abated.

    But as Smith tells it, mental health is a continuum and about a decade later, as a young mom with two kids, she found herself experiencing depression once again. At the time, she said she was caught completely off guard.

    “This is the thing that’s so treacherous about depression in particular. You think that the thing that is wrong with you is you,” Smith said. “I’ll never forget my therapist telling me, she said ‘You’re clinically depressed. That’s my diagnosis. I think that you’d benefit from medication to help you.’”

    Smith said she initially resisted. But, after a continued conversation, she agreed to start medication as part of her treatment. She remembers it took time to work, but eventually she noticed a major improvement.

    When she emerged from her depression, Smith was in her early 30s. She said she hasn’t had a resurgence of depression since then, but that she does pay very close attention to her mental health now.

    There are 535 members of Congress and just a handful of them have shared personal stories related to mental illness. Most of those who have talked about their experiences publicly are Democrats. Most of the men who have shared their stories talk about them in the context of military service. In part, it’s a risk for lawmakers to get too personal. The history of reactions to politicians being open about their mental illness has been checkered in the last several decades.

    “People still remember Tom Eagleton,” Smith told CNN.

    In 1972, Eagleton was newly selected to be the running mate for Democratic presidential nominee George McGovern. He admitted to being treated for clinical depression and receiving electroshock therapy. Days later, he withdrew from the ticket even as he continued to serve for years in the Senate.

    Memories of those kinds of episodes impact members in how they approach talking about mental health, even in recent memory.

    “When I was in Congress, I did everything I could to keep everybody from finding out that I needed help,” former Rep. Patrick Kennedy told CNN.

    Kennedy represented Rhode Island in Congress from 1995 to 2011. He suffered from addiction and bipolar disorder. While he was there in 2006, he crashed his green Mustang convertible into a barrier outside the Capitol in the early morning. Following the crash, he pointed to sleeping pills as the culprit and checked himself into the Mayo Clinic for treatment.

    “And is the case with anybody with these illnesses is it is the worst kept secret in town and you are often the last one to realize in what bad shape you are. People won’t tell it to your face because you are a member of Congress, your staff is walking around on eggshells,” Kennedy said.

    “When I did go to treatment. I kind of did it after I had been revealed to be in trouble like I’d gotten in a car accident.”

    But when he got back, Kennedy heard from many colleagues about their own struggles with issues related to mental health.

    Kennedy predicts when Fetterman returns to the Senate, that might also happen to him.

    “I think he is going to have our colleagues from both the House and the Senate look for him in order to tell him what is going on with them. He’s the only one they know,” Kennedy said. “While stigma is going away, there is a less forgiving attitude toward people who suffer from mental illness and addiction.”

    The aftermath of January 6, 2021, was another moment where the conversation around mental health started to shift on the Hill. Suddenly, members and their staff had undergone a traumatic and shared experience in the workplace.

    Democratic Rep. Sara Jacobs of California was just four days into being a new member of Congress on January 6th when she was trapped in the gallery above the House floor with several other members of her party. The experience – the sound of gas masks being deployed, the frenzy to escape, the echo of a gunshot – left her reeling. Jacobs said she considered herself well positioned to seek help. She already had a therapist. But, she noticed some of her older colleagues didn’t have the same tools.

    “I remember actually, after January 6, talking to some of my colleagues here who were a bit older and encouraging them to seek therapy and to get help because it was just something that that wasn’t as accustomed for them,” she said.

    The group of lawmakers who were trapped in the gallery also sought therapy together via Zoom and kept in touch via a text chain.

    For Jacobs, the trauma of January 6 manifested itself in unexpected ways. Suddenly, fireworks – something she once loved – were triggering. Loud people chanting or gathering somewhere made her tense up. She said a lot of her colleagues also dealt with anger, “lots of anger toward colleagues who went back that night and continued to deny the election.”

    When her brother got married in the fall and had fireworks, she had to excuse herself to another room because “it was stressing my body, my nervous system so much.”

    Rep. Dan Kildee, a Democrat from Michigan, also came forward after January 6 to talk about his battle with post-traumatic stress disorder after that day.

    It wasn’t easy.

    “There is still a stigma. People still make their own judgments and that was one of the reasons I decided to talk about it so that people would see that it can happen to anybody. You just have to get the care that you need.”

    “Not everybody was accepting when I sought treatment. My former opponent ridiculed it,” Kildee said.

    For Jacobs, who has been taking medication for anxiety and depression since 2013, stories like Fetterman’s are a sign that maybe the discussions around mental health are beginning to change on the Hill and maybe even in the rest of the country.

    “I think there’s absolutely a generational divide. And there’s also a gender divide and that’s why I think it’s so incredibly brave that Fetterman not only got the treatment needed, but talk about it,” Jacobs told CNN. “I think for me as a young woman, I spent a lot of time with my friends and peers talking about mental health, talking about therapists and what we’re learning in therapy, but I know that that is not something that other generations really have felt open to do.”

    It’s not clear, ultimately, how Fetterman’s openness around his mental health will impact the Hill going forward. It’s not clear what resonance it will have in the rest of the country or even back home for voters. But for lawmakers who’ve taken steps already to share their stories, there is some hope that it could make a major difference.

    “It doesn’t take a statistician to tell you that of the 100 of us in the United States Senate, mental health issues are going to have touched every single one of us in one way or another,” Smith said. “I think it gives people some permission to maybe speak a little bit more openly about it.”

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