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Recognizing the Signs of Depression

Oftentimes we miss something because we don’t know what to look for or even, to look for it. And with approximately 15 million adults affected by depression, I believe we should all know how to recognize the signs of it.

#MentalHealthAwarenessMonth #MentalHealth #MentalWellness #YouAreNotAlone #CureStigma


Spotting the Signs of Depression

By Chris Iliades, MD

Medically Reviewed by Lindsey Marcellin, MD, MPH

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Being in a “blue mood” sometimes is a normal part of life. If you lose a loved one or are laid off from your job, it is natural to be sad. When you have depression symptoms because of a stress that has occurred in your life, it is called “situational depression.” Most people recover from situational depression, although it may take a few days or sometimes even weeks.

However, when depression symptoms just won’t go away and depression starts to interfere with your ability to function and live your life normally, this is called “clinical depression” or “major depression.” Major depression is a serious illness that may last for weeks, months, or years. It is therefore crucial that you know the symptoms of depression, so you can seek help when they occur.

The symptoms of depression are overwhelming. People may describe major depression as a “black hole” that they just can’t get out of. A sense of impending doom is also common in this type of depression. You may feel lifeless, limp, and apathetic.

People with serious depression do not all have the same symptoms, but they may include:

  • Sadness. When feeling sad is a symptom of depression, it may include feeling hopeless and empty. You may find that no matter how hard you try, you just can’t control your negative thoughts. You may find yourself crying for no obvious reason.
  • Guilt. People with severe depression may feel that they are worthless and helpless. They may even experience their depression as a sign of weakness, and can be overly self-critical.
  • Irritability. This depression symptom may cause you to feel angry, anxious, or restless. Men who are seriously depressed often express their depression through aggression or reckless behavior.
  • Mental symptoms. If you have trouble concentrating, making decisions, or remembering details, these could be symptoms of depression. People with depression may feel that their thought processes have slowed down.
  • Physical symptoms. People with depression often have aches and pains, headaches, or digestive problems that do not seem to have any other medical cause and do not respond to treatment.
  • Loss of energy. If you have depression, you may feel tired all the time. People with depression may feel that their physical abilities are slowed down.
  • Loss of interest. A common depression symptom is loss of interest in pleasurable activities like sex, hobbies, or social interactions. This may also show up as neglecting your responsibilities and your physical grooming.
  • Sleep changes. Waking up too early in the morning, not being able to fall asleep, or sleeping too much can all be symptoms of depression.
  • Appetite changes. Changes in eating habits due to depression can result in eating too much or too little. A weight gain or loss of more than 5 percent of your body weight in one month is one of the warning signs of depression. Some people experience a loss of interest in food, while for others food becomes a way of compensating for feelings of depression.
  • Suicidal thoughts. Having thoughts of harming yourself is a serious symptom of depression and always needs to be taken seriously. If you’re thinking about suicide, you need to get help immediately.

If you have some of these classic symptoms of depression and the symptoms are severe and have lasted longer than a few weeks, you should seek help. The best place to start is with your doctor.

The National Institute of Mental Health estimates depression affects roughly 17 million Americans a year. In many cases, depression that could be successfully treated goes undiagnosed and untreated because symptoms of depression are ignored.

Depression is not a sign of weakness or a reason for shame — it is a serious illness. The positive news is that even in serious cases of clinical depression, treatment is usually very successful. And the earlier treatment is started, the more successful it is. So don’t wait.

Diet and the Mind

It’s almost a given nowadays that your diet will has some affect on the other aspects of your life, but can it help your mental health? I came across this article a couple of years back and I thought it was interesting. When I applied it to my life (under my doctor’s care and with her blessing), interesting became life-changing. There is no cure for mental illness, but there is always a better way to take care of yourself and get the most out of life.

#MentalHealthAwarenessMonth #MentalHealth #MentalWellness #CureStigma #YouAreNotAlone


Jodi Corbitt had been battling depression for decades and by 2010 had resigned herself to taking antidepressant medication for the rest of her life. Then she decided to start a dietary experiment.

To lose weight, the 47-year-old Catonsville, Md., mother stopped eating gluten, a protein found in wheat and related grains. Within a month she had shed several pounds — and her lifelong depression.

“It was like a veil lifted and I could see life more clearly,” she recalled. “It changed everything.”

Corbitt had stumbled into an area that scientists have recently begun to investigate: whether food can have as powerful an impact on the mind as it does on the body.

Research exploring the link between diet and mental health “is a very new field; the first papers only came out a few years ago,” said Michael Berk, a professor of psychiatry at the Deakin University School of Medicine in Australia. “But the results are unusually consistent, and they show a link between diet quality and mental health.”

“Diet quality” refers to the kinds of foods that people eat, how often they eat them and how much of them they eat. In several studies, including a 2011 analysis of more than 5,000 Norwegians, Berk and his collaborators have found lower rates of depression, anxiety and bipolar disorder among those who consumed a traditional diet of meat and vegetables than among people who followed a modern Western diet heavy with processed and fast foods or even a health-food diet of tofu and salads.

“Traditional diets — the kinds of foods your grandmother would have recognized — have been associated with a lower risk of mental health issues,” Berk said. Interestingly, that traditional diet may vary widely across cultures, including wheat for some people but not for others; the common element seems to be whole, unprocessed, nutrient-dense foods.

“There’s lots of hype about the Mediterranean diet [fruits, vegetables, whole grains, olive oil, nuts, fish] but the traditional Norwegian diet [fish, shellfish, game, root vegetables, dairy products, whole-wheat bread] and the traditional Japanese diet [fish, tofu, rice] appear to be just as protective” of mental health, he said.

The association between diet and mental well-being may start even before birth. A 2013 study of more than 23,000 mothers and their children, led by Berk’s frequent collaborator and Deakin colleague Felice Jacka, suggests a link between a mother’s consumption of sweets and processed foods during pregnancy and behavioral and mental health issues in her child at age 5.

Not clear how it works

It’s unclear how diet relates to mental health, said Rif El-Mallakh, a professor of psychiatry at the University of Louisville School of Medicine. “There seems to be a clear link, but it’s an association — it doesn’t tell you cause and effect,” he said. “We don’t know which is the chicken and which is the egg.”

It could be, he said, that mood disorders change how and what people choose to eat.

But an alternate theory is that the relationship works the other way: Certain foods, or their absence, may contribute to poor mental health. For example, studies in people and rats have linked zinc deficiency to depression. Also, illnesses that cause deficiencies — including celiac disease, an autoimmune disease in which the body reacts to gluten — have shown associations with mood disorders.

“There’s a two-way street between what’s going on in the gut and what’s going on in the brain,” said Linda A. Lee, director of the Johns Hopkins Integrative Medicine and Digestive Center — and recent research points to bacteria as possible middlemen in this back-and-forth. Gut bacteria are known to make most of the body’s serotonin, one of several chemicals that regulate mood, and the bugs may even have a hand in shaping behavior. A 2011 study in mice for example, showed that swapping the gut bacteria of two strains of mice — one known for its daring behavior, the other for its fearfulness and shyness — could make the timid mice more willing to explore and the bold mice more anxious and hesitant.

Gut bacteria

Of course, mice are not men, but changing diet has been shown to change human gut bacteria, and fairly quickly. That suggests it’s possible that dietary choices can alter well-being and behavior, Lee said, but researchers aren’t yet sure if this complex interplay means that swapping food in or out of one’s diet can ease or cure a mental illness.

“We’re not at the point where we can use diet as therapy, especially when we’re dealing with someone whose mental health issues render them very disabled, because we just don’t know enough,” Lee said. “I think we’re just on the new frontier, and five or 10 years from now we’ll know more.”

Jacka, president of the International Society for Nutritional Psychiatry Research, echoes these reservations. She notes that nearly all research on the connection between diet and mental health has been limited to animal studies and observational studies in humans.

“We can’t say [that] if we improve your diet, you’ll feel better,” she said. “We have circumstantial evidence that suggests this could be true, but we can’t say for sure.”

The lack of strong evidence and well-designed studies has led to some resistance to Berk’s and Jacka’s work. Until recently, “the idea that what you put in your mouth could affect your mental health was met with great skepticism,” said Jacka, who recalled colleagues’ dismissing the idea as “rubbish.” With more studies, though, the research community is beginning to come around, she said.

Even as scientists struggle to understand the link between food and mood, some patients, such as Corbitt, seem to tap into it without intending to.

She saw a link

“I changed my diet because I had gastrointestinal issues,” said a 32-year-old woman with bipolar disorder who lives in San Francisco and asked not to be named because she worries about being stigmatized. Three years ago, at her gastroenterologist’s urging, she tried the Atkins diet and found relief — not just from her digestive issues but also from her mental illness, which had at one point nearly derailed her life.

“I noticed within a day or two the marked difference in my head,” she recalled. “It felt clear for the first time in years and years.”

That may seem like a surprisingly quick turnaround, but Jacka said it is not out of the question. “We know from animal studies and a human study that a poor diet can impair memory and attention within a week,” she said.

The woman no longer takes the medication prescribed to treat her bipolar disorder, and she said she has remained stable for the past three years. She said she has sought out psychiatric and neurological researchers across the country, hoping to share her experience and to learn what they know, but has found little interest and few studies.

“It surprised me how little information was out there, because for me it was life-changing,” she said. “I wanted to validate the experience I was having, and to make sure that everything I was doing was safe. That’s how I found Dr. El-Mallakh.”

El-Mallakh had hypothesized in 2001 that a ketogenic diet — a high-fat, moderate-protein and low-carbohydrate diet often used to control epileptic seizures and nearly identical to the diet adopted by the 32-year-old woman — could be helpful for bipolar disorder, because many of the medications that work for bipolar disorder have anti-
seizure properties.

After being contacted by the woman, El-Mallakh found several other people with bipolar disorder who said they were benefiting from a ketogenic diet. Last year,he published two case studies of its apparent effectiveness. His report drew interest from people with the mental illness, but efforts at Stanford University to test the diet with a controlled trial failed to recruit enough participants.

Without such studies, El-Mallakh acknowledged that no one can say how the diet might quell the symptoms of bipolar disorder. With his own patients, herecommends it only alongside mood-stabilizing medications. Despite his own willingness to supplement mental health treatment with dietary changes, El-Mallakh remains skeptical that diet alone can heal the mind.

“There are a lot of people out there who call themselves depressed who aren’t actually depressed,” he said. “I think people confuse low energy with depression, or sugar crashes with mood swings, but they probably don’t have a mental illness. And those people may do better with dietary interventions alone.”

And even if diet can do the trick, providers don’t yet know how to use it effectively or safely. The problem, El-Mallakh said, is that mental illness is still poorly understood. Eventually, he hopes, the connection between food and mental health could benefit researchers who study mental illness as well as those who live with it.

Experimenting with change

Berk and Jacka areconducting the most comprehensive controlled study yet, involving 176 people, of whether dietary intervention can help ease depression, but they don’t yet have results. For now, Berk advocates an integrative approach to treating mental illness that includes experimenting with changes in diet and exercise along with more traditional treatments.

“For a mood disorder like depression, there are hundreds if not thousands of risk pathways that all contribute to the disorder,” Berk said. “Targeting one factor doesn’t target all the factors that cause someone to develop depression. That’s why you need to develop an integrated package of care as the norm.”

That time can’t come soon enough for Corbitt.

“This was such a simple solution,” she said. “I could have saved myself a lot of money and a lot of misery if someone had asked about my diet 15 years ago. My life could have been different.”

Telis is a freelance science and health writer.

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The Real Question

I worked with an older gentleman many (many) years ago, who, though he didn’t come right out and say it, suffered from depression. I was young, so I didn’t pay attention to the obvious, but I remember one conversation we had in which he asked me if I thought someone who took their own life would end up in hell. My response was, “I don’t know” — not because I had no thoughts on the matter, I just didn’t want to be bothered with the conversation. I was eighteen, maybe nineteen, profoundly naive, uninterested in the plight of others, selfish.

Life, however, has a way of being ironic and now I am the one living with bipolar depression. And for all that I’ve gone through, all the pain I’ve experienced, when I think about this episode in my life (and in his), about our conversation (if you can call it that), my answer remains, “I don’t know.” Perhaps I lost my faith, you ask. Or maybe I found it. Maybe I don’t want to get into a deeply theological debate.

No, my answer remains the same because I’ve come to understand that his question had nothing to do with the issue at hand. If we take religiosity and the after-life out of the equation, we see the problem for what it is: our now-life is filled with pain, confusion and suffering to the degree that ending our lives seem to be the only remedy. It’s not, but when your vision is clouded over with depression and your mind is consumed with the negatives of life, you can’t see another way out.

But it’s not normal to want to end our lives. Take a look at all the stories out there about people surviving events that should have killed them and tell me it’s not in our DNA to fight for life, to fight to live. Why then would we consider suicide? Because we are weak and don’t want to deal with a situation? Because we are being selfish and can think of nothing else outside of ourselves? Because dying is easier than living?

Or is it perhaps we are sick and can see nothing else?

Depression is an illness, a chemical imbalance of the brain. It’s an invisible disease that, left untreated, robs a person of joy, of worth, of a will to live. And this sometimes leads to suicide ideation, which, again, is not normal. It is a symptom of a disease — not a weakness, a shortcut, or an act of selfishness. It’s the manifestation of thoughts that are difficult to turn off or turn around, the end result of an underlying condition that deteriorates with time.

And even though we know it, the imbalanced brain may not. Or it may try to justify it. It’s not our job to judge, to guilt or fight with religiosity. It’s not the time to get into a debate — it’s time to find out how they really are, to listen and hear their hearts, to find out if they need immediate help. It’s time to love them, understand them, find out how we can help. When we are willing to do that, to hear them cry for help the only way they can, to see the symptoms if the person isn’t seeking help, to sympathize — this is how we will save lives.

I didn’t work with that gentleman too much longer after that conversation — I left, or he did, I don’t remember — so I cannot tell you what became of him. I hope he is still alive. I hope he found peace. I hope he got help. I hope he found someone to talk to who truly listened to him and gave him the attention he deserved. Because I’ve learned the hard way that we all deserve someone who will truly hear us, especially in our time of need.

#MentalHealthAwarenessMonth #MentalHealth #MentalWellness #CureStigma

21 Tips for Keeping it Together During Depression

What do you do when depression hits? Rosalind Robertson offers some good advice to help keep it together during this time. You can find her original post at her Tumblr account. Bookmark it, copy it, read it and put it use. And most importantly, know you’re not alone in this.

#MentalHealthAwarenessMonth #MentalHealth #MentalWelness #YouAreNotAlone


21 Tips for Keeping it Together During Depression

By Rosalind Robertson

  1. Know that you’re not alone. Know that we are a silent legion, who every day face the solipsism and judgment of Happy People Who Think We Just Aren’t Trying. There are people who are depressed, people who have been depressed, and people who just haven’t been hit with it yet.
  2. Understand that the Happy People are usually acting out of some genuine (albeit misguided) concern for you, that it’s coming from a good place, even if the advice feels like you’re being blamed for your disease. Telling you these things makes them feel better, even if it makes you feel terrible. (If they insist on keeping it up, see #12.)
  3. Enlist the help of a professional. See your doctor. You need to talk about the ugly stuff, and there are people paid to listen and help you find your way to the light at the end of the tunnel.
  4. Understand that antidepressants will only do so much. They’re useful, they’ll level you out and give you the time you need to figure out your own path to getting well. They can be helpful. There are lots to choose from. They may not be for you, and even if they are, they take some time to kick in. Conversely, they may not be for you. Work with your doctor.
  5. Pick up a paintbrush, a pencil, an activity you got joy from in the past and re-explore that. Or, sign up for the thing you always wanted to try. There is a long history and link between depression and creativity. It’s a bright light of this condition, so utilize it to your best advantage.
  6. Eat nutritionally sound, regular small meals. If you’re having trouble eating, try to focus on what you’d like to eat. I went through a whole six week episode of tomatoes and cream cheese on a bagel twice a day. Not great, but it was something – helpful context, I’m a recovered anorexic. Conversely, if all you want to do is scarf down crap, try to off-ramp it by downing a V-8 and doing #9 for 15 minutes, and see how you feel. Chucking your blood sugar all over hell’s half acre is going to make you feel worse.
  7. While you’re doing #3, get some bloodwork done. If you’re low on iron or vitamin D, or if your hormone levels are doing the Macarena… these can all contribute to zapping your energy or switching your mood to Bleak.
  8. If you’re in bed and the “insomnia hamsters”, as I like to call them, are on the wheel of your head, watch Nightly Business News on PBS. This has the effect of Nyquil. Swap out your coffee for herbal tea. If you just cannot sleep, try the next tip….
  9. Learn how to meditate. Start by focusing on your breathing. Not sleep, not thoughts. In through the nose, out through the mouth. Meditation is focusing on being present in your body, not careening around in your brain. It may not be as good as sleep but it will give you some rest and recharge you.
  10. Face a window as often as you can – at work, at home. Look out into the world. Watch. Observe. Try to find something you find pretty or interesting to focus on. And, handily remember that one in five of those people out there feel the way you do.
  11. Cry. Better out than in. Sometimes it’s not convenient or career-enhancing to cry, so find a private place as best you can and let the tears go. Carry Kleenex and face wipes and extra concealer if you wear makeup. You can always claim allergies.
  12. Any “friend” who resolutely believes that your depression is because you’re lazy, because you’re not trying hard enough, who blames you for not bootstrapping out of it- that friend needs to be cut off. Polite (#2) is one thing, but there is a limit. You don’t have to explain, you can just not respond. You feel badly enough; you don’t need their “assistance”.
  13. Limit your time with people who drain you. You know who they are. Often you don’t have a choice- but you can put the meter on. And, subsequently, be aware of what you’re asking of those close to you.
  14. Everyone has stuff they’ve got to deal with. What you have been saddled with is your stuff. Recognize, just as you’re not alone, you’re also not unique. The grass may look greener, you may be jealous or envious of others who don’t have to deal with depression, but you likely do not know everything that’s going on with them.
  15. Let go or be dragged. This is an old Buddhist saying. It’s a very useful way to frame aspects of depression. Betrayal, anger, fear… letting go is a process – often a painful and difficult process – but it’s ultimately going to show you the path out of this terrible place. Repeating the mantra can help when you’re feeling gripped by these feelings.
  16. Wear clothes that make you feel confident. It takes as much time to put on nice clothes as it does to put on sweatpants. You will want to wear the sweatpants. Fight the urge. The whole “look good/feel better” campaign isn’t limited to cancer and chemotherapy. Or women.
  17. Avoid fictional drama and tragedy like the plague. No Grey’s Anatomy, no to The Notebook, or anything that won a Pulitzer Prize. You’ve got enough going on In Real Life. Comedy only. Or trashy stuff. Old episodes of Wonder Woman? I’ve got the box set. Mindless drivel, like the latest CGI blockbuster. Or clever, funny books. David Sedaris. Jenny Lawson. Fiction exists to elicit emotion, and the emotion you need to express most right now is laughter.
  18. Simple exercise, if you can. It can be something as simple as taking the stairs up a flight, or walking around the block. It doesn’t have to be elaborate; it doesn’t have to involve climbing a mountain or running a marathon. Baby steps.
  19. Depression will lie to you. Depression will try to tell you what others are thinking. That you are unloved and unworthy, that others think little of you or don’t care – or even wish you harm. You are not a psychic. Keep repeating that. “I am not a psychic”. Repeat. The only way to know what another person is thinking is to up and ask them.
  20. If you are well and truly losing this battle, reach out to someone. I’ve been the random friendly-but-not-close person who has fielded the occasional outreach. I like to think I’m not judgmental and generally resourceful, and others have thought the same, so they called and asked. You know someone like me. And they will help you.
  21. Forgive yourself. I’m writing out all these tips, and I can’t always muster the strength to even stick my nose outside, or walk up the stairs, or eat my vegetables. Today, I got outside for ten minutes. I will try again tomorrow. And I will try again the day after that.

This list will not cure you. This list will not flip on the happy switch. God, I wish it were that easy. The theme here is to not to unknowingly sabotage yourself. All these little things? Like your blood sugar, or watching nonstop episodes of House, or endless Try Harder lectures from your Perpetually Perky sister? They all make dealing with depression just a tiny bit harder than it needs to be. And it’s hard enough, all on its own.

That Time I Offended Alexa…

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So there was that time I offended Alexa…I was on Twitter when I read about Marianna Palka’s film ‘Bitch’. I don’t swear a whole lot, but I was intrigued by the title. More so by the premise when I got a chance to read about it. I was unable to watch the film for another week, but when I was finally able to carve out some time to do so, I preceded to ask Alexa (on my Amazon Fire Stick) to find the play ‘Bitch’. She took that personally and proceeded to get offended. She said, “Well…” with an obvious attitude and tone in her voice, and stopped talking to me. She wouldn’t even take my apology.

There’s a first for everything, right?

In any case, once I got everything straightened out with Alexa (though we’re still not on speaking terms), I watched the film. I was a big fan of John Ritter and was pleasantly surprised to find his son, Jason Ritter, was in it. He portrayed, Bill, the philandering and lying husband to Marianna Palka’s Jill, who was struggling with life in general. Her kids didn’t appreciate her and her husband…well, he wasn’t there for her for aforementioned reasons. Unbeknownst to her family, she attempted to commit suicide, but even that didn’t go right and she shattered the chandelier in the dining room instead. Then one day, she disappeared. The kids barely noticed until the husband had to pick up ‘her slack’. That was when they found her–in the basement, naked and having taken on the persona of a dog, hence the title of the film.

I usually read the reviews of any product I am about to partake of and as expected, the reviews for ‘Bitch’ were separated down the middle of the road–women loved it, men panned it as sexist and not worth anyone’s time. I fell into the I-loved-the-film camp. Oh, there were certain aspects that required you to suspend your belief, but overall, the message of the film was louder than any perceived issues. And it wasn’t that men are bad and the reason that wives go crazy. Nope. If you ask me, the message was this–we need to listen to each other.

Even though central theme of the film was Jill and her issues, it also focused on Bill and his issues. I never got the impression that Marianna Palka (who also wrote and directed the film) was trying to bash men. No, because Jill was a woman, a wife and a mother, her responses were tied to her relationships with them, her husband especially. Bill, on the other hand, had turned to another woman and his job to find fulfillment, but once things became real–and really embarrassing–for him, he was able to find himself, enabling Jill to find herself again. This wouldn’t have been capable if they didn’t listen to each other.

I could try to tie all this into Mental Health Awareness Month. The subject matter is definitely applicable as is the message. But the fact is, this is something we need to do on a daily basis, not just the one month of the year that we’re deliberate about focusing on our mental health. No man is an island and as such, we need to stop living our lives like we are. We were made for each other, made to be there for each other, made to help each other heal, whether it’s with an email saying, ‘just checking in on you,’ a text, a phone call, or sitting with someone and listening about their hurts. This is what we were made to do; and our world–and our mental health–would be better for it if more people chose to do that.

I encourage you to watch ‘Bitch’. Just don’t ask Alexa to find it for you.

#MenthalHealthAwarenessMonth #MentalHealth #MentalWellness #YouAreNotAlone

Suicide (#MentalHealthAwarenessMonth)

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Suicide is the 10th leading cause of death in the US for all ages. The causes can vary, but oftentimes, mental illness plays a big part in it. This translates into:

  • Approximately 14 per 100,000 people who die by suicide
  • 45,000 deaths per year
  • One death every 12 minutes
  • One attempt every 31 seconds
  • 25 attempts for every one death by suicide

Although these numbers may make suicide seem common, it is still a rare event. Suicidal thoughts or behaviors are more common than suicide deaths and are signs of extreme distress. Suicidal thoughts and behaviors are not harmless bids for attention and should not be ignored. Most suicidal individuals desperately want to live; they are just unable to see alternatives to their problems. Most suicidal individuals give definite warnings of their suicidal intentions, but others are either unaware of the significance of these warnings or do not know how to respond to them. The following are some of the signs you might notice in yourself or a friend that may be reason for concern:

  • Talking about wanting to die or wanting to kill oneself
  • Making a plan or looking for a way to kill oneself, such as searching online
  • Buying a gun, or stockpiling pills
  • Feeling empty, hopeless, or feeling like there is no reason to live
  • Feeling trapped or in unbearable pain
  • Talking about being a burden to others
  • Increasing the use of alcohol or drugs
  • Acting anxious or agitated; behaving recklessly
  • Sleeping too little or too much
  • Withdrawing from family or friends or feeling isolated
  • Showing rage or talking about seeking revenge
  • Displaying extreme mood swings
  • Saying good-bye to loved ones, putting affairs in order.

If you are concerned, go with your instincts and seek professional help. Immediate action is very important. Here are a few resources:

We can all play a part suicide prevention. Share this information, get comfortable with having this conversation. Make this commonplace, so that those suffering know they don’t have to suffer alone.

#MentalHealthAwarenessMonth #MentalHealth #MentalWellness #YouAreNotAlone