Category Archives: health

Let’s Talk Viruses

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denisismagilov – stock.adobe.com

What’s up with viruses? What the hell are they, anyway? And how do those sly whatsits operate? Here’s a layperson’s guide.

Disclaimer first: I’m not a doctor, nor do I play one on TV. I’m not a microbiologist and I don’t think anyone plays one on TV. I’m simply a person who stayed awake in science class and has read a lot ever since.

First, let’s make this clear: Viruses have no brains. We can talk about a virus’s goals or intentions or strategies, but we’re at least partly anthropomorphizing or speaking metaphorically. A virus is a strand of DNA or RNA (in the case of COVID-19) wrapped in a shell which can glom onto bodily tissues so the virus can duplicate itself and move on to another host.

That’s what it does, and that’s about all it does. All a virus wants is to replicate itself and continue to do so. The fact that it makes you sick is quite incidental to that.

The incubation period – the length of time before you show symptoms of an illness – is important. It gives the virus time to multiply unnoticed within the body and infect others via bodily fluids before someone notices and tries to kill it off. The longer the incubation period, the more successful the virus is. Think HIV. It has an incubation period of years, which was what allowed it to be so successful at infecting a large number of people before anyone noticed.

The incubation period for coronavirus is, we think, about two weeks, give or take. You could have the virus without any symptoms during that time and all the while be spreading it by coughing, poor hygiene, or being too close to people. The masks that you wear may seem like they are protecting you, but actually they are preventing you from making other people sick.

Viruses are tricky bastards. They can – and do – evolve and mutate and jump species. That’s when a virus becomes particularly dangerous. If it mutates, as the flu virus does pretty much every year, no one has a natural immunity to it and unless a vaccine is created for that specific version, a lot of people get the flu.

Jumping species is another thing altogether. A virus can be living happily in a pig or a chicken or a bat or a monkey, not causing too much damage (at least not right away). But when a virus mutates so that it can infect and cause illness in another sort of animal (for our purposes, a human being), that’s when things get really tricky. The virus now has a population to infect that never encountered it before. It can burn through that population like wildfire. If the incubation period is short, the virus may burn itself out rapidly and not claim too many victims, as they die before having a chance to pass it on. But if the incubation period is longer, the virus gets a free ride to any number of new hosts.

And yes, people can get infected by eating the host animal. It’s not very likely, since most people eat their meat cooked, not raw. Bodily fluids and bites or scratches are much more dangerous, as is contamination with feces. But that’s not the only way that viruses are transmitted via animals. You know how viruses are passed from person to person without us having to eat each other’s flesh? Well, the virus can travel in the bodily fluids of other animals as well. So if you don’t wash your hands after feeding your chickens, or you stir up and breathe in some bat guano while you’re exploring a cave, or a mouse pees in your storeroom, any viruses lurking there can infect the unwary, if that virus is ready to jump species.

So, that’s a basic guide to viruses. And let’s be real about this. Viruses are all around us and spread quite naturally. There’s no real need to worry about a virus being manufactured and escaping from a lab. And need I say that Hillary Clinton, the deep state, Chinese supervillains, and George Soros have nothing to do with it? Yes, I suppose I do.

When the Pandemic’s Over

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Right now there are a lot of blog posts that tell you how to get through this period when we are plagued with COVID-19, the coronavirus. There are helpful patterns for sewing masks. There are recipes to try and games to play to while away the time spent in self-isolation. There are exhortations to take up a new hobby or learn a new language or just take care of yourself – your mental and physical health. There are also entertaining conspiracy theories for the origin of the virus, which seem to involve germ warfare, Hillary Clinton, bats, the Deep State, and the elections. (Personally, “bats” is the word that comes to my mind to describe these theories.) There has even been a virtual science fiction convention online that has been running for weeks instead of just for the usual weekend.

But at some time – no one knows just when – there will be a break in the clouds of invisible invaders and we will all breathe a cautious sigh of relief. What will we all do then? Keep practicing our new hobbies and languages? Try to turn those masks back into bandanas or fetching little hats?

I have some suggestions.

Hug everyone you care about. One of the worst things about social isolation and distancing is that they make you feel … isolated and distant. We may be shy about returning to shaking hands as a social norm (I prefer the Vulcan hand salute). But hugs are life-affirming and life-sustaining.

I’m not recommending that we substitute hugs for other greetings for business or ordinary social purposes. But so many of us have been without hugs and long for a brief squeeze or a warm embrace with a friend, a grandchild, a lover, a niece – whoever has been involuntarily separated from you. It is my great good fortune to be acquainted with some world-class huggers (including my husband) and it is my intent to line them all up and hug every one of them. 

Be prepared for the next time. There will be a next time, make no mistake. COVID-19 may not confer immunity, leading to a second wave. There’s always the regular flu season, which I suspect will now make us all very anxious. And there’s been SARS, the Spanish flu, the bubonic plague, and countless other pandemics that crop up with surprising regularity (and not just at election time, either).

I’m not suggesting that we all fill one closet with toilet paper and another with bottled water, pasta, and hand sanitizer. But it couldn’t hurt to keep on hand at least one extra package of the things that the stores keep running out of. Take advantage of two-for-one sales. It’s like filling up your gas tank when it’s half empty (a thing my father did faithfully).

Eat out and shop locally. Bars, restaurants, and small local businesses are among the industries hit the hardest. Some may never recover. But those that do will need patronage to get back on their proverbial feet. And tip well. Servers in particular have been hard hit. I understand that with contactless pizza delivery now in place, customers are forgetting to leave some money in an envelope taped to the door for the driver. And the “delivery fee,” if there is one, doesn’t go to the driver. It goes to the store. (You didn’t know that?) Tip for food delivery the same as you would for a restaurant meal – 15% or 20%.

Educate yourself. There are good nonfiction books – reputable sources – that offer information on epidemiology, pandemics, zoonoses (illnesses transmitted by animals to humans), and epizootics (epidemics ditto). David Quammen’s Spillover, Richard Preston’s The Hot Zone, and Influenza by Dr. Jeremy Brown are good places to start. 

Maybe if more people understood a little bit about how these diseases develop and spread there would be less fear, scapegoating, and improbable chains of coincidences presented as theories.

Vote. Vote as if your life depends on it. It may.

 

Someone You Know Is Mentally Ill

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Let’s say you have five people in your family and another five who are close friends. Or four and six – enough to make up ten people in your life, anyway. Statistically speaking, two of those people will experience mental illness at some point in their life. Or the person experiencing mental illness could even be you. The National Association for Mental Illness (NAMI) reports that one in five – or maybe even one in four – people will experience mental illness. That’s 20% to 25% of Americans.

Don’t assume you know who those two people are. Many people with mental illnesses never talk about their difficulties because of the stigma attached to living with a mental disorder. Many others are high-functioning, able to have relationships and work and lead a relatively normal life, especially if they receive proper treatment. 

So, what are we talking about when we talk about “mental illness”?

We’re not talking about the person who straightens pictures and has a neat desk.

We’re not talking about the person who is sad after the death of a pet or grieving after the loss of a loved one.

We’re not talking about the person who is overly bubbly and laughing most of the time.

We’re not talking about the person who always seems to be on a diet, no matter how thin she is.

We’re not talking about the person who has some mood swings.

We’re not talking about the person who’s afraid of spiders and germs.

We are talking about people with serious mental conditions like OCD (Obsessive Compulsive Disorder), major depression, mania, anorexia, bipolar disorder, and anxiety disorder. (There are other psychiatric illnesses, but they are much more rare.)

For harmless habits to be actual mental illnesses, they must persist over time and usually interfere with people’s abilities to accomplish the ordinary tasks of daily living. If a person’s depression lasts for weeks or months (or even years), he may have Major Depressive Disorder. Some of the symptoms are low mood, isolation, feeling hopeless or helpless, and changes in appetite. Of course, all those things happen to most of us at one time or another, but if they last for a long time and keep a person from going out or doing their work, they may be signs of a serious mental illness.

This is not to say that you can diagnose mental illness on your own. A psychiatrist or psychotherapist is needed to tell whether any condition is severe enough to be called a mental illness. And only a doctor can prescribe the medications that can alleviate the symptoms, lessen the effects, and help the person back to stability or mental health.

But if you do have a friend or loved one experiencing mental difficulties – and you probably do – what should you do?

If you are sufficiently close to the person, you could gently express concern and suggest that he might want to tell a doctor what is going on. With an acquaintance, it may be best to simply be understanding and supportive. Don’t be offended when she cancels an outing or can’t make it to a party. Her disorder may be preventing her from going, much as she would like to.

If the person seems to be in danger of harming himself, definitely have a talk with him. Tell him how worried you are and how you’re upset to see him suffering. If the situation warrants, make sure your friend has the number of a suicide hotline or knows that he can call you when he is having excessive bad feelings.

The best thing you can do, though, is to educate yourself about mental illness from reputable sources like NAMI. You’ll find that mental illness is treatable and not likely to lead to violence unless it is very severe. Don’t joke about mental illness. Once I did and it prevented someone with depression from speaking about her condition. Sharing our stories with each other might have brought us both connection and comfort.

Think of a mental illness the way you would think about a physical illness. If a person you know had a broken leg, you wouldn’t ask him to go skiing. If a person you know had cancer, you wouldn’t make jokes about it. If a person you know had the flu, you would understand and might offer to run errands.

Dealing with mental illness is not easy, but it is important. And I assure you, someone you know needs help and support. Think about how you can provide that. Then follow through. It’s often lonely having a mental illness. Do your best to be a good friend. That will help, even if your friend or loved one doesn’t acknowledge it at the time.

 

 

Who’s Useless?

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I saw a meme the other day that defined the laundry cycle as wash, 45 min.; dry, 60 minutes; fold and put away, 7-10 business days. That would be optimistic for me and my husband. We are useless people.

We started calling ourselves that when we were so exhausted at the end of the day that we were physically and emotionally unable to cook. So we turned to what we called “Useless People Meals” – ones that come in a box or bag or tray and only need to be microwaved. We eat them in the trays they come in or share them out of a single bowl since we are also too useless to wash many dishes. Paper towels are our napkins, and I’m sorry to report that we have been known on occasion to use paper plates and plastic cutlery. At least the plates are biodegradable.

We took another step towards uselessness when we found the perfect furniture for us – a coffee table that magically rises upward to become a dining table and an end table that swings out over the sofa to make a tray. With these in place, we can happily watch TV while we eat. (We still have meaningful conversations, mostly over who will be the next chef to be Chopped. But I digress.)

As noted above, laundry is another place to practice uselessness. All our clothing is wash-and-wear. We don’t even own an iron (or if we do, I have no idea where it’s gotten itself off to). If we ever do find the iron and would actually need to iron something, we’d have to lay it on the coffee table, which would also magically transform into an ironing board. Much easier just to toss a garment in the dryer with a dryer sheet or a damp washcloth.

I admit we’re useless. We want to skate through life doing as little physical labor as possible. And there are a lot of products designed to make life easier for people like us. The meal kits that are so popular nowadays are not for completely useless people. Some of them require actual chopping and cooking. The most recent one we tried, though, had ready-prepped meals that were microwaveable. And since we didn’t know what any of the delivery meals would taste like when we ordered them, there was something to be said for not spending much time preparing them.

But there are those who mock and deride what they see as completely useless practices, gizmos, and packaging.

They are wrong. My husband and I may be slackers, but some inventions actually make life easier for people with disabilities, who are not useless but merely incapacitated in some way. Imagine a person with rheumatoid arthritis trying to shell an egg or peel an orange and suddenly those egg-cooking gizmos and individually wrapped, already-peeled oranges in vending machines make sense. It is ableist privilege that makes people view such innovations as useless.

Even some of what my husband and I think of as for the useless would actually be great for people who are handicapped. Our “useless people coffee table” makes perfect sense if you think of someone who uses a wheelchair. And our “useless people” heat-and-eat meals are dandy for people who do not have the physical stamina to stand at a counter or a stove, chopping, mixing, stirring, straining, and all the other steps that are needed for a simple plate of spaghetti.

So we’re right to call ourselves useless people, but wrong to call our time- and step-saving practices and devices useless. The tools themselves are immensely useful and many people who use them, unlike us, are not useless at all. More and more, as the Baby Boomers age and we face illness and mobility issues, we will need to use those sock-puller-uppers and canes that stand by themselves and grippers to reach the stuff on the high shelves or on the ground. Whatever the need, it seems some clever soul has come up with a fix or a work-around.

I guess what I mean is that my husband and I are useless because we take advantage of these helpful tools just because we don’t want to do the work. There are those who use them because they need to and we will likely join them someday. At least we’ll have the tools already in place.

We’re All Working for Big Pharma

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bunch of white oval medication tablets and white medication capsules
Photo by Pixabay on Pexels.com

You may not know it, but you’re likely working for Big Pharma. And you have been since the 1980s.

That was when drug companies decided to begin direct-to-consumer (DTC) advertising. Until then pharmaceutical companies had limited themselves to advertising to the medical community. There was no law that prevented them from taking their message to the streets. It was just the common practice.

Since the ’80s we have been increasingly bombarded with ads for drugs that are supposed to cure or “help alleviate” certain conditions, from the well-known ones such as diabetes to the obscure ones such as Peyronie’s disease. And since that time, ordinary people with no medical education – like you and me – have been shilling for Big Pharma.

The drugs ads all exhort you to “ask your doctor if Drug X is right for you.” Sounds simple enough. What it means, though, is that you, the consumer, are advertising the drug to your physician. In 2017, drug companies spent over $6.1 billion on DTC drug ads and you can bet that they are receiving much more than that in sales, or they wouldn’t do it.

There are FDA regulations that say that the advertising must not be false or misleading. That’s why you see in magazines one page of a smiling family, the name of a drug, and perhaps a slogan. The other page is black and white and features at least three columns of tiny type that no one ever reads, even if their eyesight is good enough. It’s the reason that the voice-over announcer on TV ads recites the list of possible side effects, which many consumers joke are worse than the disease.

One result is that consumers may pressure their doctors to prescribe the newest, most expensive drugs, even if the medication isn’t right for the patient’s condition. In the Journal of Clinical Oncology, oncology nurse practitioners were surveyed on the topic. A full 94% said a patient had requested an advertised drug; in 74% of cases, the request was for an inappropriate drug. And 43% felt pressured to prescribe the inappropriate drug.

But can’t medical people ignore the patients’ inappropriate requests? Maybe. But at least half of patients’ requested drugs are then prescribed. Patients don’t like being told that a drug is too expensive, or not thoroughly tested, or that there are other, older drugs and treatments that work just fine. Americans want the newest, the best, and the most expensive, whether it be sportscars or drugs.

You may notice that ads for brand-name drugs pop up and then hold on for a few years. Then you rarely see them again. Drug companies don’t make as much money when generic drugs become available, so they scale back the advertising. It’s much more profitable to tweak the formula and come out with a newer, even better version of the more expensive drug that consumers can sell to their doctors.

Don’t think that DTC advertising brings health care costs down, either. First, there’s that $6.1 billion dollars in advertising that must be recouped. A study reported in the Archives of Internal Medicine that the cost of Plavix increased due to the need to recoup the high costs of DTC drug advertising.  So did the Medicaid funds spent for Plavix in pharmacies.

Brand-name drugs, the only kinds you see advertised, cost more than the equivalent, just-as-good generics. If you have insurance, the company may have to pay Big Pharma more for the designer drugs, and you can bet the costs are passed along to you in the form of higher premiums.

And insurance companies have lists of drugs they will and won’t pay for, called formularies. If the drug you requested and the doctor prescribed isn’t on the right list, you’re stuck with accepting a different drug or paying exorbitant costs for the shiny new one that caught your eye while you were watching Game of Thrones or the Today Show.

Drug companies used to send employees known as drug reps to doctors’ offices and convention, often spreading dollars, free samples, and certain perks around to influence the sale of their drugs. Now they’ve got a whole new sales force – the American people.

A more thorough discussion of the situation can be found at https://prescriptiondrugs.procon.org/.

 

 

 

 

 

 

School Shootings and the Tipping Point

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Teen activists may hold an answer to school shootings.

I say “may” and “an answer” because each shooting is different. There’s no one reason for them.

There is a common denominator. It’s not mental illness, or divorce, or bullying, or the Internet, or video games, or no prayer in schools, or toxic masculinity, though each of those may be a contributing factor in some school shootings.

The common denominator is that school shootings are, well, shootings. Before we address the contributing factors, we must address that.

To do that, we must talk. Negotiate. Problem-solve. Not rant, spout slogans, or pass around memes. Not blame mythical “crisis actors.” None of that will help. Let’s discuss what proposed solutions are feasible, practical, and actually helpful.

This time the kids are taking the lead and speaking up. Mandatory suspension means their walkouts may fail, at least if they walkout until Congress does something, as was suggested.

But other students are speaking out in other ways – talking to the media, visiting elected officials and attending sessions of legislative bodies. Encouraging voter registration among their peers.

And you know, these efforts may fail as well. It’s difficult to get your message across when you’re trying to get the attention of people who live and die by ballots, not bullets.

Here’s the thing, though. With the Parkland school shooting, we may have reached a “tipping point” in our society. Even if legislation doesn’t work, as so many say it won’t, there is a force that can catch the nation’s attention.

Grass-roots activism.

Here I won’t praise the efforts of the 1960s, when under-30s protested and helped stop a war, though I surely could.

What I want to talk about is attitudinal change. Societal change. It can happen and it has happened.

Think about the things that used to be commonplace and succumbed to pressure from groups and individuals.

Smoking is a prime example. Despite push-back from tobacco lobbies and cigarette manufacturers, smoking has tapered off in public and in private. Restaurants started with smoke-free seating areas and now in some states are completely smoke-free. Public buildings and many private ones are too. Smoking around young children is particularly looked down on.

Why? People spoke up, including teens (see truth.org). And society reacted. Look at old movies and how many characters in them smoked. Then look at modern movies and notice how few do. It’s almost like someone realized that these characters are representations of our changing society and – perhaps – role models for kids, even if only subliminally.

And look at drunk driving. MADD – Mothers Against Drunk Driving – changed society’s view of drunk drivers and prompted legislative change; for example, getting states to lower the limits for what is considered “impaired,” holding drinking establishments responsible for taking the keys from patrons too wasted to drive, and requiring harsher punishments for repeat offenders.

Non-legislative solutions are having an effect as well – the “Designated Driver” idea and PSAs that say “Friends Don’t Let Friends Drive Drunk.” There are smaller, local efforts too, such as providing free cabs on the holidays associated with over-indulgence.

What happened in both examples was that society reached a tipping point. After so many deaths and so much ill health, individuals and groups decided that the prevailing practice had to change.

And change it did.

There are reasons to believe that the Parkland shootings may be that tipping point for change. For the idea that school shootings are not just an everyday reality – or shouldn’t be.

Businesses are cutting ties with the NRA, for one. These are protests that will get attention because they are backed up by dollars.

Sure, many teens (and adults and businesses and law-makers) will ignore the issue. Even teens succumb to the “it can’t happen here” mentality. But others are saying that it can and does happen anywhere. In elementary schools, where the students are too young to mount effective protests. In colleges, where students should.

And in the surrounding society, people are saying, “Enough already with the thoughts and prayers.” Even sincere ones have changed nothing, and insincere ones substitute for actual change.

Likely the change that is coming will be incremental and slow. And after the tipping point is reached and the mass of everyday Americans demand real answers to school shootings, maybe we can turn to the related factors like acceptance of bullying and the broken mental health care system. Grassroots efforts and public education are key.

But first, let’s listen to the kids. They have the most to lose.

 

The Year Our Christmas Presents Changed

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Our family Christmases were idyllic, if simple. Each year on Christmas Day, we would all open our presents. My sister and I would get doll clothes (this was when you got outfits, not multiple Barbies) and plush animals, Spirograph and paint-by-numbers, and such.

Then we’d get dressed, jump in the car, and drive to Granny’s house, where we’d open more gifts of clothes and stationery and Avon cologne. We’d wreak havoc on a turkey and trimmings, before the adults went off for naps, after dropping us kids off at the movies.

Then came the year when my sister and I had to grow up fast.

My parents had always tried to keep any bad news away from us and carry on as normal, but there was no hiding this bad news. After being accidentally hit by the garage door, my father’s injured neck turned out to be something much worse than a sprain, strain, or contusion. It wasn’t the garage door that caused it. of course, but that was when my father was diagnosed with multiple myeloma.

It’s a horrible form of cancer that attacks the bones all throughout the body and destroys them. I hope the treatments have gotten better in the decades since, but for my father cancer meant radiation, chemotherapy, and an operation to fuse the bones of his neck using bone from his hip. He lived many years longer than the doctors predicted, which I attribute to his stubbornness. He certainly wasn’t a health aficionado.

Naturally, all those cancer treatments and hospitalizations were expensive. My parents had good insurance, but even that was nowhere near covering the costs. And my father’s illness was not something my parents could keep secret from us kids, much as they would have liked to. It affected every part of our lives.

When Christmas came that year, I was 15 and my sister was 16. My mother explained that because of the family’s medical expenses, we wouldn’t be able to have Christmas as usual. No driving from Ohio to Kentucky to see our relatives. And no Christmas presents.

Except one.

My mother said that all we could afford was a magazine subscription for each of us. Our choice of titles. She hoped we weren’t disappointed.

I wasn’t. To me, a magazine subscription was special, something that grown-ups got, and something that kept giving all year long. I chose Analog, a science fiction magazine, and my sister chose Sixteen. It was exciting to watch the mail for each month’s issue. (As kids, we didn’t usually get much mail, except cards on our birthdays.)

For the Christmases after that, my mother would renew our subscriptions, or let us change to a different title. When I started studying astronomy in high school, I switched to Sky and Telescope. When she turned 17, my sister switched to Seventeen.

Now I subscribe to the electronic versions of three magazines –Smithsonian, National Geographic, and Discover. I still get a little thrill each month when the new cover icon appears on my e-reader screen. It reminds me of the first time I ever got an actual, grown-up present – when I started becoming an adult, whether I wanted to or not.

 

The Things We Do for Cats

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“Would you get me a beer, honey? I’d get it myself but there’s a cat on my lap.”

In our house, one of the things we do for cats is to give them priority seating. Often that seating is on top of us. And the person so sat upon is immune from chores or any activity that requires getting up. If the cat is sleepy, this condition can last for hours.

Other things we do for cats are less ridiculous. My husband and I, and a number of people we know, have been trained and trusted with our cats’ medical procedures. Most people can give pills or liquid medicines, eye drops or ear drops at home. (Although even these duties are not for the faint of heart. One of our cats invented the sport of projectile drooling when given a pill.)

Some go even further. When one of our beloved cats developed kidney disease, and vet visits and fluid treatments became prohibitively expensive, we were permitted to buy the supplies at cost and administer them at home.

What it takes is a dripset, a bag of fluids, and a disposable needle. You hold or hang the fluid bag higher than the cat’s head, attach the dripset (hose and controls), and carefully attach the needle. It resembles an IV for a human.

But the fluids are delivered not intravenously but subcutaneously – beneath the cat’s skin. The procedure is a little tricky. You pinch up a triangle of skin between the cat’s shoulder blades and insert the needle under the skin but above the muscle. Then you turn the little wheel and the fluids flow. You watch the bag carefully to make sure the right dose is given, and you hold the cat still.

That would be the tricky part, and the reason giving sub-cue fluids generally requires two people. Many people wrap the cat in a towel, which is supposed to be immobilizing, but isn’t. We prefer putting the cat in a pillowcase, which makes it easier to control all four paws. If kitty is feeling very poorly, she may not object strenuously, but a cat on her way back to health can be a handful.

Naturally, after the procedure, you dispose of the needle safely and give kitty a treat or let her go off by herself and sulk.

In order to do this level of cat care at home, you must have at least one person who is willing and able to stick the needle in the cat. My husband is an old softy, so I am the designated cat-poker in the family.

It’s a valuable skill. It isn’t just the cost savings that makes a person go through the sometimes distressing procedure. Ailing cats do better when they receive treatment at home from their loving, reassuring caregivers. And they avoid the stress of those extra visits to the vet.

Yes, it’s difficult (it gets easier with practice) and no, it’s not for everyone. But in our house it’s just one of the things we do for cats.

P.S. Even as I post this, I’m house- and cat-sitting for a friend whose cat needs insulin injections twice every day. I’m not suggesting this as a career, but it is nice to know someone you can trust with advanced home cat care.

What Kids Should Learn About Mental Health

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The stigma and the misinformation surrounding mental illness are staggering.

How many adults believe that depression is “just being sad”? That the weather can be “bipolar”? That you can call yourself OCD because you’re a little too organized? That suicide threats are never acted on? That mentally ill people are dangerous? That prayer, or sunshine, or positive thinking will cure all mental disorders?

We can’t do much about educating and informing the adult population that all those beliefs are false. But we can avoid raising another generation that buys in to these misconceptions – if we start now with mental health education in schools.

Whenever someone proposes this idea, there are common objections. You want kindergartners to learn about schizophrenia. You’ll have impressionable kids thinking they have every disorder you teach about. Discussing suicide will give teens ideas.

Again, those are misconceptions. Mental health education in schools could look like this:

In kindergarten and grades 1-2, part of the health curriculum should be a unit about understanding emotions and how to deal with them. This is already being done when teachers tell kids to “use your words” or “use your indoor voice.” But more could be done in the area of teaching children how they can keep from letting anger, sadness, frustration, and other emotions cause them difficulties. Yes, this may involve techniques that resemble meditation and yes, these may be controversial, but the outcomes will be beneficial.

I also think that young children ought to be taught about autism. They will certainly meet autistic children in their classes at this age. Helping them understand the condition at their age level will, one can hope, lead to more inclusion and less bullying of kids who are “different.”

Older children can learn about mental illness in their science or health classes. This should be a unit that covers the basic facts: that mental illness is like physical illness in some ways, that treatment is available, that mental or emotional disorders will affect one in four Americans in their lifetimes, and that mentally ill persons are not generally dangerous.

Middle schoolers can be taught some more specifics: the names and symptoms of some of the most common disorders, the kinds of treatments available, famous people who have succeeded in spite of mental disorders and ordinary people who live fulfilling lives despite them. Speakers from local mental health centers or the school guidance counselor would be helpful.

The topics of self-harm and suicide should be brought up at the middle school level. It is sad but true that children in the middle school age range are affected by both – if not directly, by knowing a classmate who is. And suicide is the third leading cause of death for children ages 10-14. Learning the facts may help students who need it find help before it is too late.

In high school, the focus can shift to human psychology; more detail about serious psychological conditions; and the possibility of careers in mental health treatment, nursing, or advocacy. Topics of self-harm and suicide should be covered in greater detail, with discussions of how suicide affects the families and loved ones of those who die by suicide, how to recognize possible signs that a person is thinking about suicide or self-harm, and what does and doesn’t work when a person shows those signs.

The details of mental health education in schools still need to be worked out. These suggestions come from my experience as a person with bipolar disorder, who began showing symptoms while I was a child. Organizations such as NAMI (National Alliance on Mental Illness) and NIMH (National Institute of Mental Health) provide resources that can help in understanding the need for mental health education among school-aged children.

Understanding mental health is as important for schoolchildren as understanding physical health. Why should one get all the attention and the other virtually none? Mental health education that begins early can help children and their families in ways that will resonate far into the future.

Most adults have little to no understanding of the realities of mental illness. It doesn’t have to be the same for the next generation.

For Caregivers Everywhere

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I have bipolar disorder. My husband is my caregiver. He didn’t sign up for this gig when we met, except for later vowing the part about “in sickness and in health” when we married. I could not negotiate life without him. I try to thank him daily.

My mother was my father’s caregiver when he was dying of multiple myeloma. She knew she was doing a good job of taking care of him, but she asked me to tell her that. She needed someone to tell her she was doing it right.

So this is for my husband and my mother, and for caregivers everywhere.

Thank you. Good job. We need you and we know it.

Some of you are unpaid caregivers who help loved ones for the necessity of it, for the obligation of it, or for the love of it. All of you deserve our thanks.

Some caregivers receive pay, and you deserve our thanks, too. There are many other professions or jobs you could be doing, but you chose to help those who needed it most.

All parents are caregivers, but the parents of special needs children are extra special. You share a task and a worth that few others recognize. You didn’t ask for the job, but you step up to it every day.

You work in homes, rehabilitation facilities, hospitals, schools, and group homes. Your work matters more than most people realize. You help not just the sick, but the struggling, the frail, the dying, and the trying.

Respite care workers deserve recognition too. You allow caregivers to continue their work refreshed – give them a space to catch their breath and recharge their spirits. You are caregivers as well.

The care you all give is not easily definable. It involves the physical, spiritual, mental, and emotional needs of the medically, mentally, or emotionally fragile. It provides sustenance, both literal and figurative. It keeps the people you care for going, or helps them lay down their struggles.

Recently I wrote a blog post called “Caregivers Need Care Too,” specifically about people who care for the mentally disturbed (http://wp.me/p4e9Hv-wh). It talked about what caregivers need in return for the attention, care, support, assistance, and love they give.

In it I said that those who care for others need something from those they care for, and from the rest of society. They need appreciation, validation, time away to refresh and re-energize themselves, understanding, support, and recognition. Not all of the people you care for are capable of giving back, for whatever reason.

So, please accept this from me, one who has known caregivers and benefited from caregivers, and loved caregivers. Your work and your devotion do not go unnoticed, Even if the ones you care for are not capable of saying “thank you,” I say it for them.

You are appreciated. You are worthy. You are loved. You are respected. You make a difference. You have value. You are valued. Even if you never hear these words from those you care for, please accept them from me.

I am grateful.