May is Mental Health Awareness Month, for which a recent Pew report offers some alarming statistics. In 2020 almost 46,000 Americans died by suicide, and over the last two decades the suicide rate has increased by 33%. Some 629,000 adolescents attempted suicide, and—according to the N.Y. Times—hundreds of these teens spend extended times in hospital emergency rooms because of the lack of psychiatric inpatient facilities. Among active-duty military over one soldier or sailor a day died by their own hand—a fact which Friends may take as proof of the dehumanizing effect of military service.
Research indicates that 90% of completed suicides involved mental health conditions, usually mood disorders and/or substance abuse disorders. Surprisingly, suicide is not inextricably linked to mental health disabilities. Some people seemingly conclude that their lives are just not interesting enough to continue living. Of course, these persons might be suffering from a hidden, “high functioning” depression, but—in any case—successfully treating mental health disorders would potentially result in a dramatic decrease in the number of suicides in this country.
One problem in treatment is that anti-depressants can take weeks or even months to take effect, and a minority of depressive people are “treatment-resistant.” In such cases, electroconvulsive therapy (shock treatment) can bring relief in a short time period but with the possible side effect of memory loss, usually transient but sometimes permanent. Lately, thankfully, the administration of a common anesthetic, ketamine, can alleviate even treatment-resistant depression in a matter of hours or days. Moreover, ketamine appears to have the separate effect of stopping suicidal ideation even if depressive symptoms don’t disappear.
Up until four years ago, my sister had suffered from an intense, treatment- resistant depression for much of her adult life. When she would phone me to seek some kind of relief from the pain, Gail would invariably talk about the possibility of committing suicide. The following paragraphs are her own (edited) words.
I have suffered greatly from depression for many years. When I started being seen at the Veteran’s Administration Clinic in Ft. Collins, I was severely depressed. At times I was not even able to get out of bed. I cried whenever I was awake. I even went to the emergency room 3 times (at the recommendation of mental health workers) because I couldn’t stop crying. Over many years, I have tried many antidepressants and cognitive interventions. Some didn’t work at all, some for only a time.
On May 21, 2018, I began ketamine infusions in Westminster, CO. It was a MIRACLE! For me, a couple of hours after the infusion, my depression began to lift. My suicidal ideation vanished. I no longer had painful memories from the past, and I didn’t cry all the time. I became more active. I was once hesitant to even go out to my car. Now, I go to (a recreation center) 6 days/week (for) strength training and aquarobics. As of 9/06/2019, I had lost 109 lbs.
Immediately after the first infusion, my friends would ask me (even on the phone) what had I done? Even my voice and the way I sounded was different to them. When I talked, I made sense. I didn’t cry. I believe I was and am in remission. I wasn’t high and didn’t feel medicated. I don’t take antidepressants or antipsychotics. I know some people do and that’s fine; but I don’t need them. What a wonderful life and I feel so grateful!
Gail’s experience indicates to me that when suicidal patients arrive at an emergency room, ketamine infusions should be the first line of therapy. Many lives would be saved in the ER, not to mention lives of people who are prescribed ketamine by their regular doctor or psychiatrist. Of course, this drug is not a one-time intervention. To maintain patients depression-free, ketamine has to be administered every four to six weeks at a sub-anesthetic dose. And sometimes it doesn’t work. Ketamine is “only” effective about 60 to 70% of the time with treatment-resistant patients. If we’re talking about the entire depressed population, I can imagine an effectiveness of 90%.
But how is all this relevant to Quakers? Well, we may have the Inner Light; but Friends, like other people, suffer from depression, bipolar illness, and drug addiction. George Fox himself may have been a manic-depressive. That would explain the episodes in which he kept to himself away from human company as well as the mystical, hallucinatory visions that he experienced.
If a Friend in your meeting is afflicted with depression or post traumatic syndrome, someone in the meeting could tell them about ketamine, which is still a novel treatment usually not covered by health insurance. Nevertheless, the psychological benefits of the drug are now known. Ketamine “resets” the brain and—in the case of Quakers—allows a dimmed Inner Light to shine brightly once again.
~ Richard Russell
“Am I a bad Quaker,” I wonder. “How to know,” I think. “Ah, yes,” I answer myself, “the Advices and Queries in the Book of Discipline of New York Yearly Meeting!” In reading the queries “straight down,” I have to pause at number five, which asks, “Do we keep to moderation and simplicity in our daily lives? Have we allowed the acquisition of possessions to interfere with God’s purpose for us?”
Hmm. A couple of days ago we spent a hefty sum on a new SUV for my wife. If we had gone to more than one dealer, we might have found a less expensive brand—say, a KIA instead of a Chevy Equinox. Or we might have bought a used SUV or a smaller vehicle.
Anyway, the amount we spent doesn’t really seem like “moderation and simplicity.” On the other hand, my wife does need a SUV for the large wedding and quinceañera cakes she sells in her cake decorating business. Moreover, she has recently grazed a parking lot pole twice and scratched another vehicle in traffic. Our new Equinox beeps if there’s a hazardous object on either side of it. It also has lane keeping assistance and emergency braking for unexpected obstacles detected in front. And I don’t really see how the acquisition of an Equinox will interfere with God’s purpose for us. We can still afford airfare to New York to visit Old Chatham Meeting!
Continuing with the Queries, I see that number eight says, “Have we confronted our own decisions about our use of alcohol, tobacco, and other drugs…?” Well, I don’t smoke or drink, but I do sometimes chew nicotine gum for an energy lift. The gum isn’t carcinogenic; but it is mildly addictive, and it does raise blood pressure, which I’m trying to control with prescription medications. Moreover, it’s expensive. “Gum money” could be better spent on household bills or charity. I don’t think I have a good answer for Query number eight.
Then there’s number thirteen. “Do we maintain Friends’ testimony against war?” Well, I don’t approve of our militaristic society and the U.S. tendency to wage senseless wars, but I’m not an absolute pacifist. For example, I do believe that we should send military aid to the Ukrainians as they fight to preserve their independence and freedom. It grieves me to stand apart from other Friends who approve only of humanitarian aid to Ukraine, and I applaud those who give their unqualified support to the Peace Testimony. I wish I could join them.
Considering my problematic Queries, am I a bad Quaker? Probably not. After all, I “passed” thirteen of them with only three that were doubtful. Admittedly, I’m not a perfect Quaker, but how many Friends are perfect?
By the way, the picture at the head of this article is a painting of Benjamin Lay, a good Quaker and one of the first Friends to oppose slavery. He only “looks bad.”
~ Richard Russell
Let’s face it. The average age of liberal Friends is increasing. And the greatest risk factor for Alzheimer’s Disease is simply advanced age. What can Friends do to decrease the odds of falling prey to dementia? Well, there’s a drug—norepinephrine—that can help. Norepinephrine or noradrenaline is a hormone and neurotransmitter that can improve memory and help different brain regions work together more efficiently. Specifically, norepinephrine facilitates the connections among brain cells, stimulates neuron-producing cells, and makes Alzheimer’s Disease proteins less toxic.
The nicotine in cigarettes can increase norepinephrine in the brain, but who wants to die of lung cancer in the pursuit of a sharp mind? I personally chew nicotine gum not infrequently and like to think that the resulting increase in norepinephrine helps me mentally without the danger from the carcinogenic substances in tobacco. I also take Adderall as a treatment for sleep apnea, and Adderall increases norepinephrine in the brain—as does Ritalin. But is there anything Friends can do to boost norepinephrine if they don’t smoke, don’t use smoking cessation products, and don’t need Adderall or Ritalin for ADHD or sleep apnea?
Well, yes. Physical exercise produces more cerebral norepinephrine as does concentrating hard or experiencing emotion. Other norepinephrine-boosting activities include experiencing something new or unusual, taking on a mental challenge, or even just social interaction with others.
Thus, the kind of life we lead directly impacts norepinephrine’s protection from dementia. People who travel to different countries and learn new languages are both experiencing something new and taking on the mental challenge of language learning—not to mention practicing the language through social interaction.
Of course, the novelty could be a visit to a non-Quaker church, the mental challenge might be studying Calculus, and the social interaction could be provided by a new boyfriend or girlfriend. The novelty could be observing the 2023 total solar eclipse, the mental challenge might be learning to count cards at Blackjack, the social interaction could be speed dating or a weekly Bridge club. Well, you get the idea.
So, if you want to stay mentally sharp in old age, it’s time to do or experience something new, take on a mental challenge of some kind, and interact with your fellow human beings instead of staying in your recliner and watching Better Call Saul on Netflix. May your brain stay eternally young and contribute significantly to Quaker life even though your body is old and worn-out!
(This article was based on a module from The Brain Health Project of the University of Texas at Dallas.)
~ Richard Russell
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