The Deceitful Voice Of Depression

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Teenage Depression

I never considered myself the sort of person who would take their own life…

That’s an awful lot of people, but I never expected to become one of them. I have always been known for my sunny, cheerful nature and natural ease in social situations. Neither was I an anxious person. How could someone like me become so anxious and depressed I actually contemplated taking my own life? The truth is I don’t know the answer. On paper, there’s nothing in my life that could make me feel this bad. I have a good marriage, a job I love and am financially secure. I have a decent group of friends and time to indulge in my hobbies. But some of the resources online that talk about depression are less than helpful.

“Focus on the positives,” they say. “Think of all the good things in your life.”

But that doesn’t make me feel better. It makes me feel worse because if I concentrate on the good things in my life, I feel selfish and overprivileged. Other people have far worse problems than I do. The truth is depression is common and is not always situational (e.g. a response to trauma or a bereavement). And the thing about depression is it lies to you, tells you you’re worthless and a burden and it’s not easy to ignore its insidious voice.

So after months of trying medication after medication, I was getting progressively worse to the point where I had completely lost hope.  The crushing feeling of despair that things were never going to get better was overwhelming, and what had been fleeting thoughts of suicide suddenly crystallized into a plan. I even had the music I wanted to play. It was a stupid and dangerous plan, one that could have inadvertently hurt other people and it was that thought that stopped me. I had no desire for anyone to be hurt because of me. Instead, I called the National Suicide Prevention Lifeline3 (1-800-273-8255, or text the 2-letter abbreviation for your state to 741741).

I was in my car in a parking lot and they told me to stay where I was until the crisis team found me. The police showed up and asked me a few questions before taking me off to a crisis center for evaluation. At the crisis center, I was handcuffed to be taken inside. My shame and humiliation, already at a high level, increased dramatically.

Inside the crisis center, it was a chaotic scene. Most of the people there were either drunk or high. The staff were nice but seemed harried and overstretched. Eventually, I was assessed and referred to a local hospital for inpatient treatment. The whole thing took hours and I got no sleep that night. The next day I was distressed and scared and nobody was telling me what was happening. My husband was desperately trying to get in contact with me but they had my cellphone and nobody would tell him anything or let him see me. I understand why, but it was very difficult for him.

Despite the rough beginning, it was exactly what I needed. Enclosed in this cocoon where the outside world could not penetrate, I could concentrate on myself for a while. I spent about a week in the hospital, and now I am out again, I’m looking at the world with new eyes.

Maybe you’d argue I’m oversensitive, but every time someone uses suicide hyperbolically in casual conversation, it hurts me. My throat clogs and my eyes burn. Because now I understand what it means to truly want to die.

If someone you know (or a celebrity) dies by suicide:

Don’t say you never expected it. The truth is, you have no idea. Some people, like me, are very good at faking it.

Don’t tell a suicidal person they have so much to live for. It’s not as helpful as you might think.

Don’t call suicide selfish. I used to think this but that’s because I didn’t understand. A depressed person often believes their death would be beneficial to the people in their life because they feel like a burden.

If someone in your life has depression:

Be supportive. That means being understanding if they don’t want to socialize, or aren’t feeling chatty. Be willing to listen if they want to talk, but don’t ask them how they’re feeling every 5 minutes.

Encourage them to seek help. There are resources out there, although they’re terribly overstretched. Reference 3 can help you find local resources.

Things have gotten better for me. My psychiatrist has added another medication, I’m going to start attending group therapy as well as my weekly individual therapy sessions and I’m going to try transcranial magnetic stimulation4. The new medication is already helping, and I’m investing in some wellness measures as well. I’m grateful to everyone who has been helping me. It’s still a daily battle and I’m a long way from winning this war, but now at least, I have hope.

  1. www.nimh.nih.gov/…
  2. afsp.org/…
  3. suicidepreventionlifeline.org
  4. www.mayoclinic.org/…

Why Using The Words ‘Committed Suicide’ Is Only Making Things Worse

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Someone sitting on the ground holding their head, mental health

By using the word ‘committed,’ we cast suicide in an immoral or illegal light. (Photo: songpholt/Shutterstock)

There’s little doubt that language — the words we use and how we use them — has a profound influence on culture. Over time, some words even burrow so deeply into our collective mindset that they change the way we think.

As Antonio Benítez-Burraco writes in Psychology Today, “Languages do not limit our ability to perceive the world or to think about the world, but they focus our perception, attention, and thought on specific aspects of the world.”

Different words spoken in different languages don’t just dress the same concept. They shape and often redefine that concept — imparting meaning as much as they describe it.

When it comes to language, we’ve got a lot wrapped up in the wrapping, particularly when it comes to very sensitive concepts like the taking of one’s own life.

To describe that act, we’re still using the term “committed suicide.”

And while the words may sound cold and clinical, they are, in fact, anything but sterile.

They’re loaded with meaning — in the worst possible way. Think about things that are “committed”: fraud, adultery, murder, sin.

In our society, when something is committed, that something by default is a bad thing. (When was the last time you heard about two people falling in love and “committing marriage?”)

Suicide, while inarguably a bad thing, is a lot more complex than tax evasion. It’s more like life evasion. Or at least, the need to escape from overwhelming stress and trauma. It’s often inextricably entwined with mental health.

So why heap more scorn on people battling those devastating issues? Why frame suicide as an immoral act?

“The term ‘committed suicide’ is damaging because for many, if not most, people it evokes associations with ‘committed a crime’ or ‘committed a sin’ and makes us think about something morally reprehensible or illegal,” Jacek Debiec, a professor at the University of Michigan’s department of psychiatry, tells the Huffington Post.

There are alternatives. Mental health professional suggest skirting the stigma-fraught word “committed” entirely. Some lean towards the term “completed suicide,” although that seems to introduce another wholly unwelcome meaning.

“Think of the sense of accomplishment you feel when you complete a big project. Then think of the disappointment you feel when you don’t,” writes University of Denver professor Stacey Freedenthal.

“Completion is good, and suicide isn’t.”

Indeed, that may swing the pendulum too hard in the destigmatizing direction. Freedenthal, like many mental health experts, suggests simply getting rid of the troublesome “committed” and simply saying “killed by suicide.”

Makes sense, doesn’t it? And yet, we’re still largely stuck on that victim-blaming classic: committed suicide.

The irony here? We all agree that mental health is something that improves when we talk about it. But the acme of mental distress — suicide — is so steeped in immorality and even criminality, who dares talk about it?

Someone holding up a sign that reads, 'Help'Stigmas surrounding mental health often prevent people from seeking the help they need. (Photo: Srdjan Randjelovic/Shutterstock)

And maybe that’s why the suicide rate is surging. It’s the affliction that dare not speak its name — even as we need to talk about it now, more than ever. In the U.S., suicide was the 10th leading cause of death in 2016, claiming some 45,000 lives, according to the Centers for Disease Control and Prevention. More alarmingly, suicide was the second leading cause of death among individuals between the ages of 10 and 34.

But suicide may also be the only major disease that’s entirely preventable. Communication can be a powerful vaccine.

“Suicide is not a sin and is no longer a crime, so we should stop saying that people ‘commit’ suicide,” concluded researcher Susan Beaton in a 2013 paper. “We now live in a time when we seek to understand people who experience suicidal ideation, behaviours and attempts, and to treat them with compassion rather than condemn them.”

So maybe it’s time we stopped stigmatizing the act, and, by doing so, encouraged the kinds of conversations that save lives.

No one is perpetrating a crime here. The only crime, in fact, is that we’re still using language to cast it as one.

If you’re struggling with thoughts of self harm or suicide, there is help. For a list of phone numbers and resources across the U.S., visit the U.S. National Suicide & Crisis Hotlines webpage.

We Should Be Talking About Suicide — Here’s How to Do It Correctly

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By De Elizabeth and Lauren Rearick

As the tenth leading cause of death in the United States, suicide remains an ongoing topic in the mental health community, and around the world. With more than 43 million American adults currently dealing with mental illness, the importance of how we talk about suicide has once again come to light in the wake of three highly publicized deaths, all within the span of a week: those of Sydney Aiello, a former student at Marjory Stoneman Douglas High School in Parkland, Florida; a second, currently unnamed Parkland student; and Jeremy Richman, a 49-year-old father of a Sandy Hook Elementary School shooting victim.

All three deaths were reported on within the same week, but it’s not possible to know if there was a link between each incident beyond the fact that all three people were impacted by gun violence at some point in their lives. For his part, Richman founded the Avielle Foundation in honor of his daughter, who was among the 20 students and 7 adults killed at Sandy Hook in 2012. The non-profit organization was created to “prevent violence by building compassion through brain research, community engagement, and education.” And Sydney’s mother, Cara Aiello, told CBS Miami that her daughter had struggled with post-traumatic stress disorder following the 2018 attack at MSDHS, noting Sydney remained fearful of encountering another act of gun violence. She added that she wants her daughter’s struggles to help others, and she reminded community members to seek help if they needed it.

Finding that help isn’t always easy, especially for young people with limited resources. “About halfway through my freshman year of college, I realized I was struggling with mental health,” a 20-year-old named Delaney told MTV News. Although her school provided counseling, there was a waitlist. “I was advised to go out into the community to seek out a therapist,” she explained. “I was fortunate enough to be able do do that, but I know that not everyone is.” Most mental health programs prioritize helping those with suicidal ideations if they can, but people should feel empowered to seek help at the first sign of stress, whether minor or dire.

And to point to PTSD, or one specific incident alone, as the sole cause of a suicide can dangerously oversimplify suicide and suicidal ideation, and leave many gun violence survivors feeling hopeless. Surviving a school shooting can certainly be disruptive to someone’s mental health, and such an event can understandably cause lasting trauma. However, ahost of issues contribute to instances of suicide, which is why it is imperative that those dealing with suicidal ideation feel safe enough to ask for help, and that our society at large is better equipped to talk about suicide, and provide support and resources to those experiencing ideations.

“What we know to be true is that if somebody dies by suicide in a specific community … then the other folks in that community are at a much higher risk for also dying by suicide. And that’s why the word contagion comes up in this conversation,” Chris Bright, Director of Public Training for The Trevor Project, told MTV News. “For vulnerable populations … the exposure to inappropriate ways of talking about suicide or inappropriate depictions of suicide puts them at a higher risk for attempting suicide after that exposure.” For that reason, Trevor Project offers a variety of resources for young people who might be struggling with suicidal ideation, including both a phone and text hotline, as well as a chat service.

Melissa McCormick, a licensed mental health counselor in Longwood, Florida, also told MTV News that people should avoid sharing specific details of how someone died. “When someone can envision details of a traumatic event, they can imagine it more thoroughly, and are more likely to struggle with trauma responses,” McCormick said.

The three recent deaths have received a lot of media coverage, but not all reporting has been responsible, with many outlets using troubling language to describe the events. (MTV News is choosing not to link to the stories in question in order to minimize the chances of contagion.)

But the responsibility extends beyond reporters; through social media, we have the ability to share information instantaneously with followers and friends alike. While posting news stories of highly publicized suicides is often done in good faith, such efforts can sometimes have an adverse effect. We don’t know who within our online circles might be struggling, and stories that simply relay details of suicides without any hope or information for prevention can be hugely damaging, especially if dangerous language is used.

Both Bright and McCormick note that we should never use the phrase “committed suicide” when talking about someone’s death; rather, it’s important to say “died by suicide,” as HuffPost points out.

Bright posed the question: “When do you normally hear the phrase ‘committed?’ The answer is, you usually hear it in regards to a crime… You don’t often hear it in ways that have positive connotations. So when you use that word, you’re further stigmatizing something that is already hard to talk about.”

“Died by suicide,” in opposition, is neutral. “It’s just a very factual way to talk about something that isn’t stigmatized,” Bright said. “It doesn’t use words that make people afraid.” McCormick added that making these conscious word choices “shows the importance of shifting our perspective on suicide.”

None of this is to say that we shouldn’t discuss suicide at all; in fact, it’s just the opposite. We must discuss it, both in order to continue to lower stigma, but also to reassure other people that they aren’t alone.

And that’s why it’s more crucial than ever to have the proper tools to discuss suicide safely and productively. Our words matter, and by using the right language, we can create a safer environment for those struggling with suicidal ideation. Responsible conversations can empower people to ask for help; sometimes, it’s just as simple as sharing information about suicide prevention, or telling a friend that you’re there to listen. But it’s also crucial that people feel they have access to seek professional help should they need it, without stigma; in some cases, you might not be equipped to help someone in the way a counselor or a doctor can, and the best way you can be there them is by supporting them while they find the care they need.

“Trauma and loss don’t just go away, you have to learn to live with it through getting support,” David Hogg, a member of March for Our Lives, the student-led organization dedicated to gun reform, wrote on Twitter. “We should be spending all the money politicians want to spend on arming teachers on something that will actually save lives, like mental health care in our schools.”

There are also online resources available for people experiencing suicidal ideation, and those who want to learn more about how to properly discuss suicide. Half of Us,  The National Suicide Prevention Lifeline, and the Trans Lifeline also offer support services through telephone hotlines (call 1-800-273-TALK), while the American Foundation for Suicide Prevention and Suicide Awareness Voices of Education offer online resources. The National Alliance for Mental Illness helpline can help provide answers to questions about treatment options; though they do not provide therapy or recommend individualized recommendations for therapists in your area, they may be able to help point callers in the right direction. The American Psychological Association also providesresources and databases for those seeking professional help.

“Young people should be able to talk about suicide,” Bright emphasized to MTV News. “They should be able to talk about their feelings and the things that they have going on in their lives, and they want to be able to identify the friends who are going to handle that type of conversation with respect, dignity, and support.

If you or someone you know is struggling with their emotional health, head to halfofus.com for ways to get help.

Why More Men Than Women Die By Suicide

Author Article

Six years ago my brother took his own life. He was 28 years old.

Tragically, suicide is not as rare as one might think. In 2016, the last year global data is available from the World Health Organization (WHO), there were an estimated 793,000 suicide deaths worldwide.Most were men.

In the UK, the male suicide rate is its lowest since 1981 – 15.5 deaths per 100,000. But suicide is still the single biggest killer of men under the age of 45. And a marked gender split remains. For UK women, the rate is a third of men’s: 4.9 suicides per 100,000.

It’s the same in many other countries. Compared to women, men are three times more likely to die by suicide in Australia, 3.5 times more likely in the US and more than four times more likely in Russia and Argentina. WHO’s data show that nearly 40% of countries have more than 15 suicide deaths per 100,000 men; only 1.5% show a rate that high for women.

The trend goes back a long way. “As long as we’ve been recording it, we’ve seen this disparity,” says psychologist Jill Harkavy-Friedman, vice-president of research for the American Foundation for Suicide Prevention, a health organisation that supports those affected by suicide.

Suicide is a hugely sensitive, complex issue with a tangled multitude of causes – and the very nature of a death by suicide means we can never fully know the reasons behind it.

Still, as mental health awareness has grown, there is greater public understanding about potential contributing factors. One of the questions that has persisted, though, regards this gender gap. It seems especially large given that women tend to have higher rates of depression diagnoses.

Why are men struggling? (Credit: Getty)

Why are men struggling? (Credit: Getty)

Women also are even more likely than men to attempt suicide. In the US for example, adult women in the US reported a suicide attempt 1.2 times as often as men. But male suicide methods are often more violent, making them more likely to be completed before anyone can intervene. Access to means is a big contributing factor: in the US for example, six-in-10 gun owners are men – and firearms account for more than half of suicides.

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Men may also choose these methods because they’re more intent on completing the act. One study of more than 4,000 hospital patients who had engaged in self-harm found, for example, that the men had higher levels of suicidal intent than the women.

Why are men struggling – and what can be done about it?

Risk factors

One key element is communication. It’s too simplistic to say women are willing to share their problems and men tend to bottle them up. But it is true that, for generations, many societies have encouraged men to be “strong” and not admit they’re struggling.

It often starts in childhood. “We tell boys that ‘boys don’t cry’,” says Colman O’Driscoll, former executive director of operations and development at Lifeline, an Australian charity providing 24-hour crisis support and suicide prevention services. “We condition boys from a very young age to not express emotion, because to express emotion is to be ‘weak’.”

Mara Grunau, executive director at the Centre for Suicide Prevention in Canada, points out it’s how we talk to our children and how we encourage them to communicate about themselves too: “Mothers talk way more to their girl children than their boy children… and they share and identify feelings” more, she says. “We almost expect women to be emotional.”

From a young age, we condition men to think that crying is a sign of weakness

From a young age, we condition men to think that crying is a sign of weakness (Credit: Getty)

But men may be less likely to admit when they feel vulnerable, whether to themselves, friends, or a GP. They also can be more reticent than women to see a doctor. A UK British Medical Journal study found general primary care consultation rates were 32% lower in men than women. (Consultation rates for depression, assessed by whether patients received antidepressant prescriptions, were 8% lower in men than women).

“Men seek help for mental health less often,” Harkavy-Friedman says. “It’s not that men don’t have the same issues as women – but they’re a little less likely to know they have whatever stresses or mental health conditions that are putting them at greater risk for suicide.”

Men seek help for mental issues less often (Credit: Getty)

Men seek help for mental issues less often (Credit: Getty)

If a person is not even cognisant they have a condition causing their distress, then they’re less aware anything could be done to help them. Only a third of people who take their own lives are in mental healthcare treatment at the time, says Harkavy-Friedman.

Dangerously, rather than seeking help through established channels, some men may attempt to “self-medicate”.

“There tends to be more substance use and alcohol use among males, which may just reflect the distress they’re feeling – but we know it compounds the issue of suicide,” says Harkavy-Friedman.

Indeed, men are nearly twice as likely as women to meet criteria for alcohol dependence. But drinking can deepen depression and increase impulsive behaviours and alcoholism is a known risk factor for suicide.

There tends to be more substance and alcohol use among men

There tends to be more substance and alcohol use among men, which can be a dangerous attempt to ‘self-medicate’ (Credit: Getty)

Other risk factors can be related to family or work. When there’s an economic downturn that results in increased unemployment, for example, there tends to be an associated increase in suicide – typically 18-24 months after the downturn. One 2015 study found that for every 1% increase in unemployment there is a 0.79% increase in the suicide rate.

Having to worry more about finances or trying to find a job can exacerbate mental health issues for anyone. But there are elements of social pressure and identity crisis, too. “We’re brought up our entire lives to judge ourselves in comparison with our peers and to be economically successful,” says Simon Gunning, the CEO of Campaign Against Living Miserably (Calm), a UK-based award-winning charity dedicated to preventing male suicide. “When there are economic factors we can’t control, it becomes very difficult.”

There can also be a spiralling effect. In the US, for example, health insurance often is linked to employment. If a person is being treated for depression or substance use, they may lose that care when they lose their job.

Another risk factor is a sense of isolation, as physician Thomas Joiner writes in his book Why people die by suicide. This can manifest itself in every walk of life. The outwardly successful professional who has prioritised career advancement to the detriment of all else, including social relationships, may find himself “at the top of the pyramid, alone,” says Grunau.

One potential risk factor is a sense of isolation (Credit: Getty)

One potential risk factor is a sense of isolation (Credit: Getty)

Of course, it is important to remember that while an external factor might precipitate suicidal behaviour in a person who’s already at risk, it’s never the sole cause.

“Millions of people lose their jobs, almost all of us have lost a relationship and we don’t end up dying by suicide,” says Harkavy-Friedman.

Possible solutions

There are no straightforward fixes for an issue this complex. But a number of programmes, policies and nonprofits are making inroads.

In Australia, for example, mental health and suicide prevention groups are trying to shift the cultural paradigm. One initiative that has gained traction is RU OK? day, which encourages people to support those struggling with life by starting a conversation. Another approach is the “shoulder-to-shoulder principle” – encouraging men to talk while otherwise occupied, like watching football or going for a bike ride. Mates in Construction, a training and support programme, raises awareness of high suicide rates in the industry and shows construction workers how they can help be part of the solution.

Overall, there’s an emphasis on “making it okay for men to talk about how they’re feeling – and for that to be acknowledged as a sign of strength”, says O’Driscoll.

In Australia, the programme Mates in Construction is raising awareness

In Australia, the programme Mates in Construction is raising awareness of the industry’s high suicide rates (Credit: Getty)

Technology is presenting new options too. Not everyone might want to unburden themselves to another person, even over a helpline. But artificial intelligence – such as chatbots – might allow a vulnerable person to communicate and get the help they need without fear of judgement.

Another strategy is to focus on the impact a suicide has on loved ones. Calm’s campaign Project 84 – so named to represent the 84 men who die weekly by suicide in the UK – stresses the devastation left behind. This can counteract the sense by some men that “it’s the ‘right’ thing to take themselves out of the equation”, Gunning says. He emphasises: “Staying is always an option.”

Staying is always an option (Credit: Getty)

Staying is always an option (Credit: Getty)

Other solutions have to do with simply making suicides more difficult to complete. After barriers were installed on the Clifton suspension bridge in Bristol, England, for example, one study found that deaths from jumping the bridge halved – and there was no evidence that suicides from jumping from other sites in the area increased in response.

Still, more work obviously has to be done.

O’Driscoll compares how there’s often more attention paid to reducing road fatalities than to suicide prevention, despite suicide taking more lives. In Australia, for example, the overall suicide rate in 2015 was 12.6 per 100,000 – the highest rate in more than a decade –compared to 4.7 per 100,000 for road deaths.

More research is needed too. “Clearly,” says Harkavy-Friedman, “there are differences between women and men in our biology, our hormonal structure and the way our brains develop and function.” But men and women are often studied together, and despite attempts to statistically control for the differences, it is not enough. She believes we need to study men and women separately.

But there are positive signs. Harkavy-Friedman notes a huge change on the professional side, recalling at the beginning of her career it was hard to get a paper accepted on suicide because it was thought that you couldn’t prevent suicide, she says. Now, we know that to be wrong.

She also points to more government involvement than ever before. On World Mental Health Day in 2018, the UK government announced its first suicide prevention minister. “The UK has been ahead of the game, every step along the way,” she says, adding that she believes there has been a decrease in the UK suicide rate because a national strategy has been implemented.

The situation is getting better, but there is more work to be done (Credit: Getty)

The situation is getting better, but there is more work to be done (Credit: Getty)

For Grunau too, the situation is unquestionably getting better. “We are seeing momentum we’ve never seen,” she says. “You can actually talk about suicide and people still flinch, but they’re more willing to have the conversation.”

That has had positive effects, as the decline in UK suicides shows. Still, it’s not enough. Any life lost to suicide – whether male or female – is a life too many.

More American Millennials Are Experiencing Depression and Suicide

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 | THINKSTOCK

More young adults in the U.S. are experiencing mental health issues, and digital media usage might be partly to blame, said a new study.

Between 2005 and 2017, the rate of adolescents reporting symptoms consistent with major depression in the last 12 months jumped 52 percent, according to the study published Thursday in the peer-reviewed Journal of Abnormal Psychology, run by the American Psychological Association.

The study found a 63 percent increase in young adults between the ages of 18 and 25 reporting symptoms of depression between 2009 and 2017. It also showed significant increases in the rates of young adults who reported serious psychological distress and suicidal thoughts or suicide-related outcomes during similar time periods.

Researchers also note there is no similar increase among older adults during corresponding time periods.

Jean Twenge, lead author of the study and professor of psychology at San Diego State University, said digital media might play a role in the increase among young adults.

“Cultural trends in the last 10 years may have had a larger effect on mood disorders and suicide-related outcomes among younger generations compared with older generations,” Twenge said in a statement.

Ian Gotlib, a professor of psychology at Stanford University and director of the Stanford Neurodevelopment, Affect, and Psychopathology (SNAP) Laboratory, said genetics can be ruled out as a potential factor because the increase in reports of mental health issues happens too quickly.

“It’s correlational, but what’s increased with depression is the use of social media with kids,” said Gotlib, who was not affiliated with the study. “And I don’t think that should be underestimated.”

A Pew Research survey released last month revealed 70 percent of teens believe anxiety and depression are critical issues among peers, even more than bullying or drug and alcohol use.

Several other studies have found a rise in depression among teens and young adults, leaving many experts to wonder how big a role social media might contribute.

“These results suggest a need for more research to understand how digital communication versus face-to-face social interaction influences mood disorders and suicide-related outcomes and to develop specialized interventions for younger age groups,” Twenge said.

Gotlib said having conversations with your kids is a good starting point, as well as paying attention to their digital media habits. “I would just watch for what looks to be an inability to not be with your phone,” he said. “It doesn’t necessarily mean depression but it has that potential.”

Read more at usatoday.com.

Nearly Half Of People With Depression Appear Happy – This Is Why Ignoring That Can Be So Dangerous

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The term “smiling depression” – appearing happy to others while internally suffering depressive symptoms – has become increasingly popular. Articles on the topic have crept up in the popular literature, and the number of Google searches for the condition has increased dramatically this year. Some may question, however, whether this is actually a real, pathological condition.

While smiling depression is not a technical term that psychologists use, it is certainly possible to be depressed and manage to successfully mask the symptoms. The closest technical term for this condition is “atypical depression”. In fact, a significant proportion of people who experience a low mood and a loss of pleasure in activities manage to hide their condition in this way. And these people might be particularly vulnerable to suicide.

It can be very hard to spot people suffering from smiling depression. They may seem like they don’t have a reason to be sad – they have a job, an apartment and maybe even children or a partner. They smile when you greet them and can carry pleasant conversations. In short, they put on a mask to the outside world while leading seemingly normal and active lives.

Inside, however, they feel hopeless and down, sometimes even having thoughts about ending it all. The strength that they have to go on with their daily lives can make them especially vulnerable to carrying out suicide plans. This is in contrast to other forms of depression, in which people might have suicide ideation but not enough energy to act on their intentions.

Although people with smiling depression put on a “happy face” to the outside world, they can experience a genuine lift in their mood as a result of positive occurrences in their lives. For example, getting a text message from someone they’ve been craving to hear from or being praised at work can make them feel better for a few moments before going back to feeling low.

Other symptoms of this condition include overeating, feeling a sense of heaviness in the arms and legs and being easily hurt by criticism or rejection. People with smiling depression are also more likely to feel depressed in the evening and feel the need to sleep longer than usual. With other forms of depression, however, your mood might be worse in the morning and you might feel the need for less sleep than you’re normally used to.

Smiling depression seems to be more common in people with certain temperaments. In particular, it is linked to being more prone to anticipate failure, having a hard time getting over embarrassing or humiliating situations and tending to ruminate or excessively think about negative situations that have taken place.

Women’s Health magazine captured the essence of smiling depression – the façade – when it asked women to share pictures from their social media and then to recaption them on Instagram with how they really felt in the moment they were taking the picture. Here are some of their posts .

It is difficult to determine exactly what causes smiling depression, but low mood can stem from a number of things, such as work problems, relationship breakdown and feeling as if your life doesn’t have purpose and meaning.

It is very common. About one in 10 people are depressed, and between 15 per cent and 40 per cent of these people suffer from the atypical form that resembles smiling depression. Such depression often starts early in life and can last a long time.

If you suffer from smiling depression it is therefore particularly important to get help. Sadly, though, people suffering from this condition usually don’t, because they might not think that they have a problem in the first place – this is particularly the case if they appear to be carrying on with their tasks and daily routines as before. They may also feel guilty and rationalise that they don’t have anything to be sad about. So they don’t tell anybody about their problems and end up feeling ashamed of their feelings.

So how can you break this cycle? A starting point is knowing that this condition actually exists and that it’s serious. Only when we stop rationalising away our problems because we think they’re not serious enough can we start making an actual difference. For some, this insight may be enough to turn things around, because it puts them on a path to seeking help and breaking free from the shackles of depression that have been holding them back.

Meditation and physical activity have also been shown to have tremendous mental health benefits. In fact, a study done by Rutgers University in the US showed that people who had done meditation and physical activity twice a week experienced a drop of almost 40 per cent in their depression levels only eight weeks into the study. Cognitive behavioural therapy, learning to change your thinking patterns and behaviour, is another option for those affected by this condition.

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And finding meaning in life is of utmost importance. The Austrian neurologist Viktor Frankl wrote that the cornerstone of good mental health is having purpose in life. He said that we shouldn’t aim to be in a “tensionless state”, free of responsibility and challenges, but rather we should be striving for something in life. We can find purpose by taking the attention away from ourselves and placing it onto something else. So find a worthwhile goal and try to make regular progress on it, even if it’s for a small amount each day, because this can really have a positive impact.

We can also find purpose by caring for someone else. When we take the spotlight off of us and start to think about someone else’s needs and wants, we begin to feel that our lives matter. This can be achieved by volunteering, or taking care of a family member or even an animal. Feeling that our lives matter is ultimately what gives us purpose and meaning – and this can make a significant difference for our mental health and well-being.

It’s pretty scary when you are in a stage what I call the “Blah Factor.” I say this because when you don’t feel anything you become numb to nothing. You don’t care and with a mental disorder like manic depression that blah blah feeling can lead to despair. What to do when you are face with the black factor? Hello, I’m Sunny Larue blogger, writer, storyteller, music lover and martini admirer. My blogs are about self-discovery with a positive vibe. My stories are about love and loss inspired by real life events. And this is the Blah Factor.

via THE BLAH FACTOR — Sunny Larue

What’s It Like to Be Suicidal? This Is My Experience, and How I Got Through It

Author Article

How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

At times, I’ve struggled with suicidal thoughts, even on a weekly basis.

Sometimes I’m able to ignore them. I might be driving to meet a friend for brunch and briefly think about driving my car off the road. The thought might catch me off-guard, but it quickly passes through my mind and I go about my day.

But other times, these thoughts stick around. It’s like a huge weight is dropped onto me, and I’m struggling to get out from underneath it. I suddenly get an intense urge and desire to end it all, and the thoughts can start to overwhelm me.

In those moments, I’m convinced I’ll do anything to get out from under that weight, even if it means ending my life. It’s like there’s a glitch in my brain that’s triggered and my mind goes haywire.

Even if that glitch is actually temporary, it can feel like it will last forever
With time, though, I’ve become more aware of these thoughts and found ways to manage when things get tough. It’s taken a lot of practice, but simply being aware of the lies my brain tells me when I’m suicidal helps to combat them.

If this last year has taught me anything, it’s that no matter what depression tells you, there’s always hope.
Here are four ways my suicidal ideation shows up, and how I’ve learned to cope.

1. When it feels impossible to focus on anything other than my pain, I look for a distraction
When I’m suicidal, I struggle to listen to reason — I only care about relief. My emotional pain is intense and overwhelming, so much so that it’s hard to concentrate or think about anything else.

If I find that I can’t focus, I sometimes turn to my favorite TV shows, like “Friends” or “Seinfeld.” They bring me a sense of comfort and familiarity that I need in those times, and it can be a great distraction when reality gets to be too much. I know all of the episodes by heart, so I’ll usually lay there and listen to the dialogue.

It can help me pull back from my suicidal thoughts and refocus on getting through another day (or just another hour).

Sometimes all we can do is wait for the thoughts to pass and then regroup. Watching a favorite show is a great way to pass the time and keep ourselves safe.
2. When I’m convinced that everyone would be better off without me, I challenge those thoughts
My loved ones would never want me to die by suicide, but when I’m in crisis, it’s hard for me to think clearly.

There’s a voice in my head that tells me how much better off my parents would be if they didn’t need to support me financially, or if my friends didn’t have to take care of me when I’m at my worst. No one would have to answer the late-night calls and texts or come over when I’m in the midst of a breakdown — isn’t that better for everyone?

But the reality is, I’m the only one that thinks that.

My family wouldn’t recover if I died, and my loved ones know that being there for someone when things get tough is a part of life. They would rather answer those late-night calls than lose me forever, even if I struggle to believe that in the moment.

When I’m in this headspace, it usually helps to spend some time with Petey, my rescue dog. He’s my best friend and has been there through it all this past year. On most mornings, he’s the reason I get out of bed.

I know he needs me to stick around and take care of him. Since he was already abandoned once, I could never leave him. Sometimes that thought alone is enough to keep me hanging on.

Challenge your thoughts about loved ones being better off without you by not only thinking through the reality, but spending time with loved ones — pets included.
3. When I struggle to see my other options, I reach out to my therapist — or I go to sleep
Being suicidal is, in some ways, a form of total emotional exhaustion. I’m tired of having to force myself out of bed each morning, having to take all of these medications that don’t seem to be working, and crying constantly.

Struggling with your mental health day in and day out is very tiring, and when I’ve reached my limit, it can feel as though I’m just too broken — that I need a way out.

It helps to check in with my therapist, though, and be reminded of all of the progress I’ve made so far.
Instead of focusing on the step backward, I can refocus on the two steps forward I took just before that — and how other forms of treatment I haven’t tried yet can help me get back on my feet again.

On the nights when the ideations are most intense and it’s too late to check in with my therapist, I take a couple of Trazadone, which are antidepressants that can be prescribed as a sleep aid (Melatonin or Benadryl can also be used as sleep aids, and purchased over-the-counter).

I only take them when I feel unsafe and don’t want to make any impulsive decisions, and it helps to ensure that I make it through the night. In my experience, those impulsive decisions would’ve been the wrong choice, and I almost always wake up the next morning feeling a little better.

4. When I feel completely and utterly alone, I push myself to reach out
When I’m dealing with suicidal ideations, it can feel like no one understands what I’m going through, but I also don’t know how to articulate it or ask for help.

It’s hard enough to try and explain to someone why you feel the desire to die, and sometimes, even opening up just leads to feeling misunderstood.

Even if it can feel awkward or scary at first, it’s important to reach out in these moments and keep yourself safe
If I’m feeling suicidal, I know the worst thing I can do is try to go it alone. It took me a long time to work up the courage to call someone when I was feeling this way, but I’m glad I did. Calling my mom and best friends has saved my life multiple times, even if in the moment I wasn’t convinced it would.

Sometimes you have to ignore the part of your brain that tells you it isn’t worth it, and pick up the phone anyway
Now when I’m feeling suicidal, I call a friend I trust or my parents.
If I don’t feel like talking, just having someone on the other side of the phone can still be comforting. It reminds me that I’m not alone, and that I (and the choices that I make) matter to someone.

If you don’t feel comfortable talking to a friend, text the crisis hotline by texting HOME to 741741. I’ve done this a few times, and it’s nice to just get my mind off things by texting with a compassionate person.

When you’re in a depressed state, you’re not in a position to make permanent decisions, especially when there’s no one there to offer perspective. After all, depression doesn’t just affect our moods — it can affect our thoughts, too.

Suicidal ideation can be extremely scary, but you’re never alone and you’re never without options.

If you’ve run out of coping tools and you have a plan and an intent, please call 911 or go to the nearest hospital. There’s absolutely no shame in that, and you deserve to be supported and safe.

If this last year has taught me anything, it’s that no matter what depression tells you, there’s always hope. No matter how painful it can be, I always find that I’m stronger than I think I am.

And chances are pretty good that if you’ve made it this far, you are, too.

What It’s Really Like Going Through a Deep, Dark Depression

Author Article

How we see the world shapes who we choose to be — and sharing compelling experiences can frame the way we treat each other, for the better. This is a powerful perspective.

In early October 2017, I found myself sitting in my therapist’s office for an emergency session.

She explained that I was going through a “major depressive episode.”

I’d experienced similar feelings of depression in high school, but they were never this intense.

Earlier in 2017, my anxiety had started to interfere with my daily life. So, for the first time, I’d sought out a therapist.

Growing up in the Midwest, therapy was never discussed. It wasn’t until I was in my new home of Los Angeles and met people who saw a therapist that I decided to try it myself.

I was so lucky to have an established therapist when I sunk into this deep depression.

I couldn’t imagine having to find help when I could barely get out of bed in the morning.

I probably wouldn’t have even tried, and I sometimes wonder what would’ve happened to me if I hadn’t sought professional help before my episode.

I’ve always had mild depression and anxiety, but my mental health had rapidly declined that fall.
It would take me close to 30 minutes to coax myself out of bed. The only reason I would even get up was because I had to walk my dog and go to my full-time job.

I’d manage to drag myself into work, but I couldn’t concentrate. There’d be times when the thought of being in the office would be so suffocating that I’d go to my car just to breathe and calm myself down.

Other times, I’d sneak into the bathroom and cry. I didn’t even know what I was crying about, but the tears wouldn’t stop. After ten minutes or so, I would clean myself up and return to my desk.

I’d still get everything done to make my boss happy, but I’d lost all interest in the projects I was working on, even though I was working at my dream company.

My spark just seemed to fizzle.
I’d spend each day counting down the hours until I could go home and lie in my bed and watch “Friends.” I’d watch the same episodes over and over. Those familiar episodes brought me comfort, and I couldn’t even think about watching anything new.

I didn’t completely disconnect socially or stop making plans with friends the way many people expect people with severe depression to act. I think, in part, it’s because I’ve always been an extrovert.

But while I’d still show up to social functions or drinks with friends, I wouldn’t really be there mentally. I’d laugh at the appropriate times and nod when needed, but I just couldn’t connect.

I thought I was just tired and that it would pass soon.

3 Ways I’d Describe Depression to a Friend
It’s like I have this deep pit of sadness in my stomach that I can’t get rid of.
I watch the world go on, and I continue to go through the motions and plaster a smile on my face, but deep down, I’m hurting so much.
It feels like there is a huge weight on my shoulders that I can’t shrug off, no matter how hard I try.
The switch from deep depression to considering suicide
Looking back, the change that should have signaled to me that something was wrong was when I started to have passive suicidal thoughts.

I’d feel disappointed when I woke up each morning, wishing I could end my pain and sleep forever.
I didn’t have a suicide plan, but I just wanted my emotional pain to end. I’d think about who could take care of my dog if I died and would spend hours on Google searching for different suicide methods.

A part of me thought everyone did this from time to time.

One therapy session, I confided in my therapist.

A part of me expected her to say that I was broken and she couldn’t see me anymore.

Instead, she calmly asked if I had a plan, to which I responded no. I told her that unless there was a foolproof suicide method, I wouldn’t risk failing.

I feared the possibility of permanent brain or physical damage more than death. I thought it was completely normal that if offered a pill that guaranteed death, I would take it.

I now understand those aren’t normal thoughts and that there were ways to treat my mental health issues.

That’s when she explained that I was going through a major depressive episode.

Reaching out for help was the sign that I still wanted to live
She helped me make a crisis plan that included a list of activities that help me relax and my social supports.

My supports included my mom and dad, a few close friends, the suicide text hotline, and a local support group for depression.

My Crisis Plan: Stress-Reduction Activities
guided meditation
deep breathing
go the gym and get on the elliptical or go to a spin class
listen to my playlist that includes my all-time favorite songs
write
take my dog, Petey, on a long walk
She encouraged me to share my thoughts with a few friends in LA and back home so they could keep an eye on me between sessions. She also said talking about it might help me feel less alone.

One of my best friends responded perfectly by asking, “What can I do to help? What do you need?” We came up with a plan for her to text me daily to just check in and for me to be honest no matter how I was feeling.

But when my family dog died and I found out that I had to switch to a new health insurance, which meant I might have to find a new therapist, it was too much.

I’d hit my breaking point. My passive suicidal thoughts turned active. I started to actually look into ways I could mix my medications to create a lethal cocktail.

After a breakdown at work the next day, I couldn’t think straight. I no longer cared about anyone else’s emotions or well-being, and I believed they didn’t care about mine. I didn’t even really understand the permanency of death at this point. I just knew that I needed to leave this world and unending pain.

I truly believed that it would never get better. I now know I was wrong.

I took off the rest of the day, intending to go through with my plans that night.

However, my mom kept calling and wouldn’t stop until I answered. I relented and picked up the phone. She asked me repeatedly to call my therapist. So, after I got off the phone with my mom, I texted my therapist to see if I could get an appointment that evening.

Unbeknownst to me at the time, there was still a little part of me that wanted to live and that believed she could help me get through this.
And she did. We spent those 45 minutes coming up with a plan for the next couple months. She encouraged me to take some time off to focus on my health.

I ended up taking the rest of the year off of work and went back home to Wisconsin for three weeks. I felt like a failure for having to stop working temporarily. But it was the best decision I ever made.

I started to write again, a passion of mine that I hadn’t had the mental energy to do for quite some time.

I wish I could say that the dark thoughts are gone and I’m happy. But the passive suicidal thoughts still come around more often than I want. However, there’s a little bit of fire still burning inside of me.
Writing keeps me going, and I wake up with a sense of purpose. I’m still learning how to be present both physically and mentally, and there are still times when the pain becomes unbearable.

I’m learning that this will likely be a lifelong battle of good months and bad months.

But I’m actually okay with that, because I know I have supportive people in my corner to help me continue fighting.

I wouldn’t have gotten through last fall without them, and I know they will help me get through my next major depressive episode too.

If you or someone you know is contemplating suicide, help is out there. Reach out to the National Suicide Prevention Lifeline at 800-273-8255.

Suicide Survivors Share Their Stories and Advice in These Photos

Author Article

Suicide rates in the United States have increased dramatically over the past 20 years. There are 129 deaths by suicide nationwide every day.Discussed less often, there are around 1.1 million attempts at suicide every year — or over 3,000 a day, on average — many of which do not end in death.Nevertheless, we often struggle to bring up suicidal thoughts with those we love, even when we know someone might be struggling, or we’re struggling ourselves.

I believe it isn’t that we don’t care, rather that we don’t have a common language to discuss such topics or an awareness of when we should reach out and how. We worry that we won’t say the right thing, or worse, that we’ll say something that’ll cause the person to act on their ideation.

In reality, asking someone directly about suicide is often a way to both help the person feel heard — and help them find the help and resources they need.

Too often discussions around suicide are controlled by those who have no personal experience with suicidal ideation or mental health.

SUICIDE PREVENTION’S MISSING VOICESWe rarely get to hear directly from those who have experienced suicidal ideation or survived a suicide attempt.

Hoping to shift that paradigm, Healthline teamed up with Forefront, a social impact center at the University of Washington that focuses on reducing suicide, empowering individuals, and building community.

Jennifer Stuber, the cofounder and director of Forefront, spoke about the program’s goals, sharing, “Our mission is to save lives [that would otherwise be] lost to suicide. The way that we think we’re going to get there is by simultaneously treating suicide as both a mental health and a public health issue.”

Stuber discussed the importance of every system, whether metal health care, physical health care, or education, having an understanding around suicide prevention and how to intervene if needed.

When asked what she’d say to those who are currently experiencing suicidal thoughts, Stuber said, “You can’t possibly realize how much you’d be missed if you weren’t here because of how badly you feel. There is help and hope available. It doesn’t always work the first time around, it might take several different tries at it, but your life is worth living even if it doesn’t feel like it now.”

For those who’ve attempted suicide, it’s often difficult to find spaces to tell their stories, or people willing to listen.

We wanted to hear directly from folks personally affected by suicide in order to give a face, name, and a voice to a much too common experience.

Gabe

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Gabe shares his experience with deep depression and suicidal thoughts, and how you can help a friend in need.

On their experience with mental illness

I feel like suicidality is something that’s been an inherent part my entire life.

I think that we live in a culture that values strength and perseverance and has this very naive belief that everyone is born in the same circumstances with the same bodies with the same chemicals in their brains that work the way they’re supposed to work.

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On recovering

It’s been ultimately just being lucky enough to have good enough people in my life that are willing to talk to me till 3 a.m. or give me advice and honest feedback on stuff.

For me, if I give it time, eventually I’ll will not feel like dying and that’s time — doing the best you can.

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On how you can help people experiencing suicidal ideation

Just listen to them. Be really honest and make good boundaries about what you can and can’t hear. Be wary of silence when you know that people have been doing bad, even when people seem to be doing good.

Simone

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“No one in my family talked about depression,” Simone tells Healthline. She also talks about the added pressure of being a professional who’s both black and a woman.

On learning about depression

I think almost every single day since I was 16 until maybe earlier this year, I thought about killing myself. I didn’t understand what depression was because no one ever talked about it.

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On being a black woman with depression

There have been plenty of days where I can’t physically move from depression… [but] I can’t call out, because I’m a black woman in a professional career. I’m not allowed to be depressed. I feel like I don’t get a pass.

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On how to respond to people who are experiencing depression

[Depression] can take on so many different forms [for different people]. So you can’t just apply a blanket solution.

Jonathan

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“I’ve had plenty of suicidal thoughts over the past seven years,” shares Jonathan, who has survived two suicide attempts.

On experiencing mental illness

I’ve been in the hospital three times for depression [and suicidal thoughts] and two times after suicide attempts in the last seven years.

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On the upside of mental illness challenges

There’s a stigma with mental illness. [But] I’m definitely not ashamed of my past! If I’d never dealt with this stuff, I wouldn’t be the person I am today and I wouldn’t have figured out who I am or the person I want to be.

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On advice to people who experience suicidal ideation

I think doing what makes you happy in life is the most important. That’s why I dress the way I want. I want to show others it’s okay. Don’t let other people tell you how you should live your life.

Tamar

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“We didn’t even know the term mental health. Nobody discussed it,” Tamar reflects about her childhood. She experiences suicidal thoughts and has survived a suicide attempt.

On mental illness, homelessness, and poverty

Because I grew up homeless and lived in a lot of homeless populations, we didn’t consider people sick. Drugs, alcohol, being suicidal, being schizophrenic — that was all just normal to us.

At the time it felt like the only way out was suicide. That I didn’t have any other options, there wasn’t anybody coming to save me, there was no system that was going to swoop in and take me away from the things that were causing me pain.

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On barriers to getting help for people living in poverty

I didn’t have a framework around what [it meant] to be mentally healthy, what [it meant] to get help.

Everybody says there’s help, get help. What does that mean? There was nobody who said, “Hey look, if you don’t have the money, here’s volunteer organizations.” I got no information when I was discharged from the hospital [for attempting suicide] besides don’t do it again, find help.

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On receiving affordable help for the first time (from Open Path)

It was the first time in my life that mental health was in reach.

It was the first time someone articulated to me that [following through on suicidal thoughts] wasn’t an imperative. I didn’t have to listen to it. That was life changing for me.

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On healing

It was actually when I decided to attempt sobriety that I first even learned that idea of having a toolbox of coping mechanisms and then starting to shift it. I didn’t know there were other ways to cope with these feelings that I had.

Having an alternative to feeling suicidal was a whole new world, it was a game changer. Even if I was too depressed to get off the floor, I had a mental health tool box and a language to talk to myself that I’d never had before.

I had to learn that too, that I had become one of my own abusers. That was a revelation. I was just following in the footsteps of everyone else… Yet I want to escape from the cycle.

Making those connections made me feel like my body is a worthy vessel and that I am worthy to live in it and stay on this planet.

Jo

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Jo lost her husband, who was a veteran, to suicide in 2011, when he was 45. She now works with veteran-run organizations that work to create a community for veterans in need.

On losing her husband to suicide

My husband had post-traumatic stress disorder (PTSD) and he also had what we call a “moral injury,” which I think is really important when talking about veterans. The way I’ve heard it described is that it’s basically having performed acts during your time of service that were required by your service but that go against and violate your own moral code or the code of society at large.

I think my husband suffered from tremendous guilt and neither he nor I had the tools to figure out how to process this guilt.

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Jo shares pictures of her husband and of their wedding.

On the isolation of survivors

About a year and a half after he died I quit my job as a lawyer and began to do photography because I needed something to do for my own healing.

What I experienced was profound isolation and that sense that you know, the world was out there, and everyone was moving on with their daily life, and I was on what I used to refer to as “planet my husband died by suicide.”

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On her life as a survivor of suicide

What I have come to discover is that it’s actually pretty common when you have a first-degree suicide loss like that to continue to have [suicidal] feelings yourself.

I know what’s helped me is spending a lot of time particularly with my veteran friends who have been trained in peer support and suicide prevention. It’s so helpful to have someone who can check in and say, “Are you thinking about harming yourself?” but to go further and say “Do you have a plan and do you have a date?”

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On advice to those affected by suicide

We are very antiseptic in the way we think about death and grief, particularly the taboos around suicide. When someone says “You’re very young to be a widow, what happened,” I’m always honest.

If he were around with what I know now, my message to him would have been, “You are loved unconditionally even if you never feel better than you do right now.”

There is always hope

Through organizations like Forefront, the National Suicide Prevention LifelineCrisis Text Line, and others, there’s movement towards shifting our approach to suicidality, reducing stigma, and breaking the silence.

Our hope is that the brave individuals you met above can help be a part of that movement and that breaking of silence, bringing light to a topic that is too often avoided, ignored, or stigmatized.

For those experiencing suicidality, you’re not alone, and there is always hope, even if it doesn’t feel like it now.

If you or a loved one are experiencing thoughts of suicide, please call the National Suicide Prevention Lifeline at 1-800-273-8255, check out this list of resources, or send a text here.


Caroline Catlin is an artist, activist, and mental health worker. She enjoys cats, sour candy, and empathy. You can find her on her website.

+ 4 sources

Medically reviewed by Timothy J. Legg, PhD, CRNPon February 14, 2019 New — Written by Caroline Catlin

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