Cue Cards for a Happier Mind

November 21, 2023

By Courtney Wise

Plus, a look at Sarah-Ashley Andrews, Philadelphia’s youngest school board member, who’s bringing her therapist’s lens to the work.

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Cue cards to snap your mind to better mental health

Correction: The original version of the article erred in saying in the second paragraph that Oppenheimer had been diagnosed with autism spectrum disorder. In fact, while a clinician did suggest to her that she is “somewhere on the spectrum,” he was referring to her overall mental health. She has never received an autism diagnosis.

Mental illness is a clever, hard-to-kill beast, and escaping it is akin to defeating a cluster of wild boar. With proper strategy and weaponry, the invasive species can be taken down. But armed with intelligence and tough, thick skin, it’s always poised to fight back. 

Certain mood disorders can be that way too, at least in Anh Oppenheimer’s experience. That’s where she’s an expert: Oppenheimer has endured anxiety and depression most of her life, with diagnoses of a rare mood disorder called cyclothymia, and one clinician suggested to her she may be “somewhere on the [mental health] spectrum.” High quality, accessible mental health care has kept her from perpetual critical illness. It has not, however, wholly eliminated mental episodes that at times leave her debilitated and struggling to get through a typical day. So in 2020, when the world grappled with the mental and physical horror of a virus it had never seen and did not understand, Oppenheimer created My Happier Mind Cue Cards to guide those lost in the depths of their minds’ darkness back toward the light. 

Part of what inspired the cards was the amnesia that creeps in when she is in the throes of a mental health episode. “I don’t remember that I ever was well; I just feel like this is my life,” Oppenheimer said. Periods of wellness are the same; in high times, she struggles to remember why she didn’t feel good. “So it’s sort of like those two parts of me – the well and the not-well parts – didn’t really know each other or talk to each other,” Oppenheimer said. “That’s when I realized I needed my well self to leave notes or breadcrumbs for my not well self to be able to remember the light. To remember that life isn’t 100 percent bad; it just feels that way when it is bad.”

Motherhood inspired the cards’ creation, too. As the parent of two sons, both now in college, she considered the possibility that they might be prone to similar mental health struggles on account of sharing her DNA. She figured the cue cards could offer them support at a moment’s notice, much earlier in life. 

It helps that the cards are easy to use and easy enough to keep on hand, with physical and digital decks as options. There are no rules of engagement, but Oppenheimer suggests approaching the deck by color. Yellow cards are for sunny days. Blue cards help on tough days and during off-kilter moods. (Among the blue cards lives her favorite, “Cherish Yourself Anyway.”) The purple cards are designed to help us if we’re in the midst of anxiety, and it’s good to keep an image of the red card pinned in your phone’s photos for easy access in case of emergency. Each one is printed with a reminder that even our worst feelings are temporary, along with an action that can be taken to move back toward our healthy self. And though Oppenheimer is not a psychiatrist, she did partner with San Francisco-based psychiatrist Douglas B. Anderson to ensure the cards’ validity.

“Fifty percent of depressive symptoms are left undiagnosed by physicians, in large part because they are fluctuating and present in so many disparate matters,” Anderson wrote in a letter discussing the cards and their usefulness. “Thus having a new tool to use in a casual, fun, and artistic manner allows readers to put many of their moods and feelings into a context that is not frightening, but one that directs them to better understanding and providing tools to cope with life’s stresses which have rarely been higher.”

To Oppenheimer’s delight, she’s received feedback that the cards are making an impact in the world. They’re a mainstay at Karma Club, a free teen community space housed inside of Marin County’s Northgate Mall. Her older son, who lives in London, even took them to a get-together with friends to support one who was navigating a rough breakup.

“We love them,” said Sally Newson, Karma Club’s founder and executive director. “It’s just great the way they’re organized by color… and I think [they’re] good for kind of distracting and taking your mind off of, you know, what you might be experiencing at the moment. And because they’re physical cards that you hold in your hands, I think they’re just more impactful than something that you might read about online.”

And in case you think the cards sound too, well, happy, Oppenheimer is on your wavelength. “I live in California so I know a thing or two about saccharin and woo-woo, hippies and rainbows, full moon dances and sparkles,” she writes in a recent blog. “I have a love/hate relationship with all the positivity. I practice it and shun it. Ridicule it and need it.” She has found that “one of the alleged sacchariny things that gets bandied about a lot, especially during the Thanksgiving season,” is the practice of gratitude. But even though it originally gave her “inner barstool maiden” a slight chill, she had found the research that links gratitude to greater happiness and better relationships is rock solid.

While the cards are directed toward anyone aged 14 to 114, Oppenheimer has a personal desire to get the cards into the hands of as many young people as possible. To that end, she’s reached out to high schools, colleges and universities in the hopes of donating decks to student groups and organizations that support youth mental health.

“I feel really strongly about that because it takes so many hurdles to admit, maybe you have a mental health problem that needs outside help. And then to find a therapist, and then to afford one – like, my god, it’s nuts how [many] can’t really afford mental health across the board,” Oppenheimer said. “And I know, it’s just one tool, but it takes lots of tools. This is one more.”

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How racism impacts the mental health of Black children

“Racism has a crucial impact on the mental health of Black youth, and the current mental health system is not equipped to address it,” writes Amanda Joy Calhoun, an adult and child psychiatry resident at the Yale Child Study Center and an expert in the mental health effects of anti-Black racism, in an essay for Time. She’s witnessed “the kindergartener who was sad and withdrawn for weeks after her white classmates said her skin was too dark to play with them” and “the affluent high schooler who was hospitalized after a suicide attempt because she was ostracized by her peers and excessively punished by teachers at her predominantly white prep school.” In each case, she notes, she was the only clinician involved to cite the contribution of racism.

Calhoun’s detailed and extensively footnoted essay reviews how the mental health effects of racism begin in the mother’s womb, raising the child’s risk of depression. She links to a 2018 study in JAMA which found that notes that Black children aged 5 to 12 are 80% more likely to die by suicide than their white peers. (Mysteriously, the study also notes that the suicide rate among Black children aged 13 to 17 was 50% lower than for white children.) Calhoun offers several solutions: More research funding on the impact of anti-Black racism on child mental health throughout development. More medical school curricula for psychiatrists that specifically deal with anti-Black racism. And the need for leaders of mental health facilities to adopt anti-racist hiring practices and reporting systems and to hold mental health staff accountable for any racist behaviors. 

–Don Sapatkin

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Close friendships help you live longer, whether carousing or not

Peer pressure exists at every age, and even the older among us may be tempted to imbibe more or smoke if our close friends do. But in general, people with close friends tend to have healthier habits, according to a study published last week in Epidemiology and Psychiatric Sciences. In it, researchers found that older adults with high-quality friendships had higher rates of “positive health behaviors and benefits”: they were less likely to be depressed and 9% more likely to exercise, and they had a 17% lower risk of depression and were 19% less likely to have a stroke, among other things.

The study analyzed survey responses from nearly 13,000 adults, aged 50 and up, who participated in the nationally-representative Health and Retirement Study, NPR reports. High-quality friendships were determined by the number of friends, number of interactions with friends, and feeling supported and happy around your friends.

“There’s an under-appreciation of friendships historically, not just in the research literature, but also just in general society. There’s often an exclusive focus on romantic relationships and marriages,” said psychologist and study coauthor William Chopik. “Friendships are often the first relationships of choice that we have in our lives.” They’re even beneficial if your friend dates involve some drinking and a few smokes, he adds. Study participants who admitted to indulging those negative health behaviors still lived longer and felt happier than folks whose friendships weren’t as close. “It could be that they imbibe a little bit, but then they have all these positive things that counteract that and then they end up living longer,” he said.

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In other news…

Report finds that the most common workplace injury is mental health problems: A report from Atticus, a workers’ compensation and disability benefits company found that mental health issues comprise 52 percent of all workplace injury cases, eclipsing all other kinds. Of the 1,000 people surveyed, 1 in 10 claimed to have experienced job-related mental health stress, reports Yahoo News in a report drawn from non-fatal injury data from the Bureau of Labor Statistics, fatal and catastrophic injury data from Occupational Safety and Health Administration (OSHA), and Google Trends data on workplace-related injuries,

“I think what’s happening is we’re reaching this inflection point with mental health where companies, people, corporations, insurance companies, everyone is starting to understand that it costs more for our culture and society to fix mental health problems than it would to prevent them and to help people having better mental health in a proactive way,” said Emily Anhalt, clinical psychologist and co-founder of Coa, a company that helps clients strengthen mental health programs. 

At 36, Sarah-Ashley Andrews is a therapist, nonprofit leader, minister, and Philadelphia’s youngest school board member. Ever since her parents used someone else’s address to enroll her and her sister in a public school in another side of town, Andrews has “wanted our public education to be equitable,” she told the Philadelphia Inquirer. She approaches her work from her perspective as a therapist, a role she decided to take on after a good friend died by suicide at age 25. “He dies and I’m like, ‘I don’t want this to happen to anybody else,’” said Andrews. “We don’t talk about mental health, especially in the Black and brown community.”

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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