Spreading Big Joy – Good for Mental Health

Wednesday, November 16, 2023

By Courtney Wise

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A mentoring program offers emotional support to caregivers of people with dementia

Caregivers of people with dementia have an overwhelming task. The work is all-consuming, and friends who once provided emotional support tend to slip away. It’s why Julia Sadtler, 81, looks forward to Thursday mornings on her computer. There, on Zoom, she gets guidance and support for her caregiving journey through a mentorship program developed by Penn Memory Center in Philadelphia. Though she’s 20 years older than mentor Debora Dunbar, Sadtler is grateful for the relationship they’ve built. “I knew that someone who’s been down this road would be a great help,” she told the New York Times. Dunbar’s husband was diagnosed with early onset Alzheimer’s five years ago; Sadtler’s husband is two years into his diagnosis. 

The support helps Sadtler answer some of her most pressing questions: How will she know when to take away her husband’s car keys? How can she navigate the guilt of leaving him at home to enjoy time with friends? Can they reasonably travel from Pennsylvania to California to visit their daughter and her family? “The sense of being overwhelmed can be crushing,” Sadtler said.

“Caregiving in general is hard, but caregiving for a person with dementia is harder,” said Felicia Greenfield, executive director of Penn Memory Center. “Caregivers report high rates of anxiety and depression. They have a harder time attending to their own health. Things change socially; their friends don’t understand or come around anymore.” It’s financially and physically demanding, too, even when loved ones move into assisted living or nursing  homes.

A recent study, not surprisingly, found that older adults with dementia required significantly more care than their peers without. Using data from a federal study, researchers compared 4,400 elderly adults, half diagnosed with dementia and the other half without. Caregivers in both groups spent 12 hours a month supporting basic daily activities such as bathing and dressing. But after two years, caregivers of people with dementia almost quadrupled their care hours to 45 each month, while those in the other group remained about the same. Shopping, meal prep, and managing finances added 76 more hours for the carers of people with dementia, compared to 27 hours for those without.  

Making matters worse, nearly 60 percent of study subjects with dementia lost their median wealth within eight years. “It’s a devastating problem for individuals and families, and also for society in general,” said HwaJung Choi, a health economist and lead author of the study. Advocates for dementia patients and their families argue for more social support, including education, help with care coordination, and grants for respite support. Delaware resident Mary Perkins was caring for her husband with vascular dementia and Alzheimer’s when she learned about the Penn program. “I was a mess,” Perkins said. But she “saw hope” after meeting her mentor. “I knew she’d gone through hell and she was surviving, even thriving. If she could live through it, I could, too.”

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“Micro-acts of joy” add up to big boost in wellbeing

After my friend Dorian died earlier this year, her brother challenged us in his eulogy to keep her spirit alive by celebrating every win, every moment of joy, no matter how small – for ourselves and one another. It’s truly what she always did. She had gone back to school a year before her death and would send text messages in our group chat about how excited she was to buy the books in the syllabus. When she felt especially pleased with how she foamed her cup of coffee, she’d send a picture of it. Whenever anyone she cared about accomplished anything – like me getting somewhere on time or solving the daily Wordle in three attempts – she cheered us on. As it turns out, Dorian had the right idea. Researchers for the BIG JOY Project told NPR that engaging with “micro-acts of joy” leads to measurably better wellbeing. 

An analysis of data from the project revealed that people who commit to daily moments of joy experience about a 25% increase in emotional well-being over the course of one week. “We’re really excited,” said project leader Emiliana Simon-Thomas. “There are statistically significant, measurable changes [including] greater well-being, better coping, less stress, more satisfaction with relationships.”

The BIG JOY Project is a collaboration between UC Berkeley’s Greater Good Science Center and other institutions. To date, researchers have collected data from 70,000 people in more than 200 countries – and they’re looking for more. To participate, subjects complete an online survey to assess their emotions, stress levels and social tendencies. Then, for seven consecutive days, they complete “micro-acts of joy” that are recommended to them via email. All are proven to be effective at boosting mental wellbeing. They include making a gratitude list, celebrating another’s joy, meditation and exploring what can be learned from a challenging situation. At the end of each day, participants record what they did and how it made them feel. After a week, they’re sent a final survey to determine whether their sense of wellbeing changed.

Results have been overwhelmingly positive. “So many of the things that are causing us stress and sadness are out of our control,” said Judith Moskowitz, a Northwestern University social scientist unaffiliated with the study. “So these micro moments can give you something to hold on to…Even in the context of really stressful events or sickness, there is absolutely the capacity to experience moments of positive emotion as well.” 

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Managing the sexual side effects that often come with antidepressants

Sexual difficulties, including loss of desire and erectile problems, are a common side effect of the most widely prescribed antidepressants – selective serotonin reuptake inhibitors, or SSRIs. But in many cases, the problems can be managed, the New York Times reported. If you’re taking an SSRI and experiencing shifts in sexual desire or arousal, including erectile dysfunction, loss of genital sensitivity, or pleasureless or painful orgasms, be honest with your doctor and tell them. If you don’t, doctors may fail to ask, especially in female patients, said Tierney Lorenz, a psychologist who studies antidepressant-induced sexual dysfunction in women. “The charitable interpretation is that we simply have more treatments available for male patients, and so doctors are more likely to ask after things that they feel they can actually help with,” Lorenz said. “The significantly less charitable interpretation is that we still live in a very sexist society that doesn’t believe that women should have sexual interest.” 

In 10% to 20% of cases, the symptoms may subside as your body adjusts to the medication. Switching medications and combining them sometimes helps, and men with erectile dysfunction might also be helped by a drug like Viagra. 

In rare cases, doctors work with patients to schedule “drug holidays,” or planned periods of not taking the antidepressant one to two days before having sex. But for most patients, this is a bad option. Withdrawal from SSRIs can happen nearly immediately, bringing about dizziness, nausea, insomnia, and anxiety. Doctors also worry that taking breaks from the medication may cause people to cease taking the drug altogether, endangering their mental health. 

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In other news…

Lack of sleep is harming Americans’ physical and mental health: The Centers for Disease Control and Prevention declared sleep deprivation a public health crisis back in 2014. Considering what we Earthlings have encountered over the past nine years – a pandemic, working more for less pay, climate change – I’d bet a pack of my favorite bubble gum we’re sleeping even less today. “I think that we’re all aware that we’re sleep deprived” and it has serious health implications, Jocelyn Cheng, a neurologist and vice chair of the Public Safety Committee at the American Academy of Sleep Medicine, told Salon. Getting enough sleep could even help people address obesity, diabetes, and some mental health disorders, said sleep medicine specialist Pedram Navab. Most doctors don’t know much about sleep, and focus their recommendations on diet and exercise, Navab said. “But sleep has to come into the conversation. I think it’s just as important as the other stuff.”

A Detroit-area “mental health gym” claims it can help users reboot their brains, but not everyone is convinced. The gym, called Inception, offers several services, including the “Inner Reset Circuit” which includes 30 minutes each of magnetic resonance therapy, neurofeedback or “brain training,” and floatation therapy. The gym’s founder David McCullar says the alternative healing methods he provides help to heal trauma and stress. Detroit MetroTimes reporter Randiah Camille Green tried the service for her story, but didn’t have a good experience. That hasn’t stopped people from visiting the place, especially with celebrity radio and tv host Charlamagne tha God as a loud and happy client. He even took 10 fans to experience Inception in February 2020.

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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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