Tag Archives for Ph.D.

Comic Robin Williams’ Death Puts Spotlight on Depression, Suicide

Published in Pawtucket Times, August 15, 2014

Last Monday evening, millions of Americans were shocked to hear that 63-year- old Robin Williams died from an apparent suicide. While it was well-known that he had a history of severe depression and years of alcohol and drug addiction, we were stunned by the unexpected tragic news. publically, Williams had it all, fame, fortune, loyal friends, and fans in every corner of the globe. But like millions of Americans he suffered in silence trying to slay his personal demons when he went into substance abuse treatment.

The sudden death of this Oscar-winning actor, recognized as America’s comic genius, squarely puts the spotlight on depression, a mental illness that commonly afflicts tens of millions of Americans.

DDepression Becomes a Public Conversation

Within the first 48 hours of Williams’ suicide The Samaritans of Rhode Island saw an increase in calls from people concerned about loved ones and friends, says Executive Director Denise Panichas, who expects to also see an increase in visits to her Pawtucket-based nonprofit’s website. Last year, its website received more than 50,000 visitors.

Panichas says, “William’s death reinforces the fact that suicide knows no boundaries, it being a relentless demon afflicting both rich or poor, and those having access to therapy or medical care and those not having it.

According to the Woonsocket resident, William’s suicide has raised the awareness of suicide prevention in a way that millions of dollars in public health announcements could never have done. “William’s movies as well as his dedication to community service resonate with multiple generations, says Panichas, stressing that his six plus decades had value “which will live on.”

Williams substance abuse problems also highlights the need for more awareness as to how addictions can be a risk factor for depression and suicide, states Panichas, who observes that throughout the country, in ever city and town, budgets for substance abuse treatment are being decimated, she adds.

“Promoting wellness and preventing addictions will always be a big challenge but we must do more if we want to see a decrease in suicides,” says Panichas.

Panichas expects the death of Williams, an internationally acclaimed movie star, will have an impact on fundraising for suicide prevention or addiction and depression prevention programs. She has seen an increase in donations from Rhode Islanders as well as from around the country. .

“One donor gave a donation in memory of “Mork”. The donations coming in may be small but every one counts toward keeping our programs available to the public,” says Panichas, noting that over the years public funding has “been drying up.” The Samaritans of RI is using more creative fundraising structures, like crowdfunding (www.crowdrise.com/samaritansri2014) and other social venture sites to create new revenue streams for her nonprofit, she adds.

An Illness That Can Affect Anyone

Lisa B. Shea, MD, Medical Director of Providence-based Butler Hospital, Providence, learned of William’s suicide by a CNN alert on her IPhone. To the board- certified psychiatrist who serves as a clinical associate professor at Brown University’s Alpbert Medical School, “it was tragic but preventable.”

Shea, a practicing psychiatrist for 20 years, notes that people who have suicidal thoughts, like Williams, are struggling with mental health disorders. “Their thinking can get very dark and narrow and they believe they have no options,” she says, oftentimes feeling like a burden to others. “It does not matter who you are mental illness can strike any one regardless of their wealth and fame,” she says.

According to Shea, the public’s interest in William’s tragic death sheds light on the fact that people can get help and it begins with taking a positive first step. “People with suicidal thoughts, who feel “intensely tortured and can not see any way out of their situation, can benefit from supportive therapeutic relationships, medications, and getting support from family and friends who can push them into getting professional help,” she says.

Shea calls on Congress and Rhode Island state lawmakers to positively respond to the William’s suicide by providing increased funding to create access to treatment and prevention programs and to support mental health research.

Finally, Shea says that there are a number of tell-tale signs of a person expressing hopelessness who may be thinking of ending their life. They include statements made by someone that others are better off if he or she were not around; excessive use of alcohol and/or drugs; not taking care of yourself; and giving away personal items. When these occur, talk to the person telling them that you care about them and are concerned for their well-being.

Adds Melinda Kulish, Ph.D., a Clinical Psychologist/Clinical Neuropsychologist and Instructor of Psychology at Harvard Medical School, “There are also times when depression is not easily recognizable. Some people who are depressed experience it most acutely when by themselves but can appear fine, even quite happy, when they are with other people.”

Kulish explains that, for various reasons, some people feel the need to make others happy. Cheering others up or making others laugh makes them also feel happy.

“But, if that person is suffering from depression, the happiness is fleeting – the laughter ends and they once again feel empty and sad. The cheering up of others is a fix that is OUTSIDE, not inside of them.

“And drugs and alcohol can make them feel better for a time. The high always ends, and when alone, they feel empty and even more depressed,” says Kulish. “There’s really good research to suggest that talking about traumatic and upsetting events leads to much healthier responses. The old idea, ‘I’m just not going to talk about it so it’ll go away’ doesn’t work.”

“It’s a myth that if you ask a person if they are suicidal you will put that idea in their heads,” says Shea.

Feeling Low, a Place to Call

When this happens, “feeling low with nowhere to turn” as noted singer songwriter Bill Withers once said in a public service announcement, there is a place to call – The Samaritans of Rhode Island – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to reducing the occurrence of suicide by befriending the desperate and lonely throughout the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 500,000 calls and trained more 1,380 volunteers to answer its confidential and anonymous Hotline/Listening Lines.

With the first Samaritan branch started in England in 1953, chapters can now be found in more than 40 countries of the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices,” notes its website.

Executive Director Panichas, notes that the communication-based program teaches volunteers to effectively listen to people who are in crisis. Conversations are free, confidential and, most importantly, anonymous.

A rigorous 21-hour training program teaches volunteers to listen to callers without expressing personal judgments or opinions. Panichas said that the listening techniques called “befriending,” calls for 90 percent listening and 10 percent talking. Panichas noted The Samaritans of Rhode Island Listening Line is also a much needed resources for caregivers and older Rhode Islanders.

Other services include a peer-to-peer grief Safe Place Support Group for those left behind by suicide as well as community education programs.

In 2014, The Samaritans of Rhode Island received more than 4,000 calls and hosted more than 50,000 visitors to its website.

The Samaritans of Rhode Island can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being lonely or just needing to talk, our volunteers are there to listen.”

For persons interested in more information about suicide emergencies, The Samaritans website,http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

For those seeking to financially support the programs of The Samaritans of Rhode Island, its Art Gallery and Education Center is available to rent for special events, meetings and other types of occasions. For information on gallery rental, call the Samaritans business line at 401-721-5220; or go tohttp://www.samaritansri.org.

Need to Talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll-free in RI (1-800) 365-4044.

For mental health resources, go to http://www.butler.org.

Herb Weiss, LRI ’12 is a Pawtucket-based freelance writer who covers health care, aging, and medical issues. He can be contacted at hweissri@aol.com.

Rhode Island Families Can Benefit from Expanding State’s TDI Program

Published in Pawtucket Times, May 17, 2013

In the 2012 legislative session, it was very easy for Pawtucket Rep. Elaine A. Coderre to say yes to Sen. Rhoda E. Perry, when the Providence lawmaker came looking for a House sponsor of S 2734. Perry’s legislative proposal would amend the State’s existing Temporary Disability Insurance (TDI) program to include coverage for caregivers who care for loved ones during a health care emergency or to take time off to bond with a child.

Years before, unexpectedly being pushed into the role of caregiver would bring Coderre to become the primary sponsor of H 7862, the companion bill to S 2734. To the disappointment of the Pawtucket lawmaker and her Senate colleague, their legislative proposal would be held for further study, effectively killing it.
Understanding a Caregivers Needs

In 1997, taking care of her dying mother became time-consuming for Coderre, a part-time lawmaker who served full-time as Executive Director of the Emergency Shelter of Pawtucket. Before the onset of the terminal illness, Coderre’s 78-year-old mother had lived independently on the second floor of her daughter’s three floor tenement.

With her elderly mother quickly losing her ability to live independently, being diagnosed with fourth stage Alzheimer’s disease and fourth stage colon cancer, the fifty-year old Coderre instantly became a very stressed caregiver

For over ten months, Coderre skillfully juggled the responsibilities of working two very challenging jobs, meeting family demands, and becoming the primary caregiver to her frail mother. To provide care seven days a week, 24 hours a day, Coderre would rely on her husband, three adult children, sister and her husband, to assist.

“It was a scheduling nightmare, remembered Coderre, referring to the complexity of making sure each family member was inked in the schedule and were notified when to report for duty. “We were committed to making my mother, in her final days, feel safe, secure and to have a quality of life,” she said, noting that her family did work well together, making the care giving schedule work

Looking back, Coderre considers herself extremely fortunate because she had her immediate family and was able to hire a homemaker, to provide more of the physical care, from 9:00 a.m. to 4:00 p.m.
Supporting Temporary Caregiver Insurance

But, Coderre realized from this experience and calls from constituents that not everyone has a large network of family and friends, or adequate finances to take care of a very sick loved one, even to know where to find caregiver support services. Becoming a care giver to a frail family member, an experience that many Rhode Islanders will face during their adult life, pushed Coderre to again become the primary sponsor of House legislation to create a Temporary Caregiver Insurance Program (TCIP), for the second time around.

During the 2013 legislative session, Coderre has joined Sen. Gayle Goldin, who represents areas in Providence’s Eastside, to reintroduce companion measures in the Rhode Island General Assembly (H 5889 and S 231) to create a TCIP. The legislative proposal, modified to address opponent concerns from the last session over the length of the benefit, would expand TDI to employees who must take time out of work to care for a family member or bond with a new child in their home.

If enacted, employees would be eligible to receive up to 8 weeks of replacement income while providing care for a seriously ill family member or new child. The law would provide employees with job security by allowing them to return to work when their caregiver responsibilities have concluded. The average weekly benefit for an employee would be $408.

Like Coderre, Goldin, a first-term Senator, had her own life experience as a caregiver. Over the years she, as a family advocate, she has also talked with many parents who told her of their own children’s health needs and financial and emotional stress it created and how important this program was for them.

“Paid family leave is a cost-effective way to give employees the time to balance family and work responsibilities without jeopardizing their economic security,” said Goldin.

In the early 2000s, Goldin’s interest in research on TCIPs was piqued when the program was implemented in California. Last year, as a member of the Providence-based Women’s Fund of Rhode Island’s Policy Institute, she brought this knowledge to the table when working with seven women to get legislation introduced on Smith Hill.

At that time, out of five state’s nationwide that had TDI, like Rhode Island, identified two (California and New Jersey) allowed the program to be used by caregivers, not just those who are suffering the illness or injury themselves.

The research findings gathered from the Women’s Fund of Rhode Island’s Policy Institute would give ammunition to Sen. Perry and Coderre to push for the TDI program expansion in 2012. When Goldin took over Perry’s Senatorial seat when the long-time Providence Senator retired, she picked up the TDI cause, bringing Coderre back to the plate this legislative session, to assist her in the House.
Advocates Rally to Support

On April 11, eleven groups, including AARP Rhode
Island, the Senior Agenda coalition, Woman’s Fund of Rhode Island, the Economic Progress Institute, Rhode Island Kids Count, and the Rhode Island SEIU State Council, came before the House Finance Committee, to push for passage of H 5889.

Dr. Marcia Conè, Ph.D., CEO, of the Woman’s Fund of Rhode Island, told lawmakers that the TCIP is just an updated extension of the current TDI program that “best addresses the new health and lifestyle changes of today’s society, giving “everyone the flexibility of needed to balance the new realities of family and work responsibilities.”

To put the brakes to a “brain drain” out of the Ocean State, due to higher salaries available in bordering states, Dr. Conè stressed that H 5889 would offer what all employees need, time off to care of family business in a crisis. “The prestige of having the most family friendly work environment in New England is a very strong incentive for families to stay in the state to make Rhode Island their home,” she told the panel.

In her testimony, Executive Director Kate Brewster, of The Economic Progress Institute, stated that the state’s Parental and Family Medical Leave Act of 1987, and the Federal Family Medical Leave Act of 1993, give employees up to 13 weeks of “unpaid leave” to care for a family member or new child. “These laws protect employees’ jobs, but not their wages,” she said, observing that low-income Rhode Islanders can not afford to take unpaid time off from work, they need their wages.

Countering Brewster’s comments, submitted testimony by R. Kelly Sheridan, representing The Greater Providence Chamber of Commerce, warned that H 5889 would expand the State’s existing TDI program to allow employees time off to care for family members, when most states do not even have a TDI system. This expansion “would make Rhode Island’s business climate an outlier compared to our neighboring states and would send the wrong message to the business community regarding improving the business climate in our state,” he said.

While Matt Weldon, Assistant Director, of the State’s Department of Labor and Training, took no position on the TCIP legislative proposal, he came to answer questions. Weldon noted that there could be a .2 increase to the rate an employee is mandated to pay into TDI. Currently, the state program takes 1.2% of the first $61,400 out of an employee’s paycheck.

Maureen Maigret, Policy Consultant for the Senior Agenda Coalition of Rhode Island, told the House panel that nobody can predict when a family crisis will come, specifically “the critical illness of a child or spouse, an older person’s fall and subsequent need for care.”

Maigret estimated, for just pennies per week paid by workers – the cost of a cup of coffee — passage of H 5889, would allow workers to take temporary leave to deal with sudden critical family needs and still have some income.

With the Rhode Island General Assembly gearing up to finish the people’s legislative business by the middle of June, We Care for Rhode Island (WCRI), a grass roots coalition consisting of 32 organizations, including small business owners, workers, policy centers and family and health care advocates, was established at the end of April, to push for the passage of a Rhode Island TCIP.

Last Saturday, visiting local retail stores on Hope Street, Steve Gerencser, of WCRI, passed out literature, calling on owners to support his group’s attempts to create a TCIP in the Ocean State. “It can be a boon for businesses,” he says, citing a 2011 research study detailed on his Legislative Fact Sheet, supporting the passage of H 5889 and S 231. Gerencser notes that the findings estimate that program would save employers $89 million a year by improving employee retention and reducing turnover costs.

Goldin agrees with WCRI’s assessment a TCIP’s benefit to businesses. Moreover, she claims that there is really no impact on the State’s budget, to start up this new program. “It’s revenue-neutral and is solely funded by the employee, business owners and taxpayers do not contribute.”

With a negligible expense to implement, with no cost to the taxpayer or even the business community, it’s penny-wise and pound foolish for state lawmakers to not create a Temporary Care Giver Insurance Program, to financially assist Rhode Island employees when they take off time to help seriously ill family members or to care for newly adopted child.

Sound public policy, like this legislative proposal, can only send a clear message across the United States, that the Ocean State is finally taking steps to become more family-friendly, a great way to competitively attract large corporations and even smaller businesses into our borders.

Herb Weiss, LRI ’12, is a writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

The Best of…Keeping Your Memory Sharp in Your Later Years

Published October 2008, Pawtucket Times  

          In her twenties, while attending nursing school, Donna Policastro discovered she had a photographic memory.  Years later, even in her middle years, theProvidenceresident’s memory was still pretty good.  She had no need for appointment books or PDA’s to keep up with her hurried work schedule as a Registered Nurse.  Like an elephant, she never forgot, always remembering minute details, never missing an appointment or meeting.

             Approaching age 50, missing meetings and even some appointments forced Policastro, Executive Director of the Rhode Island State Nurses Association (RISNA), to keep a To-Do list and to use her computer’s calendar program. Policastro, now age 59, speculates that being overwhelmed at work because she had no support staff combined with not being able to say no to taking on new duties and responsibilities took a toll on her memory,

            Sometimes the aging baby boomer, like many,  would forget a colleague or patient’s name all together, or just not remember either their first or last moniker.  She became physically exhausted trying to remember their full name or little details of their initial meeting.  Sometimes it even bothered Policastro “to no end” when she could not remember an actor’s name she saw on a television program, becoming obsessed in an attempting to remember the name.

          As Policastro would ultimately discover when reading Aging With Grace, a book that described a longitudinal health study of an order of nuns, she was not losing her mind or becoming afflicted with dementia or devastating Alzheimer’s, her memory loss was due to normal aging. 

 Memory Gradually Declines with Age

           Laurence M. Hirshberg, Ph.D., Director of the Providence-based Neuro Development Center, would agree with Polacastro’s self-assessment of why her memory was not as sharp or clear as in her earlier years.  “Advancing age seems to cause gradual declines in some aspects of memory and thinking, brain structure, and brain functioning, while sparing others,” he says. 

            The Clinical Psychologist notes that research findings indicate that up to half of people over age 50 have mild forgetfulness linked to age-associated memory impairment,

           According to Dr. Hirshberg, who serves as a Clinical Assistant Professor in the Department of Psychiatry and Human Behavior at Brown Medical School, as a person ages, there is often decline in one’s ability to encode new memories of events or facts, as well as the ability to hold the information you need to perform a simple task (for example, to dial a telephone number).  “Studies also show declines in memory of events, times, places, associated emotions., certain forms of reasoning, and numeric and verbal ability.  Procedural memory – remembering how to perform a process, for example playing the piano, is less affected by aging, as is memory of words and memory of emotional experience, both of which are enhanced with age,” Hirshberg says.

           “All of us show some forgetfulness at times, notes Dr. Hirshberg, especially when we forget where the car is parked, forget a persons name (but remember it later), forget events from the distant past, or forget parts of an experience.   He notes that signs of more serious memory problems include forgetting an experience or recent events, forgetting how to drive a car or read a clock, forgetting ever having known a particular person or loss of function, confusion or decreased alertness.

           Memory loss can be caused by a variety of factors, Dr. Hirshberg says, from lack of physical or mental activity, boredom, social isolation, stress, drug or alcohol use, smoking, poor nutrition, to an array of medical conditions that includes sleep disorders, head trauma, depression, diabetes, impairment to vision and hearing, head trauma, and even high blood pressure and cholesterol..

Living with Memory Loss

           Preventing memory loss in your later years can be as simple as staying socially active, keep learning and staying mentally active, eating nutritious meals, reducing stress and seeking help from medical conditions, Dr. Hirshberg suggested,  “Making lists and creating schedules can be effective strategies to increase memory skills. Many people use technological aids such as Palm Pilots.”  

            Even brain exercises can be helpful in keeping your memory sharp, Hirshberg says, specifically working cross word puzzles and soduko, playing chess, checkers, bridge and other card games. Reading, attending lectures, learning a new skill are also beneficial, along with using formal brain exercise programs for the computer (such a Mental Fitness, Brain Power, Captains Log, and Sharper Brain). Some examples of computerized brain exercise games can be seen at youcanstaysharp.com.

          Many aging baby boomers wonder when is the appropriate time to see their physician about memory loss.  Dr. Hirshberg says the rule of thumb that clinicians often use is, if you’re worried about your memory, it’s probably not that serious, but if your friends and relatives are worried about it, then it probably is more serious. . 

           Final note…You can also take part in a comprehensive mental fitness training program through the Stay Sharp Mental Fitness Center. This center offers brain fitness training exercise and EEG guided brain training to train your brain younger. For more information, visit youcanstaysharp.com or call 401 383 4104.

           Herb Weiss is a Pawtucket-based Freelance writing who has covered aging, health care and medical issues.  This article was published in October 2008.  Contact him at hweissri@aol.com .