As little as 20 minutes of moderate activity a day for five days a week can significantly lower the risk of depressive symptoms for people over 50 who have conditions often linked to depression, such as diabetes, heart disease and chronic pain, a new study found.Video above: Cardio linked to reduced risk in men developing some cancersPeople with diabetes have twice the risk for depression, according to Diabetes UK, and a 2017 study found heart disease patients are twice as likely to die if they develop depression after their diagnosis. Up to 85% of people with chronic pain experience severe depression, according to a different 2017 study.People without chronic disease in the study, however, needed to do moderate to vigorous exercise two hours a day to see improvement in depressive symptoms, according to lead study author Eamon Laird, a researcher at the Physical Activity for Health Research Centre at the University of Limerick in Ireland.Moderate physical activity is typically defined as an activity that “takes your breath” so that it is hard to speak while doing it. Examples include brisk walking, bicycling, dancing, playing tennis, or running up and down stairs. If the exercise level is increased to vigorous — such as jogging or running, during which breathing is fast and the heart rate rises — the time spent exercising can be reduced, according to the U.S. Centers for Disease Control and Prevention.“What is unique (about this study) that it is the first and largest investigation of a longitudinal cohort — with and without chronic disease — to try and work out what was the lowest minimal dose to observe a difference in depression,” Laird said.“We do not advocate for reduced activity levels in any population, but these findings suggest that even doses lower than recommended may well protect mental health over time in older adults,” he added. “These doses may be more achievable as many older adults may find it difficult to undertake physical activity for a large number of reasons.”A 10-year studyThe study, published Monday in the journal JAMA Network Open, followed more than 4,000 Irish adults with an average age of 61 for 10 years. The participants, who were part of the Irish Longitudinal Study on Ageing, were evaluated every two years. They were asked about their physical activity and exercise levels and given tests to determine the number of depressive symptoms they displayed — if the symptoms were excessive, they were classified as having major depression.“Examples of symptoms from the questionnaire included: I had trouble keeping my mind on what I was doing; My sleep was restless; I felt I could not shake off the blues even with the help from my family and friends; etc,” Laird said in an email.People who had suffered a major depressive episode during the past 12 months were also put into the major depression group. An episode is defined as a period of two weeks or longer in which the person experienced fatigue, feelings of sadness and hopelessness, a loss of interest in activities or sleeping problems, weight gain or loss, or thoughts of suicide.The study found that the more time people spent exercising, the better. People who moderately exercised for 20 minutes a day, five days a week, had a 16% lower rate of depressive symptoms and a 43% lower risk of major depression compared with those who did not exercise, the study said.Those who exercised two hours a day benefitted the most, with a 23% reduction in depressive symptoms and a 49% lower risk of major depression, according to the study.“The higher the physical activity dose, the greater the mental health benefits for depression,” Larid said.Unfortunately, the overall rate of depression for the entire group rose over the 10 years, from an average of 8% to 12%, while antidepressant use increased from about 6% to 10%. However, rates of exercise also declined by about 10% for the group over the study’s duration.Not a surpriseThe study’s findings were not surprising, Larid said, noting extensive past research that shows a strong link between exercise and reducing depression. A systematic review and meta-analysis published in 2022 found brisk walking for just 2.5 hours a week cut depressive symptoms by 25%. The same study also found that doing half that amount lowered the risk of depression by 18%.Another large review published in February found that getting physical is 1.5 times more effective at reducing stress, anxiety and mild-to-moderate symptoms of depression than antidepressant medications or cognitive behavior therapy, which is considered a gold standard treatment.Exercise does more for a person’s health than just ease depression. It keeps the body in tip-top shape, allowing it to function efficiently and do a better job at warding off diseases of all kinds.“Physical activity is just absolutely magnificent,” Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, told CNN in a prior interview.“If you blend that with eating a more plant-based diet, de-stressing, sleeping enough and connecting with others — that’s your magic recipe,” he added. “It’s the fountain of youth, if you will.”

Adults ages 19 to 64 in the United States should be screened for anxiety disorders, according to a new recommendation from the U.S. Preventive Services Task Force released Tuesday.

The final recommendation, published in the medical journal JAMA, marks the first time the USPSTF has made a final recommendation on screening for anxiety disorders in adults, including those who are pregnant and postpartum. The task force found “insufficient evidence” to screen for anxiety in older adults.

The USPSTF, a group of independent medical experts whose recommendations help guide doctors’ decisions and influence insurance plans, also continues to recommend that all adults be screened for major depressive disorder, including those who are pregnant or postpartum and older adults.

The recommendation is consistent with the task force’s 2016 recommendation on depression screenings.

While rates of clinical depression had been rising steadily in the United States, they jumped significantly during the Covid-19 pandemic. In general, about 1 in 6 adults will have depression at some time in their life, according to the U.S. Centers for Disease Control and Prevention.

And although depression and anxiety are different conditions, they commonly can happen together – and such screening recommendations can help clinicians identify which patients may need treatment for both conditions or one versus the other.

“Anxiety disorders are common, and they can really impact people’s quality of life, and what the task force found is that screening for anxiety disorders in the general adult population can lead to identifying these conditions early and then, if those people who are identified get linked up with appropriate care, they will benefit,” said Dr. Michael Silverstein, vice chair of the USPSTF and director of the Hassenfeld Child Health Innovation Institute at Brown University.

“So it really is extremely good news for the delivery of preventive services for the American public,” he said. “We also found that in the older adult population, which is defined as age 65 and older, that the task force really needs more evidence to weigh the risks and benefits of screening for anxiety disorders. And for that older adult population, we’re calling for urgent new research.”

‘We have not been treating mental health at the same level as physical health’

USPSTF researchers noted in their anxiety screening recommendation statement that most people with anxiety disorders don’t receive treatment within the first year of symptoms, if ever – showing a need for more robust screening.

“Only 11% of U.S. adults with an anxiety disorder started treatment within the first year of onset; the median time to treatment initiation was 23 years,” the researchers wrote. “A U.S. study of 965 primary care patients found that only 41% of patients with an anxiety disorder were receiving treatment for their disorder.”

Once the new screening recommendations are practiced in the real world, the results may reveal that anxiety disorders are much more prevalent than previously thought, said Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the recommendation statements.

“Anxiety has been way under the radar for a long time, and so I think it’s good that they are recommending for the broad population to be screened. When we start screening for anxiety, we’re going to find a lot more of it than we thought we had,” he said, adding that the nation should also prepare to make mental health services and treatments more easily accessible amid the ongoing mental health crisis.

“I think it’s an opportunity for us to get our hands around this crisis before we have a mental health emergency,” Benjamin said. “So we definitely have to do more. We know as a nation, we have under-invested in mental health. We have not put as much money into mental health. We have not been treating mental health at the same level as physical health. And we know that people who need mental health services are really struggling to find providers to care for them.”

What screening looks like

Medical professionals can screen for anxiety disorders using questionnaires and scales, such as asking about feeling on edge, not being able to stop or control worrying or having trouble relaxing, for example.

Some questions used to screen for depression include asking about feeling hopeless, having trouble concentrating, losing interest in daily activities or thoughts about hurting yourself. Major depressive disorder is defined as at least two weeks of mild to severe persistent feelings of sadness or lack of interest in everyday activities, according to the USPSTF.

Any positive screening result should be confirmed with a diagnostic assessment to determine the severity of symptoms and identify any other psychological concerns, and then patients should be given care. Potential harms of screening include the risk of a false positive, leading to unnecessary appointments or unnecessary treatment, according to the USPSTF, but for most adults, screening and follow-up care can reduce symptoms of anxiety disorders and depression.

Effective treatments for anxiety disorders can include talking with a therapist, known as psychotherapy, or medications such as antidepressants or beta blockers, as well as relaxation or stress management therapies. Treatments for depression also can include antidepressant medication or psychotherapy, alone or in combination.

If left untreated, major depressive disorder “can interfere with daily functioning and can be associated with an increased risk of cardiovascular events, exacerbation of comorbid conditions, or increased mortality,” according to the USPSTF recommendation. Only about half of people with major depression are identified.

A call for more research on suicide risks

Research suggests that anxiety disorders and depression may be associated with suicidal thoughts, suicide attempts and other types of suicidal behaviors.

But the new USPSTF recommendations state that there is not enough evidence to recommend for or against screening specifically for suicide risk in adults who are not showing signs or symptoms, which is consistent with the task force’s 2014 recommendation on the issue.

“So if someone goes to the doctor or their primary care provider and expresses the idea of self-harm or wanting to hurt themselves or wanting to die by suicide, by all means, that provider needs to do everything they possibly can to help the patient in front of them,” Silverstein said.

“As a task force, we are not reviewing the evidence for that population,” he said. “We’re reviewing the evidence for people who come to their primary care provider without any signs or symptoms and having either the primary care provider or someone in the primary care provider’s office ask them a series of screening questions to assess their risk for suicide.”

In the new recommendations, the USPSTF calls for more research on suicide risks among people who are not showing signs or symptoms.

“Someone experiencing death by suicide is a tragedy,” Silverstein said. “Because the suicide rate in this country has been increasing, there are so many people who have experienced a loved one having died by suicide. So this recommendation is really important, and that importance to me underlines that the American public deserves the highest quality evidence around screening for this really, really serious condition, which is suicide risk.”

Mental health experts and advocates emphasize the importance of suicide risk assessments among adults diagnosed with anxiety and major depressive disorder.

“Although not called out in the USPSTF Recommendation Statement, a positive screen result for anxiety should be immediately followed with clinical evaluation for suicidality,” Dr. Murray Stein and Dr. Linda Hill, both of the University of California, San Diego, wrote in an editorial that accompanied the new recommendations in JAMA.

“The uptake of these new anxiety screening recommendations should provide an impetus and an opportunity for primary care clinicians to become more comfortable with diagnosing and treating anxiety disorders, which may require additional training,” they wrote. “Anxiety disorders can be distressing and disabling, and appropriate recognition and treatment can be life-altering and, in some cases, lifesaving, for patients.”

The homicide rate for older U.S. teenagers rose to its highest point in nearly 25 years during the COVID-19 pandemic, and the suicide rate for adults in their early 20s was the worst in more than 50 years, government researchers said Thursday.Video above: COVID-19 pandemic increases awareness about youth suicideThe Centers for Disease Control and Prevention report examined the homicide and suicide rates among 10- to 24-year-olds from 2001 to 2021.The increase is alarming and "reflects a mental health crisis among young people and a need for a number of policy changes," said Dr. Steven Woolf, a Virginia Commonwealth University researcher who studies U.S. death trends and wasn't involved in the CDC report.Experts cited several possible reasons for the increases, including higher rates of depression, limited availability of mental health services and the number of guns in U.S. homes.Guns were used in 54% of suicides and 93% of homicides among the age group in 2021, the most recent year for which statistics were available."Picture a teenager sitting in their bedroom feeling desperate and making a decision, impulsively, to take their own life," Woolf said. If they have access to a gun, "it's game over."Suicide and homicide were the second and third leading causes of death for 10- to 24-year-olds, after a category of accidental deaths that included motor vehicle crashes, falls, drownings and overdoses. Other researchers have grouped the data by the method of death and concluded that guns are now the biggest killer of U.S. children.Earlier this year, Woolf and other researchers looking at CDC data noted dramatic increases in child and adolescent death rates overall at the beginning of the pandemic and found suicide and homicide were essential factors.The report also found:Suicide and homicide death rates remained far higher for older teenagers and young adults than they were for 10- to 14-year-olds.In 2021, there were about 2,900 suicides in youths ages 10 to 19, and 4,200 in 20- to 24-year-olds. About 3,000 homicide deaths were reported in the younger group, and nearly 3,900 in the adults in their early 20s.The homicide death rate jumped from 8.9 deaths per 100,000 teens aged 15 to 19 in 2019 to 12.3 in 2020. It rose to 12.8 deaths per 100,000 in 2021, the highest since 1997, according to CDC data.Homicide deaths became more common than suicide deaths among 15- to 19-year-olds, while suicide was more common in the younger and older age groups.While large increases were seen in homicide rates for young Black and Hispanic people in the U.S., there were no significant increases for their white counterparts, other CDC data shows.Among 20- to 24-year-olds, the homicide death rate jumped 34% from 2019 to 2020 — from 13.4 per 100,000 population to 18 per 100,000. It held stable in 2021, but the suicide rate rose enough in 2021 — to 19.4 per 100,000 — to surpass the homicide rate.Suicide death rates in children and teens were rising before COVID-19, but they jumped up at the beginning of the pandemic. Dr. Madhukar Trivedi, a psychiatrist at the University of Texas Southwestern Medical Center, said the reasons may be hard to pinpoint, but that isolation during COVID-19 lockdowns could be a factor."There is a misperception that if you talk to young people about depression, they'll get depressed. A don't-ask, don't-tell policy for depression is not effective," Trivedi said. "The earlier we can identify the ones who need help, the better chance we'll have at saving lives."

When Patrick Kennedy was in Congress, he would sneak in his treatments for substance abuse over the holidays, in between congressional work periods. And he refused mental health treatment recommended by his doctors, worried he would be recognized in that wing of the hospital.

Kennedy, a Rhode Island Democrat and the son of the late Edward Kennedy, was eventually forced to reveal his struggles when he crashed his car outside the Capitol while intoxicated in May 2006. He talked openly about his mental health and substance abuse for the first time, and something surprising happened — he became more popular with his constituency, winning reelection by a bigger margin than he had two years earlier.

On Thursday, the office of Pennsylvania Sen. John Fetterman, a Democrat who was elected to the Senate after a bruising campaign during which he suffered a stroke, announced he had checked himself into the hospital for clinical depression. The statement said Fetterman had experienced depression on and off in his life, but it had only become severe in recent weeks.

Fetterman's public struggle is extraordinary in a building where few talk about their own mental health, even while members of both parties have legislation to expand aid for it. Kennedy and a handful of others who have been open about their own problems, or those in their family, say they hope Fetterman's honesty — and his decisive action to get help — will foster more openness among lawmakers and their constituents in the wake of a global pandemic that has had far-reaching effects.

"This is a moment for us to tear down the stigma of depression and anxiety," said Kennedy, who retired in 2010 and has become a leading voice on mental illness. "Sen. Fetterman may do more for people just by admitting that he's getting help for depression than any bill he ends up sponsoring."

The U.S. Surgeon General, Vivek Murphy, tweeted praise for Fetterman, saying he hopes his "courage will serve as an example for others."

Fetterman's Senate colleagues were immediately supportive.

"In every single city and town and rural community there is someone struggling with mental health," said Minnesota Sen. Tina Smith, a Democrat who shared her own stories about periods of depression on the Senate floor four years ago. "If they see somebody else, like John, saying, 'OK, I need to get medical care,' that can be important to people."

South Dakota's John Thune, the Senate's No. 2 Republican, said he thinks politicians have become more comfortable discussing the issue since the pandemic.

"The more open, transparent people can be, the better our understanding is," Thune said.

Fetterman's hospitalization comes after a rough year in which the 53-year-old suffered a stroke just ahead of the May primary election and spent much of the summer off the campaign trail, recovering. He has said the stroke nearly killed him. He also underwent surgery to implant a pacemaker with a defibrillator to manage two heart conditions, atrial fibrillation and cardiomyopathy. He entered the Senate in January, where he has had to adjust to life in Washington and the daily grind of a federal lawmaker.

"It's unreal what @JohnFetterman has been through in the last year," tweeted Sen. Chris Murphy, D-Conn. "A stroke, a recovery, a bruising campaign, a transition to the Senate. I'm so proud of him for taking his health seriously. He's going to be a great Senator for a long time, and I'm pulling for him today."

Texas Sen. John Cornyn said the Senate "can be arduous. So I'm sure if somebody is not up to 100% then it's especially tough, so I wish him well."

Post-stroke depression is common, doctors say. And that could be even more difficult when dealing with it publicly, like Fetterman is.

"Having a stroke in and of itself is devastating and having to recover from a stroke in the public eye only adds to the level of stress as one recovers," said Dr. Bruce Ovbiagele, associate dean and professor of neurology at the University of California-San Francisco.

Dr. Eric Lenze, head of the Department of Psychiatry at Washington University in St. Louis, said he thinks it's "interesting and heroic" for a major political figure to acknowledge depression, "instead of saying they're hospitalized for exhaustion or trying to hide it."

While many members are still loath to talk about themselves or their own hardships, some have been more forthcoming about mental illness in recent years. Pennsylvania Rep. Susan Wild declared from the House floor in 2019 that suicide is a "national emergency" and told the story of her partner, who had recently taken his own life. Rep. Ritchie Torres, D-N.Y., who was elected in 2020, has said he dropped out of college and at times thought of suicide after struggling with depression, substance abuse and grief after the loss of a friend. Smith said she found that ever since she told her own story of periods of depression as a college student and young mother, people still come up to her to talk about it.

Many lawmakers have also been open about their fear and anxiety after the Jan. 6, 2021, Capitol insurrection, when many of them ran for their lives, and the months afterward when tensions between the two parties became even worse. Democratic Reps. Dan Kildee of Michigan and Annie Kuster of New Hampshire both talked about dealing with post-traumatic stress during that time.

The Jan. 6 attack was another inflection point amid the global pandemic.

"We're living in a time of extraordinary stress and crisis," said Maryland Rep. Jamie Raskin, who lost his son to suicide just a few days before the insurrection and has since written a book about his experience. "We've come through a plague, we've had tremendous mental and emotional health problems."

Raskin, who was recently diagnosed with cancer, says there may have been a time when political leaders had to pretend that hardships didn't touch their own families, "but I don't think we are living in that time."

Illinois Sen. Dick Durbin, who has been in the Senate for almost three decades, credits returning veterans from the Iraq war and other conflicts "who have convinced us that this is simple medical, mental health care that many people need from time to time. There isn't a single family that isn't touched by it."

Durbin, the No. 2 Senate Democrat, credited Fetterman for being honest. "This is a challenge, unimaginable challenge, that he's faced in life," Durbin said.

Kennedy says that when he returned from his recovery in the mid-2000s, many of his colleagues sought his help and advice privately. And he has continued to talk to some members in the decade since he retired.

He predicted Fetterman could find a "whole new world of connection with his constituency" when he returns to the Senate, and could help people understand the brain science behind depression.

"This is a very teachable moment here," Kennedy said.

___

Associated Press writers Marc Levy in Harrisburg, Pa., and Stephen Groves, Lisa Mascaro, Farnoush Amiri and Kevin Freking in Washington contributed to this report.

Senator John Fetterman’s candid approach to his struggles with mental health is unusual on Capitol Hill, where issues with members’ health are frequently kept hidden from the public.

But Fetterman’s openness has led to praise from mental health advocates, fellow members of Congress, and President Joe Biden, who said in a tweet, "We’re grateful to you for leading by example." 

Such mental health struggles in politics are not new — but they’re not mentioned often.  

In 1972, U.S. Sen. Thomas Eagleton was forced to bow out as the vice presidential pick for Democratic nominee George McGovern after his mental health struggles became public.

And in 2007, then-Congressman Patrick Kennedy opened up on Larry King live about his struggles with mental health.   

After a late-night car crash on Capitol Hill, the Rhode Island Democrat pled guilty in 2006 to charges of driving under the influence of prescription drugs.  

Since departing Congress, he founded the Kennedy Forum, which he describes as a think tank focused on mental health and addiction policy. 

"I think Senator Fetterman, simply by checking himself in saying he needs help and going to get that help, is going to probably help more people in that single act than any other bill that he sponsors or acts that he passes in Congress this year for sure," Kennedy said last week. "When I did go to treatment, I went under the cover of darkness, I did not do what Senator Fetterman has done, and that is to be very public about going to treatment. When I did go publicly, it was because I was forced to go publicly, I had had a DWI."

Fetterman suffered a stroke during his Senate campaign last year. His office said he has experienced depression on and off throughout his life but it became more severe recently.   

Mental health experts say his transparency about his struggles is an important signal to those dealing with similar issues. They say depression following a stroke isn’t unusual. 

 "We know that up to a third of people who have a stroke will suffer depression is the most common psychiatric disorder in people who have had a stroke. So I think for him to be so public about it is so courageous and he's been courageous up until this point, and he continues to do so," said Dr. Daniel Bober, a psychiatrist. 

As the importance of mental health becomes more widely accepted in the United States, men are still battling the stigma that it should not be discussed.

But that changed recently when famous MMA fighter Paddy “the Baddie” Pimblett delivered a moving public message after a fight, saying he has been struggling himself.

In his post-fight speech, Pimblett spoke about a close friend of his who had taken his life only days before the fight. He urged men to talk about their issues.

“I’d rather my mate cry on my shoulder than go to his funeral," he said.

The speech was an important message to men worldwide.

“I saw that clip of Paddy and I was just stopped. I had that sense of 'finally,'” said Eric French, a psychiatrist at the Mind Spa in Denver. “[Men] have these conceptions about [themselves] that we’re supposed to be strong, stoic, press forward no matter what is going on but we are human beings and that means there are aspects of ourselves that are no less real if we acknowledge them or not; that being our emotional state. And if acknowledging your emotional state makes you vulnerable, that’s not a bad thing.”

“I was always taught that a man is supposed to be strong, courageous. You bottle up all your feelings,” said Sam Peterson, a retired war veteran.

Peterson knows about that stigma first-hand. He was a bomb technician in Afghanistan for more than four years. The PTSD he developed from his time in the Army nearly led him to take his own life in 2014.

“It was very much like panic attacks, and, you know, I very nearly ended my own life because of it,” he said. “I had my .45 in my hand, you know, ready to pull the trigger and I got a text message from one of my very good friends and he’s like hey man come over. I sat down on the couch and I just bawled my eyes out for like three hours. Just letting it all out and it felt like someone had just taken my soul out of my body and just washed it in bleach and stuck it back in.”

After the speech by Pimblett, who is from the U.K., mental health clinicians in the region reported seeing more men coming to their practice for help.

“You have to have someone there who can hold up a mirror to your biases and help you break them down or you’re just going to be stuck in the same rut,” said Peterson.

“If you’re struggling and you get the sense that this feeling you’re having is not going away, it’s not going to go away,” added French. “It’s going to stay there until you face it.”

WASHINGTON, D.C. — With the bright lights of the holiday season now dark, experts say it is a critical time to make sure people don’t feel dim in the new year.

“It cuts across all age groups,” said Debra Wentz, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies.

Wentz said that during this time of year, winter blues - or seasonal affective disorder - usually affects about 64 percent of people.

“The likely culprit and cause of post-holiday blues is an adrenaline come down,” Wentz said.

While these “winter blues” usually last a few weeks, Wentz said isolation because of the COVID pandemic has made it worse and, in some ways, more intense.

“People are just tired of not, you know, getting back to normal,” she said.

However, there are some things experts say people can do to help themselves deal with the winter blues.

The first: practice self-care by exercising, getting enough sleep and eating well, especially foods rich in vitamin D. People normally get vitamin D when exposed to sunshine, but don’t get as much of it during the winter months.

“There are some studies that show there is a correlation with diet, as far as diminishing the effect of SAD, or seasonal affective disorder,” said Dr. John Martinez, a primary care physician.

Experts also say talking to others by phone or even online can help. Even if you can’t see them in person, connections make a difference.

Volunteering can also have an impact. Giving back can help people feel less lonely and helps strengthen a sense of gratitude.

Pets can also make a big difference in emotional health.

“Letting our pets help us to get healthy is a great way to go," said Temma Martin, with Best Friends Animal Society in Salt Lake City. "Even just eye contact with our dogs and cats is healthy, because those illicit a feeling of love and comfort for us."

If things don’t get better within a few weeks, it may be time to reach out for help from a mental health professional.

“It's also important not to be hard on yourself. Just be patient. This will pass,” Wentz said. “Sometimes you just need to take some time to bounce back.”

In Towson, Maryland, there is a street called Dunkirk Road. There are 32 homes on Dunkirk, where families of various races, religions, and political views live. The neighbors are all close friends.

Related video above: Beautiful Christmas display set up in New Hampshire

So when Matt Riggs, who lives on the block with his wife Kerry, found out his neighbor across the street was struggling with depression in December of 2020, he decided to spread some holiday cheer. Riggs, who had been having a hard time himself during the pandemic, hung his Christmas lights early because he needed some joy. He managed to get one of the strands across the street, over a tree, and connected it to his neighbor's house.

Soon, house by house followed, connecting their lights until the entire block was lit. Riggs tells CNN they all did it again this year, with one neighbor making a metal sign by hand that reads "Love lives here."

An enlightened idea

"I was decorating for the holidays and I was a little bit early. It was actually before Thanksgiving, but it was such a dark time for all of us. I really didn't want to wait anymore," Riggs recalls of last season. "I wanted to go ahead and get things lit up. So, I was climbing the tree and running lights up in my tree and I wanted to see if I could get them to go across the street. And I was so excited when I did get them to go across the street and stay lit."

Riggs' neighbor Leaba Commisso was next.

"Once Matt did it, I talked to my across-the-street neighbor and I was like, 'Hey, let's do it too,'" she says. "It'll bookend the block, you'll drive through one light and then when you leave the block, you'll drive out of it. But it's a lot harder to hang those lights than one would imagine."

That's where Tom Desert came in. He's the handy neighbor who soon figured out how to rig one strand after another, making a canopy over the block and planting anchors in each lawn to hold the strands in place.

"Once there was a job to be done, Tom came out and he was helping us because it's really hard. They're heavy, those lights," Commisso says. "Tom was able to get our lights up and then we were like, everybody let's do it. "

She says a bunch of neighbors got in the car and "cleared out Home Depot."

A message of love

Neighbor Melissa DiMuzio, decided to add a nice touch. While binging shows on Netflix, she bent wire hangers into a sign that reads "Love lives here." She wrapped it in lights and Desert helped get that displayed too.

"I had missed out on actually hanging my own strand, and I really wanted to participate," DiMuzio tells CNN. "It was moving to see just like six or seven light strands going across the street. And so I made the sign."

DiMuzio polled neighbors on what the sign should say.

"That gave me permission to think outside of the happy holiday arena," she says. "The last one was love lives here, which is actually on a wooden plaque in my garage that my mom gave me."

Desert says it was a perfect fit.

"We have 32 homes on this block and despite the differences in opinions and beliefs, however you want to look at that, everybody here loves one another," he says. "I think that love lives here is explanatory of how it works on this block."

Commisso agrees.

"It is a very special place," she says "We parent everybody else's children around here."

This year, the block even added a big mailbox, where kids can leave their letters for Santa Claus to mail to the North Pole.

When everything comes down in January, Desert is in charge of that too.

"I might have to take a day off to take it down. At least the high ones," he says. "They are about 30 feet in the air on the highest peaks of the block."

The neighbor who Riggs was originally hoping to cheer up is doing better these days, he says. The collective light display has lifted everyone's spirits.

"We all suffer that from time to time," Riggs says. "This time last year she was in a dark place and I was too. I'd applied for and been offered three jobs and they were all rescinded because of COVID and I was just broken and defeated. I think anybody that needs a little light in their life, this would be a great neighborhood to go through."

Ireland King and mom Michelle know the effect of the pandemic on mental health.

"I didn't want to leave my room," said Ireland King. "I didn't even feel like eating. My family felt like I didn't like them because I was so rude all the time."

"She basically came out and said she didn't wanna be here anymore," said Michelle King. "More than once."

The Indiana family is by no means alone.

"We describe it as a mental health tsunami going on," said Dr. Thomas Plante, licensed psychologist and psychology professor at Santa Clara University.

That tsunami has millions of Americans grasping for relief. Medication and therapy might be the medical solution, but that’s not always the answer.

"Some people act different to medications, it doesn't always work for people," said Heidi Strunk, president & CEO of Mental Health America of California.  

"A lot of times medication is trial and error."

Stigma, lack of equity and access and a mental health worker shortage are all challenges for people seeking help.

Experts say for the individual, there are some low-cost options.

A quick app store search shows dozens of apps, some focused on checking in with yourself, others can link you to a therapist.

Other ideas: 

• Jotting down what makes you happy 
• Getting movement or exercise 
• Journaling 
• Finding an outlet like music, video games, or art 
• Joining online or in-person support groups

"When you identify that, do it. There's power in doing what makes us happy," said Strunk. "These are things that people need to do, of course, before we get into crisis, but being proactive."

It's not just up to the individual.

"Lots of times it's really hard for people to do anything individually because they're paralyzed by the anxiety or the fear of the depression or whatever," said psychologist Dr. Thomas Plante. "And it's hard for them to really be proactive in helping themselves."

Plante says employers, bosses, family, and friends can start with a simple, "I get that."

"We need to journey with people in solidarity. You know, we need to be with them and we say, you're anxious. I get that. I get anxious, you're depressed, I get depressed," said Dr. Plante. "You know, you're feeling suicidal. I don't blame you, you know, but you know, the world is a mess."

And beyond that, people can follow up.

Another option: a warm line.

Warm lines aren’t crisis hotlines, but a tool for people before they’re in dire straits. There are more than 100 in the U.S. The majority are staffed by people like Bettye Foster, who have firsthand experience.

BETTYE FOSTER: We're all primary caregivers of someone with a mental health challenge.

LINDSEY THEIS: So even yourself?

FOSTER: Even myself. So I have a family member that I was the primary caregiver for. And some of our advocates are still that primary caregiver for someone.

It’s not a call for help, but it is a call to help. Because, as Bettye puts it:

"You see someone on the street and you're like, yeah, you don't know what's going on with that person," said Foster. "And you also don't know what's going on with the person who looks good, who looks well. You know, for that, you may think they've got it all together. You don't know, because mental illness doesn't have that kind of face."

Meanwhile, the Kings search for more help for Ireland. She’s lived through the COVID health crisis, and is now among the millions hit by the mental health crisis.

"There needs to be something. Something needs to change," said Ireland King.

"I’m not willing to let her slip through the cracks, and no other family should either," said Michelle King.

This story was originally reported by Lindsey Theis on Newsy.com.

Over half of people with chronic depression who attempted to stop their antidepressant medication relapsed into depression by the end of a year, compared to those who did not stop medicating, according to a randomized, double-blinded clinical trial released Wednesday.

The research, published in the New England Journal of Medicine, found that "quality-of-life measures and symptoms of depression, anxiety, and medication withdrawal were generally worse in patients who discontinued their antidepressant therapy."

Interestingly, the study did find a small percentage of people were able to successfully stop their antidepressant without having another depressive episode.

"Some people can stop their medication without relapse, although at present, we cannot identify who those people are," said coauthor Gemma Lewis, a professor of psychiatric epidemiology at University College London.

"I think we can be very cheered by the findings," said coauthor Dr. Tony Kendrick, a professor of primary care at the University of Southampton in the United Kingdom.

"This is really good evidence to support a patient's own decisions — in discussion with their doctor or other prescriber — about whether they should continue antidepressants or not," Kendrick said. "Both courses of action are reasonable."

Antidepressants for life?

When people slip into depression for the first time, current practice is to continue antidepressants between four to nine months after remission of their depression, said Dr. Jonathan Alpert, chair of the American Psychiatric Association's Council on Research, who was not involved in the study.

Remission is defined as a two-month period with no signs of major depression such as sadness and a reduced interest or pleasure in life.

"In my own practice, if the patient has a first episode of depression, and particularly if it was triggered by a life event — death of a loved one, failed business — then I try my best to get patients into remission (and) then I treat for a minimum of six months after they achieve remission," said Dr. Jeffrey Jackson, a professor at the Medical College of Wisconsin, who studies depression.

"If they stay in remission for those six months, then we can consider slowly tapering off the antidepressants — with the person carefully monitoring their own depressive symptoms," Jackson added. Jackson, who was not involved in the study, wrote an accompanying editorial published in NEJM.

Unfortunately, the danger of another bout of depression later in life is high, said Alpert, who is also the chair of psychiatry at Montefiore Health System in the Bronx.

"If one has had one episode of depression, the chances of a second episode sometime during one's lifetime is 50%," he said. "If somebody has already had two depressions, the chances of a third are even higher — over 75% of people who have had two or more depressions will have another."

Science has long known that people with recurrent depression have the most difficulty coming off antidepressants and the most likelihood of relapse when they do, Alpert added.

"For patients who have had three or more depressive episodes, I generally plan to treat them for life," Jackson said.

Addressing out-of-date research

Much of the research done on long-term effectiveness of antidepressants is old and limited, so the study was designed to fill that gap in knowledge, the study authors said.

"Many people are taking long-term antidepressants, and the evidence to advise them whether to continue maintenance or discontinue is poor," Lewis said.

The study recruited 478 people from 150 primary care practices in the U.K. Each person had experienced at least two depressive episodes or had been on antidepressant medication for two years or more. All felt well enough to stop taking their medication.

"This is the largest study that's been done in a real-world primary care setting," said Alpert.

"That's important because most patients with depression are managed by their primary care provider," Jackson said. "Most primary care providers only refer to psychiatrists if the patients are suicidal, homicidal, psychotic, bipolar or not responding to therapy."

Only people taking maintenance dosages of four antidepressants were included in the study: citalopram (Celexa), fluoxetine (Prozac), sertraline (Zoloft), and mirtazapine (Remeron). Other popular antidepressants, such as escitalopram (Lexapro), were not included due to the greater likelihood of severe withdrawal symptoms, the authors said.

All medications and the lactose placebo in the study were packaged identically in unmarked bottles so that both patients and researchers were blinded to the contents.

Half of the group was given reduced dosages of their antidepressant over a two-month period; by the beginning of the third month, all were taking placebo. The other half of the group continued to take their normal dose of antidepressant.

At the end of 52 weeks of follow-up, 56% of the people who had been weaned off their antidepressant had relapsed into depression, compared to 39% of the people who continued their medications.

"The patients who stopped their antidepressants experienced a relapse sooner than the patients who stayed on their antidepressants," Lewis said.

Symptoms of depression and anxiety were higher in the group who discontinued their medications as well, she added. But could those have been withdrawal symptoms instead?

"It's not always that easy to tell," Kendrick said. "If somebody's starting to get anxious, if they're starting to have sleep disturbances or are starting to feel low. Is that depression coming back? Or is it withdrawal symptoms?"

Regardless of the source of the symptoms, a number of people exited the trial even though they did not know if they were on medication or placebo.

"It was clear that they voted with their feet," Alpert said. "When they weren't doing as well, they were more likely to drop out of the trial and more likely to resume medications."

Long-term use

The study results did provide some insight into the benefits of long-term use of antidepressants, Kendrick said.

"It's reassuring to know that antidepressants people are taking long term do seem to be benefiting them, and this is not something that they're taking unnecessarily," he said.

There are side effects to many medications, such as weight gain and sexual dysfunction, "so we try to choose antidepressants and adjust the dose for a given person that they tolerate the best and have the fewest side effects," Alpert said.

"However, to the very best we know, there are no long-term consequences, such as increased risk of cancer, stroke, heart disease or liver problems by virtue of being on antidepressants," he added.

If you do decide to taper, do it slowly and add psychological therapy, which studies have shown "can help prevent the risk of relapse," Kendrick added.

"The latest guidelines are suggesting that you should take some weeks to come off antidepressants," he said. "If you're getting withdrawal symptoms and finding it difficult, you might need to take months to come off them."

What else can be done?

Antidepressants are, of course, not the only treatment for depression. There are many things people can do to improve their depressive symptoms while on medication or reduce the likelihood of a relapse once weaned off an antidepressant, Alpert said.

Physical activity is key. "It looks like even relatively moderate amounts of activity, like a brisk walk several times a week, can help in the treatment of depression and also help in relapse prevention," he said.

Social connections are important, too. Making an effort not to be isolated, by reaching out to others for social support, makes a difference, as do activities that are meaningful and rewarding, Alpert said.

"Community activities, volunteer activities, seem to be important in helping with depression," he said. "When people are pursuing goals that are meaningful to them, that's also helpful."

Evidence-based psychotherapy works. "People who opt to taper off their medications have a greater chance at staying well if they're pursuing certain forms of psychotherapy that have been shown in studies to be effective," Alpert said.

Cognitive behavioral therapy, or CBT, has been widely studied and considered to be comparable in effectiveness to antidepressants for depression. It's often used in conjunction with medication for people whose symptoms do not improve on antidepressants alone.

The therapy focuses on a person's thought process, attempting to interrupt false or negative thoughts about oneself and others that can lead to a depressive mood. Instead, people are encouraged to substitute healthier, more positive thoughts, which can improve self-image and behavior.

"It's not quite like lying on the couch and free associating," Alpert said. "There's specifics like homework assignments and skills that people acquire."

Acceptance and commitment therapy, or ACT, uses a similar approach, Alpert said, with more of a focus on accepting negative thoughts and discarding them.

"Rather than changing your thoughts, you accept the idea that they're just thoughts, they're not the same as reality, and they are not who I am," Alpert explained. "Realizing that thoughts like 'I'm not good enough' and so on are just thoughts, and learning how to push those thoughts away."

Interpersonal psychotherapy or IPT, focuses on changes in one's life that has to do with interpersonal relationships, Alpert said.

"Interpersonal therapy has to do a lot with relationships like losses or transitions in one's role with others ... and then working on those, like how can you go ahead with a life worth living and adapt to or will make the best of those transitions," he said.

Therapists will often tell patients about the different approaches, as one may be a "better match to where they are in their lives and the things that they're dealing with," he added. "There are many things that people can do in addition to medications."

SEATTLE, Wash. — Working in emergency services means putting yourself in dangerous situations.

Often, it is life or death, like when a devastating mudslide hit a community north of Seattle in 2014.

“I was deployed to the Oso mudslide about seven years ago and it was a mudslide that killed 40 people,” said Lt. Michael Dulas, with the Seattle Fire Department.

“My role was to help search the mudslide for people. So, we were literally digging, looking for people,” he said.

The weeks-long search effort left an impression on Dulas and hundreds of other first responders.

“We were up there for four 24 hour shifts in a row,” said Steve Yeutter, who works with Dulas at the fire department.

“The most normal part of that day was petting the search dogs at the end of the day,” said Dulas.

The Oso slide and its aftermath inspired Dulas to make a small but significant change within Seattle Fire. The department got dogs.

“Zoe’s a 2-year-old Bernedoodle, so half Bernese mountain dog and half poodle,” said Dulas.

Zoe is Mike’s dog and one of three therapy dogs who have joined the fire department as part of a pilot program. The other two, Hera and Bob, are also owned by Seattle firefighters.

“She’s just being a dog, bringing a smile to people’s faces, being goofy, doing dog things. And dogs are proven to lower your heart rate, lower your blood pressure,” said Dulas

Agencies across the U.S. are looking for a solution to the mental health crisis. Police and firefighters are now more likely to die by suicide than in the line of duty. About 30% of emergency responders will develop behavioral health conditions like depression and post-traumatic stress disorder (PTSD).

“For a number of years, those issues were really under-recognized, and it was just assumed, 'Oh, they’re tough. They see it every day,'” said Chip Schreiber, a clinical psychologist at UCLA who specializes in creating programs to reduce PTSD in first responders.

“Suicide and serious depression are the final common pathway of stress and symptoms that potentiate and then lead to greater conflict in the environment and ability to function in your family,” said Schreiber.

“In ’95, Seattle lost four firefighters in the Mary Pang warehouse fire. One of them was my very best friend. Randy Terlicker was his name,” said Yeutter. “Had a hard time for about 24 hours just even functioning.”

Yeutter has spent three decades with Seattle Fire.

Today, one of his jobs is working as a peer support coordinator, helping firefighters deal with a wide variety of scenarios.

“Possibly line of duty deaths, injuries to firefighters. Some of the other things that might trigger a response might be multi-casualty incidents, or possibly suicides or difficult runs with children,” said Yeutter.

Yeutter and Dulas both say they've had experiences where they wished there was more offered by the department.

“I lost a little brother who was in the Army to suicide. I’ve watched my older brother as a firefighter struggle with PTSD and that’s a lot of my motivation is just I want to take a different path and I want to be well,” said Dulas.

Both say there are more resources available to firefighters today.

“When you feel those reactions when you sick, when you feel stressed, when you can’t sleep for a couple weeks, get out there and ask for help,” said Yeutter.

“I want to see everyone retire healthy, happy, with their families intact and just go have a great life after,” said Dulas.

NEW ORLEANS — After being battered by tropical storms and hurricanes in the record-breaking 2020 hurricane season, and spring flooding over the last several weeks, Louisiana is under a state of emergency this weekend as severe weather heads toward the state.

“According to the National Weather Service (NWS), rainfall will be the biggest threat,” said Gov. John Bel Edwards in announcing the state of emergency. “In addition to heavy rains, there is also a threat of coastal flooding, tropical storm-force winds and isolated tornadoes."

As of Friday afternoon, the storm had winds of about 45 mph but lacked a single defined center, or eye, with a rotation that would make it classified as a tropical storm.

However, because of the chance for heavy amounts of rain in a short period of time, tropical storm warnings remain in effect for parts of southeast Louisiana, Mississippi, Alabama, and into the panhandle of Florida.

Planned Juneteenth celebrations across the area have been canceled or postponed because of the storm.

Related video: Vets backlogged, weary from COVID pet boom

Madison Vollbracht says she burned out after five years working as a veterinary technician.

Her work was already grueling before the COVID-19 pandemic.

But the pandemic sparked a dramatic increase in pet adoptions, "COVID puppies and kittens," as Vollbracht calls them, as well as a rise in inquiries about pet care, which greatly increased the workload.

Also, the mandatory lockdowns forced many people out of work, which meant some owners could no longer afford care for their pets, and in some cases, had to surrender or euthanize them.

The effects of the pandemic took a toll on Vollbracht. The vet tech says she "had more anxiety and depression than joy from the job," even after changing clinics.

"There were a couple of days where everything was dying," she says. "And it was around Christmastime. It was my first Christmas working emergency and it also happened (during) the pandemic and I had only discharged one patient that day. Everything else had been euthanized. And that was my, 'I'm kind of done with this' day. I euthanized 16 patients that day."

That holiday season in 2020, she realized she'd had enough, and is now a veterinary assistant instructor at the Pima Medical Institute.

Approximately half of all vet techs burn out of the profession within their first five years and 35% of them burn out altogether.

Rise in adoptions strain veterinary clinics

Inquiries about pet adoptions increased 70% between March 2020 and March 2021, according to Petfinder.com spokeswoman Lorie Westhoff. And an ASPCA survey released in May 2021 shows that 90% of dogs and 85% of cats adopted during the pandemic were kept by their owners.

Millennials and Gen Zers are also adopting pets at higher rates than their predecessors, says Mark Cushing, a founding partner and the CEO of the Animal Policy Group. Because baby boomers are adopting fewer pets as they grow older, millennials and Gen Z adults now make up half of all pet owners, he says.

"Millennials, last year where they had or got one dog, they got two or had one dog and thought a cat might be fun," he says. "People who are into it, they know how much fun it is and want to have a playmate for their pet when they go back to work."

While an increase in pet adoptions is generally a good thing, it also means that veterinarians and vet techs have to see more patients, field more calls from pet owners, which sometimes result in delayed visits and care. Dr. Douglas Kratt, president of the American Veterinary Medical Association, tells CNN that a recent AVMA survey found that the average number of patients a veterinarian saw per hour was 25% lower in 2020 than in prior years, which means clients are waiting longer before their animals can be seen.

"This has also resulted in an increase in client wait times — our current data indicate an average 20-minute wait in 2020, up from 11 minutes in 2019," Kratt says. "While the amount of time it takes to see each patient has increased, total veterinary visits in the United States do not appear to have gone up — according to national data compiled by the AVMA and VetSuccess, the number of veterinary visits in the United States was about the same in 2020 as compared with 2019."

That number has remained about the same not because fewer people are trying to see their veterinarians; rather, it's because there aren't enough veterinarians to meet client demand. Dr. Karl Jandrey, associate dean for Admissions and Student Programs at the University of California, Davis, who also practices as an emergency critical care specialist, says that people working from home means they're seeing problems with their pets that they wouldn't have normally noticed, leading to more calls with concern. It also means the shortage of veterinarians and vet techs has led to a need to stop taking new clients and squeezing others in.

"(You go from) not having enough prior — veterinarians and technicians — to even worse during the pandemic, where everyone else has to work harder and more," he says. "Instead of having your average emergency shift, one patient every half-hour, you now have four every hour you're trying to deliver care to. Something's gotta give, right?"

Where are all the vet techs?

Andrew Maccabe, CEO of the American Association of Veterinary Medical Colleges, says that applications to graduate veterinary medicine programs increased by 19% this past cycle compared to the previous year. But for veterinary technicians, the promise of an enriching career is not as apparent, despite only requiring two years of schooling, and even less in some states.

Jennifer Serling, president-elect of the Association of Veterinary Technician Educators, tells CNN that 35% of all vet techs eventually "burn out," while Cushing says that half of them leave the profession within five years. Vet tech educational retention is also down about five to 10%, Serling says, which she believes is "directly related to the pandemic."

Cushing says that inadequate pay often leads vet techs to leave the profession. On average, he says, veterinary technicians are paid $32,000 a year, which is "close to the poverty level" in some parts of the country. That can be as much as half the starting salary of a registered nurse in human medicine, Serling adds.

Vollbracht tells CNN her highest pay as a vet tech "started with a $16" per hour and there were times when there were more veterinarians in her clinic's emergency room floor than vet techs themselves.

"What started my burnout was really the money aspect and always being constrained with what we can do treatment-wise based on owners' financial situations," she says. "(I would go over) treatment plans and estimates with owners but (was) being constantly told 'no' or being belittled and berated for requiring such costs, in advance or at all, for certain things to be done and then not being able to do those things because they couldn't be afforded."

In addition to being underpaid, vet techs are also underutilized. Cushing says that half of vet technicians' learned skills are often ignored, leading to decreased morale as veterinarians' working dynamics with vet techs can be less delegated and collaborative than those in human hospitals and clinics.

"I'll say publicly, if you chronically underpay someone, they'll be looking to leave," he says.

"If you're trained to do it all and only do half, and you're told by a veterinarian, 'I'll do the rest,' you create a morale issue that is systemic across the profession."

Serling points out that vet techs, unlike RNs and physician assistants, are responsible for providing care to "multiple species that can't talk and tell us what's wrong." Unlike a hospital or a doctor's office, which has specialty nurses and assistants for everything, veterinary technicians are required to do it all, and then some.

"We have the same training as an RN," she says. "It's not just the same things as them but anesthesia, radiology, (etc.). We do a lot of the human components of medicine combined into multiple species, so utilizing us fully is a huge plus to the practice (of veterinary medicine)."

That ubiquitous involvement in end-of-life care, which is more specialized in human medicine, also takes its toll.

"It's both a blessing and a curse in that we can end our patients' suffering with euthanasia but that does weigh heavily on the individuals and can be incredibly mentally taxing," Serling says. "Early on, we get into this because it is a labor of love, not one we'll get rich at doing. You love your patients, love animals and want to help them. When you get that emotionally attached and driven into this field, that can also be mentally taxing as well."

Serling also points out that pet insurance is often not used, meaning that the expenses that hospitals and health care practices can largely bill to insurance companies have to be absorbed by the veterinary clinics, if not billed to the clients themselves.

"Until we're able to charge appropriately for the services we're providing, it's going to be difficult for clinics and some vets (to afford their expenses)," she says. "Veterinarian salaries and the cost of all that, even that is significantly less than their MD counterparts. There's a lot of catch-up to do so we're earning what we deserve."

How the field is trying to adapt

Maccabe says that one of the biggest causes for the perception, or reality, of a workforce shortage, is the inefficiencies caused by the pandemic. COVID-19 infection control procedures have slowed the ability of veterinarians and their health care teams to handle caseloads, and in a field that has long relied on direct, in-person care, it has caused extended waits on top of the added influx of pets.

On the educational side, Maccabe says that many virtual programs offering models and simulations for students to practice on have eased the burden the pandemic has placed on training future veterinarians. So, what are veterinary clinics doing? Some of them have adopted telehealth policies for visits in order to alleviate the burden caused by waiting for in-person care.

"With video conferencing available, even when people were taking their animals to clinics, they oftentimes had to drop the animal off, get a phone call or video call to see what the vet saw, right?" he says. "(For) how much of that did the animal need to be transported, whereas some could have been done at home? So that's where I think every crisis like (the pandemic) drives innovation."

Cushing says that veterinary medicine is a conservative field and that, on the whole, vets "don't welcome change." He says the field is about 25 years behind human medicine in terms of delegation of tasks and proper use of staff.

Some schools, such as Lincoln Memorial University, are starting to institute a middle ground master's degree, akin to a nurse practitioner, that would allow for positive movement up the ladder. Cushing says it would help vet techs who may still not want to attend or can't afford the schooling required to obtain a veterinary medicine degree to advance their careers.

The rewards aren't just financial for veterinary professionals. Private equity firms are investing more money into veterinary clinics, Cushing says, after seeing how lucrative the field is. In order for them to feel like they can get a proper return on their investments, they want to see additional outlets to prevent the staff they're invested in from burning out.

Serling says some of the improvements can take place in how clients approach their visits with veterinary staff.

"I think that owners do need to understand there are some incredible wait times right now," she says. "It can be difficult to get appointments. Usually, surgeries can be scheduled within a couple of weeks, so two months out is very unusual."

Generally speaking, though, Serling says revenue remains high enough that there should be enough money to go around to pay vet techs a higher salary.

"I think an increase in pay is the number one thing and I think technician utilization is the other," she says. "I think training veterinarians to utilize us and our education (is key). There's an AVMA study that says for every credentialed technician, they bring about a $90,000 to $100,000 increase in revenue per year. So utilizing us to the best of our ability (would change things)."

Maccabe says that despite the stresses of the pandemic, he believes necessary changes and progress in the field are on the horizon.

"I'm very optimistic about the future," he says. "I think that as challenging as this last year and a half has been, not just for our community but society in general, ... it has driven some changes to have a long-lasting impact to improve quality of teaching, care, and access in a way that might have been delayed or postponed for many years if not for this pandemic."

A new study by researchers at the University of Chicago and Washington University in St. Louis found that the effects of inhaling nitrous oxide gas, which is better known as laughing gas, can help reduce the symptoms of depression.

The study was published Wednesday in Science Translational Medicine.

According to the study, researchers found that a single, one-hour inhalation treatment with 25% nitrous oxide could relieve symptoms of treatment-resistant major depression (TRMD) rapidly.

Twenty-four participants with TRMD were assigned into three treatment groups where they inhaled 50% nitrous oxide, 25% nitrous oxide, or a placebo for a single 1-hour session for three months.

Researchers found that for those who inhaled only half the concentration of nitrous oxide, the treatment was nearly as effective as 50% nitrous oxide.

According to Washington University, researchers said 17 of the participants had improved and eight of them were no longer considered clinically depressed.

This pandemic has triggered anxiety, depression, and elevated stress for so many, even if you've never experienced it.

So now, a local mental health organization is trying to reach out to those struggling and offer free resources to help.

"Anxiety is up, depression is up and people that live with mental health conditions already, those things really can be and have been exacerbated because of this last year," explained Colleen Thayer, the executive director of NAMI, the National Association of Mental Illness in Sarasota and Manatee Counties.

Thayer says this pandemic has caused many to suffer from anxiety, stress, and even depression. So, NAMI is launching a new campaign called "You Are Not Alone."

"We try to encourage people to really reach out," Thayer said.

Thayer says it's so important to take care of your mental well-being during this challenging time.

"Sometimes self-care is just so critical. And sometimes that means, you know, you take an extra 10 minutes to walk around your neighborhood or make a phone call to a friend or write. Or, you know, whatever people can do for their own self-care. We really try to encourage that," she added.

NAMI in Sarasota and Manatee counties offers many free resources, as well.

"We have support groups, and they're peer-led. So there are peer support groups for people that live with mental health conditions. And then, there are family support groups. And we also do a wide variety of education classes geared towards family members, peers, family members of younger people," Thayer said.

If you think you should tough it out and handle the extra stress, Thayer says it's important to talk about mental issues like you would any other physical issue.

"It is like any other kind of chronic health condition. It's manageable, and people can live very, very fulfilling and happy lives," she explained.

Along with in-person support groups, NAMI also offers free virtual support groups.

For more information on that and other free resources, click here. Or you can call NAMI's office directly at (941) 444-3428.

But if you need help right away, call the National Suicide Prevention Lifeline at 1-800-273-talk or 1-(800) Suicide. They both have someone standing by 24/7.

Wendy Ryan at WFTS first reported this story.