TIME mental health/psychiatry

Why Some Antidepressants Make You Feel Worse Before Better

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There’s a paradoxical period when a person first starts an antidepressant: they may actually begin to feel worse before feeling better. The underlying cause of this phenomenon is a bit of a mystery, but a new study from researchers at Otto-von-Guericke University in Germany explains why this might occur.

The gap between starting an antidepressant and feeling its positive effects—a time period that’s typically a couple weeks but may last up to a month—can sometimes be characterized by an increased risk for harmful behaviors. Researchers have previously speculated that when a person starts an antidepressant, they may suddenly have a surge of energy they didn’t have before. If that person is suicidal, the effect may provide enough energy to act upon their feelings.

The controversial idea caught on. A decade ago, the U.S. Food and Drug Administration (FDA) issued a “black box” warning—the most stringent of warnings—on all antidepressants warning of possible suicidal thoughts and behaviors. As TIME recently reported, many psychiatrists were (and still are) upset by the label, arguing that it’s led to a drop in antidepressant use among patients. Physicians, fearful of the risks, may also be deterred from prescribing them.

MORE: Do Depression Drugs Still Need Suicide Warnings?

In the new report, published in the journal Trends in Cognitive Sciences, the researchers reviewed several recent studies and found that the issue may stem from an effect of the most commonly prescribed antidepressants: selective serotonin reuptake inhibitors (SSRIs). SSRIs release two chemicals in the brain that kick in at different times, causing a period of negative effects on mental health, the authors report. The first chemical is serotonin, which is released very soon after an SSRI is taken but might not lessen depressive symptoms until after a couple of weeks. The second chemical is called glutamate, which can take a few days longer to be properly released. According to the new study, the serotonin neurons send off a dual signal to the two chemicals, causing the variant time frames for the chemicals, and therefore the problem period.

“There’s a lot you can do [in this period] and it’s important to let patients know that,” says Dr. Donald Malone, chair of the department of psychiatry and psychology at Cleveland Clinic. (Malone was not involved in the new study.) “It doesn’t typically last longer than the first week. But you may need to go down on the dose or switch medications. We’ve always prepared patients for how it can go, and that this was the beginning.”

Depression itself—not an antidepressant—is the greatest risk factor for suicide, and these new findings provide new insight for what patients can expect at the start of their treatment.

MONEY Health Care

5 Ways to Save on the Mental-Health Care You Need

Group therapy can be 50% less expensive than one-on-one sessions.

Get the treatment you need at a price you can handle.

Affordable mental-health care has been easier to come by in recent years. Insurance coverage, once riddled with onerous caps and restrictions, is now more widely available. “Things have gotten better for many,” says Andrew Sperling, director of federal advocacy at the National Alliance on Mental Illness.

Still, paying for care can be a challenge. The high out-of-pocket costs that you’re facing for all your health care extend to behavioral coverage too. And low reimbursement rates and billing hassles have led many therapists to not take insurance. A study published last year in the journal JAMA Psychiatry found that only 55% of psychiatrists accept private insurance; for all other medical specialties, that figure is 89%.

Here’s what you need to know about finding the best treatment at the best price.

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MONEY

Insurance Options are Better

Under a 2008 law that took effect in 2010, health plans offered by large employers that include mental-health coverage must treat it like other medical care. So a plan can’t cap annual visits or impose prior authorization rules for behavioral health if it doesn’t do the same for other illnesses, says Jennifer Mathis, director of programs at the Bazelon Center for Mental Health Law. Co-insurance rates have to be the same too. As the graphic above shows, the parity law hasn’t discouraged employers from offering coverage.

Any individual plan you buy on a state insurance exchange must include mental-health coverage; it’s one of the 10 essential benefits required by Obamacare. The provision in the law that lets children stay on a parent’s health plan until age 26 is another boon, since most major psychiatric conditions show up in late adolescence or early adulthood, notes Debbie Plotnick, senior director of state policy at the nonprofit Mental Health America.

Medicare coverage is also better. As of 2014, benefici­aries are responsible for only 20% of mental-health costs, down from 50%.

Your Employer Can Often Help

Especially if you have a high-deductible health plan, start with your company’s employee assistance program, says Kathleen Mahieu, leader of behavioral-health consulting at benefits consultancy Aon Hewitt.

About three-quarters of employers offer an EAP. These programs typically provide five or six sessions of no-cost counseling, even for family members. That’s enough for some people to resolve their issues, says Katherine Nordal, the American Psychological Association’s executive director for professional practice. An EAP can help you find a provider or connect you with other mental-health resources. “It’s a one-stop shop,” says Mahieu. And, she adds, EAPs pride themselves on confidentiality. Your boss won’t know, and you don’t even have to give your name.

Your Bill is Negotiable

When your therapist isn’t in your insurance network, you’ll have to pay upfront and submit the bills for partial payment (assuming you have out-of-network coverage) or, if you’re in an HMO, pay in full. Even if you are reimbursed, you won’t get back, say, 70% of the bill. You’ll get 70% of what the insurer considers “reasonable and customary,” leaving you on the hook for the rest.

If you can’t find an appropriate provider in your plan, ask your insurer to negotiate what’s known as a single-case agreement with someone who’s not in your network, says Barbara Griswold, a licensed marriage and family therapist in San Jose. That would let you to pay the in-network rate.

You can also ask about a reduced fee, says Griswold. “Almost every therapist has a sliding scale,” she says. Be realistic about what you’ll be able to afford and how long you’re likely to want therapy.

You Have Other Ways to Save

A university with a graduate psychology program may have a clinic, says the APA’s Nordal. Care is provided by doctoral trainees who are supervised by licensed psychologists. In an urban area, you may be able to find postgraduate training programs in psychoanalysis or cognitive behavioral therapy for experienced psychologists, says Geoffrey Steinberg, a licensed psychologist in New York City. (Google “training clinic” and the specialty you’re looking for.)

Another option: Ask your therapist if your condition might benefit from group therapy led by an experienced psychologist, which can be 50% less expensive than one-on-one sessions. Says Steinberg, “Group is so underrated and can be so valuable.”

Know Which Treatment Is Best for You

“No single therapy works for everybody,” says Renée Binder of the University of California at San Francisco’s School of Medicine. Consider these approaches for five common conditions.

1. Mild to moderate depression: Go for cognitive behavioral therapy (CBT). “A therapist works with you to break negative thought patterns by teaching specific skills,” says Binder. You might learn, for example, to ID overly critical self-talk (“Everything I do gets screwed up”) and reframe it in a positive way (“I flubbed a presentation, but I know I can rock it next time.”)

2. Severe depression: Combining antidepressants with CBT is better than meds alone, a recent Vanderbilt University study found. You need to see an MD or a psychiatric mental-health nurse practitioner for the prescription, but you can get therapy from a social worker or a psychologist.

3. Social anxiety: Your best bet is either CBT or psycho­dynamic therapy (in which you explore how your past experiences and unconscious affect you). In a study published in July in the American Journal of Psychiatry, these methods were equally effective at easing social anxiety.

4. Panic attacks: CBT is usually the treatment of choice. Some research suggests psychodynamic therapy may also work: A Weill Cornell Medical College study found that 12 weeks of biweekly sessions significantly reduced symptoms in more than 70% of patients. Medications may also be used.

5. Trauma: Look for a therapist who offers trauma-focused CBT or EMDR, which stands for eye movement desensitization and reprocessing (you’re asked to recollect the event while doing a motor task such as side-to-side eye movements). “Antidepressants and anti-anxiety meds are helpful in the short term, but therapy works to change thought patterns long term,” says Binder.

 

TIME Mental Health/Psychology

Most People With Depression Aren’t Getting Treatment, Survey Finds

The latest depression report shows that the majority are suffering in silence

The latest statistics on depression in the U.S. don’t paint a picture of progress, though the condition is common. Nearly 8% of Americans over age 12 have recently been depressed, finds the new report from the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention, but the vast majority aren’t actively getting treatment.

Of those surveyed between 2009 and 2012, about 3% with depression reported having severe symptoms, and nearly all of these people (90%) said their depression made it difficult to work, go to school or participate in their normal activities at home and in other social settings.

Women are more likely than men to be depressed at any age, and women between 40 and 59 years old had the highest rates of depression among the adults studied. While the survey did not delve into the possible reasons for depression, other studies suggest that for many women in this age group, the pressures of balancing work and family responsibilities, including children as well as aging parents, may lead to added mental health burdens.

Poverty seems to be a factor in depression as well. Those living below the federal poverty level were more than twice as likely to be depressed than those living above the line; this trend applied regardless of race or ethnicity.

But what was most concerning to study co-author Laura Pratt, an epidemiologist at the NCHS, was that 65% of people with severe symptoms of depression were not getting help from a mental health professional. “The fact that people aren’t getting treatment is disturbing,” she says. “People with severe depression should be getting therapy from a mental health professional, and they should also in a lot of cases be on a more complicated medication regimen that requires a psychiatrist to treat them. The fact that only 35% have seen a mental health professional in the last year was pretty alarming.”

The data should raise awareness about the prevalence of depression, she says, and hopefully stress the importance of encouraging those with depression to seek help. “It’s serious, it really affects your life and we need to figure out a way to get people treated appropriately,” she says.

TIME Innovation

Five Best Ideas of the Day: December 2

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Let’s push for more college-educated cops.

By Keli Goff in the Daily Beast

2. As strongmen — often U.S. allies — attempt to lock up lifetime power, an African democracy movement takes shape.

By Mark Varga at the Foreign Policy Association

3. Being connected is more of a good thing than a bad thing.

By Mathew Ingram in GigaOm

4. Beyond diamonds: Conflict minerals are a growing blight. Enforcing a global standard can stop abuse.

By Michael Gibb in Project Syndicate

5. Changing the way we classify psilocybin — magic mushrooms — could open the door to research and new treatments for depression.

By Eugenia Bone in the New York Times

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Mental Health/Psychology

Suicide Risk Drops 26% After Talk Therapy

Suicide is a problem with few concrete preventive solutions, but a new study in Lancet Psychiatry finds that intervening with talk therapy after a suicide attempt seems to have some amazing long-term effects.

Researchers from Johns Hopkins Bloomberg School of Public Health looked at data from about 65,000 people who had attempted suicide between 1992-2010 in Denmark. The country opened suicide clinics in 1992 and provided them nationwide in 2007, and some of the people had gone to one of these clinics and received 6-10 sessions of talk therapy. The rest of the people did not.

When the researchers analyzed the data after a 20-year follow-up, those who had received the talk intervention fared much better. They repeated acts of self-harm less frequently and had a lower risk of death by any cause, including death by suicide.

After five years, there were 26% fewer suicides in the group who received therapy than in the other group. About 145 suicide attempts and 30 suicides were prevented in the talk therapy group, the researchers estimated.

“People who present with deliberate self-harm constitute a high-risk group for later suicidal behavior and fatal outcomes, so preventive efforts are important; yet, implemented specialized support after self-harm is rare,” the researchers wrote in the study.

Though the study had a long follow-up period and population size, it was not a randomized controlled trial, but such an intervention would be ethically impossible, the study authors write. “These findings might be the best evidence available and provide a sound basis for policy makers who wish to limit suicidal behavior and fatal events in an accessible high-risk group, which, in many countries, receives little support.”

 

TIME mental health

Women in Positions of Power Show More Signs of Depression Than Men

A study found that women in the workplace experience more symptoms as they gain job authority, while the opposite is true for men

Symptoms of depression become more prevalent for women as they obtain job authority but less prevalent for men, a new study from the University of Texas at Austin suggests.

Researchers looked at 1,300 middle-aged men and 1,500 middle-aged women for the study, “Gender, Job Authority and Depression,” which appears in the December issue of the Journal of Health and Social Behavior. Women with the ability to affect pay and fire and hire others had more symptoms of depression than women without such authority. Men with similar authority at work had fewer symptoms of depression than those without, the study reports.

“What’s striking is that women with job authority in our study are advantaged in terms of most characteristics that are strong predictors of positive mental health,” said sociologist Tetyana Pudrovska. “These women have more education, higher incomes, more prestigious occupations, and higher levels of job satisfaction and autonomy than women without job authority. Yet, they have worse mental health than lower-status women.”

One explanation is that women face more stressors at work when in positions of power because they are faced with overcoming more stereotypes and resistance to their leadership. Men, on the other hand, don’t appear to face such obstacles.

“Men in positions of authority are consistent with the expected status beliefs, and male leadership is accepted as normative and legitimate,” Pudrovska said. “This increases men’s power and effectiveness as leaders and diminishes interpersonal conflict.”

MONEY Health Care

The 7 Biggest Health Problems Americans Face—And Who is Profiting

Bottles of prescription medicine in cabinet
Kim Karpeles—Getty Images/age fotostock

Here are the most-prescribed drugs in America.

Americans include two health-related issues among the 10 most important problems facing the U.S., according to a recent Gallup survey. Healthcare in general ranked fourth on the list, with Ebola coming in at no. 8. But is Ebola really among the biggest health problems for Americans? Not when we look at the chances of actually being infected.

So, what are the actual biggest health problems that Americans face? One way to answer this question is to look at what drugs are prescribed the most. Here are the seven top health problems based on the most-prescribed drugs in the U.S., according to Medscape’s analysis of data provided by IMS Health.

1. Hypothyroidism

AbbVie’s ABBVIE INC. ABBV 2.023% Synthroid ranks at the top of the list of most-prescribed drugs. Synthroid is used to treat hypothyroidism, a condition caused by an underactive thyroid gland.

The American Thyroid Association estimates that 2%-3% of Americans have pronounced hypothyroidism, while 10%-15% have a mild version of the disease. Hypothyroidism occurs more frequently in women, especially women over age 60. Around half of Americans with the condition don’t realize that they have hypothyroidism.

2. High cholesterol and high triglycerides

Coming in at a close second on the list is AstraZeneca’s ASTRAZENECA PLC AZN 0.9057% Crestor. The drug is used to help control high cholesterol and high triglyceride levels.

According to the American Heart Association, nearly 99 million Americans age 20 and over have high cholesterol. Elevated cholesterol levels are one of the major risk factors for heart attacks and strokes. The problem is that you won’t know if you have high cholesterol unless you get tested — and around one in three Americans haven’t had their cholesterol levels checked in the last five years.

3. Heartburn and gastroesophageal reflux disease

AstraZeneca also claims the third most prescribed drug in the nation — Nexium. The “purple pill” helps treat hearburn and gastroesophageal reflux disease, or GERD, also commonly referred to as acid reflux.

Around 20% of Americans have GERD, according to the American Society for Gastrointestinal Endoscopy. A lot of people take over-the-counter medications, but that’s not enough for many others. Medscape reported that over 18.6 million prescriptions of Nexium were filled between July 2013 and June 2014.

4. Breathing disorders

The next two highly prescribed drugs treat breathing disorders. GlaxoSmithKline’s GLAXOSMITHKLINE PLC GSK 0.2863% Ventolin HFA is used by asthma patients, while the company’s Advair Diskus treats asthma and chronic obstructive pulmonary disease, or COPD.

More than 25 million Americans have asthma. Around 7 million of these patients are children. Meanwhile, COPD, which includes chronic bronchitis and emphysema, ranks as the third-leading cause of death in the U.S.

5. High blood pressure

Novartis NOVARTIS AG NVS 0.6983% claims the next top-prescribed drug with Diovan. The drug treats high blood pressure by relaxing and widening blood vessels, thereby allowing blood to flow more readily.

Around one-third of American adults have high blood pressure. Many don’t know that they are affected, because the condition doesn’t usually manifest symptoms for a long time. However, high blood pressure can eventually lead to other serious health issues, including heart and kidney problems.

6. Diabetes

Several highly prescribed drugs combat diabetes, with Sanofi’s SANOFI S.A. SNY 1.3222% Lantus Solostar taking the top spot for the condition. Lantus Solostar is a long-acting basal insulin that is used for type 1 and type 2 diabetes mellitus.

According to the National Diabetes Statistics Report released in June 2014, 29.1 million Americans had diabetes in 2012. That’s a big jump from just two years earlier, when 25.8 million Americans had the disease. Diabetes ranks as the seventh leading cause of death in the U.S.

7. Depression and anxiety

Eli Lilly’s ELI LILLY & CO. LLY 1.4727% Cymbalta fell just below Lantus Solostar in number of prescriptions. Cymbalta is the leading treatment for depression and generalized anxiety disorder.

The Anxiety and Depression Association of America estimates that 14.8 million Americans ages 18 and older suffer from a major depressive disorder each year. Around 3.3 million have persistent depressive disorder, a form of depression that lasts for two or more years. Generalized anxiety disorder affects around 6.8 million adults in the U.S.

Common thread for common diseases

One thing that stands out about several of these common diseases affecting millions of Americans is that many people have one or more of these conditions — but don’t know it. This underscores the importance of getting a checkup on a regular basis.

Regardless of what the Gallup survey found, the odds of you getting Ebola are very low. On the other hand, the chances of you or someone in your family already having one of these seven conditions could be higher than you might think. Perhaps the truly biggest healthcare challenge facing Americans is knowing the status of their own health.

TIME Mental Health/Psychology

Do Depression Drugs Still Need Suicide Warnings?

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Jonathan Nourok—Getty Images

It's been 10 years since the FDA put a black box warning on antidepressants, saying they can cause suicidal thoughts and behavior. But the psychiatry community never fully agreed. What now?

The so-called “black box” is the most severe warning label issued by the Food and Drug Administration (FDA), and for the past decade, antidepressants have been among the drugs that bear them. That means the pills come with a notice cautioning users that the drugs may increase the risk of suicidal thoughts and behaviors in children and young adults. But now, many experts say it’s time for the black box to go: that the warnings overstate the real risk and may deter doctors from prescribing them to people who could benefit from being on antidepressants. Depression, after all, is the biggest risk factor for suicide.

“There’s absolutely no evidence that [the boxed warning] has done any good. There’s certainly credible data that it’s done harm,” says Dr. Richard Friedman, a professor of clinical psychiatry at Weill Cornell Medical College who recently wrote an op-ed calling for the removal of the black box in the New England Journal of Medicine (NEJM). Dr. Marc Stone of the FDA, meanwhile, wrote a companion critique in NEJM, and tells TIME the data suggesting the black box should be removed is “extremely questionable; virtually meaningless.” Evidently, even experts disagree.

TIME spoke to 17 leaders in the field of psychiatry to get their take on the black box warning on antidepressants: 11 said the warnings should be removed; two think the media has overblown the suicide risk posed by antidepressants, resulting in more panic than is necessary; and four support the box’s place on Rx drugs. Among those four, three were involved in the FDA’s decision to issue the black-box warning 10 years ago.

Back in 2004, the FDA was prompted to look into the effects of antidepressants after data emerged linking the drug Paxil to suicidal thoughts. An FDA committee then analyzed existing data about suicidal thoughts in people on antidepressants. There were no actual suicides among children in the clinical trials, but there was a slight increase in what is called “suicidality”—suicidal thoughts and behaviors. The rate of suicidality was 4% among patients taking an antidepressant compared to 2% taking a placebo. Ultimately, the committee deemed it enough of a risk to tack on the boxed warning.

The FDA’s boxed warning for the antidepressant Lexapro FDA

“I recognized there could be a chilling effect on prescribing, but I thought it was important to get the message [about possible side effects] out. At least that’s certainly what I felt at the time,” says Dr. Wayne Goodman, chair of psychiatry at Mount Sinai Hospital, who led the FDA committees back in 2004.

Studies have shown that antidepressant use and prescriptions did drop after the warnings were added. In June 2014, Harvard researchers published a study in the BMJ linking awareness of the warning to a decrease in antidepressant use and simultaneous increase in suicide attempts among young people. All the data, however, is observational. Data does show that from 2000 to 2009, suicides have gradually increased.

But back in the early 2000s, says Goodman, the FDA’s hands were tied. Worry about antidepressants and suicide became hugely politicized. Goodman, who says he’s open to revisiting the issue, still vividly remembers family members’ graphic testimonies. “[My mother] completely transformed into an emaciated woman who paced the floors, picked her skin, barely slept, and struggled to perform the simplest tasks like cooking a meal,” reads the transcript of one woman’s testimony of how her mother hung herself after just 10 weeks on antidepressants. The committee heard nearly 80 similar claims.

The FDA’s intention at the time was to quell public fear and to ensure that doctors and patients to have a discussion about risks, and make sure physicians monitored their patients during vulnerable periods, particularly during the first few months when some people get worse before they get better. “The intention was never to discourage appropriate use,” says Dr. Thomas Laughren, former director of the FDA’s Division of Psychiatry Products, who remembers being booed and hissed at professional meetings after the decision.

Still, not every expert agrees the pills are a panacea. “I’m 70 years old, I’ve been practicing for a long time,” says Dr. Norman Sussman, a psychiatry professor and clinician at New York University. “I’m not enamored by these drugs. They have their limitations and they really don’t work for most people, but the ones they work for best are the ones who are the most seriously depressed.” While the drugs may not be for everyone, most of the experts TIME spoke with agreed that the warnings deter depressed people from taking drugs that could improve their wellbeing.

“We don’t want wild and crazy prescribing, but we don’t want good clinicians afraid to use useful drugs,” says Dr. Mark Riddle, Professor of Psychiatry and Pediatrics and Johns Hopkins. “Though I am generally a cautious person and most of my research is on side effects, I think the FDA needs to back off a little.” The FDA does not currently have plans to revisit the warning.

 

TIME Mental Health/Psychology

4 Ways Being Lonely Can Affect Your Health

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Research consistently shows that lonely people have a higher risk of heart disease

When you’re lonely, you may look for friends in all sorts of unexpected places. At least, that’s the conclusion of a recent study in Psychological Science that found that folks who felt socially disconnected—aka lonely—were more likely to view a doll’s face as human.

But the health implications of being lonely go much further. “People who are lonely have more physical and mental health problems than those who feel connected to others,” explains Bruce Rabin, MD, director of the University of Pittsburgh Medical Center Healthy Lifestyle Program. Here, four ways loneliness affects your health:

You’re more likely to be down in the dumps

The more lonely you feel, the more likely you are to have depressive symptoms, according to research at the University of Chicago.

“When you’re lonely, brain hormones associated with stress such as cortisol become active, which can cause depression,” Rabin explains. “In fact, for mild and moderate depression social interaction is even more effective at alleviating symptoms than a prescription antidepressant.” One 2009 Colorado State University study found that the more positive social interactions people with depression had, the more improvement in symptoms they experienced.

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You’re less likely to take care of yourself

Research shows you’ll eat less healthful fare if you frequently dine solo: Single and widowed men and women 50 and older, for example, eat fewer veggies daily than married or cohabiting counterparts. “If you’re cooking for other people, you’re more likely to prepare a healthier meal that contains a range of foods—a meat, a starch, a vegetable—than if you’re just throwing together something for yourself,” Rabin points out.

Folks who are lonely are also more likely to be physically inactive, according to a 2009 study published in the journal Health Psychology.

HEALTH.COM: 18 Habits of the Happiest Families

You may be more susceptible to heart disease

Middle aged adults who live alone have a 24% increased risk of dying of heart disease, according to a 2012 Harvard study. “Research has consistently shown lonely people have a higher risk of heart disease, and it’s for many reasons,” Rabin says. “Since they don’t have social support, they’re more susceptible to the effects of stress, which increases the likelihood of getting heart disease. We know elevated stress hormones increase the accumulation of cholesterol deposits in the heart. Secondly, if they’re lonely they’re less likely to be physically active or eat properly. And finally, if they don’t feel well, they’re much less likely to confide that in someone who will insist that they go to the doctor to get checked out.”

HEALTH.COM: 12 Signs You May Have an Anxiety Disorder

You could have a weaker immune system

Loneliness can strain the immune system, according to Ohio State University research presented in 2013. People who were lonely produced more inflammation-related proteins in response to stress than folks who felt more socially connected. Inflammation is linked to numerous health conditions including heart disease, Type 2 diabetes, arthritis, and Alzheimer’s disease.

What to do about it

Joining a bevy of social groups isn’t necessarily the best way to combat loneliness. “It’s important to note that someone can be alone, or have only a handful of close friends, and not be lonely,” Rabin stresses. “Or you can be a social butterfly and out with friends every night of the week and still feel isolated.” His advice? Volunteer. Doing good deeds for others will lift your mood, and you’ll most likely meet kindred spirits that you can cultivate a real connection with—which in turn will leave you feeling less lonely.

HEALTH.COM: 12 Ways We Sabotage Our Mental Health

This article originally appeared on Health.com

TIME Economy

How We Underestimated the ‘Black Tuesday’ Stock Market Crash

Black Tuesday
From the Nov. 4, 1929, issue of TIME TIME

The "Black Tuesday" stock market crash that precipitated the Great Depression happened on this day 85 years ago

It was pretty impossible not to notice that something bad had happened: in the days leading up to Oct. 29, 1929, the stock market was already reeling from a series of smaller sell-offs leading up to “Black Tuesday,” the day commonly used to mark the onset of the Great Depression.

But with only a few days of hindsight to put that event into perspective, it was pretty easy not to see how bad things were.

TIME was one of the outlets that made that very miscalculation. Reporting on the stock market in a Nov. 4, 1929, article, TIME recounted that the liquidation of stocks that day “might technically be termed orderly but was certainly extremely depressing.” (That take now seems ironically apt.) But the sell-off was balanced out by plenty of “don’t panic” speechifying — President Hoover said that Industry in the nation was “sound.” By the end of the day, TIME reported, “it seemed again that the worst was past.”

A move by the country’s biggest bankers to shore up the market by purchasing stocks had, it appeared, worked. Along with the lack of hindsight, that effort was partly to blame for the miscalculation. For example, a few days before Oct. 29, the broker Richard F. Whitney had personally stopped a panic by buying shares of U.S. Steel at 15 points above its market value; at a time when the whole banking industry seemed ready to take such extraordinary measures to save the economy, and when the market had done so well for so many years, optimism would have been easy. (Whitney later became president of the New York Stock Exchange. After that, in 1938, he went to jail for grand larceny.)

“Hysteria, it was hoped, had met its master in the Banking Power of the U.S.,” TIME wrote. That quote would later make it into TIME’s 75th-anniversary run-down of the most off-the-mark statements in the magazine’s history, alongside predictions that war would end in the 20th century and the sincere belief that the media would stay out of Bill Clinton’s personal life.

Even a week after the crash, when the economy was the Nov. 11, 1929, cover story, the gist of the story was that the valiant bankers who had banded together to keep things orderly had prevented the worst of possible outcomes. (This version of history, while incorrect in its optimism, may well be true nonetheless; it’s always possible that the Great Depression could have been even worse than it was. As long as The Hunger Games is still fiction, that will always be true.) As TIME reported:

Monday, Nov. 4, when the Exchange re-opened there were more sellers than buyers but none were frenetic. Toward noon prices climbed, then dropped again. In general stocks closed lower than Thursday. U. S. Steel closed at 180, Radio at 43¼, General Motors at 45¼. The market except at the very opening was dull as though it were tired. But it seemed to rest securely. Stock Exchange Governors ordered the Exchange closed after 1 o’clock Wednesday, Thursday, Friday; all day Saturday. Tuesday was a legal holiday (election day). Thus was further rest insured.

Friday there were no quotations nor Saturday for the Exchange was closed. Clerks who had passed many a sleepless night, slept, then returned to clean up the greatest amount of work which brokerage houses have ever had in so short a time. In the hurly-burly many an error had been made. The clerks had to discover them, rectify them. But in the Stock Exchange Friday and Saturday there was quiet.

Thus did Confidence win its subtle race against Panic.

But not everyone was having trouble seeing what was about to happen. The following letter ran in the Dec. 2, 1929, issue:

stock market letter
From the Dec. 2, 1929, issue of TIME

Read Niall Ferguson’s comparison between 1929 and 2008 here in TIME’s archives: The End of Prosperity?

Read more: A Brief History of the Crash of 1929

Photos: The Crash of ’29

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