Emotional Support Animals Help Lick Depression, Anxiety – Medscape

Use of emotional support animals (ESAs) yields quantifiable reductions in depression, anxiety, and loneliness for patients with serious mental illness (SMI) who live alone, early research suggests.

Investigators followed 11 community-dwelling adults with SMI who were paired with a shelter dog or cat for 1 year. Participants’ depression, anxiety, and loneliness were assessed at baseline and 12 months after receipt of their ESA.

At regular home visits during the study, participants also underwent saliva testing before playing with their pets and after 10 minutes of enjoyable pet, interaction to assess levels of oxytocin — a biomarker associated with bonding — as well as cortisol and alpha-amylase, which are markers of stress.

Significant reductions in measures of anxiety, depression, and loneliness were found between baseline and 12 months for all participants. Moreover, there was a pattern of an increase in levels of oxytocin and a decrease in levels of cortisol after 10 minutes of ESA interaction, but the degree of change did not reach statistical significance.

“Although this was a small pilot study and the findings are correlational, rather than causal, we can nevertheless say from the self-report of this group of participants and from the data collected that having an emotional support animal was beneficial to their mental health,” lead author Janet Hoy-Gerlach, LISW-S, PhD, professor of social work, University of Toledo, in Toledo, Ohio, told Medscape Medical News.

“We feel this data is a strong justification for additional study, and we hope that it will be a catalyst for future research with larger samples and more rigorous methodology,” said Hoy-Gerlach, who is the author of Human-Animal Interaction: A Social Work Guide, published by the NASW Press in 2017.

The study was published online on May 20 in Human-Animal Interaction Bulletin.

Everyday Interactions

An ESA is a “companion animal (pet) who helps to reduce disability-related impairment for a particular person through the animal’s presence and everyday interactions,” the authors write.

Unlike service animals, which perform specific functions, ESAs “provide benefits that fall along the same dimensions as the benefits of pets — physical, social, emotional, and psychological — and there is research supporting the role that animals can play in each of these arenas,” Hoy-Gerlach said.

ESAs require no special training. All that is needed is a letter from a medical or mental health professional “that the individual meets the definition of ‘disability’ under the Fair Housing Act and a companion animal is a needed disability-ameliorating accommodation and should be allowed in buildings that don’t ordinarily permit pets,” she noted.

There is currently no peer-reviewed research that focuses explicitly on the impact of ESAs in individuals with SMI. To investigate, the researchers turned to the Hope and Recovery Pet Program (HARP) — a community partnership of the University of Toledo, the Toledo Humane Society, and ProMedica, a large regional nonprofit Toledo-based healthcare system — that pairs community-living individuals who have depression and/or anxiety with shelter animals that require adoption. The program pays for pet food, supplies, and veterinary care for those unable to afford these.

Participants (n = 11; mean age, 53.67 years; 78% women) were recruited from the HARP program. Participants were required to be psychiatrically stable, have stable housing, live alone, be at risk for social isolation, have low income, be sober, and have no history of violence. Their primary diagnoses were major depressive disorder, bipolar disorder, and schizoaffective disorder (63%, 18%, and 18%, respectively).

Six participants adopted a cat, and five adopted a dog.

Prior to ESA adoption and at 12 months, participants completed the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the UCLA Loneliness Scale Version 3.

Prior to ESA adoption and at 1, 3, 6, 9, and 12 months, saliva samples were collected from participants by researchers at the beginning of a home visit and then after 10 minutes of “focused pleasant interaction” with the ESA. The saliva was tested for oxytocin, alpha amylase, and cortisol.

Motivation, Comfort, Calm

The researchers found statistically significant decreases in UCLA Loneliness Scale scores from pre-ESA (mean [SD],59.20 [9.47]) to 12 months (49.90 [13.66], P = .004). The eta-squared statistic (.62) indicated a large effect size.

For 18 of the 20 items on the loneliness scale, mean values were lower after the intervention than before the intervention. Of these, four were statistically significant.

A statistically significant decrease in BDI total scores was also seen from pre-ESA to 12 months (21.09 [8.43] to 14.64 [7.03], respectively; P = .03). The eta-squared statistic (.41) indicated a large effect size.

Of the 21 items on the BDI scale, the mean value was lower for 19 after the intervention. Of these, five were statistically significant.

Similarly, a statistically significant decrease in BAI score was found from pre-ESA to 12 months (23.55 [9.81] to 17.73 [11.79], P = .049). The eta-squared statistic (.36) indicated a large effect size, although there were no statistically significant changes in individual item scores.

The researchers found “observable patterns” of decreases in cortisol and increases in oxytocin after the 10-minute enjoyable ESA interactions. The highest oxytocin increase occurred at 12 months; however, these improvements did not reach statistical significance.

Participants offered open-ended statements about the positive impact of their ESA on their mental health, Hoy-Gerlach said. “For example, they described feeling motivated to take better care of themselves because their ESA needed them. Some described feeling ‘comforted,’ distracted from symptoms, soothed, and calmed.

“There is definitely a place for ESAs, especially with mental health post pandemic, when we need all the resources that we can for those who can benefit,” she added.

Post-Pandemic Mental Health

Commenting on the study for Medscape Medical News, Christine Crawford, MD, MPH, assistant professor of psychiatry, Boston University School of Medicine, Boston, Massachusetts, observed that ESAs “are not on the radar for a lot of clinicians, and a lot of clinicians don’t know about the science [supporting their use] or what an emotional support pet entails.

“We need to educate ourselves about what other options are available to provide symptomatic relief for patients besides traditional forms of treatment, such as medication and therapy. Even a little relief is important, and having an emotional support pet is a good option,” said Crawford, who is the associate medical director of the National Alliance on Mental Illness. She was not involved with the study.

Hum Anim Interact Bull. Published online May 20, 2021. Abstract

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9 Emotionally Devastating Mental Illness Graphic Memoirs – Book Riot

One of my favorite combinations of format and topic is mental illness and graphic memoir. The best way to get inside someone’s head, to really see the world as they see it, is through their own artwork. Comics artists wield a special talent when it comes to writing graphic memoirs about mental illness, and I am so grateful to them.

The first books that turned me into a reader were about teens with mental illnesses — I’m looking at you, Beatrice Sparks — and it’s remained one of my go-to book topics when I need something to remind me why I love books. Sometimes they’re like looking inside my own brain, but more often than not, they’re offering a brand new perspective that I hadn’t known much about before opening the book.

Here are some of the best graphic memoirs about mental illness, covering depression, anxiety, addiction, obsessive-compulsive disorder, borderline personality disorder, eating disorders, postpartum depression, and grief. Please exercise your best self-care when reading any of these books; they go deep into dark topics.

Mental Illness Graphic Memoirs

The Way She Feels: My Life on the Borderline in Pictures + Pieces by Courtney Cook

The Way She Feels is a really moving memoir in comics, essays, and lists about a life with a borderline personality disorder. Courtney Cook writes about how no one writes about BPD (there are, like, four books out there on the topic), and her work makes the disorder a little less scary, taboo, and misunderstood. She writes candidly about her experiences with self-harm, dermatillomania (obsessive skin-picking), and numerous hospitalizations in an astounding way that feels like reading a friend’s diary. In fact, it often feels like she was one of my friends in high school. The book is raw, but also full of humor, heart, and oh so many bright colors.

My Solo Exchange Diary Vol. 2 by Kabi Nagata, Translated by Jocelyne Allen

Kabi Nagata’s diary-in-manga is so good. My Solo Exchange Diary Vol. 2 is the third book in the series, following the same themes as the previous — loneliness, depression, and finding her way in the world as a young person — but with an addition of alcohol addiction. Amid her darkest days of drinking and wetting the bed, Nagata is brought to a hospital to monitor her well-being. And in the end, she realizes that she was loved all along, just not in the ways she was expecting.

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Everything Is an Emergency: An OCD Story in Words Pictures by Jason Adam Katzenstein

Jason Adam Katzenstein’s art is stunning. Told in the present tense, starting when he was a young boy, we are taken on his journey through life with obsessive-compulsive disorder. Everything is an Emergency puts us inside Katzenstein’s brain and shows that OCD is much more than merely being tidy — it’s seemingly inane obsessions that disrupt daily life until the ritual is complete. This mental illness graphic memoir will give you a much deeper understanding of this disorder.

Feelings: A Story in Seasons by Manjit Thapp

I don’t have the words that can do this book justice. Majit Thapp is an incredible artist, and her illustrations speak volumes over the sparse words that connect the images throughout the book. Feelings is a year in Thapp’s life, told through the ebbs and flows of six seasons: the anxiety of monsoon, the exuberance of high summer, the desolation of winter. Each page is a marvel.

Solutions and Other Problems by Allie Brosh

Allie Brosh was on hiatus for many years between this book and her previous one, Hyperbole and a Half, and in that time she endured a lot of terrible experiences. Her sister died by suicide. She got divorced. Solutions and Other Problems is dark and poignant and somehow also hilarious, covering those devastating events alongside her weird childhood and dumb dogs.

Dear Scarlet- The Story of My Postpartum Depression by Teresa Wong

Dear Scarlet: The Story of My Postpartum Depression by Teresa Wong

In this arresting graphic memoir, Teresa Wong pens a letter to her daughter, chronicling the hours, days, weeks, and months after she was born. Dear Scarlet gets deep into the seemingly taboo topic of postpartum depression, showing just how devastating a beautiful moment can be when one’s body is ravaged by hormones.

Ink in Water: An Illustrated Memoir by Lacy J. Davis and Jim Kettner

I have not been able to stop thinking about this book. Amid a breakup, Lacy J. Davis has a passing thought: am I not small enough to be loved? Thus begins her derailment into the land of disordered eating and overexercising. Ink in Water is her journey back toward wellness with numerous setbacks and a riot grrrl attitude. Jim Kettner’s black-and-white illustrations are visceral.

Barely Functional Adult: It’ll All Make Sense Eventually by Meichi Ng

Meichi Ng’s webcomics probably need no introduction. She draws perfect, #relatable little scenes of life as a young adult trying to figure everything out. Barely Functional Adult is a series of stories from her life, covering heartbreak, therapy, and everything in between, illustrated with cartoons in her signature style. It’ll make you laugh and sigh and feel so seen.

Dancing at the Pity Party

Dancing at the Pity Party: A Dead Mom Graphic Memoir by Tyler Feder

While not directly a mental illness, grief is a major deal and can manifest as mental illnesses. Tyler Feder’s graphic memoir about losing her mom to cancer is just stunning. She writes openly about her grief but also the guilt that follows loss, like the relief of death after a terminal illness. The oldest of her sisters, Feder had the most time with their goofy mom and often felt like she’d hogged her for those years before her sisters were born and cognizant. Because grief makes your brain think weird things. Dancing at the Pity Party is so beautiful and sad and made me want to hug my mom and smell her wonderful mom smell for the rest of time.

For further reading in the world of mental illness graphic memoirs, be sure to check out these comics for people with anxiety, comics about depression, and comics about mental illness.

Continue Reading 9 Emotionally Devastating Mental Illness Graphic Memoirs – Book Riot

what lays within…

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depression, anxiety, and a host of unwelcome feelings are all unpredictable.

one minute you’re on cruise control just flowing along ..then boom! something triggers something and you feel as though you’ve walked into a maze of haze.

it’s enveloping, heavy, even impedes your movements. definitely a debilitating feeling…affecting your emotional, mental, and even physical being.

sometimes when this happens it’s good to just be still…inhale slowly and exhale even slower.

all that we have been seeking outside of ourselves…stability, calmness, peace of mind, understanding, love, balance, truth .. we look for answers through books, philosophical views, listening to others, and trying to refocus…ALL of these things and much more could really help us.

maybe before frustratingly searching for the answer to our ‘whys’ maybe we can pause, listen and try to connect with our inner being.

yes, go within.

often its not what or who we surround ourselves with, its actually what lays deep inside our soul.

seeking ourselves within ourselves its a great start.

try to ‘go within’…’ feel’ and ‘trust’.

approach things from a different perspective.

this is not a solution to our disease…but it could be that trestle preparing us for whatever comes next.



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