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    We need to talk about America’s mental health crisis – and its larger causes | Robert Reich

    I want to talk about an uncomfortable topic that needs much more open discussion than it’s receiving: the United States’ extraordinarily high level of anxiety.A panel of medical experts has recommended that doctors screen all patients under 65, including children and teenagers, for what the panel calls anxiety disorders.Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan medical school, who serves on the panel, calls mental health disorders “a crisis in this country”.A recent New York Times article discussed what’s called “persistent depressive disorder”, or PDD, which an estimated 2% of adults in the United States have experienced in the past year.Nearly 50,000 people in the US lost their lives to suicide last year, according to a new provisional tally from the National Center for Health Statistics. (The agency said the final count would likely be higher.)The suicide rate, now 14.3 deaths per 100,000 Americans, has reached its highest level since 1941, when the US entered the second world war.Men aged 75 and older had the highest suicide rate last year, at nearly 44 per 100,000 people, double the rate of people aged 15-24. While women have been found to have suicidal thoughts more commonly, men are four times as likely to die by suicide.Suicide rates for Native Americans are almost double the rates for other Americans.(Some good news: suicide rates for children aged 10 to 14 have declined by 18%, and for those between 15 and 24 by 9%, bringing suicide rates in those groups back to pre-pandemic levels.)What’s going on?Maybe the widespread anxiety and depression, along with the near record rate of suicide, should not be seen as personal disorders.Maybe they should be seen – in many cases – as rational responses to a society that’s becoming ever more disordered.After all, who’s not concerned by the rising costs of housing and the growing insecurity of jobs and incomes?Who (apart from Trump supporters) isn’t terrified by Trump’s attacks on democracy, and the possibility of another Trump presidency?Who doesn’t worry about mass shootings at their children’s or grandchildren’s schools?Who isn’t affected by the climate crisis?Add increasingly brutal racism. Mounting misogyny. Anti-abortion laws. Homophobia and transphobia. Attacks on Asian Americans, Hispanic Americans, Jews, Arab Americans and other minority groups. And the growing coarseness and ugliness of what we see and read in social media.Consider all this and it would almost be stranger if you weren’t anxious, stressed and often depressed.Studies show that women have nearly double the risk of depression as men. Black people also have higher stress levels – from 2014 to 2019, the suicide rate among Black Americans increased by 30%.Are women and Black people suffering from a “disorder”? Or are they responding to reality? Or both?White men without college degrees are particularly vulnerable to deaths from suicide, overdoses and alcoholic liver diseases, with contributions from the cardiovascular effects of rising obesity.Are they suffering from a “disorder”, or are they responding to a fundamental change in American society? Or both?In their book Deaths of Despair and the Future of Capitalism, economists Anne Case and Angus Deaton argue that “the deaths of despair among whites would not have happened, or would not have been so severe, without the destruction of the white working class … .”Part of the problem, they say, is that the less educated are often underpaid and disrespected, and feel that the system is rigged against them.skip past newsletter promotionafter newsletter promotionEven if we had far more mental health professionals, what would they do against these formidable foes? Prescribe more pills? If anything, Americans are probably already overmedicated.Don’t get me wrong. I’m not arguing against better access to mental health care. In fact, quite the opposite. Increased staffing and improved access to mental health care are very much needed.Mental health care is harder to find now than before the pandemic. About half of people in the US live in an area without a mental health professional, federal data shows, and some 8,500 more such professionals would be needed to fill the gap. Most people rely on family doctors for mental health care.Officials are trying to widen familiarity with a national suicide and crisis lifeline that last year received a nationwide number, 988.But in addition to providing more and better access to mental health care, and a suicide and crisis hotline, shouldn’t we try to make our society healthier?Americans experience the least economic security of the inhabitants of any advanced nation. A healthy society needs more job security and stronger safety nets.The distribution of income and wealth in the United States is the most unequal of any other advanced nation. A healthy society ensures that no one working full-time is poor, and levies high taxes on the wealthy to help pay for what society needs.Guns and assault weapons are easier to buy in the United States than in any other advanced nation. A healthy society bans assault weapons and makes it difficult to buy guns.A lower percentage of Americans has access to affordable medical care than in any other advanced nation. A healthy society keeps its people healthy.The United States puts more carbon dioxide into the air per capita than almost any other advanced nation. A healthy society better protects the environment.Big money plays a larger role in American politics than it does in almost any other advanced nation. A healthy society does not allow big money to buy politicians.Some American politicians – like Donald Trump – gain power by stirring up racism, xenophobia and homophobia. A healthy society does not elect these sorts of people.The list could be much longer, but you get the point. The anxiety disorders suffered by Americans are real, and they apparently are growing. But instead of regarding them solely as personal disorders, maybe we need to understand them at least partly as social disorders – and get to work remedying them as a society.Granted, it would be difficult to achieve any of these criteria for a healthy society.But without seeking to achieve them, no number of mental health professionals, and no amount of medications or hotlines, will be enough to substantially reduce the stress, anxiety, depression and suicidal thoughts that so many Americans are now experiencing.In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org or text HOME to 741741 to connect with a crisis counselor. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org
    Robert Reich, a former US secretary of labor, is a professor of public policy at the University of California, Berkeley, and the author of Saving Capitalism: For the Many, Not the Few and The Common Good. His newest book, The System: Who Rigged It, How We Fix It, is out now. He is a Guardian US columnist. His newsletter is at robertreich.substack.com More

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    US surgeon general on why loneliness threatens democracy | podcast

    In a public advisory, written back in the summer, Dr Vivek Murthy warned of a growing ‘epidemic of loneliness and isolation’, which he believes is not just destined to affect the physical and mental health of individuals but could end up being detrimental to democracy itself.
    ‘The nation’s doctor’ speaks to Jonathan Freedland about why some bad faith actors are choosing to manipulate this problem and how political leaders on all sides can address it before it gets worse

    How to listen to podcasts: everything you need to know More

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    US surgeon general issues advisory on ‘profound’ risks of child social media use

    Social media use by children and teenagers can pose a “profound risk of harm” to their mental health and wellbeing, the US surgeon general is warning.In a new advisory released on Tuesday, Dr Vivek Murthy calls on tech companies, policymakers and parents to take “immediate action to protect kids now”. He says that in the absence of robust independent research it is impossible to know whether social media is safe for children and adolescents.“The bottom line is we do not have enough evidence to conclude that social media is, in fact, sufficiently safe for our kids. And that’s really important for parents to know,” Murthy told the Associated Press.The 25-page advisory, produced as part of the surgeon general’s ongoing investigation into what he sees as a full-blown youth mental health crisis, points to the ubiquitous use of social media by young people. Up to 95% of 13- to 17-year-old Americans use a social media platform, and more than a third say they do so “almost constantly”.The report shows how current controls on access by children are not working. While most sites apply a minimum age requirement of 13, almost 40% of eight- to 12-year-olds are regular users.The surgeon general’s warning came as the White House put out its own notice on Tuesday about what it called the “unprecedented youth mental health crisis” in the US. The number of children and adolescents dealing with depression and anxiety had risen almost 30% in recent years, with social media a clear factor.The White House is forming a new taskforce on kids and online health and safety. Its job would be to identify the potential harms posed by online platforms and to come up with a tool kit designed to combat the problems for tech companies developing new products.Concern over the effects of popular online apps on children has been building in recent years. In 2021 a whistleblower, Frances Haugen, exposed that Facebook and Instagram knew they were directing young users towards harmful content including material that promoted anorexia – and that they were expressly targeting children under 13.One internal study from Facebook’s parent company, Meta, reported 14% of teenage girls said that when they used Instagram their suicidal thoughts intensified, while 17% of teen girls said it exacerbated eating disorders.In the wake of Haugen’s revelations, Meta sidelined plans to launch a kids’ version of Instagram.Murthy told AP: “I recognize technology companies have taken steps to try to make their platforms healthier and safer, but it’s simply not enough.”His advisory underlines the critical nature of adolescence in the development of the human brain, which leaves kids aged 10 to 19 highly vulnerable to peer pressure. It is within these years that an individual’s sense of self-worth is formed, and it is when mental health challenges such as depression often emerge.The report says that social media use is predictive of a decline in satisfaction with life, especially for girls aged 11 to 13 and boys aged 14 and 15.Accessing apps does have positive benefits, Murthy says, including providing community and connection with others who share similar interests or identity. That can be particularly valuable for LGBTQ+ youth who can easily find each other.Seven out of 10 adolescent girls of colour said they found positive and affirming content this way. Across all user groups, most American adolescents report that social media helps them feel more accepted and supported through tough times.But such positive indicators are currently overshadowed by risk factors, the surgeon general warns. A long-term study of 12- to 15-year-olds found that adolescents who spend more than three hours each day on social media have twice the risk of mental health challenges including depression and anxiety.Figures from 2021 suggest that the current average in that age group is 3.5 hours a day.Excessive social media use, which can result in compulsive or uncontrollable behaviour, can lead to sleep problems which in turn can alter the neurological development of the adolescent brain. Depressive symptoms and suicidal thoughts can ensue, the advisory says.Murthy is calling on tech companies to be more open with the public and to put the health and safety of their young users first when creating new products. He also has words for parents.“For every family, it may not be feasible to stop your child from using social media or there may be benefit,” he told the AP. “But drawing boundaries around the use of social media in your child’s life so there are times and spaces that are protected, that are tech-free, that can be really helpful.” More

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    Senator John Fetterman ready to make up for ‘lost time’ after leaving hospital

    Having just been discharged from a hospital which treated him for mental depression for six weeks, the US senator from Pennsylvania John Fetterman has said he is committed “to start making up [for] any lost time”.“My aspiration is to take my son to the restaurant that we were supposed to go [to] during his birthday but couldn’t because I had checked myself in for depression,” the first-term Democratic senator said in an interview with CBS News that was aired Sunday. “And being the kind of dad, the kind of husband and the kind of senator that Pennsylvania deserves.”Fetterman’s remarks to CBS were recorded days before Friday’s announcement that he had been discharged from Washington DC’s Walter Reed medical center after a hospitalization of more than a month. He spoke frankly in the interview about the circumstances that convinced him to seek inpatient treatment for depression.In November, the 53-year-old former mayor of Braddock, Pennsylvania, and ex-state lieutenant governor known for wearing shorts and hooded sweatshirts defeated Republican celebrity doctor Mehmet Oz for an open Senate seat. Fetterman’s victory over Oz – who was endorsed by former president Donald Trump – helped give the Democrats control of the upper congressional chamber by a margin of 51 seats to 49, firmly establishing his status as a rising star in his party.But during the campaign, Fetterman – who is also known for his imposing, 6ft 8in physical frame – had suffered a stroke that he says nearly killed him. The medical ordeal required him to be hospitalized for a time, which Republicans tried to use to argue that he was unfit for office.Medical experts say that as many as a third of stroke patients later develop symptoms of mental depression, with which Fetterman had already privately struggled for years.Then, those around Fetterman noticed that he seemed to be emotionally miserable when he was sworn in on 3 January. He said he had stopped eating in the preceding weeks, had been losing weight and was struggling to find the energy to get out of bed, too. He also was no longer engaging in the usual banter or work discussions with his staff and had been avoiding spending time with his wife, Gisele, and their three children, who are between the ages of eight and 14.“The whole thing about depression is that, objectively, you may have won [the Senate seat] – but depression can absolutely convince you that you actually lost,” Fetterman said in the interview on Sunday. “And that’s exactly what happened. And that was the start of a downward spiral.”Gisele Barreto Fetterman told CBS that she initially had a hard time understanding what her husband could be depressed about. “He just became a senator, he’s married to me, he has amazing kids and he’s still depressed? And I think the outside would look and say, ‘How does this happen?’”But she said she read as much as she could about depression and learned that the very nature of the complex condition means it “does not make sense, right? It’s not rational.”Fetterman checked into the Walter Reed medical center for clinical depression treatment on 15 February, which was the day of his son’s 14th birthday and marked a week after his having been briefly hospitalized for feeling lightheaded.skip past newsletter promotionafter newsletter promotionThe Democrat’s most recent hospitalization drew some political fire from the Republican side of the aisle, which has continued casting aspersions about his physical fitness.Yet while a hospital stay of six weeks is longer than is typical for inpatient treatment for depression, many others have praised Fetterman for publicly disclosing that he had sought care. They said Fetterman’s choice could inspire people who need help and are scared to get it to overcome their reluctance.“My message right now isn’t political,” Fetterman said in Sunday’s interview. “I’m just somebody that’s suffering from depression.”Fetterman was back home on Sunday and, according to his office, intended to return to Capitol Hill for when the Senate was scheduled to resume its work on 17 April. Democrats are counting on Fetterman to provide them with votes for some nominations in the chamber that they have been struggling to ratify without him. More

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    John Fetterman can help lift the stigma around mental illness and depression | Akin Olla

    John Fetterman can help lift the stigma around mental illness and depressionAkin OllaThe US senator checked into a hospital for clinical depression – and has provoked a conversation about mental healthMy senator, John Fetterman, has checked into a hospital for clinical depression.This is an action that an increasing number of Americans will likely take in their lifetimes, given the rising rates of depression. Still, Fox News has already pounced: Tucker Carlson argued that Fetterman is “unfit to serve in the United States Senate”, while Laura Ingraham went as far as to imply that Fetterman’s wife has worked to hide his condition and that the act was “craven or a cruel political calculation by a stage wife and political nihilist”.Fetterman isn’t exactly the only person in the United States suffering from some form of depression. According to a Boston University study, “[d]epression among adults in the United States tripled in the early 2020 months of the global coronavirus pandemic – jumping from 8.5% before the pandemic to a staggering 27.8%”, and it only got worse from there. According to the same study, rates of depression continued “climbing to 32.8% and affecting 1 in every 3 American adults”.Stroke victims, which Fetterman is, are particularly susceptible to depression. According to a study in the Journal of Clinical Medicine, “depression occurs in roughly one-third of stroke survivors.” In terms of major depression, which involves at least two weeks of depressive symptoms like problems with sleep and sense of self-worth, the National Institute of Mental Health reported that roughly 8.4% of all Americans had at least one depressive episode in 2020, with higher rates among “adult females (10.5%) compared to males (6.2%)”.This disparity is why it’s important for women in positions of influence like Olympian Simone Biles and former New Zealand Prime Minister Jacinda Arden to speak out about their own mental health struggles. Similarly, it’s important for men in positions of power like Fetterman, especially given the reluctance of men in particular in seeking treatment. Trying to push Fetterman out of politics belittles millions of Americans and signals to roughly one-tenth of the country that they are not worthy of being elected to office.Fetterman, like many Americans who have experienced clinical depression, can still accomplish much of what he sets out to do. Shooting him down now would be similar to what was done to Thomas Eagleton, the original running mate of democrat George McGovern’s 1972 run for the presidency. Eagleton was essentially shamed out of the position after it was revealed that he’d suffered from depression in the past and received electroshock treatment for it. Despite the slights against him and his resignation from the candidacy, he’d won the heart of his constituents and served another two terms as senator.Every day, millions of depressed Americans go to work, the country wouldn’t function without them. While Fetterman may need to step down or decline to run in the future as Arden did, he should actually be given a chance to govern.Fetterman seeking treatment should not trigger calls of incompetency. Instead, it should trigger empathy and questions of how we can ensure that others can seek the help that they need.In the words of Senator Tina Smith of Minnesota, who spoke openly about her depression in 2019: “De-stigmatizing and de-mystifying mental illness is just the beginning. Everyone can be a friend to those in need by urging them to take advantage of the resources available to them. But the one hundred of us here in the Senate have a responsibility to make sure those resources are available to everyone.”
    Akin Olla is a contributing opinion writer at the Guardian US
    TopicsDepressionOpinionMental healthUS politicsHealthUS CongressPennsylvaniacommentReuse this content More

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    John Fetterman hospitalised to treat clinical depression, chief of staff says

    John Fetterman hospitalised to treat clinical depression, chief of staff saysPennsylvania senator suffered a stroke while campaigning last year and has experienced depression ‘off and on’ throughout life The Pennsylvania US senator John Fetterman checked into hospital on Wednesday to receive treatment for clinical depression, his chief of staff said.The news came a week after the Democrat, who suffered a stroke while campaigning last year, was hospitalised after feeling light-headed. Fetterman is a rising star among Democrats.In a statement on Thursday, Fetterman’s chief of staff, Adam Jentleson, said: “While John has experienced depression off and on throughout his life, it only became severe in recent weeks.”Last November, the 53-year-old former mayor of Braddock and state lieutenant governor flipped a Republican-held Senate seat, defeating the Trump-endorsed celebrity doctor Mehmet Oz to give his party control of the chamber by 51 seats to 49.Fetterman suffered a serious stroke during the campaign, prompting Republicans to claim he was not fit to take office.In his victory speech, Fetterman referred to the stroke when he said he campaigned for “anyone that ever got knocked down that got back up”.Last Wednesday, Fetterman was taken to hospital in Washington DC after feeling light-headed at a Democratic event.He was released last Friday. A spokesperson said then: “In addition to the CT, CTA, and MRI tests ruling out a stroke, his EEG test results came back normal, with no evidence of seizures. John is looking forward to spending some time with his family and returning to the Senate on Monday.”In his statement on Thursday, Jentleson said: “On Monday, John was evaluated by Dr Brian P Monahan, the attending physician of the United States Congress. Yesterday, Dr Monahan recommended inpatient care at Walter Reed” in Bethesda, Maryland.“John agreed, and he is receiving treatment on a voluntary basis. After examining John, the doctors at Walter Reed told us John is getting the care he needs, and will soon be back to himself.”Among well-wishers, the former Obama adviser Tommy Vietor said Fetterman was “incredibly brave … to talk about his mental health challenges publicly, especially knowing that people will try to exploit it for political purposes.“But his decision to come forward will undoubtedly help encourage others to seek help.”TopicsUS SenateDemocratsPennsylvaniaUS politicsMental healthnewsReuse this content More

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    New York mayor plans to hospitalize mentally ill people involuntarily

    New York mayor plans to hospitalize mentally ill people involuntarilyAdvocacy groups for civil rights groups and the homeless criticized mandate: ‘Mayor is playing fast and loose with the legal rights’ The mayor of New York City announced on Tuesday that he is ordering police and emergency services to more aggressively hospitalize those with mental illness who are on the streets, even if the hospitalization is involuntary and they pose no threat to other people.Mayor Eric Adams’ directive would give outreach workers, city hospitals and first responders, including police, discretion to forcibly hospitalize anyone they deem as not “meeting their basic human needs, causing them to be a danger to themselves”, Adams told a news conference.The mayor called the directive an attempt to clear up a “gray area where policy, law and accountability have not been clear”, adding that the mandate is “a moral obligation to act” in light of “a crisis we see all around us”.“These New Yorkers and hundreds of others like them are in urgent need of treatment, yet often refuse it when offered,” said Adams.“The very nature of their illnesses keeps them from realizing they need intervention and support. Without that intervention, they remain lost and isolated from society, tormented by delusions and disordered thinking. They cycle in and out of hospitals and jails.”The Adams administration did not provide evidence that forced treatment is effective in treating mental illness or preventing crime.Advocacy groups for civil rights groups and the homeless criticized the mayor’s mandate.“The mayor is playing fast and loose with the legal rights of New Yorkers and is not dedicating the resources necessary to address the mental health crises that affect our communities,“ said Donna Lieberman, executive director the New York Civil Liberties Union.“Forcing people into treatment is a failed strategy for connecting people to long-term treatment and care.”The Coalition for the Homeless also denounced the mayor’s plan, saying the city should focus on expanding access to voluntary psychiatric treatment.“Mayor Adams continues to get it wrong when it comes to his reliance on ineffective surveillance, policing and involuntary transport and treatment of people with mental illness,” said the coalition’s executive director, Jacquelyn Simone.State law also generally limits the ability of authorities to force someone into a mental health facility unless they pose a danger to themselves or others.But Adams called such limitations a “myth”, stating that the law does not require a person to be behaving in an “outrageously dangerous” or suicidal way before a police officer or medical worker could take action.As part of its initiative, the city said it would open a phone line to allow police officers to consult with clinicians.The mayor has also announced a subway safety plan and vowed to expand outreach teams, made up of clinicians and police officers. But critics called the plan a crackdown on the mentally ill and the homeless.A spokesperson for the New York governor, Kathy Hochul, said the city’s plan builds on mutual efforts to increase capacity at psychiatric hospitals, as well as expand outreach teams in subways.TopicsNew YorkMental healthUS politicsnewsReuse this content More

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    ‘If I’d not got help, I’d probably be dead’: Jason Kander on PTSD, politics and advice from Obama

    Interview‘If I’d not got help, I’d probably be dead’: Jason Kander on PTSD, politics and advice from ObamaDavid Smith, Washington bureau chief He was a rising star in the Democratic party and ‘sorta ran for president’ but, as he recounts in his new book, haunted by his experiences in AfghanistanAs luck had it, Jason Kander’s book tour in New York coincided with a family wedding. The star turn was his 95-year-old great-uncle, composer John Kander, who performed Married from Cabaret, the revered musical he wrote with lyricist Fred Ebb.“It was very cool,” smiles Kander, a day after breakfasting with his famous relative. “He’s still writing: he’s got a musical coming out next year. He is my life goal. People who meet him probably figure he’s in his late 70s. He always says if you just keep doing what you love, it will keep you young. There’s something to that.”Twenty years on from 9/11, is US democracy working?Read moreJason Kander is only 41 but already well into his third act. His new, unflinchingly honest memoir tracks his journey from soldiering in Afghanistan to politicking in his native Missouri, from sitting in the Oval Office with Barack Obama to being put on suicide watch in a windowless cell.Invisible Storm: A Soldier’s Memoir of Politics and PTSD tells how Kander endured post-traumatic stress disorder for 11 years – and kept it secret from everyone. The more his political star shone, the darker his hinterland became. He tried to outrun his demons by seeking elected office, including the presidency, until an epiphany led him to finally confront his mental illness.“I went to get help because, if I didn’t go get help, I was probably going to kill myself,” says Kander, wearing a grey “army” T-shirt and speaking via Zoom from a functional New York hotel room.“It’s not like, ‘Oh, man, if I’d hung around, maybe I’d be president!’ If I’d hung around and not got help, I’d probably be dead. Instead I’m really enjoying my life and I wasn’t before. It’s not to say I’ll never run. It’s just to say, I’m glad I didn’t then and, if I ever do choose to run, I’ll be doing it as a person who has dealt with their shit. And maybe we need more of that.”Kander trained as a lawyer but, after the September 11 2001 terrorist attacks on New York and Washington, felt the compulsion to serve and be tested like his grandfather and other relatives. To his surprise, he loved the military with its sense of order and mission.He spent four months in Afghanistan in 2006-07 and was not involved in firefights or direct combat (later a source of constant guilt that he somehow wasn’t worthy of PTSD). His work as an intelligence officer involved going with an interpreter to meetings in remote locations with people who might be “bad guys” linked to the Taliban, terrorism or corruption. The prospect of being kidnapped and killed was real.“I was 25 years old and it was an exhilarating experience and that’s why they don’t send 41-year-old fathers of two to war,” he reflects. “If I went into those meetings now, I’d be very aware of everything I had to lose but also probably very aware of how much danger I was in.”When he got home to Kansas City, Kander turned to politics in search of the same sense of purpose and belonging to something bigger than himself. Knocking on thousands of doors, he outworked and outcampaigned rivals to win election to the Missouri state house of representatives and, later, as secretary of state.In 2016 he ran for the US Senate against the Republican incumbent, Roy Blunt, and caught national attention with a campaign ad in which he assembled an AR-15 rifle while blindfolded and advocating for background checks on gun buyers. Kander still lost but by a much narrower margin than Hillary Clinton to Donald Trump in the same state.PTSD trailed him like a shadow, however.There was insomnia and night terrors: bad dreams in which he was back in Afghanistan with someone rushing into a room, taking him captive and lining him up for a beheading video on YouTube. Over time these evolved into fears about home invaders threatening his family.There were nights when Kander patrolled the house with a loaded gun. He had symptoms such as back pain, a twitch in his left eyelid and an aversion to sitting in restaurants with his back to the door. “It’s exhausting to be on alert all the time and then, when you combine that with about 10 years without a good night’s sleep, you just get worn out. When you get worn out enough and have all these other feelings of shame and guilt and then you’re having these symptoms, eventually you get depressed. When you’re depressed long enough, eventually you have suicidal thoughts.”His political career, he assesses now, was a quest for redemption. “I had this idea that I hadn’t done enough for my country, I was an irredeemable piece of shit personally and, while I was achieving all these things politically, people didn’t really know that I was completely undeserving of this praise or adulation.”The Hollywood version of redemption for Kander would have had him winning the presidency and casting PTSD aside on inauguration day. And for a while it seemed possible. When, in his final Oval Office interview, Obama was asked who gave him hope for the future of the country, Kander’s was the first name on his lips. The pair had a private meeting in which Obama gave “mentorship-type advice”.Kander was exalted as the Democrats’ new hope, a veteran from the heartland who could provide the antidote to forces that put Trump in the White House. He made frequent visits to early presidential nominating states; his Twitter bio says he “sorta ran for president”.But after a major speech in New Hampshire, things unravelled.“Like any other addict who is not dealing with their own trauma, their own underlying stuff, I was addicted to the adulation, to the crowds, to performing and to the adrenaline that came with it. The only time I felt truly present was when I was in front of a crowd or doing an interview that really mattered.“Those endorphin highs generally for a long time worked in the sense that they would hold me over until the next one. So when I had this moment that was the zenith of my career as a political performer and it lasted about 12 hours, I realised that was a real problem. This wasn’t working any more.”When someone suggested that he lower his sights and run for mayor of Kansas City instead, Kander grabbed the chance to ease the pressure. He was comfortably ahead in the polls and in fundraising when, on 1 October 2018, he walked into the Kansas City Veterans Affairs medical center and acknowledged suicidal thoughts going back 10 years.He was duly put in a windowless cell with pale-green walls and dressed in dark-green scrubs that were about five sizes too big. “So this was suicide watch,” he writes.Most of the staff instantly recognised him but a young resident psychiatrist did not. For half an hour, Kander bared his soul about the night terrors and his consuming fear of someone hurting himself and his family. Then the psychiatrist asked: “Do you have a particularly stressful job or something?”Kander said he was in politics and explained: “I almost ran for president, but then decided to run for mayor instead, and tomorrow I’m planning on calling that off.”Confused, the psychiatrist said: “You were going to run for president? Of what?”Kander told him: “Of the United States.”The psychiatrist asked: “Who told you that you could run for president?”Now irritated, Kander said: “I don’t know what to tell you, man. I mean, I spent an hour and a half talking it over one on one with Obama in his office, and he seemed to think it was a pretty good idea.”The psychiatrist sat back in his chair and remarked: “Barack Obama told you that you could run for president? So how often would you say you hear voices?”Kander can laugh about the exchange now and includes it in his book.The therapy has worked wonders – “It’s getting a master’s in yourself,” is how his great-uncle John described it – and allowed him to rediscover the joys of marriage (his Ukrainian-born wife, Diana, contributes moving passages in the book), fatherhood (their children are eight and one) and baseball (he coaches a little league team).“The difference is now I will frequently choose to sit facing the door but I can sit with my back to the door usually without fidgeting a great deal. I generally don’t get the twitch in my eye. I generally don’t have, most of the time, nightmares.“PTSD treatment is not about getting cured. It’s about getting to the point where the symptoms of PTSD don’t disrupt your life and that’s what I was able to achieve in therapy.”Kander is also better equipped to deal with difficult ruptures such as last year’s chaotic US withdrawal from Afghanistan. He admits: “At first it was quite triggering and then I got very involved in evacuating people I care about from the country. That experience was newly traumatic and I had to go back and see my therapist again but I’m glad I did. It’s not simple but now I have the tools to navigate that.”Kander is the president of national expansion at Veterans Community Project, a non-profit organisation to which he will donate all the book’s royalties, and host of Majority 54, a political podcast. Kander has little time for the perennial moderates v progressives narrative dividing the Democratic party. “Everybody is engaged in this debate about whether the party needs to go further to the left or stay closer to the middle and they’re all completely missing the point. That’s not what’s going on in the part of the country I live in. You don’t get points for being less liberal; you get points for caring about what people are going through.”Kander says he wrote Invisible Storm because it was the book he would have wanted to read 14 years ago. He hopes it will encourage people to confront their own problems and understand that recovery and post-PTSD growth are possible.But given the bottomless cynicism in politics today, there will doubtless be somebody somewhere who theorises that the book is a calculated move towards resurrecting Kander’s career, perhaps even his White House ambitions.He finds that idea absurd.“I wrote this book understanding that if I ever get the desire to run for president again, people are going to say we can’t have a president who could end up stalking the White House at night because he’s worried about intruders,” he says. “If I ever run, it will be on me to be like, ‘I don’t have to do that any more because I got therapy.’“Yeah, that’s probably not the ideal debate to have in a presidential campaign. But I made the decision that if this book turns out to be something that precludes me from ever being able to to run for president but, if it helps a lot of people and saves a lot of lives, that is absolutely a trade I’m willing to make.”TopicsBooksUS politicsDemocratsMental healthinterviewsReuse this content More