It’s time to talk about rural mental health challenges

In farming, you often have to work even when you're not feeling well. There are no options to call off or get substitutes when you need time off. The strong work ethic passed down from fathers to sons (and daughters in many cases) is admirable, but it can lead to medical issues if not managed properly.

Photo: Melissa Mayes/PEXELS

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by Tim Ditman
OSF Healthcare

ALTON - While living in Greene County, Illinois, in the 1980s and 1990s, Lea Anne Varble took a gut punch each time she heard about a suicide in her community. Eight to 10 in total in 15 years, she says.

“It just took me aback,” she says.

What the tragedies had in common: the person faced mental health challenges common to a rural setting.

Lea Anne Varble

Varble, a clinical psychotherapist at OSF HealthCare, knew she had to do something about it. So not only did she devote higher education time to studying the problem, but she’s also now getting the word out about the resources available.

The issues

Varble says stress and isolation are often experienced by people living in a rural setting, such as a farmer. There’s also a desire to be self-sufficient – a trope associated with farmers and other rural residents for decades.

“People living rurally often are independent. So, when stress comes, they want to handle it on their own,” Varble says.

Varble also knows the issues – stress, anxiety and even depression – of planting and harvest season.

“Hours and hours,” in the field, she says. “You’re expected to keep working even if you don’t feel well. Even if the stress is getting to you. You have to get up and do it again. Or at least that’s what your father before you did and his father before him.”

The work ethic can be admirable, but it can lead to medical issues if left unchecked.

And, the heads of some rural households are caring for two generations: their kids and their parents. School, chronic illnesses and advanced care planning are just more things to add to the to-do list. Varble adds that older adults in a rural setting are more likely to see themselves as a burden and choose to end their life.

Treatment

Varble says getting better starts simply with noticing the problem and talking about it with a trusted adult, like a friend, family member, faith leader or a medical professional.

The good news is that mental health professionals have made strides in this area, such as telemedicine and mobile health services. And society is more willing to talk about mental health. Farming magazines have articles on mental health, for example.

Other ways to help that Varble has picked up over the years:

• Get to know your neighbors and local organizations, like churches and businesses. Then, lean on them for help when the stress gets to be too much.
• Look into resources offered by state or federal agencies. In Illinois, where Varble works, the Family Farm Resource Initiative operates a 24/7 hotline and email.

  “Individuals can receive support from trained professionals who understand the unique challenges faced by those in the agricultural sector,” the initiative website states. “The helpline offers specialized assistance, including mental health resources and agriculture-related support, ensuring that farm families have access to the help they need.”
   

• Health care professionals should encourage people with rural backgrounds to become therapists.

“It’s someone from their community who understands what’s going on,” Varble says.

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Is it depression, ADHD or bipolar disorder?

Illustration: Goska Malgoska/Pixabay

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by Tim Ditman
OSF Healthcare

DANVILLE - Lavender Zarraga, APRN, a behavioral health provider at OSF HealthCare, says it’s not uncommon for her patients to ask for a medication that isn’t the right fit.

The culprit? She says symptoms of common mental health issues like depression, attention deficit hyperactivity disorder (ADHD) and bipolar disorder can overlap. So, it’s important to stay in contact with your provider to make sure you’re on the best treatment plan.

On depression mimicking ADHD: “You have changed executive functioning. You can’t decide. You feel dull. You can’t concentrate,” Zarraga says. “You have a hard time learning new things. You can’t remember things or forget things easily. Attention and concentration are low. You think ‘Why am I processing everything so slow?.’”

Lavender Zarraga, APRN

Zarraga adds that she’s seen people with depression take prescribed medicine and feel better, but then residual symptoms that mimic ADHD creep in. And, she says, ADHD can seem like bipolar disorder.

“If you start somebody on an antidepressant and they have an underlying bipolar disorder that they have not been diagnosed with, that can trigger mood symptoms. It could potentially trigger mania [a high energy period where high-risk behaviors can occur],” Zarraga says.

It’s a lot to sort out, and it may make the person feel like they have a whole new set of problems.

“Talk to a provider. See what’s going on,” Zarraga says to people in that situation, noting that kids should not have to carry these issues into adulthood.

“There’s a lot of talking involved,” she adds. “Let’s start from the beginning. Let’s go back to your childhood. How were you doing then? And we relate that to how you are now.”

From there, Zarraga says treatment could include more counseling or different medication. She says medicine for children is more straightforward. But for adults, a provider will make sure the pill isn’t impacting the rest of the person’s body.

There are also science-backed written tests that can help diagnose someone with ADHD. Questions along the lines of: Can you sit still in class? Does your mind wander all the time?

And a word for caregivers, friends and family members: watch for symptoms of these disorders in your loved ones and have a conversation, if needed. Don’t ignore things, Zarraga says.

“There’s nothing wrong with just talking about it. It’s not going to hurt anybody to discuss it,” she says, noting that society is now more accepting of mental health issues.

Signs to watch for in your close companion: irritability, aggression, anxiety and trouble sleeping. If you or someone you know needs to talk to a professional quickly, the national suicide and crisis lifeline is 9-8-8.

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