Well Being Trust had an opportunity to talk with Dawnel DeRubeis, Mrs. California, and recently crowned inaugural Mrs. USA America International 2018. Dawnel has given thousands of hours of volunteer service to a wide array of humanitarian organizations and noble causes. Today she works closely with American Foundation for Suicide Prevention to inspire hope and resilience, with a focus on young people facing mental health challenges. We asked her about depression, motherhood, her advocacy work, and more.
Later we talk with Well Being Trust’s own Dr. Clayton Chau for a clinical perspective on depression, suicide, and the prevalence of both across the nation.
1. Have you ever been depressed or thought about suicide? What helped you get through it?
Yes and yes! Although as I was growing up and through my teenage years I wouldn’t have labeled it depression because I really didn’t know what that was or understand my families dynamic and history.
I do recall the first time suicidal thoughts ever crept up on me…those thoughts are one of the traits of my illness that I have to fight through even now, chronic suicidal thoughts. This is a journey, this is something that I have to work through on a daily basis. So even though I am at a much stronger place with a deep understanding of who I am, this is not something I will ever be “over”. I have spent a great deal of time researching, reading, asking questions, reaching out to professionals, therapy, journaling, etc. so that I could understand and recognize my triggers and more importantly, what I need on a daily basis to stay mind healthy.
2. How did you become involved with the American Foundation for Suicide Prevention?
I can actually remember having a few free minutes to come to my computer on a day where I felt strong and told myself I would not cry another day…I just started googling topics like depression and suicide and for whatever reason, one of the first links I clicked on was the website for the AFSP. On the home page they were advertising for their upcoming Out of the Darkness Community Walk in Ventura. I was curious, recruited a few friends and attended my first community walk. That afternoon when I got home, after being completely overwhelmed with emotion, I immediately emailed the LA Chapter Director and introduced myself. I stated quite simply that I knew nothing about the organization but if she was willing to take me under her wing, I was willing to learn and wanted to be a part of what they were doing. I guess you can say the rest is history. 4 years later I have been blessed to emcee all of their LA Chapter walks, raise money for the organization, work closely with all of the Board Members and volunteers through tabling events and other community events, through the AFSP I have joined several coalitions and committees. I also assist in coordinating training with my main focus of educating our youth through their Junior High/High School and College programs.
3. How has your depression affect your family life?
Depression can affect any family. It goes far beyond the one struggling. I have days where I don’t want to even get out of bed let alone be a mom or a wife. Those days usually come after not getting the necessities my mind needs to stay strong and healthy. This is the hardest question to answer honestly because it can be a vicious cycle. If there are other moms reading this, I want you to know that I get it. You are not alone in those moments where you feel like you are going to completely lose it. I am not proud of the way some days have gone and my reactions to my kids who are just being kids. There are days where I definitely don’t live up to the vision I have of the type of mom I want to be and the cycle begins because then I fill myself up with guilt and have to fight through that. You know, it’s good day and then bad day… One of the most important focuses for me to find my light and maintain my hope is open and hone communication with my family. My husband has learned over the recent years in all of my self-discovery, just how to respond to me when Iam down, and I am more honest than ever in asking for what I need. My kids, are resilient and loving and understanding. I have educated them on mental health and they know the history of my family.
4. What caused you to seek help with your depression and anxiety?
After silently suffering for so many years…It was after having my second child and crying everyday for two years straight. I remember reading baby books that talked about postpartum depression and relating to so many of the stories but then the next moment I would push away that relation and tell myself I was the only mom to feel this down and there must be something wrong with ME. I kept quiet even to my husband about how deep my thoughts went. I became so good at being fake!!!!! But I was exhausted to my core. I can close my eyes now and picture my little boys big brown eyes looking up at me and I knew in my heart that I loved him beyond measure, but all I could think about is how I wanted to run away and crawl in a hole and disappear. The moment those suicidal thoughts came creeping back in my mind I knew for my families sake I had to seek help. It took my therapist all of 5 minutes talking with me to diagnose me with postpartum depression. Therapy and my treatment plan taught me more about myself and all of those years that I had felt “off” what that really meant. It made me research and learn about my family history, and gave me the tools I needed to dig deep and understand how to cope with and live a happy life everyday. It taught me how to fight!
5. How did you overcome the stigma associated with getting help for mental illness?
Overcoming the stigma associated with mental illness happened for me almost naturally and in some ways it was almost magical. I had never talked openly about my struggles, in fact I don’t think my husband even understood the true depth of my struggle until the first time I shared my story in public. But there was something about sharing my story in front of hundreds of strangers (haha) that freed me, and from that moment on I have never felt embarrassed or shame for being who I am. I quickly felt the impact that I could make on someone by allowing myself to become so vulnerable.
6. How has getting involved with the American Foundation for Suicide Prevention helped you?
Each and every person I have met in the last few years that I have been volunteering with the AFSP has become like family. I don’t know that I have ever met a group of people with the amount of strength and compassion as this organization. Honestly, I can say that about everyone in the mental health space that I have met since I have started seeking help and healing. That first walk I ever did with the AFSP showed me what I believe to be my life mission or purpose and my passion. There is a quote out there (and I have come to rely heavily on quotes as part of my daily need and healing) that says,“I want to inspire people. I want someone to look at me and say, because of you I didn’t give up.” Just one person, and I will have fulfilled my purpose (I am honored to mentor a few young ladies now).
7. What have you learned about depression, anxiety and suicide that you want people to know about?
I will be honest, I am constantly learning. This is a journey that I am on for life…but if I had to pick just one thing for people to know I guess it would be that they are stronger than any challenges they may face, they are braver than they might ever believe, and there is help, there is hope, and YOU ARE NOT ALONE!!!!!!! I really believe the moment you embrace every part of who you are, flaws and all, is the day you can start healing. I guess thats more than one =)
8. What are some ways people can get involved in suicide prevention efforts? What do you think is the biggest need out there right now?
I have actually had the opportunity to do some outreach and speak with people interested in volunteering and they all have their own story. I think its important to note that any volunteer work you do, whether it be for this cause or something else, that you explore your options so that you can work on something that speaks to your heart. More importantly, that you are not volunteering on something that is too much for you to handle emotionally.
I know we can always use more fighters in the advocacy area and that piece is easy. If you choose to advocate with the AFSP, you can actually sign up on the website and you will receive templates and easy to follow steps on getting our voices heard at the State and Federal level. Otherwise, I think the biggest need is for those willing to speak up for those without a voice, that they continue to do so as far and wide as they possibly can!!!!!! I will always be the voice!!!!!!
9. Does competing in pageants trigger your depression and anxiety? If so, how?
So this is an interesting question simply because I have been competing for so much longer than I have sought to understand my illness. Like in my teenage years, if I did feel depression or anxiety when competing, I didn’t recognize it as that. Since, I have competed several times and will probably never stop. Haha. Competing for me is an adrenaline rush. An adrenaline rush releases a stress hormone and perhaps it makes me feel balanced.
Competing is so much preparation ahead of time and so there are definitely times during that process where I feel completely overwhelmed with the amount of things I have to get done, with the financial aspects that come along with it. Most definitely it can trigger self-doubt because the reality is you are competing against other amazing women. It makes you question everything about who you are. The areas of competition encompass all aspects of who you are and you are being judged in those areas. It ranges from your ability to communicate, your resume and accomplishments, how self—confident you are on stage, your overall stage presence including physical appearance. So the answer to the question is absolutely!!!!!
10. What kind of mental preparation do you need to help you when you’re in competition?
I appreciate this being the follow-up question to the previous one because I want people to know why I would put myself in a situation where my depression or anxiety might play on me and why I might expose myself to something that makes me ever feel doubt about who I am when I am trying so desperately to accept every part of me. It is probably hard to put into words but I will start by saying that I began competing in pageants as a way of meeting people. I went into my first pageant never expecting to win, and I have maintained that mentality for all of these years. The truth is I don’t compete to win. What?????? Of course taking home the title and all that the title offers is the ultimate goal, but it is the bonus for me and I think it is why I am able to move through all of those emotions in the preparation process. At the end of that roller coaster ride of prep, I re-focus on the reason I wanted to compete in the first place. Competing is my way of building my self-confidence through all that I have to do to prepare for the competition and all of the challenges that competing presents. Despite being on stage with other women, I believe that the only person I am competing against is myself. It makes me want to be the best version of me from the inside out. It motivates me and I think motivation is absolutely critical in accomplishing your goals and dreams.
Next we chatted with Dr. Clayton Chau, MD, PhD, Regional Executive Medical Director for mental health and wellness for Providence St. Joseph Health. Here is what he had to say on depression, suicide, and facing mental illness as a family.
How does depression start?
- Depression is a very complex disease. No one knows exactly what causes it, but it can occur for a variety of reasons. Some people experience depression during a serious medical illness. Others may have depression with life changes such as a move or the death of a loved one. Still others have a family history of depression. Those who do may experience depression and feel overwhelmed with sadness and loneliness for no known reason.
- Of the precipitating factors that cause depression, chemical imbalances in the brain is a big problem. Genes that produce mood-enhancing neurotransmitters are switched off by epigenes that are chemical tags serving as an intermediary between genes and the environment. Epigenes have the ability to turn on or turn off gene segments in ways that promote health or facilitate disease. Because of faulty chemical signaling in the brain, neural circuits go awry and lead to depression and anxiety. Which is why many antidepressant and antianxiety medications target certain neurotransmitters (brain chemical messengers).
- There are a number of factors that may increase the chance of depression, including the following:
- Abuse - Past physical, sexual, or emotional abuse can increase the vulnerability to clinical depression later in life.
- Certain medications - Some medications, such as high blood pressure medication, the antiviral drug interferon-alpha, and corticosteroids, can increase your risk of depression.
- Conflict - Depression in someone who has the biological vulnerability to develop depression may result from personal conflicts or disputes with family members or friends.
- Death or a loss - Sadness or grief from the death or loss of a loved one, though natural, may increase the risk of depression.
- Major events - Even good events such as starting a new job, graduating, or getting married can lead to depression. So can moving, losing a job or income, getting divorced, or retiring. However, the syndrome of clinical depression is never just a "normal" response to stressful life events.
- Other personal problems - Problems such as social isolation due to other mental illnesses or being cast out of a family or social group can contribute to the risk of developing clinical depression.
- Serious physical illnesses - Sometimes depression co-exists with a major illness or may be triggered by another medical condition, such as hypothyroidism, diabetes, cancer, heart disease, etc.
- Substance abuse - Nearly 30% of people with substance abuse problems also have major or clinical depression. And, substance abuse is common among people who are battling a depressive disorder. Because alcohol and many illicit drugs are central nervous system depressant, the use of these drugs tend to trigger depression symptoms like lethargy, sadness and hopelessness. However, many depressed individuals reach for drugs or alcohol as a way to lift their spirits or to numb painful thoughts. As a result, depression and substance abuse feed into each other, and one condition will often make the other worse.
Are people predisposed to mental illness?
- Research has shown that people with parents or siblings who have depression are up to three times more likely to have the condition. This can be due to heredity or environmental factors that have a strong influence.
- A family history of depression may increase the risk. It's thought that depression is a complex trait, meaning that there are probably many different genes that each exert small effects, rather than a single gene that contributes to disease risk. The genetics of depression, like most psychiatric disorders, are not as simple or straightforward as in purely genetic diseases such as sickle cell’s or cystic fibrosis.
- Studies of families with depression have indicated that the disorder has a genetic link and scientists think around 40 percent of the risk of developing it is contributed by genes, with the rest down to environmental and other external factors.
- Perhaps, many genes are involved in depression.
What are the ways that mental illness can affect a family?
It's difficult to be diagnosed with a serious mental illness such as schizophrenia, bipolar disorder, panic disorder, obsessive-compulsive disorder and major depressive disorder. It's also difficult when a loved one is experiencing one of these diseases. When a person is living with a serious mental illness, the whole family may be affected. Mental illness is more pervasive than we would like to admit. It is easier to tell someone that you have Cancer than a Mental Illness. When you tell someone you have Cancer they react with sympathy. When you say you have a mental illness most people don't know how to react or they try to change the subject. For this reason most people suffering from mental illness stay silent about it.
Serious mental illnesses often have a biological component. They are not the result of bad parenting, and they probably couldn't have been prevented by anything that anyone might have done differently. Even still, after the diagnosis it's normal to feel a range of powerful — and often unpleasant — emotions. It's not abnormal to feel ashamed, or hurt, or embarrassed by a family member whose behaviors can be difficult to understand and deal with.
When mental illness first surfaces, family members may deny the person has a continuing illness. During the acute crisis episode family members will be alarmed by what is happening to their loved one. When this event is over and the family member returns home, everyone will feel a tremendous sense of relief. All involved want to put this painful time in the past and focus on the future; partly, also supported by the fact that the treatment providers do not stress on the importance of viewing mental illnesses as chronic health conditions. Many times, particularly when the illness is a new phenomenon in the family, everyone may believe that since the person is now doing very well that symptomatic behavior will never return. They may also look for other answers, hoping that the symptoms were caused by some other physical problem or external stressors that can be removed. Some family members feel they must protect the loved one with mental illness from those who do not and who blame and denigrate the ill person for unacceptable behavior and lack of achievement. Many people also feel anger at the circumstances and even at the person who has been diagnosed. And though it may not be logical, parents often engage in some degree of self-blame. Such feelings of shame and anger may also go hand-in-hand with feelings of guilt. Grief is also common. This leads to tension within the family, and isolation and loss of meaningful relationships with those who are not supportive of the family member living with mental illness.
More frequent than not, many families may also have little knowledge about mental illness; burdened by the fact that it is difficult to know where to turn to get information. Without information to help families learn to cope with mental illness, families can become very pessimistic about the future. The illness seems to control their destiny rather than the family, gaining control by learning how to manage the illness and to plan for the future. It is imperative that the family find sources of information that help them to understand how the illness affects the person. They need to know that with medication, psychotherapy or a combination of both, and family/community supports the majority of people do recover and can be a productive member of society. It is also imperative that the family finds sources of support for themselves. Entities such as the National Alliance for Mental Illness (NAMI), Depression and Bipolar Support Alliance (DBSA) and others including faith based organizations can play a critical role in identifying resources in the community that can help the family build the knowledge base that will give them the tools to assist their loved one and themselves.
How common are depression and suicide?
- In 2015, an estimated 3 million adolescents aged 12 to 17 and 16.1 million adults aged 18 or older in the US had at least one major depressive episode in the past year. These numbers represented 12.5% and 6.7% of all people living in the US within those age range respectively.
- In the same year, of those with depression, an estimated 2.1 million adolescents aged 12 to 17 and 10.3 million adults aged 18 or older had at least one major depressive episode in the past year with severe impairments. These numbers represented 8.8% and 4.3% of all people living in the US within those age range respectively.
- Rate of youth depression increased to 12.5% in 2015 from 8.5% in 2011.
- Major depression is the psychiatric diagnosis most commonly associated with suicide. About 2/3 of people who complete suicide are depressed at the time of their deaths.
- One out of every 16 people who are diagnosed with depression eventually go on to end their lives through suicide. The risk of suicide in people with major depression is about 20 times that of the general population.
Each year, almost 45,000 Americans die by suicide. According to the American Foundation for Suicide Prevention:
- Suicide is the 10th leading cause of death in the U.S.
- For every completed suicide there are 25 attempts
- Rate of youth depression increased to 12.5% in 2015 from 8.5% in 2011.
- Suicide costs the U.S. $44 billion annually
- On average, 121 people die by suicide a day = one person every 12 minutes
- Firearms account for almost 50% of all suicides
- White males accounted for 7 of 10 suicides in 2015
- While males are four times more likely than females to die by suicide but females attempt suicide three times as often as males
- While still low, there is an alarming increase among suicides in girls ages 10 to 14; the suicide rate in that group has tripled in the last decade.
- Many suicide attempts go unreported or untreated. Surveys suggest that at least 1 million people in the U.S. each year engage in intentionally inflicted self-harm.