Low commodity prices, debt load, family disagreements, negative weather events — the list of challenges that stress farm business owners can go on and on.

So it’s not surprising that farming — in recent years, and depending on the survey — has ranked in the top 10 most stressful occupations in the United States. Accordingly, about 20% of farmers may suffer from depression, and some statistics have indicated high suicide rates. Men on farms today commit suicide nearly twice as often as other men in the general population.

According to a 2016 Centers for Disease Control and Prevention report, rates of suicide by occupation were highest in farming, fishing and forestry in 2012. Specific to farming, the report’s authors noted that farmers’ chronic exposure to pesticides might affect the neurologic system and contribute to depressive symptoms. Other factors they noted that might contribute to suicide among farmers include social isolation, potential for financial losses, barriers to and unwillingness to seek mental health services, and access to lethal means.

Depression is a common mood disorder that many, if not all, people experience at some time in their lives. For busy farming folks, it can be one of those stressed feelings that gets tamped down and ignored, because there is too much to do. However, depression interferes with being mentally healthy, and it also can affect your physical health.

“Whole health begins with mental health,” says Cynthie Christensen, a therapist who farms near Rushford, Minn. When we talk about mental health, we are simply referring to the state of psychological or emotional well-being, she says. A healthy psychological state is the ability to successfully cope with the ups and downs in life, and to have a hopeful outlook.

“When we are physically ill, there are a set of symptoms that define our illness. The same is true of mental illness,” Christensen adds. “There are a specific set of symptoms that define a diagnosis of depression and/or anxiety, bipolar disorder or dementia.”

The stigma
For a farmer to admit that he or she may be struggling with depression is tough. Those feelings of helplessness do not align with the traditional image of farmer stoicism and independence.

“Unfortunately, there continues to be significant stigma on those with mental health challenges,” Christensen says. “The emotion that goes with the stigma is often shame — believing that there is something wrong with me, that I can’t cope like other people are coping.” People who are struggling emotionally get good at emotional masking — which is hiding your true emotions and pretending that everything is fine when it’s not.

Yet, those who have the courage to seek treatment and mental health healing often worry about what they will tell their neighbors, co-workers and fellow parishioners about "where they’ve been" if they are hospitalized for mental health issues. Christensen says she thinks the stigma continues because of fear and misunderstanding. People are uncomfortable, and do not know how to react or support someone wrestling with mental health issues. They don’t know what to say, so they say nothing.

“On several occasions, clients and patients have told me ‘Nobody brings you a casserole or sends you a card when you are hospitalized in the psychiatric unit,’” she adds.

When to seek help
Specific to depression, if someone has been "out of sorts" for more than a few weeks, it would be beneficial to seek professional help. Attempts at self-diagnosis — mental or physical — are tricky, because you can misinterpret or distort your own thoughts, Christensen points out.

“When I was in nursing school, I often would worry that I had the disease that we were studying that week. With some imagination, I could convince myself that I had most of the signs and symptoms,” she says. “However, with mental health issues, I see almost the opposite effect — a disbelief and minimizing of symptoms, so as not to be labeled as mentally ill. Unfortunately, this often causes people to suffer with symptoms, sometimes for years, when they could be receiving treatment. Often, people tell me that they wish they had sought help earlier, rather than suffering.”

Medical professionals make a diagnosis of clinical depression when a person has been in a depressed mood or has had a loss of interest or pleasure in daily activities for more than two weeks. Specific symptoms include irritability, feelings of sadness or emptiness, decreased interest or pleasure in most activities, significant weight change or change in appetite, change in sleep (insomnia or hypersomnia), fatigue or loss of energy, feelings of guilt or worthlessness, diminished ability to think or concentrate, or thoughts of suicide.

If you have had several of the above symptoms for some time, Christensen urges you to seek out a mental health professional trained in diagnosing and treating mental illness.

“An accurate, honest description of symptoms is very important in making the diagnosis because, unlike medical conditions, there is no X-ray or lab test used to diagnose. It is a conversation,” she says.

Here are some available resources:

• your local medical clinic, your county social and/or mental health services, your church

• National Alliance on Mental Illness, St. Paul office, 888-626-4435. Many cities have local chapters.

• Crisis Response for Southeast Minnesota (staffed 24/7), 844-274-7472 

• University of Minnesota Extension's "Live Healthy, Live Well" program

• Minnesota Department of Agriculture's Farmer Assistance Network; or call toll-free at 877-898-MFAN (6326) or in the Twin Cities at 651-201-6327. The website also lists a farm and rural help line, 833-600-2670.

Christensen is a licensed professional clinical counselor and has her own therapy practice, Oak Ridge Teletherapy. She is also credentialed as a distance counselor, which prepares her to work with clients via the Internet. She has worked as an acute psychiatric nurse at Mayo Clinic in Rochester, Minn., for the past 18 years. Contact her at [email protected].

Editor’s note: This article is the first in a series on mental health that will be published over the next few months. Future articles will discuss what to expect at your first counseling appointment, and how to rebuild your resilience. We also are open to questions and comments from our readers. Please email them to [email protected] and/or [email protected].