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June 26, 2023

Data Point | The gender disparity in healthcare

The Data Point is a bi-weekly newsletter in which The Hindu’s Data team decodes the numbers behind today’s biggest stories.

(This article forms a part of the Data Point newsletter curated by The Hindu’s Data team. To get the newsletter in your inbox, subscribe here.)

The difference in the anatomy between various genders implies that diseases and their symptoms may affect them differently. Moreover, some diseases affect certain genders more than others, while a few are gender-specific conditions. Thus, it is imperative to look through a gendered lens for a better understanding of diseases.

Equal representation of genders in clinical trials, and impartiality and unbiasedness in testing and diagnosis help in creating a healthcare system that addresses the needs of all genders.

Yet, various studies conducted in the U.S. reveal that in some fields of medicine such as oncology, psychiatry, neurology and cardiology, the disease burden was higher among women while their share in clinical trials was not proportionate.

In a study where 1,433 trials were conducted from 0.3 million people in the U.S. between 2016 and 2019, the average share of women was 41.2%. In psychiatry, where women comprised 60% of patients, the share of women participating in clinical trials was 42%. Similarly, the difference was significantly high in the case of cardiovascular diseases (41.9% female participants vs. 49% female patients) and cancer trials (41% female participants vs. 51% female patients)

Gender disparity is also observed in research funding. For instance, according to the National Institutes of Health (NIH) data, the 2023 research funding estimate for substance misuse (a condition more prevalent among men) was $2,583 million while that for depression (a condition more prevalent among women) was $664 million. Similarly, research funding in 2022 for HIV/AIDS, a disease more prominent among men (DALY of 0.361 million in 2015) was $3,294 million, while that for inflammatory bowel disease (IBD), a disease dominant among women (DALY of 0.475 million) was $203 million. (expand DALY somewhere)

To know more about the gender gap in clinical trials and research funding, click here

Women faced the challenge of a gender gap in testing, diagnosis and treatment, which arose from a lack of comprehensive research about conditions dominant among women and biases toward women in healthcare.

In a multicentre observational study published in 2023, it was revealed that the median time taken to diagnose IBD from the onset of a symptom was more prolonged in women than in men. For instance, it took about 12.6 months to diagnose Crohn’s disease (a type of IBD) for women, while it only took 4.5 months for men. Similarly, it took 6.1 months for women and 2.7 months for men, in the case of ulcerative colitis.

NIH data also revealed that funding given for women’s reproductive disorders was significantly lower than that for conditions with a similar disease burden.

Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic abnormality among women with a worldwide prevalence of up to 21%, depending on diagnostic criteria. Yet, while diseases with equal or lesser disease burden like rheumatoid arthritis, tuberculosis, and systemic lupus erythematosus, were awarded funds worth $454.39 million, $773.77 million, and $609.52 million respectively, the funding for PCOS research between 2006 and 2015 was limited to $215.12 million.

Thus, a limited understanding of disease further delays diagnosis, especially for diseases affecting women’s reproductive system.

In the Indian context, the taboo towards menstrual health in society, which extends to the health sector adds to this problem. Endometriosis, a disease that affects roughly 10% (190 million) of women and girls of reproductive age worldwide according to the WHO, is highly underreported in the country.

Despite persistent visits to multiple gynaecologists over a decade, my journey to obtain a proper diagnosis for endometriosis was marked by significant delays. My experiences of enduring intense menstrual cramps, accompanied by nausea and bowel disorders, were consistently dismissed by doctors who attributed them to natural menstrual processes. Prescription of painkillers became routine without a genuine effort to comprehend the severity of my discomfort or suggest diagnostic scans for underlying issues. Only after my insistence, despite initial reluctance from doctors, did I finally receive a diagnosis. Regrettably, by that time, the lesions within my ovaries had grown larger than the organs themselves.

Even with a diagnosis, treatment options remain limited due to the narrow understanding of this condition. While invasive surgeries like laparoscopic procedures and hormonal medications seem to be the only options, these treatments come with significant side effects and cannot guarantee the complete eradication of recurring lesions.

In an article titled, “Male-centric medicine is affecting women’s health” in The Hindu, the author explains that women are less likely to receive appropriate medications, diagnostic tests and clinical procedures even in developed countries such as Canada and Sweden as the stereotype of the “hysterical woman” continues to haunt women even when they need urgent clinical interventions.

Therefore, it is crucial to implement appropriate interventions, create awareness within the medical community to mitigate bias and push for gender-sensitive clinical trials and equitable allocation of research funding. These measures are imperative to ensure equal and unbiased healthcare for all individuals, regardless of their gender among other identities.

Fortnightly figures

10.3% was the decrease in India’s merchandise exports in May 2023 at $34.98 billion from $39 billion in May 2022. Imports contracted at a slower 6.6% rate to $57.1 billion, lifting the trade deficit to a five-month high of $22.1 billion. This is the sixth time in the last eight months that goods exports have declined year-on-year, although May’s decline was lower than the 12.6% fall recorded in April.
110 million people have had to flee their homes because of conflict, persecution, or human rights violations, the UN High Commissioner for Refugees (UNHCR) said. The war in Sudan, which has displaced nearly 2 million people since April, is but the latest in a long list of crises that have led to the record-breaking figure. Last year alone, an additional 19 million people were displaced, including more than 11 million who fled Russia’s invasion of Ukraine in the fastest and largest displacement of people since World War II.
1 lakh people were shifted to approximately 1,500 temporary shelters set up as part of the disaster management efforts by the Gujarat State against Cyclone Biparjoy before the cyclone made landfall. Cyclone Biparjoy caused widespread damage in Gujarat’s Kutch-Saurashtra region as it made landfall late on June 15, Thursday. The Gujarat government also shut schools and other educational institutions for the next day as the State received heavy downpours in the aftermath of the cyclonic storm.
4.25% was India’s retail inflation in May from 4.7% in April this year, a 20-month low. The price rise in food items faced by consumers moderated to 2.91%. This is the third successive month that inflation has remained below the Reserve Bank of India’s (RBI’s) upper tolerance limit of 6% after a prolonged streak above it. Base effects from May 2022 when retail inflation was over 7% also played a role in lowering the inflation rate this May.
₹1.13 lakh crore was the third instalment of tax devolution released by the Centre to States, according to the Finance Ministry. This surpasses the normal monthly devolution of ₹59,140 crore. The additional advance aims to enable expedited capital spending, financing of development/welfare-related expenditure and increased resource availability for projects and schemes of the States.

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May 26, 2023

Social Media Can Harm Kids. Could New Regulations Help?

Post By zittrexstore Science And Technology anxiety, children, depression, social media, Stress No Comments

This week Surgeon General Vivek H. Murthy released a warning about the risks that social media presents to the mental health of children and teenagers. Adolescent mental health has been declining for years, and an increasing amount of research suggests that social media platforms could be partially to blame. But experts continue to debate just how much impact they have—and whether new and proposed laws will actually improve the situation or will end up infringing on free speech without addressing the root of the problem.

Numerous studies demonstrate that adolescent rates of depression, anxiety, loneliness, self-harm and suicide have skyrocketed in the U.S. and elsewhere since around the time that smartphones and social media became ubiquitous. In fact, in the U.S., suicide is now the leading cause of death for people aged 13 to 14 and the second-leading cause of death for those aged 15 to 24. In October 2021 the American Academy of Pediatrics declared a “national state of emergency in children’s mental health,” stating that the COVID pandemic had intensified an already existing crisis. The U.S. Centers for Disease Control and Prevention issued a similar warning in 2022, after the agency found that nearly half of high school students reported feeling persistently “sad or hopeless” during the previous year. According to the CDC, LGBTQ and female teens appear to be suffering particularly poor mental health.

Yet the role social media plays has been widely debated. Some researchers, including Jean Twenge of San Diego State University and Jonathan Haidt of New York University, have sounded the alarm, arguing that social media provides the most plausible explanation for problems such as enhanced teen loneliness. Other researchers have been more muted. In 2019 Jeff Hancock, founding director of the Social Media Lab at Stanford University, and his colleagues completed a meta-analysis of 226 scientific papers dating back to 2006 (the year Facebook became available to the public). They concluded that social media use was associated with a slight increase in depression and anxiety but also commensurate improvements in feelings of belonging and connectedness.

“At that time, I thought of them as small effects that could balance each other out,” Hancock says. Since then, however, additional studies have poured in—and he has grown a bit more concerned. Hancock still believes that, for most people most of the time, the effects of social media are minor. He says that sleep, diet, exercise and social support, on the whole, impact psychological health more than social media use. Nevertheless, he notes, social media can be “psychologically very detrimental” when it’s used in negative ways—for instance, to cyberstalk former romantic partners. “You see this with a lot of other addictive behaviors like gambling, for example,” Hancock says. “Many people can gamble, and it’s not a problem. But for a certain subset, it’s really problematic.”

Some recent studies have attempted to clarify the link between social media and mental health, asking, for instance, whether social media use is causing depression or whether people are being more active on social media because they’re depressed. In an attempt to present causal evidence, Massachusetts Institute of Technology economist Alexey Makarin and two of his colleagues compared the staggered rollout of Facebook across various U.S. colleges from 2004 to 2006 with mental health surveys taken by students at that time. Their study, published in 2022, found that swollen rates of depression and anxiety, as well as diminished academic performance, followed Facebook’s arrival. Makarin says much of the harm they documented came from social comparisons: students viewed the online profiles of their peers and believed them to “[have] nicer lives, party more often, have more friends and look better than them.” Facebook’s parent company Meta did not responded to requests for comment by press time.

Other studies have obtained similar results. In one paper, participants were paid to deactivate Facebook for four weeks prior to the 2018 U.S. midterm elections and reported experiencing improved happiness and life satisfaction when they weren’t on the platform. And in February 2023 researchers at Swansea University in Wales found likely physical health benefits, including a boost to the functioning of the immune system, when social media use was reduced by as little as 15 minutes per day.

“In total, there’s a more and more coherent picture that, indeed, social media has a negative impact on mental health,” Makarin says. “We are not saying that social media can explain 100 percent of the rise of mental health issues…. But it could potentially explain a sizeable portion.”

Mitch Prinstein, chief science officer at the American Psychological Association (APA), which recently released recommendations for adolescent social media use, points out that there’s nothing inherently harmful or beneficial about social media. “If I’m 12, and I’m reading Scientific American and going on social media to talk with my friends about how interesting the articles are,” he says, then that’s a far cry from “going on a site that’s showing me how to cut myself and hide it from my parents.” He suggests that social media companies should take down the potentially harmful content, letting youth use social media more safely.

In addition to toxic content, Prinstein worries about the effects of social media on young people’s sleep—and therefore brain development. “No kid should be on their phone after 9 P.M.,” he says, “unless they’re going to sleep well into the morning.” But actually closing down the social apps and putting that phone down is difficult, Prinstein says. This is in part because of the design of these platforms, which aim to hold users’ attention for as long as possible. Kris Perry, executive director of the nonprofit Children and Screens: Institute of Digital Media and Child Development and a former senior adviser to California governor Gavin Newsom, agrees. Besides being sucked in by app design, she says, adolescents fear disappointing their peers. “Kids feel genuinely scared that they’ll lose friendships, that they won’t be popular, if they don’t like their friends’ posts instantly,” Perry says.

The flood of new studies on social media’s harms is spurring lawmakers to action. Except for the Children’s Online Privacy Protection Act, which passed in 1998—years prior to the advent of smartphones or social media—the U.S. Congress has never really involved itself with what kids do online. “It’s kind of the Wild West out there,” Prinstein says of the lack of oversight. Since around 2021, however, when a Facebook whistleblower testified that the company knew its platforms harmed youth mental health—allegations that Facebook denied—both Republican and Democratic lawmakers have moved to follow Europe’s lead on stronger Internet regulations. On the federal level, members of Congress have introduced a slew of overlapping bills: at least two would bar social media use outright for kids under a certain age, while others would restrict targeted advertising and data collection, give young users more control over their personal information, prioritize parental supervision, facilitate additional research and hold social media companies liable for toxic content viewed by minors. Though nothing has yet passed, President Joe Biden seems largely onboard with these measures. In his February State of the Union speech, Biden said, “We must finally hold social media companies accountable for the experiment they are running on our children for profit.” And on the same day as the surgeon general’s warning this week, the White House commissioned a task force to analyze how to improve the health, safety and privacy of kids who go online.

Meanwhile state legislatures have jumped into the fray. California recently passed a law designed to protect children’s online data. Montana banned TikTok. And Arkansas and Utah mandated, among other things, that social media companies verify the ages of their users and that minors get parental consent to open an account. Similar bills are pending in many other states.

Of the federal bills currently pending, arguably the Kids Online Safety Act (KOSA) has gained the most attention thus far. Sponsored by Republican Senator Marsha Blackburn of Tennessee and Democratic Senator Richard Blumenthal of Connecticut, the bill would require social media companies to shield minors from content deemed dangerous. It also aims to safeguard personal information and rein in addictive product features such as endless scrolling and autoplaying. Supporters of KOSA include Children and Screens, the APA and the American Academy of Pediatrics, along with several parents whose kids died by suicide after being relentlessly cyberbullied.

On the opposing side, organizations that include the Electronic Frontier Foundation, a digital rights nonprofit, and the American Civil Liberties Union have come out against KOSA, stating that it might increase online surveillance and censorship. For instance, these parties have raised concerns that state attorneys general could weaponize the act to suppress content about, say, transgender health care or abortion. This is particularly problematic because it could negate some of the positive effects social media has on teen mental health.

Researchers acknowledge that social media can aid kids by, among other things, connecting them with like-minded people and facilitating emotional support. This appears to be especially important for “folks from underrepresented backgrounds,” Prinstein says, “whether you’re the only person around who looks like you or the only person with your identity in your family.” If KOSA leads to the restriction of speech about LGBTQ issues, for instance, it could be detrimental to members of that community. “That support, and even accessing information, is a great benefit,” Prinstein says. “There really was no other way to get that resource in the olden times.”

Jason Kelley, associate director of digital strategy at the Electronic Frontier Foundation, says that rather than a bill like KOSA, he would prefer to see stronger antitrust laws that might, for example, increase competition among platforms, which could encourage each one to improve its user experience in order to win out. More options, he says, would force social media companies “to deal with the ways they ignore user interest and desire and safety and privacy.”

As the debate continues over the best legislative fixes, essentially all the researchers Scientific American spoke to agree on one idea: more information about these platforms can help us figure out exactly how they’re causing harms. To that end, KOSA would mandate that the social media companies open up their closely held datasets to academics and nonprofits. “There’s a lot we don’t know,” Hancock says, “because we’re prevented.”

IF YOU NEED HELP

If you or someone you know is struggling or having thoughts of suicide, help is available. Call or text the 988 Suicide & Crisis Lifeline at 988 or use the online Lifeline Chat.

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May 11, 2023

How psilocybin, the psychedelic in mushrooms, may rewire the brain to ease depression, anxiety and more | CNN

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CNN
—

Shrooms, Alice, tweezes, mushies, hongos, pizza toppings, magic mushrooms — everyday lingo for psychedelic mushrooms seems to grow with each generation. Yet leading mycologist Paul Stamets believes it’s time for fans of psilocybin mushrooms to leave such childish slang behind.

“Let’s be adults about this. These are no longer ‘shrooms.’ These are no longer party drugs for young people,” Stamets told CNN. “Psilocybin mushrooms are nonaddictive, life-changing substances.”

Small clinical trials have shown that one or two doses of psilocybin, given in a therapeutic setting, can make dramatic and long-lasting changes in people suffering from treatment-resistant major depressive disorder, which typically does not respond to traditional antidepressants.

Based on this research, the US Food and Drug Administration has described psilocybin as a breakthrough medicine, “which is phenomenal,” Stamets said.

Psilocybin, which the intestines convert into psilocin, a chemical with psychoactive properties, is also showing promise in combating cluster headaches, anxiety, anorexia, obsessive-compulsive disorder and various forms of substance abuse.

“The data are strong from depression to PTSD to cluster headaches, which is one of the most painful conditions I’m aware of,” said neurologist Richard Isaacson, director of the Alzheimer’s Prevention Clinic in the Center for Brain Health at Florida Atlantic University.

“I’m excited about the future of psychedelics because of the relatively good safety profile and because these agents can now be studied in rigorous double-blinded clinical trials,” Isaacson said. “Then we can move from anecdotal reports of ‘I tripped on this and felt better’ to ‘Try this and you will be statistically, significantly better.’ “

Classic psychedelics such as psilocybin and LSD enter the brain via the same receptors as serotonin, the body’s “feel good” hormone. Serotonin helps control body functions such as sleep, sexual desire and psychological states such as satisfaction, happiness and optimism.

People with depression or anxiety often have low levels of serotonin, as do people with post-traumatic stress disorder, cluster headaches, anorexia, smoking addiction and substance abuse. Treatment typically involves selective serotonin reuptake inhibitors, or SSRIs, which boost levels of serotonin available to brain cells. Yet it can take weeks for improvement to occur, experts say, if the drugs even work at all.

With psychedelics such as psilocybin and LSD, however, scientists can see changes in brain neuron connectivity in the lab “within 30 minutes,” said pharmacologist Brian Roth, a professor of psychiatry and pharmacology at the University of North Carolina at Chapel Hill.

“One of the most interesting things we’ve learned about the classic psychedelics is that they have a dramatic effect on the way brain systems synchronize, or move and groove together,” said Matthew Johnson, a professor in psychedelics and consciousness at Johns Hopkins Medicine.

“When someone’s on psilocybin, we see an overall increase in connectivity between areas of the brain that don’t normally communicate well,” Johnson said. “You also see the opposite of that – local networks in the brain that normally interact with each other quite a bit suddenly communicate less.”

It creates a “very, very disorganized brain,” ultimately breaking down normal boundaries between the auditory, visual, executive and sense-of-self sections of the mind – thus creating a state of “altered consciousness,” said David Nutt, director of the Neuropsychopharmacology Unit in the Division of Brain Sciences at Imperial College London.

And it’s that disorganization that is ultimately therapeutic, according to Nutt: “Depressed people are continually self-critical, and they keep ruminating, going over and over the same negative, anxious or fearful thoughts.

“Psychedelics disrupt that, which is why people can suddenly see a way out of their depression during the trip,” he added. “Critical thoughts are easier to control, and thinking is more flexible. That’s why the drug is an effective treatment for depression.”

There’s more. Researchers say psychedelic drugs help neurons in the brain sprout new dendrites, which look like branches on a tree, to increase communication between cells.

“These drugs can increase neuronal outgrowth, they can increase this branching of neurons, they can increase synapses. That’s called neuroplasticity,” Nutt said.

That’s different from neurogenesis, which is the development of brand-new brain cells, typically from stem cells in the body. The growth of dendrites helps build and then solidify new circuits in the brain, allowing us to, for example, lay down more positive pathways as we practice gratitude.

“Now our current thinking is this neuronal outgrowth probably doesn’t contribute to the increased connectivity in the brain, but it almost certainly helps people who have insights into their depression while on psilocybin maintain those insights,” Nutt said.

“You shake up the brain, you see things in a more positive way, and then you lay down those positive circuits with the neuroplasticity,” he added. “It’s a double whammy.”

Interestingly, SSRIs also increase neuroplasticity, a fact that science has known for some time. But in a 2022 double-blind phase 2 randomized controlled trial comparing psilocybin to escitalopram, a traditional SSRI, Nutt found the latter didn’t spark the same magic.

“The SSRI did not increase brain connectivity, and it actually did not improve well-being as much as psilocybin,” Nutt said. “Now for the first time you’ve got the brain science lining up with what patients say after a trip: ‘I feel more connected. I can think more freely. I can escape from negative thoughts, and I don’t get trapped in them.’ “

Taking a psychedelic doesn’t work for everyone, Johnson stressed, “but when it works really well it’s like, ‘Oh my god, it’s a cure for PTSD or for depression.’ If people really have changed the way their brain is automatically hardwired to respond to triggers for anxiety, depression, smoking — that’s a real thing.”

How long do results last? In studies where patients were given just one dose of a psychedelic “a couple of people were better eight years later, but for the majority of those with chronic depression it creeps back after four or five months,” Nutt said.

“What we do with those people is unknown,” he added. “One possibility is to give another dose of the psychedelic — we don’t know if that would work or not, but it might. Or we could put them on an SSRI as soon as they’ve got their mood improved and see if that can hold the depression at bay.

“There are all sorts of ways we could try to address that question,” Nutt said, “but we just don’t know the answer yet.”

The mycelium, or rootlike structure, of Lion's mane mushroom is part of the

Stamets, who over the last 40 years has discovered four new species of psychedelic mushrooms and written seven books on the topic, said he believes microdosing is a solution. That’s the practice of taking tiny amounts of a psilocybin mushroom several times a week to maintain brain health and a creative perspective on life.

A typical microdose is 0.1 to 0.3 grams of dried psilocybin mushrooms, as compared with the 25-milligram pill of psilocybin that creates the full-blown psychedelic experience.

Stamets practices microdosing and has focused on a process called “stacking” in which a microdose of mushrooms is taken with additional substances believed to boost the fungi’s benefits. His famous “Stamets Stack” includes niacin, or vitamin B3, and the mycelium, or rootlike structure, of an unusual mushroom called Lion’s mane.

Surveys of microdosers obtained on his website have shown significantly positive benefits from the practice of taking small doses.

“These are self-reported citizen scientists’ projects, and we have now around 14,000 people in our app where you register yourself and report your microdose,” Stamets told an audience at the 2022 Life Itself conference, a health and wellness event presented in partnership with CNN.

“I’m going to say something provocative, but I believe it to my core: Psilocybin makes nicer people,” Stamets told the audience. “Psilocybin will make us more intelligent and better citizens.”

Scientific studies so far have failed to find any benefits from microdosing, leaving many researchers skeptical. “People like being on it, but that doesn’t validate the claims of microdosing,” Johnson said. “People like being on a little bit of cocaine, too.”

Experimental psychologist Harriet de Wit, a professor of psychiatry and behavioral science at the University of Chicago, was excited to study microdosing because it solves a key problem of scientific research in the field – it’s hard to blind people to what they are taking if they begin to trip. Microdosing solves that problem because people don’t feel an effect from the tiny dose.

De Wit specializes in determining whether a drug’s impact is due to the drug or what scientists call the “placebo effect,” a positive expectation that can cause improvement without the drug.

She published a study in 2022 that mimicked real-world microdosing of LSD, except neither the participants nor researchers knew what was in the pills the subjects took.

“We measured all kinds of different behavioral and psychological responses, and the only thing we saw is that LSD at very low doses produced some stimulant-like effects at first, which then faded,” de Wit said.

The placebo effect is powerful, she added, which might explain why the few additional studies done on it have also failed to find any positive results.

“I suspect microdosing may have an effect on mood, and over time it might build up resilience or improve well-being,” Nutt said. “But I don’t think it will rapidly fragment depression like macrodosing and going on a trip.”

Obviously, not all hallucinogenic experiences are positive, so nearly every study on psychedelic drugs has included therapists trained to intercede if a trip turns bad and to maximize the outcome if the trip is good.

“This is about allowing someone access into deeper access into their own mental processes, with hopefully greater insight,” Johnson said. “While others might disagree, it does seem very clear that you need therapy to maximize the benefits.”

There are also side effects from psychedelics that go beyond a bad trip. LSD, mescaline and DMT, which is the active ingredient in ayahuasca tea, can increase blood pressure, heart rate, and body temperature, according to the National Institute on Drug Abuse. Ayahuasca tea can also induce vomiting. LSD can cause tremors, numbness and weakness, while the use of mescaline can lead to uncoordinated movements. People hunting for psychedelic mushrooms can easily mistake a toxic species for one with psilocybin, “leading to unintentional, fatal poisoning.”

Another issue: Not everyone is a candidate for psychedelic treatment. It won’t work on people currently on SSRIs — the receptors in their brains are already flooded with serotonin. People diagnosed with bipolar disorder or schizophrenia, or who have a family history of psychosis are always screened out of clinical trials, said Frederick Barrett, associate director of the Center for Psychedelic and Consciousness Research at Johns Hopkins.

“If you have a vulnerability to psychosis, it could be that exposing you to a psychedelic could unmask that psychosis or could lead to a psychotic event,” Barnes said.

Then there are the thousands of people with mental health concerns who will never agree to undergo a psychedelic trip. For those people, scientists such as Roth are attempting to find an alternative approach. He and his team recently identified the mechanisms by which psychedelics bond to the brain’s serotonin receptors and are using the knowledge to identify new compounds.

“Our hope is that we can use this information to ultimately make drugs that mimic the benefits of psychedelic drugs without the psychedelic experience,” Roth said.

“What if we could give people who are depressed or suffer from PTSD or anxiety or obsessive-compulsive disorder a medication, and they could wake up the next day and be fine without any side effects? That would be transformative.”

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April 7, 2023

How to tell when stress is a problem | CNN

Post By zittrexstore Health brand safety-nsf health issues, brand safety-nsf sensitive, depression, diseases and disorders, domestic alerts, domestic-health and science, health and medical, iab-business and finance, iab-diseases and conditions, iab-healthcare industry, iab-industries, iab-medical health, iab-mental health, international alerts, international-health and science, leana wen, mental health, mental illnesses, misc people No Comments

It’s National Stress Awareness Month, which means it’s a good time to sign up for CNN’s Stress, But Less newsletter. Our six-part mindfulness guide will inspire you to reduce stress while learning how to harness it.

CNN
—

As we mark Stress Awareness Month in April, I know there’s so much to be stressed out—mass shootings, wars around the world, the pandemic’s long-term effects and the daily stresses of living and working in the 21st century. I’m sure you’ve got your list.

Everyone experiences stress at different points in their life. But when is stress a problem that requires our attention? What symptoms should people be on the lookout for? What are the health impacts of long-term stress? What are healthy and unhealthy coping mechanisms? And what techniques can help in addressing—and preventing—stress?

Fresh from dropping off my kid at school late (sorry, kid, my fault), I was looking forward to this advice from CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She previously served as Baltimore’s Health Commissioner and as Chair of Behavioral Health Systems Baltimore.

CNN: Let’s start with the basics. What exactly is stress?

Dr. Leana Wen: There is no single definition of stress. The World Health Organization’s definition refers to a state of worry or tension caused by a difficult situation. Many people experience stress as mental or emotional strain. Others also have physical manifestations of stress.

Stress is a natural reaction. It’s a human response that prompts us to respond to challenges and perceived threats. Some stress can be healthy and can prompt us to fulfill obligations. Perceived stress can spur us to study for a test or complete a project by a certain deadline. Virtually everyone experiences that kind of stress to some extent.

CNN: Why can stress be a problem?

Wen: The same human response that motivates us to work hard and finish a project can also lead to other emotions, like not being able to relax and becoming irritable and anxious. Some people develop physical reactions, like headaches, upset stomach and trouble sleeping. Longer-term stress can lead to anxiety and depression, and it can worsen symptoms for people with pre-existing behavioral health conditions, including substance use.

CNN: What are symptoms of stress that people should be on the lookout for?

Wen: In addition to feeling irritable and anxious, people experiencing stress can also feel nervous, uncertain and angry. They often express other symptoms, including feeling a lack of motivation; having trouble concentrating; and being tired, overwhelmed and burnt out. Many times, people in stressful situations will report being sad or depressed.

It’s important to note that depression and anxiety are separate medical diagnoses. Someone with depression and/or anxiety could have their symptoms exacerbated when they are undergoing times in their life with added stress. Long-term stress can also lead to depression and anxiety.

One way to think about the difference between stress versus anxiety and depression is that stress is generally a response to an external issue. The external cause could be good and motivating, like the need to finish a project. It could also be a negative emotional stress, like an argument with a romantic partner, concerns about financial stability or a challenging situation at work. Stress should go away when the situation is resolved.

Anxiety and depression, on the other hand, are generally persistent. Even after a stressful external event has passed, these internal feelings of apprehension, unworthiness and sadness are still there and interfere with your ability to live and enjoy your life.

CNN: What are the health impacts of long-term stress?

Wen: Chronic stress can have long-term consequences. Studies have shown that it can raise the risk of heart disease and stroke. It’s associated with worse immune response and decreased cognitive function.

Individuals experiencing stress are also more likely to endorse unhealthy behaviors, like smoking, excessive drinking, substance use, lack of sleep and physical inactivity. These lifestyle factors in turn can lead to worse health outcomes.

CNN: What techniques can help in addressing stress?

Wen: First, awareness is important. Know your own body and your reaction to stress. Sometimes, anticipating that a situation may be stressful and being prepared to deal with it can reduce stress and anxiety.

Second, identifying symptoms can help. For example, if you know that your stress reaction includes feeling your heart rate increase and getting agitated, then you can detect the symptoms as they occur and become aware of the stressful situation as it’s occurring.

Third, know what stress relief techniques work for you. Some people are big fans of mindfulness meditation. Those, and deep breathing exercises, are good for everyone to try.

For me, nothing beats stress relief like exercise. For me, what helps is exercising, in particular swimming. Aerobic exercise is associated with stress relief, and mixing it up with high-intensity regimens can help, too.

A lot of people have other specific techniques that help them. Some people clean their house, organize their closets or work in their gardens. Others spend time walking in nature, writing in a journal, knitting, playing with their pets or cycling.

I’d advise that you experiment with what works, take stock of existing techniques that help you and incorporate some of those practices into your regular routine. Then, in times of stress, they are good tools to turn to that you know will help you.

CNN: What unhealthy copings strategies should people avoid?

Wen: Definitely. There are things people turn to in an effort to make themselves feel better in the short-term that can actually make things worse. Excessive alcohol intake, using drugs and smoking aren’t healthy coping strategies. It’s the same with staying up all night, binge-eating and taking out your frustration on loved ones. These have wide-ranging consequences, and you should reconsider them if they have been your go-to coping mechanisms in the past.

CNN: When is it time to seek help?

Wen: If the stress you are feeling is consistently interfering with your work, social or personal life or if you are experiencing signs and symptoms of depression, anxiety and other mental health disorders, it’s time to seek help.

Consider speaking with your primary care physician to get a referral to a therapist. Your workplace may have an Employee Assistance Program that you can turn to, too. And the federal mental health crisis hotline number, 988, is another resource.

This April, for Stress Awareness Month, I hope we can all assess our own stress levels as well as our reaction to stress. We should recognize what helps us to reduce and alleviate stress as we aim to improve our physical and emotional well-being.

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March 19, 2023

Senator John Fetterman’s hospitalization for depression has raised awareness of the condition. Our medical analyst explains what it is and how it’s treated | CNN

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Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the 988 Suicide and Crisis Lifeline, or visit the hotline’s website.

CNN
—

Sen. John Fetterman of Pennsylvania is continuing to receive treatment for depression at Walter Reed Medical Center in Bethesda, Maryland, after checking himself into the hospital on February 15. His office has said he has experienced depression “off and on” during his life, but that his condition “only became severe in recent weeks,” necessitating inpatient care.

Fetterman’s disclosure, widely praised by mental health advocates, has prompted many people to ask questions about the often misunderstood illness: What is depression and what are the symptoms? What are its risk factors? How can one distinguish clinical depression from feeling sad? How common is major depressive disorder? What treatments are available and when is hospitalization needed? And how can someone who needs help find assistance?

To guide us through these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also chair of the advisory board for Behavioral Health Group, a network of outpatient opioid treatment and recovery centers around the United States. Previously, she served as Baltimore’s health commissioner and chaired the board of Behavioral Health System Baltimore, a nonprofit organization that oversaw mental health services in the city.

CNN: What is depression, and what are its symptoms?

Dr. Leana Wen: Major depressive disorder, colloquially referred to as depression or clinical depression, is a common illness. It is a serious mental health condition characterized by a persistently low or depressed mood and a loss of interest in activities that previously brought a person joy. Other symptoms include a lack of energy, feelings of guilt or worthlessness, an inability to concentrate, appetite changes, sleep disturbances or suicidal thoughts. These symptoms often affect someone’s ability to function at work, at home, and in social interactions.

CNN: How can one distinguish clinical depression from feeling sad? How is a diagnosis made?

Wen: It’s very common to feel down from time to time; many people experience periods of sadness, especially when facing challenging life situations. But this is different from major depressive disorder, for which there are specific diagnostic criteria including depressed mood or lack of interest in normal activities causing social or occupational impairment, and other specified symptoms such as problems with sleep, eating, concentration, energy or self-worth. These symptoms must persist for at least two weeks for a diagnosis of major depressive disorder to be made.

Screening for major depressive disorder generally begins with a physical examination by a health care provider. Often, laboratory tests are done to rule out other ailments, such as hypothyroidism and vitamin deficiency. There are questionnaires that can help screen for depression and aid your physician or other provider with the diagnosis.

CNN: How common is major depressive disorder?

Wen: An estimated 21 million adults in the United States had at least one major depressive disorder episode lasting at least two weeks in 2020, according to the US Substance Abuse and Mental Health Services Administration. This is about 8.4% of all US adults. The prevalence is higher among girls and women compared to boys and men (10.5% compared to 6.2%). The age group with the highest prevalence is young adults 18-25 years old (17%).

The lifetime prevalence of major depressive disorder is even higher; some studies estimate it affects on average 12% of people in the US, but that it could be as high as 17%. That’s 1 in every 6 people.

CNN: What are risk factors for depression?

Wen: There are several different types of risk factors. One is a recent change in life circumstances. The death of a loved one, getting a divorce, losing a home or a job and other major upheavals can increase risk. Other behavioral health conditions, such as anxiety and substance use disorders, are also associated with depression.

A recent illness can increase the risk of major depressive disorder, too. Serious chronic conditions such as heart disease, cancer, multiple sclerosis and dementia are associated with higher rates of depression.

Senator John Fetterman on Capitol Hill in Washington, D.C., on February 14, 2023.

There is a link, too, between stroke and depression; about a third of people who have had a stroke suffer some depressive symptoms.

Senator Fetterman suffered a stroke in May 2022, during his Senate campaign. That could have increased his risk for a depressive episode, especially as, according to his office, he has had episodes of depression in the past.

CNN: What treatments are available, and when is hospitalization needed?

Wen: It’s very important to note that effective treatments are available for major depressive disorder. Initial treatment includes anti-depressant medications and psychotherapy. Sometimes, lifestyle modifications and social supports can also help.

Most patients can be managed effectively with outpatient treatment, meaning that they do not need to be hospitalized. But there are circumstances under which someone may need inpatient treatment in the hospital. A patient could have worsening symptoms and may be suicidal, for instance. They could also have several other medical conditions and may need medication adjustments that are best provided in a hospital setting.

(These refer generally to patients who require hospitalization for major depressive disorder, and not specifically to Senator Fetterman, for whom such detailed medical information is not known and should not be presumed.)

Other individuals can be treated well on an outpatient basis and still from time to time, require inpatient care. This is not dissimilar to how we manage other medical conditions. Patients with diabetes, for example, may be doing well with oral medication then need to switch to insulin. Sometimes, they may have complications that require hospitalization. I think it’s important for us to think about major depressive disorder and other mental health conditions the same as we would physical health conditions.

CNN: How can someone who needs help find assistance?

Wen: For those with a trusted health care provider, a good place to start is to speak with that person. Your physician or other provider can help with the initial assessment, often can make the diagnosis and either begin treatment or refer to someone else who can.

If your primary care provider is delayed in making a referral to a mental health specialist or treating you themselves, you should follow up and emphasize the importance of getting care. Many workplaces and universities offer resources, and there are online telehealth services that could provide some care while you are pursuing referrals through your physician. Local and state health departments often provide some treatment options as well.

In addition, the federal government last year launched the 988 hotline that provides 24/7, free and confidential support for people experiencing emotional distress. The 988 hotline is a network of local and regional hotlines that can refer people and help them get information about where to seek treatment in their area. People can — and should — call or text this number if they are experiencing a mental health crisis.

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February 19, 2023

Fetterman’s hospitalization: What is clinical depression? | CNN

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Editor’s Note: If you or someone you know is struggling with mental health, please call the Suicide & Crisis Lifeline at 988 to connect with a trained counselor or visit 988lifeline.org.

CNN
—

Democratic Sen. John Fetterman of Pennsylvania voluntarily checked himself into a hospital on Thursday “to receive treatment for clinical depression,” according to a statement by Adam Jentleson, his chief of staff.

“While John has experienced depression on and off during his life, it only became severe in recent weeks,” Jentleson wrote.

In May, during his campaign, Fetterman suffered a stroke as he faced off against Republican Mehmet Oz for the Senate seat.

“After what he’s been through in the past year, there’s probably no one who wanted to talk about his own health less than John. I’m so proud of him for asking for help and getting the care he needs,” his wife, Gisele Barreto Fetterman, tweeted.

“I think it’s fantastic that Sen. Fetterman was working with a provider that recommended he get a higher level of care, and that he was able to access services quickly,” said Kristen Carpenter, chief psychologist in the department of psychiatry and behavioral health at Ohio State University College of Medicine.

“Many patients struggle and suffer with these symptoms for a long time before seeking or getting the help they need,” she added. “At a minimum, you can have relief faster when you’re linked for care.”

Depression after a major illness such as stroke is not uncommon, according to the American Stroke Association.

“After a stroke there are biochemical changes within the brain structure which might put him more at risk for depression,” said stress management expert Dr. Cynthia Ackrill, a fellow at the American Institute of Stress.

“After you’ve had a stroke, it takes more work to do what you did before,” Ackrill added. “So you’re more tired and more stressed, and we know that chronic exposure to the cortisol that comes from stress puts you more at risk for depression.”

No one knows the exact cause for depression, and why it is worse in some people than others, according to the US Centers for Disease Control and Prevention.

“It may be caused by a combination of genetic, biological, environmental, and psychological factors,” the CDC noted.

Having a family member with depression raises the risk; so do traumatic experiences such as physical abuse or sexual assault, financial problems and a major life change, such as losing a loved one, the CDC said.

Depression is also more common after having a heart attack or being diagnosed with cancer or chronic pain, and people with anxiety disorders are more likely to suffer from depression, too, the CDC said. Substance abuse, such as alcoholism, is also linked to depressive symptoms.

Feelings of depression can be a side effect of many medications, including common ones such as beta blockers used to treat high blood pressure, some proton pump inhibitors used to treat acid reflux, steroids used for inflammation and pain, hormonal contraceptives and more. A 2018 study found over 37% of US adults used medications that might lead to depression.

Symptoms of depression include an ongoing sad, anxious or vacant mood, along with “feelings of hopelessness, pessimism, guilt, worthlessness or helplessness,” according to the American Stroke Association.

Other symptoms include fatigue and decreased energy; less interest or pleasure in daily activities, including sex; changes in appetite and weight; trouble with memory, concentration, planning and decision-making; sleep changes, such as insomnia or oversleeping; and thoughts of death or suicide.

Depression can be mild, moderate or severe. Clinical depression, also called major depressive disorder, is the more severe form of depression.

To be diagnosed with clinical depression “an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks,” according to the National Institute on Mental Health.

“One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad,” the institute noted.

“We all experience times of sadness, or lack of interest in things we usually enjoy, or other sorts of depressive symptoms,” Ohio State’s Carpenter said. “However, when someone slips into a major depressive episode that means those symptoms are present daily, for most of the day, and they are functionally impairing — meaning they inhibit one’s ability to work, to interface with their families and loved ones, and to engage in the usual activities of living.”

There are a number of treatments for depression, including antidepressant medications, psychological therapy or a combination of both. Antidepressants typically take between four to eight weeks to work, and it’s not uncommon to try a variety of medications before finding the best for that individual, Carpenter said.

“There are higher levels of care like hospitalization, which provides services available all day to help get you on your recovery journey faster.”

If depression fails to respond to first-line treatments, providers may suggest other medications such as esketamine, Carpenter said. Delivered as a nasal spray by doctors, esketamine is a newer US Food and Drug Administration-approved medication for treatment-resistant depression.

“It often acts rapidly — typically within a couple of hours — to relieve depression symptoms,” according to the National Institute on Mental Health.

“If you have what we refer to as a treatment-resistant depression, we may use things like TMS — transcranial magnetic stimulation — and we still use ECT, or electroconvulsive therapy. So there really is a large compendium of therapies available,” Carpenter said.

“The key is getting care. The vast majority of people will have their symptoms remit with proper treatment through psychotherapy and/or medication.”

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February 17, 2023

John Fetterman Hospitalized For Depression, Everybody Awesome About It If You Ignore GOP

Post By zittrexstore Politics 1972 presidential election, 2022 midterms, adam jentleson, adaptive technology, audio-to-text transcription, auditory processing issues, clinical depression, closed captioning, conversation on mental health, depression, dr. brian p. monahan, george mcgovern, giselle barreto feterman, john fetterma stroke, john fetterman, john fetterman hospitalized, major depression, mehmet oz, mental health, national institute of mental health, pandemic and depression, pennsylvania, ruben gallego, thomas eagleton, tina smith, twitter, us senate, walter reed hospital No Comments

On Wednesday evening, Sen. John Fetterman (D-Pennsylvania) checked in to Washington’s Walter Reed National Military Medical Center to be treated for clinical depression, according to a statement from his office yesterday. Fetterman, the statement said, has long suffered from depression, but the condition has recently become “severe.” The Philadelphia Inquirer reports,

“While John has experienced depression off and on throughout his life, it only became severe in recent weeks,” his chief of staff, Adam Jentleson, said in a statement. “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. John agreed, and he is receiving treatment on a voluntary basis.”
Jentleson added that, “After examining John, the doctors at Walter Reed told us that John is getting the care he needs, and will soon be back to himself.”

Fetterman had also been hospitalized briefly last week after feeling lightheaded; tests determined he had not suffered another stroke, and his office said an EEG showed no signs of seizures, either. He returned to work in the Senate Monday for a vote.

Major depression is one of the most common mental disorders in the US, affecting almost a tenth of all adults, according to the National Institute of Mental Health. It’s a fucking bear to live with, although many of us manage pretty well with antidepressant meds, according to me. Also, a 2021 study found that rates of depression in the US increased during the early months of the pandemic in 2020. And of course, depression is very common among people who’ve survived a stroke.

Frankly, we’re pretty sure everyone in America has been in a state of existential crisis since election night 2016, at least if they’ve been paying attention. Shit has been unrelenting, and that has to go triple for people actually in the middle of things.

Fetterman’s wife, Giselle Barreto Fetterman, wrote on Twitter yesterday,

After what he’s been through in the past year, there’s probably no one who wanted to talk about his own health less than John. I’m so proud of him for asking for help and getting the care he needs. […]
Take care of yourselves. Hold your loved ones close, you are not alone.

The New York Times reports that aides to Sen. Fetterman expect he won’t be hospitalized longer than a few days, although no firm estimate of when he’ll be released home has yet been determined.

Fetterman’s health had been steadily improving since a stroke last summer, but the already stressful work of starting a new job as a senator has been complicated by the continued effects of the stroke, which left him with auditory processing difficulties, as we saw during his campaign debate against Republican snake oil merchant Mehmet Oz in October. Fortunately, there’s a lot of adaptive technology that has been helpful, the Times notes:

The sergeant-at-arms has arranged for live audio-to-text transcription for Mr. Fetterman’s committees and installed a monitor at his desk so he can follow proceedings with closed captioning. His Democratic colleagues in the Senate have been growing accustomed to communicating with him through a tablet that transcribes their words, technology he needs after suffering from auditory processing issues associated with his stroke.

The Times also points out that Fetterman simply never had the usual period of convalescence that would be the norm after a stroke, which

has become a source of pain and frustration for Mr. Fetterman and people close to him, who fear that he may suffer long-term and possibly permanent repercussions. His schedule as a freshman senator has meant that he has continued to push himself in ways that people close to him worry are detrimental.

The Inquirer adds that a “source close to Fetterman” said he had voted and attended hearings Wednesday, but that the stress was showing:

“He was doing everything. He’s been doing everything, he just hasn’t been himself,” the person said, asking for anonymity to disclose personal information. “He decided to get help, and the good news is, he’s getting the help he needs.”

And for Crom’s sake, he deserves that. Doesn’t everyone?

Reactions to Fetterman’s hospitalization have been — at least outside Troll World — overwhelmingly supportive and empathetic. The Washington Post notes that Rep. Ruben Gallego (D-Arizona) tweeted, “There is never any weakness in seeking help.” Gallego has spoken publicly about having experienced PTSD after serving in Iraq, and said the January 6 insurrection had triggered a recurrence. In addition,

Sen. Tina Smith (D-Minn.), who’s spoken publicly about her own battle with depression, also said Fetterman was displaying strength, “not weakness.”

Smith has spoken in Congress about dealing with depression in college, and while raising her children, and told the Post that she’s regularly approached by young people who say that her openness has made them feel able to talk about their own experiences with depression.

We’ve finally reached a point in our crazy society where mental illness can be talked about in the same register we’d discuss a heart attack or other serious physical illness, and that’s a hell of an improvement within my own lifetime. Recall that in 1972, George McGovern suddenly dropped his vice presidential nominee, Sen. Thomas Eagleton (D-Missouri), when news broke that Eagleton had been hospitalized three times for severe depression, and that he’d also had electroconvulsive therapy.

A lot has changed in 50 years.

Here’s wishing all the best to John Fetterman and his family, and we hope — perhaps naively, we’re prone to that — that we’ll take this as a chance to talk about mental illness and how we’re all navigating this strange reality we’ve been in for over half a decade. We’re deliberately staying away from Twitter for a while for that reason.

Be kind to each other. Try to remember we’re all just trying to get through all this, and it isn’t fucking easy.

[Philadelphia Inquirer / NYT / WaPo / Photo: Office of Gov. Tom Wolf, Creative Commons License 2.0]

Yr Wonkette is funded entirely by reader donations. If you can, please give $5 or $10 monthly so we can all, as Mark Vonnegut said, help each other get through this, whatever it is.

Do your Amazon shopping through this link, because reasons.

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February 16, 2023

Finding Comfort and Meaning After a Child’s Suicide

Post By zittrexstore Health children, depression, grief, mental health, Parenting, Suicide No Comments

Feb. 16, 2023 – Janet Shedd lost her youngest son to suicide 7 years ago.

“Tom had suffered from depression for about 9 months. We had gotten counseling for him, and he had been taking medication. We thought things were starting to turn around,” says Shedd, who lives in Kentucky.

But as soon as he turned 18 and was legally allowed to buy a gun, he died by suicide. Shedd’s life was shattered. “After his death, I became the walking wounded. It was hard to function,” she says. “I spent days crying and not getting out of bed.”

She calls the loss “devastating because, as a parent, one of your major functions is to keep your child safe. When you’re not able to do that – usually through no fault of your own – you go through a lot of guilt.”

Shedd is far from alone. In 2020, suicide was the second leading cause of death in youngsters and young adults (ages 10 to 34) and the 12th leading cause of death in the U.S..

And more young people are apparently considering taking their own lives.

Just this week, the CDC released a study showing a crisis in mental health among teen girls. The report found girls are experiencing record high levels of sexual violence, and nearly 3 in 5 girls report feeling persistently sad or hopeless.

Nearly one-third of girls (30%) reported seriously considering suicide, up from 19% in 2011. In teenage boys, serious thoughts of suicide increased from 13% to 14% from 2011 to 2021. The percentage of teenage girls who had attempted suicide in 2021 was 13%, nearly twice that of teenage boys (7%).

All these hurting children, and all those lost lives, have left a significant number of bereaved parents.

No Universal Pattern

William Feigelman, PhD, a professor emeritus of sociology at Nassau Community College in Garden City, NY, lost a son to suicide 20 years ago.

“He had a lot of winning characteristics, was engaged to be married, and was getting ahead in the film industry,” Feigelman says. “We were shocked and stunned, and it was the worst experience of our lives.”

It turned out that their son had been “coming off a drug high in an industry where drugs are commonplace and was depressed and self-punishing at the time.”

The decision to die by suicide is complex and shouldn’t be reduced to single issues, Feigelman says.

“Drugs are common and played a role in my son’s suicide. But people take their lives for a variety of reasons. Maybe something went wrong. They were jilted by a girlfriend or boyfriend or lost their job. They feel dishonored and humiliated and can’t face other people. Maybe they feel they’ve let their families down. They’re in deep psychic pain and see suicide as the only way out.”

Traditional bullying and cyberbullying have played a role in suicides of youngsters. Last week, a 14-year-old girl in New Jersey died by suicide. She had been beaten up in school, with a video of the assault posted online afterward. Unfortunately, many parents aren’t aware if their child is being bullied. The girl’s father says the school and the school district have not done enough to respond.

Just being aware of a child’s mental health problems doesn’t guarantee they’ll be resolved, Feigelman says. Many parents have struggled, “going from one clinic to another, one medication to another, and never successfully getting the right kind of help for their child who was in pain.”

On the other hand, some parents have seemingly successful, high-functioning children “who suddenly have one mishap – such as a bad math test – which pushes them over the edge into suicide, and they feel they can’t go home and tell their parents about it.”

The point, according to Feigelman, is that “the reasons for suicide vary from case to case, with no universal pattern.”

A Combination of Events

Erin Hawley and Angela Wiese agree. They are sisters in Lexington, KY, who lost children to suicide.

Wiese’s oldest son, Mason, died by suicide when he was 19 years old. She describes him as a “quiet kid, but also fun, outgoing and athletic, with lots of friends.”

“He had just graduated from high school and was going through a transitional time,” she says. “He wasn’t sure he wanted to go to college, so he enlisted in the Navy Reserves on a delayed entry.”

She wonders if he was overwhelmed or stressed by his schooling or perhaps didn’t want to open up to his family out of fear of upsetting them. “We don’t know why he chose to kill himself. It’s hard to pinpoint one thing.”

Then, 23 months later, Wiese’s 18-year-old son, Ethan, also took his life. “We didn’t realize at the time how much at risk Ethan was after Mason’s suicide. We now believe he was struggling and just didn’t know how to cope with that loss,” she says.

Hawley, whose 13-year-old daughter, Myra, also died by suicide, says her daughter’s death was particularly shocking and “came out of the blue” because she “came from a family who already had two children – her first cousins – die by suicide, and we talked about it all the time in our house.”

For Hawley, the “hardest part was her choosing not to tell us that she was struggling or having these thoughts and that she wanted to kill herself. I never imagined we would lose another child to suicide in our family.”

Some research suggests that the risk of suicide is higher in those who have been bereaved by another family member or close friend’s suicide. But Feigelman says that multiple suicides in the same family are “relatively rare.”

And Hawley has learned that the motives for suicide are “unique to every situation, and it’s usually a ‘perfect storm’ of several events, some of which may be common, everyday things that parents may think they understand and can connect to.”

At the end of the day, “our children were the only people who knew the reasons, and we don’t want to speculate,” Hawley says.

Get the Best Support

After her older son’s death, Wiese “reached out to resources and grief therapists, but they didn’t have experience with suicide grief and the understanding how complicated a suicide grief is to the bereaved, especially to a sibling. Ethan was mourning the loss of his brother, as we all were, but he did not have the coping skills to handle his grief.”

Wiese recommends that parents seeking help after a child’s suicide – for themselves or their other children – should “find professionals and support systems that deal specifically with suicide bereavement.”

Shedd agrees. “My advice to other parents is to know you’re not alone. One of the best things I did was to hook up with someone else who had gone through the experience of losing a child to suicide, which was a touchstone during the early days,” she says. “Having someone to talk to who had been through it and was standing upright and functioning in the world was incredibly helpful to me.”

Feigelman and his wife, Beverly Feigelman, a licensed social worker, joined support groups for people who lost loved ones to suicide. Eventually, they founded a support group of their own – Long Island Survivors of Suicide.

“The group is still flourishing, and we’ve been running it for the last 15 years,” Feigelman says. “It’s important to be with people who have sustained a similar loss because we have unique issues that don’t affect people bereaved by other losses – we’re racked by guilt, shame, and anger toward the loved one who died by suicide, and we’re shaken and mystified that our children, whom we loved and even thought we knew well, could take their own life.”

Turning Pain Into Purpose

“I’m definitely in a better place than I was immediately after Tom’s death,” Shedd says. “Time helps, and you move slowly forward. But even 7 years later, it’s still very fresh, and little things can tick off the memories – if I see someone who looks like him walking down the street, for example. And of course, you miss your child forever.”

Nevertheless, “Helping other people who have gone through this type of loss and working to change things has been very helpful.”

Shedd became involved in advocating for changes in gun laws. “If I can save someone else from going through a similar tragedy, this honors Tom, and that’s a comfort,” she says.

After the death of her second son, Wiese founded Brothers’ Run, a nonprofit organization dedicated to raising money for suicide prevention efforts within schools and communities. The money also supports critical services and mental health professionals who care for suicide-bereaved families.

“Since losing my sweet boys, I’ve found that pain can be turned into purpose,” says Wiese.

Beyond running the support group, Feigelman and his wife joined forces with two psychologists to conduct a large study of people bereaved by suicide, including 462 parents. And together, they also wrote Devastating Losses, a book for health care professionals working with suicide-bereaved family members.

Some parents may not be drawn to involvement in volunteer work, advocacy, or similar activities. But there are still many healing approaches, including spiritual practice, yoga, mindfulness, art, and physical exercise.

“But I think the most helpful thing is working with a good, trained clinician and getting the support of other parents,” Feigelman says. “Engaging with other bereaved parents contributes to posttraumatic growth.”

Shedd says her posttraumatic growth led to a deepening of empathy and compassion.

“I hesitate to say this because some people might regard it as a punch in the face, but a mentor told me, ‘You’re going to get gifts from this experience.’ I didn’t want any ‘gifts.’ I just wanted my child back. But I have to admit that – although I would never have chosen to pay the price for these ‘gifts’ – what happened has indeed changed me into a better person.”

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February 14, 2023

What’s Behind Rise in Girls’ Report of Sadness, Sexual Violence?

Post By zittrexstore Health depression, girls health, mental health, Sexual violence, Suicide, teen girls No Comments

Feb. 14, 2023 – The recent discovery of a dramatic spike in the number of teen girls saying they’ve been victims of sexual assault could have a now-familiar cause: the COVID-19 pandemic.

The CDC reported Monday that teenage girls are experiencing record high levels of sexual violence, and nearly 3 in 5 girls report feeling persistently sad or hopeless.

The numbers were even worse for students who identify as LGBTQ+, nearly 70% of whom report experiencing feelings of persistent sadness and hopeless, and nearly 1 in 4 (22%) LGBTQ+ teens had attempted suicide in 2021, according to the report.

Protective factors, such as being in school and participating in various activities, were largely nonexistent for many teens during the pandemic, which could explain the spike in sexual violence cases, says Carlos A. Cuevas, PhD, clinical psychologist and Center on Crime Race and Injustice co-director at Northeastern University in Boston.

That — on top of other mental, emotional, and physical stressors amid the COVID-19 crisis — created an unsafe and unhealthy environment for some girls.

“Once people started to kind of come out of the pandemic and we started to see the mental health impact of the pandemic, there were waiting lists everywhere. So being able to access those resources became more difficult because we just had a boom in demand for a need for mental health services,” says Cuevas.

Teen girls are also more likely to be victims of sexual assault than teen boys, which could explain the why they are overrepresented in the data, Cuevas says.

If your child experiences sexual assault, there are a few things parents should keep in mind. For one, it’s important that your child knows that they are the victims in the situation, Cuevas says.

“I think sometimes you still get kind of a victim blaming sort of attitude, even unintentionally,” he says. “Really be clear about the message that it’s not their fault and they are not responsible in any way.”

Parents should also look out for resources their child might need to work through any trauma they may have experienced. For some, that could be medical attention due to a physical act of assault. For others, it could be mental health services or even legal remedies, such as pressing charges.

“You want to give those options but the person who was the victim really is the one who determines when and how those things happen,” Cuevas says. “So really to be able to be there and ask them what they need and try to facilitate that for them.”

One more thing: Your teen sharing their sexual assault experiences on social media could result in several outcomes.

“Some teens will talk about this [sexual assault] and post on TikTok, Snapchat, and Instagram, and that means that they may get people giving feedback that’s supportive or giving feedback that’s hurtful,” says Cuevas. “Remember that we’re talking about kids; they’re not sort of developmentally able to plan and think, ‘Oh, I may not get all the support that I think I’m going to get when I post this.’”

Goldie Taylor, an Atlanta-based journalist, political analyst and human rights activist, has her own history with sexual assault as a young girl. She experienced it as a 11-year-old, a story she shares in her memoir, The Love You Save.

When Taylor saw the news of the CDC study, she hurried to read it herself. She, too, see signs of the pandemic’s work in the report.

“While notably mental health continues to be a post-pandemic story given the issues surrounding quarantine, I also believe it fueled a renewed interest in seeking care— and measuring impacts on children,” Taylor says. “What was most startling, even for me, were the statistics around sexual violence involving young girls. We know from other studies that the vast majority of pregnancies among girls as young as 11 involve late teen and adult males.”

Unfortunately, Taylor says little has changed since her own traumatic experience as a child. There was little support available then. And now, she says, “there are far too few providers in this country to deal effectively with what can only be called a pandemic of sexual violence.”

The study’s findings are indeed a stark reminder of the needs of our children, says Debra Houry, MD, MPH, the CDC’s acting principal deputy director, in a press release about the findings.

“High school should be a time for trailblazing, not trauma. These data show our kids need far more support to cope, hope, and thrive,” she says.

The new analysis looked at data from 2011 to 2021 from the CDC’s Youth Risk and Behavior Survey, a semiannual analysis of the health behaviors of students in grades 9-12. The 2021 survey is the first conducted since the COVID-19 pandemic began and included 17,232 respondents.

Although the researchers saw signs of improvement in risky sexual behaviors and substance abuse, as well as fewer experiences of bullying, the analysis found youth mental health worsened over the past 10 years. This trend was particularly troubling for teenage girls: 57% said they felt persistently sad or hopeless in 2021, a 60% increase from a decade ago. By comparison, 29% of teenage boys reported feeling persistently sad or hopeless, compared to 21% in 2011.

More than half of students with a same-sex partner (58%) reported seriously considering suicide, and 45% of LGBTQ+ teens reported the same thoughts. One-third of students with a same-sex partner reported attempting suicide in the past year.

The report did not have trend data on LGBTQ+ students because of changes in survey methods. The 2021 survey did not have a question about gender identity, but this will be incorporated into future surveys, researchers say.

Hispanic and multiracial students were more likely to experience persistent feelings of sadness or hopelessness compared with their peers, with 46% and 49%, respectively, reporting these feelings. From 2011 to 2021, the percentage of students reporting feelings of hopelessness increased in each racial and ethnic group. The percentage of Black, Hispanic, and white teens who seriously considered suicide also increased over the decade. (A different CDC report released last week found that the rate of suicide among Black people in the United States aged 10-24 jumped 36.6% between 2018 and 2021, the largest increase for any racial or ethnic group.)

The survey also found an alarming spike in sexual violence toward teenage girls. Nearly 1 in 5 females (18%) experienced sexual violence in the past year, a 20% increase from 2017. More than 1 in 10 teen girls (14%) said they had been forced to have sex, according to the researchers.

Rates of sexual violence was even higher in lesbian, bisexual, gay, or questioning teens. Nearly 2 in 5 teens with a partner of the same sex (39%) experienced sexual violence, and 37% reported being sexually assaulted. More than 1 in 5 LGBTQ+ teens (22%) had experienced sexual violence, and 20% said they had been forced to have sex, the report found.

Among racial and ethnic groups, American Indian and Alaskan Native and multiracial students were more likely to experience sexual violence. The percentage of white students reporting sexual violence increased from 2017 to 2021, but that trend was not observed in other racial and ethnic groups.

Delaney Ruston, MD, an internal medicine specialist in Seattle and creator of Screenagers, a 2016 documentary about how technology affects youth, says excessive exposure to social media can compound feelings of depression in teens — particularly, but not only, girls.

“They can scroll and consume media for hours, and rather than do activities and have interactions that would help heal from depression symptoms, they stay stuck,” Ruston says in an interview. “As a primary care physician working with teens, this is an extremely common problem I see in my clinic.”

One approach that can help, Ruston says, is behavioral activation. “This is a strategy where you get them, usually with the support of other people, to do small activities that help to reset brain reward pathways so they start to experience doses of well-being and hope that eventually reverses the depression. Being stuck on screens prevents these healing actions from happening.”

The report also emphasized the importance of school-based services to support students and combat these troubling trends in worsening mental health. “Schools are the gateway to needed services for many young people,” the report says. “Schools can provide health, behavioral, and mental health services directly or establish referral systems to connect to community sources of care.”

“Young people are experiencing a level of distress that calls on us to act with urgency and compassion,” Kathleen Ethier, PhD, director of the CDC’s Division of Adolescent and School Health, says in a statement. “With the right programs and services in place, schools have the unique ability to help our youth flourish.”

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February 14, 2023

Long-term exposure to air pollution may raise risk of depression later in life, study says | CNN

Post By zittrexstore Health Air Pollution, brand safety-nsf health issues, brand safety-nsf oil negative, brand safety-nsf sensitive, depression, diseases and disorders, domestic alerts, domestic-health and science, environment and natural resources, health and medical, iab-diseases and conditions, iab-environment, iab-medical health, iab-mental health, iab-science, international alerts, international-health and science, mental health, mental illnesses, Pollution No Comments

CNN
—

Exposure to air pollution may be tied to the risk of developing depression later in life, a large new study finds.

Scientists are finding more and more evidence that people who live in polluted areas have a higher risk of depression than those who live with cleaner air. But this study published Friday in JAMA Network Open is one of the first to examine the associations between long-term exposure and the risk of depression diagnosed after age 64.

Depression itself is a serious health condition. When it develops in an older adult, it can also contribute to problems with the ability to think clearly, studies show, as well as physical problems and even death.

Previous research has found that a new diagnosis of depression is less common among older adults than in younger populations.

“That’s one of the biggest reason we wanted to conduct this analysis,” said Dr. Xinye Qiu, co-author of the new study, published Friday in JAMA Network Open. Qiu is a postdoctoral research fellow in the Department of Environmental Health at Harvard T.H. Chan School of Public Health. “Surprisingly, we saw a large number of late-onset depression diagnoses in this study.”

The researchers looked at information on more than 8.9 million people who got their health insurance through Medicare and found that more than 1.52 million were diagnosed with depression later in life during the study period of 2005 to 2016. But the number is probably an undercount; studies show that late-in-life depression is often underdiagnosed.

To determine the study participants’ pollution exposure, Qiu and her co-authors looked at where each of the people diagnosed with depression lived and created models to determine the exposure to pollution at each ZIP code, averaged across a year.

The researchers looked at the study participants’ exposure to three kinds of air pollution: fine particulate matter, also known as PM2.5 or particle pollution; nitrogen dioxide; and ozone.

Particle pollution is the mix of solid and liquid droplets floating in the air. It can come in the form of dirt, dust, soot or smoke. Coal- and natural gas-fired power plants create it, as do cars, agriculture, unpaved roads, construction sites and wildfires.

PM2.5 is so tiny – 1/20th of a width of a human hair – that it can travel past your body’s usual defenses.

Instead of being carried out when you exhale, it can get stuck in your lungs or go into your bloodstream. The particles cause irritation and inflammation and may lead to respiratory problems. Exposure can cause cancer, stroke or heart attack; it could also aggravate asthma, and it has long been associated with a higher risk of depression and anxiety.

Nitrogen dioxide pollution is most commonly associated with traffic-related combustion byproducts. Nitrogen oxides are also released from traffic, as well as through the burning of oil, coal and natural gas. Exposure can increase inflammation of the airways, cause coughing or wheezing and reduce lung function.

Ozone pollution is the main ingredient in smog. It comes from cars, power plants and refineries. This particular pollution is best known for exacerbating asthma symptoms, and long-term exposure studies show a higher risk of death from respiratory diseases in people with higher exposures. The American Lung Association calls it one of the “least well-controlled pollutants in the United States,” and it’s one of the most dangerous.

In the new study, the scientists found that people who lived in areas with higher pollution levels long-term had an increased risk of a depression diagnosis. All three of the pollutants studied were associated with a higher risk of late-onset depression, even at lower pollution levels.

“So there’s no real threshold, so it means future societies will want to eliminate this pollution or reduce it as much as possible because it carries a real risk,” Qiu said.

There were greater associations between depression and exposure to particle pollution and nitrogen dioxide among socioeconomically disadvantaged groups. That may in part be because they are simultaneously exposed to social stress and these poor environmental conditions, the study says.

Older adults who had underlying problems with their heart or breathing were also more sensitive to developing late-in-life depression when exposed to nitrogen dioxide pollution, the study found.

The study has some limitations. The majority of the participants were White, and more research would be needed to see whether there would be a difference among diverse populations.

This is also a population-level study, so there is no way to pinpoint exactly why people exposed to these kinds of air pollutions would have a higher risk of depression.

Other studies have found that exposure to air pollution may affect the central nervous system, causing inflammation and damaging the body’s cells.

Some air pollution, studies show, can also cause the body to release harmful substances that can hurt the blood-brain barrier, the network of blood vessels and tissues made up of closely spaced cells that protect the brain, and that may lead to depression and anxiety.

Because aging can impair the immune response, older adults may be particularly vulnerable to the negative effects of air pollution. More research will be needed to fully understand these connections, as the neural basis for depression is not completely understood.

Another possibility may be that people who live in polluted areas develop physical problems that are associated with worsening psychiatric health, the study said.

“Late-life depression should be a geriatric issue that the public and researchers need to be paying more attention to, like on a similar level with Alzheimer’s and other neurological conditions,” Qiu said.

She is particularly concerned about the effects that climate change will have on this phenomenon. Ozone pollution will increase as the world gets warmer, and the study found that ozone pollution had a stronger association to late-onset depression than particle and nitrogen dioxide pollution.

“Because of this concerning effect we are seeing with ozone, it makes more sense for the government to put some regulation on pollution and also climate mitigation, because rising temperatures and ozone pollution are definitely linked to each other,” Qiu said.

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Long-term exposure to air pollution may raise risk of depression later in life, study says | CNN