Finding Comfort and Meaning After a Child’s Suicide

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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Bullying doesn’t look like it used to. Experts share how to fix it | CNN

Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 988 (or 800-273-8255) to connect with a trained counselor or visit the NSPL site.



CNN
 — 

Every generation has tales of bullying, but perhaps today’s adults are not as familiar with what it means now for a kid to be bullied.

Physical bullying — like confrontations involving hitting or shoving — actually showed very little association with a risk for mental distress, according to a new study.

“For adults doing this research, you kind of assume that bullying consists of being stuffed in a locker and beaten up on the playground,” said lead study author John Rovers, professor and John R. Ellis Distinguished Chair in Pharmacy Practice at Drake University in Des Moines, Iowa. “We found out that that really has remarkably little effect.”

Researchers took data from the 2018 Iowa Youth Survey of sixth, eighth and 11th graders to see whether there was an association between bullying and mental health and suicidal ideation, according to the study published Wednesday in the journal PLOS ONE.

The results showed different forms of bullying did have an impact on feelings of sadness or hopelessness or thoughts of suicide — but that they did not impact students equally.

Identity bullying, which includes bullying based on sexual orientation or gender identity as well as sexual jokes, was correlated with significant feelings of distress or suicide attempts, the study said.

Cyberbullying and social bullying — leaving someone out or turning peers against them — followed identity bullying on degree of impact.

The study is limited in that the sample did not include a high level of racial and religious diversity, but it does show “a theme very consistent with recent surveys as well as what I’m seeing in my clinical practice,” said child and adolescent psychiatrist Dr. Neha Chaudhary, chief medical officer at BeMe Health who is in the faculty at Massachusetts General Hospital and Harvard Medical School. Chaudhary was not involved in the research.

The teachers and school administrators surveyed were worried most about physical bullying, however, according to the study.

“This is a good learning for schools and families as they think about anti-bullying initiatives and how to talk to young people about the effects of bullying,” Chaudhary said.

It makes sense that identity would be a particularly painful form of bullying.

“Identity is so incredibly important for kids and teens as they develop, and not being able to be themselves without fear of judgement or bullying from others is not only isolating, it can significantly alter their confidence, peace of mind, and ability to see a future for themselves that’s free of pain,” Chaudhary said in an email. “People just want to be themselves, and be loved for who they are.”

The survey data reviewed by the study team revealed a troubling statistic when it came to the state of adolescent mental health.

“About 70,000 students responded to this survey. Five percent of them had attempted suicide in the last year,” Rovers said. “That’s 3,500 kids.”

And this week’s results of the US Centers for Disease Control and Prevention’s biannual Youth Risk Behavior Survey showed mental distress among teens is getting worse.

In rates that “increased dramatically” over the past decade, most high school girls (57%) felt persistently sad or hopeless in 2021, double the rate for teen boys (29%), according to the CDC. Nearly 1 in 3 teen girls seriously considered attempting suicide.

Most LGBTQ students (52%) have also recently experienced poor mental health, and more than 1 in 5 attempted suicide in the past year, the CDC survey showed.

Solutions that address adolescent mental health may come from families and schools working together — not in focusing on what the kids themselves can change, Rovers said.

“Blaming this on some 9-year-old kid is not right,” he added.

When it comes to bullying, there are three types of players: the bully, the victim and the child that is both being bullied and bullying others, Rovers said.

All three need support, said Dr. Hina Talib, adolescent medicine specialist at the Atria Institute in New York and associate professor of clinical pediatrics at the Albert Einstein College of Medicine in New York City.

“Bullying is such a pattern of behavior that causes harm to the victim of the bully, the children that might just be witnessing the bullying happening and even to the bully themselves,” said Talib, who was not involved in the research.

Rarely is a child exerting power over others just for its own sake, Talib added.

While caregivers may have the first reaction to punish their child when they hear they are bullying others, it is important to probe a little deeper into what is going on with them, she said.

“There are likely reasons there that are causing them to act out in this way,” Talib explained. “Underneath that, I think it’s important to see that their child is hurting also.”

She recommended coming to them with the mindset of “this is not acceptable behavior, and this is why, and I’m here to help you through it,” Talib said.

“The bully can and should be helped as well,” she added. “There’s almost always more to it.”

There are many ideas about what motivates bullying behavior, but one could be that kids are emulating how they see the adults in their lives resolve conflict, Rovers said. These adolescents might learn that violence is a way to protect themselves.

For children that are being bullied, they may not always be direct in telling the adults in their lives what is wrong, Talib said.

Instead of hearing about cruel words or isolating actions, families might first see stress, anxiety, depression, stomachaches and avoiding school, she said.

She recommended being attentive to your child and their individual behaviors and stepping in when you see a change. That could mean asking directly, having their pediatrician speak to them about it privately or even coming to them indirectly.

A helpful way in could be to ask about their friends’ experiences.

Say something like: “There was an interesting research report about bullying, and it made me think about bullying. It made me interested in if your friends were bullied or if you ever witnessed a bullying situation,” Talib said.

If you do find that your child is the victim of bullying, Talib said it’s a good idea to get in contact with the school and the other family to develop an action plan together.

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Almost half of children who go to ER with mental health crisis don’t get the follow-up care they need, study finds | CNN

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
 — 

Every night that Dr. Jennifer Hoffmann works as an attending physician in the pediatric ER, she says, at least one child comes in with a mental or behavioral health emergency. Over the span of her career, she’s seen the number of young people needing help grow enormously.

“The most common problems that I see are children with suicidal thoughts or children with severe behavior problems, where they may be a risk of harm to themselves or others,” said Hoffmann, who works at Ann & Robert H. Lurie Children’s Hospital of Chicago. “We’re also seeing younger children, especially since the pandemic started. Children as young as 8, 9 or 10 years old are coming to the emergency department with mental health concerns.

“It’s just mind-blowing.”

The surge of children turning up in emergency departments with mental health issues was a challenge even before 2020, but rates soared during the Covid-19 pandemic, studies show.

ER staffers may be able to stabilize a child in a mental health care crisis, but research has shown that timely follow-up with a provider is key to their success long-term. Unfortunately, there just doesn’t seem to be enough of it, according to a new study co-authored by Hoffmann. Without the proper follow-up, these children too often wound up back in the ER.

For their study, published Monday in the journal Pediatrics, Hoffmann and her co-authors looked at records for more than 28,000 children ages 6 to 17 who were enrolled in Medicaid and had at least one trip to the emergency department between January 2018 and June 2019. They found that less than a third of the children had the benefit of an outpatient mental health visit within seven days of being discharged from the ER. A little more than 55% had a follow-up within 30 days.

Research has shown that follow-up with a mental health care provider lowers a person’s suicide risk, raises the chances that they will take their prescription medicine and decreases the chances that they will make repeated trips to the ER.

The new study found that without a follow-up, more than a quarter of the children had to go back to the ER for additional mental health care within six months of their initial visit.

“The emergency department is a safety net. It’s always open, but there’s limited extent to the types of mental health services we can provide in that setting,” Hoffmann said. “This really speaks to inadequate access to services that these kids need.”

This dynamic can be “devastating” for parents and emergency department staff alike, she said.

“We know what a child needs, but we’re just not able to schedule follow-up due to shortages among the mental health profession. They’re widespread across the US,” she said.

A lack of professional help is a problem for many children. Before the Covid-19 pandemic, the US Centers for Disease Control and Prevention found that 1 in 5 children had a mental health disorder, but only about 20% got care from a mental health provider.

Children’s mental health has become such a concern in the US that the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association declared a national emergency in 2021.

Hoffmann’s study found that Black children fared worse than their peers. They were 10% less likely to have timely follow-up than White children – “which is very concerning, given that there are many disparities in access to care in our mental health system,” Hoffmann said.

The study can’t pinpoint why there is this racial disparity, but Hoffmann thinks there may be a few factors at play.

Black children are more likely to live in neighborhoods that have shortages of mental health professionals. There is also limited diversity among the mental health work force. Studies show that nearly 84% of psychologists are White, as are nearly 65% of counselors and more than 60% of social workers. And Black children more often rely on school-based mental health services, studies show.

Although the number of school counselors has been increasing over the years, few schools meet the National Association of School Psychologists’ recommended ratio of one school psychologist to 500 students. The national ratio for the 2021-22 school year was 1,127 to 1, the association found.

The new study found that the children who did not have mental health help before their ER visits had the most difficulty finding timely care afterward.

Dr. Toni Gross, chief of the Emergency Department at Children’s Hospital New Orleans, said she wasn’t entirely surprised by the study findings. Her hospital’s beds for with mental health concerns are “always busy,” she said.

“I’m well aware of the fact that we need more providers for these services. We deal with it every day,” said Gross, who was not involved in the new research.

The lack of providers who can do follow-up is a real source of concern. It’s not ideal to hand a phone number to a parent and hope they can arrange care, she said. It often takes weeks or even months to get a first appointment with a child and adolescent psychiatrist.

“It leaves a lot of us feeling like we wish we could do more,” Gross said. “When you always leave asking yourself at the end of the day, ‘did I really do what I set out to do, and that is to help people,’ it’s one of our biggest frustrations, and it may be one of the biggest reasons people in my group of physicians feel burnout.”

Like many children’s hospitals, hers has an active partnership with local school health programs that can provide some mental health care.

Hoffmann said that the amount of support varies by emergency department. Lurie has 24/7 coverage by mental health workers who can do an evaluation and provide recommendations for appropriate care, but not all areas do. For example, many rural emergency rooms don’t have pediatric mental health providers and may have few resources in the community, if any.

Several US counties have no practicing child and adolescent psychiatrists. Primary care physicians can help, but some patients would benefit from more specialized care, Hoffmann said.

President Joe Biden’s administration announced in August that plans to make it easier for millions of children to get access to mental health services by allowing schools to use Medicaid dollars to hire additional school counselors and social workers. He even mentioned the issue in his State of the Union address Tuesday.

But even more will need to be done. Hoffmann hopes her study will prompt policy-makers to invest more so children can access care no matter where they live. Investing in telehealth could also bridge the gap, she said, as would increasing Medicaid reimbursement rates for mental health services and more funding to pay for people to train to work with children as a mental health professional.

In a commentary published alongside the new study, the authors say their research shows that the US “is not meeting the behavioral health needs of our young people.”

“EDs are the last stop when all else has failed, and they, too, lack the resources to support, or even discharge, these patients,” the commentary says.

It points out that research has found this lack of access as far back as 2005.

“This new analysis adds to the overwhelming evidence that there is an urgent need for a dramatic change in our pediatric mental health care system,” the commentary says. “We believe it is time for a ‘child mental health moonshot,’ and call on the field and its funders to come together to launch the next wave of bold mental health research, for the benefit of these children and their families who so desperately need our support.”

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How rivers are vital for everything from biodiversity to mental health

The river Dee flows through England and Wales

Henry Ciechanowicz/Alamy

This article is part of New Scientist and the i’s joint campaign, Save Britain’s RiversThe year-long collaboration will reveal what’s happening to the UK’s rivers and how to restore them through a series of special articles, films, podcasts and events.

STAND by a river in the UK and you are in touch with the ancients. Their short, gruff names – Thames, Leith, Taff, Lagan – speak volumes of the history of the islands, from ancient Britons through Romans, Saxons and Vikings. These rivers are part of the past and present. Yet they face an uncertain future.

All over the world, rivers are valuable, often sacred, cultural and practical assets. They are a defining feature of human settlements, exploited for millennia as a source of drinking water, food, irrigation, waste disposal, power, navigation, defence and even inspiration.

In the UK, many of these services are just as relevant today. Tap water comes mostly from rivers. Sewage is disposed into them – preferably treated but often not. Rivers irrigate crops, power homes, take away floodwaters and float boats. Millions of people spend some of their leisure time messing about on, or near, rivers.

Save Britain's rivers

The UK is a riverine country. Globally, about 0.8 per cent of the land is covered in freshwater. In the UK, that number is 3 per cent. It has about 1500 river systems, with a combined length of over 200,000 kilometres, ranging from gushing upland headwaters to languid floodplain meanderers, via a vast range of intermediate habitats.

By global standards, these rivers are short, narrow and shallow – “mere streams”, according to the National River Flow Archive at the UK Centre for Ecology & Hydrology in Wallingford. Yet they are extremely diverse in character. According to a recent report by the National Committee UK of the International Union for Conservation of Nature (IUCN), “rivers and their floodplains are among the most important environments in the UK”.

“It’s well known that rivers and their floodplains – and the two go hand in hand – support a disproportionate level of biodiversity relative to their size within landscapes,” says report co-author Stephen Addy at the James Hutton Institute in Aberdeen, UK.

Drinking water and flood management

Although rivers are important for many reasons, their most obvious benefit in the UK is the water they supply. According to Water UK, which represents the country’s water industry, about two-thirds of tap water in England and Wales comes from rivers and the reservoirs and lakes they flow into; the rest is taken from aquifers. Northern Ireland and Scotland rely almost exclusively on rivers, reservoirs and lakes. All told, 87 per cent of the UK water supply comes from these sources.

According to government statistics, water companies in the UK abstract about 4.6 cubic kilometres of river, lake and reservoir water in England for the public supply every year. People drink it, bathe in it, flush their toilets with it, irrigate their gardens with it and use it to wash their clothes, floors and cars. Offices, shops, restaurants and other firms drink deep of it too.

Water is abstracted for other purposes. Electricity generators take 3.4 cubic kilometres to turn their steam turbines, while fish and watercress farms use 0.8 cubic kilometres and agriculture and private water supplies another 0.8. That adds up to a grand total of 9.6 cubic kilometres, equivalent to a cubic tank of water more than 2 kilometres in all dimensions.

Even in a relatively rainy country like the UK, that is milking it. The UK government estimates that about 1 in 5 surface water sources are depleted by over-abstraction, which has knock-on effects on river health.

The opposite problem – too much water – is an increasingly familiar hazard during the winter. Flooding is a growing problem as climate change causes extreme weather events, including biblical downpours. According to the Environment Agency, the UK has had six of its 10 wettest years on record since 1998. Last year was the first to see three named Atlantic storms in the space of a week.

Natural floodplains can help to mitigate flood risk by corralling the excess water and releasing it slowly back into the river. That is especially true of riverine landscapes engineered by beavers, whose dams and pools massively slow the passage of water through the system. Where rain used to hit the ground and surge straight into the waterways, it now is trapped for weeks. Beavers are being reintroduced all over the UK after they gained legal protection last year.

2H2XMMC Plastic waste pollution, River Thames, East London, UK

Plastic waste dumped along the bank of the river Thames in London

Mark Phillips/Alamy

The problem is that many of those floodplains are far from natural, let alone beavered: housing estates and industrial development are often sited on them and these are generally quite useless at mitigating floods.

Water supplies and flood defences are two of many “ecosystem services” supplied by rivers. These are vital goods and services, such as water, pollination and clean air, that flow from nature, or what is increasingly referred to as natural capital.

Economic and health benefits

The UK was the first nation – and remains one of only 26 countries – to audit its natural capital. In 2012, the government established the (now disbanded) Natural Capital Committee (NCC) to advise it on the state of England’s natural capital, in order to help deliver its commitment “to be the first generation to leave the natural environment of England in a better state than it inherited”. In 2020, the NCC published its first set of accounts.

These are by no means complete, as the system for totting up natural capital, called experimental ecosystem accounting, remains a work in progress and nature is complex. But they still speak volumes about the value of rivers.

Water abstraction alone is worth £6.8 billion a year – essentially what it would cost to keep the taps on if rivers didn’t supply the UK with water – and the asset is worth £134 billion (the NCC stressed that these aren’t price tags on nature: given that the natural world supports all life on Earth, its value is infinite). Wetlands sequester 3.5 million tonnes of carbon a year, worth £831 million; that asset is valued at nearly £30 billion. Hydroelectricity generation produces 6865 gigawatt-hours a year, worth £136 million; the value of that asset is £2.2 billion.

These “provisioning and regulating” services are supplemented by some less tangible, but no less valuable cultural services. Around 1 in 10 of the UK’s 5.8 billion annual outdoor recreational and tourist visits are centred on freshwater, worth £681 million; the asset is worth £32 billion. Recreational fishing is a £1.7 billion a year industry. Around 2.7 million people gain health benefits from being in or around freshwater, worth £870 million a year. The asset value of this is nearly £48 billion. Even house prices benefit from the proximity of a river to the tune of £2.9 billion a year.

Essential habitats for biodiversity

One asset that has yet to be incorporated into natural capital accounting is biodiversity, but it is clear that rivers are an important repository of what is left in the UK. Globally, rivers and other bodies of fresh water are disproportionately biodiverse. Despite covering less than 1 per cent of Earth’s surface, they are home to around a third of described species of vertebrate, including approximately 40 per cent of all fish.

The UK’s rivers and the wetlands they feed are disproportionately biodiverse too, though to a lesser extent. They are home to around 10 per cent of the UK’s species, according to the Environment Agency. The IUCN lists 346 river-dependent species, some endangered, including eels, otters, the bar-tailed godwit and feather mosses. The Environment Agency says that over 10 per cent of UK freshwater and wetland species are threatened with extinction.

Rivers are biodiverse in part because they themselves are diverse. A short stretch of lowland river can feature 10 different habitats – pools, riffles (shallow water flowing quickly over stones), glides (deeper, slow-flowing water), backwaters, beds of aquatic vegetation, submerged tree roots, exposed sediment, riverbanks, riparian vegetation and floodplains – all of which provide food and shelter for a different repertoire of species. Further upstream are headwaters, waterfalls and rapids, which also host specialist species such as the freshwater pearl mussel, white-clawed crayfish, brook lamprey and bullhead, as well as juvenile salmon, trout and grey mullet. These juvenile fish will eventually migrate out to sea and become part of the UK fishing industry’s £713 million annual earnings.

Rare chalk streams and poor ecological health

England is also home to the vast majority of the world’s chalk streams, rare and internationally important habitats fed from alkaline aquifers in chalk and characterised by their gravel and flint beds and crystal clear water. They are home to unique ecosystems and have been described as an English Great Barrier Reef. There are only 210 of these waterways in the world and 170 of them are in England (the rest are in northern France).

Unsurprisingly, the value of ecosystem services is strongly related to the ecological state of the asset. In much of the UK, that isn’t a happy tale. England, Wales and Northern Ireland have no rivers considered to be in high ecological health, according to criteria laid down in the four nations’ Water Framework Directives; only 14 per cent are good. The rest are moderate, poor or bad. None is in a good state in terms of chemical pollution and none is in good overall health. In Scotland, 8 per cent of rivers are in high ecological health.

The IUCN report is blunt on this issue, concluding that “truly natural [river] environments that have escaped both direct and indirect human alteration no longer exist”. However, there is hope, according to Addy. “There are some grounds for being optimistic. River restoration in the UK is undergoing a step change, there are more and more projects going on everywhere.”

More on these topics:

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

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. 

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%). 

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



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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Don’t serve Girl Scout cookies with a side of shame | CNN

Editor’s Note: Dr. Katie Hurley, author of “No More Mean Girls: The Secret to Raising Strong, Confident and Compassionate Girls,” is a child and adolescent psychotherapist in Los Angeles. She specializes in work with tweens, teens and young adults.



CNN
 — 

It’s Girl Scout cookie season again, which means young female entrepreneurs are outside your favorite stores and community centers selling you the latest flavors and old favorites.

While this program that helps girls learn and practice important leadership skills remains the largest girl-led entrepreneurial program in the world, cookie season can also include unwelcome messaging about calorie counting, restricted eating and diet culture.

During the course of the selling season, and even just in a single shift, girls are likely to hear negative comments about weight, body image and disordered eating from both customers and passersby. While many comments are passed off as humor, a seemingly benign joke about needing to exercise more to “earn” a Thin Mint isn’t as innocent as it might seem.

“We know that children can internalize body image concerns as young as 3 to 5 years old, so it’s important to keep in mind how we talk about our bodies and the food we eat in front of children very early on,” said Dr. Nicole Cifra, an attending physician in the division of adolescent medicine at Children’s Hospital of Philadelphia.

“We also know that dieting is a major risk factor for developing an eating disorder, so minimizing talk about diets or restricting certain food groups is beneficial,” she added.

Although a single comment isn’t likely to trigger an eating disorder, repeated exposure to diet talk can have an effect on the thought patterns girls develop around eating and body image.

“There’s a cumulative effect of kids getting these messages directly,” said Oona Hanson, parent coach and founder of the Facebook community, Parenting without Diet Culture. “One individual customer is not solely responsible for internalized messages that lead to disordered eating, but all adults play a role in the messaging kids hear around diet culture and positive body image.”

What might feel like a humorous way to deflect a cookie purchase in the moment could do more harm than anticipated. It’s probably not the only negative commentary the young entrepreneurs hear during a shift. Given that over 200 million boxes of cookies are sold each year, that’s a lot of girls fending off a lot of snarky remarks about bathing suit season or earning the confection through extra workouts or starvation.

If you’re inclined to crack a joke because you just don’t want the cookies, consider taking a moment to engage a Girl Scout in conversation about their business model and where the funds land. This gives these young businesswomen a chance to practice public speaking while sharing what they’re learning. Chances are you might even learn that you can make a cookie donation through the “Cookie Share” program. My family likes to buy some for our home and send some via Cookie Share to United States troops.

Charlotte Markey, author of “The Body Image Book for Girls,” notes that it is nearly impossible to address every negative comment heard in the background of cookie sale booths. “Some of this is so commonplace that if we take every single comment seriously, we spend too much energy on it,” Markey said.

However, there are steps parents, educators and Girl Scout troop leaders can take to mitigate some of this negative messaging so that girls don’t internalize it.

“The best thing that troop leaders and parents can do for their kids is to model their own healthy body image,” said Dr. Cheri Levinson, associate professor in the department of psychological and brain sciences at the University of Louisville and director of the university’s Eating Anxiety Treatment Lab. “It’s also important to talk about all of the good things that bodies do for us — like letting us hug people, dance or pet our pets.”

Practicing gratitude as it relates to our bodies is a powerful way to reframe thinking away from unrealistic expectations or negative thoughts about our bodies and toward being mindful of the many ways our bodies carry us through our days.

Kids are always listening.

“One of the most important things is not to talk negatively about your body or food in front of kids,” Levinson said. When we talk kindly to ourselves, she noted, they learn to do the same.

Balanced eating includes having treats at times and taking the time to enjoy the foods we consume. When adults label foods or eating choices as “good” or “bad” and “healthy” or “unhealthy,” kids get the message some foods are either off-limits or harmful. This can create feelings of shame around eating, particularly when sweets are restricted to these categories.

“One thing troop leaders can do is talk about the joy around food by sharing their favorite combinations of cookies,” Hanson said. “This tips the scales in the direction of creating a balanced relationship with food.”

It might be tempting to ignore the commentary and simply move on, but if girls are hearing diet culture talk, they need to talk about it with a trusted adult.

“I recommend having an open line of communication about these topics. Talking to children about the media they consume or comments they hear from others related to body image can be helpful in giving them a space to process the information they’re receiving,” Cifra said.

One way to do this is to debrief the girls after the shift ends. A troop leader can say, “We heard a few jokes and comments about diets and not eating cookies. I wonder how you felt when you heard those things?” This opens the door to a discussion about negative body comments and how girls can reframe their thinking.

There might be times when an adult has to step in and gently redirect another adult who is making uncomfortable comments, but girls can also take the opportunity to use their voices to stand up to diet talk.

Assertiveness is an essential leadership skill, and countering unwanted commentary with positive messaging is one way to help girls sharpen their skills. Plan ahead to come up with some talking points to use if they encounter any negative messaging. Phrases like “We love our cookies and they only come around once a year!” or “Gift a box to our troops — we know they love our cookies!” change the tone from negative to hopeful while empowering the girls to speak up for a cause they believe in.

Cookie season does only come around once a year, and the dollars earned from these sales go directly back to the local and regional troops to fund activities for the girls throughout the year. Whether you donate the cookies to someone else or pick up a box of favorites to enjoy yourself, your purchase empowers up-and-coming leaders. So go ahead and grab those Thin Mints while you still can.

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Pathological lying could finally be getting attention as a mental disorder | CNN



CNN
 — 

When Timothy Levine set out to write a book about deception in 2016, he wanted to include a chapter on one of its most extreme forms: pathological lying.

“I just couldn’t find any good research base on this,” said Levine, chair of the Department of Communication Studies at the University of Alabama at Birmingham.

Now, it seems it’s the only thing anyone wants to talk to him about.

“Santos has brought more reporters to me in the last couple of weeks than probably in the last year,” Levine said.

Santos, of course, is US Rep. George Santos, a Republican from Long Island who was recently elected to represent New York’s third congressional district.

In the months since his election, key claims from Santos’ biography – including where he earned his college degree, his employment at Citigroup and Goldman Sachs, an animal rescue group he says he founded and his Jewish religious affiliation – have withered under the scrutiny of reporters and fact-checkers. Now, he says, he doesn’t have a college degree; he wasn’t employed by Citigroup or Goldman Sachs; and the IRS has no record of his animal rescue group. He also says he never claimed to be Jewish, but rather he was “Jew-ish.”

Santos defended himself in media interviews in December, saying that the discrepancies were the result of résumé padding and poor word choices but that he was not a criminal or a fraud.

It’s not clear what is driving Santos’ statements.

But the story has given professionals who study lying in its most extreme forms a rare moment to raise awareness about lying as a mental disorder – one they say has been largely neglected by doctors and therapists.

“It is rare to find a public figure who lies so frequently in such verifiable ways,” says Christian Hart, a psychologist who directs the Human Deception Laboratory at Texas Woman’s University.

Psychiatrists have recognized pathological lying as a mental affliction since the late 1800s, yet experts say it has never been given serious attention, funding or real study. It doesn’t have its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the bible of psychiatry. Instead, it is recognized as a feature of other diagnoses, like personality disorders.

As a result, there’s no evidence-based way to treat it, even though many pathological liars say they want help to stop.

The standard approach to treating lying relies on techniques borrowed from cognitive behavioral therapy, which emphasizes understanding and changing thinking patterns. But no one is sure that this is the most effective way to help.

We don’t know necessarily what’s the most effective treatment,” said Drew Curtis, an associate professor of psychology at Angelo State University in Texas who studies pathological lying.

Curtis had someone offer to drive across the country to see him for treatment, which he says he wasn’t able to offer.

“So that’s the heartbreaking side of it for me, as a clinician: people that are wanting to help and can’t have the help,” Curtis said.

Longtime collaborators Curtis and Hart recently published a study laying out evidence to support the inclusion of pathological lying as a standalone diagnosis in the DSM.

Over the years, Hart said, almost 20 people have proposed definitions of pathological lying, but there’s very little overlap between them: “The only truly common feature is that these people lie a lot.”

The first thing to know about pathological or compulsive lying is that it is rare, Levine says. His studies show that most people tell the truth most of the time.

“These really prolific liars are pretty unusual,” said Levine, whose book about deception, “Duped,” was published in 2019.

Which isn’t to say that lying isn’t common. Most people lie sometimes, even daily. In his studies, people lied up to twice a day, on average.

Levine himself regularly lies at the grocery store when workers ask whether he found everything he was looking for. Since the Covid-19 pandemic began, that answer is almost always no, but he says yes anyway.

One of his students worked in a retail clothing store and regularly lied to people who were trying on clothes. Another – a receptionist – lied to cover for a doctor who was always running late.

That’s all pretty normal, Levine said. He believes that honesty is our default mode of communication simply because people have to be honest with each other to work effectively in big groups, something humans do uniquely well in the animal kingdom.

But sticking to the facts isn’t easy for everyone.

In their studies, Hart and Curtis have found that most people tell an average of about one lie a day. That’s pretty normal. Then there are people who lie a lot: about 10 lies a day, on average.

Hart and Curtis call prolific or especially consequential liars – someone like Bernie Madoff, who dupes and defrauds investors, for example – “Big Liars,” which is also the title of their recent book.

Big lying is pretty unusual. Pathological lying is even more rare than that.

Hart thinks he’s only ever interacted with two people that met the classical case study description of pathological lying.

“It was dizzying,” Hart says.

When people start to lie so much that they can’t stop or that it begins to hurt them or people around them, that’s when it becomes abnormal and may need treatment.

“It’s more the clinical category of people who tell excessive amounts of lies that impairs their functioning, causes distress, and poses some risk to themselves or others,” Curtis said, sharing the working definition of pathological lying that he and Hart hope will eventually be included in the DSM.

“What we found, examining all the cases, is that the lying appears to be somewhat compulsive,” Hart said. “That is, they’re lying in situations when a reasonable person probably wouldn’t lie, and it seems like even to their own detriment in many cases.

“It tends to cause dysfunction in their lives,” Hart said, including social, relationship and employment problems.

On some level, pathological liars know they’re lying. When confronted with their lies, they’ll typically admit to their dishonesty.

Lying can also be a feature of other disorders, but Hart says that when they assessed people who met the criteria for pathological lying, they found something interesting.

“It turned out that the majority of them don’t have another psychological disorder. And so it seems like lying is their principal problem,” he said, lending weight to the idea that it deserves to be its own diagnosis.

The American Psychiatric Association, or APA, publishes the DSM and regularly reviews proposals for new diagnoses. Curtis says he has been gathering evidence and is in the process of filling out the paperwork the APA requires to consider whether pathological lying should be a new diagnosis.

As for whether certain professions seem to attract people who lie more than average, Hart says that’s a complicated question.

It’s not that people who lie a lot tend to gravitate to certain jobs. Rather, certain jobs – like sales, for example – probably reward the ability to lie smoothly, and so these professions may be more likely to have a higher concentration of people who lie more than average.

“The evidence we have suggests that politicians aren’t by their nature any more dishonest than the typical person,” Hart said. “However, when people go into politics, there’s pretty good evidence that the most successful politicians are the ones that are more willing to bend the truth” and so they may be the ones more likely to be re-elected.

Only time will tell, how the situation may play out for Santos.

So far, he has resisted calls to step down, saying he intends to serve his term in Congress. This week, though, Santos announced he would step down from any committee assignments while the investigations are ongoing.

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Children’s mental health tops list of parent worries, survey finds | CNN



CNN
 — 

Forty percent of US parents are “extremely” or “very” worried that their children will struggle with anxiety or depression at some point, a new survey finds.

The Pew Research Center report said mental health was the greatest concern among parents, followed by bullying, which worries 35% of parents. These concerns trumped fears of kidnapping, dangers of drugs and alcohol, teen pregnancy and getting into trouble with the police.

Concerns varied by race, ethnicity and income level, with roughly 4 in 10 Latino and low-income parents and 3 in 10 Black parents saying they are extremely or very worried that their children could be shot, compared with about 1 in 10 high-income or White parents.

Nearly two-thirds of the respondents said that being a parent has been at least somewhat harder than they expected, about 41% say that being a parent is tiring, and 29% say it is stressful all or most of the time.

The report captured the perceptions of a nationally representative sample of 3,757 US parents whose children were younger than 18 in 2022.

Experts say mental health issues among children and adolescents have skyrocketed in recent years.

“I would say over the last 10 years, since I’ve been practicing as a general pediatrician, I have seen a shift both in the amount of patients and of all ages dealing with anxiety and depression. And their parents being concerned about this is a key issue,” said Dr. Katherine Williamson, a pediatrician and spokesperson for the American Academy of Pediatrics. “Even before the pandemic, we were seeing skyrocketing numbers of kids and adolescents dealing with mental health issues, and that has increased exponentially since the pandemic.”

Suicide became the second leading cause of death among children 10 to 14 during the Covid-19 pandemic, according to the US Centers for Disease Control and Prevention. Mental health-related emergency room visits among adolescents 5 to 11 and 12 to 17 also jumped 24% and 31%, respectively.

Many parents feel helpless when their children have mental health issues because they don’t feel equipped to offer support in this area.

“They are unable to relieve [mental health issues] and address that as they could if they were struggling with their grades or other things that seem more traditional to for kids to struggle with,” said Allen Sabey, a family therapist at the Family Institute at Northwestern University.

Parents trying to “work out and look at and connect with their own feelings will give them important information about what feels off or OK for their kid,” he said.

When it comes to anxiety and depression in children, pediatricians say, parents can watch for signs like decreased interest or pleasure in things they previously enjoyed, poor self-esteem and changes in mood, appetite or sleep.

Experts also say parents should consider the amount and content of social media their child consumes, as research has found that it can have negative effects on their mental health.

But, they say, having more parents recognize the importance of mental health in children is a step in the right direction.

“I have always felt there’s been so much resistance to seeking care for mental health among the population that I serve. And I am actually happy that since the Covid pandemic, at least people now are recognizing this as a very key and important health need,” said Dr. Maggi Smeal, a pediatrician at Stanford Medicine Children’s Health.

Smeal hopes that “all people that are interacting with children can be aware of these issues and feel empowered to identify and advocate for these children, to tell them to go to their primary care provider and have an assessment just like you do if your kid has a cough or a fever or ear infection.”

The number of parents concerned about gun violence reflects the fact that guns are the leading cause of death among children in the US, research has showed. From 2019 to 2020, the rate of firearm-related deaths increased 29.5% – more than twice the increase as in the general population.

“Gun violence is a real risk to our kids today. And that is both being killed by somebody else as well as suicide in the face of the mental health issues that we’re seeing today,” Williamson said.

The survey found that Black, Hispanic and lower-income parents were most likely to be concerned about gun violence, a finding that’s consistent with the communities most affected. Research has shown that from 2018 to 2021, the rate of firearm-related deaths doubled among Black youth and increased 50% among Hispanic youth. Another study found that children living in low-income areas are at higher risk of firearm-related death.

Direct and indirect exposure to gun violence can contribute to mental health problems.

“Even if they hear gunshots in their community, they hear adults talking, there’s all different ways that children are traumatized and victimized by gun violence. And what we see is all the symptoms of anxiety in even the youngest of children. We see children with somatic complaints – stomachaches, headaches. They have post-traumatic stress disorder,” Smeal said.

Most of the parents in the survey said parenting is harder than they expected, and that they feel judgment from various sources.

“The findings of this of this report were, as a pediatrician and a parent, just exactly what you would expect. Parenting is the hardest thing you’ll ever do, and there are very high levels of stress and fatigue, especially in the parents of young children,” Smeal said.

One of the best things parents can do is lean on fellow parents, experts say.

“The main challenge for parents is our siloed independent nature sometimes, and so we want to find people who we trust and kind of work towards being more vulnerable and open with,” Sabey said. “To where it’s like not just you and your kid, but it’s a kind of a group of people caring and working together.”

Pediatricians emphasize that no parent is perfect and that the most important thing you can do is to just be there for your child.

“We know that the best chance for a child to be successful and happy is for them to have at least one person in their life who believes in them and advocates for them. So I think it’s important for parents to know that there’s no such thing as a perfect parent, because we are all human, and humans are imperfect by nature, but that is OK,” Williamson said.

A parent’s job is to “really make sure that they know how important they are and they have a voice in this world,” she said. “Every child will have their own unique struggles, whether it is academically, emotionally, physically. Our job is to help them with the areas [where] they struggle, but even more, help them recognize their strengths.”

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Healing and Rebuilding Your Life After a Spouse’s Suicide

Jan. 24, 2023 — Betsy Gall, a real estate agent, seemed to have everything: three children, a comfortable home, a handsome, “life-of-the-party” oncologist husband whom she loved. But her world shattered on Thanksgiving Day 2019, when her husband, Matthew, took his life.

The couple had just moved from Minneapolis to Charlotte, where Matt took a new position in a private practice. “He felt the move had been a mistake and referred to it as ‘career suicide’” Gall says. “I wanted him to get help and take antidepressants, but he was afraid of losing his medical license if he took medication.” 

A few months after moving, he ended his life.

Lynette Eddy, a Reno, NV-based social worker, lost her husband to suicide in 2010. 

“I watched Bob depart from his own value system over the years, giving up on his true self,” she says. “Unfortunately, he was swayed by money and greed, got involved with gambling, and got in over his head. I had no idea of the life he was leading, but I know he was suffering greatly.”

Both Gall and Eddy had to find ways to heal and rebuild their lives in the wake of the self-inflicted death of a husband.

Haunting Questions

Losing a loved one to suicide is a loss like no other, says Julie Cerel, PhD, professor at the University of Kentucky College of Social Work and director of the Suicide Prevention and Exposure Lab.

Unlike other causes of death (like illnesses or accidents), which happen to the person, suicide is an act performed by the person who has chosen death, leaving bereaved survivors with guilt and haunting questions, says Cerel, who is the co-author of Seeking Hope: Stories of the Suicide Bereaved.

“When you lose someone to suicide, you instantaneously become an investigator,” Gall says. “Why did it happen? What did I miss? What could I have done differently? Everyone who knew my husband was asking themselves the same questions. We all blamed ourselves in some way, feeling that we should have been able to anticipate or stop it,” says Gall.

Eddy agrees. “Survivor’s guilt is super common. I look back and asked myself the same questions a million times.”

Sometimes, according to Cerel, “we really don’t know what motivated the person.”

Gall now realizes “there was nothing else we could have done. Mental health issues are excruciatingly difficult. People have to be willing to help themselves, and we can’t force them. Matt refused to go on antidepressants and there was no way I could ‘make’ him do so.”

Eddy has reached a similar conclusion. “I feel he had some serious things going on and it didn’t matter what we did or didn’t do. I got him to go to counseling, but that didn’t work. I tried to get him to open up, but never got the truth out of him. I know he was suffering and can only imagine how tortured he was. Obviously, I would have done anything I could have done to alleviate that, but he wouldn’t let me in.”

Stigma, Secrecy, Shame

Research comparing suicide-bereaved people to people who have sustained other losses has found higher levels of shame, stigma, and feeling the need to hide the loved one’s cause of death. Secrecy often develops, both within the family and toward people outside the family, and can lead to family dysfunction. Withdrawing from social networks and friends can make mourning and recovery more difficult.

“Many people bereaved by suicide are reluctant to tell others about the cause of death or to talk about it,” Cerel says. “But our research has found that being able to talk openly about the death and the loved one is actually very helpful.”

Gall and Eddy have spoken openly about their losses. And both have written books describing their experience. Gall is the author of The Illusion of the Perfect Profession and Eddy is the author of The Fight Inside. Both hope that their books will pave the way for deeper understanding of why people might end their lives and how families can cope with such a major loss.

Family members don’t have to reveal personal details, but memorializing the deceased and allowing people to offer love and support helps with feeling less alone and reduces stigma. 

‘Complicated Grief’

Grief researcher Katherine Shear, MD, writes: “Mourning is the process by which bereaved people seek and find ways to turn the light on in the world again.” Mourning is normal and healthy following loss. But suicide can lead to “complicated grief” (also called prolonged grief), which can “prevent the natural healing process from progressing.”

Some people feel anger, rejection, or betrayal when their loved one dies by suicide, which can compound their sense of guilt and place them at greater risk for complicated grief. 

But not everyone reacts that way. “People say to me, ‘you must be so angry at your husband, he betrayed, you, he lied,’ but I never did get angry and I’m not angry today,” Eddy says. 

She attributes her reaction to her spiritual practice, which has enabled her to “see through the heart” into her husband’s pain. “I know he was suffering greatly and trying to fill a void with quick-fix pleasure.”

Getting Help

Cerel encourages suicide-bereaved people to seek professional help if necessary. “They often have symptoms of posttraumatic stress disorder or even full-blown PTSD, even if they weren’t there to see the actual event happen.” 

There are effective treatments for PTSD and complicated grief, as well as other aspects of suicide-related grief, like anger and guilt. Support groups are also helpful, particularly consisting of people bereaved by suicide. Resources can be found at the end of the article.

“It’s taken thousands of hours on my therapist’s couch to realize that my husband had no more control over his mental illness than his cancer patients had over their cancer,” Gall says. “I’ve accepted that and no longer wake up every morning with that thud in my heart and that searing, searing pain that goes along with the kind of grief I had.”

Not only family but also friends, classmates, community members, and co-workers can be devastated by a suicide, Cerel points out. Getting professional help or joining a support group can be valuable for them too.

Spiritual Practice as a Resource

Gall and Eddy draw upon their spiritual practice for comfort and strength.

“Faith in a higher power is where I turned first,” says Gall. “I’ve always been a Christian but didn’t go to church every Sunday and wasn’t extremely religious.” In the months before her husband’s death and since then, she’s turned to the Bible and to devotional readings “for some sort of road map as to how to get through the most tumultuous, confusing, awful, torturous, chaotic time of my life.”

Eddy also draws on her spiritual practice — A Course in Miracles — and mindfulness-based approaches. “The spiritual path I took started years before this even happened and played a huge role in giving me strength.”

The phrase from A Course in Miracles that had a profound impact on her was: “Nothing real can be threatened. Nothing unreal exists. Therein lies the peace of God.” In other words, “I feel that there’s an outside drama happening. I can be one of the ‘actors’ in the play or I can ‘watch’ the play and be the observer.” 

Eddy developed Open-Heart Mindfulness, an approach that involves “observing and witnessing feelings, thoughts, and reactions without becoming judgmental.” She says, “everyone has an ego voice that can drive them to despair, as happened to my husband. But everyone also has another voice — the spirit voice — and we can tune in to that and release our suffering.”

She advises others: “Grieve, of course, but don’t be identified with the grief. Stay in the witness seat. Understand and be gentle with yourself, and recognize that healing will take time.”

Spirituality and mindfulness-based approaches don’t resonate with everyone, Cerel points out.

“Spiritual practices are very individual. Faith or mindfulness may be exactly what some people need, but not others. There are many paths.” And mindfulness doesn’t necessarily mean meditation. Any activity demanding close attention — for example, exercise, art, music, even horseback riding — can bring that quality to the fore. 

Moving Forward

As horrific as the experience is of losing a loved one to suicide, some people emerge changed for the better, which is often called “posttraumatic growth,” says Cerel.

“I think anyone who’s had a traumatic experience that brought them to their knees and stripped them down to the core has a decision to make,” says Eddy.

“I had identified as Bob’s wife and he was my rock, and everything was about him. Then all of a sudden, that was gone, and I knew I had to reinvent myself, rebuild my life, and do something positive.”

Eddy, who completed her MSW after the death of her husband, was working with homeless teenagers and decided to open up a facility, Eddy’s House, for this vulnerable population. “It was a deep feeling I had in my spirit as a way of helping young people. It’s been a big healer for me.” She teaches Open-Heart Mindfulness to the teens and feels it’s made a difference in their lives.

Writing her book contributed to healing. Eddy wanted to shed light on the inner conflicts that had led her husband to die by suicide and to “get the reader to see how, collectively, we have to move toward our authentic selves.”

Gall wrote her book not only as a way of processing her loss, but also to highlight forces that might drive a doctor to suicide. “I’m sharing my story and Matt’s experience to open up a conversation because our [medical] system is broken.”

Gall has been able to start feeling joy again. “Life is so precious, and I feel blessed that I had such a beautiful life with Matthew, and I still have a beautiful life, even without him. Difficult some days, but we must move forward. You never ‘move on’ — you only move forward.”

If you are having suicidal thoughts, call or text the 988 Suicide and Crisis Lifeline or text HOME to 741741.

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