mental health

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Sweet Dreams: Study Finds Later Nights, Less Sleep Linked To Negativity

(eltpics via compfight)

(eltpics via compfight)

Sleep is the new Prozac. Or, put another way, sleep is emerging as one of the most potent weapons you can use to stave off depression, anxiety and a whole host of other physical and mental ills.

Here’s the latest pro-sleep research by psychologists at Binghamton University in New York. Their new paper, “Duration and Timing of Sleep are Associated with Repetitive Negative Thinking” is just published in the journal Cognitive Therapy and Research.

From the news release:

When you go to bed, and how long you sleep at a time, might actually make it difficult for you to stop worrying. So say Jacob Nota and Meredith Coles of Binghamton University in the U.S., who found that people who sleep for shorter periods of time and go to bed very late at night are often overwhelmed with more negative thoughts than those who keep more regular sleeping hours…

Previous studies have linked sleep problems with such repetitive negative thoughts, especially in cases where someone does not get enough shuteye. Nota and Coles set out to replicate these studies, and to further see if there’s any link between having such repetitive thoughts and the actual time when someone goes to bed.

They asked 100 young adults at Binghamton University to complete a battery of questionnaires and two computerized tasks. In the process, it was measured how much the students worry, ruminate or obsess about something – three measures by which repetitive negative thinking is gauged. Continue reading

Instead Of Therapy, Put A Little Thanksgiving Into Regular Family Dinners

Mark's postcards from Beloit/flickr

Mark’s postcards from Beloit/flickr

Anne K. Fishel, Ph.D.
Guest Contributor

When a colleague recently told me about her Thanksgiving tradition, it got me thinking about family dinners — a topic I consider every night around 7 pm and with every patient I see in family therapy.

Indeed, as a mental health provider, I sometimes feel I’d go out of business if families had regular dinners with one another. Truly. There are dozens of research studies that show that frequent family dinners promote kids’ mental and emotional well being — by lowering rates of depression, anxiety, eating disorders and substance abuse, for starters. Family meals also strengthen children’s resilience, self-esteem and sense of connectedness to their parents. Isn’t that exactly the goal of therapy?

It’s no wonder that I often have to stifle the urge to say, ‘Stop wasting your time here. Go home and eat dinner together.’

But, I’m well aware of how hard it is for busy, harried families to find time to sit down to dinner, and I’m always looking for new ways to unlock the benefits without adding any guilt or pressure. So, that is why my colleagues remarks sparked my interest. Here’s what she said:

“My sisters and I love Thanksgiving so much that our father makes a Thanksgiving-like meal throughout the year that he dubs ‘Harvest Dinner.’ We just can’t get enough of his mashed potatoes!”

I love the idea of bringing the special quality and spirit of Thanksgiving dinner to everyday meals. Two elements could easily translate to everyday dinners: sharing the workload, and focusing on more than just food. Continue reading

Silent Wars: Helping Vets Fight Mental Health Battles At Home

By Evan Bick
Guest Contributor

The movies have it wrong. Combat, at least in my experience, was not non-stop or action-packed. Those who have experienced it know that modern warfare usually involves a lot of starting and stopping. Long stretches of quiet, even boredom, can be broken in an instant.

I was deployed to Iraq as an infantry platoon leader in 2008-2009. During that time, there may not have been constant action but there was tension — my fellow soldiers and I were on edge most of time, soldiers among civilians, going on patrols in the northwest corner of Baghdad.

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

On our first day in the city, the leaders from the unit we were replacing took us on a walk through their area of responsibility. We saw the sidelong glances from civilians as Americans walked through their streets, hidden behind rifles and sunglasses, and weighed down by cumbersome body armor. We also saw an area filled with stark contrasts — stucco houses with gated courtyards in one neighborhood, and refugee camps for Iraqis displaced by ethnic violence in the next.

Deployment is a challenging experience even when it’s boring. Whether you are patrolling ‘outside the wire’ or working behind the scenes, the sense of danger is real and omnipresent. While deployed, soldiers typically work far longer hours, and with less opportunity for relaxation than they experience at their home station. Isolation from loved ones, of course, is an important challenge both for the deployed soldier and family members back home.

Even with all those challenges, the bigger battle for many veterans begins when they return home. Without a unit that shared in your experience of war, you can feel lost — more lost than you would ever feel on patrol. It’s easy to get trapped inside your own head, and to dwell on what did not go well, and what you should have done differently. The quick reflexes and adrenaline that may have helped keep you alive overseas are probably no longer helpful.

Strategies that kept you and your fellow soldiers safe, like driving fast and straight down the middle of a road, become dangerous, and loud noises or crowds may make some part of you feel like you’re back in the desert. Continue reading

When You’re Dealing With A Stressed-Out High School Junior: 5 Tips

By Steve Schlozman, MD
Guest Contributor

(Miguel Angel/Flickr)

(Miguel Angel/Flickr)

Sometimes things are so obvious we fail to take notice.

For example, if I tell you that high school students who plan on attending college are under a lot of pressure, your response might sound like, well, a 17-year-old:

“Duh,” you might say, “What else is new?”

This is not new, of course, but the pressure continues to get exponentially worse. Students from all walks of life are increasingly overscheduled, academically burdened and socially overwhelmed. We pile all this stuff on top of the already treacherous waters of adolescence, and it’s no wonder kids feel emotionally battered.

I started thinking more about this when a friend of mine from high school called about his 9th grade daughter.

“She’s 14,” my friend said, “And they’re telling her in the fifth week of school about college. Did we worry about college in 9th grade?”

No way.

I used to think that the pressure on high school teens was largely a regional issue. I was raised in the Midwest, so of course things weren’t quite so high-stress compared to here in Boston. But my friend was calling from Colorado, and this is therefore not a regional issue. What is clear, is that this pressure is not good for our kids.

Let’s look at some of the data:

•According to the Department of Education, there are around 2,675 nonprofit four-year undergraduate colleges in the United States.

•Although the number of students in high school continues to slowly decline, the number of students applying to college is steadily increasing. In 2011, there were about 20.4 million students enrolled in college, and that number is projected to reach about 23 million by 2020.

•One out of four teenagers submitted college applications in 2011, at an average of around $40 per application

•In 2001, the typical college admitted around 71 percent of its applicants. By 2011, this number dropped to around 65 percent. I could go on. The common application increases the overall number of applications that students complete, schools look to college acceptance rates as a means of measuring their success and they therefore pass this pressure onto their students, and students themselves are more and more led to view the junior year of high school as something akin to academic and extracurricular boot camp. I’ve seen students get freaked out even before the first week of 11th grade.

This this kind of systemic stress is not good for anyone. A 2008 study found that the increased rate of academic dishonesty on high school campuses stemmed, at least according to some students, from the increasingly high achievement bar that the students themselves experienced. This of course does not excuse cheating, but it is worth noting that both cheating and academic and social pressures seem to have grown in concert with one another. Continue reading

Curb Your Hysteria: Talking Rationally To Kids About Ebola Risk

A man diagnosed with Ebola this week is being treated at Texas Health Presbyterian Hospital in Dallas. (AP)

A man diagnosed with Ebola this week is being treated at Texas Health Presbyterian Hospital in Dallas. (AP)

By Gene Beresin, MD and Steve Schlozman, MD

On Sept. 30 the first case of Ebola was diagnosed in the United States. The patient, who is currently being treated in Dallas, had recently traveled to Liberia, and was back in this country for a few days before symptoms began.

Understandably, the coverage of this news is pervasive. Although it seemed inevitable that a case in the U.S. would eventually emerge, the story still ignites a fair bit of hand-wringing among just about everyone who has learned of it.

Additionally, our country has experienced some novel infections that have ignited increased concerns in recent weeks. Enterovirus D-68 has made its way across the nation, causing severe cold-like symptoms, and, in some children with conditions such as asthma, the need for hospitalization. There’s also a potentially new contagion on the horizon that appears to cause varying degrees of muscular paralysis, and may or may not be related to Enterovirus D-68.

But, as public health officials are eager to stress, a nuanced and thoughtful approach to these issues has been as necessary as it has been fleeting. Experts agree that our medical infrastructure is well-equipped to handle even a virus as scary as Ebola, and some doctors are quick to point out that viruses like respiratory syncytial virus (RSV) and influenza are much more likely to cause harm than these new ones.

This raises a critical point:

Ebola, as scary as it is, poses a relatively minor threat to the United States; and the current cases of Enterovirus D-68 are far out-numbered by the RSV and influenza cases we experience on a yearly basis. And the currently unknown contagion that appears to cause paralysis has only happened in a very small population of kids.

So why the massive reaction in the media and among worried parents? Intellectually, at least at this point, all indications point to little danger for our children and ourselves. Why, then, do we get so frightened?

Well, let’s start with this confession: We’re frightened.

Sort of.

We know, intellectually, that the threat is minor. But, when has intellect played a leading role in the emotionally driven process of threat assessment? And, especially with regard to infectious disease, when has anyone other than the most statistically driven scientists been able to preserve perspective? We’re not saying that we should massively worry, or even that we’ll be changing our instructions to our kids or our patients on how to behave with these new bugs dancing around.

What we’re saying is that germs, especially new germs, are scary. We have a long and probably evolutionarily derived tendency to fear disease, and when new ones rear their heads, we get alarmed.

Germs In Hollywood

As a society, we think about germs a lot — and nowhere, perhaps, does that play out more than in Hollywood. The 1954 novella “I am Legend” has been made into no less than three movies (“The Last Man on Earth,” “The Omega Man” and the more recent movie of the same title as the written work). You can rattle off other movies as well — there’s “Dawn of the Dead” (in 1978 and again in 2004), “Outbreak,” “Carriers,” “Contagion,” “The Crazies” (in 1973 and again in 2010),

“Quarantine” (and “Quarantine 2″) and most recently “World War Z.” You get the picture. Continue reading

Why To Exercise Today: To Beat Back The Toxic Stress Of Life

frodrig/flickr

frodrig/flickr

Apparently all manner of stress — whether it’s bad morning traffic, or the death of someone you love — can harm your health in deep and profound ways. That’s according to a soon-to-be published study by researchers at Oregon State University. But the key, as NPR reports, is how you manage your stress:

Chronic stress is hazardous to health and can lead to early death from heart disease, cancer and of other health problems. But it turns out it doesn’t matter whether the stress comes from major events in life or from minor problems. Both can be deadly.

And it may be that it’s not the stress from major life events like divorce, illness and job loss trickled down to everyday life that gets you; it’s how you react to the smaller, everyday stress.

The most stressed-out people have the highest risk of premature death, according to one study that followed 1,293 men for years.

OK, so wouldn’t it be great to take little pill for combatting all of this health-undermining stress; something that allowed you to just laugh at all the bad drivers in Boston rather than screaming obscenities and giving everyone the finger?

Well, apparently, there’s something even better!

NPR quotes Dr. Robert Waldinger, a psychiatrist at Massachusetts General Hospital and Harvard University, who offers what appears to be the closest thing to a secret, stress-busting heavy weapon: exercise. Continue reading

When Teens Talk Of Suicide: What You Need To Know

By Gene Beresin, MD and Steve Schlozman, MD
Guest Contributors

Here’s the kind of call we get all too frequently:

“Doctor, my son said he just doesn’t care about living anymore. He’s been really upset for a while, and when his girlfriend broke things off, he just shut down.”

Needless to say, situations like this are terribly frightening for parents. Kids break up with girlfriends and boyfriends all the time; how, parents wonder, could it be so bad that life might not be worth living? How could anything be so awful?

For clinicians like us who work with kids, these moments are at once common and anxiety-provoking. We know that teenagers suffer all sorts of challenges as they navigate the murky waters of growing up. We also know that rarely do these kids take their own lives. Nevertheless, some of them do, and parents and providers alike must share the burden of the inexact science of determining where the greatest risks lie.

Suicide has been in the news lately with a flurry of new research and reports and, of course, the high profile death earlier this summer of Robin Williams.

But suicidal behavior among teenagers and kids in their early 20s is different and unique.

So let’s look at a couple of fictional — yet highly representative — scenarios.

depressed

Charlie, a 16-year-old high school junior was not acting like himself. In fact, those were his parents’ very words. Previously a great student and popular kid, Charlie gradually started behaving like a different person. He became more irritable, more isolated and seemed to stop caring about or even completing his homework. Then one morning, just before before school, he told his mother that he wished he were dead.

Myths: Common But Distorted 

There are countless other examples. Sometimes kids say something. Sometimes they post a frightening array of hopeless lyrics on Facebook. And most of the time — and this is important — kids don’t do anything to hurt themselves. Morbid lyrics and even suicidal sentiments are surprisingly common in adolescence. Still, this does not mean for a second that we take these warning signs lightly. In fact, there is a common myth that asking about suicide perpetuates suicide. There is not a shred of evidence in support of this concern, and in the studies that have been done, the opposite appears to be true. Kids are glad to be asked.

We have to ask. It’s really that simple. But, we ask with some very basic facts in mind. Suicidal thinking, and even serious contemplation of suicide, is, as we mentioned, very common among high school students. In the Center for Disease Control Youth Risk Behavior Surveillance Survey distributed every two years to about 14,000 high school kids in grades 9-12, students are queried about a range of high-risk behaviors, including suicide.

The Underlying Mood Disorder

In 2013, 17% of teens reported seriously considering suicide, and 8% made actual attempts. Each year in the United States, about 15 in 100,000 kids will die by suicide, making suicide the third leading cause of death in this age group. Additionally, we have no idea how many deaths by accidents (the leading cause of death) were, in fact, the product of latent or active suicide.

The greatest risk factors for a teenager to die by suicide include the presence of some mood disorder (most commonly depression), coupled with the use of drugs, or other substances, and previous attempts.

Although research suggests that girls attempt suicide more often, boys more often die from suicide. Add these risk factors together, and it turns out that Caucasian boys are at highest risk.

Some of this is also driven by a still immature brain. Impulsive behavior is notoriously common in teens, and in many cases, it looks as if the act of suicide was the result of a rash and sudden decision. Continue reading

Study: Bullying By Siblings May Double Risk Of Depression, Self-Harm

(Wikimedia Commons)

(Wikimedia Commons)

By Nicole Tay
CommonHealth intern

When I was growing up, I used to complain about the loneliness of being an only child. “I want an older brother like Mandy!” I would plead to my parents. I just wanted an older, cooler playmate; I never considered the potential downside.

Now, at 22, I’ve heard my share of horror stories; the sibling bullies who called my friends “butt face” or “stupid” or “brat;” the burnt Barbie dolls; the bag of caterpillars dumped on my poor friend’s head.

Is sibling bullying just a harmless rite of passage — or can it actually entail developmental repercussions?

A new study published today by the American Academy of Pediatrics targets that very question. After surveying more than 6,900 young people in the UK, researchers found that victims of frequent sibling bullying were twice as predisposed to depression, anxiety, and self-harm in young adulthood as non-bullied controls. This British-based study comes on the heels of similar findings in an American study last year. From the paper:

Of the 786 children who reported that they had been bullied by a sibling several times a week (55.3% female), depression was reported by 12.3% at age 18 years, self-harm occurred in 14.1%, and anxiety was reported by 16.0%.

And from the abstract: Continue reading

Even In Mass., Hundreds Of Young Central American Refugees Seek Care

"Flor" (Richard Knox for WBUR)

“Flor” (Richard Knox for WBUR)

By Richard Knox

CHELSEA, Mass. — The young Honduran woman appeared at the Chelsea HealthCare Center last February, fearing she was pregnant.

“Flor” — a pseudonym to protect family members back in Honduras — had paid a “coyote” $8,000 to escort her and her 3-year-old daughter to the U.S.-Mexican border. But when they got to the border town of Nuevo Laredo, the coyote sold her to a gang that held her in a tiny room with seven other women.

They raped her, then told her to pay $17,000 or they’d sell her daughter’s organs and force her into sex slavery.

Up in Massachusetts, her mother and father scrambled to borrow the money and wire it to Nuevo Laredo. Her kidnappers released Flor and the little girl; she doesn’t know what happened to the other women.

Flor and her daughter are among hundreds of Central American immigrants who’ve made their way to the blue-collar town of Chelsea, Mass., over the past year.

They represent a quiet influx that began months before the phenomenon hit the headlines and protests began flaring in communities from Cape Cod to California.

They come to Chelsea because many of them have family there. Sixty-two percent of the town’s 35,000 residents are Latino, and many are from Honduras, El Salvador and Guatemala.

As we sit in a conference room at the Chelsea health center, the sun backlights the thick dark hair that frames Flor’s broad face as she tells me how and why she made the 2,300-mile trek from the Honduran capital of Tegucigalpa.

“The decision I made, why I came here, was to give a better future to my daughter,” Flor says in Spanish, silent tears trickling down her cheeks. “In Honduras, it is very difficult. The gangs, they’re killing a lot of people. You have to give money month-to-month or they go to your house and they kill you.” Continue reading

P.S. To Jill Abramson: Grads, You Must Learn The Word ‘Fungible’

Jill Abramson, former executive editor of The New York Times, speaks at the commencement ceremony at Wake Forest University on Monday. (Neil Redmond/AP)

Jill Abramson, former executive editor of The New York Times, speaks at the commencement ceremony at Wake Forest University on Monday. (Neil Redmond/AP)

On Monday, ousted New York Times editor Jill Abramson began her post-firing public life by speaking at the Wake Forest University commencement, and shared her father’s buck-up maxim for when you’re dumped or disappointed: “Show what you’re made of.” Here, I add one other bit of advice: Learn the word “fungible.”

Dear soon-to-be-college grads:

I regret to inform you that at the last minute, we at the University of Hard Knocks have added one additional graduation requirement: You must learn the meaning of the word ‘fungible.’

But not to worry. We’ll help you out with the dictionary definition:

fun·gi·ble [fuhn-juh-buhl]: adjective.
(especially of goods) being of such nature or kind as to be freely exchangeable or replaceable, in whole or in part, for another of like nature or kind.

And here’s the deeper meaning: When you enter the working world, you will almost certainly be fungible. That is, no matter how hard you work, you will remain, at base, replaceable. Disposable.

This is not a cynical-making thing. It’s just a hard fact that it’s important to know as you plan your life and make decisions along the way. You might love your work as much as Jill Abramson loved hers, to the point that you wear your love not just on your sleeve but in a tattoo on your shoulder. But your work may not — cannot — love you back the same way.

The fact of her presence before a gigantic crowd said — indeed, shouted — ‘I am not ashamed. I soldier on.’

I use “work” here as a collective noun, and your working-world fate will likely rest in collective hands, just as Jill Abramson’s firing stemmed from rejection not only by the publisher but by the “masthead” — the newspaper equivalent of nobility. You’ll never know all the structural constraints and financial challenges and personal machinations that could converge into a pink slip for you. You just need to know, deep down, that it’s possible.

What to do with that knowledge?

First, you need to watch for the signs. Is your industry in trouble? Is your company hemorrhaging cash or known as a brutal shucker of staff? Have you noticed that you have no higher-level manager who seems invested in you, who has your back?

Second, live your life accordingly. There are some people for whom you are not fungible. Your parents. Your partner, if you’re lucky. Most of all, your children, if and when you have them. “The currency of love is time,” they say. Work can suck you in and make you forget that. But there are unpaid tasks that only you can perform. Continue reading