You probably know one. Or maybe you are one: a telecommuter, a work-at-home employee or a virtual commuter. Amazingly, in just over a decade, the number of U.S. employees working from home-based offices ‘at least half the time’ has reached 3.9 million, or nearly three percent of the American workforce.

These statistics are part of the results released this past summer in The 2017 State of Telecommuting in the U.S. Employee Workforce Report—a project undertaken by Global Workplace Analytics and FlexJobs. To compile their report on the decade 2005-2015, the companies partnered to collect and analyze data from both the U.S. Census Bureau and the U.S. Bureau of Labor Statistics.

Results indicate a 50-50 male-female split with the average remote worker over 45 years old, with “at least a bachelor’s degree, [earning] a higher median salary than an in-office worker”. According to the 2017 report, most telecommuters “average yearly income is $4,000 more than non-commuters”.

And what’s more, working in the category of ‘management professional’ is now the most popular stay-at-home position.

Although Canada has been slower to embrace the idea of virtual commuting, its numbers are also on the rise. On the website CanadiansInternet.com/Business, writer Melody McKinnon wrote about the most recent statistics from The 2013 Arcus Human Capital Survey. According to survey results, she explained that, “18 percent of employed Canadians say they telecommute to one degree or another”.

McKinnon also quoted Steve Murphy, senior vice-president of commercial banking for the Bank of Montreal, who focused on the positives of teleworking. “These flexible work arrangements help employees achieve greater work-life balance, improve workplace productivity and strengthen employee morale.”

But regardless of the impressive statistics and positive line graphs indicating an increase in the stay-at-home employee numbers, the stereotypical disregard for this kind of work--and the resulting stress on home-workers--is not yet decreasing at an equivalent inverse rate.

While improved technology makes working at home easier, allowing for a greater work-life balance, a recent joint study by the United Nations International Labour Organization (ILO) and Eurofund found several downsides to the choice. According to the report released in February, “People teleworking have a tendency to work longer hours, and have higher levels of stress as a result of overlapping paid work and personal life.”

The U.N. report, titled Working anytime, anywhere: The effects on the world of work, also showed a surprising 42 percent of remote workers indicated that they suffered from insomnia, compared to only 29 percent of in-office workers.

Some home-based workers are better able to balance their work-life selves while others the report labels “high-mobile workers”, a group less able to maintain the same balance, result in telecommuters with the potential for increasingly negative physical and mental health results.

The U.N. report recommends employers encourage and recognize the importance of more formal part-time “teleworking so that people working from home can maintain their ties with co-workers and improve their well-being”.

Similarly, in a June 2017 article, CNN reporter Kathryn Vasel quoted Sara Sutton Fell, Chief Executive Officer of FlexJobs, on this growing class of worker: "There is still this stigma . . . that telecommuting is just a work-from-home mom thing or for lower level jobs or not as dedicated workers".

Vasel added that findings from the 2017 State of Telecommuting report help disprove the stigma. According to the report, “Professional, scientific and technical services industries have the highest percentage of telecommuters relative to their share of the workforce.”

CEO Sutton Fell was also quick to denounce the archaic view, adding, "[Working at home] is a very professional and viable option and it's not going anywhere."

Positive statistics indeed, but trying to manage the stress, insomnia, and telecommuting im-balance these surveys have identified presents a real challenge. In an effort to address these challenges, Linda Wasmer Andrews provided a top 10 list of solutions to manage work-at-home stress in an article for PsychologyToday.com. Andrews prefaced her list with a poke at telecommuter hopefuls, writing, “Working from home sounds so laid-back and stress-free. Then you try it.”

To reduce stress and improve work-life balance, Andrews says it is important to:

• Establish boundaries and claim territory—set firm times and locations within the house when you cannot be disturbed by family or friends. Use allotted office space and equipment for work only.

• Meet and manage deadlines—make to-do lists and rank items from most urgent to least; break down large projects into manageable chunks; avoid procrastinating by diving into the work; find a babysitter, if necessary.

• Meet with colleagues—avoid social isolation and loneliness by keeping up with work interactions; join networking groups.

• Count your blessings—there are so many positives to the work-at-home opportunity. And remember that home-based does not mean super human. If you need help--professional help for stress/anxiety, assistance from colleagues, or help from family to get chores done—ask for it.

• Go “home” after work. While it is tempting to keep working on a project long past a reasonable time, working at home means when you close the door or walk away from the “office”, you leave it alone until the next day. And sleep.

References

Andrews, L.W., (November 5, 2011). Psychology Today. 10 Solutions for Work-at-Home Stress. https://www.psychologytoday.com/blog/minding-the-body/201111/10-solutions-work-home-stress

Global Workplace Analytics & FlexJobs. (Retrieved November 13, 2017). The 2017 State of Telecommuting in the U.S. Employee Workforce Report.https://www.flexjobs.com/2017-State-of-Telecommuting-US/

McKinnon, M., (April 12, 2017). Remote Hiring, Virtual Employment and Telecommuting in Canada.http://canadiansinternet.com/mobile-virtual-commuting-telecommuting-increasing-in-canada/

UN News Centre. (February 15, 2017). Teleworking may seem easier, but it could disrupt your work-life balance—UN reports. http://www.un.org/apps/news/story.asp?NewsID=56176#.WgvoIsYZNp8

Vasel, K., (June 21, 2017). CNN. Working from home is really having a moment. http://money.cnn.com/2017/06/21/pf/jobs/working-from-home/index.html

If your eyes are burning and you have lost all track of time, unless cramming for exams, you probably just finished streaming and binge-watching the latest new or returning television series.

No longer is it necessary to record one episode of a TV program you may miss on a given night—to catch up at a later date. With myriad TV streaming services (also known as major streaming video platforms), one needs only to subscribe to a service and then prepare the couch for a lengthy viewing session of one, two, or all episodes of the newest season of a favorite program.

Not since the introduction of the television into North American living rooms (in 1948 in the U.S., and in Canada in 1952), have people been more consumed by the tube. With countless streaming services like Amazon, CraveTV, FandangoNOW, Google Play, Hulu, Microsoft, Netflix, PlayStation Video, and Vudu—the dizzying prices and offerings are a menu for study.

Depending on your viewing preferences and on the amount of viewing you do, pay-per-view or monthly subscription rates can range from the rare find--free of charge--to $35.00 USD per month and everywhere in between.

In her September 2017 article for Business Insider, Caroline Cakebread explained that binge-watching involves devoting many hours—or days—to watching multiple episodes of a TV program at once. Thanks to the availability of these streaming services, statistics show “58 percent of Americans have engaged in binge-watching, and of that number 72 percent say it’s how they normally consume TV shows”.

In a recent survey conducted by theguardian.com, most respondents defined binge-watching "as two to five hours of consecutive viewing in one day". Earlier, in a 2014 Psychology Today article, Jonathan Fader, Ph.D., said binge-watching “is commonly defined as watching 2-6 episodes of a TV show in a single sitting”.

So why are people binge-watching and what effect is it having on the viewer? Cakebread’s article explains the why saying that prior to online streaming, viewers did not have the option to “watch multiple episodes at once until after a TV season was available to buy or rent in stores”. But binge-watching allows the audience to consume the full story in one sitting, without waiting a week or more for the next episode to air.

The effects of binge-watching are perhaps less obvious than the reasons why people do it. But, researchers are beginning to understand the real impact this pattern of watching programs is having on viewers’ mental health.

Writing for nbcnews.com in early November, Danielle Page stated the obvious: if viewers did not enjoy binge-watching, they would not be doing it in such large numbers. In a recent Netflix survey, Page continued, 73 percent indicated they associated “positive feelings” with binge-watching.

“But,” Page countered, “if you spent last weekend watching season two of 'Stranger Things' in its entirety, you may have found yourself feeling exhausted by the end of it—and downright depressed that you're out of episodes to watch.”

Page refers to an explanation by clinical psychologist, Dr. Renee Carr, Psy.D., of the chemical reactions in the brain causing the highs and lows of binge-watching. According to Carr, writes Page, “when binge-watching your favorite show, your brain is continually producing dopamine [a chemical providing the body an internal feeling of pleasure], and your body experiences a drug-like high. You experience a pseudo-addiction to the show because you develop cravings for dopamine."

The brain does not differentiate between whether the dopamine is the result of a drug like heroin, or the sixth in a ten-episode binge-watched series. The brain—and body--only knows it craves the all-over good feeling. Like a heroin addict looking for the next high, the ‘hooked’ viewer feels the need to keep watching.

Page also includes the interpretation of Chicago clinical psychologist, Dr. John Mayer, Ph.D., who believes “the act of binge-watching offers us a temporary escape from our day-to-day grind, which can act as a helpful stress management tool”. Mayer equates this way of watching programs to “. . . a steel door that blocks our brains from thinking about those constant stressors that force themselves into our thoughts”.

But what happens to that same viewer’s brain when the ten-episode series is over? According to Mayer, viewers tend to feel a sense of loss and can actually go through a sad period of time, much like a mourning process. “We call this situational depression because it is stimulated by an identifiable, tangible event,” he explained.

If binge-watching causes highs and lows similar to a drug addiction, as well as depression—what is the solution? In Jonathan Fader’s Psychology Today article, he suggests asking yourself a few questions to determine whether there is a need to change viewing habits—for the sake of your mental health. His questions include:

1. Has your TV binging caused you any significant impairment or distress?
2. Has it made you late for work?
3. Caused you to lose sleep?
4. Caused arguments?
5. Is there time to discuss the show with your loved ones?
6. How frequently do you eat while you watch?

Overall, Fader encourages moderation as the key. Binge-watching every now and then is probably just fine as long as it does not become a detriment to one’s daily activities and overall well-being. And with that, perhaps there will indeed be time for one more episode.

References

Cakebread, C., (September 15, 2017). Business Insider. Here are all the reasons why Americans say they binge-watch TV shows. http://www.businessinsider.com/reasons-why-americans-binge-watch-tv-shows-chart-2017-9

Fader, J., Ph.D., (February 16, 2014). Psychology Today. Binge TV: Is Our New Way of Watching (Breaking) Bad? https://www.psychologytoday.com/blog/the-new-you/201402/binge-tv-is-our-new-way-watching-breaking-bad

Karmakar, M., & Sloan Kruger, J., (March 4, 2016). The Guardian. Is binge-watching bad for your mental health? https://www.theguardian.com/commentisfree/2016/mar/04/binge-watching-mental-health-effects-research

Littleton, C., (August 9, 2017). Variety. Peak TV: The Count of Scripted Series in 2017 So Far. http://variety.com/2017/tv/news/peak-tv-scripted-series-count-2017-1202521118/

Page., D., (November 4, 2017). NBC News. What Happens to Your Brain When You Binge-Watch a TV Series. https://www.nbcnews.com/better/health/what-happens-your-brain-when-you-binge-watch-tv-series-ncna816991

Seymour, G., (January 4, 2016). CNN. Is this draining your life of meaning? http://www.cnn.com/2016/01/04/opinions/seymour-binge-watch-tv/index.html

The holiday season, the jolliest time of the year. Or, is it? There is no doubt that the holiday season brings a significant amount of joy into our lives. However, the holiday season can also have another, much darker, side.

The holiday season is a busy time of the year. There is so much to do, attend, and plan. Therefore, it is not unusual to start to feel stressed, overwhelmed, anxious and/or depressed. Conversely, this is also a time of the year when many of us may become more aware of the void left by the loss we experienced, and our own personal loneliness. Therefore, in a way, the holiday season can act as a trigger to significant mental health struggles and, consequently, it can bring our mental wellness into serious question.

Tips & Tricks

So, if we are already aware of the struggles we might experience, what is the best way to approach them? Well, it seems that the key is in being prepared. And how to become prepared? Well, in order to prepare ourselves for a wide variety of experiences, it would be useful to review some of the most common strategies that people use in order to ensure that the holiday season is indeed the jolliest time of the year.

Budgeting Appropriately

During the holiday season, there are so many things we have to prepare for or do. For example, many of us will spend a significant amount of money on gifts and, consequently, experience significant financial distress. And, how can we avoid this distress? Well, the best we can do is sit down and think about our budget for this holiday season. By being prepared for the financial stress we might experience, and by being engaged in appropriate planning, we can avoid many negative effects of excessive spending. In addition, for some of us who already struggle financially, creative and meaningful gifts that don’t have a price tag can be a way to go. Alternatively, we can also talk with family and friends about a gift price limit to prevent the pressure of buying an expensive gift.

Maintaining Healthy Contact with Family

It seems that during the holiday season everything revolves around family values. However, for many of us, the biggest source of holiday negativity is our family - the family dinners, the obligations, and the burden of family traditions. In addition, it is not unusual that not everyone in the family gets along and oftentimes conflict may start even during the holiday family gatherings. Therefore, it is important to be realistic about what we can do with our family and set firm boundaries with our family members. Oftentimes, it is helpful to limit the duration of the family gathering. For example, rather than staying the whole day with our family it is perfectly fine to stay with them only for few hours and then dedicate the rest of our time to ourselves.

Avoiding Overindulgence

During the winter, our activity level is low. However, we are exposed to large quantities of tasty food and drinks. Overindulging in food in drinks can result in weight gain, as well as have serious long-term consequences on our health. Therefore, it is very important to be gentle with ourselves and limit our food and drink consumption to a healthy level, as well as find opportunities to be active.

Delegating Responsibilities

When it comes to taking on different holiday responsibilities, it is very important to have realistic expectations. Being over-committed and having unrealistic expectations will only attribute to feelings of anxiety and stress. Therefore, it is very important to take on only the responsibilities we are able to handle and delegate the other responsibilities. Also, a good idea is to prioritize certain responsibilities and, if needed, make a priority list. Knowing that the most important responsibilities have been completed will alleviate any anxiety and stress we could experience if we find ourselves not having enough time to complete everything we planned.

Addressing Loneliness and Isolation Appropriately

It is very difficult to be alone during the holiday season, given that everything around us points to the importance of closeness with family and friends. However, some of us will be alone during this holiday season. In order to address are loneliness and isolation, we can choose to engage in many activities offered through the holiday season. During the holiday season, there are many free activities that we can join, as well as volunteer positions where we can socialize with others and experience the holiday spirit. This can bring us closer to other people and alleviate the feelings of loneliness and isolations we might be experiencing. It is important to give others an opportunity to engage with us, and the best way to do that is to go out from our room and experience the holiday spirit on our own skin.

Overcoming the Feelings of Loss

The holiday season can often remind us of a loss we experienced. A significant someone who we used to spend the holiday season with, who is not with us anymore. The first step in overcoming these difficult feelings is the acknowledgment that nothing will be same without that person. However, it is also important to acknowledge that now we have an opportunity to create new traditions that will help keep the memory of the people we lost alive. Sometimes, that means having a decoration that will remind us on that person or even making a special tradition that will help us remember the person.

Being Aware of Seasonal Effects

The effects of seasonal changes on our mental health can be profound. Many changes accompany the shifting seasons: the length of daylight; the intensity of the sunlight; our diet; our routine; how and where we spend our time. And all these changes may have an effect on our well-being. As late fall turns to winter, it's common for people to feel tired, unmotivated, and depleted. Anxiety can increase, too, because these changes can create a vague, unsettled feeling. Also, symptoms of depression can begin or increase. It is important to be aware of these effects, in order to be able to address them appropriately. At times, only being aware of the effects will help us feel better. However, for some of us, that will not be enough and we will need to seek help from a mental health professional.

Reaching Out

It is not shameful to admit that we need help. We are all social beings and at times we will need social support in order to overcome certain struggles. Therefore, it is important to be comfortable to reach out to someone who can help. At times that might be a close family member or a close friend, and at times that might be a doctor or mental health professional.
In summary, there are many things we can do in order to make sure that we will enjoy this holiday season. Essential ingredients that can help us reach this goal are awareness and preparedness, as well as the ability to recognize when we need support.

Black Friday--the beginning of the holiday shopping season has officially begun! But do you anticipate the day of spending with excitement and elation or dread and trepidation? Some people are buoyed by the lineups, the bargains, the noise, and the crowds! Others are repelled by the same crowds and noise; by the stress, the indecision, and the regret.

For people struggling year-round with challenges to their mental health, the highs and lows of Black Friday can be detrimental--triggering panic attacks, anxiety and depression.

In a New York Times article published this week, writer Hilary Stout explained the history of the much-anticipated event. According to Vocabulary.com executive producer Ben Zimmer, the use of the term ‘Black Friday’ can be traced back to the 1960s where it was first used in Philadelphia to represent the day of shopping immediately following U.S. Thanksgiving. Based on Zimmer’s research, Stout wrote that, back in the ‘60s, the reference was a surprisingly negative one.

“The local police took to calling the day Black Friday because they had to deal with bad traffic and other miseries connected to the throngs of shoppers heading for the stores,” Stout explained.

It was years later that a more positive association adhered to the labeled day—as one where retailers began to turn a profit and stay in the ‘black’ instead of the ‘red’.

This holy grail of annual days became so popular in the psyche of shoppers and retailers worldwide that Black Friday has, in recent years, been adopted by Canada, England, Ireland, and parts of South Africa.

For those who prime themselves all year for the physical and emotional rally that is Black Friday, the event is akin to the Olympics, requiring preparation and a desire to win—to nab the all-important, half-priced item scouted in the sales advertisements filling newspapers and television commercials weeks earlier.

Summer Beretsky, in her article for PsychCentral.com, described the dichotomy between the kinds of shoppers who view the event as a challenge compared to the people who view it as a challenge to their mental health.

“Die-hard consumers line up well before stores open. They camp out in tents. They chug coffee to get pumped up,” Beretsky wrote. “They stand in line, store circulars at the ready, and prepare to sprint toward their loot when the doors open.”

Beretsky contrasts those competitors to her own group: the anxious, panicky people. “The kind of people who have to fight our hardest on a normal day at the store . . . to ward off the fight-or-flight sensation. And to calm our breathing. And to slow our heart rate down.”

Watching televised news reports of shoppers pepper spraying fellow shoppers when fighting over reduced price merchandise and seeing footage of others “pushing, shoving, grabbing, crowding, yelling, throwing, rushing, and screaming”, over something as trivial as towels, helps Beretsky feel better about avoiding the Black Friday scene altogether. 

In addition, thanks to the principle of contrast, Beretsky wrote, these videos are helpful to her mental wellness and, she hopes, perhaps helpful to others with similar anxieties and agoraphobia. “[They] make a standard day of non-Black Friday shopping seem like a cakewalk,” she wrote. “Acknowledging the worst-case shopping scenarios puts a normal, everyday trip to a supercenter like Walmart or Target into a better light.”

Beretsky reasons that by visualizing a “worst-case scenario” (here an outrageous shopping event)—where the anxiety sufferer cannot manage to participate, one can then bring a more realistic perspective to an everyday shopping trip. As such, the anxious shopper may be able to face the calmer store experience, knowing it will be more manageable than the outlandish Black Friday scenes shown in the newscasts.

For those who , unlike Beretsky, want to give Black Friday shopping a try, Jacquelyn Hart of Fox News this week published a list of self-care tips to use before and during the event. Her suggestions include: 

1. Choose store locations carefully—It may be less stressful to visit a store or mall in a more remote area, where parking is easier and crowds are smaller.

2. Visit the store ahead of time—Rather than waiting until Black Friday to visit a store for the very first time, Hart suggests checking it out a week ahead to acclimatize to its setup.

3. Know a store’s hours—Double check a store’s holiday hours before you plan to go. Think about shopping during less busy hours--close to closing time or at the dinner hour.

4. Go shopping with someone—If you know you are nervous in crowds, take a friend or family member with you. They can act as a distraction and help monitor your anxiety. 

5. Plan ahead--Be well rested. Eat before you go to the mall. Carry water to keep you hydrated.

6. If the store and crowd is too overwhelming, do not force yourself to stay.

7. Respect your overall wellness.

References

Beretsky, S., (November 27, 2011). PsychCentral.com. Black Friday, Anxiety, and the Contrast Principle. https://blogs.psychcentral.com/panic/2011/11/black-friday-anxiety-and-the-contrast-principle/

Hart, J., (Retrieved November 22, 2017). Fox News. 7 Black Friday survival tips for a successful shopping spree. http://www.foxnews.com/lifestyle/2017/11/23/7-black-friday-survival-tips-for-successful-shopping-spree.html

Stout, H., (November 23, 2017). New York Times. Why is ‘Black Friday’ Called ‘Black Friday’? https://www.nytimes.com/2017/11/23/business/black-friday-meaning-definition.html

The good news, familiar by now, is that people are living longer. We also know the world’s population is aging. With the maturing of North America’s largest demographic group, thebaby boomers (people born between 1946-1964), the U.S. and Canada anticipate nearly one-quarter of their citizens will be over 65 as early as 2031. For the adult children of aging parents, this statistic can seem daunting.

In Paola Scommegna’s February 2016 report, Today’s Research on Aging: Family Caregiving for the Population Reference Bureau, she summarizes current U.S. aging statistics, housing trends and their effect on family caregivers. “In the United States, the vast majority of care that allows older people to live in their own homes is provided by family members who do not receive pay for their services,” she writes.

In addition, as parents live longer, “with chronic disabling conditions, particularly dementia,” and government policies move to “deemphasize nursing home care” in support of community living, the pressure felt by the sandwich generation (those simultaneously caring for aging parents/parents-in-law and their own children) has never been greater. As a result, “meeting the care needs of older Americans will become more challenging for families,” Scommegna explains.

Although a growing number of options exist as living choices for aging parents, they can be divided into four very general categories:

• those who continue to live independently in their private residence (house, apartment, condominium);
• those who move in with one of their adult children;
• those who live in senior housing—also known as assisted living--where a variety of levels of service and assistance are offered;
• and those who are placed in long-term care facilities.

Scommegna notes that providing “uncompensated care for a spouse or parent living with physical limitations can be both rewarding and . . . harmful to the care provider’s well-being”. Nevertheless, the choice to move an aging parent into a long-term care facility is not an easy one.

Based on the Canadian Coalition for Seniors’ Mental Health (CCSMH) guide, Mental Health Issues in Long-Term Care Homes, when an older adult can no longer accomplish daily living “tasks like bathing, getting dressed, going to the bathroom, and eating. . . independently, this can lead to [the] decision.”

Understandably, the actual move into a long-term care facility and the ongoing experience there can take both a physical and mental toll on the elderly parent. Researchers are also starting to pay more attention to the effects of the relocation experience on the child/ren or spouse who had previously provided care.

The Family Caregiver Alliance’s 2016 publication, Depression and Caregiving, reports that although “many caregivers are finally able to catch up on much-needed rest, the loneliness, guilt, and monitoring the care a loved one receives in this new location can add new stress”. Furthermore, for some caregivers, the depression felt “at the time of placement” may persist long enough to require their own professional mental health assistance.

For the residents, thanks to increased respect for and recognition of mental illnesses and treatments, researchers are beginning to document the mental health challenges of elderly people before, during and after moving to senior care facilities.

CCSMH’s guide on mental health issues in care homes underlines the fact that mental illnesses do not go hand-in-hand with old age: "Many people think that mental health problems are just a normal consequence of aging. This simply isn’t true. They are usually signs that something is wrong that requires attention from a healthcare professional.”

Moreover, the guide sheds a positive light on the knowledge that mental health “. . . problems can be treated. . . Some problems associated with aging cannot be cured yet, but there is still a lot that can be done.”

A 2011 study by the University of Adelaide’s Joanna Briggs Institute in South Australia--The experiences of older adults from moving into residential long-term care—examined existing research into the effects of these care facilities from data collected as far back as 1945. The study found evidence of “a variety of negative consequences associated with relocation including depression, increased sense of loneliness and alienation, decrease in functional competence, cognitive decline, decline in general condition . . .”

On a positive note, however, Adelaide’s researchers reported that negative statistics were countered by evidence of good experiences in long-term facilities, including “. . . positive outcomes such as improved emotional well-being, enhanced environmental awareness, increased activity participation and greater social engagement”.

Education and professional development opportunities for professionals in the field of mental health are also on the rise, supporting the need to ensure the mental health of long-term care residents. The American Psychological Association, which sponsors continuing education for its psychologists, recently supported a course taught by William Matteson, Ph.D., called Aging, Mental Health and Long-term Care.

The mission of the course, Matteson wrote, is to recognize that “currently the quality and availability of mental health care [in long-term facilities] leave much to be desired”. In order to improve, Matteson puts the onus on the professionals: “. . . there must be a fundamental reworking of the delivery of services, and this includes the establishment of high-quality mental health care – delivered by you.”

In order to promote the mental health and overall well-being of seniors in care, CCSMH’s guide suggests staff of every long-term care facility participate in ongoing training to ensure residents receive personalized care; think of families as “partners in care”; focus on a resident’s strengths; and, inherent to mental health, staff must consider the physical, social and spiritual health of its seniors.

References

Canadian Coalition for Seniors’ Mental Health. (2009). Mental Health Issues in Long-Term Care Homes. http://ccsmh.ca/wp-content/uploads/2016/03/ccsmh_long_termBooklet.pdf

MacLeod, B., LCSW, Reviewer., (Retrieved November 29, 2017). Family Caregiver Alliance. Depression and Caregiving. https://www.caregiver.org/depression-and-caregiving

Matteson, W., Ph.D., (Retrieved November 29, 2017). ContinuingEdCourses.Net. http://www.continuingedcourses.net/active/courses/course071.php

Richards, S., (May 2011). The Joanna Briggs Institute, University of Adelaide. The experiences of older adults from moving into residential long term care. http://journals.lww.com/jbisrir/Fulltext/2011/09161/_The_experiences_of_older_adults_from_moving_into.20.aspx

Scommegna, P., (February 2016). Population Reference Bureau. Today’s Research on Aging: Family Caregiving. http://www.prb.org/Publications/Reports/2016/todays-research-aging-caregiving.aspx

True or false: babies and toddlers can suffer from mental health illnesses.

If you answered false, you are not alone. But you are incorrect.

In fact, at the turn of this new century, parents, professionals and medical specialists had not yet fully investigated the concept, nor faced the reality, that infants and toddlers (those from birth to age 5 or 6) could indeed experience psychological disorders.

And given the recent concentration on improving support for teens and youth facing psychological issues, it may be hard to believe that the study of these same challenges in babies and toddlers is still in its infancy—less than a couple of decades old.

Nevertheless, the need exists for mental health diagnoses and treatments for infants and young children. Yet for parents who suspect their child may have a mental health challenge, the path toward help is anything but smooth.

In 2011, the American Psychological Association (APA) published an analysis by researchers Joy D. Osofsky, PhD, and Alicia F. Lieberman, PhD, of the existing conditions for infant and toddler mental health care. According to the APA’s summary of their work, “the articles explore how infants develop mental health problems, recommend improvements in diagnostic criteria, and outline public policy opportunities for psychologists and policy makers”.

In their report, Osofsky and Lieberman identify the biggest hurdle in mental health care for such young patients as “the pervasive, but mistaken, impression that young children do not develop mental health problems and . . . ‘grow out of’ behavioral problems and emotional difficulties”.

On the contrary, write the analysts, young children can suffer serious psychological disorders, but they are still “unlikely to receive treatment that could prevent lasting developmental problems”.

According to a 2011 APA article by Florence Nelson and Tammy Mann, “mental health intervention” has long been identified by treatments that attempt to lower the impacts of someone’s psychological challenges on their daily life. More recently, however, mental health specialists recognize “that infants and toddlers can suffer from significant mental health disorders and that these difficulties can have a lasting impact on their development”.

Historically, the opportunity for infants and young children to receive early intervention “before serious problems are entrenched” has been stymied by two unfortunate reactions, write Nelson and Mann. Firstly, mental health professionals and pediatricians have long practiced the “wait and see attitude toward behaviors and symptoms of concern in very young children”. Secondly parents may not know how to recognize or interpret “warning signs” in their child’s behavior or they may choose to ignore their own instincts, and not obtain testing and diagnosis “because of the stigma associated with acknowledging that their child has a mental health problem”.

In British Columbia, Canada, Sue Potma’s son is older than the baby to young child/toddler age range considered for very early intervention discussions, but she and nine-year-old Josh openly admit he is struggling with mental illness. In BC’s Vancouver Sun newspaper, last week, reporter Lori Culbert explained Josh’s complicated diagnoses. His challenges include “severe attention deficit hyperactivity disorder (ADHD), Tourette syndrome, generalized anxiety disorder, and bipolar disorder (mood swings from extremely low to extremely high)”.

Josh’s difficult, multiple mental health issues have resulted in school suspensions, problems with other children and classmates, and his removal from sports teams and camps. Sue Potma is calling for child and teen mental illnesses to be taken more seriously, explaining that the services he currently receives “allow Josh to survive, but not thrive”.

BC Children’s Representative Bernard Richard recently released a report called Missing Pieces, addressing the need to improve support for children with mental illnesses. In Culbert’s newspaper article, she quotes Richard's appeal: “This is a growing issue. More and more kids suffer from mental illness earlier,” he said. “The system needs an overhaul. It’s time to get on with it.”

Details in Nelson’s and Mann’s APA-published article underscore Richard’s recognition of the limitation of mental health support for such young children, explaining that “the infant years” are not considered a priority. “The field of early childhood mental health has a limited number of training programs and qualified practitioners,” they write, “making it difficult for parents and child-serving programs to access experienced professionals when they believe such help is needed.”

When a program or professional is eventually available or located, prohibitive treatment costs in conjunction with limited insurance coverage make accessibility difficult.

Almost 20 years after the move to recognize mental health issues in infants and young children (under age 5/6), Canada and the U.S. are slowly seeing some positive changes. Nelson and Mann report on Head Start/Early Head Start, a program first established in the U.S. in 1965. They describe its current mandate as a “broad-based federally funded effort that requires early childhood programs to engage the services of mental health professionals”.

In Culbert’s Vancouver Sun article, she notes that after BC’s summer 2017 provincial elections, “it created a new ministry for mental health and addictions . . . to respond to . . . calls for government to create a comprehensive system of mental health services for youth over the next year, and to implement it the following year”.

References

American Psychological Association. (February 22, 2011). Babies and Toddlers Can Suffer Mental Illness, Seldom Get Treatment. http://www.apa.org/news/press/releases/2011/02/babies-mental-illness.aspx

Culbert, L., (December 1, 2017). Vancouver Sun. Not enough services for mentally ill kids, says family of struggling boy. http://vancouversun.com/health/local-health/family-of-mentally-ill-9-year-old-boy-say-they-need-more-support-to-try-to-keep-son-healthy-calm

Denney, M. (Retrieved December 1, 2017). Everydayfamily.com. Mental Illness in Toddlers and Early Childhood. https://www.everydayfamily.com/mental-illness-in-toddlers-and-early-childhood/

Nelson, F., & Mann, T., American Psychologist. Opportunities in Public Policy to Support Infant and Early Childhood Mental Health (Feb.-Mar., 2011).http://www.apa.org/pubs/journals/releases/amp-66-2-129.pdf

Von Klitzing, K., (May 25, 2015). U.S. National Library of Medicine National Institutes of Health. Mental Disorders in Early Childhood. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496484/

Zero to Three. (Retrieved December 1, 2017). Our Mission and Vision. https://www.zerotothree.org/about/our-mission-and-vision

Eco-therapy is the practice of using nature-centric activities to cope with mental or physical illness. It is typically combined with other therapies and/or exercises. The concept that spending time in nature can be therapeutic is not new, but is gaining greater traction in contemporary scientific research and medical treatment.

“We work with the doctors, nurses and health care providers around the country and show them why it’s so relevant to prescribe [spending time in] parks and how easy it is to do, so that they can make it a part of their daily routine,” said Dr. Robert Zarr, medical director of the nonprofit Park RX America, which connects health care providers with public land managers in order to make eco-therapy readily available to patients and clients.

Lauren Huddle is a 31-year-old in Washington who suffers from anxiety and depression. Her doctor wrote her a prescription that read, “Five times a week, spend 30 minutes at a park near your home,” according to NBC. After three weeks, she says, "Just going out there, little bit by little bit, I noticed my temperament was better and my anxiety started to greatly decrease.”

Patients who are prescribed eco-therapy are often encouraged to focus on their senses in order to experience the forest around them. The sounds of the birds, wind and water, if present, the visual appearance of the trees and plants, and other sensations such as the sun or shade can all become part of the patients’ experience and treatment.

Dr. Nooshin Razani is a pediatrician and nature researcher with UCSF Benioff Children's Hospital Oakland who is another proponent of eco-therapy. "Studies have shown that within 15 minutes of being in nature, your stress level goes down [and] your heart rate [and] blood pressure improve," she says. Reduced stress levels can often help people to go about their daily lives and achieve their goals more successfully.

Research has indeed backed up the positive influence nature can have on mental health and functioning. For example, in 2009, University of Michigan researchers found that a brief walk through an arboretum resulted in a 20 percent performance improvement on memory and attention tests.

In 2011, researchers at the University of Essex monitored individuals with severe mental health difficulties who participated in a six-month walking and outdoor-based therapy program called Discovery Quest. They found that 88 percent of participants saw improved self-esteem and 89 percent experienced “a positive change in their mental well-being.” Paul Lefever, project manager of Discovery Quest, says that while wilderness activities may not suit everyone, they should perhaps be used more widely to support mental wellness.

The great outdoors can boost creativity as well, which can in turn also benefit mental health for some. In 2012, a study by scientists from the Universities of Kansas and Utah focused on 56 hikers taking a four-day hike without any technology. Based on the results of a creativity test and evaluation taken before and after the experience, the researchers found that the nature-immersion boosted the hikers' creativity by 50 percent.

In Japan, Forest Bathing (shinrin-yoku, or "immersing in the forest atmosphere”) is a tradition that encourages people to spend unstructured, unrushed time outdoors. The Japanese government has managed forests specifically to encourage this behavior since the 80s in an attempt to support its citizens’ relaxation and health. This practice has been gaining more popularity worldwide including in North America.

In 2016, a study from the Center for Environment, Health and Field Sciences at Chiba University and the Forestry and Forest Products Research Institute in Japan examined the “Physiological Effects of Nature Therapy.” The conclusion states that they found proof of “the physiological relaxation effects of nature therapy on activities of the central nervous system, autonomic nervous system, endocrine system and immune system … “

Julia Plevin founded the Forest Bathing Club in San Francisco in 2014 after suffering from anxiety during grad school in New York. She told CNN that spending time in a forest provides "a remembering for our whole being that we are nature and we're not separate from it.” She also focused a portion of her thesis on the effects of being separated from a natural environment.

Daniel Sherman is a 28-year-old public relations executive who participates in the San Francisco club. "I spend a lot of time at my desk and not a lot of time in nature. We never stop to look at the leaves and feel the trees.” Sherman is not alone – an Environmental Protection Agency survey found that Americans spend an average of 93 percent of their time inside each week.

The researchers from Japan mentioned above point out in their abstract that out of the 6 to 7 million years of human evolution, urbanization has accounted for only about 0.01 percent of our existence. Therefore, “Humans have spent over 99.99 percent of their time living in the natural environment.” With this in mind, perhaps it is no surprise that periods of reintegration into nature might help us feel calmer.

“We’re starting to see nature and parks not just as a place to recreate, but literally as a place to heal yourself," Zarr says.

References:

Atchley, Ruth Ann, et al. “Creativity in the Wild: Improving Creative Reasoning through Immersion in Natural Settings.” PLOS ONE, Public Library of Science, journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0051474.

Charles, Shamard. “A Dose of Nature: Doctors Prescribe a Day in the Park for Anxiety.”NBCNews.com, NBCUniversal News Group, 25 Nov. 2017, www.nbcnews.com/health/health-news/dose-nature-doctors-prescribe-day-park-anxiety-n823421.

Chillag, Amy. “Why You Should Be Forest Bathing.” CNN, Cable News Network, 11 Aug. 2017, www.cnn.com/2017/08/10/health/forest-bathing/index.html.

Song, Chorong, et al. “Physiological Effects of Nature Therapy: A Review of the Research in Japan.” MDPI, Multidisciplinary Digital Publishing Institute, 3 Aug. 2016, www.mdpi.com/1660-4601/13/8/781.

“The National Human Activity Pattern Survey (NHAPS): A Resource for Assessing Exposure to Environmental Pollutants.” The National Human Activity Pattern Survey (NHAPS): A Resource for Assessing Exposure to Environmental Pollutants | Indoor Environment Group, indoor.lbl.gov/publications/national-human-activity-pattern.

Walk on the Wild Side to Help Mental Health - News - University of Essex, www1.essex.ac.uk/news/event.aspx?e_id=2959.

The newest generation of adults is also the most anxiety-ridden. They are the Millennials. Depending on which definition one uses, they are members of the group roughly between the ages of 18-33.

Also known as Generation Y, this collective group of young adults has been the subject of a surprisingly large amount of mental health research and data collection in both the U.S. and Canada. And the research continues.

Results of testing and surveys on both sides of the border have been congruous: not only are Millennials the largest generational group to suffer from stress and anxiety, but they make up the highest percentage of adults at risk for mental illness.

As part of its analysis of the outcomes of its Stress in America survey, the American Psychological Association (APA) recently wrote: “findings show that our ability to manage stress and achieve healthy lifestyles varies by age. Younger Americans report experiencing the most stress and the least relief--they report higher stress levels than older generations and say they are not managing it well.”

The APA defines the four generations for which data was collected as: “Millennials (18- to 33-year-olds), Gen Xers (34- to 47-year-olds), Boomers (48- to 66-year-olds) and Matures (67 years and older)”. 

Like the U.S., Canada’s statistics based on generational categories show the same mental health vulnerability of Millennials. Canada’s Global News reported that pollster Ipsos, in its spring 2017 commentary on its third annual Mental Health Risk Index, indicated “[a] staggering 63 percent of Canadian millennials are at “high risk” for mental health issues.”

Originally founded as the Angus Reid Group in 1979, Ipsos is Canada’s largest market research and public opinion polling firm. Jennifer McLeod Macey, vice president of the Ipsos Health Research Institute told Global News writer Carmen Chai, “We saw that a proportion of Canadians at high risk increased overall but really there’s this chunk of millennials feeling the weight on their shoulders.”

In addition, throughout North America, statistics show that more than 50 percent of Millennials surveyed have been unable to sleep at night due to anxiety, and almost half say they outwardly exhibit anger and irritability as a result of stress.

According to the APA report, “Each generation experiences negative consequences of stress, but Millennials and Gen Xers are most likely to say that they engage in unhealthy behaviors because of stress and experience symptoms of stress.”

So why is this group, painted by society as the carefree, tech-savvy future of tomorrow—so stressed out? 

Research confirms that technology—primarily in the form of social media--indeed plays a big part in the anxiety of the Millennial generation. As the first group to completely grow up under the influences of the likes of Facebook, Snapchat, Instagram, and Twitter—the impact is now becoming clear.

Developing into an adult is anything but simple in the social media influenced world of augmented reality where posted images are first photoshopped to achieve perfection. Feeling the need to advertise only immediate successes, the pressure to appear perfect, happy and prosperous is often in contradiction with Millennial realities as they struggle to become competent young adults.

In her article last week for the National Alliance on Mental Illness, Jenny Marie compared the difference between dealing with her own mental health challenges in her generation and her daughters’ experiences with their mental illnesses as Millennials. “By the time I was in my 20s, I panicked every time I drove or went to the grocery store. I knew my symptoms weren’t normal, but I still said nothing.” Marie wrote. “Stigma and fear kept me quiet.”

Although Marie recognizes the “immense weight” that comes with the “fast-paced, . . . competitive” world of social media her daughters live in, she is grateful for the opportunities it has provided for them to discuss mental illness. “Word is spreading through social media that mental health is an important part of overall well-being,” Marie explained. “. . . I’m not saying stigma is completely gone. But at least it’s not a totally taboo subject like it was when I was growing up.”

Ed Mantler, vice president of programs and priorities at the Mental Health Commission of Canada, echoes Marie and her daughters’ experiences: “We’ve been tackling stigma and forcing awareness on youth, so now we have a population of millennials who are more comfortable than previous generations for speaking up early about mental health issues they’re facing,” he said.

According to Mark Henick, national director of strategic initiatives at the Canadian Mental Health Association (CMHA), another reason for the anxiety and stress challenging the mental health of Millennials, is the difficulty the generation faces when making significant life transitions.

“They tend to spend a longer time at home,” Henick said. “They have different expectations for life and the workplace. It’s a major life transition when you’re redefining what the norm is for your life. Millennials experience that more than any other prior generation.”

As Caroline Beaton wrote in her 2016 Forbes.com article, high post-secondary student debt and struggles to save enough money to live independently in an increasingly expensive world make Millennials’ stress levels soar.

“Sources of millennial anxiety may include a tough job market and student debt as well as . . . ambition addiction, career crises and choice-overload," she wrote.

Nevertheless, with a nod to social media and the reduced stigma surrounding mental illness, Millennials, more than any generation before them, are the most likely to “write or post about their mental health status online or on social media,” said CMHA’s Mark Henick. “While 10 percent of Canadians said they’ve opened up online in the past year when they were experiencing difficulties, it was millennials who led the way at 24 percent – or almost one in four.”

References

American Psychological Association (2012). Stress By Generation. http://www.apa.org/news/press/releases/stress/2012/generations.aspx

Beaton, C., (February 18, 2016). Forbes.com. 8 Habits That Make Millennials Stressed, Anxious And Unproductive. https://www.forbes.com/sites/carolinebeaton/2016/02/18/8-habits-that-make-millennials-stressed-anxious-and-unproductive/#4c96fa971ef1

Chai, C., (May 2, 2017). Global News. Why more Canadian millennials than ever are at ‘high risk’ of mental health issues. https://globalnews.ca/news/3417600/why-more-canadian-millennials-than-ever-are-at-high-risk-of-mental-health-issues/

Ipsos. (April 2017). 3^rd Annual Canadian Mental Health Check-Up. https://www.ipsos.com/sites/default/files/2017-08/IpsosPA_PublicPerspectives_CA_April%202017%20Mental%20Health.pdf

Marie, J., (December 1, 2017). National Alliance on Mental Health. Millennials And Mental Health. https://www.nami.org/Blogs/NAMI-Blog/December-2017/Millennials-and-Mental-Health

Markowicz, K., (March 20, 2016). New York Post. ‘They can’t even’: Why millennials are the ‘anxious generation’ https://nypost.com/2016/03/20/they-cant-even-why-millennials-are-the-anxious-generation/

Do you become anxious when you briefly misplace your smartphone?

Do you feel nervous when circumstances (driving, social rules of engagement, etc.) cause you not to be able to check your smartphone for social media updates and messages?

If you answered yes to these questions, you are not alone.

In her article last week, CNN writer Sandee LaMotte explained: ‘"NO MObile PHOne phoBIA" is a 21st-century term for the fear of not being able to use your cell phone or other smart device.”

Mental health researchers and professionals credit the first mention of the term nomophobia to a 2008 survey on the topic by a research company in the United Kingdom. Since then, however, a variety of studies and evaluations continue to take place worldwide, providing statistics and recommendations to avoid or overcome the condition.

But is nomophobia a true disorder? Opinions about its legitimacy as a mental health malady do not agree. According to John M. Grohol, author, researcher, and founder of PsychCentral.com, discussions of smartphone addictions, as suggested by the term nomophobia, can lead to hyperbole or extreme exaggeration.

Grohol says concern over society’s fixation with technology actually began back in the 1960s when television became mainstream, and in the 1970s with the introduction and excitement over video games.

“Researchers still disagree over whether it’s appropriate to use the term “addiction” to describe behavioral compulsions or problems,” wrote Grohol in 2015. “The DSM-5--the diagnostic manual for mental disorders--still lists only a single behavioral compulsion in this category--compulsive gambling. There is no other ‘behavioral addiction’ that can technically be diagnosed today (not even “smartphone addiction”).”

In May 2014, researchers Nicola Luigi Bragazzi and Giovanni Del Puente tried in vain to propose a case for the inclusion of nomophobia in the DSM-5 prior to its publication. “The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases,” they explained.

“According to the DSM, a specific phobia is an anxiety disorder that represents unreasonable and irrational fear prompted by a specific stimulus (an object or a situation).” Bragazzi and Del Puente attempted to illustrate the correlation between nomophobia—the condition they consider an anxiety disorder--and the fears prompted by the ‘specific stimulus’—in this case, by the smartphone--or inability to find/use it.

Although their efforts were unsuccessful, the two remain optimistic. “Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media [smartphones], and the interest in this topic will increase in the near future.”

Following Bragazzi’s and Del Puente’s rejected 2014 proposal, additional recognition has been given to nomophobia by scientists and analysts who believe it is a disorder that can be diagnosed and treated. In her CNN article, Sandee LaMotte described one such experiment in which a group of researchers from Seoul’s Korea University compared the brain imaging of 19 students “who were diagnosed with internet or smartphone addiction. . . with 19 teenagers who were not addicted”.

The imaging differences, wrote LaMotte, provided visual proof that smartphone addiction can change the human. The Korea University researchers concluded, “the brains of the addicted boys had significantly higher levels of GABA, a neurotransmitter in the cortex that inhibits neurons”. Slower neurons, they explained, result in reduced attention spans and less ability to focus.

In the same CNN article, LaMotte quotes Stanford neuroradiologist Dr. Max Wintermark, who commented on the Korean results. "It's a very small study, so you have to take it with a grain of salt," he said.

From small studies to individual accounts, acknowledgment of the prevalence of nomophobia continues. After experiencing sudden, tremendous anxiety when his smartphone was not in his pants back pocket, Piercarlo Valdesolo, Assistant Professor of Psychology at Claremont McKenna College in California, felt compelled to write. His 2015 article appeared in Scientific American.

Chastising his own reaction to the missing cell phone, Valdesolo wrote, “My dependence on devices reached an embarrassing low . . . [but revealed] two important aspects of what new research has called ‘nomophobia’.” Valdesolo refers to the I don’t know where my phone is! anxiety and the I’ll just get my phone to help me dependency. 

Are you or someone you know suffering from nomophobia? Agreement on the condition may still be years away. In the meantime, the paradox of the smartphone is indisputable: it has both positive and negative effects on its users.

And while the discussion continues, scientists like Aarti Gupta, Psy.D., offer some self-care advice. The suggestions Gupta provides in her article for the Anxiety and Depression Association of America, on another 21st-century affliction, FOMO (Fear of Missing Out), are applicable to nomophobia discussions. She suggests:

• Admit you have a problem: Gupta suggests being honest with oneself, admitting the anxiety exists (in this case, surrounding one's dependence on the smartphone).
• Switch off the chatter: She proposes turning one’s phone off at night and not bringing it into the bedroom. In addition, Gupta discusses one CBT (cognitive-behavioral therapy) technique that “prescribes setting aside a certain time of day to check all your social media outlets. . . . Make this your one and only time of day to check your accounts.”

Finally, where significant technology dependency questions or concerns exist, contact professional mental health services for more information and assistance.

References

Bragazzi, N.L., & Del Puente, G., (May 16, 2014). U.S. Library of National Medicine—National Institutes of Health. A proposal for including nomophobia in the new DSM-V. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036142/

Grohol, J.M., Psy.D., (July 14, 2015). PsychCentral.com. Is There a Pandemic of Smartphone Addiction? https://psychcentral.com/blog/archives/2015/07/14/is-there-a-pandemic-of-smartphone-addiction/

Gupta, A., Psy.D., (November 2017). Anxiety and Depression Association of America. Tips to Get Over Your FOMO, or Fear of Missing Out. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/tips-get-over-your-fomo-or-fear-missing-out

LaMotte, S., (December 1, 2017). CNN. Smartphone addiction could be changing your brain. http://www.cnn.com/2017/11/30/health/smartphone-addiction-study/index.html

Valdesolo, P., (October 27, 2015). Scientific American. Scientists Study Nomophobia—Fear of Being without a Mobile Phone. https://www.scientificamerican.com/article/scientists-study-nomophobia-mdash-fear-of-being-without-a-mobile-phone/

Long before weight-loss and exercise guru Richard Simmons jumped and flexed across television screens in the 1980s, it was clear that exercise is good for the body. From helping to maintain a healthy weight, to moving oxygen through the blood, to increasing flexibility, the benefits of exercise on the human physique are seemingly endless.

But what about the benefits of exercise to the brain? The epicenter of the human nervous system, the brain controls movement, development, decision-making, thoughts, and emotions. And common sense tells us if exercise is good for the body, it must be good for the brain. Right?

Right. In her July article for CNN.com, writer Kristen Domonell quoted Dianna Purvis Jaffin, Ph.D., director of strategy and program at the Center for Brain Health's Brain Performance Institute in Dallas, TX. "What benefits the body benefits the brain," Jaffin said. "You are not a separate brain walking around on top of a body."

According to Jaffin, exercise accelerates “complex processes inside your mind that can curb depression.”

Domonell explained that the brain contains roughly 86 billion neurons, “designed to bark orders to the rest of your body . . . [via] chemical messengers called neurotransmitters”. Neurotransmitters control “everything from your mood and sleep cycle, to memory and appetite”.

She also cited the work of University of California Davis Medical Center researcher Richard Maddock, M.D.—a study measuring the neurotransmitter levels of experiment participants before and after taking part in 20 minutes of exercise of moderate intensity. Maddock reasoned that since the result of low concentrations of two of the brain’s key neurotransmitters (glutamate and gamma-aminobutyric acid (GABA) can cause depression—perhaps exercise could raise their levels.

Maddock and his team of researchers published their “good news” outcomes in the February 2016 edition of The Journal of Neuroscience. “The result, whether you suffer from depression or not,” wrote Maddock for the journal, “is an increased resilience and capacity to respond to mental challenges, a concept known as mental fitness”. 

Jaffin echoed Maddock’s good news, focusing on her own studies of the benefits of exercise to the brain. Comparing the good and bad effects of stress, Jaffin said life’s everyday stressors cause the brain to emit cortisol--its fight or flight hormone. “This is good if you're about to get mugged on the street,” she said, “but if your cortisol levels are chronically elevated, it can cause problems [including memory loss and high blood pressure]”.

Exercise introduces a positive effect on the brain--something Jaffin calls controlled stress. As a result of the exercise then, the brain’s response to stress becomes something that can be switched on and off, instead of elevated all the time.  

In a 2016 article for The New York Times, author Gretchen Reynolds reported on three analyses of exercise and the brain, together encompassing over one million male and female study participants. “Scientists have long questioned whether and how physical activity affects mental health,” Reynolds wrote. “While we know that exercise alters the body, how physical activity affects moods and emotions are less well understood.”

After evaluating the results of the more than 1,140,000 test participants [in the three experiments], Reynolds said, “the links between fitness and mental health turned out to be considerable”. She wrote that, in fact, researchers Schuch et al found “those men and women with the lowest fitness were about 75 percent more likely to have been given diagnoses of depression than the people with the greatest fitness”.

Reynolds explained that for the most “innovative” of the three different studies, scientists directed their focus on whether exercise had the ability to prevent depression from occurring or developing. Their results were printed in Preventive Medicine in December 2016.

In a completely unconnected study, many of the same researchers examined whether exercise could be seen as a treatment to reduce depression. The evaluation of this study was published in the Journal of Psychiatric Research in June 2016. According to their assessments, the researchers concluded that “[people’s] mental health tended to demonstrably improve if they were physically active”.

In a November article for the American Psychiatric Association’s Psychiatric News, writer JoAnn Blake reported on the findings of a large population study published in October in the American Journal of Psychiatry’s [AJP] in Advance.“Research over the years has shown that regular physical activity can help relieve depression, but this study may be the first to recommend a specific dose of exercise,” she wrote.

Based on a study that followed almost 34,000 Norwegian adults over an 11-year period, results showed even “low levels of exercise” [e.g., walking, cycling] provided mental health protection from depression. Of interest to Blake was that this study did not prove exercise prevented anxiety. Nevertheless, researchers concluded that “combined physical and social benefits of exercise may mediate the protective effects against depression, according to the study”.

Studies and results continue to provide support for exercise as prevention and treatment of such mental illnesses as depression. And while the benefits to mental health are well documented, researchers and professionals continue to advise anyone considering participation in new or strenuous physical exercise to first consult a physician.

References

Blake, J., (November 30, 2017). Psychiatric News. American Psychiatric Association. Minimal Exercise May Help Prevent Future Depression https://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.11a11

Domonell, K., (July 26, 2017). CNN. How workouts give your brain a boost. http://www.cnn.com/2016/04/29/health/exercise-benefits-brain/index.html

National Institute of Mental Health. (June 9, 2011). Stress-Defeating Effects of Exercise Traced to Emotional Brain Circuit. https://www.nimh.nih.gov/news/science-news/2011/stress-defeating-effects-of-exercise-traced-to-emotional-brain-circuit.shtml

Reynolds, G., (November 16, 2016). New York Times. How Exercise Might Keep Depression at Bay. https://www.nytimes.com/2016/11/16/well/move/how-exercise-might-keep-depression-at-bay.html

Rodriguez, T., MA, LPC., (December 13, 2017). PsychiatryAdvisor.com. Effectiveness of Exercise in Decreasing Depressive Symptoms.

http://www.psychiatryadvisor.com/depressive-disorder/depression-may-be-preventable-by-exercise/article/713771/?DCMP=EMC-PSYCH_Update_20171215&cpn=&hmSubId=0o1kVhC9ORk1&hmEmail=Q2j7u6GfyHQwEk23-XwhCg2&NID=&dl=0&spMailingID=18674144&spUserID=NDA3NTg3NDkyNzA3S0&spJobID=1161327897&spReportId=MTE2MTMyNzg5NwS2

Should mental health professionals be upfront about their own battles with mental illnesses? Would you sooner go to one psychologist over another if she suffered from and/or overcame the same illness for which you are seeking assistance?

Not only is there a stigma around mental illness in the general population, but there is a long-standing stigma in the mental health profession—around professionals not exposing their own mental health struggles.

Research into the experiences of mental health professionals with their own mental illnesses is still new. Newer still—a handful of these specialists are now choosing to open up about their mental health experiences.

Therapist and University of Washington researcher Marsha M. Linehan was first treated for “extreme social withdrawal” when she was 17, and was eventually diagnosed with borderline personality disorder.

In a June 2011 article for The New York Times, writer Benedict Carey interviewed Linehan, who had recently publicly revealed, for the first time, her own lifetime of mental health struggles and successes.

“No one knows how many people with severe mental illness live what appear to be normal, successful lives,” wrote Carey, “because such people are not in the habit of announcing themselves.” But more and more, these seemingly normal, successful people are taking a risk and exposing the truth of their own challenges, “saying that the time is right”.

In his blog for TheHuffPost.com, Dr. Harold Koplewicz, a child and youth psychiatrist and president of the Child Mind Institute in New York, commented on Linehan’s courage. “Acceptance by a broader public of the reality of psychiatric illness is the key to effective treatment,” he wrote. “That’s why it’s so important that Dr. Lineman decided, after decades, to go public about her own story, an unusual enough step for a clinician that one of my colleagues . . . called it coming out.”

According to the 68-year-old Linehan, throughout her years in practice, many patients had asked her: “Are you one of us?” One patient’s reasoning that it would provide hope for other sufferers to know success like Linehan’s is possible, persuaded the psychologist to confess.

Interviewed in Carey’s New York Times article, she explained: “So many people have begged me to come forward, and I just thought--well, I have to do this. I owe it to them. I cannot die a coward.”

Koplewicz further applauded Linehan’s choice to speak about her lifetime of struggles and recovery as “an opportunity to give hope to others in the same kind of hell she knew”. He emphasized that hope may not seem like the missing link, but, he wrote, “it’s absolutely critical to recovery.” 

Linehan is not alone. Students in graduate school are also exploring whether to reveal their first-hand knowledge of the work they will soon practice professionally. In the January 2012 edition of the American Psychological Association’s gradPSYCH Magazine, Cassandra Willyard examined the instances of mental health problems among graduate students—and the very limited research that has been completed on the pervasiveness of mental health issues specifically in graduate psychology students. 

Willyard wrote that students with interest in psychology research have been referred to as students undertaking me-search since they may have chosen their field of study to better understand their own mental health challenges. Willyard found agreement from Russell Federman, Ph.D., the Director of counseling and psychological services at the University of Virginia in Charlottesville. “I think people who are drawn towards professions such as psychology, usually their interest comes from something very personal,” Federman said.

On the topic of support for graduate psychology students to publicly expose their own mental illnesses, Federman thinks every educational program will respond differently. Graduate programs may believe "their department turns out exceptional individuals," he said in Willyard’s article. “So if one of their students discloses that he or she is struggling with mental illness, that doesn't fit into that picture of We are producing the best of the best.”

Willyard referred to the advice of John C. Norcross, Ph.D., a psychology professor at the University of Scranton in Pennsylvania, who focuses on self-care and personal therapy among psychologists. Norcross suggests, “If you do decide to disclose, wait until you've been accepted to a program to avoid any potential bias in the interview and admissions process.” In addition, Norcross emphasizes that regardless of a student’s decision to reveal his or her mental illness to faculty, self-care must take precedence.

Anna Lente, a graduate student completing her clinical mental health counseling practicum, last week wrote about the stigma surrounding counsellors (or future counselors like herself) with mental illness and self-care. After a public panic attack during a lunch with classmates, Lente realized: “I . . . came dangerously close to people finding out that this future counselor struggles with mental illness herself.”

Lente said she has encountered counsellors who disclosed their own mental illnesses or who say they have colleagues with mental health challenges. “These professionals tell me that their struggle with mental illness helps them relate to clients, and their recovery process has uniquely equipped them to be more effective,” she wrote.

Still, mental health professionals who are publicly frank, like Marsha Linehan, are still outnumbered by those who choose to keep their private struggles private. “The stigma against counselors with mental illness seems to hold people back,” Lente admits.

References

Carey, B., (June 23, 2011). The New York Times. Expert on Mental Illness Reveals Her Own Fight. http://www.nytimes.com/2011/06/23/health/23lives.html

Koplewicz., H., (July 8, 2011). HuffingtonPost.com. Mental Illness: When A Therapist ‘Comes Out’. https://www.huffingtonpost.com/dr-harold-koplewicz/mental-illness-stigma_b_891359.html

Randle, K., Ph.D., LCSW. (June 22, 2009). PsychCentral.com. Can I Be a Good Psychologist if I Have Mental Health Issues? https://psychcentral.com/ask-the-therapist/2009/06/22/can-i-be-a-good-psychologist-if-i-have-mental-health-issues/

Willyard., C., (January 2012). American Psychological Association, gradPSYCH Magazine. Need to heal thyself? http://www.apa.org/gradpsych/2012/01/heal.aspx

Mental illnesses do not take time off for the holidays. And while schools, colleges, and offices are taking a break to celebrate the festive season and ring in the New Year, now is not the time to take time off of caring for our mental health. In fact, nothing triggers mental health challenges more than the December holidays. No matter how improved or in control one’s mental health disorders may be, the last two weeks of the year can provoke a resurgence of social anxiety disorders, stress, eating disorders, body image challenges, depression, anger issues, grief, sleep deprivation, and more.

The already precipitous stability someone with a mental illness has strived so hard all year to establish—often working with a team of medical professionals, balancing medications and securing ongoing supports—can be thrown completely out of equilibrium during the build-up to the holidays--and the toll from those last days of the year can be detrimental to one's mental wellbeing.

For weeks—even months—before the December celebrations, every self-help and fashion magazine is filled with tips and tricks to survive the year-end festivities. Wading through the surplus of pedestrian advice can be daunting and of little help. However, several reliable sources do provide some common sense and easily overlooked recommendations to assist people with mental health challenges to survive this special time of the year.

In her article last week for the National Alliance on Mental Illness (NAMI), writer Colleen O’Day suggested some coping tips to maintain mental wellness. Of foremost importance, O’Day advises people to keep their therapy appointments. “Although the holiday season is overwhelmingly busy, do not cancel your therapy sessions to make time for other activities,” she wrote. “The holidays can bring up difficult emotions. If you can, keep your scheduled therapy sessions to ensure you have built-in time to explore anything that comes up.”

As well as keeping appointments with professional therapists, O’Day suggests looking to mindfulness exercises as a way to support daily wellness. Smart phone users have access to countless mental health apps [many free ones] and there are lists of mental health websites for use in Canada and the U.S., but O’Day recommends “the online Mindfulness Toolkit created by the Masters of Social Work program at the University of Southern California, featuring free mindfulness resources, like guided meditations for beginners,” she explained. The toolkit also includes exercises in breathing, stress reduction, listening, and concentration.

As important as keeping up with therapy appointments during the holidays, it is paramount to maintain any medication routines already in place. Irregular hours, odd eating patterns and late nights are characteristic of year-end celebrations, and can make medicating a challenge, but treatment doses and timetables must be a priority for wellness.

O’Day also recommends against using additional drugs or alcohol to manage the added stress that results from holiday family and social gatherings. “While the prospect of escape can be appealing,” she wrote, “substance use can ultimately worsen your issues.”

According to an article on the website of the American Psychological Association (APA), it may be more helpful to anticipate the holidays not with dread, but with a positive mindset and optimistic outlook—recognizing them as opportunities to “enhance . . . psychological wellbeing”.

The APA’s advice includes taking “time for yourself”, volunteering, maintaining “realistic expectations” and reminding oneself of what is really important at this time of the year—family, good health, and time spent in enjoyable activities. Above all, however, the APA suggests that if the tips supplied in its holiday article are “not helpful and you are feeling stressed and overwhelmed, consult with a psychologist or other licensed mental health professional . . . [to] develop an action plan”.

Dr. Charles Raison, CNNHealth’s mental health expert in 2012, wrote about a method he uses with patients all year-round. “[The] holidays, [impose] upon us once again a template for what happiness and interpersonal success is expected to look like,” wrote Raison. Instead of being forced to choose between the emotional upheaval of visiting family or the depression of being alone over the holidays, Raison suggests “reframing” the choices and finding a third option by answering the question: Who says?

“Who says things have to be the way you think they should be?" he asks. "Who says you have to suffer over a painful fantasy of what you think Christmas ought to be?"

Raison has encouraged patients to try taking a vacation away instead of resorting to past choices. The vacation may benefit the patient’s mental health and may lead other family members to join, or re-evaluate some long-held traditions and find ways to make positive changes.

Raison suggests loosening our hold on fantasies and expectations of the holiday season. In this way, he suggests, “we can see new possibilities for how to be at peace with our lives and find a little joy”.

Finally, in a recent article for its website on tips for coping with the holidays, Mayo Clinic staff suggested maintaining healthy habits for overall wellness, including: eating healthy snacks, getting “plenty of sleep”, and “incorporating regular physical activity into each day”.

Like Colleen O’Day’s advice, the Mayo Clinic article also emphasizes the importance of seeking professional help if self-care is not enough. “Despite your best efforts, you may find yourself feeling persistently sad or anxious, . . . unable to sleep, irritable and hopeless, . . . If these feelings last for a while, talk to your doctor or a mental health professional.”

References

American Psychological Association. (Retrieved December 22, 2017). Making the most of the holiday season. http://www.apa.org/helpcenter/holiday-season.aspx

Mayo Clinic [Staff]. (Retrieved December 21, 2017). Mayo Clinic. Stress, depression and the holidays: Tips for coping. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/art-20047544?pg=1

O’Day, C., (December 19, 2017). National Alliance on Mental Health. Managing Your Mental Health During The Holidays. https://www.nami.org/Blogs/NAMI-Blog/December-2017/Managing-Your-Mental-Health-During-the-Holidays

Raison, C., M.D., (December 24, 2012). CNN.com. When the holidays trigger depression. http://www.cnn.com/2012/12/24/health/holiday-depression-blues/index.html

In January 2017, outrage followed the livestreamed suicide 12-year-old Katelyn Nicole Davis posted on Facebook Live of her own final moments as she ended her life at home in a small U.S. town in Georgia. Video and livestream apps by Facebook and YouTube allow anyone to share anything, anytime. Live and unedited.

John M. Grohol, Psy.D., is the founder and CEO of PsychCentral.com and has been writing about online behavior since 1992. In his article for PsychCentral last January, Grohol pointed out that regardless of attempts to erase Davis’s video from the online world, it was still easily located for viewing. Similarly, wrote Grohol, “Facebook and YouTube could remove such videos (and sometimes do), but copies soon replace them on those same services (or elsewhere online), since people simply upload a copy they’ve saved to their computer.”

Fast forward almost exactly one year and the same anger is now circulating over a YouTube video, ironically on the same subject—suicide.

Logan Paul, a 22-year-old American ‘celebrity’ YouTuber with 15 million subscribers, posted a video on YouTube last Sunday that received millions of views before it was pulled down. In the video, Paul was shown joking with his friends in the notoriously famous Aokigahara Forest, at the foot of Japan’s Mount Fuji. The forest is a well-known “suicide spot” and, while walking there, Paul and his friends came upon a body hanging from a tree, the aftermath of an apparently recent suicide.

In an article for The Guardian, writer Justin McCurry explained that Paul’s video showed the male victim’s body from several angles but with the face blurred. “A member of the group is heard remarking that he ‘doesn’t feel good’”, McCurry added. “Paul replies: ‘What, you never stand next to a dead guy?’ and then laughs.”

Like the public anger vented after young Davis’s suicide posting last year, the criticism of Paul’s treatment of his findings in the Aokigahara Forest abounds. So does the public condemnation of YouTube for the length of time the video was available to view.

Paul later took to Twitter to post a written apology, and a day later made a video telling his audiences his disgraced posting was not done “for views”, but to “raise awareness for suicide and suicide prevention.” YouTube said Paul’s video violated its policies, but did not respond to calls to suspend him from the site,” wrote McCurry.

YouTube’s website explains in its policies for reporting inappropriate content that it relies on its viewing members to “flag content that they find inappropriate”. It also cautions that although YouTube staff review flagged material around the clock, “when something is flagged, it’s not automatically taken down.”

John Grohol’s response, in last year’s PsychCentral article, to public outrage at social media’s failings—can again apply to this year’s example. “This is upsetting to people,” Grohol wrote. “But the outrage misses the point completely.”

It is Grohol’s opinion that the public outcry is misdirected. “Outrage shouldn’t fall on the fact that our technology and tools allow such videos to be produced and distributed so easily,” he explained. “You can’t stop the inevitable progress of technology, nor regulate how people will use it.”

Grohol called on the public to stop pointing fingers at myriad social media sites like YouTube, Facebook Live, Instagram, and Twitter. “The problem is suicide,” he explained. “The problem is a society that has so few social resources available . . . that a 12-year-old feels her only choice is to end her own life.” Or, for an unidentified male, to hang himself from a tree.

While social media technology has continued to evolve, Grohol argues, services for people in crisis situations like suicide are outdated. “We don’t have state-of-the-art interventions for people contemplating suicide,” he wrote last year. Instead we mostly rely on the same efforts and technologies--like the telephone!--that we’ve relegated suicidal people to for decades.”

And options to text crisis lines or use mental health apps are only band-aid solutions that Grohol feels do nothing to improve the situations for people in crisis.  

Like Grohol, mental health professionals in Japan are trying to turn the location of Paul’s questionable video into a positive resource for people in crisis. Also known as the Sea of Trees, the Aokigahara Forest is located two-hours west of Tokyo.

In an article yesterday for CNN.com, writer Michael Nedelman explained: “At the entrance of the forest, a sign reminds visitors that "life is a precious gift from their parents.” Written in Japanese, the sign also says: "Quietly think once more about your parents, siblings or children. Please don't suffer alone, and first reach out."

In McCurry’s article for The Guardian, he added that “in an attempt to reduce the area’s association with suicide”, police no longer publicize annual death statistics. And while the country’s suicide rates have dropped in the last few years to just below 30,00 per year, “the lack of services for people with mental health problems, as well as debt and serious illness . . . have also been cited as common causes of suicide in Japan".

Grohol’s message remains timeless then: “let’s stop being outraged that such videos exist.” Instead, he suggested focusing public outrage “on the lack of accessible services to individuals who suffer from depression and other mental illness who sincerely believe that ending their own life is the best available option”. 

References

Grohol, J.M., Psy.D., (January 24, 2017). PsychCentral.com. Outrage Over Katelyn Nicole Davis Video Suicide Misses the Point. https://psychcentral.com/blog/archives/2017/01/24/outrage-over-katelyn-nicole-davis-video-suicide-misses-the-point/

McCurry, J., (January 2, 2018). The Guardian. https://www.theguardian.com/world/2018/jan/02/outcry-as-youtube-star-posts-video-of-dead-body-in-japan

Nedelman, M., (January 3, 2018). CNN.com. Inside Japan’s ‘suicide forest’. http://www.cnn.com/2018/01/03/health/japan-suicide-forest-intl/index.html

YouTube., (Retrieved January 3, 2018). Policies and Safety. www.YouTube.com

The latest research out of a Canadian university last week suggested psychology should never underestimate the power of the nose. A recent study from the Department of Psychology at the University of British Columbia (UBC) in Vancouver, Canada, found test participant stress levels could be lowered as a result of access to the aroma of a “romantic partner”. Results of the analysis were published in this month's Journal of Personality and Social Psychology.

According to UBC psychology graduate student and lead author of the study, Marlise Hofer, outcomes from the experiment showed female participants felt calmer after exposure to their male partner’s natural scent. Meanwhile, exposure to the natural scent of a male stranger caused contrary results of increased stress levels and measurably raised production of cortisol, the stress hormone, in female test participants.

“Many people wear their partner’s shirt or sleep on their partner’s side of the bed when their partner is away, but may not realize why they engage in these behaviours,” Hofer explained in an article for the UBC News. “Our findings suggest that a partner’s scent alone, even without their physical presence, can be a powerful tool to help reduce stress.”

Researchers worked with a pool of “96 opposite-sex couples”. Since, according to the researchers, the female sense of smell tends to be more sensitive, the female participants were asked to take on the role of the smellers.

Male participants received one clean t-shirt each to wear for a full 24 hours. The men were told not to use any scented personal care products during that time and were instructed not to influence their natural scents by eating certain foods or smoking. After 24 hours of wear, the t-shirts were stored in a frozen state in order to “preserve the scent”.

When the smellers (women) reported for testing, they were not told which of three possible shirts they were given to smell. The possibilities included: an unworn shirt, a shirt worn by a stranger, or a shirt worn by their romantic partner.

After smelling one of the three random shirts, the women’s cortisol levels in their saliva were measured and they participated in a series of stress tests including “a mock job interview and a mental math task, and . . . questions about their stress levels”.

Study findings showed that for women who were given their partner’s shirt to smell, they felt less stress “both before and after the stress test”. Cortisol levels were even more reduced for females who had themselves recognized that the shirt they were smelling belonged to their own partner.

Interestingly, the women who smelled a shirt from a stranger recorded much higher levels of cortisol throughout the post-smell stress tests.  

“From a young age, humans fear strangers, especially strange males, so it is possible that a strange male scent triggers the ‘fight or flight’ response that leads to elevated cortisol,” Hofer speculated. “This could happen without us being fully aware of it.”

UBC psychology assistant professor Frances Chen is also the study’s senior author. She believes the experiment’s results “could have practical implications to help people cope with stressful situations when they’re away from loved ones”.

Chen referred to the influence of globalization and the stressors it can have on modern life. “People are increasingly traveling for work and moving to new cities,” said Chen. “Our research suggests that something as simple as taking an article of clothing that was worn by your loved one could help lower stress levels when you’re far from home.”

The researchers emphasized that their study “speaks to the critical role of human olfactory cues in social communication and reveals that social scents can impact both psychological and physiological reactions to stress.”

In her article for Forbes Magazine in 2016, writer Kristina Moore interviewed Stanford University graduates Erika Shumate and Christine Luby, who had used their post-secondary studies in human olfactory signals to become successful perfumers.

According to Shumate, the olfactory bulb, where smell is processed, is located in the brain’s limbic system in conjunction with the brain’s area for emotional memory. “So literally, your brain is set up to process scent with memory and emotion,” she explained. “Scent is the hardest of the five senses to logically assess due to its close proximity to emotion and far distance from vocabulary and logic processing.”

Like Shumate and Luby, other scientists are recognizing the importance of smell to human wellbeing. In May 2017, Science Magazine writer Lindzi Wessel interviewed neuroscientist John McGann of Rutgers University in New Brunswick, New Jersey who believes “the myth of the nonessential nose is a huge mistake--one that has led scientists to neglect research in a critical and mysterious part of our minds”. 

McGann referred to the fact that while the human olfactory abilities have not yet been studied in a “head to head” contest with dogs or other super-olfactory animals, researchers at the University of California, Berkeley, prepared a human smell trail in a field. “They blindfolded undergraduate subjects and gave them earmuffs so they couldn't use any senses other than smell,” he explained. “They found the students were perfectly capable of following the trail out in the field."

References

Collins, H., & Whillans, A., (January 24, 2018). Stressed out? Try smelling your partner’s shirt. UBC News. https://news.ubc.ca/2018/01/04/stressed-out-try-smelling-your-partners-shirt/

Hofer, M. K., Collins, H. K., Whillans, A. V., & Chen, F. S. (2018). Olfactory cues from romantic partners and strangers influence women’s responses to stress. Journal of Personality and Social Psychology, 114(1), 1-9. http://dx.doi.org/10.1037/pspa0000110

Moore, K., (October 4, 2016). Pinrose Personalized Fragrance Algorhythm Assures Wearers Best Scent. Forbes.com. https://www.forbes.com/sites/forbesstylefile/2016/10/04/designer-spotlight-pinrose-personalized-fragrance-algorithm-assures-wearers-best-scent/#becdbdc1373f

Wessel, L., (May 11, 2017). Your nose knows more than scientists thought. Science Magazine. http://www.sciencemag.org/news/2017/05/your-nose-knows-more-scientists-thought

In a throwback to the hallucinogenic, mind-altering, drug-infused days of the ‘60s, the U.S. and Canada are very close to seeing a psychedelic drug approved for use in treating some mental health disorders.

If the third round of test studies into the safety of using MDMA in controlled medical settings to assist in the treatment of Post-Traumatic Stress Disorder (PTSD) is successful, researchers hope the drug will be approved for psychotherapeutic use within three years--by 2021.

Illegal in most countries, MDMA is a drug recognized more commonly as the party drug Ecstasy and is known to have psychedelic, euphoric, and stimulating effects. In addition to being addictive, it can also cause a multitude of negative side effects including vomiting, headaches, and an increased heart rate.

In her recent article for Britain’s International Business Times, writer Kashmira Gander wrote that with this “latest chapter” of clinical trials scheduled to take place in Vancouver, Canada, the potential for treatment “has been dubbed the ‘psychedelic renaissance’”. She quoted Canada’s CTV News which reported that the third phase “will involve 150 participants and cost $26 million".

Writer Geordon Omand of The Canadian Press explained in his CTV News article that “Vancouver is one of 16 locations in the United States, Canada, and Israel where clinicians hope to demonstrate that a drug historically associated with gurus and raves can revolutionize psychotherapy and trauma treatment”.

Omand quoted one participant’s results after being treated in an earlier trial phase with MDMA. Ed Thompson was suffering from severe PTSD as a result of his twin daughters’ medical issues and his own trauma from years of working as a firefighter. The experiences sent “him into a spiral of post-traumatic stress, substance abuse and thoughts of suicide”, wrote Omand.

In 2015, Thomson joined a psychotherapy study treating patients who were suffering from severe PTSD with “clinical-grade MDMA”. Of the results, Omand wrote: “Thompson said the experience saved his life and kept his family together”.

According to Gander’s article, the Multidisciplinary Association for Psychedelic Studies (Maps), a non-profit research and educational organization founded in 1986, studies the benefits of psychedelic drugs and is the organization overseeing the clinical trials.

Gander referred to University of British Columbia (UBC) public health professor Mark Haden who established the Maps Canadian branch. "We hope to prove that MDMA-assisted psychotherapy is the most effective treatment for PTSD that exists on the planet," Haden declared to CTV News.

While conventional treatments of PTSD focus on “desensitization to the triggers,” Haden explained, progress can be slow and, with “just a 10 to 15 percent chance of success,” long-term results have been disappointing. “In contrast, MDMA-assisted therapy can take four months or less, with two-thirds of participants reporting no symptoms after a year, according to a preliminary study,” he said.

According to Gander, initial trial therapies proved to be incredibly successful, enough to cause the U.S. Food and Drug Administration (FDA) to grant MDMA designation “as a breakthrough therapy for PTSD in August 2017, giving researchers greater powers to investigate the drug further”.

In its advertisement for a sold-out launch party and benefit for MDMA therapy research, being hosted in Fort Collins, CO, Maps described the importance of the Phase 3 trials and their need for “more clinical sites, more therapists, more patients, and more support”. Achieving approval of governments for “MDMA-assisted psychotherapy as a legal treatment . . . would radically shift policy and public perception surrounding psychedelics”.

In addition to Maps, numerous scientists and academic professionals are studying how other drugs with “psychoactive substances” can make the leap into more traditional healthcare streams. Psychoactive substances can cross the “blood-brain barrier”, affect the central nervous system, and affect change in moods, perception, and behaviors.

Gander explained that the current “resurgence in research in the past half a decade” is the psychedelic renaissance. Studies have shown “LSD, MDMA, magic mushrooms, ayahuasca, and peyote ibogaine have beneficial properties when used in a controlled medical environment”. These findings are a stark contrast to the pervasive, limited vision of these illegal drugs in the 1950s and ‘60s “and the subsequent banning of hallucinogens in the U.S.,” she wrote.

Although researchers do not support the use of these “party drugs . . . outside of a controlled laboratory environment”, they do believe conditions like PTSD, depression, addiction, and cluster headaches may be treatable with controlled clinical use, Gander added.

“Experts are still trying to understand exactly what psychoactive substances do to the brain and the mind,” Gander wrote, citing research done at the University of Cambridge. “It is believed that psychedelics boost communication between parts of the brain that generally have little connection, and lower the activity in areas that do.”

Writing an article for science website MassiveSci.com, Johns Hopkins University neuroscientist Benjamin Bell questioned whether the psychedelic renaissance would survive this time. He wrote that “psychedelics have embodied the highest highs and the lowest lows of the American consciousness”.

Referring to the latest clinical trials on MDMA and the possible FDA approval, Bell said research is indeed raising hopes that “psychedelics may yet revolutionize mental health care”. The difficulty he foresees “is convincing an anti-drug society to accept such a radical new viewpoint, and to do so with evidence, ethics, and scientific backing”. This said Bell, “will take work for scientists and citizens alike”.

References

Bell, B., (October 9, 2017). MassiveSci.com. The psychedelic renaissance is here. Will it last this time? https://massivesci.com/articles/psychedelic-research-renaissance-culture/

Gander, K., (January 22, 2018). International Business Times. The psychedelic renaissance: Can Ecstasy really be used to treat mental illness? http://www.ibtimes.co.uk/psychedelic-renaissance-can-ecstasy-really-be-used-treat-mental-illness-1656176

Omand, G., (January 21, 2018). CTV News. Vancouver kicks off final phase of MDMA-assisted psychotherapy trials. https://www.ctvnews.ca/health/vancouver-kicks-off-final-phase-of-mdma-assisted-psychotherapy-trials-1.3768935

It isn’t groundbreaking news, but it needs to be repeated: "Perfection, by definition, is an impossible goal.” The quote is credited to social psychologist Thomas Curran, Ph.D., of Britain’s University of Bath in the Department for Health, as it relates to his most recent research on the topic.

What is groundbreaking is the work Curran led with study co-author Andrew Hill, Ph.D., of York St. John University in England into an examination of group generational differences in perfectionism. Study findings were published recently by the American Psychological Association (APA). Together, the two scientists explained that the quest for perfection involves “an irrational desire to achieve along with being overly critical of oneself and others”.

Focusing more specifically on students in post-secondary studies, their research shows the pursuit of perfection “in body, mind and career among today’s college students has significantly increased compared with prior generations, which may be taking a toll on young people’s mental health”.

Curran and Hill used an existing “model of multidimensional perfectionism” created in 1991 by scientists P.L. Hewitt and G.L. Flett. The model measures three kinds of perfectionistic traits: self-oriented perfectionism [i.e., the irrational need to be perfect]; other-oriented perfectionism [putting unrealistic expectancies on others]; and socially prescribed perfectionisms [the perception of excessive expectations from others].

Using the Multidimensional Perfectionism Scale, the two collected and analyzed data from 41,641 American, Canadian and British post-secondary students from 164 samples. The scale tested for generational changes in perfectionism from the late 1980s to 2016.

Results from the study were published in the APA journal Psychological Bulletin and showed that “more recent generations of college students reported significantly higher scores for each form of perfectionism than earlier generations”.

Data showed that between the years 1989 and 2016, the scores in “self-oriented perfectionism” increased by 10 percent. Similarly, examining the same period of time, the scores for “socially prescribed perfectionism” and “other-oriented perfectionism” increased by 33 percent and 16 percent, respectively.

According to Curran, results from the Millennial group (APA defines Millennial as ages 18–33)] demonstrated an escalated drive for perfectionism. And he believes a handful of factors are to blame.

In his article for CNN.com, writer Ben Tinker described perfectionism as an “idiosyncratic trait” and explained Curran’s perception of its recent explosion. “He says it's not just the result of parents pushing their children harder than ever before but rather a larger shift in ideology at a societal level,” Tinker wrote.

"Perfectionists have a lot of baggage that other people don't,” Tinker quoted Curran. "For a perfectionist, failure is catastrophic. It's catastrophic for their sense of self, and it's catastrophic for their emotional well-being."

Curran reported that in 1976, roughly one half of high school seniors believed they would earn a post-secondary degree. By 2008, he said, the percentage had increased to more than 80 percent believing they would complete a degree. “Yet, numbers of those earning degrees has failed to keep pace with rising expectations,” Curran explained. “The gap between the percentage of high school seniors expecting to earn a college degree and those with one doubled between 1976 and 2000 and has continued to rise.” 

Examining his data further, Curran wrote that an increased desire among post-secondary students to “perfect their grade point averages” and their tendencies to “compare them to their peers” is a clear example of “a rise in meritocracy among millennials, in which universities encourage competition among students to move up the social and economic ladder,” he said.

Curran reported that data collected from these young respondents showed they possess alarmingly “unrealistic educational and professional expectations for themselves”, resulting in such a rise in the desire for perfectionism. “Meritocracy places a strong need for young people to strive, perform and achieve in modern life,” said Curran.

Based on the study’s findings, Curran believes more “recent generations of college students have higher expectations of themselves and others than previous generations”. Pressures from current society are causing “today’s young people [to be] . . . competing with each other in order . . . to succeed and they feel that perfectionism is necessary in order to feel safe, socially connected and of worth,” he added.

In addition to the pressures to secure a good education and professional pressures to earn a high income, Curran’s results did not omit the effect of social media on young adults and the unparalleled expectations it causes “to perfect themselves in comparison to others, which makes them dissatisfied with their bodies and increases social isolation,” he wrote. 

The study’s co-author, Andrew Hill recognized that with higher recorded numbers of young people reporting depression, suicidal thoughts, and anxiety, the escalating perfectionistic tendencies in the millennial group indicate “perfectionism may in part be affecting the psychological health of students.”

Hill hopes the current climate in educational settings that encourages such competition among young people will be examined and “curbed” in an attempt “to preserve [their] good mental health”.  

In his CNN article, Tinker quoted Curran’s nod to the reality of change: "Well, it's difficult," Curran said. "You cannot change culture overnight." But "there is a kind of counterculture occurring across the West," he said. "Young people are beginning to recognize that, potentially, this structure is not necessarily serving their needs."

Tinker said Curran's advice is: “don't be afraid to fail. And, when--not if--you do, don't think of failure as catastrophic.”

References

American Psychological Association. (January 2, 2018). Perfectionism Among Young People Significantly Increased Since 1980s, Study Finds. http://www.apa.org/news/press/releases/2018/01/perfectionism-young-people.aspx

Curran, T., Ph.D., & Hill, A., Ph.D., (December 28, 2018). APA: Psychological Bulletin. Perfectionism Is Increasing Over Time: A Meta-Analysis of Birth Cohort Differences From 1989 to 2016https://www.apa.org/pubs/journals/releases/bul-bul0000138.pdf

NewsMedical.net. (January 4, 2018). Study finds significant increase in perfectionism among young people since the 1980s. https://www.news-medical.net/news/20180104/Study-finds-significant-increase-in-perfectionism-among-young-people-since-the-1980s.aspx

Tinker, B., (January 9, 2018). CNN. The modern problem with pursuing perfection. https://www.cnn.com/2018/01/09/health/perfection-mental-health-study-intl/index.html

Current trends show the number of North American children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) continues to rise. Recent parent-reported data collected by the National Survey of Children’s Health(NSCH) indicated the incidence of U.S. children aged 4-17 diagnosed with ADHD increased by an astounding 42 percent between 2003 and 2011.

As a result of these numbers, researchers have begun to investigate the possibility of misdiagnosis of what is becoming a very common disorder.

In her recent article for Harvard Medical School’s blog, Harvard Health Publishing, Faculty Editor Claire McCarthy, M.D., explained that “one in 10 children between the ages of 4 and 17 has been diagnosed with [ADHD].” With these statistics, McCarthy said, it is understandable “when parents notice that their child has trouble concentrating, is more active or impulsive than other children, and is having trouble in school, they think that their child might have ADHD.”

According to the CNN.com Health page, “Children and adults with ADHD exhibit characteristic behaviors which fall into three common behavioral groupings,” including inattention, hyperactivity, and impulsiveness.

But, McCarthy cautioned, ADHD is not the only issue that results in a child with difficulties in behavior, concentration or school success. “There are actually lots of problems that can cause symptoms that mimic ADHD,” she wrote. McCarthy pointed to five familiar problems that should be ruled out by parents, their family doctors, and specialists before jumping to conclusions or assuming a child has ADHD.

1. Difficulties Hearing.

Children who cannot hear well may appear distracted or inattentive—behaviors that can be mistaken for one of the common symptoms of ADHD. Although newborns are screened for hearing problems, some hearing losses can be overlooked and children can acquire hearing problems later in life from illnesses, high fevers or ear infections. McCarthy suggested, “Any child with behavioral or learning problems should have a hearing test to be sure their hearing is normal.”

2. Learning or Cognitive Disabilities.

Children who have difficulty understanding the activities and lessons in class may seem unwilling or fail to participate or may be unable to focus on tasks. Learning or cognitive challenges may also cause a child difficulty in student-student and student-teacher interactions since such communications may be “very quick, complex, and nuanced”.

McCarthy recommended evaluating the challenges and needs of any child who seems to be progressing poorly and establishing Individualized Education Programs (IEPs) for a child’s specific needs. “Parents should talk to their child’s teacher and their pediatrician for guidance,” advised McCarthy.

3. Sleep Problems.

Children suffering a lack of sleep, or a lack of quality sleep, may exhibit characteristics like those of ADHD—with behavioral issues or difficulty learning and retaining information. McCarthy suggested parents who notice repetitive nights of snoring from a child not suffering from congestion from a cold or flu, should see a doctor. She also warned parents who notice a child making choking sounds or pausing their breathing while asleep.

The amount and quality of a teen’s sleep should also be monitored to ensure they avoid late-night homework and turn off phones early enough to get a minimum of eight hours sleep. Most importantly, wrote McCarthy, is that “any time a diagnosis of ADHD is being considered, it’s important to take a close look at a child’s sleep and make sure there aren’t any problems." 

4. Mental Health Issues.

With greater recognition and respect given to mental health issues, the number of adolescents seeking professional assistance for depression and anxiety is on the rise. However, even with positive media attention, there are still too many cases of child and youth mental health disorders that remain undiagnosed and untreated.  

For those suffering from depression, anxiety, or other mental health challenges, classroom behavior may imitate symptoms of ADHD. Some children act out, others withdraw. As a result, McCarthy urged that in “any evaluation for ADHD, a child should also be evaluated for other mental health issues, not just because they can mimic ADHD, but because other mental health issues can occur with, or because of, ADHD.” 

5. Substance Abuse.

McCarthy noted that for a child or adolescent to receive a diagnosis of ADHD, symptoms must have presented before age 12. Thus, while it may be hard to question alcohol or illicit drugs, parents of a child whose debatable symptoms were not present earlier in childhood should rule out substance abuse before suspecting ADHD.

In addition to McCarthy’s five suggestions, an October 2017 article on Canada’s HuffPost on research from the University of Nottingham in the U.K. and Finland’s University of Turku found younger children in classrooms “were more likely to be diagnosed with ADHD than their older peers in the same school year”. With school starting in the month of August in Finland, the youngest children are those born in December. The oldest are those born in January.

Kapil Sayal, professor of child and adolescent psychiatry and lead author of the study, explained: "With an age variation of up to 12 months in the same class, teachers and parents may misattribute a child's immaturity. This might lead to younger children in the class being more likely to be referred for an assessment for ADHD.”

And the results of a retrospective study published by researchers at the University of Birmingham, Alabama, School of Medicine in 2016 recognized the diagnosis of children with ADHD was higher in those with “uncorrectable vision problems” or impaired vision and believed misdiagnosis might explain the higher numbers.

Lead author Dawn DeCarlo, O.D., with the university's Department of Ophthalmology, said, “It could be as simple as children with vision problems being mislabeled as ADHD because they are not able to pay attention to things they cannot see.”

The bottom line, concluded Claire McCarthy in her Harvard article, is that many issues can result in a child presenting behavioral and attention difficulties. “Any child who is showing those difficulties deserves a thoughtful, thorough evaluation,” she wrote, “to be sure that they get the right diagnosis and the best treatment.”

References

CNN.com. (Retrieved January 27, 2018). ADHD. http://www.cnn.com/HEALTH/condition.clinic/adhd.html

HuffPost Canada. (October 11, 2017). ADHD Is Over-Diagnosed In The Youngest Children In A Class: Study. http://www.huffingtonpost.ca/2017/10/11/adhd-misdiagnosis-younger-children_a_23240468/

McCarthy, C., M.D., (January 9, 2018). Harvard Health Publishing. 5 common problems that can mimic ADHD. https://www.health.harvard.edu/blog/5-common-problems-that-can-mimic-adhd-2018010913065

Melton, C., ELS., (May 25, 2016). Psychiatry Advisor. Children With Vision Problems More Likely to be Diagnosed With ADHD. https://www.psychiatryadvisor.com/adhd/adhd-diagnoses-more-prevalent-in-children-with-vision-problems/article/498677/

National Institute of Mental Health. (November 2017). Attention-Deficit/Hyperactivity Disorder (ADHD).  https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd.shtml

Sayal, K., Ph.D., (October 9, 2017). The Lancet, Psychiatry. Relative age within the school year and diagnosis of attention-deficit hyperactivity disorder: a nationwide population-based study. http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30394-2/fulltext

The answer to a difficult problem or decision comes to you after a good night’s sleep. You realize a different way to approach a challenging task after going for a run in the park or after seeing a movie with a friend. You remember where you put your keys hours after you’ve given up looking for them.

Sound familiar? These examples are all part of the human condition—the result of the unconscious mind at work.

In her article last month for Psychiatry Advisor, Tafari Mbadiwe, M.D., J.D., revisited an experiment done at Nijmegen University in The Netherlands to illuminate her own discussion of how humans make decisions. More specifically, she examined how the conscious and unconscious minds are used in everyday problem solving. To begin her discussion, Mbadiwe examined a set of experiments done in The Netherlands almost 10 years ago—the results of which, she said, set “academic circles . . . abuzz . . . [because] the studies had produced some curious findings.

According to Mbadiwe, the experiments were done on two groups of students in post-secondary studies. Each applicant was asked to choose the better of two versions of an item they might purchase in real life. The items were “common consumer products” in addition to higher priced purchases—such as a car or apartment. Both groups of participants received the same information about the product before making their choice. However, some students were “given data about a greater number of attributes” of the products Mbadiwe explained.

The results showed that the study participants made better choices and “more frequently selected the superior item” if, prior to making a decision, they were provided with time away from the test situation. “They were subjected to a period of what is known as deliberation without attention,” wrote Mbadiwe.

The students were given such brainteasers as word searches and anagrams to solve for a few minutes. Thus, by focusing on something else instead of fixating only on the assigned problem, “the quality of their decision making improved”. In fact, “the effect seemed to become more pronounced as the complexity of the scenario increased,” she wrote.

Fast-forward a decade, and the discussion of the tangled relationship between the conscious and unconscious mind continues. “When making complex decisions that require us to weigh multiple factors, some researchers believe we can benefit from learning to combine our conscious deliberations with unconscious processing,” explained Rose Hoare in her article for CNN.com. The conscious mind, by comparison, is of “low capacity”, she continued.

Hoare referred to the Theory of Unconscious Thought, the work of Ap Dijksterhuis and Loran F. Nordgren from the University of Amsterdam’s Social Psychology Program. In their research, Dijksterhuis and Nordgren presented their theory about human thinking as it applies to decision making and problem solving, called the Unconscious-Thought Theory (UTT).

The theory “distinguishes between two modes of thought: unconscious and conscious,” they wrote. “For instance, contrary to popular belief, decisions about simple issues can be better tackled by conscious thought, whereas decisions about complex matters can be better approached with unconscious thought."

Hoare explained that according to the UTT, the strength of the conscious mind is in its ability to arrange information according to “rules, and performing precision maneuvers such as those involved with arithmetic”. The unconscious mind, by comparison is able to synthesize “large amounts of information, and [privilege] important considerations over trivial ones”.

The results from the two groups of college students support the Unconscious-Thought Theory—illustrating how the unconscious mind continues to analyze and synthesize even when its conscious focus is distracted or relaxed.

The results from the two groups of college students . . . “stands in stark contrast to what (we think) we know about thinking and problem solving,” Mbadiwe continued. Like members of the medical profession, more specifically—novice professionals--who are called upon to make snap decisions—based solely on “consciously considering the problem”, she suggested that most people have to make high-risk, complex decisions without an opportunity to allow input from the unconscious mind.

“If we could improve decisions simply by replacing conscious deliberation with a brief period of distraction, it would represent a great--and essentially costless--step forward for us,” she said.

Leonard Mlodinow, American theoretical physicist, followed the studies of professionals and scientists with his 2012 publication, Subliminal: How Your Unconscious Mind Rules Your Behavior. In it, Mlodinow explained the “two-tiered brain”—a term he coined to explain the relationship between the unconscious and conscious mind. Without realizing it, humans “are constantly shifting back and forth between [the two states],” he said.

In her blog article for HuffPost (UK), anxiety expert Chloe Brotheridge suggested the importance of allowing the conscious brain to “let go” before making an important decision. Anxiety about making the wrong decision, or feeling overwhelmed by the details of both sides of a decision can lead to a standstill.

“I suggest that you go for a walk and get outside to reconnect with nature. If that's not available to you right now, then have an early night tonight. 'Sleeping on it' will help,” Brotheridge wrote. “The aim is to get in a relaxed state then you can hear your inner voice and you can choose, and it will be the right choice.”

References

Brotheridge, C., (September 28, 2015). HuffPost (UK). Four Ways to Help Decision Making Anxiety. http://www.huffingtonpost.co.uk/chloe-brotheridge/four-ways-to-help-decision-making-anxiety_b_8195830.html

Dijksterhuis, A., & Nordgren, L.F., (2006). University of Amsterdam. A Theory of Unconscious Thought. http://www.alice.id.tue.nl/references/dijksterhuis-nordgren-2006.pdf

Hoare, R., (August 28, 2012). CNN.com. Got a big decision to make? Sleep on ithttps://www.cnn.com/2012/08/27/business/unconscious-mind-sleep-decision/index.html

Mbadiwe, T., M.D., J.D., (December 15, 2017). Psychiatry Advisor. Making a Decision: Using Conscious vsUnconscious Thinking to Solve the Problem. https://www.psychiatryadvisor.com/opinion/conscious-vs-unconscious-problem-solving/article/718200/

Smith, J.E., (Retrieved January 29, 2018). PsychCentral.com. Subliminal: How Your Unconscious Mind Rules Your Behavior. https://psychcentral.com/lib/subliminal-how-your-unconscious-mind-rules-your-behavior/

As the general population moves towards a greater understanding and awareness of mental illness in campaigns such as Bell Let’s Talk in Canada and Time To Talk in the U.K., scientists, doctors and researchers continue to examine the causes of varying mental disorders in order to improve prevention, screening and treatment.

In the first of its kind, a Canadian study is looking at whether adverse events before birth and in infancy up to two years of age could be biologically embedded into the molecules and genes of the children who may go on to develop a mental illness as an adult – and more importantly, whether it can be prevented.

A synopsis of the ongoing Healthy Foundations Study: A Randomized Controlled Trial To Evaluate Biological Embedding of Early-Life Experience was published in The BMJ in December 2017.

“Findings illustrate that prenatal exposure to maternal stress, postnatal adversity and non-optimal caregiving may exert programming influences reflected in the child’s capabilities to regulate stress and may impact inflammation and DNA,” notes the study.

Exposure to adverse early life experiences such as prenatal stress, poverty, maltreatment, bullying, low-quality care and maternal distress results in increased proinflammatory cytokines. “There is emerging evidence that psychological interventions may have the potential to influence inflammatory markers,” notes the study. A study just published in the American Journal of Obstetrics and Gynecology in January 2018 shows that higher levels of cerebrospinal fluid inflammatory cytokines results in increased odds of a woman developing perinatal depression.

And then there’s the question of genetics and epigenetics – effects on genes that can be passed down to future generations. Researchers are also looking at this question and whether an intervention program can prevent this from happening.

“Emerging evidence suggests that early-life experiences may cause epigenetic modifications of the genome which influence the development of mental and physical health throughout the lifespan,” notes the study, including antenatal depression.

Researchers believe it’s essential to try and prevent long-term negative mental health effects in children earlier rather than later because brain plasticity decreases over time. Researchers believe that “a greater understanding of the biology of early adversity and the potential to mitigate detrimental effects will provide a powerful framework with which to inform basic and applied research, practice and policy.”

Researchers began by recruiting 400 pregnant women from British Columbia who were less than 28 weeks gestation in 2013. Researchers used hair samples from the women to measure physiological stress first at the beginning of the study and then again at two months postpartum. Saliva samples of their infants were collected at two and 24 months to analyze stress and immune function, specifically the effect on the hypothalamic-pituitary-adrenal (HPA) axis.

The HPA axis is located in the brain and is what helps us respond to stress. Studies have shown how prenatal stress has resulted in HPA dysregulation in children. However, studies have also shown how interventions can have a “positive impact on HPA axis functioning in children exposed to adverse experiences including foster care children, adopted institutionalised children, maltreated children, children at risk for antisocial behaviour problems, parentally bereaved children and infants whose mothers were at risk for antenatal depression.”

Previous studies have shown that adverse early experiences can have detrimental effects on adulthood and future generations. Studies of animals as well as humans also show how the nervous system and immune system are altered and the resulting negative effects on brain function which are hard to reverse over time. Researchers in the current study wonder whether these experiences might be biologically embedded and whether a preventative program in pregnancy and postpartum could reverse biological embedding.

The program researchers are using in their study is the home visitation, evidence-based, Nurse-Family Partnership (NFP) program. The program was created to help low-income, first-time mothers under the age of 24 which represents about 5% of live births annually in Canada. Women in this category have been shown to experience higher levels of intimate partner violence, smoking and street drug use, and poor prenatal care with negative mental health effects resulting in their children.

“Children born to these young mothers are at an increased risk for cognitive difficulties, impairment in educational and social outcomes, including school adjustment problems, and poorer physical and mental health outcomes,” the study notes.

Researchers are now in the process of analyzing the data. They believe that if the NFP proves successful at positively impacting children at a biological level, there’s a “greater likelihood of future health” and at convincing policymakers of the “influence of early developmental processes.”

References:

(Jan. 2018), American Journal of Obstetrics and Gynecology, 50: Biomarkers of inflammation in perinatal depression, http://www.ajog.org/article/S0002-9378(17)31699-X/fulltext

(Dec. 2017), The BJM, The Healthy Foundations Study: A Randomized Controlled Trial To Evaluate Biological Embedding of Early-Life Experience, https://www.ncbi.nlm.nih.gov/pubmed/29374668

Sunday, February 4, 2018 was the 18^th annual World Cancer Day, and with it came media coverage of cancer survival rates continuing to improve in North America. In fact, according to the American Cancer Society, trends in five-year relative survival rates for women after breast cancer have increased from 75 percent in 1975-1977 to 91 percent in 2006-2012. Similarly, numbers of male survivors of prostate cancer compared over the same periods of time have increased from 68 to 99 percent.

Yet with all this positive news, it may be surprising to know that for many cancer survivors, when the treatments are finished, the side effects to their mental health may be long-term or permanent.

A day before World Cancer Day, Canada's CTV News reported on Canadian ovarian cancer survivor Charlotte Cook-Dowsett, one of a growing number of patients who are living proof of a “medical system [that] is doing better than ever at curing cancer”. The problem, the news source stated, is that the system “does a poor job of providing mental health care after [patients] get the all-clear”.

According to CTV News, research indicates 70 percent of survivors face challenges to their mental health resulting from their diseases and treatments, and 80 percent experience such lasting and non-treated effects as fatigue and reduced sexual health. Roughly 20 percent report symptoms of Post-Traumatic Stress Disorder.

In Cook-Dowsett’s case, she “felt cast adrift when the surgery and chemotherapy ended,” and she was left to find her own reinforcements. "When you're going through the treatment, you have this warrior attitude . . . and you're surrounded by a community of support," CTV News quoted the Winnipeg, Manitoba woman.

"But when the cancer is gone and the chemo is done . . . the community support isn't as strong because they feel you are done," she asserted. Yet, for Cook-Dowsett, the anxiety and depression had just begun.

CTV News also quoted Jackie Manthorne, president of the Canadian Cancer Survivor Network and a cancer survivor herself, who echoed Cook-Dowsett’s post-treatment experiences, saying there are many who “feel abandoned” after successful treatments for the disease.

"There isn't one survivor who won't tell you that they don't fear recurrence," she said. "They're dealing with an illness that they know sometimes kills people." Besides influencing their own mental and emotional well-being, Manthorne said, “cancer can also strain relationships with partners and children”.

In her September 2017 article for the National Alliance on Mental Illness(NAMI), Laura Greenstein, the organization’s communication coordinator, wrote that “cancer survivors are more than twice as likely to have mental health problems compared to adults without cancer”.

For patients who recover from the disease, Greenstein explained, many will suffer anxiety that persists for years. “Surviving cancer is a traumatic event: You live in fear that you might not survive,” she wrote. “You worry about your family. You lose your independence. You watch as your body weakens and your physical appearance declines.”

Greenstein wrote about Heather Von St. James who not only beat her disease, malignant pleural mesothelioma, but as an 11-year survivor—she had long outlived the original 15-month prognosis. She “faced unease about a future she never planned alongside her husband and daughter, Lily,” Greenstein said. “And in the wake of survivorship, she uncovered debilitating mental health symptoms.”

Von St. James ended up seeking the assistance of professional mental health services after her own attempts to cope with her mental health challenges proved unsuccessful. “While working with a counselor specializing in post-cancer care, Heather received a diagnosis of PTSD and anxiety,” Greenstein added, and she now advocates for cancer survivors’ mental health support.

Professors Michelle J. Naughton and Kathryn E. Weaver, in their 2014 journal article for the U.S. National Library of Medicine, recognized that with greater medical advances and more patients surviving their cancer diagnoses, the disease and the management of post-treatment symptoms and/or recurrences should result in cancer being labelled as a chronic disease, i.e., one that requires long-term patient care, even after recovery.

“For cancer survivors, as for individuals without a history of cancer, physical health directly influences mental health status and overall quality of life,” they wrote. “Physical symptoms are more likely to be detected and treated by health care providers, as the mental health and social consequences of illness are less well recognized.”

According to Naughton and Weaver, population studies indicate “cancer survivors are more than twice as likely to have disabling psychological problems compared with adults without cancer, and individuals who have both cancer and other chronic illnesses have a risk of psychological disability that is nearly six times higher than that of adults without cancer.”

The two professors suggested “screening for mental health morbidity” and overall screening for mental health challenges should be “better integrated” into the patient’s treatment and “survivorship”.

Dr. Gary Rodin is a psychiatrist who heads up the Supportive Care department at the Princess Margaret Cancer Centre, a teaching hospital and scientific research facility in Toronto, Canada. In a June 2017 article for The Toronto Star newspaper, writer Peter Goffin explained that Rodin “is part of a [specialized] field known as psychosocial oncology--identifying and treating the mental, emotional and social impacts of cancer”.

Rodin believes supportive care for a patient “needs to be systemic and routine”, providing proactive instead of reactive assistance. “We need to be sure this happens across . . . cancer care,” he added. Because . . . we need to make sure there is a continuum of support throughout the whole process.”

References

American Cancer Society. (Retrieved February 3, 2018). Cancer Statistics 2017 Slide Presentation. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html

CTV News.ca Staff. (February 3, 2018). CTV News. ‘They feel abandoned’: Cancer survivors say post-treatment support is lacking. https://www.ctvnews.ca/health/they-feel-abandoned-cancer-survivors-say-post-treatment-support-is-lacking-1.3788402

Goffin, P., (June 12, 2017). The Toronto Star. Cancer survivors struggle with mental health issues. https://www.thestar.com/news/gta/2017/06/12/cancer-survivors-struggle-with-mental-health-issues.html

Greenstein, L., (September 25, 2017). National Alliance on Mental Illness. Life After Survival: Why Cancer Survivors Need Mental Health Care. https://www.nami.org/Blogs/NAMI-Blog/September-2017/Life-After-Survival-Why-Cancer-Survivors-Need-Men

Naughton, M.J., Ph.D., M.P.H., & Weaver, K.E., Ph.D., M.P.H., (July-August, 2014). U.S. National Library of Medicine. Physical and Mental Health Among Cancer Survivors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503227/