#mentalhealth – News in Mind http://www.newsinmind.com Tue, 19 Mar 2019 00:26:31 +0000 en-US hourly 1 https://wordpress.org/?v=5.1.1 Mental health patients share their experiences to call for an end to stigma http://www.newsinmind.com/stigma-reduction/mental-health-patients-share-their-experiences-to-call-for-an-end-to-stigma http://www.newsinmind.com/stigma-reduction/mental-health-patients-share-their-experiences-to-call-for-an-end-to-stigma#respond Sun, 28 Feb 2016 23:16:58 +0000 http://www.newsinmind.com/?p=8179 Louis Collenette, 24, was diagnosed with obsessive compulsive disorder (OCD) eight years ago. From a young age he felt he had to repeat certain tasks to prevent disastrous consequences. Four was his safe number. If he did something six times, he felt he was putting his family in danger.

When he was 12, Louis’ anxiety intensified. He vividly remembers the incident which triggered his deepest fear. He was on the tube, when he was overcome by a desperate urge for the toilet. With no toilet nearby, his brothers suggested he relieve himself in a plastic bottle on the empty tube. Terrified of wetting himself, he did. As the train drew into Ravenscourt Park station and people stared at him in disgust.

Louis was determined he would never be humiliated like this again. He became obsessed with going to the toilet. His fear of wetting himself in public took over his life. Avoidance became his coping mechanism. He skipped school and missed social events. He felt he couldn’t share what he was thinking with anyone.

“I was incredibly embarrassed about my worries. Shame stopped me from telling people I had OCD,” he says.

After years of lies and secrecy, Louis decided to share his story of living with OCD with all of his Facebook friends.

“I went from never having told anyone the whole story except my psychiatrist, to telling everyone I knew in one go. It was easier to share it in a Facebook post, than to explain it in person.”

Stigma around mental illness prevents many people from speaking out. Time to Change, an anti-stigma campaign launched in 2007 by the charities Mind and Rethink Mental Illness, conducted a survey in January of 7,171 people who have experienced mental health problems. 86 per cent says that they have faced stigma and discrimination as a result of their condition, with 64 per cent reporting that it came from friends, and a further 57 per cent from family members.

Kate Nightingale, a campaign spokesperson, says: “Our latest survey shows that nearly two thirds of people with mental health problems are left feeling isolated (64 per cent), worthless (61 per cent) and ashamed (60 per cent) because of the stigma and discrimination they have faced. Often people with mental health problems state that the stigma is worse than the illness itself.”

David Cameron promised in mid-February to help more than a million extra people and invest £1bn annually in mental health services by 2020/21.

Paul Farmer, chief executive of Mind, described the five-year strategy as “a once-in-a-generation opportunity to transform services and support for people with mental health problems.”

Rebecca Bird, 25, saw the crippling effect of stigma first hand when her mother Tracey Bird was admitted to a mental health unit.

“She didn’t want anyone to know she had anxiety. It was a massive embarrassment to her,” says Rachel.

Her mother was released from the unit because there weren’t enough beds. She killed herself a few weeks later.

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Rebecca Bird pictured with her mother Tracey

After her mother’s death, Rebecca became reluctant to leave the house and started having panic attacks. The doctor immediately diagnosed her with anxiety.

She is incredibly open about her illness, and finds it worrying that mental illness is such a taboo.

“I’m determined not to let my condition ruin me like it did my mum.

“It’s fine to say you’re coming into work late because you have a blood test, but nobody ever says they’re coming in later because of counselling.”

Many people who reveal their mental health problems to others are met with a negative reaction. The Time to Change survey found that 48 per cent of people stopped looking for work or returning to work because of people’s reactions when they disclosed their condition.

Nick Burnley, 31, felt stigmatised by the health care assistants who says borderline personality disorder (BPD) wasn’t a legitimate reason for him being in hospital.

“They told me I was taking up a hospital bed,” he says, adding that he received little support from his parents. “They backed away and said they couldn’t handle me when I was ill.”

However, he is keen to emphasise that others have been incredibly supportive.

“I work as a personal trainer and my colleagues have been brilliant. Out of my last 50 clients, only one or two were apprehensive.”

Louis has found the reaction to his “coming-out blog” overwhelming.

“I was convinced that revealing the truth was reprehensible. I never thought about the fact that everyone has got something they’re insecure about.”

He has since been contacted by a lot of people saying they can relate to his experience.

“One of the rugby lads from school got in touch. I’ve always been insecure about not being a manly guy and I was very embarrassed at the thought of him reading my piece.

“He’d been suffering from depression and panic attacks and wrote to me: ‘thanks for encouraging me today when I wanted to curl into a ball and pretend I was fine.’ There’s a misconception that if you’re a tough guy, mental illness is a weakness.”

Greater awareness and an honest, open dialogue are needed to break the vicious cycle of stigma around mental illness, campaigners urge.

“We need to replace silence and stigma with talking, greater understanding and support. You don’t have to be an expert to talk about mental health. A few small words can make a big difference,” says Ms Nightingale.

A lack of understanding lies at the heart of the problem, Nick believes.

“They’re scared because they struggle to rationalise my condition,” he says. When asked why he thinks people with mental health problems are so hesitant to come forward, he quotes a line from the film Man of Steel: “My father believed that if the world found out who I really was, they’d reject me…out of fear.”

Investment in mental health services is urgent, Rebecca says. “At the moment the waiting list for counselling is 6-8 weeks. In the meantime your mind is just getting worse and worse.”

The report published by the NHS taskforce said that funding will help 600,000 more people access counselling services. One of the main recommendations was that £1.4bn should be invested in mental health care for children. Louis believes it is essential to raise awareness about mental illness among young people.

“I had no idea I had a condition which could be diagnosed and treated,” he says.

“I just lived with my problem in silence. I would focus all my energy on getting out of going to school. Every day I would think about letting a car run over my foot. No child should seriously have to consider that as an option.”

This article first appeared on ‘Independent’ on 26 February 2016.

 

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Climate change is wreaking havoc on our mental health, experts say http://www.newsinmind.com/research/climate-change-is-wreaking-havoc-on-our-mental-health-experts-say http://www.newsinmind.com/research/climate-change-is-wreaking-havoc-on-our-mental-health-experts-say#respond Sun, 28 Feb 2016 23:05:10 +0000 http://www.newsinmind.com/?p=8172 As a provincial coroner and past palliative care physician, Dr. David Ouchterlony has seen suffering and death up close, experiences that have occasionally led to brief moments of sadness. But Ouchterlony describes such emotions as “trivial” compared to the dread he feels when thoughts about climate change linger, as they often do. He worries almost obsessively about a future he won’t see. How will younger generations be affected? Why are we failing to act on the threat?

“I was completely blind to it, and then five years ago it just hit me,” Ouchterlony, 74, said. “I went through this stage of losing sleep, thinking about my grandchild, wondering what I could do.”

He described the feeling as an “absence of hope” characterized by despair and, at times, exhausting guilt. Some researchers have called it a “pre-traumatic” stress disorder that, in some, is feeding anxiety and depressive thoughts.

Ouchterlony isn’t alone. Signs of mental distress related to climate change have appeared in vulnerable populations, from drought-stricken prairie farmers to isolated aboriginal communities and the scientists who crunch climate data.

Our fast-changing climate has long been identified as a threat to physical health, but more psychologists are warning that the mental health impacts and the economic toll they take are real, likely to spread and need closer study.

“We may not currently be thinking about how heavy the toll on our psyche will be, but, before long, we will know only too well,” warned a 2012 report from the U.S. National Wildlife Federation.

It predicted that cases of mental and social disorders will rise steeply as the signs of climate change become clearer and more frequent, and as more people are directly affected by heat waves, drought and other extreme events that put pressure on clean water resources, food prices and public infrastructure.

“These will include depressive and anxiety disorders, post-traumatic stress disorders, substance abuse, suicides and widespread outbreaks of violence,” predicted the report. It singled out children, the poor, the elderly and those with existing mental health problems as those likely to be hardest hit.

“At roughly 150 million people, these groups represent about one half of the American public,” it calculated. In addition, the mental health profession is “not even close to being prepared” and the report warned the existing problem is likely being underestimated because most research is based on self-reporting.

“People may, indeed, suffer from anxiety about climate change but not know it. They will have a vague unease about what is happening around them, the changes they see in nature, the weather events and the fact that records are being broken month after month. But they won’t be sufficiently aware of the source, and furthermore, we all conflate and layer one anxiety upon another.”

Jennie Ferrara, an American expat living in Copenhagen, began having episodes of climate-related anxiety and depression shortly after the first of her two children were born.

Life comes with all sorts of stresses, “but this one really broke the camel’s back for me,” said Ferrara, who as a therapeutic exercise started the blog Confessions of a Climate Worrier in 2011. “I’m convinced hordes of people are filing their mental malaise under divorce, the economy, or whatever, when it’s actually the slow drip of climate reality.”

The drips show up daily on social and mainstream media. We now know that 2015 was the hottest year on record. In the past few months alone, we have heard about snow in Saudi Arabia in January, back-to-back late-season cyclones in the Arabian Peninsula, a 500-year drought in California, the hottest ever Christmas Eve in Toronto and end-of-year temperatures in the North Pole that were warmer than parts of California — all extremely rare or unprecedented events being filed in our subconscious.

Behind the scenes, the 122,000-member American Psychological Association (APA) is taking the issue seriously. It set up a task force in 2008 to survey the limited research. A comprehensive report followed, leading to a member resolution in 2011 to recognize “the current and anticipated psychosocial impacts of climate change.” It also encouraged more awareness of this nascent field of study.

“I see parallels to the fears we went through in the 1950s about the world ending because of atomic war. There was this general dread among people, and this fear of annihilation,” said University of Victoria psychology professor Robert Gifford, who calls himself the “token Canadian” on the APA task force.

In Canada, the issue has barely landed on the radar. Karen Cohen, chief executive of the Canadian Psychological Association, said the organization had “no plans at present” to develop a position. Last year, the Mental Health Commission of Canada released a major report detailing 55 indicators that will be used to track mental illness and well-being among Canadians. There was no mention of climate change.

“I don’t know why the Canadian Psychology Association hasn’t been more active,” said Gifford, who speculates that most in the profession likely see it as a fringe issue. “We should do more.”

The climate casualties

Climate change can seem a distant threat, but not to these people:

Wounded on the front lines

Australian Joe Duggan began asking climate scientists in 2014 how they felt being on the front lines of climate science. The responses showed a level of emotion and concern the public never sees: “It makes me feel sick,” read one. “I feel exasperation and despair in equal measure,” says another. Scientists wrote of being “nervous,” “worried,” “anxious” and “depressed” by what they know. Duggan posted the letters on the website Is This How You Feel? and has been receiving submissions ever since. “These people write complex research papers, unpacking every aspect of climate change, analyzing it thoroughly and clinically,” Duggan writes. “But they’re not robots. These scientists are mothers, fathers, grandparents, daughters. They are real people. And they’re concerned.”

A “sleeping giant”

The iconic Princess Cottage, built in 1855, remains standing after being ravaged by flooding on November 21, 2012 in Union Beach, New Jersey. Little more than half of the home remains and more than 200 homes were destroyed by Superstorm Sandy in the town.

Mario Tama

The iconic Princess Cottage, built in 1855, remains standing after being ravaged by flooding on November 21, 2012 in Union Beach, New Jersey. Little more than half of the home remains and more than 200 homes were destroyed by Superstorm Sandy in the town.

Environmentalists also struggle. Many describe an epidemic of depression in their profession that can lead to broken marriages, mental breakdown and even suicide. “I’ve become aware of it with a lot of the young people I work with,” said Glen Murray, Ontario’s minister of environment and climate change.

Lawyer David Boyd describes it as “sleeping giant of a problem.” He wrote The Optimistic Environmentalist to counter the “relentless” bad news by highlighting the real progress. “For me, writing this was a voyage of recovery.”

After the storm — Calgary’s historic flood

The historic Calgary flood of 2013 took the lives of five people and displaced tens of thousands. When the waters retreated the city looked like a war zone. Cars and waste were strewn everywhere and the Calgary Stampede grounds and the  Saddledome arena were closed

Andy Clark

The historic Calgary flood of 2013 took the lives of five people and displaced tens of thousands. When the waters retreated the city looked like a war zone. Cars and waste were strewn everywhere and the Calgary Stampede grounds and the Saddledome arena were closed

Calgary real-estate agent Emma May remembers June 19, 2013, as the day her community was under water. “We’re still seeing the impacts — the divorces, the stress placed on families, some with PTSD,” says May. “There are kids in families who don’t want to live near the river ever again. Some cry when it begins to rain.”

Distress Centre Calgary, which provides 24-hour crisis support, says that since the 2013 flood call volumes have risen 30 per cent, including an increase in calls related to suicide ideation and domestic violence. “The emotional and mental well-being of those affected by the flood needs to be addressed and is likely to need support well into the future,” according to the centre.

“No one can argue our weather isn’t getting more severe,” says Catherine Bell, a board member with the centre. “We need to absolutely be doing something on all fronts as it relates to climate change and mental health.”

More frequent, more extreme

The British medical journal Lancet estimated in June that we are four times more likely to be exposed to extreme rainfall later this century compared to 1990 levels.

BEN STANSALL

The British medical journal Lancet estimated in June that we are four times more likely to be exposed to extreme rainfall later this century compared to 1990 levels.

Increased flooding — more frequent and more extreme — is probably the most visible impact of climate change, at least for city dwellers. We saw it in South Carolina last October and in the United Kingdom in December. A report in the British medical journal The Lancet last June estimated we are four times more likely to be exposed to extreme rainfall later this century compared to 1990 levels.

A July 2015 study from Rutgers University and NYU found that the emergence of mould in waterlogged houses after Hurricane Sandy was “significantly associated” with the rate of mental health distress. It also found that children living in hurricane-damaged homes were four times more likely to feel depressed and twice as likely to develop sleeping disorders. It caught public health officials off guard.

The already vulnerable

Members of a New York Police Department tactical team rescue Haley Rombi, 3, in the Dongon Hills neighborhood of the Staten Island borough of New York, Oct. 30, 2012. As Hurricane Sandy churned inland as a downgraded storm, residents up and down the battered mid-Atlantic region woke on Tuesday to lingering waters, darkened homes and the daunting task of cleaning up from storm surges and their devastating effects.

MICHAEL KIRBY SMITH

Members of a New York Police Department tactical team rescue Haley Rombi, 3, in the Dongon Hills neighborhood of the Staten Island borough of New York, Oct. 30, 2012. As Hurricane Sandy churned inland as a downgraded storm, residents up and down the battered mid-Atlantic region woke on Tuesday to lingering waters, darkened homes and the daunting task of cleaning up from storm surges and their devastating effects.

New immigrants, small children, the elderly and disabled and sufferers of existing mental health conditions, particularly those living in poverty, are more prone to experience psychological distress from the impacts of climate change, according to the American Psychological Association.

They are also more likely to live in low-income housing without air conditioning and in communities with poor infrastructure and access to services, making them vulnerable to flooding, heat waves and storms. Indirectly, rising food prices as a result of climate-related disruptions will put pressure on struggling low- and fixed-income households. “There are clear relationships between environmental risk, poverty and vulnerability,” wrote psychologists Thomas Doherty and Susan Clayton in a 2011 article in American Psychologist. “Paradoxically, the people that face the highest risk of impacts are the least well-prepared.”

This article first appeared on ‘The Star’ on 9 February 2016.

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Transgender Kids With Family Support Can Have Good Mental Health http://www.newsinmind.com/stigma-reduction/transgender-kids-with-family-support-can-have-good-mental-health http://www.newsinmind.com/stigma-reduction/transgender-kids-with-family-support-can-have-good-mental-health#respond Sun, 28 Feb 2016 22:59:48 +0000 http://www.newsinmind.com/?p=8169 A new study has found that transgender children who have the support of their families have positive mental health, with rates of depression and anxiety no higher than a control group of children.

The findings challenge long-held assumptions that mental health problems in transgender children are inevitable, or even that being transgender is itself a type of mental disorder, said lead author Dr. Kristina Olson, an assistant professor of psychology at the University of Washington.

“The thinking has always been that kids who are not acting gender-stereotypically are basically destined to have mental health problems,” said Olson. “In our study, that’s not the case.”

Published in Pediatrics, the study looked at 73 children between the ages of three and 12 who have “socially transitioned,” changing their preferred pronouns and, typically, their names, clothing and hairstyles.

The researchers found that these children had rates of depression and anxiety no higher than two control groups — their own siblings and a group of age- and gender-matched children.

And their rates of depression and anxiety were significantly lower than those of gender-nonconforming children in previous studies, the researchers noted.

Co-author Dr. Katie McLaughlin, a University of Washington assistant professor of psychology, called the findings “incredibly promising.”

“They suggest that mental health problems are not inevitable in this group, and that family support might buffer these children from the onset of mental health problems so commonly observed in transgender people,” she said.

For the study, researcher had the parents complete two short surveys under the National Institutes of Health’s Patient-Reported Outcome Measurement Information System. The surveys asked parents whether their children had experienced symptoms of depression or anxiety during the past week, for example, feeling sad or being worried when going to bed.

The researchers found that the transgender children’s levels of depression averaged a score of 50.1, almost the same as the national norm of 50. Their anxiety rates were 54.2, only slightly higher than the national norm.

The higher anxiety rates aren’t exactly surprising, Olson said. Though transgender children are becoming increasingly visible in the mainstream media, their reality remains little understood even within the medical community.

Transgender people were long classified under the umbrella of “gender identity disorder” by the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM). The term was replaced with “gender dysphoria” in 2013, after considerable debate and lobbying from advocates to remove the word “disorder” from its name.

“It is hard to be transgender in 2016 in the United States,” Olson said. “If peers know that a child is transgender, they often tease that child. If peers do not know, the transgender child has to worry about being found out. It’s not surprising that transgender children would have some more anxiety, given the state of the world for transgender children right now.”

The researchers acknowledge that the positive mental health among study participants might be explained by factors other than just parental support.

Parents could be biased in their reporting, for example, wanting their kids to appear healthier than they are. Or the children themselves might have personality traits, such as confidence, that correlate to a healthy emotional state. Future studies will investigate these possibilities, they noted.

The study is part of the TransYouth Project led by Olson. The first large-scale, longitudinal study of transgender children in the U.S., it involves more than 150 transgender children and families from about 25 states. The project’s initial study, published in 2015, found that transgender children’s gender identities were as deeply rooted as those of their non-trans peers.

The researchers next plan to look at how factors outside of the family, such as treatment by peers, might predict mental health in transgender children, and whether the age of transition makes a difference.

“It will be important to follow these children over time, particularly during the transition to adolescence, to understand patterns of mental health and positive adjustment across development for transgender youth who are supported by their families,” McLaughlin said.

Olson said while there is still a tremendous amount to be learned about transgender children, the study’s findings suggest it’s possible for them to live happier lives than previous generations of transgender people.

“I think they’re proof that you can be a young transgender kid today and be happy and healthy and doing just as well as any other kid,” she said. “It’s some good news, finally, which I don’t think there’s much of in what we hear about transgender kids.”

This article first appeared on ‘Psych Central’ on 29 February 2016.

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Once-popular party drug ketamine now used to treat severe depression http://www.newsinmind.com/therapies/once-popular-party-drug-ketamine-now-used-to-treat-severe-depression http://www.newsinmind.com/therapies/once-popular-party-drug-ketamine-now-used-to-treat-severe-depression#respond Wed, 03 Feb 2016 00:57:05 +0000 http://www.newsinmind.com/?p=7925 It was in November 2012 that Dennis Hartman, a Seattle business executive, managed to pull himself out of bed, force himself to shower for the first time in days and board a plane that would carry him across the country to a clinical trial at the National Institute of Mental Health (NIMH) in Bethesda, Maryland.

After a lifetime of profound depression, 25 years of therapy and cycling through 18 antidepressants and mood stabilisers, Mr Hartman, then 46, had settled on a date and a plan to end it all. This clinical trial would be his last stab at salvation.

For 40 minutes, he sat in a hospital room as an IV drip delivered ketamine through his system. Several more hours passed before it occurred to him that all his thoughts of suicide had evaporated.

“My life will always be divided into the time before that first infusion and the time after,” Mr Hartman says today. “That sense of suffering and pain draining away. I was bewildered by the absence of pain.”

Ketamine, popularly known as the psychedelic club drug Special K, has been around since the early 1960s. It is a staple anaesthetic in emergency rooms, regularly used for children when they come in with broken bones and dislocated shoulders.

It’s an important tool in burn centres and veterinary medicine, as well as a notorious date-rape drug, known for its power quickly to numb and render someone immobile.

Since 2006, dozens of studies have reported that it can also reverse the kind of severe depression that traditional antidepressants often don’t touch. The momentum behind the drug has now reached the American Psychiatric Association (APA), which, according to members of a ketamine taskforce, seems headed towards a tacit endorsement of the drug for treatment-resistant depression.

Experts are calling it the most significant advance in mental health in more than half a century. They point to studies showing ketamine not only produces a rapid and robust antidepressant effect; it also puts a quick end to suicidal thinking.

Traditional antidepressants and mood stabilisers, by comparison, can take weeks or months to work. In 2010, a major study published in JAMA, the journal of the American Medical Association, reported that drugs in a leading class of antidepressants were no better than placebos for most depression.

A growing number of academic medical centres, including Yale University, the University of California at San Diego, the Mayo Clinic and the Cleveland Clinic, have begun offering ketamine treatments off-label for severe depression, as has Kaiser Permanente in Northern California.

“This is the next big thing in psychiatry,” says L. Alison McInnes, a San Francisco psychiatrist who over the past year has enrolled 58 severely depressed patients in Kaiser’s San Francisco clinic.

She says her long-term success rate of 60 per cent for people with treatment-resistant depression who try the drug has persuaded Kaiser to expand treatment to two other clinics in the Bay Area.

The excitement stems from the fact that it’s working for patients who have spent years cycling through antidepressants, mood stabilisers and various therapies.

“Psychiatry has run out of gas” in trying to help depressed patients for whom nothing has worked, she says.

“There is a significant number of people who don’t respond to antidepressants, and we’ve had nothing to offer them other than cognitive behaviour therapy, electroshock therapy and transcranial stimulation.”

Dr McInnes is a member of the APA’s ketamine taskforce, assigned to codify the protocol for how and when the drug will be given. She says she expects the APA to support the use of ketamine treatment early this year.

The guidelines, which follow the protocol used in the NIMH clinical trial involving Mr Hartman, call for six IV drips over a two-week period. The dosage is very low, about a 10th of the amount used in anaesthesia. And when it works, it does so within minutes or hours.

“It’s not subtle,” says Enrique Abreu, an anaesthesiologist from Portland, Oregon, who began treating depressed patients with it in 2012.

“It’s really obvious if it’s going to be effective. And the response rate is unbelievable. This drug is 75 per cent effective, which means that three-quarters of my patients do well. Nothing in medicine has those kind of numbers.”

So far, there is no evidence of addiction at the low dose in which infusions are delivered. Ketamine does, however, have one major limitation: its relief is temporary.

Clinical trials at NIMH have found that relapse usually occurs about a week after a single infusion.

Ketamine works differently from traditional antidepressants, which target the brain’s serotonin and noradrenalin systems. It blocks N-methyl-D-aspartate (NMDA), a receptor in the brain that is activated by glutamate, a neurotransmitter.

In excessive quantities, glutamate becomes an excitotoxin, meaning that it overstimulates brain cells.

“Ketamine almost certainly modifies the function of synapses and circuits, turning certain circuits on and off,” explains Carlos Zarate, NIMH’s chief of neurobiology and treatment of mood disorders, who has led the research on ketamine.

“The result is a rapid antidepressant effect.”

A study published in the journal Science in 2010 suggested that ketamine restores brain function through a process called synaptogenesis.

Scientists at Yale University found that ketamine not only improved depression-like behaviour in rats but also promoted the growth of new synaptic connections between neurons in the brain.

Even a low-dose infusion can cause intense hallucinations. Patients often describe a kind of lucid dreaming or dissociative state in which they lose track of time and feel separated from their bodies. Many enjoy it; some don’t. But studies at NIMH and elsewhere suggest that the psychedelic experience may play a small but significant role in the drug’s efficacy.

“It’s one of the things that’s really striking,” says Steven Levine, a psychiatrist from Princeton, New Jersey, who estimates that he has treated 500 patients with ketamine since 2011.

“With depression, people often feel very isolated and disconnected. Ketamine seems to leave something indelible behind. People use remarkably similar language to describe their experience: ‘a sense of connection to other people’, ‘a greater sense of connection to the universe.’ ”

Although bladder problems and cognitive deficits have been reported among long-term ketamine abusers, none of these effects have been observed in low-dose clinical trials.

In addition to depression, the drug is being studied for its effectiveness in treating obsessive-compulsive disorder, post-traumatic stress disorder, extreme anxiety and Rett syndrome, a rare developmental disorder on the autism spectrum.

Fleeting remission effect

The drug’s fleeting remission effect has led many patients to seek booster infusions. Mr Hartman began his search before he even left his hospital room in Bethesda.

Four years ago, he couldn’t find a doctor in the Pacific Northwest willing to administer ketamine.

“At the time, psychiatrists hovered between wilful ignorance and outright opposition to it,” says Mr Hartman, whose depression began creeping back a few weeks after his return to Seattle.

It took nine months before he found an anaesthesiologist in New York who was treating patients with ketamine. Soon, he was flying back and forth across the country for bimonthly infusions.

Upon his request, he received the same dosage and routine he’d received in Bethesda: six infusions over two weeks. And with each return to New York, his relief seemed to last a little longer. These days, he says that his periods of remission between infusions often stretch to six months. He says he no longer takes any medication for depression besides ketamine.

“I don’t consider myself permanently cured, but now it’s something I can manage like diabetes or arthritis,” Mr Hartman says. “Before, it was completely unmanageable. It dominated my life and prevented me from functioning.”

In 2012, he helped found the Ketamine Advocacy Network, a group that vets ketamine clinics, advocates for insurance coverage and spreads the word about the drug.

And word has indeed spread. Ketamine clinics, typically operated by psychiatrists or anaesthesiologists, are popping up in major cities around the country.

Dr Levine, for one, is about to expand from New Jersey to Denver and Baltimore. Dr Abreu recently opened a second clinic in Seattle.

Depression is big business. An estimated 15.7 million adults in the United States experienced at least one major depressive episode in 2014, the NIMH says.

“There’s a great unmet need in depression,” says Gerard Sanacora, director of the Yale Depression Research Program.

“We think this is an extremely important treatment. The concern comes if people start using ketamine before CBT [cognitive behavioral therapy] or Prozac. Maybe someday it will be a first-line treatment. But we’re not there yet.”

‘More research needed’

Dr Sanacora says a lot more research is required. “It’s a medication that can have big changes in heart rate and blood pressure. There are so many unknowns, I’m not sure it should be used more widely until we understand its long-term benefits and risks.”

While a single dose of ketamine is cheaper than a $2 bottle of water, the cost to the consumer varies wildly, running from between $US500 and $US1500 per treatment. The drug itself is easily available in any pharmacy, and doctors are free to prescribe it – as with any medication approved by the Food and Drug Administration – for off-label use. Practitioners attribute the expense to medical monitoring of patients and IV equipment required during an infusion.

There is no registry for tracking the number of patients being treated with ketamine for depression, the frequency of those treatments, dosage levels, follow-up care and adverse effects.

“We clearly need more standardisation in its use,” Dr Zarate says. “We still don’t know what the proper dose should be. We need to do more studies. It still, in my opinion, should be used predominantly in a research setting or a highly specialised clinic.”

As a drug once known almost exclusively to anaesthesiologists, ketamine now falls into a grey zone.

“Most anaesthesiologists don’t do mental health, and there’s no way a psychiatrist feels comfortable putting an IV in someone’s arm,” Dr Abreu says.

It’s a drug, in other words, that practically demands collaboration. Instead, it has set off a turf war. As the use of ketamine looks likely to grow, many psychiatrists say that use of ketamine for depression should be left to them.

“The bottom line is you’re treating depression,” says psychiatrist David Feifel, director of the centre for Advanced Treatment of Mood and Anxiety Disorders at the University of California at San Diego.

“And this isn’t garden-variety depression. The people coming in for ketamine are people who have the toughest, potentially most dangerous depressions. I think it’s a disaster if anaesthesiologists feel competent to monitor these patients. Many of them have bipolar disorder and are in danger of becoming manic. My question [to anaesthesiologists] is: ‘Do you feel comfortable that you can pick up mania?’ ”

But ketamine has flourished from the ground up and with little or no advertising. The demand has come primarily from patients and their families; Dr Zarate, for instance, says he receives “at least 100 emails a day” from patients.

Nearly every one of them wants to know where they can get it.

This article first appeared on ‘Sydney Morning Herald’ on 2 February 2016.

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Research links prenatal stress to babies’ health in war zones http://www.newsinmind.com/research/research-links-prenatal-stress-to-babies-health-in-war-zones http://www.newsinmind.com/research/research-links-prenatal-stress-to-babies-health-in-war-zones#respond Wed, 03 Feb 2016 00:57:03 +0000 http://www.newsinmind.com/?p=7928 pregnant-377451Children from war-torn areas of the globe are affected by trauma even before they are born, according to a new University of Florida study.

To gather their results, researchers went to the eastern Democratic Republic of Congo, a region routinely called “the worst place in the world” to be a woman, said Darlene A. Kertes, the study’s lead author and an assistant professor in UF’s department of psychology. Women in this unstable region are routinely the target of rape and other war-related traumas.

“Our research shows that stressful life experiences affect our bodies all the way down to our genes,” said Kertes, who also is affiliated with the University of Florida Genetics Institute.

The study was published in the January/February issue of Child Development, the flagship journal for the Society for Research in Child Development. The results showed that mothers’ stressful life experiences were linked with epigenetic markers in key genes that regulate the body’s response to stress, in both mothers and newborns.

“The study is one of the first of its kind to be conducted in a developing country,” Kertes said. “Most information to date about effects of stress and trauma on prenatal development has been gathered in a Western context.”

Samples of umbilical cord blood, placenta and the mothers’ blood were collected at birth and tested for impacts of war trauma and chronic stress. The researchers looked at DNA methylation, an epigenetic process that makes genes more or less able to respond to biochemical signals in the body.

During pregnancy, a mother’s bodily responses to stress are passed onto the fetus, affecting a child’s brain development, birth weight and functioning of the children’s own HPA axis even after they are born.

The researchers looked at the babies’ birth weight as an indicator of children’s overall development. They found that stress-linked DNA methylation differences predicted lower birth weight.

“The stress exposure affected the maternal and fetal tissues differently, which shows that the impact of stress differs depending on an individual’s life phase,” Kertes said, adding that stress experienced at very young ages affects the way the body responds to stress throughout life.

This is the first time researchers have documented stress effects, either pre- or postnatal, on methylation of a gene called CRH in humans. CRH makes a hormone that triggers the body’s stress response. The study also confirmed stress effects on several other genes known to be involved in the stress response.

Kertes and her colleagues have started to examine the longer term effects of stress on child development in conflict-ridden regions. She emphasized that traumatic events can also have cross-generational impacts.

“War and conflict do not just impact the health and well-being for people who experience it directly,” she said. “It can potentially have long-term consequences for future generations.”

This article first appeared on ‘Eurek Alert’ on 2 February 2016.

 

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Depression increases with age: study http://www.newsinmind.com/research/depression-increases-with-age-study http://www.newsinmind.com/research/depression-increases-with-age-study#respond Thu, 19 Nov 2015 23:26:36 +0000 http://www.newsinmind.com/?p=7741

People get more depressed after the age of 65, says an English study using data on older Australians.

It’s the first to show depressive symptoms continue to increase throughout old age, says lead researcher Dr Helena Chui from the University of Bradford.

“We are in a period of unprecedented success in terms of people living longer than ever and in greater numbers and we should be celebrating this but it seems that we are finding it hard to cope,” she said.

 The study, published in the international journal Psychology and Aging, builds on a 15-year project observing over 2000 older Australians living in the Adelaide area.

Both men and women reported increasingly more depressive symptoms as they aged, with women initially having more than men.

“However, men showed a faster rate of increase in symptoms so that the difference in the genders was reversed at around the age of 80,” the researchers said.

Levels of physical impairment, the onset of medical conditions and the approach of death all played a part in having the symptoms.

“It seems that we need to look carefully at the provision of adequate services to match these needs, particularly in the area of mental health support and pain management,” Dr Chui said.

“Social policies and ageing-friendly support structures, such as the provision of public transport and access to health care services are needed to target the ‘oldest-old’ adults as a whole.”

This article first appeared on ‘9 News’ on 16 November 2015. ]]> http://www.newsinmind.com/research/depression-increases-with-age-study/feed 0 Government urged to continue supporting mental health program http://www.newsinmind.com/politics/government-urged-to-continue-supporting-mental-health-program http://www.newsinmind.com/politics/government-urged-to-continue-supporting-mental-health-program#respond Wed, 28 Oct 2015 00:55:32 +0000 http://www.newsinmind.com/?p=7605 There are calls for the Federal Government to continue funding a program that is making a massive difference for people with severe and persistent mental illness.

Hunter Partners in Recovery aims to better support people with mental illness by getting multiple services to work in a more collaborative and integrated way.

The service is hosting a forum today, called ‘Working Together for Change’, in a bid to identify and address gaps in the system.

Hunter Primary Care CEO Kevin Sweeney said the service has already helped more than 550 people.

“It’s very important that we retain a consistent strategy and approach for these people,” he said.

“Clearly they need a comprehensive suite of services to be able to assist them to recover, to function well in society.

“So it’s important that the funding continues in whatever form.”

The forum’s keynote speakers are Frank Quinlan from Mental Health Australia, and Leanne Wells from Consumer Health Forum Australia.

Doctor Sweeney said support services are already working together, but more can be done.

“It’s a question of bringing them together and looking at the particular issues of this client group,” he said.

This article first appeared on ‘ABC’ on 28 October 2015.

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Marital Issues May Give Rise to Different Emotions in Men & Women http://www.newsinmind.com/research/marital-issues-may-give-rise-to-different-emotions-in-men-women http://www.newsinmind.com/research/marital-issues-may-give-rise-to-different-emotions-in-men-women#respond Wed, 28 Oct 2015 00:50:51 +0000 http://www.newsinmind.com/?p=7602 Researchers have found that when a long marriage has troubles, women worry, become sad and get frustrated. For men, it’s sheer frustration and not much more.

The study appears in the Journal of Gerontology: Social Sciences, and finds gender differences when long-married partners are asked about their marital relationship.

Dr. Deborah Carr, a Rutgers University sociology professor, looked at sadness, worry, and frustration, the negative emotions commonly reported by older adults. She found men and women in long-term marriages deal with marriage difficulties differently.

“The men don’t really want to talk about it or spend too much time thinking about it,” said Carr. “Men often don’t want to express vulnerable emotions, while women are much more comfortable expressing sadness or worry.”

The finding supports Carr’s belief that men and women have very different emotional reactions to the strain and support they experience in marriage. While talking about issues and offering support makes the wives — who traditionally feel responsible for sustaining the emotional climate of a marriage — feel good, this only frustrated the husbands surveyed.

“For women, getting a lot of support from their spouse is a positive experience,” said Carr. “Older men, however, may feel frustrated receiving lots of support from their wife, especially if it makes them feel helpless or less competent.”

In the study, 722 couples, married an average of 39 years, were asked how their marital experience and the reactions of their spouse affected them.

They responded to whether they could open up to their spouse if they needed to talk about their worries, whether their spouse appreciates them, understands the way they feel about things, argues with them, makes them feel tense, and gets on their nerves.

The husbands in the study more often rated their marriages positively and reported significantly higher levels of emotional support and lower levels of marital strain than their wives. But they felt frustrated giving as well as receiving support.

“Men who provide high levels of support to their wives may feel this frustration if they believe that they would rather be focusing their energies on another activity,” Carr said.

It may also have something to do with the age of the couples, with one spouse in the study having to be at least 60. Men of this generation may feel less competent if they need too much support from their wives, Carr said.

This article first appeared on ‘Psych Central’ on 27 October 2015.

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Expert calls for mental health shake-up http://www.newsinmind.com/general-news/expert-calls-for-mental-health-shake-up http://www.newsinmind.com/general-news/expert-calls-for-mental-health-shake-up#respond Thu, 22 Oct 2015 00:00:19 +0000 http://www.newsinmind.com/?p=7574 Mental health sufferers are stigmatised by the professionals that are supposed to be caring for them, according to a globally-renowned expert calling for a shake-up of the system.

Professor Mike Slade, from King’s College London’s Institute of Psychiatry, says the current attitude of mental health professionals is one of “do what we tell you to do and you will be well again.”

He says stigma against mental illness is alive and well among health professionals, who continue to maintain “hope-destroying” practices.

While developed countries have closed most asylums, they’ve inadvertently created “virtual institutions”, where sufferers who appear to live in the community are actually stuck in a “mental illness-defined bubble”.

Prof Slade is calling for a shift to a ‘nothing about us without us’ attitude, where those affected by mental health problems are involved in the debate about their future.

“If we only listen to professional constructions and narratives, we inadvertently oppress,” he told Mental Health Australia’s Grace Groom Memorial Oration in Canberra on Wednesday night.

Treatment should be offered as a resource in someone’s recovery, “rather than done to them in their best interests”.

Prof Slade wants the mental health system to employ more people with lived experience of mental illness.

Instead of focusing only on patients, the system should be working with employers, educating them on how to accommodate workers with mental illness.

Mental health needed to move from a treatment-based model to a citizenship model, focusing on supporting people to make their own way rather than providing interventions.

“Living well for most of us does not happen in the hospital or in mental health service settings” Prof Slade said.

“It happens as we live our lives in our chosen community.”

This article first appeared on ‘SBS’ on 21 October 2015.

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Snapchat Promises the Most Positive Mood Among Social Media Platforms http://www.newsinmind.com/general-news/snapchat-promises-the-most-positive-mood-among-social-media-platforms http://www.newsinmind.com/general-news/snapchat-promises-the-most-positive-mood-among-social-media-platforms#respond Wed, 21 Oct 2015 23:54:56 +0000 http://www.newsinmind.com/?p=7572 According to a recent online study, Snapchat promises the most positive mood and social enjoyment out of all the social media platforms, including Facebook.

The University of Michigan study found that there’s only one interaction that offers more rewarding feelings than Snapchat: face-to-face communication stole the show, once again.

Published online in Information, Communication & Society, the study seems to be one of the first known published findings on the matter of daily mood in relation to Snapchat. For those who have live under a rock for the past four years, Snapchat is the mobile app that made “ephemeral social media” popular.

In other words, there are some platforms that promote sharing content for a limited period of time (e.g., 10 or 20 seconds). For a lot of people, Snapchat only equals to that “sexting app,” as the description could surely hint to that.

But according to lead author Joseph Bayer, researcher at U-M, the study revealed that Snapchat seems to be the preferred social media for instant and spontaneous communication with close friends, one that often leads to goofy and enjoyable times.

Bayer’s team enrolled in the study 154 college students who had and used smartphones. The researchers used a method called “experience sampling” – one that measures the way people feel, think, and behave on a day-to-day basis – as to have an understanding on what made the participants feel well.

In order to do that, researchers would text them the same survey at random times six times a day. The phase of gathering data went on for two weeks, in which the participants were asked to answer the same five questions:

How negative or positive do you feel right now? How did your most recent interaction occur? How pleasant or unpleasant was your most recent interaction? Within that interaction, how supportive or unsupportive was that person to you? How close are you to that person?

Researchers discovered that no other social media interaction was associated with such high levels of positive emotions as Snapchat – and Facebook scored significantly lower than others. One of the reasons behind this statistic is that Snapchat involved reduced “self-presentational” concerns, meaning that users did not have to worry if they looked conceited or ugly in their Stories.

Facebook is better known for sharing “perfect” moments – such as newborns, engagements and graduations – while Snapchat offers users a separate environment where the small moments are equally appreciated.

This article first appeared on ‘Mirror Daily’ on 21 October 2015.

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