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Mental Health, Stanford News, Videos

Workaholics vs work engagement: The difference is play

Workaholics vs work engagement: The difference is play

In a culture that places high value on “hard work,” we often lionize the wrong kind of work. A new study from the Journal of Management explores the difference between “workaholics” and “work engagement” – the former has serious negative consequences for health and social relationships, just like any addiction, while the latter actually has overwhelmingly positive effects. And when people are healthier and happier, they’re also more productive at work. Malissa Clark, PhD, one of the study’s authors, was quoted in UGA Today:

We see that there are two very different constructs. One is feeling driven to work because of an internal compulsion, where there’s guilt if you’re not working—that’s workaholism. The other feeling is wanting to work because you feel joy in work and that’s why you go to work everyday, because you enjoy it. And I say that is work engagement.

Stanford alum Brendan Boyle, MS, knows how to enjoy work, and teaches his audience in this Stanford+Connects video. The secret is play.

Boyle, who teaches at the d.school (School of Design), is an expert on the interaction between play and design thinking. He asserts that the opposite of play is not work, but boredom. Play is not frivolity, but a certain set of behaviors that can be incorporated into a multitude of tasks, whether at work or at home. Play can be, in a sense, a way of interacting with the world.

Watch the video to learn more – it ends with laughter.

Mental Health, Research, Technology

Reducing your stress level could be as simple as checking email less frequently

Reducing your stress level could be as simple as checking email less frequently

4329363938_26522735d1_zAs the end of 2014 approaches, many of us are thinking about what changes we’re going to make come Jan. 1 to be healthier and happier. Those looking for ways to reduce their stress level in 2015 may want to consider adopting a New Year’s resolution to limit how often they check their email throughout the day.

A study (subscription required) recently published in Computers in Human Behavior suggests that there are psychological benefits to easing up on the number of times you click your inbox. For the experiment, researchers at the University of British Columbia instructed half the participants to read emails no more than three times a day for a week, while a second group was allowed to check their inbox as often as they wished. The groups’ instructions were then reversed the following week. New York Magazine reports:

Overall, “limiting the number of times people checked their email per day lessened tension during a particularly important activity and lowered overall day-to-day stress,” the researchers write, and was associated with various other positive measures of psychological well-being. Those who checked their email a lot also didn’t perceive themselves as any more productive than those who were on an email diet.

…This study, combined with a lot of prior research into things like the distractions imposed by task-switching, paint a pretty clear picture: Ceaselessly checking your email probably isn’t making you more productive, and it probably is making you more stressed.

Previously: What email does to your brain
Photo by Ian Lamont

Cancer, Mental Health, Research, Women's Health

Women with mental illness less likely to be screened for breast cancer

Women with mental illness less likely to be screened for breast cancer

Previous research has shown that women are up to 40 percent more likely to experience a mental-health condition than men. Now findings published in the British Journal of Psychiatry caution that women with depression, anxiety or other mood disorders are likely missing out on important breast-cancer screenings.

In the study, British researchers conducted a systematic review and meta-analysis and comparing rates of mammography screening between women with mental illness and those without. PsychCentral reports:

Researchers found that there were significantly reduced rates of mammography screening in women with mental illness, depression, and severe mental illness such as schizophrenia.

The effect was not present in women with distress alone, suggesting distress was not the explanation.

“In this study, we found that mental ill health was linked with 45,000 missed screens which potentially could account for 90 avoidable deaths per annum in the UK alone. Clearly patients with mental illness should receive care that is at least comparable with care given to the general population. Every effort should be made to educate and support women with mental illness called for screening,” [said Alex Mitchell, MD, who led the study.]

Previously: A new way of reaching women who need mammograms, Despite genetic advances, detection still key in breast cancer, Medicine X explores the relationship between mental and physical health: “I don’t usually talk about this”Examining link between bipolar disorder, early death and Examining the connection between mental and physical health

In the News, Medicine and Society, Mental Health, Pediatrics

Advice and guidance on teen suicide

Advice and guidance on teen suicide

12389778613_ed6496a72f_zNot again, I thought as I read the opening line of a recent Palo Alto Weekly op-ed: “As a community we are grieving.” Reading further, my fears were confirmed: Now, additional teens have died by suicide in this California city.

A handful of years ago, I was a reporter for the Weekly. I was so grateful to cover city government, rather than schools — what a pressure cauldron, I thought at the time. As a teen, I too struggled with perfectionism, the drive to earn straight As and attend a top college, while excelling at extracurriculars. How awful to be surrounded by others like me, I thought.

Of course this is a one-dimensional glimpse at the problem. Suicides aren’t explained by perfectionism or academic stress and they certainly aren’t a Palo Alto-only problem. Shashank Joshi, MD, a child psychiatrist with Lucile Packard Children’s Hospital; Palo Alto Medical Foundation physician Meg Durbin, MD; and Sami Harley, a mental-health specialist, discuss this and other issues in a piece written to offer guidance to the saddened community. “Suicide does not have a single ’cause.’ Many factors and life circumstances must be taken into account,” they write.

They go on to clarify misperceptions about depression, an underlying condition that can make suicide or suicidal thoughts more likely:

Depression isn’t something you can or must just ‘deal’ with on your own… Though positive thinking can be an important part of having a healthy and resilient life, positive thinking by itself does not treat clinical depression. Talk therapy with antidepressant medications, if needed, are the only proven treatments for teen depression.

These local experts have held depression education and suicide-prevention training sessions with several thousand students at the two Palo Alto public high-schools since 2010. “Solutions must come from all those who interact with youth, including schools, parents and family, friends, medical and mental health providers, community and faith leaders and mentors,” they conclude.

Previously: “Every life is touched by suicide:” Stanford psychiatrist on the importance of prevention, Lucile Packard Children’s Hospital partners with high schools on student mental health programs  and Volunteers watch train crossings to prevent suicides
Photo by jimmy brown

In the News, Mental Health, Patient Care

Imagining voices: A look at an alternative approach to treating auditory hallucinations

Imagining voices: A look at an alternative approach to treating auditory hallucinations

Artistic_view_of_how_the_world_feels_like_with_schizophrenia_-_journal.pmed.0020146.g001Updated 12-2-14: The headline and parts of the first paragraph were edited for clarity.

***

11-13-14: The idea of hearing voices, or auditory hallucinations, is an experience that frightens many of us. It can be seen as a sign that you are no longer in control of your mind. Auditory hallucinations are also a symptom of schizophrenia, and those with the disease often hear voices which are hostile, mean and disturbing. But some clinicians, including Marius Romme, MD, PhD, a Dutch psychiatrist and president of Intervoice, are exploring alternate ways to treat the problem of hearing distressing voices. A recent interview with one of Romme’s colleagues, Dirk Corstens, MD, and two of his patients, was featured in The Atlantic.

Stanford anthropologist Tanya Luhrmann, PhD, has worked extensively with people who hear voices, and a recent study she conducted compared the experiences of psychotic patients with auditory hallucinations living in three very different locales – San Mateo, California; Chennai India; and Accra, Ghana. Her team found that the voices of Indian and Ghanaian patients were more likely to be playful and benign, whereas those of U.S. patients were on average more threatening.

When Luhrmann took time to talk with me to discuss the implications of her research and the approach, which calls itself the Hearing Voices movement, she noted early on that although the treatments espoused by the movement won’t work for everyone, “The Hearing Voices approach is very important and has an important kernel to it.”

Some of what the group advocates is controversial. “They often reject the idea of schizophrenia, are hesitant about medication, and have a model of hearing voices that identifies sexual trauma as the most important cause of hearing voices,” she says. But a growing body of scientific evidence shows that it may be useful to teach people to interact with their voices.

The Hearing Voices movement, says Luhrmann, advocates seeing the voices as meaningful, treats them as people, respects the voices and encourages patients to interact with them with the help of a trained clinician. One of the patients featured in The Atlantic piece described how he learned to work with the voices he heard:

[Dr. Corstens and I] started to work with each other five years ago, or more. I was around 20 years old. It took about two years of work to actually figure out what the relationships were, what the triggers for the voices were, and what feelings are coupled to these voices. Once you start to learn to express yourself and work out these problems on your own, the voices don’t have to act out their part. Now, when I hear voices, I know what triggered them. I ask, “What is happening with me? What am I neglecting in my own emotions?” Does that make sense?

Luhrmann says that while more research needs to be done, it seems that some patients appear to benefit and the voices they hear diminish, or at least become less aggressive and intrusive. But she cautions that the method may not be appropriate for all patients. “I think it’s important to remember that schizophrenia is a difficult heterogeneous experience,” she says. “It’s pretty clear, even at this early point, that these techniques don’t work for everyone.” At the same time, she points out, research on related practices like cognitive behavioral therapy has been shown to ease the severity of the voice-hearing experience.

The Hearing Voices movement is mostly centered in European countries at the moment, but Luhrmann notes that it’s growing fast in a grassroots kind of way, somewhat in the way Alcoholics Anonymous grew in the last century. She predicts that some of the approaches used by the group will probably be used among patients with schizophrenia here in the U.S. in the next decade.

Previously: The link between mental-health conditions and cardiovascular diseaseNew thinking on schizophrenia, it’s the mind, body and social experience and Study shows meditation may alter areas of the brain associated with psychiatric disorders
Image by Craig Finn

Mental Health, Public Health, Research

Survey shows nearly a quarter of U.S. workers have been diagnosed with depression in their lifetime

Survey shows nearly a quarter of U.S. workers have been diagnosed with depression in their lifetime

4369627924_ccd7f6f7ff_zDepression is a major contributor to absenteeism, reduced productivity and disability among adults in the United States. Now results from a survey examining the societal and economic burden of depression in the workplace show that almost a quarter of employees have been diagnosed with depression in their lifetime and that two in five patients have missed work, for an average of 10 day per year, because of it.

The findings underscore the importance of decreasing the stigma associated with mental-health conditions in the workplace and providing workers with support services and resources. According to a release, additional results also showed:

…64 percent of survey participants reported cognitive-related challenges, as defined by difficulty concentrating, indecisiveness and/or forgetfulness, have the most impact on their ability to perform tasks at work as normal. Presenteeism (being at work, but not engaged/productive) has been found to be exacerbated by these challenges related to thinking on the job.

Despite how depression is affecting our workforce, 58 percent of employees surveyed who have been diagnosed with depression indicate they had not told their employer of their disease. In addition, 49 percent felt telling their employer would put their job a risk and, given the economic climate, 24 percent felt it was too risky to share their diagnosis with their employer.

These figures directly contribute to the estimated $100 billion annually spent on depression costs by U.S. employers including $44 billion a year in lost productivity alone.

The survey was commissioned by Ohio-based Employers Health and conducted by market research company Ipsos MORI. Questions were asked via an online panel of 1,000 adults, aged 16-64, who have been workers or managers within the last year. Responses were weighted to ensure the sample was representative of this profile. Funding was provided by international pharmaceutical company H. Lundbeck A/S.

Previously: Anxiety shown to be important risk factor for workplace absence, Research shows working out may benefit work life and How work stress affects wellness, health-care costs
Photo by Ryan Hyde

Addiction, Behavioral Science, In the News, Mental Health, Research, Stanford News

Veterans helping veterans: The buddy system

Veterans helping veterans: The buddy system

image.img.320.highI interviewed Army specialist Jayson Early by phone over the summer, shortly after he completed an in-patient program for PTSD at the Veterans Affairs hospital in Menlo Park. This was for a Stanford Medicine magazine story I was researching about a pilot project to help get much needed mental-health services to the recently returned waves of Afghanistan and Iraqi vets. What struck me most after talking with Early was just how clueless he had been, first as a teenaged-recruit, then as a young veteran, about the fact that going to war could cause mental wounds.

As the mother of a 17-year-old boy, though, I completely understood: Early just wanted to serve his country. He requested to be sent to war. In 2008, he got his wish and was deployed to Iraq just a year after exchanging his high-school baseball uniform for military fatigues. His first field assignment, an innocuous-sounding public affairs errand to photograph a burned out truck at an Iraqi police station, would be the first of many that left him with permanent scars:

“There were body parts, coagulated blood, hair all over,” [Early] says, pausing. “I just wasn’t expecting it.” An Iraqi family had been executed in the vehicle, presumably by insurgents. Early had gone through intense military training to prepare for moments like these. He blocked any emotions. He followed orders, clicked the camera and moved on. It wasn’t until years later that he realized just how permanently those images, and many more like them, had burned into his brain.

Stanford psychiatrist Shaili Jain, MD, interviewed in a podcast about her work with PTSD and veterans, had told me about a new pilot project that connects veterans with other veterans as a unique way to bridge what she called a “treatment gap” – the difficulty of getting mental-health services to the veterans that need them. My article – which is a timely read, given that today is Veterans Day – tells the story of Early’s connection with one of the veteran’s hired through this project, Erik Ontiveros, who went through treatment for addictions and PTSD himself, and just why it’s so hard to get treatment to veterans. As one well-known expert on PTSD explains in the story:

“It’s wicked difficult to treat anyone with moral injuries from combat in the traditional medical model,” says psychiatrist Jonathan Shay, MD, an expert on PTSD known for his books on the difficulties soldiers face returning home from war. “It destroys the capacity for trust. What it leaves is despair, an expectation of harm, humiliation or exploitation, and that is a horrible state of being. The traditional medical model – in an office with the door closed – is the last thing they want. I’m convinced that’s where peers come in. Peers are indispensable.”

Early told me many of his horror stories from war – stories that he rarely talks about. The time he was called to another execution area where there were enough body parts for 12 people who had all been gagged, bound, shot and burned. But, he said, they could only put together eight people. “We were trying to find a way to identify them,” he said. “Whenever I grabbed a hand, it would just crumble to dust.”

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Aging, In the News, Mental Health, Women's Health

Love your body, love yourself

Love your body, love yourself

10227014165_7e464321d2_zAs someone with not much regard for my body, I can hear my nutritionist cackling with glee at the thought of this post. She’s spent months trying to brainwash me into liking it anyway. I fight back, chafing at the idea.

Now along comes Martha C. Nussbaum, PhD, a leading ethical thinker based at the University of Chicago, saying we should not just like our bodies or merely tolerate our young bodies in their prime. No, she writes in a recent New Republic essay, we should consider our bodies as “dynamic, marvelous, and, more important, just (as) us ourselves.” We should celebrate our bodies with the spirit captured by the 1970s movement Our Bodies, Ourselves, sparked by the book-turned-organization. The alternative is ugly:  Prejudice, bigotry and other social ills will surge when fueled by self-dislike.

Nussbaum mourns the loss of body-embracing spirit: “I fear that my generation is letting disgust and shame sweep over us again, as a new set of bodily challenges beckons.”

Flaccid muscles, graying hair, foreheads creasing with wrinkles. Not yuck, not gross, do not withdraw, do not hide in shame, she writes:

[The poet Walt] Whitman knew that we will not be able to love one another unless we first stop hiding from ourselves—meaning our bodies…

As we age, we are yielding to all the forces we tried, back then, to combat: not only the forces of external medical control, but the more insidious force of self-loathing. Whitman knew that disgust was a social poison. Psychologists studying the emotion today confirm his intuitions about its link with prejudice and exclusion.

If you don’t like yourself, your body, then what must you think of others, Nussbaum questions. Worth pondering, I’ll concede.

Previously: Ask Stanford Med: Director of Female Sexual Medicine Program responds to questions on sexual health, Blogging may boost teens’ self-esteem and Tai chi linked to mental-health boost, but more study is needed
Photo by Jennifer Morrow

Aging, Mental Health, Parenting, Research

Girls at high risk for developing depression show signs of stress and premature aging

Girls at high risk for developing depression show signs of stress and premature aging

14465-telomeres_newsAs we age and our cells divide, caps at the ends of our chromosomes called telomeres shorten. When a telomere grows too short, it will die or lose its ability to divide, which causes our skin to wrinkle or sag, as well as damage to our organs. Previous research has shown that depression, chronic stress and inflammation can accelerate this process, causing premature aging and making our bodies more susceptible to infections and disease.

In an effort to better understand the connection between stress, depression and changes in the body, Stanford psychologist Ian Gotlib, PhD, and colleagues studied healthy girls with a family history of depression and compared them to a group of their peers without that medical background. During the experiment, researchers measured participants’ stress response through a series of tests and analyzed their DNA samples for telomere length. According to a Stanford Report story:

Before this study, “No one had examined telomere length in young children who are at risk for developing depression,” Gotlib said.

Healthy but high-risk 12-year-old girls had significantly shorter telomeres, a sign of premature aging.

“It’s the equivalent in adults of six years of biological aging,” Gotlib said, but “it’s not at all clear that that makes them 18, because no one has done this measurement in children.”

The researchers are continuing to monitor the girls from the original study. “It’s looking like telomere length is predicting who’s going to become depressed and who’s not,” Gotlib said.

Based on these findings, researchers recommended that girls at high-risk for depression learn stress reduction techniques.

Previously: How meditation can influence gene activity, Shrinking chromosome caps spell aging cells, sniffles, sneezes… and cognitive decline?, Study finds phobias may speed biological aging and Study suggests anticipation of stress may accelerate cellular aging
Photo by Paulius Brazauskas/Shutterstock

Cardiovascular Medicine, Mental Health, Research

The link between mental-health conditions and cardiovascular disease

The link between mental-health conditions and cardiovascular disease

14496537236_932d9a9acd_zA growing body of research has shown the connection between our emotional well-being and physical health. Among the latest findings: Schizophrenia, bipolar disorders and major depressive and anxiety disorders can greatly increase a person’s risk of heart disease and stroke.

In a study presented at this year’s Canadian Cardiovascular Congress in Vancouver, Canada, researchers examined connections between mental-health conditions, use of psychiatric medication, and heart health using data from the Canadian Community Health Survey. Medical News Today reports:

They found that patients who had a mental illness at any point in their life were twice as likely to have had a stroke or experienced heart disease than the general population, while patients who had not experienced heart disease or stroke had a higher long-term risk of cardiovascular disease.

Furthermore, patients who used psychiatric medications for their mental illness were twice as likely to have heart disease and three times as likely to have had a stroke than those who did not use such medications.

“This population is at high risk,” says [Katie Goldie, PhD, lead author of the study and a postdoctoral fellow at the Centre for Addiction and Mental Health in Toronto], “and it’s even greater for people with multiple mental health issues.”

Goldie and colleague said that there are three main factors that contribute to mental-health patients’ increase cardiovascular risk. They are: lifestyle behaviors, such as tobacco and alcohol use, poor diet and physical inactivity; psychiatric medications, which can induce weight gain and inhibit the body from breaking down fats; and inadequate access to health care.

The findings are significant in light of statistics (.pdf) from the National Alliance of Mental Health showing that 1 in 4 adults in the United States experience a mental health disorder in annually and that serious mental illness costs the nation $193.2 billion in lost earnings per year.

Previously: Examining how mental stress on the heart affects men and women differently, Study shows link between traffic noise, heart attack and Study offers insights into how depression may harm the heart
Photo by Holly Lay

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