Mental Health

New findings analyzing Internet search data for major mental illnesses shows that seasonal weather changes may have a larger impact on such health conditions than previously believed.

In the study (.pdf), researchers used Google’s public database of queries to identify and monitor users’ searches for mental-health disorders, including anxiety, eating disorders, schizophrenia, ADHD, bipolar and obsessive compulsive disorder (OCD), in the United States and Australia from 2006 through 2010. According to a release:

The research showed eating disorder searches were down 37 percent in summers versus winters in the U.S., and 42 percent in summers in Australia. Schizophrenia searches decreased 37 percent during U.S. summers and by 36 percent in Australia.

Bipolar searches were down 16 percent during U.S. summers and 17 percent during Australian summers; ADHD searches decreased by 28 percent in the U.S. and 31 percent in Australia during summertime. OCD searches were down 18 percent and 15 percent, and bipolar searches decreased by 18 percent and 16 percent, in the U.S. and Australia respectively.

Searches for suicide declined 24 and 29 percent during U.S. and Australian summers and anxiety searches had the smallest seasonal change – down 7 percent during U.S. summers and 15 percent during Australian summers.

While some conditions, such as seasonal affective disorder, are known to be associated with seasonal weather patterns, the connections between seasons and a number of major disorders were surprising. “We didn’t expect to find similar winter peaks and summer troughs for queries involving every specific mental illness or problem we studied, however, the results consistently showed seasonal effects across all conditions – even after adjusting for media trends,” said James Niels Rosenquist, MD, PhD, a psychiatrist at Massachusetts General Hospital.

The work appears in the latest issue of American Journal of Preventive Medicine.

Previously: Sweating the small stuff may harm your mental health and Ask Stanford Med: David Spiegel answers your questions on holiday stress and depression
Via The Atlantic
Photo by Tom Hilton

German philosopher Friedrich Nietzsche famously said, “What doesn’t kill us makes us stronger.” But that may not be the case when it comes to daily stress, according to findings recently published in Psychological Science.

In the study, researchers analyzed survey data from the Midlife Development in the United States (MIDUS) and National Study of Daily Experiences (NSDE). Study results showed that minor sources of stress, not just major life events, can have long-term consequences on mental-health outcomes. According to a UC Irvine release:

.. [R]esearchers found that participants’ negative emotional responses to daily stressors – such as arguments with a spouse or partner, conflicts at work, standing in long lines or sitting in traffic – predicted psychological distress and self-reported anxiety/mood disorders 10 years later.

“How we manage daily emotions matters to our overall mental health,” said [lead researcher Susan Charles, PhD, UC Irvine professor of psychology & social behavior.] “We’re so focused on long-term goals that we don’t see the importance of regulating our emotions. Changing how you respond to stress and how you think about stressful situations is as important as maintaining a healthy diet and exercise routine.”

The results were based on data from 711 men and women between 25 and 74.

The study builds on earlier work showing that how people react to everyday stressors, rather than the stress itself, influences physical chronic-health problems later in life, such as pain and cardiovascular conditions.

Previously: How does your body respond to stress?, Using an app to get a better handle on what stresses you out, Study suggests anticipation of stress may accelerate cellular aging and Workplace stress and how it influences health
Photo by bikesandwich

We’ve partnered with Inspire, a company that builds and manages online support communities for patients and caregivers, to launch a patient-focused series here on Scope. Once a month, patients affected by serious and often rare diseases share their unique stories; the latest comes from cancer survivor Dan Adams.

This past November I had my semi-annual cystoscopy. My visit was an early Christmas present, as I wound up receiving an “all clear” from my urologist. This coming May, if I get another “all clear,” it will mark five years of cancer-free living.

I had a resection to remove a bladder tumor in April 2008. I received an inconclusive pathology report following that procedure and a lot of hesitation from my first urologist. That’s when I sought a second opinion from a urologist at a major university hospital. Another resection and a couple of rounds of immunotherapy, and my bladder cancer was gone.

My follow-up cystoscopies were initially every three months, and now I’m comfortable with a six-month schedule. If something is going on in there, I want to catch it early. I’m not ready to move to an annual checkup. I don’t know if I will ever be ready.

It’s been a bumpy road; a few “red spots” in the bladder that required biopsies and a perforated bladder (those damn catheters) elevated my anxiety above and beyond what might be the norm following a cancer diagnosis. Having a cancer with a high reoccurrence rate also contributes to my feelings of anxiousness.

During the first couple of years in this war with bladder cancer, anxiety consumed my everyday living. Cancer was always on my mind, but I was unaware that anxiety was running my life. It took a long time, but eventually I learned to recognize changes due to anxiety, things that aren’t really “me.” Inattention to details, aimlessly daydreaming and becoming much more emotional were some of the telltale signs. I realized things weren’t right and I sought the professional help I needed. Thankfully, this help and the encouragement and support of a close family brought me through a very trying period.

While my anxiety is more or less under control, I’m still very aware that it’s there – and I’ve come to realize that knowing you have anxiety issues is essential to dealing with them. I know my anxiety level increases as I approach my next cystoscopy, and so I now slow down in the weeks leading up to the procedure and defer major decisions to a less anxious time.

I’m very aware now of anxiety and how it has affected my life beyond cancer. In this nearly five-year battle, anxiety has been the one medical issue, or side effect, that no one brought up; no one mentioned it as an issue to be aware of or offered treatment. I wish someone, in the beginning, had told me that cancer is a game changer, that my life will never be the same. I wish someone had explained that I need to be aware of how powerful anxiety can be, how it can affect your life, your relationships, your work.

I’ve been a bladder cancer warrior for almost five years, but it’s been only the last few years that I’ve come to realize that anxiety – not just the disease – is something I need to conquer.

Dan Adams lives along the Southern New Jersey Shore where he and his wife of 35 years raised three children and recently became grandparents for the first time. Dan is committed to raising awareness of bladder cancer and supporting those who are newly diagnosed through the Inspire/BCAN Support C0mmunity.

Stress, especially when it’s chronic, can invoke a range of physical symptoms ranging from a pounding heart to sleepless nights. As Stanford psychiatrist David Spiegel, MD, explains today in a Huffington Post article, these responses are hardwired in us because our bodies were built to respond to sense physical dangers — the much discussed fight-or-flight response. He says, “We are not particularly splendid physical creatures… The only thing that has allowed us to explore the planet is the fact that we can respond effectively to threats.”

To help you better understand the biological response to stress, Spiegel joined forces with Amit Sood, MD, associate director of complementary and integrative medicine at the Mayo Clinic, to create a handy infographic illustrating how the stress travels through the body. Scroll through the graphic to see how the fight-or-flight response initiates in a region of the brain called the amygdala and can affect a range of systems, including digestion, immunity and sleep.

Previously: Using an app to get a better handle on what stresses you out, How your reactions to everyday stressors may influence future health, Study suggests anticipation of stress may accelerate cellular aging, Workplace stress and how it influences health and How work stress affects wellness, health-care costs
Photo by Katy Warner

In a powerful piece published this weekend in the Concord Monitor, journalist Annmarie Thimmins shares her story of living with a mental illness. She courageously opens up about topics that most people take great pains to hide, including being hospitalized for suicidal thoughts, professional breakdowns, and the strength it takes to keep going.

Thimmins decided to post the piece after receiving calls from readers questioning whether 26 percent of New Hampshire’s residents have a mental-health disorder, a statistic that appeared in the newspaper’s recent mental-health series, “In Crisis.” She writes:

“Didn’t 26 percent seem high?” a caller asked me last week.

Not to me. But I’m one of the 26 percent.

I have been hospitalized twice for “suicidal ideation,” most recently for eight days in 2009 with a diagnosis of “major depressive order and anxiety disorder,” according to my records. I take four medications a day and have my counselor’s name and number in my emergency contacts on my cell phone.

This will be news to most of the people who know me, family members included. That’s because with lots of help from my husband, a lot of exercise (one of my therapies) and medication, I’m able to keep my depression and breakdowns private.

…

My colleague Sarah Palermo and I had hoped to introduce you to some of [the patients in the series] because even though they aren’t visible, they and their families are also affected by state budget cuts that have diminished community mental health care. Long waits in emergency rooms show the state hospital doesn’t have enough beds to accommodate the patients who need them. Cuts to Medicaid have prompted several community hospitals to shut their own mental-health wings and left case workers with more clients than they can adequately care for.

But many of the people we talked with declined to go public, for fear of stigma.

I asked Michael Cohen, the former executive director of the state chapter of the National Alliance on Mental Illness, what it would take for the prevalence of mental illness to be better understood. Awareness, Cohen said.

“Personal stories . . . are powerful tools for changing minds,” he said.

Taking this advice, Thimmins chronicles her story and doesn’t shy away from including the unpleasant details. As you read her story, keep in mind that past data has shown that 4.9 million Californians need help for a mental or emotional health problem, but only a third of them have visited a professional for treatment.

Via Common Health
Previously: Supporting medical students’ mental, emotional health, Report shows 1 in 5 adults in the U.S. have experienced mental illness in the past year, How gender differences shape attitudes toward depression, Breaking the silence about depression among men, Gender differences and mental health and Why are women more likely to need mental-health help?
Photo by Lawrence Murray

I’m not really in the dark when it comes to things that cause me stress (even my very small daughters can tell you that traffic ranks right up there), but I’m nonetheless intrigued by an app that monitors users’ stress levels and logs their daily stressors. Developer Dirk Trossen, PhD, with the University of Cambridge, describes how the app works and shares a few other thoughts in a New Scientist Q&A:

Aren’t people aware of what stresses them and how their bodies respond? We want to help people get away from preconceived ideas of what is important. Heart rate is a very good example. It is such a concrete, well-known parameter that people tend to focus on it. But increased heart rate alone actually gives you very little sense of someone’s stress level.

Why is it important to keep track of all of this? Stress can undermine our health in the long run. The fact that today’s workforce is likely to work longer than the previous generation increases the importance of stress management as an aspect of general well-being. We want users to be aware of the ways stress can negatively impact them.

…

You’ve been monitoring yourself with the app for over a year. What stresses you? Email. Insights into how it interrupts my work have caused me to change my behaviour. I now have clear intervals between checking email, and even entire blackout days where I don’t look at it. I have also changed how I travel. Yet, apart from stress management, it is sometimes just fun to look back. Though this isn’t its main purpose, the app also makes a worthwhile memory collection tool.

Previously: Stressed? There’s an app for that and No surprise here: Anger and stress are bad for your health
Via @RitaRubin
Photo by Danielle Scott

“Blood is a very special juice.”

Goethe didn’t know the half of it when he penned this line for the character of Mephistopheles, in “Faust,” more than 200 years ago.

In those days people believed blood held mystical qualities and was a potent life force. No wonder Mephisto wants the contract for Faust’s soul signed in the stuff.

But what exactly does blood do?

The new issue of Stanford Medicine magazine tells blood’s story, from 17th-century attempts at blood transfusion to the workings of a modern blood bank to today’s studies of gene therapy to treat hemophilia.

Inside the issue:

• “Blood quest:” An article on Stanford’s early fight to prevent the spread of AIDS by screening blood – while other blood banks argued against testing.
• “Blood, sweat and fears:” The story of a blood phobic and his attempt to conquer the surprisingly common condition.
• “Roll up your sleeve:” An explainer on the irreplaceable resource that is human blood, and why blood donation remains so crucial.
• “Life of blood:” A visual primer on blood cells, the most numerous cells in your body.
• “Against the flow:” A feature on why blood transfusions are declining, and why that’s good news for health.
• “In his blood:” A look at growing up with hemophilia, featuring a physician with hemophilia who is dedicating his life to finding cures for the life-threatening disease.

This issue’s “Plus” section, featuring stories unrelated to the special report, includes:

• “Bubble girl:” A feature on a new treatment for severe combined immunodeficiency disease, also known as “bubble boy disease.”
• “A Nobel experience:” An insider’s view of this year’s Nobel Prize festivities.

Previously: The money crunch: Stanford Medicine magazine’s new special report and The data deluge: A report from Stanford Medicine magazine
Photo by Renphoto

Convincing my grandparents to join me in a game of Wii bowling or try their hand at playing Mario Kart would be a long shot, to say the least. But perhaps I could change their minds by telling them about new research from North Carolina State University showing that seniors who play video games have higher levels of well-being.

In the study, researchers surveyed a group of participants aged 63 and older about their video-game playing habits. Individuals then completed a number of tests designed to evaluate emotional and social well-being. Overall, nearly half of the participants said they played a digital game in the past year and a third reported playing once a week. Researchers wrote in the discussion section:

… Much of the psychological research conducted on the impact of digital games has focused on the possible adverse effects of playing digital games. Contrary to these and other studies, the findings of the current investigation suggest that older adults who reported playing digital games score, on average, significantly better than non-digital game playing on measures assessing a number of domains of successful aging. Specifically, older adults who were classified as Regular and Occasional Gamers reported less depression and lower negative affect as well as higher well-being than their non-gaming counterparts. One possibility for these findings is that digital games serve as a source of entertainment, which may lower negative affect and depression and increase well-being. In support of this interpretation, previous studies have found that adults who engage in more leisure activities report better emotional outcomes

The findings are particularly interesting in light of the nation’s aging population and past research showing baby boomers are more depressed than other age groups.

Previously: Improving patients’ lives through video games and Elderly adults turn to social media to stay connected, stave off loneliness
Photo by North Carolina State University

In case you haven’t seen it, the front page of the New York Times includes a story today on the “growing effort” among health officials to ban smoking at psychiatric hospitals. Describing the history of promoting smoking among the mentally ill, Pam Belluck writes:

Hospitals often used cigarettes as incentives or rewards for taking medicine, following rules or attending therapy. Some programs still do. And smoking was endorsed by advocates for people with mental illness and family members, who sometimes sued to preserve smoking rights, considering cigarettes one of the few pleasures patients were allowed.

…

Socially, smoking provides “cover rituals for patients having psychiatric symptoms,” said Dr. Rona Hu, medical director of the acute psychiatric inpatient unit at Stanford Hospital in Palo Alto, Calif. “You [tap] the box, you kind of play with the lighter, you can exhale and look into the middle distance and not look like you’re hallucinating.”

The article goes on to outline the problems with supporting cigarette use; Belluck cites a report showing that “people with the most serious mental illnesses die on average 25 years earlier than the general population, with many from smoking-exacerbated conditions like heart or lung disease.”

Photo by Kr. B

An article in the current issue of AAMC Reporter offers a look at medical schools’ efforts to de-stress and provide support for their (often very stressed) students. Some schools have made adjustments to their curricula or developed wellness programs, Rebecca Goldberg writes, and:

Another approach to supporting students’ mental health involves building a sense of community through participation in extracurricular activities. At Vanderbilt University School of Medicine, the student-run Wellness Committee divides first-year students into colleges that train and compete each year in The College Cup. The event features athletic and nonathletic events, including 5K runs, trivia challenges, and cooking competitions.

“It’s perfectly okay to come here and study hard and do as well as you can, but it’s also okay to take care of yourself,” said Scott Rodgers, M.D., associate dean of student affairs at Vanderbilt. “You don’t want to lose your humanity by becoming a doctor. Students should participate in activities outside of medicine, maintain personal connections, and make their own physical health a priority.”

While medical school should be challenging, it also can be fun, Rodgers added…

Previously: The need to address med students’ mental health and A closer look at depression and distress among medical students