Mental Health

Last year, the University of North Carolina at Chapel Hill opened the country’s first inpatient psychiatric unit for pregnant women and new mothers suffering from severe depression. Today, Time Healthland’s Bonnie Rochman profiles a former patient and offers a look at the breadth of services offered by the program:

There’s weekly therapy from psychologists who practice mother-infant attachment therapy, which works on how mom relates to her baby and reads her baby’s cues, and there’s partner-assisted psychotherapy, which helps dad understand how he can be most effective. Moms learn stress-management skills, practice yoga and participate in biofeedback sessions and mindfulness-based stress reduction groups. They have access to lactation consultants and hospital-grade breast pumps if they want to express milk. Coping skills and medication help get these moms back on track; counselors help connect departing mothers with hometown resources or transition them to outpatient programs.

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The real attraction, however, is the camaraderie. “To be there with people who are going through the same thing is hugely important,” says [Samantha Meltzer-Brody, director of the perinatal psychiatry program at UNC and an associate professor of psychiatry].“You don’t feel alone.” For many women, being surrounded by others experiencing the same struggles is akin to opening the floodgates. “Everyone is in there because things are really not going well,” says Meltzer-Brody. “There is a rawness.”

Previously: In study, health professionals helped prevent postpartum depression and A call for depression screening for pregnant women, moms
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Using yoga to engage in brief, simple daily meditation could lead to improved cognitive functioning and lower levels of depression for caregivers of patients with dementia, according to findings published this week in the International Journal of Geriatric Psychiatry.

In the study (subscription required), UC Los Angeles researchers randomly assigned 49 family caregivers who were taking care of their relatives with dementia into two groups. One group participated in a daily 12-minute yoga and meditation practice for eight weeks.
The remaining volunteers were asked to relax in a quiet place for 12 minutes daily with their eyes closed while listening to a relaxation CD for eight weeks. Participants ranged in age from 45 to 91 years old and included 36 adult children and 13 spouses. According to the UCLA release:

At the end of the eight weeks the researchers found that the meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning, compared with the relaxation group. In the meditation group, 65 percent showed a 50 percent improvement on a depression rating scale, and 52 percent of the group showed a 50 percent improvement on a mental health score. This compared to a 31 percent depression improvement and a 19 percent mental health improvement for the relaxation group.

The researchers also found that meditation increased telomerase activity and thus slowed cellular aging. Telomerase is an enzyme that maintains the DNA at the ends of our chromosomes, known as telomeres. Telomeres are associated with a host of health risks and diseases, which may be regulated in part by psychological stress. In the absence of telomerase activity, every time our cells divide, our telomeres get shorter and shorter, until eventually, they become so short the cells die. If high telomerase can be maintained or promoted, though, it will likely promote improvement in telomere maintenance and immune cell longevity.

Previously: Study shows cell health linked to positive mood changes in meditation
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Previous research has shown that volunteering can be beneficial to your mental and physical health. A segment yesterday on KQED’S Forum took a closer look at how helping others can aid in healing and focused on the efforts of Adversity to Advocacy, which helps patients living with disabilities and chronic illnesses turn their personal challenges into service.

During the program, Stanford psychiatrist David Spiegel, MD, joined the discussion and spoke about his 30 years of research showing that women with advanced metastatic breast cancer involved in a support group, along with traditional medical care, had a better quality of life and lived longer. Spiegel went on to explain that sharing personal stories empower patients and make them realize they are in a position to help others, which can be beneficial in their recovery.

Previously: Emotional, social support crucial for cancer patients and Stanford study shows depression symptoms may predict breast cancer survival

As many of us have experienced, chronic stress can take a toll on your emotions and ability to think clearly. Now findings published in Neuron offer new insights into how chronic stress may affect the brain during adolescence and adulthood.

In the study (subscription required), University of Buffalo researchers analyzed whether repeated stress negatively influenced glutamate receptors in juvenile rats. Glutamate signaling plays an important role in prefrontal cortex (PFC) function. According to the university release:

[The] study involved male rats at an age corresponding to human adolescence–a period when the brain is highly sensitive to stress.

When the rats were exposed to repeated stress, they lost glutamate receptor expression and function in the prefrontal cortex, a region of the brain that controls working memory, decision-making and attention and doesn’t fully mature until age 25.

This loss significantly impaired the adolescent rats’ ability to remember and recognize objects they had previously seen. Similarly stressed adult rats, however, did not experience the same cognitive deficit.

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[R]esearchers also report that by disrupting the enzymes that trigger loss of glutamate receptor expression they were able to prevent the cognitive impairment induced by repeated stress. As a result, they have discovered that there may be a way to prevent chronic stress’ detrimental effects.

Previously: Stanford’s Robert Sapolsky talks stress and the brain, Study suggests anticipation of stress may accelerate cellular aging, Workplace stress and how it influences health, How work stress affects wellness, health-care costs, Robert Sapolsky discusses stress physiology, Can stress increase risk of neurodegenerative diseases? and No surprise here: Anger and stress are bad for your health
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Coming out isn’t always a party. It gets better, according to a project that aims to inspire hope among LGBT youth facing harassment, but the teenage years can still prove painful and lonely. Last week’s episode of Glee, in which the former bully Dave Karofsky (played by Max Adler) attempted suicide after being outed as gay by his high school peers, voiced the issue on a major media platform. The fictional TV show’s winter finale surprised viewers with its heavy subject matter.

Today, an article from The Atlantic reports the real-life statistic that LGBT youth are twice as likely to commit suicide as their heterosexual peers. And it discusses new research (subscription required) published in the American Journal of Preventive Medicine that followed 246 LGBT participants, aged 16-20 years, and found:

General and LGBT-specific risk factors both uniquely contribute to likelihood of suicidal ideation and self-harm in LGBT youth, which may, in part, account for the higher risk of these phenomena observed in this population.

In the piece, Brian Mustanski, PhD, lead author of the study and a psychologist at Northwestern University, also lists ways that parents can demonstrate support of their gay children. He asserts that family love can provide the most important protection from the path toward suicide and even lessen the effects of bullying at school:

If your child does come out to you remember that he’s sharing a core part of his identity, so react with acceptance, not judgment. This lets him know that your love is unconditional and that you’re available for support as he faces the trials of growing up as a minority.

Bullies: Stand down. Dave Karofsky: Life gets better after high school.

Previously: Medical schools neglect LGBT issues, Gay, lesbian, bisexual and transgendered health issues not being taught in medical school, Apple employees tell bullied teens “it gets better”, Advances being made for LGBT medical students and Tim Gunn speaks to depressed LGBT youth in ‘It Gets Better’ video
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If you were the sole witness to a troubled person peering over the edge of the Golden Gate Bridge, would you lunge to hold him back? How about if an acquaintance demonstrated self-destructive behavior or dropped suicidal thoughts on his Facebook status? What is a bystander to do when she is seated at a computer?

The latter questions were the focus of a recent ABCNews.com article, which told the story of a UC Berkeley student who overdosed after leaving many hints on Facebook of his steady drug and alcohol abuse. The student’s mother wishes she had been alerted sooner to his profile page, which foretold the tragedy of his irreparable brain damage, and others in the article weighed in on the importance of taking action in cases like this:

Aida Ingram, a youth counselor in Clayton, N.J., said it’s better to speak up than to assume the person is fine.

“It’s a shame for a whole community to watch a child spiral out of control, whether on Facebook or in the real world,” said Ingram, whose daughter will soon head to college. “The last thing you want is to go to someone’s funeral knowing you saw a worrying Facebook post and did nothing. I’d rather embarrass myself.”

Noting that up to 98 percent of U.S. college students use social networks such as Facebook, the article also explains how health experts believe we may be able to benefit from information shared on such sites:

“I think Facebook is a new window on an old problem,” said Dr. Megan Moreno, a pediatrician at UW Health in Madison, Wis. Moreno has been studying whether online posts can predict offline problems, from drug and alcohol abuse to depression. “I don’t think we can use Facebook to make a judgment, but we can use it as a trigger to ask more questions face-to-face.”

Previously: Using Facebook to assess alcohol-related problems among college students
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Lucile Packard Children’s Hospital has taken an active role at two Palo Alto, Calif., high schools on initiatives aimed at encouraging students to seek help, improve their understanding of mental illness and strengthen social bonds through peer networks.

The initiatives are described in a story published today in Inside Stanford Medicine:

At Palo Alto High School, the More Than Sad initiative is a 90-minute program that includes a video developed by experts in suicide prevention, which teaches teens how to identify and respond appropriately to depression. The program can be delivered in the classroom in one or two sessions and is portable, making it appealing to teachers.

Meanwhile, Gunn has instituted a wellness program called Sources of Strength, built around a student-led peer support group called ROCK (Reach Out. Care. Know.). Its central effort is to have peer leaders from disparate social groups deliver positive messages while empowering students to help friends who appear to be in distress.

Further down in the story, Shashank Joshi, MD, director of the child and adolescent psychiatry residency program at Packard Children’s and a Project Safety Net executive committee member, comments on how the efforts underway represent a broader shift across Palo Alto. He says:

The city, the schools, the organizations – everyone’s doing an excellent job of coming together. They’re asking, ‘How do we get better at reaching the greatest number of kids?’ We believe we’re creating a model of how a community can collaborate on school mental health and truly have an impact on such an important issue.

Previously: Volunteers watch train crossings to prevent suicides and The link between teen depression and suicide
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There’s more evidence today that regular exercise can offer benefits beyond an improved physique. Findings recently published in the Journal of Applied Psychology suggest that employees who engage in physical activity are less likely to experience deterioration in their mental health, including symptoms of burnout and depression.

In the study (subscription required), Israeli researchers evaluated the personal, occupational and psychological states of more than 1,600 healthy workers employed in both the private and public sectors. Volunteers completed questionnaires when visiting medical clinics for routine check-ups and had three follow-up appointments over a period of nine years. Based on their responses, participants were divided into four groups: no engagement in physical activity and three levels of exercise (75 to 150 minutes a week, 150 to 240 minutes a week and more than 240 minutes a week). PsychCentral reports:

Depression and burnout rates were clearly the highest among the group that did not participate in any physical activity, [said Tel Aviv University researcher Sharon Toker, PhD]

The more physical activity that participants engaged in, the less likely they were to experience depression and burnout during the next three years. The optimal amount of physical activity was a minimum of 150 minutes per week, where its benefits really started to take effect.

In those who engaged in 240 minutes of physical activity or more, the impact of burnout and depression was almost nonexistent, she said, adding that even 150 minutes a week will have a positive impact, helping people to deal with their workday, improve self-esteem, and stave off the spiral of loss.

Previously: Why you should encourage your boss to exercise, Taking time out to exercise during the workday may boost productivity, Do exercise breaks improve mental and physical fitness? and Exercise may be effective in treating depression
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In general, Americans seem to be a pretty happy bunch. The country ranks in the top five on the United Nations Human Development Index 2011, which tracks happiness in different nations based on factors such as income, education, health, life expectancy and sustainability.

If, however, we really want to move up on the list of happiest countries and boost human well-being, then national leaders should focus on promoting access to healthy natural environments and building supportive social systems and focus less on increasing gross domestic product (GDP). That’s according to findings recently presented at the annual American Association for the Advancement of Science conference.

In the study, Roly Russell, PhD, a researcher at the Canadian-based Sandhill Institute for Sustainability and Complexity, examined how countries’ social structures, environmental health and GDP influence human well-being and happiness. Scientific American’s Observations blog reports:

Russell studied numerous studies about happiness in many nations, assessing 248 variables that the various investigations had relied on. The variables ultimately fell into three broad groups of factors: financial and infrastructure (traits such as GDP and gross domestic savings); human and social (years of schooling, freedom of choice); and natural (health of land on which people live, access to nature). He then correlated those factors with the degree to which people said they were happy. Preliminary results indicated that financial factors reflected only about half the variability in happiness across countries, but human and natural capital each accounted for about two thirds of the difference.

Previously: Study advises prioritizing personal relationships over work success to boost happiness, How social ties can influence our health, happiness, If spent wisely, can money buy you happiness? and A call to “legislate the good life”
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The number of male eating disorder cases is on the rise. This NBC Nightly News segment takes a closer look at increasing prevalence of anorexia among boys and how the disorder differs between genders. In the video, James Lock, MD, PhD, a psychiatrist at Lucile Packard Children’s Hospital, explains why anorexia is generally more advanced among boys by the time they seek treatment.

Previously: Shedding light on how binge eating affects men, What a teenager wishers her parents knew about eating disorders, Stanford’s eating disorder program owes its success to holistic treatment and KQED health program examines causes and effects of disordered eating

Previous studies have shown that stress can contribute to a range of health conditions, from the common cold to heart disease. Now new research from UC San Francisco suggests that the mere anticipation of a stressful situation may increase a person’s risk for age-related diseases.

In the study, researchers examined how major forms of stress in individuals’ lives can influence how they respond to more minor forms of stress and how this psychological response impacts neurobiology and cellular health. To do so, they informed 50 women, about half of which were caregivers for a relative with dementia (and who, presumably, deal with daily stress), that they would be asked to perform public speaking or math tasks. The researchers then assessed participants’ cellular age by measuring the women’s telomeres, the protective caps on the ends of chromosomes. Short telomeres index older cellular age and are associated with increased risk for a various chronic diseases of aging such as cancer, heart disease and stroke.

According to a university release:

…The psychologists found that those most threatened by the anticipation of stressful tasks in the laboratory and through public speaking and solving math problems, looked older at the cellular level.

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The researchers also found evidence that caregivers anticipated more threat than non-caregivers when told that they would be asked to perform the same public speaking and math tasks. This tendency to anticipate more threat put them at increased risk for short telomeres. Based on that, the researchers propose that higher levels of anticipated threat in daily life may promote cellular aging in chronically stressed individuals.

Although the findings are preliminary, researchers say the study results are a significant step forward in their goal of understanding how psychological stress promotes biological aging and developing interventions to reduce the risk for disease in chronically stressed individuals.

The research is slated to appear in the May issue of Brain, Behavior and Immunity.

Previously: Workplace stress and how it influences health, How work stress affects wellness, health-care costs, Robert Sapolsky discusses stress physiology, Can stress increase risk of neurodegenerative diseases?, No surprise here: Anger and stress are bad for your health, Robert Sapolsky on stress and your health and New year, new (less stressed) you
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Here’s something to reflect on this Valentine’s Day. A recent study shows that Americans’ deep-seated regrets most often involve personal relationship mishaps, not missed career opportunities.

In the study (subscription required), researchers surveyed 500 U.S. adults about their biggest disappointments in life and then analyzed their remorse to identify what parts of their lives were most directly impacted. Healthland reports:

Study participants were asked to describe regrets that they considered both strong and weak, along with the situation that surrounded the regret. Analysis revealed that regrets involving love — think ending a relationship or cheating — rankle more than those related to less intimate choices such as dropping out of college or quitting a job. The study, published online last week in the journal Social Psychological and Personality Science, reported that love regrets outnumbered work regrets by more than 2 to 1 — 56% to 20% — in some of the comparisons. The more intense a regret, the more likely it was to be connected to personal relationships.

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What that means in general is that being bad at keeping in touch with old friends or forgetting to buy Valentine’s chocolates for your sweetie has the potential to make you feel worse — much worse — than making a mistake at work. “As you are thinking about how to feel good about your life, the thing you will feel most strongly about is protecting and strengthening your personal relationships,” says [Neal Roese, PhD, a marketing professor at the Kellogg School of Management at Northwestern University].

Previously: How social ties can influence our health, happiness
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Stanford psychology researchers are using imaging techniques to learn more about what happens in the brains of young girls at risk of depression and, as recently described here, they’re exploring a novel way to train brains away from negative situations. Ian Gotlib, PhD, discusses the work, which represents a “critical step in learning how to prevent the onset of a depressive episode,” in a Stanford Report article and the video above.

And for more on the topic, my colleague recently reported on adolescent depression and efforts to prevent it in Stanford Medicine.

Previously: Using brain-training games to stave off depression in adolescents

A new social network called AnxietySocialNet aims to help people suffering from anxiety disorders address their symptoms, find information and network with others.

Founded by Salomon Ptasevich, a former anxiety sufferer, the site also hopes to attract friends and family members who may be watching a loved one struggle with anxiety who feel helpless or confused about how to help. In a WebWire news release, Ptasevich explains:

The whole idea behind ASN is to allow people to share their emotions in a safe place and learn from each other’s experiences. We try to encourage users to get themselves out there and conquer their anxiety.

AnxietySocialNet hopes to help sufferers of agoraphobia, social anxiety disorders, obsessive compulsive disorder or any of the other forms of anxiety affecting many. The National Institute of Mental Health estimates that anxiety disorders affect as many as 40 million Americans age 18 or older.

Photo courtesy of Thinkstock Photos

Since she was a toddler, my five-year-old has been utterly devoted to a mint-green stuffed hippo named, appropriately, Hippo. He/she (the toy’s gender remains undecided) has been a faithful companion to my daughter, accompanying her on vacations, snuggling up with her at naps and bedtime, and serving as a playmate when my other daughter is otherwise engaged. Hippo even benefits me by offering traffic advice in the car: “Mommy, Hippo says we should go the other way because there’s an accident straight ahead,” my daughter will say.

I’ve always assumed that having an imaginary friend – in stuffed or human form - is normal and healthy for children, but I was still heartened to read today that this is, indeed, the case. In summarizing some of the research on the benefits of imaginary companions, Huffington Post’s Lisa Belkin writes:

They serve a variety of roles in a child’s development. The NYU Child Study Center describes the creation of these companions as “the product of a creative and curious mind figuring out how to make sense of the widening world.” Marjorie Taylor, the University of Oregon professor who is one of the leading voices in the field, and who runs a website that is all about imaginary friends, says one of the many reasons for their existence is as a shield against fear. “Children can walk confidently past a scary dog when there is an invisible tiger at their side,” she writes. Others researchers have looked at how these pals help children to “try out different relationships at a critical point in their social development,” or “allow children to explore issues of control, discipline and power with the anxiety attached to interactions with real authority figures,” or just have have “fun.”

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Children are better off because of them. Among the conclusions of research into children with imaginary companions are: “those who have them more able to see things from someone else’s perspective;” “children who pretend and imagine usually are healthier emotionally as adults”; “these children are likely to be less shy and have more real life friends.”