The consent dilemma. Patient consent is an important principle in medicine, but when it comes to mental illness, things get complicated. Other diseases don’t affect a patient’s cognition the way a mental illness can. When the organ with the disease is a patient’s brain, how can it be trusted to make decisions? That’s one reason that, historically, psychiatric patients were given very little authority to make decisions about their own care.
Mental illness and incompetence were considered the same thing. People could be hospitalized and treated against their will if they were considered mentally ill and “in need of treatment.” In the 1970s, the situation began to change. Today, even when hospitalized, psychiatric patients in about half of U.S. states have the right to refuse medication if they are competent. The truth is that many patients with psychiatric disorders don’t want to be on psychotropic medications, and many patients, in and out of hospitals, refuse. My own story helps explain why. Elyn R.
Addictions. MH Apps. Gamification. Mapping the Health Impacts of Urban Noise - CityLab. Researcher Erica Walker wants to change the way cities think about their aural landscapes. A taxi honks its horn. A delivery driver guides his noisy two-wheeled cart, stacked high with boxes, across the street. And underground, the subway rumbles. Erica Walker wants to capture it all. For the past year, the Ph.D. candidate at Harvard’s T.H. Walker, a Mississippi native with a background in math, economics, and furniture construction, will eventually co-analyze more than 900 surveys and 400 decibel readings to assign a noise value to individual homes. “Noise is insidious,” she says. What she’s already discovered is that low-frequency noise may be the most insidious.
Trouble is, those lowest decibel readings (along with the highest—think jackhammer or ambulance siren), are frequently discarded in noise studies, which tend to weigh only the mid-range levels that most people hear. Which is why Walker has become such a voracious surveyor. “Cities will never be quiet,” she says. Steve Holt. A New Study Links Long-Term Exposure to Loud Traffic Noise and Depression - CityLab. A robust new study strengthens the link between loud traffic noise and depression. Increasingly, health researchers are realizing that noise pollution is more than just a nuisance.
A 2012 study found that exposure to the sounds of car traffic can raise the risk of heart attack in people over 50. A more recent study reported that it increases the risk of obesity. Still other work has linked city noise to impaired sleep. But while these and other studies identify the effects of traffic noise on our bodies, few have looked at how it impacts our minds. New research, published in Environmental Health Perspectives, does just that—providing strong evidence that noise pollution is indeed a mental health problem. The study found that people living in areas with high traffic noise were 25 percent more likely than those in quieter neighborhoods to have symptoms of depression, even when adjusting for socioeconomic factors.
Top image: Cleanfotos / Shutterstock.com Drug Side Effects Make You Rethink What a ‘Good Life’ Means -- Science of Us. Even if you aren’t aware of it, the chances are good that someone you know is taking some sort of psychiatric medicine. According to the most recent research, an estimated one in six adults in the U.S. have a prescription for antidepressants, anti-anxiety pills, or some other drug to help them manage their mental health. And with those drugs, for many of those people, come the side effects — some of which can feel dire enough to become a problem in and of themselves, requiring a second treatment to offset the first. Many commonly prescribed antidepressants, in particular, can come with a host of side effects that can paradoxically contribute to depression. “Antidepressants saved my life and killed my orgasms,” writer Sofia Barrett-Ibarria recently declared in Self magazine; problems with sex are common, as are struggles with weight.
“It’s like, if the side effects make me just as depressed, then what’s the point?” For many patients, the physical impact can be just as frustrating. A New Way for Therapists to Get Inside Heads: Virtual Reality - The New York Times. This App Connects Veterans In Crisis With Other Veterans Who Are Willing To Talk. As a teenager growing up in Wheeling, West Virginia, Justin Miller wanted nothing more than to get out and join the armed forces. He tried a couple times; after the planes struck the World Trade Center on September 11, he met with a recruiter but was turned away after meeting with some personal objections from the recruiter. At that point in his life, he’d already given up his passion for baseball and turned to drugs and alcohol, following in the footsteps of his father, who was himself an addict.
But strangely, it was his father who encouraged Miller to again try to join up, and in 2003, he was successful; it was a different recruiter this time, who understood where Miller was coming from. But his two tours through Iraq shattered him. He reached out to Chris Mercado, an Army officer and friend of Miller’s who was, at the time, getting a masters degree at Georgetown University’s School of Foreign Service, to tell him that he was contemplating suicide. Screening tool makes it easy for emergency physicians to assess kids’ mental health - Hospital News. By Mike Foster A simple questionnaire can help busy emergency physicians accurately assess kids’ mental health needs within minutes, a new study shows. The HEADS-ED screening tool developed at the Children’s Hospital of Eastern Ontario (CHEO) allows Emergency Room physicians to rapidly assess whether children and youth need immediate intervention or follow-up referrals. Their decisions were found to be as accurate as assessments made by specialized crisis intervention workers, according to a study, “The HEADS-ED: Evaluating the clinical utility of a brief, action-oriented, pediatric mental health screening tool”, published in the May 2017 edition of Pediatric Emergency Care.
Dr. Mario Cappelli, CHEO’s Director of Psychiatric and Mental Health Research, lead author of the study, says: “We’ve shown that emergency physicians can effectively use this tool: it’s as easy and straightforward as a thermometer. Working with Dr. Dr. “Emergency services are a gateway. England’s Mental Health Experiment: Free Talk Therapy - The New York Times. Repairing Bad Memories - MIT Technology Review. It was a Saturday night at the New York Psychoanalytic Institute, and the second-floor auditorium held an odd mix of gray-haired, cerebral Upper East Side types and young, scruffy downtown grad students in black denim. Up on the stage, neuroscientist Daniela Schiller, a riveting figure with her long, straight hair and impossibly erect posture, paused briefly from what she was doing to deliver a mini-lecture about memory.
She explained how recent research, including her own, has shown that memories are not unchanging physical traces in the brain. Instead, they are malleable constructs that may be rebuilt every time they are recalled. The research suggests, she said, that doctors (and psychotherapists) might be able to use this knowledge to help patients block the fearful emotions they experience when recalling a traumatic event, converting chronic sources of debilitating anxiety into benign trips down memory lane. Fear training Moment of silence Altering the story The safest memories. The Social Workers Humanizing Homelessness at the San Francisco Public Library. Leah Esguerra, a social worker in San Francisco, begins her workday roaming in between the bookshelves at the city's Main Library. She's looking for homeless people who need her assistance. Esguerra is the nation's first library social worker. Since 2009, she's been providing social services and outreach programs to many of the city’s homeless patrons.
On this particular rainy morning, she’s hoping to find her client, John, who suffers from depression and is in need of mental health care and temporary housing. Esguerra is excited to tell John that she’s arranged some resources like food stamps and made an appointment for him to meet with a psychiatrist who will help treat his depression. John is one of more than 7,000 homeless people living in San Francisco. At the library, Esguerra recognizes at-risk patrons when she sees them talking to themselves or pacing back and forth between the bookshelves.
“I feel authentic compassion for the people I’m trying to help,” adds Henry. Genetic study provides first-ever insight into biological origin of schizophrenia. Landmark analysis reveals excessive “pruning” of connections between neurons in brain predisposes to schizophrenia Cambridge, Mass. January 26th, 2016 — A landmark study, based on genetic analysis of nearly 65,000 people, has revealed that a person’s risk of schizophrenia is increased if they inherit specific variants in a gene related to “synaptic pruning” — the elimination of connections between neurons. The findings represent the first time that the origin of this devastating psychiatric disease has been causally linked to specific gene variants and a biological process. They also help explain decades-old observations: synaptic pruning is particularly active during adolescence, which is the typical period of onset for schizophrenia symptoms, and brains of schizophrenic patients tend to show fewer connections between neurons.
The study has the potential to reinvigorate translational research on a debilitating disease. The path to discovery Paper cited: Sekar A, et al. Four Ways Hospitals are Improving Behavioral Health Care. The hectic, stressful nature of the typical emergency department makes it a less than ideal setting for mental health care. Nevertheless, hospital EDs have become a major component of the nation’s de facto behavioral health system.
The reasons: Years of funding cuts to public mental health organizations and the resulting loss of thousands of inpatient beds at state and county facilities, coupled with increased demand for services. Mental illness and substance abuse account for 4 percent of ED visits, or nearly 5.5 million visits a year. The increased pressure on already overburdened emergency departments results in distracted staff, bed shortages and, too often, a worsening of mental health patients’ conditions, asserts the American College of Emergency Physicians. Adds AHA President and CEO Rich Umbdenstock, “The other unfortunate thing is if it’s not the hospital, it’s the local jail or prison system, and that’s equally problematic.”
Montefiore: Integrating psychiatry into primary care. Gut feelings: the future of psychiatry may be inside your stomach. Her parents were running out of hope. Their teenage daughter, Mary, had been diagnosed with a severe case of obsessive–compulsive disorder (OCD), as well as ADHD. They had dragged her to clinics around the country in an effort to thwart the scary, intrusive thoughts and the repetitive behaviors that Mary felt compelled to perform. Even a litany of psychotropic medications didn’t make much difference. It seemed like nothing could stop the relentless nature of Mary’s disorder. Their last hope for Mary was Boston-area psychiatrist James Greenblatt. Greenblatt started by posing the usual questions about Mary’s background, her childhood, and the onset of her illness. That’s what prompted Greenblatt to take a surprising approach: besides psychotherapy and medication, Greenblatt also prescribed Mary a twice-daily dose of probiotics, the array of helpful bacteria that lives in our gut.
Her parents may have been stunned, but to Greenblatt, Mary’s case was an obvious one. Read next: Amar Toor. Why the Definition of Depression Isn't Working. Health Many psychiatrists believe that a new approach to diagnosing and treating depression—linking individual symptoms to their underlying mechanisms—is needed for research to move forward.
Please consider disabling it for our site, or supporting our work in one of these ways Subscribe Now > In his Aphorisms, Hippocrates defined melancholia, an early understanding of depression, as a state of “fears and despondencies, if they last a long time.” It was caused, he believed, by an excess of bile in the body (the word “melancholia” is ancient Greek for “black bile”). Ever since then, doctors have struggled to create a more precise and accurate definition of the illness that still isn’t well understood. Today, Schneider’s subtypes have largely fallen out of favor—but over the years, many more definitions were offered in their place. Some scientists believe that the DSM-V definition is still too vague.
Many recent studies have corroborated Goldberg’s concerns. Abusive parents: What do grown children owe the mothers and fathers who made their childhood a living hell? Illustration by Charlie Powell What do we owe our tormentors? It’s a question that haunts those who had childhoods marked by years of neglect and deprivation, or of psychological, physical, and sexual abuse at the hands of one or both parents. Despite this terrible beginning, many people make it out successfully and go on to build satisfying lives. Now their mother or father is old, maybe ailing, possibly broke. With a sense of guilt and dread, these adults are grappling with whether and how to care for those who didn’t care for them. Emily Yoffe is a contributing editor at the Atlantic. Rochelle, 37, wrote to me in my role as Slate’s Dear Prudence because of the pressure she was getting from friends to reach out to her mother. Rochelle started waitressing when she was 15. That was Rochelle’s breaking point—after that, she didn’t see her mother for the next 13 years.
The visits took a toll. There is no formula for defining one’s obligations to the parents who didn’t fulfill their own. Inherit_stress_from_parents_snowshoe_hares_provide_new_research_video. A recent study from the University of Pennsylvania used 60 years of data on the snowshoe hare to identify stress as a major factor in the wildly varying numbers from generation to generation. Freaked-out hare females with high levels of stress hormones give birth to smaller litters, with smaller babies who also possess high stress hormone levels, and subsequent generations then decline in numbers. In humans, we know stress is a factor in heart disease, diabetes, and obesity.
And an increasing body of work suggests we may be able to inherit stress by means other than our DNA. How Smartphone Apps Can Treat Bipolar Disorder and Schizophrenia. Bryan Timlin always carries an iPhone and an Android phone. The 57-year-old is an app and graphic designer with a Michigan company called OptHub, but he doesn’t carry two phones for work. He carries the iPhone because that’s what he likes, and he carries the Android because it’s what he needs. The Android phone monitors his behavior. Five years ago, Timlin was diagnosed with rapid-cycling bipolar disorder, a mental illness characterized by four or more manic or depressive episodes a year.
Click to Open Overlay Gallery The phone, provided by researchers at the University of Michigan, includes an app called Priori that runs constantly in the background, using the phone’s microphone to analyze his voice and track when he is, and isn’t, speaking. At the moment, the app only collects data on his behavior. Priori is one of many efforts to address mental health through smartphone apps.
A Look Into the Future The Potential These projects remain in the early stages. Thermometer of a Different Kind.