Category: Health

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What Can Minimalism do for Mental Health?

00Consumer Behavior, Featured news, Gratitude, Happiness, Health, Loneliness, Mindfulness, Sensation-Seeking February, 19

Source: Torley at flickr, Creative Commons

Ryan Nicodemus was once a senior executive making a six-figure income in a corporate job. He found himself unsatisfied with his life and depressed. He explains:

“I had everything I ever wanted. I had everything I was supposed to have. Everyone around me said, ‘you’re successful.’ But really, I was miserable.”

He looked to his life-long friend Joshua Fields Millburn for advice. Millburn pointed him toward Minimalism, namely, placing less focus and meaning on material possessions, and simplifying life to concentrate on what makes a person happiest and most fulfilled.

Nicodemus re-evaluated his circumstances and decided to de-clutter and downsize, leaving his career to pursue a life of simplicity. Together, he and Millburn branded themselves “The Minimalists.” The two attribute improved mental health to this change.

These experiences are detailed in their film Minimalism: A Documentary About the Important Things where they also reveal their difficult upbringings. Both Nicodemus and Millburn witnessed addiction and substance abuse in their families. They faced the limitations that come with living in low-income households. Their challenging pasts initially led them to aspire to acquiring wealth and material objects.

Rick Hanson, a psychologist whose work lies in personal well-being, states in the film:

“I think we’re confused about what’s going to make us happy. Many people think the material possessions are really at the center of the bull’s eye and they expect that gratifying each desire as it arises will somehow summate into a satisfying life.”

He goes on to say that this is not the case, and that the media perpetuate this way of thinking.

In the film, philosopher and neuroscientist Sam Harris argues that it is natural to use other’s lives or what’s in the media as yardsticks to measure one’s own success. He adds that this approach can lead to immense dissatisfaction.

Research seems to back up Harris’ claim. Mario Pandelaere of Ghent University cites a relationship between materialism and depression. Further, Pandelaere has found that “materialists” are, on average, not the happiest people.

In fact, Rik Pieters of Tilburg University has established a link between materialism and an increase in loneliness over time, and also reports a correlation between loneliness and depression.

And, there is support that materialistic consumption doesn’t lead to satisfaction.

The Minimalists advocate tackling materialism and consumption to fight depression. They describe excess consumption as a hunger that never gets fulfilled, and as a hopeless search for contentment. They say that, when letting go of the need to consume, people can tune in to their feelings and address unhappiness. Nicodemus and Millburn note:

“No matter how much stuff we buy, it’s never enough.”The two maintain that, if people abandon what is superfluous and only keep the items that add value, they can lead more satisfying lives. By regularly asking “Does this add value to my life?”, people are left with possessions that either serve a purpose or bring joy. Nicodemus and Millburn claim that answering this question leaves more room to build meaningful relationships and facilitate personal growth.

Not everyone agrees. With increased attention on Minimalism and de-cluttering in the news, there is some backlash to the movement. Many people are asking “How accessible is Minimalism? Is it something only for the wealthy elite?”

Most cannot afford to uproot their lives or leave their jobs to engage in a Minimalist lifestyle. Also, the portrayals of Minimalism so often seen on social media—images of chic white walls and trendy delicate jewelry—are far from attainable. Some people even say that they like having lots of knick-knacks and “clutter”, opting to call themselves “Maximalists.”

In his discussion of materialism, Pandelaere says:

“Everybody is to some extent materialistic, and materialistic consumption may not necessarily be bad. It may largely depend on the motives for it. If people consume in an effort to impress others, results may be adverse.”

– Fernanda de la Mora, Contributing Writer

The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Pressures to Breastfeed Can Harm Maternal Mental Health

00Child Development, Decision-Making, Embarrassment, Featured news, Guilt, Health, Parenting, Postpartum, Stress, Suicide January, 19

Source: sevenfloorsdown at DeviantArt, Creative Commons

Florence Leung of British Columbia, Canada went missing on October 25, 2016 while struggling with post-partum depression. Less than a month later, her family discovered that she had taken her own life, leaving behind a husband and infant son.

In an emotional public letter, Leung’s husband Kim Chen wrote an impassioned plea to new mothers asking them to seek help if they felt anxiety or depression. He also revealed that his wife’s difficulties with breastfeeding, and the resulting feelings of inadequacy, likely contributed to her condition. Urging women not to criticize themselves about an inability to breastfeed or a decision not to breastfeed, Chen wrote:

“Do not ever feel bad or guilty about not being able to exclusively breastfeed, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

Speaking with the Trauma and Mental Health Report, Melissa (name changed) said that she was struck by Chen’s words, and recalled the scrutiny around breastfeeding she experienced with her first child:

“I was tired, sore, and the baby was cranky and constantly wanting to feed. It surprised me that, despite my vocal frustration and obvious difficulty breastfeeding, the nursing staff and lactation consultants were adamant that I continue to breastfeed exclusively.”

The frustration worsened once the couple returned home. The week that followed was exhausting, spent trying to calm a screaming newborn who constantly wanted to feed. The couple attended several breastfeeding clinics that reiterated the same message: breast is best. Melissa and her husband felt confused and defeated.

Shortly thereafter Melissa became completely overwhelmed:

“I began to get scared, and not trust myself. My inability to easily nurse and soothe my baby without intense discomfort led to feelings of failure. My emotions were overwhelming. I wasn’t sleeping because I was constantly pumping breastmilk or nursing.”

Within a week after giving birth, Melissa’s infant was suddenly much quieter and less agitated. Upon closer examination, she noticed that the baby looked pale, and was lethargic and dehydrated. A frantic trip to the emergency room (ER) revealed the newborn was not getting enough liquids and nourishment—despite the many scheduled feedings. Melissa said:

“When the ER doctor apologized for the miscommunication and advised us that supplementing with formula is not only okay, but sometimes necessary, I felt a mixture of relief and betrayal. Relief because I knew we would be okay, yet betrayed by some health professionals who put their personal agendas above our health and well-being.”

In an interview with the Trauma and Mental Health Report, Diane Philipp, a Child and Adolescent Psychiatrist at SickKids Centre for Community Mental Health in Toronto, shared that she meets many mothers suffering from stress, shame, and guilt associated with breastfeeding. Philipp explained that the judgements of others place unnecessary pressure on mothers:

“It’s important for mothers to have access to frank and open discussions that are safe and non-judgemental where they can seek out information and make the most knowledgeable decision that is best for their child and for themselves in terms of breastfeeding.”

Every woman’s situation is unique. Lifestyle habits, medication use, and medical and psychological history can complicate the post-partum experience. With this context in mind, the healthcare team should provide a comfortable environment—free of judgement—when discussing post-partum issues, including how to provide an infant’s nourishment.

For mothers who are unable to nurse, be it for medical, physical, or personal reasons, their decision can be supported and honoured in a way that promotes emotional well-being and encourages healthy parent-child bonding. Philipp said:

“For parents who can’t breastfeed for whatever reason, wonderful attachment bonds can still be made. Breast milk is not the only ingredient in a valuable, long-lasting relationship.”

Melissa, now a mother of two healthy school-age children, remains sensitive to others’ assumptions of breastfeeding:

“I felt so pressured to get it right, and so judged when I couldn’t provide for my child. Even when you come to terms with your decision not to breastfeed, people question your choice. Looking at my children today, I know I did the right thing.”

– Kimberley Moore, Contributing Writer, The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Mental Illness in Youth Often Goes Undetected

00Adolescence, Anxiety, Child Development, Decision-Making, Depression, Emotion Regulation, Featured news, Health December, 18

Source: Zarina Situmorang at DeviantArt, Creative Commons

When university student Kinga (name changed) was young, she struggled with symptoms she couldn’t identify. She had shortness of breath and would suddenly get anxious. Her mother took her to a doctor, and Kinga was diagnosed with asthma. Despite asthma treatment, her inability to catch her breath persisted, and she had feelings of panic.

In retrospect, Kinga isn’t so sure she had asthma at all, believing she was misdiagnosed. In an interview with the Trauma and Mental Health Report, she explains:

“The doctors never knew what was wrong with me, probably because I didn’t have the right words to explain what was happening, and maybe because I wasn’t failing in school.”

Some mental illnesses, even those that are familiar, such as anxiety and depression, can be hard to identify. For youth with subtle to moderate symptoms, diagnosis can be especially difficult. Psychiatrist Peter Jenson and colleagues emphasize that diagnoses tend to rely on adults noticing symptoms. Children and teenagers often don’t have the knowledge to recognize their own mental-health difficulties.

As Kinga entered her pre-adolescent years, she always felt tired. Everything she did took a little more effort. While she continued her day-to-day activities, her symptoms followed her around. She says:

“I always performed well in school. I went out with friends, attended dance and language classes, but the fatigue was almost too much to bear. I had to fight the fogginess in my head to concentrate in school, and push myself through the exhaustion in dance class.”

Struggling pre-teens may not even realise that their mental health is at risk. They might only feel a little more tired or pessimistic. But these symptoms can hinder their ability to perform to their full potential.

Kinga also experienced other symptoms, like irritability:

“Sometimes, I would scream at my parents or siblings over the smallest things. My mom called it ‘being a teenager’, she didn’t realise, none of us realised, that it was more than that.”

Despondent and unable to get help, Kinga took matters into her own hands and researched her symptoms on the Internet. She recalls:

“I was so fed up with feeling like this. So I turned to Google. I searched ‘what is tiredness a symptom of?’ In my 16-year-old mind, that was all it was. I was just tired. I clicked on a link— ‘symptoms of depression.’ Other symptoms listed were feelings of hopelessness, negative thoughts, difficulty concentrating, feelings of numbness… I suddenly realised what must be going on.”

With this new information, she went back to her doctor.

“I finally had a name for these feelings. But for so long, I was doing too well for anyone to notice something was wrong. I suffered for years, believing that everyone felt like this—everyone felt a little out of breath, a little empty.”

A form of depression where people appear to function normally is called dysthymia, and it often begins in childhood. Although it may not be as debilitating as major depression, dysthymia can prevent positive feelings and interfere with daily tasks. On average, it lasts five years, does not usually resolve on its own, and requires treatment. About 75% of those with dysthymia develop severe forms of depression if left untreated.

While Kinga’s symptoms did not prevent her from continuing her usual activities, if she had not received help when she did, she may very well have developed a more serious mental illness.

In a post on Up Worthy, college student Amanda Leventhal shares a similar experience. Four years passed before she was diagnosed and treated. And Leventhal believes the process took so long because of stereotypes regarding mental illness:

“Even though we’re often told that mental illness comes in all shapes and sizes, I think we’re still stuck with certain ‘stock images’ of mental health in our heads.”

She says that ideas of how mental illness “should look” are so prevalent, it is difficult to believe that someone who doesn’t look mentally ill could be struggling. In fact, a study out of Duke University reports that only half of teenagers with mental health problems receive treatment at all.

Kinga says:

“I don’t know where I would be today if I didn’t get help. I don’t even want to think about that. I know I’m not the only one who suffered from mental illness as a kid, so I hope there is an increase in awareness of mental illness in young people.”

– Anika Rak, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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What Can A Lizard Tell Us About Mental Health?

00Animal Behavior, Child Development, Epigenetics, Evolutionary Psychology, Featured news, Genetics, Health, Parenting, Stress, Trauma December, 18

Source: Hayke Tjemmes at flickr, Creative Commons

A new study on lizards has found that, when exposed to stress, their responses can be passed down genetically. Scientists now believe there may be more to the process of heritability than once thought. This process is called “Transgenerational Stress Inheritance.”

As recently as 2011, most research did not examine the possibility that parental stress could affect sperm or egg cells. Since genes are transferred to offspring through these cells, anything that modifies them can have an impact on genetic expression in children. The idea that parents’ experiences prior to pregnancy can change gene expression and, therefore, affect offspring behaviour, is novel.

In the lizard study, researchers from Pennsylvania State University exposed young lizards to fire ants (a natural stressor) and compared stress levels to unexposed lizards. Interestingly, contact with the stressor did not affect the lizards’ behaviour later in life. But, their offspring had stronger stress reactions than offspring of lizards who had not been subjected to the ants.

Lead researcher Gail McCormick told PsyPost:

“Our work reveals that the stress experienced by an individual’s parents or ancestors may overshadow the stress that an individual faces within its lifetime. In this study, offspring of lizards from high-stress sites were more responsive to stress as adults, regardless of exposure to stress during their own lifetime.”

These findings suggest that, although early life stress may not manifest later in adulthood, the effects may be passed down to offspring, even if offspring are not directly exposed to the stressor.

A similar study involved researchers conditioning mice to associate the smell of cherries with a mild electric current. When the fragrance permeated the air, the mice were given a small electric shock. And so, the mice began to fear the scent even when the shock wasn’t administered. Even more fascinating was that offspring of these mice, as well as their offspring, experienced fear in the presence of the odor. The fear reaction occurred even though the later generations didn’t experience the conditioning process.

Of course, the question these studies pose is whether there is a similar effect in humans.

As recently reported in the Guardian newspaper, researchers from New York’s Mount Sinai School of Medicine compared the genes of direct descendants of Jews who were “interned in a Nazi concentration camp, witnessed or experienced torture or who had had to hide during the second world war” to the offspring of Jews living outside of Europe who were unharmed. The children of parents who experienced WWII trauma showed genetic changes and a greater risk of stress disorders. These were not present in the other children. The Guardian article stated:

“[The] new finding is [a] clear example in humans of the theory of epigenetic inheritance: the idea that environmental factors can affect the genes of your children.”

In other research, psychologist Margaret Keyes from the University of Minnesota and colleagues examined twins to determine if the behaviour of biological parents could affect offspring who were not raised by them. The study found that children of parents who smoked were more likely to be smokers, even if those children weren’t raised by the parents, and as such, did not have parental smoking behavior modeled to them. Scientists are still questioning, though, whether it’s parental behavior directly affecting these genes or a genetic predisposition to smoking being passed down for generations.

On the whole, these studies make the case that genetic changes can happen a lot faster than previously thought, within a few generations or even one generation. And, as reported in Science magazine, people can see evolution in real time:

“Now, thanks to the genomic revolution, researchers can actually track the population-level genetic shifts that mark evolution in action—and they’re doing this in humans. [Studies] show how our genomes have changed over centuries or decades…”

Research in this field is still new and is subject to several caveats. Perhaps the most important one is the complexity of human beings and their environments. Indeed, there may be too many variables that factor into the human experience for researchers to arrive at definitive conclusions.

But, these studies do suggest that individuals may be affected by the stress felt by ancestors in  before them. Further research is required to determine whether these findings are the result of transgenerational stress inheritance or an external factor that has yet to be considered.

– Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

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Ketamine Depression Treatment Poses Unknown Risks

00Decision-Making, Depression, Education, Featured news, Health, Psychopharmacology, Suicide November, 18

Source: SnaPsi at flickr, Creative Commons

New evidence that ketamine, an anesthetic medication, might be effective in treating depression is leading to increased research on the drug. What’s significant is the rapid relief in symptoms seen in some patients. After just one dose of ketamine, their depression can decline within three days, much quicker than with conventional anti-depressants.

This finding is particularly meaningful for people at risk for suicide. Ketamine may provide an option for physicians to quickly treat acutely suicidal patients by creating a window of opportunity to begin long-term behavioral and pharmacological therapies. If a patient’s symptoms are relieved even for a short time, it may be long enough to intervene.

Recent excitement also surfaced when researchers from New York’s Mount Sinai School of Medicine demonstrated the drug’s ability to alleviate treatment resistant depression (TRD). TRD occurs when feelings of intense sadness, loss of energy, and inability to experience pleasure persist even after multiple attempts at treatment. In the study, a shocking nine out of 10 patients with TRD experienced significantly reduced symptoms after their first dose of ketamine.

Despite this finding, questions remain about the drug’s long-term efficacy, as well as its side effects.

Anthony (name changed) has first-hand experience with ketamine to treat TRD. In a Reddit thread and interview with the Trauma and Mental Health Report, he explained that, prior to receiving ketamine treatment, he had tried numerous anti-depressants. After spending weeks or months on each drug to no avail, his doctor would switch him to a new drug in hopes of finding one that worked, but nothing did. Anthony began researching alternative treatments himself. He explained:

“When you try so many drugs—SSRIs, SNRIs, TCAS, antipsychotics, lithium, depakote—you are pretty open to anything that will help.”

He discovered ketamine and was enticed by the prospect of its therapeutic benefits:

“Before ketamine, I was in a hole. This was as depressed as I had ever been. I was suicidal. I called my mom and dad. They rescued me, letting me live in their basement. There, I began researching ketamine until I knew almost every study. I convinced my doctor to let me try it.”

But ketamine is only approved for use as an anesthetic by the U.S. Food and Drug Administration (FDA). This provision means that any patient who receives ketamine treatment for depression must have it prescribed as an “off-label” treatment. In other words, the doctor prescribes the drug for a non-FDA-approved use.

Choosing to participate in an unapproved treatment may expose a patient to more risks than they are aware of. FDA approval for ketamine use in anesthesia indicates that one time treatments are not harmful, but it is uncertain whether repeated treatments are safe. And, the long-term effects are not known.

Not surprisingly, the off-label prescription of ketamine has been criticized. A study by Melvyn Zhang at the Institute of Mental Health in Singapore and colleagues cited multiple problems with ketamine treatment for depression. A major criticism was that current information is based on inadequately short periods of observation. These observations indicate depression relapse rates as high as 73% one month after treatment ends.

Nevertheless, after deciding he was scared, but prepared to do anything to overcome his depression, Anthony began intravenous (IV) ketamine treatment in his doctor’s office:

“[When taking the drug] I feel completely disconnected from my body. I cannot move. I feel partly elated, and partly terrified. Reality becomes distant. I have no awareness of my body; only my mind exists. In this space, I can see my own struggle with depression. I recognize in this strange way that the depression isn’t real, not a part of me. I realize that I am surrounded by people who love me. Slowly, I come back to the chair I’m in, back to the doctor’s office. Somehow, I already feel better.”

After his initial treatment, Anthony said that his thoughts of suicide disappeared. He remembers feeling clear-headed, not high or euphoric. He felt normal again. This realization was so profound, he was moved to tears:

“After the initial five treatments, I was having moments when it felt like all my symptoms of depression were gone. But they would always eventually return. I was prescribed a nasal spray about a month after my last IV treatment. That worked for a while.”

Unfortunately, these benefits had serious contraindications. Anthony experienced lingering feelings of being disconnected from his body and from reality. Another study investigating ketamine use for TRD found that three out of 10 participants experienced dissociative symptoms from the drug.

These side effects have yet to be fully understood. Although Anthony believes that the treatment saved him, it also opened the door for other mental-health problems:

“Looking back, I would do it over again, as ketamine literally pulled me from suicidal thoughts. But, in my opinion, ketamine opened the door for the feelings of disconnection. And they are a huge struggle for me every day now.”

With alarmingly high post-treatment relapse rates, little knowledge of long-term safety, and worrisome side effects, ketamine has yet to be proven as a lasting treatment for depression.

– Stefano Costa, Contributing Writer. The Trauma and Mental Health Report

-Chief Editor: Robert T Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Should Those with Mental Illness Have the Right to Die?

00Chronic Pain, Decision-Making, Featured news, Health, Resilience, Suicide September, 18

Source: KingaBritschgi at DeviantArt/Creative Commons

On June 17, 2016, Canada joined a handful of countries and several U.S. states in enacting assisted suicide legislation. Medical Assistance in Dying (MAID), also known as euthanasia, was passed into Canadian law as Bill C-14 in an effort to provide relief from unbearable suffering to those whose death is reasonably foreseeable.

Although having the choice to die brings relief to many individuals and their families, Bill C-14 does not cover those who wish to end their life due to an unendurable mental illness.

Being denied a legal right to assisted death for significant mental illness was the plight of 27-year-old Adam Maier-Clayton. Since childhood, Maier-Clayton suffered from unrelenting psychological disorders that robbed him of sustaining a reasonable quality of life. In an essay published in The Globe and Mail, he detailed the unrelenting pain his psychological disorder caused him:

“I’m not suicidal in the sense that I hate myself and I want to leave. I think this world is beautiful, but this amount of pain is intolerable… Some people are confined to lives of truly horrifying amounts of suffering that no amount of treatment can stop.”

Maier-Clayton lobbied the Canadian federal government to change the criteria that would allow people with severe mental illness to qualify for medical assistance in dying. His bid was not successful. Sadly, in April 2017, he took his own life.

Currently, the law in Canada excludes access to MAID for people suffering from psychological issues alone. For right-to-die supporter, author, and journalist Sandra Martin, this position is disrespectful to the severely mentally ill. In an article written for The Globe and Mail, Martin argued for what she believes is the best interest of the patient:

“We can’t leave it to vote-wary politicians and risk-averse medical associations to campaign for an equitable MAID law….We can’t wait for another constitutional challenge to recognize that not all suffering is physical. That struggle is Maier-Clayton’s legacy—and fighting for it might make a difference to you or somebody you love.”

Not having an available, safe, and medically supervised solution to dying does not prevent death. According to Dying With Dignity Canada, the absence of a legal and feasible option pushes individuals into making agonizing and expensive decisions. They must either take their own life or travel abroad to countries where assisted suicide is legal.

Despite the pressure to change MAID, lawmakers are taking a cautious approach to considering future regulation on right-to-die policies involving psychological disorders. Many mental health professionals and organizations meet this unhurried approach favourably, as they feel it is necessary to protect potentially vulnerable members of society who may recover.

The Centre for Addiction and Mental Health (CAMH) supports the Canadian government’s decision to painstakingly consider the implications of MAID for psychiatric patients. CAMH stated:

“CAMH recognizes that people with mental illness can experience intolerable psychological suffering as a result of their illness, but there is always the hope of recovery. In those rare cases where a mental illness may be determined to be irremediable, safeguards must be in place to make sure that an individual truly has the capacity to consent to MAID.”

On February 8, 2017, in a panel discussion jointly hosted by the University of Toronto Faculty of Law and CAMH, mental health professionals converged to dissect this multifaceted debate. In addition to the vast legal issues, they discussed the enormous ethical dilemmas inherent in right-to-die policies. Panel member Scott Kim, Senior Investigator at the National Institute of Health, summarized some of the ethical, moral, and legal issues at play, and cautioned against enacting policy without the appropriate research on euthanasia available. Kim emphasized the risk of human error in the medical profession in making this type of decision:

“Euthanasia is permanent….Even the most sophisticated psychiatrist does not have too much data to go on except their own experience and impressions to make these prognostic determinations.”

Kim goes on to point out that wanting to die is often part of the mental illness manifestation itself, and with correct and consistent treatment, the desire to end one’s life may abate.

MAID currently requires a medical practitioner to support a patient’s resolve to die. The magnitude of such a permanent decision lies not only with the patient, but also with the medical professional. In an occupation that is obligated to ‘do no harm’, supporting the death of someone with a non-terminal illness, despite an intolerable life, appears contradictory.

Tarek Rajii, panel member and Chief of Geriatric Psychiatry at CAMH, has worked with patients that he knows may never recover. However, based on the current research available, Rajii remains hesitant about MAID for mental illness:

“We don’t know who will die suffering. We don’t know how to identify that person….If we are considering MAID as a form of treatment intervention, when there is very limited evidence, as a medical profession, do we introduce an intervention without enough evidence, that we don’t [fully] understand?”

With making the decision to end a life of psychological suffering, mistakes are not an option. There is no room for error; there is no reversal. And yet, how much suffering can one person endure? Ultimately, we are left with the realization that, despite the pain from devastating mental illness, hope for recovery cannot be ruled out.

– Kimberley Moore, Contributing Writer, “The Trauma and Mental Health Report”

“-Chief Editor: Robert T. Muller, The trauma and Mental Health Report”

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Dangerous Eating Has Become a Problem in High-Level Sports

00Anorexia Nervosa, Body Image, Coaching, Diet, Eating Disorders, Featured news, Health, Sport and Competition July, 18

Source: Image Credits Feature: Thomas Wolter at pixabay, Creative Commons

As profiled by the media during the Summer 2016 Olympics and Paralympics in Rio de Janeiro, doping is a problem that continues to plague sporting events worldwide. For the past half-century, international sports federations, including the International Olympics Committee (IOC), have tried to stop the infiltration of illegal substances into sports.

Despite harsh punishments, some coaches and athletes persist in employing banned drugs, such as stimulants and hormones, to improve performance. Through periodic drug testing, these federations monitor the substances that athletes consume. Educational programs and medical treatment also help athletes address drug use and the pressures of high-performance sports.

But is anyone paying attention to what athletes are not consuming?

Disordered eating behaviours are another tactic used to heighten performance. Although highly controlled eating practices can cause serious health problems, dangerous eating among athletes is not heavily monitored by sports organizations.

Disordered eating is defined as a spectrum of harmful and often ineffective eating behaviours used to lose weight or attain a lean appearance. When defining disordered eating, the American College of Sports Medicine uses a behavioural continuum that starts with healthy dieting among athletes, proceeding to more extensive weight or dietary restrictions, to passive or active dehydration (e.g., saunas), and end at the onset of diagnosable eating disorders.

In an interview with the Trauma and Mental Health Report, Roy Cowling, Technical Director and Club Head Coach at North Toronto Soccer Club and volunteer for the Special Olympics Ireland and Special Olympics Great Britain, says that “involvement in organized and professional sports can offer a lot of benefits—improved self-esteem and body image, and encouragement to remain active throughout one’s life.”

But from his day-to-day interactions with clients who are training for professional sports, he thinks that athletic competition can cause severe psychological stress.

“The sports culture, with its emphasis on optimal or ideal body size or shape for best performance, is at many times an influencing factor in developing odd or abnormal eating patterns. Even extreme dieting or not eating at all.”

When the pressures of athletic competition are layered on top of an existing cultural emphasis on thinness, the risks increase for athletes to end up with disordered eating—a strong predictor that individuals may progress to an eating disorder (anorexia nervosa, bulimia nervosa, and binge-eating disorder).

In a study of Division 1 NCAA (National Collegiate Athletic Association) athletes, over one-third of female athletes reported pathological attitudes and symptoms toward eating, placing them at risk for anorexia nervosa. Although most athletes with eating disorders are female, males are not immune. Athletes competing in sports that tend to place an emphasis on diet, appearance, size, and weight requirements—such as wrestling, bodybuilding, running, and ‘anti-gravity’ sports (jumping sports where excess body weight is a disadvantage)—face more pressure to maintain a certain body weight.

Athletes are also at a higher risk than the general population of suffering harsh health consequences of eating disorders. According to Cowling:

“Athletes already exercise heavily, so their bodies and energy levels are depleted sooner and their health is heavily tested and challenged.”

Doping is deemed harmful to an athlete’s health by sports federations and is monitored. So why aren’t eating disorders carefully screened? This question is particularly crucial, given that pathological eating behaviours, specifically anorexia nervosa, have the highest mortality rate of any psychiatric illness.

Cowling, through his work at the Olympics, says that it often boils down to time, resources, and ultimately, athletes’ willingness to speak out.

“Testing for illegal substances is a fairly quick and standard process, whereas inquiring about someone’s eating behaviours or dieting leaves a lot of room for misinterpretation. There’s no guarantee that the athlete is even going to be honest, since that could risk them getting excluded from the team or competitions. Plus, a lot of resources and training would have to go into properly screening for abnormal eating behaviours—something that international, and even national or local sports organizations, can’t be bothered with.”

Unless sports federations pay closer attention to this issue, the onus is on coaches who work closest with athletes to help keep eating and dieting behaviour in check.

Despite the lack of screening and prevention on the part of international sports federations, the National Eating Disorders Association and the National Eating Disorders Collaboration have guidelines for coaches to enhance their awareness and ability to address and prevent problematic eating behaviours in athletes.

“-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.”

“–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.” http://trauma.blog.yorku.ca/

“Copyright Robert T. Muller.” https://psychotherapytoronto.ca/

This article was originally published on Psychology Today

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Dangerous Eating Habits Enhance Sports Performance

00Anorexia Nervosa, Body Image, Coaching, Diet, Eating Disorders, Featured news, Health, Sport and Competition July, 18

Source: Image Credits Feature: Thomas Wolter at pixabay, Creative Commons

As profiled by the media during the Summer 2016 Olympics and Paralympics in Rio de Janeiro, doping is a problem that continues to plague sporting events worldwide. For the past half-century, international sports federations, including the International Olympics Committee (IOC), have tried to stop the infiltration of illegal substances into sports.

Despite harsh punishments, some coaches and athletes persist in employing banned drugs, such as stimulants and hormones, to improve performance. Through periodic drug testing, these federations monitor the substances that athletes consume. Educational programs and medical treatment also help athletes address drug use and the pressures of high-performance sports.

But is anyone paying attention to what athletes are not consuming?

Disordered eating behaviours are another tactic used to heighten performance. Although highly controlled eating practices can cause serious health problems, dangerous eating among athletes is not heavily monitored by sports organizations.

Disordered eating is defined as a spectrum of harmful and often ineffective eating behaviours used to lose weight or attain a lean appearance. When defining disordered eating, the American College of Sports Medicine uses a behavioural continuum that starts with healthy dieting among athletes, proceeding to more extensive weight or dietary restrictions, to passive or active dehydration (e.g., saunas), and end at the onset of diagnosable eating disorders.

n an interview with the Trauma and Mental Health Report, Roy Cowling, Technical Director and Club Head Coach at North Toronto Soccer Club and volunteer for the Special Olympics Ireland and Special Olympics Great Britain, says that “involvement in organized and professional sports can offer a lot of benefits—improved self-esteem and body image, and encouragement to remain active throughout one’s life.”

But from his day-to-day interactions with clients who are training for professional sports, he thinks that athletic competition can cause severe psychological stress.

“The sports culture, with its emphasis on optimal or ideal body size or shape for best performance, is at many times an influencing factor in developing odd or abnormal eating patterns. Even extreme dieting or not eating at all.”

When the pressures of athletic competition are layered on top of an existing cultural emphasis on thinness, the risks increase for athletes to end up with disordered eating—a strong predictor that individuals may progress to an eating disorder (anorexia nervosa, bulimia nervosa, and binge-eating disorder).

In a study of Division 1 NCAA (National Collegiate Athletic Association) athletes, over one-third of female athletes reported pathological attitudes and symptoms toward eating, placing them at risk for anorexia nervosa. Although most athletes with eating disorders are female, males are not immune. Athletes competing in sports that tend to place an emphasis on diet, appearance, size, and weight requirements—such as wrestling, bodybuilding, running, and ‘anti-gravity’ sports (jumping sports where excess body weight is a disadvantage)—face more pressure to maintain a certain body weight.

Athletes are also at a higher risk than the general population of suffering harsh health consequences of eating disorders. According to Cowling:

“Athletes already exercise heavily, so their bodies and energy levels are depleted sooner and their health is heavily tested and challenged.”

Doping is deemed harmful to an athlete’s health by sports federations and is monitored. So why aren’t eating disorders carefully screened? This question is particularly crucial, given that pathological eating behaviours, specifically anorexia nervosa, have the highest mortality rate of any psychiatric illness.

Cowling, through his work at the Olympics, says that it often boils down to time, resources, and ultimately, athletes’ willingness to speak out.

“Testing for illegal substances is a fairly quick and standard process, whereas inquiring about someone’s eating behaviours or dieting leaves a lot of room for misinterpretation. There’s no guarantee that the athlete is even going to be honest, since that could risk them getting excluded from the team or competitions. Plus, a lot of resources and training would have to go into properly screening for abnormal eating behaviours—something that international, and even national or local sports organizations, can’t be bothered with.”

Unless sports federations pay closer attention to this issue, the onus is on coaches who work closest with athletes to help keep eating and dieting behaviour in check.

Despite the lack of screening and prevention on the part of international sports federations, the National Eating Disorders Association and the National Eating Disorders Collaboration have guidelines for coaches to enhance their awareness and ability to address and prevent problematic eating behaviours in athletes.

“-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.”

“–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.” http://trauma.blog.yorku.ca/

“Copyright Robert T. Muller.” https://psychotherapytoronto.ca/

This article was originally published on Psychology Today

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Domestic Abuse Linked to Financial Crisis

00Domestic Violence, Featured news, Health, Marriage, Psychopathy, Relationships, Stress June, 18

Source: isabellaquintana at pixabay, Creative Commons

Self-reported spousal violence has declined in most Canadian provinces over the past ten years, according to Statistics Canada. But an increase in domestic violence calls to the police in the province of Alberta was reported for 2016 by The Globe and Mail. The increase occurred concurrently with the loss of thousands of jobs in the mining and oil industries.

This connection has also been established in other countries. During the financial collapse in Greece, the Greek police reported a 53.9% increase in family violence in 2011 from before the crisis in 2008. Additionally, when sociologist Claire Renzetti and colleague reviewed research in the United States, they found evidence of a relationship between economic stresses and domestic abuse.

Another study of American households indicates that intimate partner violence occurs at disproportionate rates among impoverished groups of women. The World Health Organization states that 13-61% of women worldwide recount experiencing physical violence from a partner at some point in their lifetime, and that poverty is a risk factor.

In an interview with the Trauma and Mental Health Report, Barbara MacQuarrie, the community director of the Centre for Research and Education on Violence Against Women and Children at Western University, described the link:

“At the heart of domestic violence is a dynamic of power and control, where one person feels they have the right to control another. When one loses control over their finances, they may attempt to regain that control by controlling their spouse through physical violence and other abusive tactics.”

Awareness of how financial stressors affect violent behaviour becomes important during times of financial hardship, such as economic recessions. Although macro research on the influence of economic crises on domestic violence is limited, the findings in Alberta, Greece, and the United States are telling. There are also personal accounts of spousal aggression surrounding financial problems.

Anne (name changed for anonymity), a survivor of domestic violence, recounted her experience to the Trauma and Mental Health Report. She recalled financial struggles preceding violent episodes from her previously non-violent husband.

In 1991, Anne moved from Russia to Canada to join her husband Jonathan (name changed). This move coincided with a severe recession beginning in the early ’90s. Johnathan’s wages were cut in half, to the detriment of the family. A once promising future was now out of reach. In Anne’s words:

“I needed to work to help ends meet. Because I took care of our children and household during the day, I had to work at night. I cleaned at a corporate office for minimum wage, so money was tight. “

Months after the move to Canada, arguments became heated, and he became more aggressive, at one point, pushing her hard enough that she hit her head against concrete, and fell unconscious. Anne believes that their financial stresses brought out another side of Jonathan that led him to become both physically and emotionally abusive. She decided to leave, but was afraid for her life and the safety of her children if she did.

“He was supposed to be my partner, but instead of my being able to go to him for help or support, I feared him. “

Women who are survivors of domestic violence are right to feel afraid. The Canadian Women’s Foundation reports that 26% of women killed by their spouse are killed after they leave the relationship, and women are six times more likely to be murdered by an ex-partner than a current partner. Nonetheless, with proper planning and support, women can safely leave a violent situation. Anne said:

“When Jonathan left on a work-related trip, I took the children with me to a women’s shelter. It was highly secure, padlocks on every door, and a security guard at the main entrance. Eventually we moved into an apartment.”

Anne and her children now live safely. She encourages those who are facing potential domestic violence to seek help immediately, especially as warning signs increase. Barbara MacQuarrie explains that more than one risk factor in the perpetrator increases the chances of violence:

“Unemployment is a very significant risk factor, especially if it’s present with other factors, such as the perpetrator having experienced abuse as a child or witnessed domestic violence.”

–Anika Rak, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Solitary Confinement Is Torture

00Ethics and Morality, Featured news, Health, Politics, Psychopathy, Punishment, Suicide May, 18

Source: The Euskadi 11 at flickr, Creative Commons

Sixteen-year-old Kalief Browder spent three years in New York’s notorious Rikers Island prison, awaiting trial for robbery. Two of those years were spent in solitary confinement. Browder’s case was eventually dismissed and, after surviving four suicide attempts during incarceration, he was released. Suffering from depression and paranoia from his years in isolation, Browder died by suicide in June of 2015.

Former U.S. President Barack Obama referenced Browder’s story in an opinion piece he wrote for the Washington Post, explaining his decision to ban solitary confinement for juveniles in all federal prisons, and calling for greater restrictions on its use as a punitive measure. New York had already ended the use of isolation for prisoners 16 and 17 years old, but in October 2016, the age restriction was extended to age 21 and younger.

In 2015, Canada’s Prime Minister Justin Trudeau moved to ban the use of long-term solitary confinement by placing a 15 consecutive-day limit on its use—as of writing, this ban had not come into effect. His decision was motivated in part by the death of Ashley Smith, a young offender who had spent more than 1,000 days in isolation. At the age of 19, while being held in solitary, Smith died by hanging herself. A coroner’s inquest ruled her death a homicide, indicating that other people’s actions were factors in her death.

Reforms are moving in the right direction, but results of a 2011 United Nations (UN) report raise the question—should isolation be permitted under any circumstances? UN Special Rapporteur Juan E. Mendez said in this report:

“Solitary confinement, [as a punishment] cannot be justified for any reason, precisely because it imposes severe mental pain and suffering beyond any reasonable retribution for criminal behaviour and thus constitutes an act defined [as] … torture.”

Nevertheless, according to the National Conference of State Legislatures, many American states impose no restrictions on the use of solitary confinement, even for juveniles. In Canada, there is currently no limit on how much time a prisoner can spend in solitary confinement. And, if adopted, the limits proposed by Trudeau will only affect federal prisons.

According to an American National Survey by the Association of State Correctional Administrators at Yale, “between 80,000 and 100,000 people were in isolation in prisons as of the fall of 2014.” In Canada, The Globe and Mail reports, “1,800 Canadian inmates are held in segregation on any given day.”

According to Mendez, the adverse health effects of this type of imprisonment are numerous, and include ‘prison psychosis,’ which can lead to anxiety, depression, irritability, cognitive disorders, hallucinations, paranoia, and self-inflicted injuries. Mendez concluded that “solitary confinement for more than 15 days…constitutes cruel and inhuman, or degrading treatment, or even torture”—well below the time Browder and Smith spent in isolation.

The adverse effects of solitary confinement on mental health have a long history of documentation. David H. Cloud, head of the Vera Institute of Justice’s Reform for Healthy Communities Initiative, stated:

“Nearly every scientific inquiry into the effects of solitary confinement over the past 150 years has concluded that subjecting an individual to more than 10 days of involuntary segregation results in a distinct set of emotional, cognitive, social, and physical pathologies.”

These findings prompted Kenneth Appelbaum from the Center for Health Policy and Research at the University of Massachusetts Medical School to write an article calling for American psychiatry to join the fight against the use of solitary confinement.

Many prison administrators disagree. In an interview with the Boston Globe, the Massachusetts Commissioner of Correction defended the use of solitary, explaining:

“We have to be realistic when we’re running these prisons. Segregation is a necessary tool in a prison environment.”

An article by Corrections One, an online news outlet for the correctional field, explains that segregation keeps jails safer by removing violent and dangerous inmates from the prison population, in the same way that imprisonment removes dangerous people from society. Segregation, the article states, is primarily used on prisoners that pose a risk of harm to themselves or others.

Speaking with the Canadian Broadcasting Company (CBC), Lisa Kerr, law professor at Queen’s University in Southern Ontario, reported that:

“Prison administrators have long been convinced that they cannot manage their institutions without easy, limitless recourse to segregation.”

Watch-dog groups point out that other countries apply the use of solitary confinement more selectively and with greater oversight than is used in North American prisons. In the U.K., while solitary is still in practice, the number of prisoners subjected to this form of punishment is much lower. Even more progressive are correctional institutions in Norway, where prison reform has moved away from punitive approaches and has placed rehabilitation and reintegration as a key focus during incarceration.

Eliminating the use of solitary confinement for juveniles is a promising first step towards abolishing the practice entirely. While supporters of solitary may not feel there are effective alternative punishments, human rights advocates continue to fight for prison reform. Looking at solutions used in other countries, perhaps more effective and humane incarceration methods can be realized, and the current paradigm of punishment may shift.

–Stefano Costa, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report. 

Copyright Robert T. Muller. 

This article was originally published on Psychology Today