Tag Archives: Mental Health

Journal of American Medical Association study: Folic acid may reduce autism risk

12 Feb

Moi has written several blog posts about autism. In University of Connecticut study: Some children with autism may be ‘cured’ with intense early therapy:

In order for children with autism to reach their full potential there must be early diagnosis and treatment.

Autism Speaks reports about a University of Connecticut study in the post, Study Confirms “Optimal Outcomes”:

Some children diagnosed with autism in early childhood reach “optimal outcomes” with levels of function similar to their typical peers. The findings appear today in the Journal of Child Psychology and Psychiatry.

“Although the diagnosis of autism is not usually lost over time, the findings suggest that there is a very wide range of possible outcomes,” says Thomas Insel, M.D., director of the National Institutes of Mental Health (NIMH). “For an individual child, the outcome may be knowable only with time and after some years of intervention.”

This week’s report is the first in a series of autism studies on optimal outcomes, sponsored by the NIMH. They follow up on earlier reports that a small group of children appear to “lose” their autism diagnosis over time. Some experts have questioned the accuracy of these children’s initial diagnoses. Others argued that simply being able to function in a mainstream classroom doesn’t mean that these children don’t quietly struggle with autism-related disabilities. http://www.autismspeaks.org/science/science-news/study-confirms-%E2%80%9Coptimal-outcomes%E2%80%9D

https://drwilda.com/2013/01/19/university-of-connecticut-study-some-children-with-autism-may-be-cured-with-intense-early-therapy/

The Journal of the American Medical Association (JAMA) is reporting in a new study that folic acid use during pregnancy may reduce autism risk.

Steven Reinberg, Health Day Reporter for WebMD reports in Folic Acid in Pregnancy May Lower Autism Risk:

A new study suggests that women who start taking folic acid supplements either before or early in their pregnancy may reduce their child’s risk of developing autism.

“The study does not prove that folic acid supplements can prevent childhood autism. But it does provide an indication that folic acid might be preventive,” said study lead author Dr. Pal Suren, from the division of epidemiology at the Norwegian Institute of Public Health in Oslo.

“The findings also provide a rationale for further investigations of possible causes, as well as investigations of whether folic acid is associated with a reduced risk of other brain disorders in children,” he said.

Taking folic acid supplements during pregnancy is already known to prevent birth defects such as spina bifida, which affects the spine, and anencephaly, which causes part of the brain to be missing.

Alycia Halladay, senior director of environmental and clinical sciences at Autism Speaks, said that “parents always wonder what they can do to reduce the risk [of autism], and this [folic acid] is a very inexpensive item that mothers can do both before pregnancy and very early in their pregnancy.”

As to why folic acid may be beneficial, Halladay speculated that the nutrient might blunt a genetic risk for autism or boost other processes during pregnancy that are protective.

Another expert, Dr. Roberto Tuchman, director of the Autism and Neurodevelopment Program at Miami Children’s Hospital’s Dan Marino Center, said, “This study suggests that in some kids autism spectrum disorders may be preventable. As a clinician who works with autism spectrum disorders it is exciting that we can look at potentially preventable factors in autism. This is really encouraging.”

Still, Tuchman cautioned that the study findings are very preliminary, and it isn’t possible to tell which autism spectrum disorders, if any, folic acid may prevent. http://www.webmd.com/brain/autism/news/20130212/folic-acid-in-pregnancy-may-lower-autism-risk

Citation:

February 13, 2013, Vol 309, No. 6 >

Original Contribution | February 13, 2013

Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children FREE

Pål Surén, MD, MPH; Christine Roth, MSc; Michaeline Bresnahan, PhD; Margaretha Haugen, PhD; Mady Hornig, MD; Deborah Hirtz, MD; Kari Kveim Lie, MD; W. Ian Lipkin, MD; Per Magnus, MD, PhD; Ted Reichborn-Kjennerud, MD, PhD; Synnve Schjølberg, MSc; George Davey Smith, MD, DSc; Anne-Siri Øyen, PhD; Ezra Susser, MD, DrPH; Camilla Stoltenberg, MD, PhD

JAMA. 2013;309(6):570-577. doi:10.1001/jama.2012.155925.

Text Size: A A A

Article

Figures

Tables

References

Importance  Prenatal folic acid supplements reduce the risk of neural tube defects in children, but it has not been determined whether they protect against other neurodevelopmental disorders.

Objective  To examine the association between maternal use of prenatal folic acid supplements and subsequent risk of autism spectrum disorders (ASDs) (autistic disorder, Asperger syndrome, pervasive developmental disorder–not otherwise specified [PDD-NOS]) in children.

Design, Setting, and Patients  The study sample of 85 176 children was derived from the population-based, prospective Norwegian Mother and Child Cohort Study (MoBa). The children were born in 2002-2008; by the end of follow-up on March 31, 2012, the age range was 3.3 through 10.2 years (mean, 6.4 years). The exposure of primary interest was use of folic acid from 4 weeks before to 8 weeks after the start of pregnancy, defined as the first day of the last menstrual period before conception. Relative risks of ASDs were estimated by odds ratios (ORs) with 95% CIs in a logistic regression analysis. Analyses were adjusted for maternal education level, year of birth, and parity.

Main Outcome Measure  Specialist-confirmed diagnosis of ASDs.

Results  At the end of follow-up, 270 children in the study sample had been diagnosed with ASDs: 114 with autistic disorder, 56 with Asperger syndrome, and 100 with PDD-NOS. In children whose mothers took folic acid, 0.10% (64/61 042) had autistic disorder, compared with 0.21% (50/24 134) in those unexposed to folic acid. The adjusted OR for autistic disorder in children of folic acid users was 0.61 (95% CI, 0.41-0.90). No association was found with Asperger syndrome or PDD-NOS, but power was limited. Similar analyses for prenatal fish oil supplements showed no such association with autistic disorder, even though fish oil use was associated with the same maternal characteristics as folic acid use.

Conclusions and Relevance  Use of prenatal folic acid supplements around the time of conception was associated with a lower risk of autistic disorder in the MoBa cohort. Although these findings cannot establish causality, they do support prenatal folic acid supplementation. http://jama.jamanetwork.com/article.aspx?articleid=1570279

One of the implications of this study is the necessity that women receive adequate prenatal care and women really should have pre-pregnancy counseling and care.

United Health Foundation reports Prenatal Care (1990 – 2011): Percentage of pregnant women receiving adequate prenatal care, as defined by Kessner Index:

Prenatal care is a critical component of health care for pregnant women and a key step towards having a healthy pregnancy and baby. Early prenatal care is especially important because many important developments take place during the first trimester, screenings can identify babies or mothers at risk for complications and health care providers can educate and prepare mothers for pregnancy.  Women who receive prenatal care have consistently shown better outcomes than those who did not receive prenatal care[1]. Mothers who do not receive any prenatal care are three times more likely to deliver a low birth weight baby than mothers who received prenatal care, and infant mortality is five times higher[2].  Early prenatal care also allows health care providers to identify and address health conditions and behaviors that may reduce the likelihood of a healthy birth, such as smoking and drug and alcohol abuse.                                           http://www.americashealthrankings.org/All/PrenatalCare/2012

Given this recent study it is imperative that ALL women receive prenatal care particularly poor and those women at risk of difficult pregnancies.

Related:

Autism and children of color                                                https://drwilda.com/tag/children-of-color-with-autism/

Archives of Pediatrics and Adolescent Medicine study: Kids with autism more likely to be bullied                                   https://drwilda.com/2012/09/06/archives-of-pediatrics-and-adolescent-medicine-study-kids-with-autism-more-likely-to-be-bullied/

Father’s age may be linked to Autism and Schizophrenia https://drwilda.com/2012/08/26/fathers-age-may-be-linked-to-autism-and-schizophrenia/

Chelation treatment for autism might be harmful  https://drwilda.com/2012/12/02/chelation-treatment-for-autism-might-be-harmful/

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The 02/01/13 Joy Jar

31 Jan

Moi is a ‘bus chick’ and rides the bus all over Seattle or she walks. She is registered with the two pay-by-use car programs, but rarely uses them. The bus takes moi everywhere she needs to go. The bus tunnel runs under downtown Seattle and is deep underground. To reach the surface, one takes an escalator, at the deepest points of tunnel, to the street. Today moi was leaving the tunnel and riding the escalator to the street. There were several people who went past moi walking up the escalator. They shaved maybe 30 seconds off the escalator ride. Than got moi thinking about the speed of contemporary life. Today’s deposit into the ‘Joy Jar’ is a liveable pace of life.

Life is made up of special moments which make it worth living. There are many cherished moments that are missed due to the stress and fast pace of daily living. We must slow down and remember how precious it is to be alive and to love!!!!  

Unknown

“Smile, breathe, and go slowly”                                                                          Thich Nhat Hanh

“Take rest; a field that has rested gives a bountiful crop.”                                        Ovid

“Tension is who you think you should be. Relaxation is who you are.”                  Chinese proverb
“There is more to life than increasing its speed.”                                                Mahatma Gandhi

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GAO report: Children’s mental health services are lacking

12 Jan

Moi wrote about troubled children in Schools have to deal with depressed and troubled children:

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.

As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Schools are developing strategies to deal with troubled kids….

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?      

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical,  cognitive, emotional/affective, and motivational well-being, no matter  their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.

Prevalence and Risk Factors

While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk  of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:

* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression    

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression. 

How to Recognize Depression In Your Child?     

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.

Signs and symptoms of depression in children include:       

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced  ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or  interests

* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide        

Not all children have all of these symptoms. In fact, most will  display different symptoms at different times and in different settings.  Although some children may continue to function reasonably well in  structured environments, most kids with significant depression will  suffer a noticeable change in social activities, loss of interest in  school and poor academic performance, or a change in appearance.  Children may also begin using drugs or alcohol,
especially if they are  over the age of 12.

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Joy Resmovits reported in the article, Mental Health Care For Kids Severely Lacking, Says GAO which was posted at Huffington Post:

“Most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year,” the GAO wrote.

The report comes after Sen. Tom Harkin (D-Iowa), Rep. Rosa DeLauro (Conn.), and Rep. Lucille Roybal-Allard (Calif.) requested that the GAO look into how psychotropic drugs affect the long-term development of kids who grow up in foster care. While the report is very specific in its scope, it’s sure to be a relevant piece of evidence as the Obama administration formulates policy to deal with the ramifications of the Newtown, Conn. elementary school shooting. The shooting has sparked a nationwide debate on gun control, but it has also directed America’s attention to the state of its mental health care system.

Here are some findings:

  • On average, 6.2 percent of noninstitutionalized children in Medicaid and 4.8 percent of privately insured kids received psychotropic medications.

  • 30 percent of foster children who might have required mental health care didn’t receive them over the last year.

  • Most kids outside the foster care system whose behavior displayed red flags didn’t receive mental care services.

  • Many kids who got psychotropic medication didn’t get counseling or therapy to complete the care.

  • While the National Institutes of Health spent1.2 billion on children’s mental health care research between 2008 and 2011, most of the funding focused on research studying therapy, rather than the effects of such medication. http://www.huffingtonpost.com/joy-resmovits/mental-health-care-for-ki_b_2449205.html?utm_hp_ref=education

Here is the GAO press release:

What GAO Found

An annual average of 6.2 percent of noninstitutionalized children in Medicaid nationwide and 4.8 percent of privately insured children took one or more psychotropic medications, according to GAO’s analysis of 2007-2009 data from the Department of Health and Human Services’ (HHS) Medical Expenditure Panel Survey (MEPS). MEPS data also showed that children in Medicaid took antipsychotic medications (a type of psychotropic medication that can help some children but has a risk of serious side effects) at a relatively low rate–1.3 percent of children–but that the rate for children in Medicaid was over twice the rate for privately insured children, which was 0.5 percent. In addition, MEPS data showed that most children whose emotions or behavior, as reported by their parent or guardian, indicated a potential need for a mental health service did not receive any services within the same year. The Centers for Medicare & Medicaid Services (CMS) and many states have initiatives under way to help ensure that children receive appropriate mental health treatments. However, CMS’s ability to monitor children’s receipt of mental health services is limited because CMS does not collect information from states on whether children in Medicaid have received services for which they were referred. GAO recommended in 2011 that CMS identify options for collecting such data from state Medicaid programs. Findings in this report underscore the continued importance of CMS’s monitoring of children’s receipt of mental health services.

HHS’s Administration for Children and Families (ACF) reported that 18 percent of foster children were taking psychotropic medications at the time they were surveyed, although utilization varied widely by the child’s living arrangement. ACF also reported that 30 percent of foster children who may have needed mental health services did not receive them in the previous 12 months. HHS agencies are taking steps to promote appropriate mental health treatments for foster children, such as by sending information to states on psychotropic medication oversight practices.

HHS’s National Institutes of Health spent an estimated $1.2 billion on over 1,200 children’s mental health research projects during fiscal years 2008 through 2011. Most of the funding–$956 million–was awarded by the National Institute of Mental Health, with more research projects studying psychosocial therapies than psychotropic medications. Other HHS agencies spent about $16 million combined on children’s mental health research during this period.

HHS reviewed a draft of this report and provided technical comments, which GAO incorporated as appropriate.

Why GAO Did This Study

Experts have concerns that children with mental health conditions do not always receive appropriate treatment, including concerns about appropriate use of psychotropic medications (which affect mood, thought, or behavior) and about access to psychosocial therapies (sessions with a mental health provider). These concerns may be compounded for low-income children in Medicaid and children in foster care (most of whom are covered by Medicaid)–populations who may be at higher risk of mental health conditions. Within HHS, CMS oversees Medicaid, and ACF supports state child welfare agencies that coordinate health care for foster children.

GAO was asked to provide information on children’s mental health. This report examines (1) the use of psychotropic medications and other mental health services for children in Medicaid nationwide, and related CMS initiatives; (2) HHS information on the use of psychotropic medications and other mental health services for children in foster care nationwide, and related HHS initiatives; and (3) the amount HHS has invested in research on children’s mental health.

GAO analyzed data from HHS’s MEPS –a national household survey on use of medical services–from 2007 through 2009 for children covered by Medicaid and private insurance. GAO reviewed two recent ACF foster care reports with data from a national survey conducted during 2008 through 2011. GAO analyzed data from HHS agencies that conduct or fund research and interviewed HHS officials and children’s mental health providers, researchers, and advocates.

For more information, contact Katherine Iritani at (202) 512-7114 or iritanik@gao.gov.

Concerns Remain about Appropriate Services for Children in Medicaid and Foster Care GAO-13-15, Dec 10, 2012

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Resources:

Counselors, School Support Staff Toil Amid Scant Resources http://www.edweek.org/ew/articles/2013/01/10/16staffing.h32.html?tkn=VPLFw6EYbOz23lTzoeSKlVNGV4SNwasebCry&cmp=clp-edweek&intc=EW-QC13-EWH

About.Com’s Depression In Young Children

  1. Psych Central’s Depression In Young Children
  2. Psychiatric News’ Study Helps Pinpoint Children With Depression
  3. Family Doctor’s What Is Depression?
  4. WebMD’s Depression In Children
  5. Healthline’s Is Your Child Depressed?
  6. Medicine.Net’s Depression In Children
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Study: Current therapies may not be effective in preventing teen suicide, but targeted treatment helps

8 Jan

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Why Do Teens Attempt Suicide?

The American Academy of Adolescent Psychiatry has some excellent suicide resources

Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds.

Teenagers experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while growing up. For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems and stress.

Sometimes, people see suicide as an answer to their problems. All of us must stress that suicide is always the WRONG answer to what in all likelihood is a transitory situation.

What are the Warning Signs of Suicide?

According to Teen’s Health there are some suicide warning signs

Warning Signs

There are often signs that someone may be thinking about or planning a suicide attempt. Here are some of them:

talking about suicide or death in general

talking about “going away”

referring to things they “won’t be needing,” and giving away possessions

talking about feeling hopeless or feeling guilty

pulling away from friends or family and losing the desire to go out

having no desire to take part in favorite things or activities

having trouble concentrating or thinking clearly

experiencing changes in eating or sleeping habits

engaging in self-destructive behavior (drinking alcohol, taking drugs, or cutting, for example)

These are signs that indicate a person may be depressed.

According to JaredStory.com the primary cause of suicide is depression.

# 1 CAUSE OF SUICIDE: UNTREATED DEPRESSION

It can be very hard to diagnose depression. There are many different kinds of depression and not all people will have the same symptoms, or have them to the same degree. Here are some symptoms to watch for and if they last more than a few weeks, a doctor or psychiatrist should be consulted.

Persistent sad or “empty” mood

Feeling hopeless, helpless, worthless

pessimistic and or guilty

Substance abuse

Fatigued or loss of interest in ordinary activities

Disturbances in eating and sleeping patterns

Irritability, increased crying, anxiety and panic attacks, (Post Traumatic Stress Disorder)

Difficulty concentrating, remembering or making decisions

Thoughts of suicide; suicide plans or attempts

Persistent physical symptoms or pains that do not respond to treatment

The site also lists events that might trigger depression in a person.

A death of a family member or close friend – which could include a fellow student from school

An assault, car accident or painful physical event – which could include physical bullying

Mental, or emotional event – which could include non-physical bullying

Marriage breakup, or love lost suddenly – which could include “breaking up” with a girlfriend or boyfriend

Constant physical, mental, or emotional pain that goes on for a length of time – which includes constant bullying that is not intervened, resolved or stopped entirely

Major Financial setback – which includes a teenager who may have lost a job

Something “embarrassing” happens – as an example; getting kicked off a football team or a public insult by a teacher or popular student; bullying

Failing an important exam a school – not a normal trigger unless the exam was life changing and the individual is under a lot of stress

A best friend moves out of town – especially true for teenagers who are being bullied and have very few friends as it is

If you notice these signs, the key is to get help for yourself or a friend. The type of treatment will depend upon the underlying symptoms.

Benedict Carey reports in the New York Times article, Study Questions Effectiveness of Therapy for Suicidal Teenagers:

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference. ..

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies. http://www.nytimes.com/2013/01/09/health/gaps-seen-in-therapy-for-suicidal-teenagers.html?hp&_r=0

See, A Tragedy and a Mystery http://harvardmagazine.com/2011/01/tragedy-and-mystery

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center has some excellent advice about suicide prevention

Resources

Teen’s Health’s Suicide

American Academy of Adolescent Psychiatry

Suicide Prevention Resource Center

Teen Depression

Jared Story.Com

CNN Report about suicide

American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

Youth Suicide Prevention

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The 01/02/13 ‘Joy Jar’

1 Jan

The ‘Joy Jar’ is a year-long exercise based upon the proposition that one can choose to have a good attitude no matter one’s circumstance or whatever events life throws at a person. As many athletes play through pain, a successful attitude means that one plays through feelings and circumstances. Today’s deposit in the ‘Joy Jar’ is wisdom.

Proverbs 16:16  “How much better is it to get wisdom than gold! and to get understanding rather to be chosen than silver!”

I’ve learned that no matter what happens, or how bad it seems today, life does go on, and it will be better tomorrow. I’ve learned that you can tell a lot about a person by the way he/she handles these three things: a rainy day, lost luggage, and tangled Christmas tree lights. I’ve learned that regardless of your relationship with your parents, you’ll miss them when they’re gone from your life. I’ve learned that making a “living” is not the same thing as making a “life.” I’ve learned that life sometimes gives you a second chance. I’ve learned that you shouldn’t go through life with a catcher’s mitt on both hands; you need to be able to throw something back. I’ve learned that whenever I decide something with an open heart, I usually make the right decision. I’ve learned that even when I have pains, I don’t have to be one. I’ve learned that every day you should reach out and touch someone. People love a warm hug, or just a friendly pat on the back. I’ve learned that I still have a lot to learn. I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.

Maya Angelou

By three methods we may learn wisdom: First, by reflection, which is noblest; Second, by imitation, which is easiest; and third by experience, which is the bitterest.
Confucius

Do not go where the path may lead, go instead where there is no path and leave a trail.
Ralph Waldo Emerson

A good head and a good heart are always a formidable combination.
Nelson Mandela

The art of being wise is the art of knowing what to overlook.
William James

Be happy. It’s one way of being wise.
Sidonie Gabrielle Colette

Knowing others is wisdom, knowing yourself is Enlightenment.
Lao Tzu

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The Dr.Wilda.com chronicles

4 Dec

Here’s today’s COMMENT FROM AN OLD FART: Moi is like most people. A little this, a little that. She is no angel, but certainly not eeevil. She has this dream, Dr. Wilda.com which is a brand based upon the premise “Where information leads to hope.”

EVERYTHING IS AGAINST MOI’S SUCCESS. Building my brand is like a blind climber scaling the highest mountain. They can only succeed with some ONE guiding them. Everything that the world can throw against a person in terms of challenges is what moi faces. That includes moi’s nearly terminal stupidity. In the view of the world, someone like moi could NEVER succeed. In God’s world, ALL THINGS ARE POSSIBLE, even for someone like, moi. In fact, God just loves people that the world thinks are not worthy. You see God has a great sense of humor. God likes to chuckle when people like moi succeed because the world is forced to acknowledge that their success was purely a “God Thing.”

Moi wants Dr. Wilda.com to be a place of hope, nurturing, safety, and acceptance.

More later.

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The wretched excess file: Why is Starbucks selling $7 coffee?

2 Dec

Here’s today’s COMMENT FROM AN OLD FART: The Flash Card Machine provides this thought about “wretched excess.”

Term

Wretched Excess
Definition

The Protagonist pushes the limits of acceptable behavior, destroying themselves in the process

Josh Sanburn reports in the Time article, The $7 Cup of Starbucks: A Logical Extension of the Coffee Chain’s Long-Term Strategy:

This week Starbucks began selling a cup of coffee for $7. This may seem ridiculous, but it’s the logical next step of the chain’s long-term marketing strategy: To convince consumers that a product that used to sell for less than a buck is in fact worth much more.

In almost 50 locations throughout the Northwest, coffee drinkers can find a curious item next to peppermint mochas and gingerbread lattes: Costa Rica Finca Palmilera, a hard-to-grow bean also called “Geisha” that sells for $7 for a “grande” and $40 for a half-pound bag.
http://business.time.com/2012/11/30/the-7-cup-of-starbucks-the-culmination-of-the-coffee-chains-long-term-strategy/#ixzz2DscZu2Bp

What does it take to produce happiness in the average person?

Marilyn Elias reported in a 2002 USA Today article, Psychologists now know what makes people happy:

The happiest people surround themselves with family and friends, don’t care about keeping up with the Joneses next door, lose themselves in daily activities and, most important, forgive easily….

The happiest people spend the least time alone. They pursue personal growth and intimacy; they judge themselves by their own yardsticks, never against what others do or have.

“Materialism is toxic for happiness,” says University of Illinois psychologist Ed Diener. Even rich materialists aren’t as happy as those who care less about getting and spending. http://usatoday30.usatoday.com/news/health/2002-12-08-happy-main_x.htm

Moi wrote about altruism in Should Christmas gifts be banned? What is the meaning of a gift? Altruistic people are often happier.

According to PBS’ This Emotional Life and the discussion of altruism:

Acts of kindness

Altruism—including kindness, generosity, and compassion—are keys to the social connections that are so important to our happiness. Research finds that acts of kindness—especially spontaneous, out-of-the ordinary ones—can boost happiness in the person doing the good deed.

Reasons why acts of kindness make people happier:

  • Being generous leads us to perceive others more compassionately; we typically find good qualities in people to whom we are kind

  • Being kind promotes a sense of connection and community with others, which is one of the strongest factors in increasing happiness

  • Being generous helps us appreciate and feel grateful for our own good fortune

  • Being generous boosts our self-image; it helps us feel useful and gives us a way to use our strengths and talents in a meaningful way

  • Being kind can start a chain reaction of positivity; being kind to others may lead them to be grateful and generous to others, who in turn are grateful and kind to others

Volunteers see greater benefits than those they are serving

One study followed women with multiple sclerosis (MS) who volunteered as peer supporters to other patients. They received training in compassionate listening techniques and called the patients to talk and listen for 15 minutes at a time. The study followed the volunteers for three years and found that they had increased self-esteem, self-acceptance, satisfaction, self-efficacy, social activity, and feelings of mastery. The positive outcomes for the volunteers were even greater than for the patients they were helping.

Compassion fosters happiness, but being sacrificial reduces well-being

Being kind and compassionate is linked to greater happiness, greater levels of physical activity well into old age, and longevity. One important caveat: if people get overextended and overwhelmed by helping tasks, as can happen with people who are caregivers to family members, their health and quality of life can rapidly decline. It seems being generous from an abundance of time, money, and energy can promote well-being; but being sacrificial quickly lowers well-being. This seems to be a good argument for communities sharing the burden for everyone’s benefit. http://www.pbs.org/thisemotionallife/topic/altruism/altruism-happiness

A gift should be an act of altruism, otherwise it is a form of extortion. People who pay $7 for a cup of coffee are within their rights and have their free will to do so. They probably would be happier being more modest.

The answer to why Starbucks is selling a $7 cup of coffee other than it can, is because the think they have found a bumper crop of morons.

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Study: Early stress in girls may be the source of later anxiety

13 Nov

Prolonged stress can have adverse effects on humans. Moi wrote about the Adverse Childhood Experiences Study in Study: Some of the effects of adverse stress do not go away:

Sarah D. Sparks writes in the Education Week article, Research Traces Impacts of Childhood Adversity:

Research from Dr. Shonkoff’s center and from other experts finds that positive stress—the kind that comes from telling a toddler he can’t have a cookie or a teenager that she’s about to take a pop quiz—causes a brief rise in heart rate and stress hormones. A jolt can focus a student’s attention and is generally considered healthy.

Similarly, a child can tolerate stress that is severe but may be relatively short-term—from the death of a loved one, for example—as long as he or she has support….

‘Toxic’ Recipe

By contrast, so-called “toxic stress” is severe, sustained, and not buffered by supportive relationships.

The same brain flexibility, called plasticity, that makes children open to learning in their early years also makes them particularly vulnerable to damage from the toxic stressors that often accompany poverty: high mobility and homelessness; hunger and food instability; parents who are in jail or absent; domestic violence; drug abuse; and other problems, according to Pat Levitt, a developmental neuroscientist at the University of Southern California and the director of the Keck School of Medicine Center on the Developing Child in Los Angeles…. http://www.edweek.org/ew/articles/2012/11/07/11poverty_ep.h32.html?tkn=QLYF5qldyT3U0BI0xqtD5885mihZIxwbX4qZ&cmp=clp-edweek

Here is information about the Adverse Child Experiences Study. The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/

https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

Waisman Laboratory for Brain Imaging and Behavior published a study which looks at the effects of stress on girls.

Science Daily is reporting in the article, Early Stress May Sensitize Girls’ Brains for Later Anxiety:

High levels of family stress in infancy are linked to differences in everyday brain function and anxiety in teenage girls, according to new results of a long-running population study by University of Wisconsin-Madison scientists.

The study highlights evidence for a developmental pathway through which early life stress may drive these changes. Here, babies who lived in homes with stressed mothers were more likely to grow into preschoolers with higher levels of cortisol, a stress hormone. In addition, these girls with higher cortisol also showed less communication between brain areas associated with emotion regulation 14 years later. Last, both high cortisol and differences in brain activity predicted higher levels of adolescent anxiety at age 18.

The young men in the study did not show any of these patterns.

“We wanted to understand how stress early in life impacts patterns of brain development which might lead to anxiety and depression,” says first author Dr. Cory Burghy of the Waisman Laboratory for Brain Imaging and Behavior. “Young girls who, as preschoolers, had heightened cortisol levels, go on to show lower brain connectivity in important neural pathways for emotion regulation — and that predicts symptoms of anxiety during adolescence….”

The current paper has its roots back in 1990 and 1991, when 570 children and their families enrolled in the Wisconsin Study of Families and Work (WSFW). All of the children were born in either Madison or Milwaukee. Dr. Marilyn Essex, a UW professor of psychiatry and co-director of the WSFW, said the initial goal was to study the effects of maternity leave, day care and other factors on family stress. Over the years, the study has resulted in important findings on the social, psychological, and biological risk factors for child and adolescent mental health problems. Subjects are now 21 and 22 years old, and many continue to participate.

For the current study, Burghy and Birn used fcMRI to scan the brains of 57 subjects — 28 female and 29 male — to map the strength of connections between the amygdala, an area of the brain known for its sensitivity to negative emotion and threat, and the prefrontal cortex, often associated with helping to process and regulate negative emotion. Then, they looked back at earlier results and found that girls with weaker connections had, as infants, lived in homes where their mothers had reported higher general levels of stress — which could include symptoms of depression, parenting frustration, marital conflict, feeling overwhelmed in their role as a parent, and/or financial stress. As four-year-olds, these girls also showed higher levels of cortisol late in the day, measured in saliva, which is thought to demonstrate the stress the children experienced over the course of that day. http://www.sciencedaily.com/releases/2012/11/121111152930.htm#.UKEogDfvMTo.email

Citation:

Nature Neuroscience | Article

Developmental pathways to amygdala-prefrontal function and internalizing symptoms in adolescence

Nature Neuroscience
(2012)
doi:10.1038/nn.3257
Received
23 July 2012
Accepted
11 October 2012
Published online
11 November 2012
Abstract

Early life stress (ELS) and function of the hypothalamic-pituitary-adrenal axis predict later psychopathology. Animal studies and cross-sectional human studies suggest that this process might operate through amygdala–ventromedial prefrontal cortex (vmPFC) circuitry implicated in the regulation of emotion. Here we prospectively investigated the roles of ELS and childhood basal cortisol amounts in the development of adolescent resting-state functional connectivity (rs-FC), assessed by functional connectivity magnetic resonance imaging (fcMRI), in the amygdala-PFC circuit. In females only, greater ELS predicted increased childhood cortisol levels, which predicted decreased amygdala-vmPFC rs-FC 14 years later. For females, adolescent amygdala-vmPFC functional connectivity was inversely correlated with concurrent anxiety symptoms but positively associated with depressive symptoms, suggesting differing pathways from childhood cortisol levels function through adolescent amygdala-vmPFC functional connectivity to anxiety and depression. These data highlight that, for females, the effects of ELS and early HPA-axis function may be detected much later in the intrinsic processing of emotion-related brain circuits.

Stress has negative effects on the body.

According to the Mayo Clinic article, Stress symptoms: Effects on your body, feelings and behavior:

Common effects of stress …
… On your body … On your mood … On your behavior
  • Headache
  • Muscle tension or pain
  • Chest pain
  • Fatigue
  • Change in sex drive
  • Stomach upset
  • Sleep problems
  • Anxiety
  • Restlessness
  • Lack of motivation or focus
  • Irritability or anger
  • Sadness or depression
  • Overeating or undereating
  • Angry outbursts
  • Drug or alcohol abuse
  • Tobacco use
  • Social withdrawal

Source: American Psychological Association’s “Stress in America” report, 2010

http://www.mayoclinic.com/health/stress-symptoms/SR00008_D

This study points to the need for quality prenatal care.

The March of Dimes discusses stress during pregnancy in the article, Emotional and life changes:

What types of stress can cause pregnancy problems?

Stress is not all bad. When you handle it right, a little stress can help you take on new challenges. Regular stress during pregnancy, such as work deadlines and sitting in traffic, probably don’t add to pregnancy problems.

However, serious types of stress during pregnancy may increase your chances of certain problems, like premature birth. Most women who have serious stress during pregnancy can have healthy babies. But be careful if you experience serious kinds of stress, like:

  • Negative life events. These are things like divorce, serious illness or death in the family, or losing a job or home. 
  • Catastrophic events. These are things like earthquakes, hurricanes or terrorist attacks. 
  • Long-lasting stress. This type of stress can be caused by having financial problems, being abused, having serious health problems or being depressed. Depression is medical condition where strong feelings of sadness last for long periods of time and prevent a person from leading a normal life. 
  • Racism. Some women may face stress from racism during their lives. This may help explain why African-American women in the United States are more likely to have premature and low-birthweight babies than women from other racial or ethnic groups. 
  • Pregnancy-related stress. Some women may feel serious stress about pregnancy. They may be worried about miscarriage, the health of their baby or about how they’ll cope with labor and birth or becoming a parent. If you feel this way, talk to your health care provider.

Does post-traumatic stress disorder affect pregnancy?
Post-traumatic stress disorder (PTSD) is when you have problems after seeing or experiencing a terrible event, such as rape, abuse, a natural disaster, a terrorist attack or the death of a loved one. People with PTSD may have:

  • Serious anxiety 
  • Flashbacks of the event 
  • Nightmares 
  • Physical responses (like a racing heartbeat or sweating) when reminded of the event

As many as 8 in 100 women (8 percent) may have PTSD during pregnancy. Women who have PTSD may be more likely than women without it to have a premature or low-birthweight baby. They also are more likely than other women to have risky health behaviors, such as smoking cigarettes, drinking alcohol or taking street drugs. Doing these things can increase the chances of having pregnancy problems. If you think you may have PTSD, talk to your provider or a mental health professional.

How does stress cause pregnancy problems?
We don’t completely understand the effects of stress on pregnancy. But certain stress-related hormones may play a role in causing certain pregnancy complications. Serious or long-lasting stress may affect your immune system, which protects you from infection. This can increase the chances of getting an infection of the uterus. This type of infection can cause premature birth.

Stress also may affect how you respond to certain situations. Some women deal with stress by smoking cigarettes, drinking alcohol or taking street drugs, which can lead to pregnancy problems.

Can high levels of stress in pregnancy hurt your baby later in life?
Some studies show that high levels of stress in pregnancy may cause certain problems during childhood, like having trouble paying attention or being afraid. It’s possible that stress may also affect your baby’s brain development or immune system.

How can you reduce stress during pregnancy?
Here are some ways to reduce stress:

  • Figure out what’s making you stressed and talk to your partner, a friend or your health care provider about it. 
  • Know that the discomforts of pregnancy are only temporary. Ask your provider how to handle these discomforts. 
  • Stay healthy and fit. Eat healthy foods, get plenty of sleep and exercise (with your provider’s OK).
  • Exercise can help reduce stress and also helps prevent common pregnancy discomforts. 
  • Cut back on activities you don’t need to do. 
  • Have a good support network, including your partner, family and friends. Ask your provider about resources in the community that may be able to help. 
  • Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, or you may want someone to go with you to your prenatal visits. 
  • Try relaxation activities, like prenatal yoga or meditation. 
  • Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation techniques you learn in your class. 
  • If you’re working, plan ahead to help you and your employer get ready for your time away from work. 
  • If you think you may be depressed, talk to your provider right away. There are many ways to deal with depression. Getting treatment and counseling early may help.

Last reviewed January 2012 http://www.marchofdimes.com/pregnancy/lifechanges_indepth.html

See, The Importance of Quality Prenatal Care http://www.mdnews.com/news/2010_07/national_jul10_the-importance-of-quality-prenatal-care

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

The Effects of Stress on Your Body                                           http://www.webmd.com/mental-health/effects-of-stress-on-your-body

The Physical Effects of Long-Term Stress                              http://psychcentral.com/lib/2007/the-physical-effects-of-long-term-stress/all/1/

Chronic Stress: The Body Connection                            http://www.medicinenet.com/script/main/art.asp?articlekey=53737

Understanding Stress Symptoms, Signs, Causes, and Effects http://www.helpguide.org/mental/stress_signs.htm

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Colleges beginning to address student mental health issues

29 Jul

When parents are packing their children off to college, some are sending children to school who have some severe mental health and emotional issues. Trip Gabriel has an article in the New York Times which outlines the issues some students face while they are at college. In Mental Health Needs Growing At Colleges Gabriel reports:

Stony Brook is typical of American colleges and universities these days, where national surveys show that nearly half of the students who visit counseling centers are coping with serious mental illness, more than double the rate a decade ago. More students take psychiatric medication, and there are more emergencies requiring immediate action.

“It’s so different from how people might stereotype the concept of college counseling, or back in the ’70s students coming in with existential crises: who am I?” said Dr. Hwang, whose staff of 29 includes psychiatrists, clinical psychologists and social workers. “Now they’re bringing in life stories involving extensive trauma, a history of serious mental illness, eating disorders, self-injury, alcohol and other drug use.”

Experts say the trend is partly linked to effective psychotropic drugs (Wellbutrin for depression, Adderall for attention disorder, Abilify for bipolar disorder) that have allowed students to attend college who otherwise might not have functioned in a campus setting.

There is also greater awareness of traumas scarcely recognized a generation ago and a willingness to seek help for those problems, including bulimia, self-cutting and childhood sexual abuse.

The need to help this troubled population has forced campus mental health centers — whose staffs, on average, have not grown in proportion to student enrollment in 15 years — to take extraordinary measures to make do. Some have hospital-style triage units to rank the acuity of students who cross their thresholds. Others have waiting lists for treatment — sometimes weeks long — and limit the number of therapy sessions.

Some centers have time only to “treat students for a crisis, bandaging them up and sending them out,” said Denise Hayes, the president of the Association for University and College Counseling Center Directors and the director of counseling at the Claremont Colleges in California.

“It’s very stressful for the counselors,” she said. “It doesn’t feel like why you got into college counseling.”

A recent survey by the American College Counseling Association found that a majority of students seek help for normal post-adolescent trouble like romantic heartbreak and identity crises. But 44 percent in counseling have severe psychological disorders, up from 16 percent in 2000, and 24 percent are on psychiatric medication, up from 17 percent a decade ago.

The most common disorders today: depression, anxiety, suicidal thoughts, alcohol abuse, attention disorders, self-injury and eating disorders.

If a student has had prior problems, the student and family should have a plan for dealing with issues like depression or eating disorders while the student is at college. Often that might include therapy sessions with a counselor near the college. Often, students and families do not want to seek help because many feel there is a stigma to mental illness.

Stephen Cesar has written an informative Los Angeles Times article about a new program to reach students with problems. In UC reaching out to depressed students online, Cesar reports:

The anonymous online conversation began after the student revealed that he planned to kill himself.

“What should I do?” the sophomore asked a counselor at his Midwest college. “I figure you will probably tell me that killing myself is not a good idea, and I know that. But it does seem like a good option at the moment.”

The counselor hoped to persuade him to come in to see her, but first she had to build trust. They continued the discussion on the website, a tool used by the school to reach troubled students.

“It sounds as though you are very stressed and sometimes just having a safe ‘ear to bend’ is helpful?,” she wrote back.

It took more than a month, but eventually the student walked into the counseling center.

The online effort had worked.

In the fall, about 70 universities nationwide will have the service, including all 10 University of California undergraduate campuses. It is designed to bridge conversation between students who need help and those equipped to provide it.

Created by the New York City-based American Foundation for Suicide Prevention, the program aims to identify troubled students anonymously through their responses to a voluntary survey they will receive a link to in an email that will be sent to everyone admitted to UC.

If survey answers raise red flags, a counselor will initiate contact and invite the student to continue communicating, still anonymously, via a dialogue on the website.

The goal is to have the student agree to a meeting. Studies suggest that about 80% of students who commit suicide had not sought services from counseling centers on their campuses, said Ann Haas, a project specialist for the foundation. http://www.latimes.com/news/local/la-me-uc-suicide-20120729,0,693193.story

The JED Foundation has some excellent resources for both parents and students dealing with mental health issues.

ULifeline has information about dealing with college mental health issues:

Complete a self-assessment to learn telling insights about your current state of mind…

STUDENTS

Learn more about protecting your emotional health and what to do if you or a friend are struggling with mental health issues. Continue…


Check out the Half of Us campaign, a project with mtvU that includes videos of your favorite artists and other students sharing how they’ve coped with mental health issues. Continue…

CAMPUS PROFESSIONALS

Sign in or Find out more about joining ULifeline

Parents must recognize the signs of distress and get help for their child. If you are a student in distress, get help because there are many different therapies to get you back on track.

See:

College Students Exhibiting More Severe Mental Illness, Study Finds

Health & Medicine

Mind & Brain

Reference

Mental Health Issues In Student Advising

How to Handle Holiday Stress

Resources for Parents & Students

Trauma Resources

Evaluation Resources

Mental Health Screening Tools

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