Tag: mental health

A Blueprint to “Win” the War on Drugs

What can the United States learn from Portugal about the war on drugs?

A Guest Post by Becca Fritton.

On October 26, 2017, Trump declared the opioid crisis a National Public Health Emergency. As Andrew Bradford discussed in his October 27 post, while a first step, this announcement does not immediately open up additional funding for the crisis, but instead gives access to funding that already exists. Unfortunately, this funding is almost running out. [1] It is important to note that while this announcement raises the voice of the conversation around opioid use in the United States, many do not even consider this a beginning of a plan to address the epidemic.

Any discussion or solution proposed around addiction is remiss without discussing criminalization. Nicholas Kristof of the New York Times put forth a stunning summary of how Portugal has managed to “win” the war drugs. While drug dealers still go to prison in Portugal, they have made it an “administrative offense” to possess or purchase a small quantity of drugs. Instead of going to jail or to trial, offenders attend a meeting with social workers who work towards preventing a casual user from becoming dependent on drugs. Rather than viewing an individual as a criminal, officials in Portugal focus on the individual’s health and help them find resources they need to stay healthy.

Those who are dependent on drugs need medical care, not punishment. The Health Ministry of Portugal also targeted certain neighborhoods and populations for passing out clean needles and encouraging methadone instead of heroin. At large events or concerts, the ministry would offer to test individuals’ drugs to advise if they were safe or not. Portugal’s government has also funded widespread use of methadone vans that supply users with a free and controlled amount of methadone.

This approach has worked extremely well for Portugal and now they have the lowest drug mortality rate in Western Europe, and one-fiftieth the latest count in the United States. [2] The United States should take note and begin moving in a different direction. Instead of funding prisons and jails, the government should place more funding and infrastructure in place to address addiction from a mental and public health standpoint.

Becca can be contacted via email at: rfritton [@] berkeley [dot] edu

 

[1] Allen, G. and Kelly, A. (2017). Trump Administration Declares Opioid Crisis a Public Health Emergency. National Public Radio. Retrieved from: https://www.npr.org/2017/10/26/560083795/president-trump-may-declare-opioid-epidemic-national-emergency

[2] Kristof, N. (2017). How to “Win” the War on Drugs. New York Times. Retrieved from: https://www.nytimes.com/2017/09/22/opinion/sunday/portugal-drug-decriminalization.html

Impostor Experience: The Advice I Keep Giving Myself in Graduate School

Impostor experience is characterized as having an inability to internalize one’s accomplishments, where those who experience it feel that they are a fraud, that they have somehow deceived others to believe that they are smarter than they actually are. These feelings occur even when contradicted by success, often crediting luck or good timing over their own hard work and effort. And it is quite prevalent in academic spaces.

When I started my graduate career, I was lucky enough to have professors who were well aware of this topic, encouraging students to reach out when they needed to, reminding us that we all have expertise to contribute to the classroom, we all have a space.

As a first generation college student, I still have moments almost daily where I feel like I don’t belong, that this isn’t really the place for me. Sometimes it’s a simple comment, someone in class sharing an experience, like “Oh my dad’s a doctor”. Don’t get me wrong, my parents are two of the hardest working people I know. But there are constantly reminders for me that in pursuing a graduate degree, I’m taking a career path that not many people who knew me as a child could even imagine.

Below I’ve attached some resources that I have found particularly helpful at some low points in my academic career. But what has helped the most for me is opening up to my friends and classmates, and realizing that I am not the only one having these feelings. I’m writing this because I’m not perfect at taking my own advice, I still need to step back and use some of these strategies, and I still need to practice opening up when I’m struggling.

Sources:

APA Cover Story: Feel like a fraud? http://www.apa.org/gradpsych/2013/11/fraud.aspx

The Chronicle of Higher Education: Impostor Syndrome is Definitely a Thing: http://www.chronicle.com/article/Impostor-Syndrome-Is/238418

Straight Skinny, but Gay Fat? Reflections on Pride, the intersection of identity and mental health, and the stigmatization of queer bodies

This past weekend marked the 33rd annual celebration of North Carolina Pride, a time to celebrate the beauty, diversity, and resiliency of the LGBTQ community. The week of October 1-7 is Mental Illness Awareness Week, observed by the National Alliance on Mental Illness, to “fight stigma, provide support, educate the public and advocate for equal care” in regards to mental health. Studies have shown that LGBTQ+ identified individuals are three times more likely to live with a mental health condition than their heterosexual counterparts. This includes, but is not limited to: depression, anxiety, eating disorders, or Body Dysmorphic Disorder, to name a few.

Body Dysmorphic Disorder, or BDD, is classified as a body-image disorder where individuals have persistent and intrusive preoccupations with a defect in their appearance, which can be imagined or slight. Obsessions about appearance can be all consuming, and make it hard for those affected to focus on other areas of their lives. Oftentimes, those living with BDD can perform a compulsive or repetitive behavior, with some examples being: avoiding mirrors, skin picking, excessive grooming, excessive exercise, frequently changing clothes, trying to hide or conceal body parts, or in extreme cases seeking surgery to correct the perceived flaw or flaws. These behaviors can lead to feelings of low self-esteem, resulting in avoiding social situations and having difficulties with work responsibilities and personal life. Individuals suffering with severe BDD are also at a higher risk of having suicidal thoughts or to attempt suicide.

People living with BDD often also suffer from other anxiety and mental health disorders, such as social anxiety disorder, depression, eating disorders, or obsessive compulsive disorder (OCD). Because of similarities and overlap of symptoms, BDD can be misdiagnosed as one of these other mental health disorders, specifically with similarities to OCD, being distinguished when behaviors focus specifically on appearance. According the American Psychiatric Association, between 2.2-2.5% of people in the US experience BDD, and it usually begins to occur around the age of 12-13.

As someone living with BDD, I spent years of my life not having words to describe what I was feeling, being hyper aware of my body and the way I see it as being perceived by others. Most of the time, these are internal conflicts, rarely do they manifest in ways that are visible for others. On Saturday night, I was waiting in line to get into a gay night club to celebrate Pride with friends. When it was time to pay the cover to enter, the thought of people looking at my body, of people touching parts of my body that I find unsightly, resulted in a panic attack where I ended up leaving and going home. This isn’t the first time I’ve felt uncomfortable in a space like this, but I can’t shake the feeling of letting my friends down, of allowing my insecurities to get in the way of what was supposed to be a fun night out.

My bigger concern is that my experience isn’t unique, that others have also struggled to feel accepted in places that are supposed to be welcoming to then. The unrealistic standards around body image in queer spaces foster an environment of self-doubt, generate feelings of insecurity, and further reinforce the heteronormative narrative that is already placed on us by larger society as a whole.

But issues around unrealistic body issues aren’t the only problem facing the LGBTQ community. Blatant and covert racism, misogyny, and the policing of how others live their lives are also major hurdles that we need to overcome. And many of our spaces aren’t accessible to a number of people due to cost.

On top of all of this, we don’t give each other spaces to talk about the ways we are struggling, whether that be with our mental health, our interpersonal relationships, or how we are handling navigating a society that simply is not designed for us. My hope is that by sharing, it will open up a space for others to acknowledge what they are feeling, to finally have words to define those feelings, or to simply be aware of the struggles that others are going through.

Below are some sources if you are interested in learning more about the topics that I discussed here. If you feel that you need to reach out, talking with a mental health professional can be a great place to start. If you are a student here at UNC, CAPS offers a variety of mental health services, more information can be found below.

For CAPS Walk-In Services:

Go to the 3rd floor of the Campus Health Services Building

MON-THURS: 9 am – noon or 1 pm – 4 pm

FRI: 9:30 am – noon or 1 pm – 4 pm

Sources –

National Alliance on Mental Illness Awareness Week – https://www.nami.org/Get-Involved/Awareness-Events/Mental-Illness-Awareness-Week

National Alliance on Mental Illness LGBTQ – https://www.nami.org/Find-Support/LGBTQ

Anxiety and Depression Association of America: Body Dysmorphic Disorder – https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd

9/11, Hurricane Season, and disaster-related Secondary Traumatic Stress

Yesterday was the 16th anniversary of the 9/11 Terror Attack, and like many Americans I can easily recount where I was at when I saw the coverage of the attack. The event dominated news media for weeks after the events unfolded, and became enshrined as a defining moment of 21st century America.

I cannot even begin to fathom the first hand experiences of people who directly impacted from the attack, but for many, the day is a permanent memory of the way they felt, perceived, and witnessed everything unfold.

Secondary Traumatic Stress occurs when an individual hears the recounting of another’s traumatic life event. Often, the symptoms are similar to that of the more commonly known Post Traumatic Stress Disorder, or PTSD. In recent years, there has been more research being done to see the effects of disasters that affect those beyond those immediately experiencing an event.

In the wake of the recent disasters of Hurricane Harvey and Irma, we have seen coverage of their destruction everywhere from major news sources to the social media that we consume for updates from loved ones. A recent New York Times piece noted that the Weather Channel, being the only network to provide 24/7 access to coverage of the recent Hurricanes, had seen its audience increase nearly tenfold. The coverage of these storms has been vast, because the scale of the destruction of these storms has been unprecedented.

Covering these events is vital, it is important that we do not sensor the news that we receive just because of the harmful effects that it may have on us. But, by being more aware, and staying informed, we can acknowledge the way that having information so freely available can help us to cope, and hopefully heal, together.

 

Sources –

New York Times Piece: https://www.nytimes.com/2017/09/09/business/media/weather-channel-hurricane-irma.html?_r=0

Secondary Traumatic Stress: http://www.nctsn.org/resources/topics/secondary-traumatic-stress

The Fault in Our Stars: What the Movie Didn’t Tell Us about Childhood Cancer

There are numerous movies about adolescents living with cancer and overcoming it; The Fault in Our Stars, Me Earl and the Dying Girl, etc. Typically, they include a heartwarming love story or  a monumental last hurrah and then receive a promising prognosis. The audience walks away after shedding a few tears and laughs and moves on with their own lives. However, what these movies don’t tell us is what happens after the credits roll and these adolescents continue their lifelong journey as a “cancer patient”.

 

Research has shown that adolescent cancer survivors tend to report lower quality of life compared to peers such as more general health concerns, mental health concerns and physical activity limitations. Additionally, many of them experience difficulties such as academic problems, low self esteem, anxiety and depression. Luckily, we are starting to see a trend of programs created specifically for this population to help ease the transition of cancer patient to returning to a “normal kid/teen lifestyle”. Dana- Farber and Boston Children’s Hospital have a unique program called the “Transition to Survivorship Program” to provide resources and opportunities to help ease this transition for children and adolescents and their families and caregivers. While the movie’s show a happy ending, for many of these patients it’s a quite a long road before arriving at their happy ending.

 

Sources:

http://www.danafarberbostonchildrens.org/why-choose-us/cancer-survivorship/transition-off-therapy.aspx

http://ascopubs.org/doi/full/10.1200/JCO.2009.23.4278

Narrative Reconstruction: a Lesson we can learn from Taylor Swift

This past Sunday, Taylor Swift premiered the music video for her latest single, Look What You Made Me Do, at the MTV Video Music Awards. The video went viral upon release, and subsequently has been the subject of a number of internet think pieces breaking down the star’s critiques on different personas of herself in the public eye over the course of her career. In case you missed it, you can find it here.

 But beyond providing a tongue in cheek look into the perceptions of a widely successful pop artist, the idea of reconstructing narratives for self-affirmation can be key to those who have suffered previous traumatic experiences.

 A study recently published in Qualitative Social Work studied the effect of narrative construction, or having an organized and logical story of their previous traumatic experiences, along with a clear sense of self throughout and a sense of how that experience has shaped them. They found that compared to those who had not constructed a narrative, those with a higher level of narrative construction noted an increased acceptance of their experiences, and being more likely to perceive life experiences as positive and significant. Those with an elevated sense of narrative construction credited their success to strategies such as reflective writing, informal conversations with supportive friends and family, and seeking professional help such as Cognitive Behavioral Therapy.

But often, the stressors of daily life are somewhere between trauma and celebrity feud. As summer is ending and the school year here again, it’s a great time to begin to regularly process emotions, especially with the seemingly constant stream of news and celebrity gossip. With September being Self-Awareness month, taking the time for some reflective journaling, or simply maintaining a strong support system of friends and family can set you up for success. If you feel like talking to a professional, the university has wonderful Counseling and Psychological Services, with walk in services regularly available. Beyond that, if you need additional help for figuring out to find a therapist, or if you’re curious about what therapy could look like, check out this article published by the New York Times – How to Find the Right Therapist.

 

For CAPS Walk-In Services:

Go to the 3rd floor of the Campus Health Services Building.

MON-THURS: 9 am – noon or 1 pm – 4 pm

FRI: 9:30 am – noon or 1 pm – 4 pm.

 

Sources-

Qualitative Social Work: http://journals.sagepub.com/doi/abs/10.1177/1473325016656046

New York Times Article: https://www.nytimes.com/2017/07/17/smarter-living/how-to-find-the-right-therapist.html?mcubz=1&_r=0

Study Drugs Limitless? More Like Limited: Know the Risks

By: Shauna Ayres MPH: Health Behavior candidate 2017

There has been much attention on the opioid and heroin epidemic in the last several years. Appalachian states in particular have suffered a great deal from a sharp rise in addiction and overdoses caused by opioid drugs. However, like many other addictive behaviors, there is silent rise in rates of “study drugs” on college campuses across the nation. Study drugs are prescription drugs, such as Adderall, Ritalin, and Vyvanse, that are used to treat Attention Deficient Hyperactivity Disorder (ADHD). Those with ADHD suffer from a brain abnormality that causes difficulties in concentration and increases impulsivity; but, college students without ADHD are using them to increase focus, sleep less, or do more academic, professional, and/or social activities.

The strong marketing and pressure by drug companies to prescribe and sell new ADHD drugs has resulted in more youth being diagnosed with this disorder and more prescriptions being written. There are currently 2.5 million Americans prescribed ADHD drugs and manufacturing of prescription stimulants has increased by 9 million percent in the past decade! I think the real questions are: Do more Americans suffer from ADHD? Or, has American’s need for drugs increased? The sad reality is that the more drugs available, the more opportunities there are to abuse those drugs.

It is estimated up to one third of college students have used study drugs. Common characteristics of users include being white, belonging to a fraternity or sorority, and having a grade point average of a B or lower. Interestingly, these drugs may keep students awake longer, but do not increase cognitive ability or capacity, or said another way, they do not make students smarter and are not like the magic pills in the movie Limitless. Most college students report getting or buying these types of drugs from a friend or peer with ADHD and a legit prescription.

Just because a drug is approved by the FDA, does not mean it does not have side effects, especially if it was prescribed to someone other than the person actually consuming it–every drug comes with risks. Some of the more common consequences of ADHD stimulant drugs are increased blood pressure, irregular heart rate, restlessness, anxiety, nervousness, paranoia, headache, dizziness, insomnia, dry mouth, changes in appetite, diarrhea, constipation, and changes in sex drive. Hallucinations, cardiac arrest, and death have been reported among people with prior heart conditions. In addition, ADHD stimulants are classified as a schedule II drug due to being highly addictive and the suggested sentence for distribution of schedule II drugs is 20 years in prison and a fine of 1 million dollars.

So, if you are using or considering using these types of drugs, please seek support from Campus Health Services or another health professional.

If you have these drugs for ADHD, do not share them with others. Here is a link to ways to “Protect Your Prescription”.

Resources

Cherney, Kristeen (2014). ADHD Medications List. Healthline. http://www.healthline.com/health/adhd/medication-list#Stimulants2

University of Texas at Austin, University Health Services. HealthyHorns: Study Drugs. https://healthyhorns.utexas.edu/studydrugs.html

University of North Carolina at Chapel Hill. Campus Health Services: Home. https://campushealth.unc.edu/

Drug Enforcement Administration. Federal Trafficking Penalties for Schedules I, II, III, IV, and V (except Marijuana): https://www.dea.gov/druginfo/ftp_chart1.pdf

Center on Young Adult Health and Development (n.d.) Nonmedical Use of Prescription Stimulants: What college administrators, parents, and student need to know. University of Maryland School of Public Health. http://medicineabuseproject.org/assets/documents/NPSFactSheet.pdf

Aberg, Simon Essig (2016). “Study Drug” Abuse by College Students: What you need to know. National Center for Health Research. http://center4research.org/child-teen-health/hyperactivity-and-adhd/study-drug-abuse-college-students/

The Brain Controls the Body, But Can the Body Control the Brain?

We all know our moods can affect how active we are, but did you know how much you move can also have an affect on our mood?

That’s right, according to researchers at Harvard Medical School, the connection between your brain and your body is a two-way street. They found that consistent exercise, such as running, cycling, and aerobics can affect your mood by increasing a protein found in the brain called brain-derived neurotrophic factor, or simply BDNF, which aids in the growth of nerve fibers.

Other studies have shown that those with ADHD can reduce their symptoms (although only temporarily) by doing 20-minutes of exercises such as cycling. Afterward, participants were motivated to do tasks that required thought and were less depressed, tired, and confused.

Forms of meditation, such as yoga, qigong, and tai chi were all shown to be helpful at alleviating depression, by allowing people to pay closer attention to their bodies and not on external factors. These changes in posture, breathing, and rhythm have all shown to affect the brain in a positive way. In some cases, people with post-traumatic stress disorder (PTSD) no longer met the qualifications for it once they began practice meditative movement.

Additionally, another study has shown that while exercise is beneficial for well being, self-esteem if further improved when moving synchronously with someone else. Moving along with someone else also showed signs of cooperation and charity toward others, as well as improved memory and recall skills.

Ultimately, these findings only stress the close connection held between your brain and body, and show that how much you move can not only help you stay physically fit, but can also affect the way you think and feel. These findings also present an alternative remedy to more traditional treatments for depression, such as psychotherapy and medication.

So next time you find yourself exhausted and completely overwhelmed, put on your sneakers and take a few minutes to get some exercise. You’ll not only sleep better, but in time, you may find yourself feeling more positive about life as well.

The New Suicide Prevention App Designed to Save Lives.

According to the World Health Organization, more than 800,000 people in the world commit suicide each year, and many more attempt it. While suicide is often preventable, those at risk don’t always have access to care when they need it the most. Because of this, developers have created MindMe, a new mental health app designed to put the resources and care needed right on your phone.

The app, currently in it’s beta stages, hopes to use the emerging idea of telemedicine to address the critical need for healthcare delivery to become more accessible for individuals in times of crisis. The app is not meant to replace a therapist, but rather allow therapists to use technology to provide real-time support.

So, how does the app work? Well, during a time of crisis, the app first suggests exercises to users that are preset by the users’  therapist and vary depending on intensity of the situation. These exercises can range from playing a game on a phone to watching a video pep-talk from a therapist, and are overall tailored to what has previously worked best for the user.

 

Users can also use the app to log triggers of suicidal thoughts, and emotions felt throughout the day. This information can be accessed by therapists in order to monitor well-being and progress over time.

Developers of the app are currently crowdfunding to raise money for a large clinical trial that will help prove the app is successful in leading to fewer suicides and better mental health care. If you wish to donate money to help them reach there goal, you can do so here.

If you or someone you know is in danger of harming themselves, call the National Suicide Prevention Lifeline, 1 (800) 273-8255.

I’m one in a million, are you?

The American Heart Association’s CPR & First Aid training has become a common certification. In fact, I first became certified when I was required to complete the training as part of my 8th grade health class. Chances are that you or someone you know has gone through the training at some point in time. Much more recently, however, I also learned about and was trained in a newer form of first aid that you probably haven’t heard about, and that’s mental health first aid.

Mental Health First Aid, a training course offered by the National Council for Behavioral Health, teaches participants how to help a person who is experiencing a mental health crisis or problem. This is incredibly important since 43.6 million Americans met the diagnostic criteria for a mental illness in 20141, a far greater number than the 359,400 Americans who experienced cardiac arrest in 20132. But despite the high prevalence of mental health issues in our society, most Americans receive little to no education or training regarding mental health disorders.

The National Council for Behavioral Health is trying to reduce this training gap and has set a goal to train 1 million mental health first aiders in the U.S., hoping to make the training as common as CPR certification.

Visit this website to learn more about Mental Health First Aid or to find a course near you. Or follow #1in1m on Twitter.

 

1http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-us-adults.shtml

2http://cpr.heart.org/AHAECC/CPRAndECC/General/UCM_477263_Cardiac-Arrest-Statistics.jsp