Archive For: Patient News

The Gratitude Attitude

The Gratitude Attitude

If your parents repeatedly exhorted you to count your blessings, it may well prove to be one of the best pieces of medical advice they shared. In this season of giving and thankfulness, we share a brief synopsis of how gratitude – defined as appreciation of what is valuable and meaningful to oneself – is associated with a host of beneficial health effects.

Mental Health

A grateful outlook may contribute to lower rates of depression, stress and anxiety, greater emotional functioning, stronger social relationships, higher life satisfaction, and help reduce the impact of stress on negative health outcomes.

Physical Health

Studies suggest that an attitude of gratitude may help lower blood pressure and glucose, improve immune function, promote more efficient sleep, boost pain tolerance, and lead to better cardiovascular health. Specifically, research has pointed to how practicing gratitude may help decrease hemoglobin A1c levels and contribute to reducing biomarkers of inflammation. A recent observational Harvard study of more than 49,000 registered nurses found that those scoring in the highest level of gratitude had a 15% lower risk of death from cardiovascular disease. Other reports have found that grateful individuals tend to be more health-conscious, avoiding smoking and drinking alcohol. For instance, a recent experimental study showed that evoking feelings of gratitude in people who smoke reduced their urge to do so and increased the likelihood of their enrollment in smoking cessation programs.

The Gratitude and Health Connection

Taken together, research suggests that interventions targeted at increasing gratitude may be an effective resource for health promotion and maintenance. Or as Dr. Robert Emmons, a long-time leader in the field of gratitude research and professor emeritus of psychology at UC-Davis, more eloquently explains:

“Gratitude heals, energizes and changes lives. Studies have shown that gratitude is often deepened and strengthened in trying times, as they lead us to not take things for granted. Gratitude is not simply a switch that we turn on when life is going well, but also shines a light in the darkness.”

Interested in trying this out? Visit UC Berkley’s Thnx4.org site, which offers free 10- or 21-day group or solo journaling challenges.

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Unpacking the Mysteries of the Microbiome

Unpacking the Mysteries of the Microbiome

In the past decade it has become well recognized that the millions of bacteria in the gut, collectively known as the microbiome, can influence the health of the brain, lung, heart, metabolism and the immune system. Thousands of studies have been conducted since the term was first introduced in 2001, with research shifting from an early focus on cataloging microorganisms in the human microbiome to pathogen identification and now to understanding their functional roles and how they interact with the host. Following are some of the key learnings to date, including a conversation with a leading microbiome researcher on behalf of our Well Read Patient readers. Please keep in mind that microbiome research is still in its infancy, and probiotic/prebiotic treatments are not the standard of care at this time.

What exactly is the microbiome?

Scientists define it as the sum of the microorganisms (bacteria, viruses, fungi, etc. that live in the body in healthy conditions), their genetic information, and their ecological niches. The microbiome is spread across different organs and tissues of the human body, but the most important and best studied is the gut microbiome. Studies show that under normal conditions, formation of the adult gut microbiome occurs over the first 3 years of life and is affected by events such as birth method, cessation of breastfeeding and starting solid food. Over time, it is thought that diet, drugs, age, smoking, exercise and host genetics affect the composition of the gut microbiome, and that some of these changes may contribute to metabolic, neurological, and immune disorders.

A high fiber, low animal fat diet may have beneficial effects on the gut microbiome.  With this in mind, the principle of “You are what you eat” is further clarified as “You are what your gut microbes do with what you eat,” according to the European Society of Neurogastroenterology & Motility. This is precisely the area that has long fascinated Christopher Damman, MD, a gastroenterologist who has studied the microbiome’s role in health and disease for the past two decades.

“While there are many ways to consider the role microbes play in our health, most essentially they activate or transform components of food that the body can’t process by itself,” he explains. “The microbiome converts polyphenol, the colorful compounds that occur naturally in plants, and fiber, a carbohydrate prebiotic that resists host digestion, to metabolites, which are molecular byproducts of digestion. These in turn influence the mitochondria, our cells’ metabolic powerhouses, that generate most of the energy needed for the cell to function.”

Metabolites also underly the gut’s natural production of hormones GLP and GLP-1, best known for its use in weight loss and type 2 diabetes drugs like Wegovy and Ozempic. Together, with another lower gut hormone called PYY, they help coordinate the body’s response to food by regulating appetite and blood sugar.

The traditional focus has been on therapeutic use of live microbes to repopulate the gut; for some, however, says Dr. Damman, there may be more power in postbiotics. “It can be very difficult to repopulate the microbiome of individuals whose guts may resemble a bleached coral reef as opposed to a vibrant aquarium, by just increasing intake of prebiotics through whole foods. The next best approach may be to therapeutically provide the metabolites naturally produced by a healthy gut microbiome,” he says.

While the gut responds to everything in your environment, from exercise to stress levels, food appears to be disproportionately important, asserts Dr. Damman. “The key to fostering a healthy microbiome may focus on four nutrients: fiber, phenols, bioactive fats, and ferments.” To that end, he has created a tool to help guide people to microbiome-friendly choices by assigning a Nutrient Consume Score (NCS) from one to 100 for a wide range of foods. Based on an algorithm that promotes increased fiber, phytonutrients, bioactive fats and potassium, and decreased amounts of simple carbs, additives, saturated fats and sodium, NCS is available as a prototype online at Dr. Damman’s website gutbites.org.  An app is in development that will enable easier use, such as scanning UPC codes at the grocery store. “I believe this is the first microbiome-focused nutrient calculator, and my intent is to have it validated scientifically and clinically before a beta release, possibly by early next year,” he says.

The takeaway from all this is deceptively simple. “We have gone on these really interesting, complex journeys intellectually, but at the end of the day, we return to our original understanding of healthy eating,” muses Dr. Damman. “As Michael Pollan (influential best-selling author and fellow at the Radcliffe Institute for Advanced Study at Harvard) says, eating mostly plant-based food, and not too much, is the way to go. All the research on the microbiome, metabolites, mitochondria, bioactives, etc. points in screaming ways right back at something we’ve known all along. We’ve evolved over centuries in concert with our microbiome and healthy whole foods that naturally regulate our appetites.”

In terms of preventing obesity, diabetes and metabolic disease, Dr. Damman maintains: “There’s no substitute for a healthy diet complemented by mindfulness, movement, and adequate sleep.”

New Tools, New Strategies for Gut Microbioma Therapy

Initially, gut microbiome therapies ranged from probiotics and prebiotics to fermented foods and fecal transplants.

But these are still early days, and new approaches are continually under the microscope, including:

  • According to research from Nature Aging, in healthy individuals the microbiome can continue to change after age 50, in contrast with a static microbiome composition seen in people who are less healthy and die earlier. Of particular note is the finding that each person’s microbiome becomes more distinct as they age, emphasizing the ineffectiveness of a ‘one size fits all’ approach and influencing the need for personalized health therapies.
  • Mayo Clinic’s recently announced Gut Microbiome Wellness Index 2, a tool designed for healthcare practitioners to identify adverse changes in their patients’ gut health before serious symptoms arise. By screening a gut microbiome sample, the tool can predict with 80% accuracy or greater whether a person’s gut is healthy or trending toward a diseased state. The ability to detect shifts in gut health was tested in various clinical scenarios, including people who had undergone fecal microbiota transplantation, or had made changes in dietary fiber intake, or who had antibiotic exposure. Additional testing is in progress.
  • New technologies that allow physicians to more easily examine the small intestine and upper part of the colon are sure to shine a bright light on these often neglected areas of microbiome research, according to Dr. Damman. Most exciting is the recent launch of swallowable devices with compartments that open up when certain acidity levels are reached to sample the small intestine. “This could be a real breakthrough for exploring how to best help those with small intestinal bacterial overgrowth (SIBO), Crohn’s, irritable bowel syndrome (IBS) and other conditions who frequently experience significant gastrointestinal symptoms from macro nutrient-rich diets.” Future possibilities may include partnering small intestine bacteria with their preferred prebiotics and personalized combinations of prebiotics.

Sources:

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Ageism, the Last Unacceptable Bias

Ageism, the Last Unacceptable Bias  

“I’m having a senior moment.

I’m too old to try that.

I look good for my age.

It’s time to put her/him out to pasture.

These are just aches and pains from old age.

Sweetie, you don’t look a day over 29.

Ok boomer.

There will be a tsunami of aging dependents in the coming decade.”

These oft-used phrases may sound inoffensive but they’re actually examples of ageism, perhaps the only stereotype in America yet to be banished, or even fully recognized. Raising awareness of ageist beliefs as inaccurate at best, and physically and psychologically harmful at worst, is the work of a lifetime for a diverse group of medical and scientific advocates. Why is changing the narrative so important?

Research shows that ageism can influence health through three pathways: psychological, behavioral and physiological. Negative age stereotypes can increase biological markers of stress and may predict detrimental brain changes decades later, while also spurring worse health behavior, such as noncompliance with prescribed medications.  A national poll on healthy aging showed those who regularly experienced three or more forms of ageism were less likely to rate their mental health as excellent or very good (61% vs. 80%) and more likely to report symptoms of depression (49% vs. 22%) than those who did not. Additionally, ageism can lead to inequities in healthcare, with age-based exclusions common in clinical trials, and older adults more apt to be left out of screenings, investigations and treatment for mental health issues.

Ageism: A Mental and Physical Toll

What may be most important to appreciate is how the internalizing of age stereotypes by older adults themselves can be an important determinant of health and well-being. Experts have found that negative self-perceptions of aging are associated with a higher prevalence for many of the most frequently seen health conditions among Americans, including heart disease, lung disease, diabetes, musculoskeletal disorders, and injuries, and tend to show more shrinkage of hippocampal volume in the brain. They may also show poorer memory performance and start to walk slower, reinforcing the negative loop around their aging process.

The Power of Positive Aging

Flipping the narrative, however, can result in dramatically improved outcomes. As reported in the Gerontologist, those who have more positive age beliefs live on average 7.5 years longer than those who harbor negative age beliefs. As the researchers noted: “If there were a pill that gave people an extra seven years of life in relatively good health, we would encounter very long lines at the pharmacy.”

The reasons for optimism around aging are based on science, not magical thinking. Consider that steep declines in physical and cognitive abilities are not inevitable parts of aging. According to the Administration on Aging, 80% of adults over 65 are not experiencing a physical or cognitive  disability such as hearing impairment or memory loss that impacts their function, and 60% report only moderate or small impairments in their mobility.  Procedural memory (e.g. how to ride a bike) is maintained in normal aging, and there is evidence suggesting abstract thinking and metacognition improve.

Challenging the Aging Myth

Despite the stereotype of people becoming more curmudgeonly with age, Manfred Diehl, PhD, a lifespan developmental psychologist, reports the opposite: “The conclusion from several meta-analyses is that in the personality area, we see quite a bit of positive development in terms of becoming socially more mature, with improved coping strategies and more regulation of emotions. Conscientiousness tends to increase at least until the mid-60s, possibly early 70s.”

Most remarkably, ongoing research at the Yale School of Public School by epidemiologist Dr. Becca Levy pointed to the conclusion that beliefs about aging rather than aging itself help explain why some older adults thrive while others do not. Her studies found that adults briefly primed with pos­itive statements about aging showed improvements in their memory, gait speed, and balance that were measurable months later, and further generated increasing confidence in their abilities that endured over years. Additional studies suggest that positive beliefs about aging may protect against dementia, even among those with a high-risk gene.

Changing the Conversation Around Aging

How can we help shift the conversation? Start by increasing awareness of the culture of ageism around us and recognize how it can impact health rather than the actual aging process, encourages Levy.

You may also want to explore how to get involved in organizations that focus on bringing generations together, including:

Generations Over Dinner – A free global initiative to create meaningful experiences and conversations by hosting in-person or virtual multi-generational dinner events.

Generations United– A nonprofit network with a comprehensive database of intergenerational programs across the country.

CoGenerate –A nonprofit organization aiming to bridge generational divides and foster intergenerational collaboration.

When to seek help for mental health

Remember: it is not normal for older adults to be unhappy as they age. Seek help for these treatable medical conditions:

Anxiety

  • Panic disorder: Panic attacks or sudden feelings of terror that strike repeatedly
  • Obsessive-compulsive disorder: Repetitive, unwanted thoughts or rituals
  • Post-traumatic stress disorder (PTSD): Nightmares, depression after a traumatic event
  • Phobias: Extreme fear of something that poses little real danger
  • Generalized anxiety disorder: Chronic worry about everyday activities

Depression

Feelings of intense sadness that last for weeks or months. Symptoms include:

  • No pleasure in everyday activities
  • Poor sleep
  • Rapid weight gain or loss
  • Low energy
  • Unable to focus

While grieving a loss may look similar to depression, there are differences. A mix of good and bad days is common when grieving. With depression, feelings of emptiness are constant and don’t improve over time.

Sources:Aging Research Reviews; Breaking the Age Code; Contemporary Clinical Trials, NCOA, Helpguide.org

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Testosterone Therapy for Midlife Males: More Questions Than Answers

Testosterone Therapy for Midlife Males: More Questions Than Answers

At around the same time as females enter menopause in their late 40s or early 50s, males are experiencing their own hormonal decline, called andropause. As part of the normal aging process, a man’s testosterone levels decrease by about 1% a year after age 40.

Low testosterone by itself is not concerning, but with symptoms, may indicate a more serious issue called male hypogonadism. Men may notice changes in body such as decreased muscle bulk, increased body fat, and fatigue; in mind, including depression, difficulty concentrating and disturbed sleep; and reduced libido.

When Should Men Consider Testosterone Therapy

For men diagnosed with hypogonadism, testosterone replacement therapy can help improve libido, energy, muscle mass and bone density. However, for those with low testosterone (low “T”) and symptoms due to aging, if or when testosterone therapy should be recommended is not clear, because:

  • Mental health symptoms may be due to other conditions, and there is no evidence to date of improvement from therapy.
  • Risks can include acne, sleep disturbances, and blood clots.
  • More research is needed: earlier studies pointed to a potentially higher risk of prostate cancer or cardiovascular disease while later ones seemed to allay those concerns but are not yet conclusive.

The best course to pursue? First, consult with our office about your concerns, and we will discuss your individual risks and benefits. Second, be aware that current medical guidelines do not recommend testosterone therapy for men with age-related low testosterone to improve energy, vitality, physical function, or cognition. Third, avoid over-the-counter supplements for boosting testosterone as evidence is lacking regarding their efficacy. Finally, consider natural ways to boost testosterone, such as losing excess weight, increasing muscle mass through resistance exercise, getting quality sleep, and eating a healthy diet.

Sources: Mayo Clinic, Harvard Health Letter.

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A New Look at Moving through Menopause

A New Look at Moving through Menopause

Defined simply as the final menstrual period, when it is no longer possible for a woman to get pregnant, the current approach to menopause has become increasingly nuanced, recognizing that each individual’s experience varies widely. Many women transition into this stage smoothly with minimal discomfort, but others experience severe vasomotor symptoms such as hot flashes, night sweats, sleep disruption, vaginal dryness, and possibly, “brain fog” and poorer mental health.

The Popularity of Hormone Therapy for Menopause

While hormone therapy (HT) was once routinely prescribed to relieve the symptoms of menopause, this stopped as a result of a large Women’s Health Initiative (WHI) study in 2002 which showed an increased risk of heart attacks, breast cancer, blood clots, and strokes for older postmenopausal females using the estrogen-progestin combination.

However, the pendulum may now be swinging back as subsequent trials that addressed the limitations of the WHI study found hormone therapy – consisting of estrogen for symptom relief and progesterone to protect the uterine lining – may be safer than previously thought. For women under 60 who are less than 10 years out from the start of menopause, an estradiol oral pill or transdermal patch can eliminate symptoms that impact sleep and mood and may decrease the risk for heart disease, diabetes and fractures due to osteoporosis. Progesterone can be taken as a pill, patch or IUD.

Further studies have shown that HT needn’t be routinely discontinued after 10 years for women at low risk for breast cancer and cardiac disease who continue to be challenged by persistent menopause symptoms.

Depression and Menopause

Additionally, new research suggests that despite a long-held association of depression with menopause, women are not universally at risk of depressive symptoms over the transition. For those more vulnerable to depression because of severe sleep disruptions, a long transition through menopause, stressful life events, or a previous history of clinical depression, a combination of psychological interventions and medication is advised. Other studies found estrogen treatment, sometimes with an antidepressant, effective in managing mood-related symptoms.

A Healthy Lifestyle to Mitigate Menopause Symptoms

The renewed acceptance of HT has spurred a reconsideration of our entire approach to menopause with practitioners asking: Can a healthy lifestyle play a key role in mitigating menopause symptoms? Can this passage be navigated successfully with informed, individualized decision-making and social and medical support? In 2024, all signs point to yes.

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Midlife Crisis or Midlife Reassessment?

Midlife Crisis or Midlife Reassessment?

Like so many popular 20th century concepts, the image of a man in an existential crisis at age 50 who trades in his long-time wife and car for newer models is on the wane – and may never have been correct. Psychoanalyst Elliott Jaques coined the term in 1965 to describe his midlife client’s sudden change in lifestyle and productivity, but the breakthrough “Midlife Development in the U.S. (MIDUS)” studies conducted over three decades beginning in 1995, proved otherwise. Only an estimated 10% of adults actually experienced a midlife crisis while the majority considered it a period of great satisfaction, redefining it as a time of deepened connections and continuity, peak earning power, career advancement, and greater emotional intelligence. In fact, asserts study author Margie Lachman, PhD, adults reach the apex of their competence and expertise in middle age, with time to chart a healthy course for the future.

Midlife Challenges and Stressors

Still, midlife does pose its share of challenges in terms of concurrently balancing as many as eight roles, including spouse, parent, grandparent, adult child, sibling, friend, co-worker, and caregiver. Partially a result of an ongoing cultural shift encouraging openness around mental health, today’s midlife adults are more frequently diagnosed and seek help with issues such as depression and anxiety – from 31% in 2019 to 45% in 2023 among ages 35 to 44; and from 26% to 36% among ages 45 to 64, as reported in the American Psychological Association’s annual “Stress in America” survey.

Work is the primary stressor for many midlife patients of concierge psychologist Dr. Rebecca Osei. “Their self-worth is intertwined with career achievement,” she says. “If they haven’t yet reached the goals they set for themselves, there can be issues with depression and how to move forward from this point.”

High achievers face their own set of problems, according to psychiatrist Brook Choulet, MD, who works with CEOs and elite athletes contending with mental health concerns despite the outward appearance of great success. “I often start by asking how they would feel if I sent them on a two-week vacation right now,” she says. “Their answer can help reveal whether they’re headed toward burnout (removing the stress factor of work improves their mood) or struggling with clinical depression or an anxiety disorder.”

Strategies for High Achievers to Overcome Stress and Anxiety

Top performers are driven to constantly keep chasing the next goal, rather than taking the time to appreciate their achievements, says Choulet. “Many also have perfectionist tendencies, leading to stress and fear of failure if everything is not done flawlessly.” She helps them overcome their challenges with strategies that include:

  • Establishing good boundaries between personal and professional life.
  • Adopting a growth mindset focused on progress rather than perfection.
  • Developing stress management and self-care techniques. “Prioritize your own mental health in order to lead effectively.”
  • Taking a pulse on what brings you joy. “This is particularly important as you near retirement and can’t imagine life without work. Lean into your network of friends and family and learn how to step away and enjoy what you really love,” says Choulet.

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A Welcome Change: Mental Health Issues Lose Their Stigma at Every Age

A Welcome Change: Mental Health Issues Lose Their Stigma at Every Age

From unmentionable to oft discussed, American attitudes toward mental health have made a seismic shift over the years. It’s heartening to see recent polls showing 87% of U.S. adults agree having a mental health disorder is nothing to be ashamed of, and 86% saying people with mental health disorders can get better. Seeking help from a therapist has become normalized, due in part to an epidemic of mood disorders among Gen Z.

“It is this generation that may, in fact, finally break the stigma around mental health,” says Ken Ginsburg, MD, Children’s Hospital of Philadelphia, “freeing millions of Americans who have suffered terribly and silently to seek help.”

Mental healthcare has gradually worked into the mainstream, says concierge psychologist Dr. Rebecca Johnson Osei. “Just a generation ago, people were happy or angry and we didn’t label many feelings beyond that. Now there’s a lot of positive talk about therapy on tv and in films, which begets more conversations. The language in children’s literature has also changed to teach about feelings, so youngsters will be great stewards of this approach when they’re adults.”

Osei says some are beginning to view therapy as an opportunity to become better versions of themselves. “It’s gratifying to work with young couples who want to be in a good place emotionally before they get married, and people looking to address issues from their own childhood before they have children.”

Does that pave the way for annual mental health checkups? “The sooner you identify a problem, the easier it is to manage,” says Osei. “We can’t prevent everything, but we can listen to our minds the same way we listen to our bodies and seek help at the first sign of troubling symptoms.”

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Mental Health in Children

Mental Health in Children

Age of Innocence – Or Anxiety for Today’s Kids?

From loud claps of thunder to dogs that can bite, a child’s world is filled with new, sometimes scary experiences. However, if fears can’t be managed with reassurance or distraction and persistently interfere with daily activities, your child may have an anxiety disorder. These most common childhood mental health disorders are now regularly screened for in children ages 8-18, and include:

  • Generalized anxiety disorder: excessive worry about everything that’s happening in their world; focus on failures rather than successes.
  • Social anxiety disorder: intense fear of doing or saying the wrong thing; shy, withdrawn, self-conscious; avoids social and performance situations.
  • Panic disorder: suffers from unexpected panic attacks, described as “going crazy” with severe feelings such as “I feel like I’m going to die.”
  • Separation anxiety disorder: worries about something bad happening when not with caregivers, difficulty sleeping on own, excessive homesickness; may avoid playdates, sleepovers.
  • Specific phobias: intense, irrational fear of a specific object or a situation such as animals, storms, heights, water, blood, the dark, and medical procedures.
  • Selective mutism: inability to talk when faced with new people or places, but have no trouble speaking in situations where they feel comfortable.

Symptoms of Anxiety in Children

Anxiety in children manifests in numerous ways: crying, tantrums, clinging, headaches, stomach aches, shortness of breath, sleep problems, under- or overeating, and poor school performance.

Treatment of Anxiety in Children

Exposure and response prevention (ERP) therapy – exposing children to the things that trigger their anxiety in structured, incremental steps and teaching them how to master their fear – has proven very effective. When appropriate, ERP therapy can be combined with anti-anxiety medications (SSRIs).

Fear Factor: Helping Children Understand and Manage Their Fears

The frequently experienced fears shown below can often be managed with education, exploration through play, and “bibliotherapy,” the use of reading aloud to children to address their worries. In a pilot study of a four-week bibliotherapy intervention for young children with persistent and interfering nighttime fears, clinically significant change in anxiety severity was reported. Additionally, increases in the number of nights children slept in their own bed, and decreases in child-reported nighttime fears were observed.

Try it: Magination Press, the children’s book imprint of the American Psychological Association, offers a large selection of literature designed to help families navigate life’s challenges. For example, in Booma Booma Boom, a boy guides his stuffed animals through a thunderstorm using sensory-based mindfulness to ease fear, find quiet, and understand that storms also bring good things, such as calming rain and water for plants.

Age Years Common Fears
1 Separation, falling, animals/insects, toilet training, bath
2 Separation, noises, toilet training, bath, bedtime
3 Animals/insects, bedtime, monsters/ghosts, getting lost
5 Animals/insects, monsters/ghosts, divorce, getting lost, loss of parent
7 Separation, noises, falling, bedtime
9 Social rejection, war, new situations, adoption, bodily injury, school performance
10 World disasters (tsunamis, earthquakes, sinking ships)
12 Falling, burglars, bodily injury
14 Adoption, burglars, injections, sexual relations
Older Teens Social affairs, death, and illness

Adapted from: UptoDate Overview of Fears and Phobias in Children and Adolescents
Sources: Child Mind Institute, CDC, Anxiety and Depression Association of America (ADAA), UptoDate

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Mental Health in Adolescent & Young Adults

Mental Health in Adolescent & Young Adults

Drugs, Drinking & Depression: The Kids May Not Be Alright

Every generation has seen their share of thrill-seeking teens acting out and making dubious choices regarding drugs and alcohol. “There’s a normative aspect to risk taking at this age,” assures clinical psychologist Gilly Kahn. “It’s hardwired into our systems to allow us to learn our place in the world.”

In the 2020s it’s increasingly likely that these kinds of activities are also being used by Zoomers (born between 1997 – 2012), particularly the older ones, to temporarily ease their depression and anxiety. New research from Harvard shows that, based on well-established measures used to screen for generalized anxiety disorder or major depressive disorder, 42% of people ages 18 to 25 reported being either anxious or depressed – almost twice as many as the teens surveyed. Additionally, more than half said their lives lack meaning or purpose.

If there’s a silver lining to be seen here, it may be the respondents’ willingness to share their condition, unashamed and unafraid to reveal mental health issues. “Young adults these days may be more emotionally aware and articulate than any generation in American history,” wrote the researchers.

Like older people, symptoms of depression in young adults and teens can include:

  • Diminished pleasure in things they used to enjoy
  • Fatigue and sleep issues
  • Anxiety
  • Constant sadness
  • Feeling worthless, guilty or restless
  • Physical ailments such as headaches and stomach aches
  • Significant weight loss or gain
  • Difficulty concentrating
  • Isolation
  • Thoughts of death or suicide

Dissimilar to older adults, they may also do poorly at school, be more apt to ‘act out’, and feel irritable, negative and argumentative.

Effective ways to treat depression include cognitive behavioral therapy to help change negative patterns of thinking and behaving, and interpersonal psychotherapy to develop healthier relationships at home and school. An anti-depressant drug (selective serotonin re-uptake inhibitor or SSRI) may also be prescribed when appropriate.

Most importantly, Kahn advises parents and grandparents to keep the lines of communication open by taking every opportunity to talk about emotions and ‘actively listen’. “Sometimes parents are completely surprised by a call from the school guidance counselor who alerts them to the fact that their teen was Googling information about depression or suicide. But teens are really good at trying to cover up how they feel and may not want to burden family members with their sadness or anxiety,” she says.

Consistently expressing unconditional love and acceptance, even if it seems unappreciated, is key. “Teens may give you attitude or not show gratitude in the moment, but don’t stop because it has a huge positive impact on their mental wellbeing,” says Kahn.

Essential Coping Skills for Teens and Young Adults Dealing with Anxiety and Depression

  1. Understand. Put your emotions in perspective, gather your thoughts, and problem solve.
  2. Distract. Take time away from a problem and stop spiraling; you’ll have a clearer mind when you return to it.
  3. Move. Release endorphins to increase a feeling of well-being while decreasing cortisol (stress hormones).
  4. Ground. Reconnect with your senses, be present in the moment.
  5. Connect. Tap into your support system, engage in caring for others in the community.

`Adapted from: Harvard GSE Making Caring Common Project

Learn more from resources dedicated to supporting mental health:

Anxiety & Depression Association of America offers extensive information about anxiety, depression, PTSD, suicide and how to join free peer-to-peer support communities.

Cogenerate is an organization that fosters intergenerational collaboration through diverse programs, events, and media initiatives.

DoSomething is one of the largest nonprofits dedicated to providing opportunities for young people to take action on various pressing social issues.

Jed Foundation is a nationally recognized nonprofit that works to protect emotional health and prevent suicide among teens and young adults. Provides comprehensive resources to help young people prioritize their mental health while managing important life transitions.

Wondermind is a popular online resource for expert advice, candid conversations, and tailored content to help young people put their mental fitness first every day. It also has a “filter by
feels” feature, allowing you to find content specific to how you feel.

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Teens & Social Media

Teens & Social Media

In Real Life (IRL), Can We Protect Teens from the Emotional Impact of Social Media?

YouTube, TikTok, Snapchat, Instagram, Facebook, WhatsApp, X, Reddit, BeReal. A majority of American teens visit these social media platforms at least once daily, and 30% say they are on them almost constantly. Their ubiquity is unquestionable, and teens’ connection with them seemingly unshakeable, but the impact on emotional health is still being explored.

Recent reports found frequent social media use may be associated with changes in the developing brain, potentially affecting emotional regulation and impulse control. “In early adolescence, when identities are forming, brain development is especially susceptible to social pressures, peer opinions, and peer comparison,” according to the U.S. Surgeon General. Of particular concern is evidence linking social media use to body image dissatisfaction, eating disorders, poor sleep and depressive symptoms.

Also noted however, are the benefits of social media, which include positive interactions among teenagers who find an online community of peers with a common interest or identity. Polling has shown a majority of teens and parents gave social media high marks for connecting them with support in tough times, giving them a place to show creativity, and feeling more connected with friends’ lives.

To keep youngsters safe, experts advise a combination of limits, discussion and coaching around social media use. “When children are young, hold the reins tightly by establishing specific expectations and rules,” advises psychologist Gilly Kahn. “Build trust and loosen the reins as they get older to allow less supervision…but let them know you’ll tighten it up again if they break your trust in any way.”

While a proliferation of parental control apps are available, like Bark which sends notifications when alert words are used (e.g. drugs, suicide), Kahn notes: “These are considered really invasive by teens, and if they want to get on social media, they’re going to find a way to do it.”

Instead, start with a family media plan to set rules about online time, content boundaries, and not disclosing personal information. Continue to have age-appropriate conversations with youngsters about who they’re connecting with and how they’re spending their time online. Try and keep family mealtimes and in-person gatherings device-free to help youngsters build social bonds. Consider restricting the use of phones, tablets, and computers for at least an hour before bedtime and through the night to help ensure restful sleep. Finally, model positive behavior on your own social media accounts.

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