Catch up on all the news related to psychiatry and mental health from this week!
Depression is one of the most common mental health issues. Fortunately, research and science has led us both to the discovery and development of numerous medications, from tricyclic antidepressants to selective serotonin reuptake inhibitors, that have the ability help some suffering from depression.
With many individuals and groups working towards reducing stigma, plus the increase in awareness of mental health and knowledge of the efficacy of antidepressants, as well as with medications becoming cheaper and more widely available, the world is seeing an increase in the number of prescriptions for antidepressants. But when is it too much? And could these high numbers of patients on antidepressants actually indicate not necessarily a rise in depression or need, but rather society's dependence on and excessive and sometimes unnecessary use of these psychiatric medications?
In the article, "Are We Using Antidepressants to Paper Over The Cracks of a Fractured Society?" by Frankie Mullin (Guardian), these questions are explored further, in addition to investigating whether patients and physicians may be too quick to resort to medication when other options such as therapy may be best and more effective in the long term.
"While almost everyone with experience of antidepressants reports finding them useful, many could have made use of alternative forms of help. "We know that people go to the doctor because they're feeling low, and the reasons may be domestic violence, debt, bereavement, marriage breakup, difficulties from past trauma," says Corlett [the executive director of Mind]. "Some of these are practical and could have practical solutions, while some are deep-rooted psychological issues that need dealing with. Antidepressants are not always the answer"" (theguardian.com).
In addition, the article, "The Antidepressant Generation" by Doris Iarovici, explores the use of antidepressants among the young adult/college student population, which is often forgotten, yet as many news reports have been suggesting as of late, they are a group seeking medical attention more for support with their mental health issues. The article also delves into the idea of how society may be medicalizing sadness, particularly in early adulthood which is often fraught with transitions, big changes and challenges, and is a time characterized by immense personal growth and discovery.
"We walk a thinning line between diagnosing illness and teaching our youth to view any emotional upset as pathological. We need a greater focus on building resilience in emerging adults. We need more scientific studies — spanning years, not months — on the risks and benefits of maintenance treatment in emerging adults" (nytimes.com).
The concept of mental illness is not universal, rather mental illness is perceived and treated differently around the world. In Morocco for instance, mental health issues can be viewed extremely negatively, and many believe that mental illnesses as well as addictions are due to possession by evil spirits or demons.
"The level of awareness in the general population is so low that a lot of people tend to interpret their syndromes, their delusions and anxieties, as a curse, as something that has nothing to do with medicine" (news.yahoo.com).
Whether it be from an extreme lack of psychiatrists and adequate psychiatric facilities, poor education, and/or cultural, spiritual or political beliefs, mental illness is not readily perceived as a medical issue in Morocco , and as such it is handled very differently than in other regions like North America.
The article, "Morocco's mentally ill await deliverance from their 'demons'" by Simon Martelli (Yahoo News), discusses in particular, a sanctuary of a former Moroccan saint, where many with mental health issues are sent in the hopes that they are cured by the healing spirits and powers that are believed to exist there. However, reports have been surfacing that suggest the treatment patients receive in this sanctuary may be anything but healing ...
"Activists say hundreds of people have been kept in chains here, sometimes starved and beaten, making the place a byword for cruelty and highlighting the stigma attached to mental illness in Morocco" (news.yahoo.com).
Dese'Rae Stage, is a photographer, writer, and a suicide awareness advocate. More than that though, she's personally experienced bipolar disorder, self-injury and a suicide attempt, in addition to experiencing the grief and loss following loved ones passing from suicide. Based on her experiences with mental health, particularly in witnessing firsthand the #stigma, shame, and secretiveness that goes along with mental illness and suicide, as well as finding mental health resources lacking for suicide attempt survivors, Dese'Rae felt something needed to be done. So, this past December, she created an initiative called Live Through This, a growing collection of portraits and stories of suicide attempt survivors.
"The intention of Live Through This is to show that everyone is susceptible to depression and suicidal thoughts by sharing portraits and stories of real attempt survivors—people who look just like you. These feelings could affect your mom, your partner, or your brother, and the fear of talking about it can be a killer.
Historically, suicide attempt survivors, in particular, have spoken under conditions of anonymity in order to save them from being discriminated against. The silence and shame created in that act are dangerous. Live Through This encourages survivors to own their experiences publicly—using both their full names and likenesses—and thereby works to strip the issue of anonymity and raise awareness by, simply, talking about it. It's the first known project of its kind, exploring a world that has remained a taboo for far too long" (livethrougthis.org)
Live Though This is a project worth checking out. It aims to not only increase awareness and provide hope for those struggling with depression and suicidal thoughts, but also has the potential to teach us immensely about #mentalhealth. The project "asks you to look into their [the survivors'] eyes, to see their humanity, to find empathy" (livethroughthis.org) and perhaps by doing so we can better understand these experiences and provide better support.
More information about the project can be found here:
While we previously posted that sharing psychiatry records with other members of a patient's healthcare team or the patient themselves may help to increase the efficiency of the healthcare system, and involve patients more directly in their care among other benefits, limits or guidelines do need to be put in place with regards to the accessibility of one's sensitive mental health information.
Many individuals remain concerned over their personal health records being or becoming too accessible. Adding to that concern has been the recent news that "mental health episodes", particularly those involving suicides or suicide attempts are entered into the Canadian Police Information Centre (although it is not mandatory to do so), which the FBI and US Customs and Border Control have access to. Based on this information, the US agents then have the ability to make decisions about who can enter the country, as they did in the case of Ellen Richardson, who was not permitted to enter the US for a vacation this past fall because of her history of depression and a suicide attempt.
More information about this story, and what the Information and Privacy Commissioner is suggesting to help address this issue, can be found here:
"Canadians' Mental Health Information Routinely Shared With FBI, US Customs" (CBC News)
While many believe ADHD medications are overprescribed for children, it is also important to consider other patient populations where medications may be too often or unnecessarily given, in addition to potentially putting patients at increased risk of experiencing adverse events. For example, the widespread use of anti-psychotics among the elderly, particularly in those with dementia, has been receiving increasing attention and is starting to be questioned.
The article below addresses this issue in Canada, and offers some intriguing statistics about the numbers of dementia patients who are being treated with anti-psychotic drugs, primarily to reduce aggressive behaviours and agitation, as well as the number that actually seem to improve on the medication. The article also delves into the factors that contribute to the reliance on these medications, particularly in long-term care facilities, and the side effects of anti-psychotics, in addition to suggesting some non-pharmacological alternatives that may be more safe and effective.
"About 60 per cent of long-term care residents have dementia and half of those exhibit aggressive behaviour or agitation, Wiens says. But studies show fewer than one in five actually improves on anti-psychotic drugs."
"Overprescribed? Anti-psychotic drugs used too commonly on dementia patients, some say" by Don Butler (Ottawa Citizen)
Catch up on all the news related to psychiatry and mental health from this week!
In the medical profession, patient privacy and confidentiality are important to uphold in order to maintain a trusting physician-patient relationship.
For many psychiatry patients, keeping one's files and records of their psychiatric diagnoses is of the utmost importance, primarily because of the continued stigma many of these patients experience at their workplace and in their own communities. Some individuals also avoid seeking medical attention for their mental health concerns out of fear of such incredibly personal and sensitive information being documented and then becoming available to others. Back in November for example, a Canadian woman was denied entry into the United States because of her history of depression, raising concern over how such private health information had become available to the US border agents.
However, could keeping patients' psych records on lockdown be more detrimental than protective? Are there any benefits to sharing such health information with other healthcare providers? In the Time article, "How Keeping Psych Records Too Private Can Hurt Patient Care" by Maia Szalavitz, the other side of this ongoing debate is investigated. Through persuasive arguments, the article goes on to suggest that allowing psych records to be accessible by other healthcare professionals caring for a patient with a mental illness may actually be beneficial, improve patient care, and help to make the healthcare system more efficient.
Also commonly debated is patients' access to their own psych records. While patients have the right to request access to their medical records should they so choose, there are now some hospitals and physician groups that have been posting notes from patient visits on secure online systems for their patients to access and read. In the Boston Globe article, "Doctors' Notes on Mental Health Shared with Patients" by Liz Kowalczyk, mental health providers from the Beth Israel Deaconess Medical Centre explain how they have begun posting mental health notes online for patients' viewing pleasure. While many worry of patients misinterpreting the notes or becoming confused or upset by them, there are plenty of benefits with making such information and healthcare more transparent. As the article explains, "sharing the notes could improve care by encouraging patients to more actively participate in their treatment, while inspiring providers to describe patients nonjudgmentally. Patients can correct mistakes, such as a wrong medication dose. And rather than write a word such as “paranoid,'’ which to many people “means crazy or bad,’’ Kahn said he now uses less-loaded terms such as “persecutory anxiety"" (The Boston Globe).
Important articles for any medical professional to read and consider!
As part of Autism Awareness Month, Time author Alexandra Sifferlin put together a collection of four powerful and extremely personal pieces written on autism and autism spectrum disorders. These stories not only allow readers to develop a better understanding of what a diagnosis of ASD means, but they also provide insight into the life and challenges families affected by an ASD experience every day.
While the first story, "Reaching My Autistic Son, Through Disney" by Ron Suskind was previously mentioned in the Psych In The News - Week 9 post, it is definitely worth a read if you haven't yet checked it out!
Sifferlin also gives worthy mention of three other stories including "Catch Me If You Can" by Dean King (about an autistic and nonverbal child who went missing), "Navigating Love and Autism" by Amy Harmon (a story about autism and love and dating), and "Autism's First Child" by John Donvan and Caren Zucker (about the first person who was ever diagnosed with autism). All worth a read!
In thinking about PTSD, it's not only important to be aware of the variety of experiences and symptoms patients exhibit from developing substance use problems to having flashbacks or nightmares, to developing anxiety and depression, but it's also crucial to be aware of the impact such a mental health condition can have on their loved ones.
In "Living With Post-Traumatic Stress Disorder: Wives' and Partners' Stories" by Sally Howard, the effect of PTSD on the family of former soldiers is further explored with troubling, but honest, accounts of couples from the UK who have experienced the effects of PTSD first-hand ...
"The “invisible wounds” of combat-related PTSD affect not only the soldier or veteran, but also those around him or her. According to American and Israeli studies, veterans with PTSD are three times more likely to divorce than veteran counterparts not diagnosed with PTSD and are more likely to perpetrate physical and psychological aggression against their partners, with rates as high as 63 per cent for some forms of physical aggression in the past year ... “In almost every case of PTSD there is a ‘ripple’ effect of secondary trauma experienced by the patient’s partner,” explains Prof Gordon Turnbull of Capio Nightingale Hospital in London, a leading expert in PTSD" (Telegraph).
Supporting and enhancing students' and health professionals' knowledge and understanding of mental health and psychiatry