“Your brain can get injured just like any other body part, and it can heal just like any other body part.”
Olympic Runner Alexi Pappas had no choice but to be surrounded by mental health growing up. Her mother, who had bipolar disorder, died by suicide when Alexi was only four years old. That did not mean, however, that she really understood mental health or had the vocabulary to describe it. It was both a taboo subject in the 1990s and in her household. Nobody around her talked about it in a way that helped her to know that mental illness was treatable and her mother’s death in any way preventable.
Alexi explains she thought that her mother, “Was so sick and unhelpable that she had to go. Therefore, I wanted to never be in that situation where I reminded myself of her, because I thought in that case I might be unhelpable, too, and I might have to go.” So, Alexi tried to do everything she could to be different from her mother. To her, that meant becoming someone great, someone happy, and ultimately an Olympian. She did what she describes as, trying to solve an internal problem with an external solution.
But, that that didn’t stop her from becoming depressed. It did, however, make her unprepared for it.
After the Olympics she experienced a post-Olympic low, as many athletes do. She describes herself as being nearly at crisis level. She says, “I was in the middle of Mammoth Lakes, California with no vocabulary or understanding [about mental health] and just a complete denial that I was experiencing certain feelings, because I thought if I admitted it...if I wasn't okay, then I really might not be okay. And that just, of course, makes things worse.”
She didn’t even notice how bad she was herself. It was actually her dad who made her get help. Even still, getting to help was much harder than she could have ever imagined. She did not know how to find a provider and describes the process as humiliating, feeling she needed to ask for favors to find doctors and get in quickly given her urgency. This humbling experience inspired how she thinks about the challenges in the mental health system. It is one of the reasons she has since teamed up with Monarch, the largest therapist directory in the United States that allows people to both find a therapist and to request an appointment directly, as she believes that if it had existed when she tried to get help, a lot of her story would not have happened the way that it did.
Her treatment also profoundly changed the way she viewed mental health by her doctor simply reframing it for her. All it took was the right words that she was missing all along.
Her doctor explained, “Your brain can get injured just like any other body part, and it can heal just like any other body part.” By equating physical injury to mental injury, Alexi felt she could commit to healing her brain, just like an athlete commits to recovering from a physical injury. Healing, she says, then became a process she could understand just like an Olympic goal. When she explained the same concept to soldiers about PTSD in a talk she gave with the Pentagon’s US Army Resilience Directorate, they also resonated with it.
For Alexi, this messaging has been the number one thing that changed the course of her healing from mental illness. Understanding depression as a broken bone, allowed her to give herself grace for how long it could take to heal. Broken bones, she says, take time, and that is OK. Just like there are not many things that could prevent someone from breaking a bone in the first place, the same is true of an episode of depression or a mental health crisis. Within that frame, it became easier for her to have self-compassion and focus only on healing. Struggling with your mental health is not your fault, let alone the timing of those struggles.
There is perhaps no better example for this than Simone Biles withdrawing from her Olympic events, as one can only imagine that given the option no one would want to have to stop competing mid-competition at the Olympics.
Yet, if a person feels they can’t compete, physically or mentally, it should their decision to make. Alexi explains that if an athlete said they thought they would risk a leg injury by playing a match or doing an event, people would embrace the decision, and understand that they don’t want her to hurt her leg. Mental health is no different.
Alexi emphasizes, “[It] is a legitimate bodily need. I think the answer is so simple. It's like, what do you need in order to compete? And if you're unable to compete, because you're risking your body then don't compete.” By understanding that the brain, too, can get injured, Simone’s decision, and Naomi Osaka’s, make so much sense. But, given some of the backlash, perhaps more people could use to understand the vocabulary.
Mental health, like physical health, is also not only for the people who are extremely ill, or as Alexi describes, so self aware that they know what to look for. It is for everyone along the healing spectrum, and includes, where Alexi is now, maintenance. Her goal today, by going to psychiatry and therapy appointments, is to continue her health after her injury, or prevent another injury from occurring in the first place, with what she calls “prehab.”
In her newfound conceptualization of mental health, Alexi has also changed how she views sports and how we can actually be mentally prepared to survive and thrive within them. She says, “I think the big misconception is that the problem is chasing the dream. I think we could be much more prepared to handle that dream and to handle the moment after as like a legitimate chapter in the process.”
In other words, the problem is not wanting to be the best, or striving to be an Olympian, or even becoming one, but not including mental health in every conversation. Pappas, who is also the author of Bravey, adds, “I think it's just being able to come into it as prepared mentally as your body is prepared...We might be physically peaked, but mentally, we’re still human beings”
Even the GOAT Simone Biles is slowly realizing that herself.
by: Jessica Gold, July 29, 2020
by Elizabeth Millard, Oct. 13, 2020
Oxytocin, a hormone related to feelings of love and bonding, may play a major role in regulating gastrointestinal functions, especially as it pertains to stress, according to the preview of a new study to be published in The Journal of Physiology.
Looking at rats in a controlled laboratory setting, researchers introduced stress through several scenarios, such as by restraining them or forcing them to swim in a container where they couldn't touch the bottom. They then tested the rats' gastric emptying rate—how quickly food leaves the stomach—of a solid meal, along with assessing their hormone levels.
Thirty minutes before the stress tests, researchers injected the rats with a saline solution (control) or a drug designed to trigger the release of oxytocin. They found that oxytocin had a significant effect on gastric emptying. The rats that had been under the most stress had the slowest emptying rate, but when oxytocin was triggered, it increased muscle contractions in the stomach and shortened the delay.
While the results of the study only provide preliminary evidence, they do hold promise for further investigation. The information could lead to new targets for digestive drug development in the future, especially since oxytocin hasn't been investigated as a stress-response hormone in the past.
Reevaluating the Role of Oxytocin
In terms of stress response and gut health, oxytocin has not been thought to be a major player compared to other hormones like cortisol, dopamine, and serotonin.
Serotonin in particular has garnered the most attention. Since it's so strongly connected to mental health, it's often a target in antidepressant medications. About 90% of serotonin is produced in the digestive tract, which then sends signals up to the brain, according to Elaine Hsiao, PhD, research assistant professor of biology and biological engineering at Caltech.
Oxytocin, sometimes called the "love hormone" or the "cuddle hormone" because it's released when people bond socially or physically touch each other, is often highlighted not for its potential role in gut health, but for the birth process. The hormone causes uterine contractions, helps shrink the uterus after delivery, aids in breastfeeding, and promotes mother-child bonding.
A 2007 study in Psychological Science concluded that the higher a woman's oxytocin levels in the first trimester of pregnancy, the more likely she would be to initiate bonding behaviors with a baby, such as singing to the infant.
What This Means for You
You’ve likely experienced the negative effects of stress on your digestion—it can cause all kinds of symptoms like stomach aches, bloating, and nausea.4 Understanding the role of oxytocin on stress and digestion should encourage you to seek out activities that promote the production of this hormone, like working out or spending time with people you love, which in turn could help alleviate the associated gastrointestinal symptoms.
Gut and Brain Health
Highlighting oxytocin's potential role in digestive health adds to evidence about the importance of the gut-brain axis, says Lisa Mosconi, PhD, author of Brain Food: The Surprising Science of Eating for Cognitive Power.
"The value of maintaining good gut health for better emotional regulation can't be overstated, because they're so connected," she says, adding that if one is thrown off, the other can be affected, sometimes dramatically. "It's a delicate balance because they're sending messages to each other all the time. But that's also the good news because if you work to improve one, you'll likely see benefits for the other."
The value of maintaining good gut health for better emotional regulation can't be overstated, because they're so connected.
— LISA MOSCONI, PHD
That means taking steps for better brain health—like eating healthy foods and pursuing de-stress strategies—can also be beneficial for your digestion.
Focusing on foods like fruits, vegetables, whole grains, and lean proteins can be useful for better hormone regulation, but another solid strategy is simply to move more. Potentially a lot more.
“Your brain is wired to respond positively to exercise,” says Loretta Graziano Breuning, PhD, author of Habits of a Happy Brain. “When you exercise consistently, your brain gets even more efficient at making and releasing the natural chemicals that keep you upbeat, like serotonin, dopamine, and oxytocin.”
Although the recent study focused on oxytocin specifically, hormones like these don't work independently, says Breuning. Rather, they are released in combinations that are thought to improve functioning—creating streamlined processes related to everything from blood sugar control to stress relief to digestion.
When you exercise consistently, your brain gets even more efficient at making and releasing the natural chemicals that keep you upbeat, like serotonin, dopamine, and oxytocin.
— LORETTA GRAZIANO, PHD
Exercise can provide a major boost. Other strategies that could help with oxytocin include:
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March 31, 2021
A new study published in the International Journal of Molecular Sciences has found that the presence of a stress hormone may aggravate nasal allergies.2 The findings may eventually open the door to new treatments for seasonal allergies in the future.
Here’s what to know about the latest research on the relationship between stress and allergies.
In a study published earlier this month, a team of researchers led by scientists in Osaka, Japan, ran a series of experiments to explore the link between increased allergic reactions and the corticotropin-releasing stress hormone (CRH). Stress causes the body to release CRH, which then helps release cortisol, the primary stress hormone that puts the body in fight-or-flight mode. When people are stressed out, it worsens all allergic conditions. Sinus allergies get worse, and if a person is prone to hives or rashes, that gets worse, too.
— PURVI PARIKH, MD
When the researchers added CRH to a nasal polyp organ culture, they noticed that the number of mast cells, which drive allergic reactions, increased substantially in human nasal mucosa (the lining of the nasal cavity). The reaction also stimulated activity in mast cells, which leads to the release of chemicals that trigger allergic reactions.
“Mast cells have receptors where allergens and antibodies can interact. When the allergen and antibodies get connected to the mast cell, the mast cell extrudes chemicals responsible for itchiness, mucus production, or coughing that can go along with allergy symptoms,” explains Dr. Tiffany Owens, an allergist and immunologist at The Ohio State University Wexner Medical Center. “Everyone has mast cells, but not everyone’s mast cells interact with antibodies because the allergy antibodies are made by the individual person.”
The researchers also explored the potential of antalarmin, an experimental drug that blocks CRH receptors, as a treatment for allergies. They found that antalarmin helped prevent stress hormones from increasing the number of mast cells and their activity in the nasal mucosa of mice. Still, more research is needed to determine the effect of the drug on humans.
“We don’t have antalarmin as a treatment we use now, but if it helps prevent stress-related inflammation, it could be a potential treatment option far down the road in the future,” says Dr. Owens.
The findings offer confirmation of what some allergists like Dr. Purvi Parikh, spokesperson for the Allergy & Asthma Network, have seen when treating patients with allergies and high levels of stress.
“When people are stressed out, it worsens all allergic conditions. Sinus allergies get worse, and if a person is prone to hives or rashes, that gets worse, too,” she says. “We also notice that people have anaphylactic reactions even more so when they are under stress, either physical or mental.”
Earlier Research on Stress and Allergies
This new research builds upon earlier studies on the relationship between stress and allergies.
A 2013 study published in Annals of Allergy, Asthma and Immunology found that people who had persistent emotional stress tended to have a higher frequency of allergy flares. However, it did not find that cortisol was associated with allergy symptoms.
It’s hopeful that’s this is not just a pharmaceutical study focused on what drug we can sell you to make this better.
— TIFFANY OWENS, MD
And a randomized controlled trial from 2009 showed that stress and anxiety could worsen and prolong symptoms of allergic rhinitis, a group of nasal symptoms (like sneezing and itchy, watery eyes) that occur when you inhale something you’re allergic to. The latest study helps advance scientific understanding of how a particular stress hormone can lead to an allergic reaction.
“This continues to intrigue us as physicians and as patients, to think about our bodies as this complex machinery interacting with our internal and external environments, and there are many factors involved,” says Dr. Owens. “It’s hopeful that’s this is not just a pharmaceutical study focused on what drug we can sell you to make this better.”
Coping With Allergies
If allergies make you miserable in the spring (or any time of year), consider working with an allergist to control your symptoms. They may recommend medications to ease your symptoms and/or allergy shots (immunotherapy) to build your tolerance to certain allergens, such as pollen. While the research on stress and allergies is promising, experts say that reducing stress probably isn’t enough to provide relief from allergy symptoms.
“I want to stress that this is not a replacement for traditional therapies,” says Dr. Parikh. “Managing stress should be done together with other treatments. Sometimes people think, ‘I’ll do yoga and not take my medications,’ but you should do both if you need them.“
I want to stress that this is not a replacement for traditional therapies. Managing stress should be done together with other treatments.
— PURVI PARIKH, MD
The findings on the latest study are just further evidence that stress reduction should be incorporated into a broader healthy lifestyle routine — not only for people with allergies, but for everyone, says Dr. Owens.
“I do recommend stress reduction, not so much if someone came in and said they have itchy eyes and a runny nose, but more in terms of general health and wellness,” she says. “This is just another encouragement to take care of ourselves, pay attention to what our bodies are telling us, and do the least amount of detriment. We can do some really good things for ourselves by taking time to rest and pay attention to healthy habits.”
What This Means For You
High stress levels can damage your physical and mental health. Now, new research shows that it may also aggravate symptoms of seasonal allergies, which affect up to 60 million people in the U.S. each year.
While experts say that stress reduction is not a substitute for traditional allergy treatment, it can be beneficial to incorporate it into an overall healthy lifestyle routine that may, in turn, improve your symptoms. If your allergies are acting up, get in touch with an allergist to see if medications or immunotherapy can help.
Progressive Muscle Relaxation is a favorite mindfulness technique to improve body awareness and help tackle feelings of anxiety and depression. Use this guide to try it out!
If you’re stressed out, anxious or feeling lonely, you are not alone.
From: Katie Anderson
By Alex Smith, KCUR JUNE 24, 2020
The Trevor Project’s 2020 National Survey on LGBTQ Youth Mental Health paints a stark picture of pervasive mental distress among America’s queer youth.
July 15, 2020, 11:44 AM CDT
By Tim Fitzsimons
Two in 5 LGBTQ youth in the United States have "seriously considered" suicide in the past year, a sobering survey released Wednesday said, showing what one expert called the "devastating mental health consequences" of society's failure to create a safer and more affirming environment for America's queer youth.
The 2020 National Survey on LGBTQ Youth Mental Health by The Trevor Project, an LGBTQ youth crisis intervention and suicide prevention organization, paints a stark picture of pervasive mental distress among America’s lesbian, gay, bisexual, transgender and queer youth, with a majority reporting symptoms consistent with generalized anxiety disorder and major depressive disorder.
The survey, the largest of its kind, polled 40,000 LGBTQ people between ages 13 and 24 and found that 68 percent of the respondents reported symptoms of generalized anxiety disorder, 55 percent reported symptoms of major depressive disorder and 48 percent reported engaging in self-harm. In addition, 40 percent say they have “seriously considered” attempting suicide in the past year.
In a clinical mental health setting, survey responses like these would lead to follow-up screenings, according to Amy Green, the study lead and director of research at The Trevor Project.
“Our physicians, pediatricians and mental health providers need to be screening youth,” she said, urging professionals to take a closer look at sexuality and gender issues in youth mental health settings.
Dr. Jack Turban, a fellow in child and adolescent psychiatry at the Stanford University School of Medicine, where he researches the mental health of transgender youth, said the findings "highlight that our society has a long way to go to create a safer and more affirming environment for LGBTQ youth.”
“We once again see the devastating mental health consequences of our failures," he said in an email.
As the survey’s own data show, many LGBTQ youth are not getting screened for the mental health issues they report. About half of the respondents say they want but could not get mental health care in the past year, with affordability the “strongest barrier to receiving mental health care."
The risks associated with unmet mental health care needs are stark. Overall, suicide is the second leading cause of death for American adolescents, according to the Centers for Disease Control and Prevention, and LGBTQ youth are at a higher risk of suicide than straight and cisgender youth. Fifteen percent of the respondents attempted suicide in the past year, the survey found.
“If we take a step back and look at minority stress model, that says that experiences of rejection, discrimination and victimization are the primary causal mechanisms that cause that ideation,” Green said, adding that it’s not who they are, “but how they are treated.”
In the survey, LGBTQ youth who reported facing greater rejection, violence and discrimination also reported higher rates of suicide attempts.
For transgender and nonbinary youth, having their identity and pronouns respected by “all or most” people was associated with a greatly reduced risk of a suicide attempt.
Even so, respect is still rare: Just 20 percent of trans and nonbinary youth said their gender identity is respected by “all or most” people in their lives.
LGBTQ youth in the survey identified with more than 100 different combinations of terms to describe their gender identity.
Turban said rejection “takes an insidious toll and plants the seed for mental health problems.”
“We can’t underestimate the broad adverse health effects caused by societal discrimination against LGBTQ people, and youth in particular,” he said. “Things like rejection from family and conversion therapy lead to a range of adverse mental health problems by telling these young people that something they can’t change about themselves makes them ‘bad’ or ‘wrong.’”
Green said understanding that rejection can lead to worse mental health outcomes can also illuminate a path forward.
While many LGBTQ youth face discrimination, the vast majority (86 percent) reported having a rock — at least one person who strongly supports them as an LGBTQ person — and those who have a rock also report lower rates of suicide attempts overall.
“The simple act of acceptance and letting kids express their identity can be incredibly powerful,” Green said.
If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
If you are an LGBTQ young person in crisis, feeling suicidal or in need of a safe and judgment-free place to talk, call the Trevor Lifeline now at 1-866-488-7386.
Mental Health America Releases May 2020 Screening Data; 88,000 Have Anxiety Or Depression, And Results Point To Possible Epidemic Of Suicidal Ideation
TUESDAY, JUNE 2, 2020
Alexandria, VA - More than 88,000 additional people have developed anxiety or depression as a result of the COVID-19 pandemic, according to new data released today by Mental Health America (MHA) from its online screening program.
In addition, more than 21,000 depression screeners reported thinking of suicide or self-harm on more than half the days – a number that suggests a coming wave of mental impacts that could be of epidemic proportions.
In May 2020, more than 211,000 people took a free, anonymous online mental health screen at www.mhascreening.org. The results from those screenings continued the upward trends in mental health conditions observed by MHA – and confirmed by recent analysis from the U.S. Census Bureau – since the start of the COVID-19 pandemic.
“Our May screening numbers were unprecedented,” commented MHA President and CEO Paul Gionfriddo. “And what is most troubling,” he added, “is that the numbers – consistent with the numbers from the U.S. Government’s Census Bureau - demonstrate not only that there is not yet any relief from the mental health impacts of the pandemic, but that the impacts actually seem to be spreading and accelerating.”
Gionfriddo also emphasized on the suicidal/self-harm ideation numbers. “These numbers are just so striking. When you consider that a total 45,000 to 50,000 Americans die by suicide every year and nearly half that number reported suicidal or self-harm thinking in just May alone, this has to be a wake-up call to policymakers to act now to prevent this,” he said.
“There are three options immediately available to federal policymakers – pass the 988 legislation already approved by the Senate, pass the funding for the mental health block grants and other safety net mental health providers and services already approved by the House, and work together to make mental health screening the norm for the entire population to find new cases of mental illnesses as soon as they emerge.”
Since the beginning of the pandemic:
· There have been at least 88,405 additional positive depression and anxiety screening results over what had been expected (using November 2019-January 2020 average as a baseline).
· There have been 54,093 additional moderate to severe depression and more than 34,312 additional moderate to severe anxiety screening results from late February through the end of May.
· The per day number of anxiety screenings completed in May was 370% higher than in January, before coronavirus stress began. The per day number of depression screens was 394% higher in May than in January.
· These impacts on mental health are more pronounced in young people (<25): roughly 9 in 10 are screening with moderate-to-severe depression, and 8 in 10 are screening with moderate-to-severe anxiety.
· “Loneliness and isolation” is cited by the greatest percent of moderate to severe depression (73%) and anxiety (62%) screeners as contributing to mental health problems “right now.”
· In May 2020, 21,165 depression screeners reported thinking of suicide or self-harm on more than half of days to nearly every day, with 11,894 reporting these thoughts nearly every day.
· Special populations are also experiencing high anxiety and depression, including LGBTQ, caregivers, students, veterans/active duty, and people with chronic health conditions.
· This isn’t just affecting people with anxiety and depression, but other mental health conditions, too. Among all psychosis screeners in May, more than 16,000 were at risk of psychosis, and the percentage at risk (73%) also increased.
MHA has had an online screening program since 2014. People who come to the website can screen anonymously and for free, using the same evidence-based mental health screening tools that are used by most clinicians. Over five million people have taken a mental health screen in the last 5 years. More than 300,000 took an anxiety screening in 2018 and 2019 alone. Most people who take a screen have never been diagnosed with a mental health condition.
MHA will continue to monitor its screening data and report out details in the coming weeks and months. To take a mental health screen, visit www.mhascreening.org. MHA offers customized resources to everyone who takes a mental health screen, based on the screen taken, severity of the result, age of the individual, and other factors.
COVID-19 and Mental Health: What We Are Learning from www.mhascreening.org
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