Publications - Anxiety Disorders

Does weed help with anxiety or cause it? Here’s what experts say., by Teddy Amenabar, The Washington Post, May 3 2023.

“Cannabis has different effects at lower doses than high doses. Generally, low doses of THC are well-tolerated, stimulating a release of dopamine, and higher doses of THC can cause people to feel anxious, said Peter Grinspoon, a primary care physician at Massachusetts General Hospital and the author of “Seeing Through The Smoke,” a book reviewing the latest medical research on cannabis.  “The main way you can get into mischief with cannabis is by using too high a dose and becoming very, very anxious,” said Grinspoon, who’s also an instructor at Harvard Medical School. “There are some patients who can’t use it at all, even a teeny bit, because any little bit makes them anxious.” Cannabis affects virtually every neural connection in the brain, even more so than stimulants such as cocaine and opioids, said Judy Grisel, a professor of psychology at Bucknell University and the author of “Never Enough: The Neuroscience and Experience of Addiction.” This, in turn, means cannabis can cause a wide array of reactions, depending on the person, she said.    Decades of clinical research has found THC can negatively effect the developing brain, and regular cannabis use in the teen years is associated with a higher likelihood of developing anxiety and depression later in life.  “Smoking early can catalyze anxiety and depression,” Grisel said. “It’s not exactly clear how that happens but the evidence for it is very strong.” ”

Kids’ Declining Mental Health Is the ‘Crisis of Our Time,’ Surgeon General Says, by Caitlynn Peetz , EducationWeek, Apr 25 2023.

“In a conversation with Vermont Sen. Bernie Sanders livestreamed on Twitter, Murthy called the increase in youth mental health needs “the defining public health crisis of our time,” and underscored that kids’ mental health has taken a hit as they turn to social media more often and at younger ages. The increased use has led to more feelings of isolation, stress, and inadequacy as they constantly compare themselves to others, he said. It also keeps kids awake well into the night when they should be getting much-needed rest and makes it harder for young people to focus.  The most recent results of the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey showed an alarming increase of self-reported mental health challenges, most notably among girls and children who identify as LGBTQ+. The survey was conducted in 2021, when many schools were still in remote or hybrid learning, but illustrates how sharply children’s mental health needs have increased in recent years. In 2021, for example, 42 percent of high school students said they experienced persistent feelings of sadness or hopelessness during the past year, according to the report. This was a 13.5 percent increase from 2019 and a 50 percent increase from 2011. Nearly one in five high school students had seriously considered attempting suicide during the previous year, while 18 percent made a suicide plan, and 10 percent attempted suicide. The CDC’s report does not explore what is driving the increased challenges. The rates were higher among girls and students who identify as LGBTQ+. ”

Are you ready to forgive? A new study shows letting go is good for health., by Tara Parker-Pope, The Washington Post, Apr 20 2023.

“While the act of forgiving is often discussed by faith communities, Worthington has found that a secular approach to forgiveness also can be a useful strategy in improving health. He and his colleagues recently completed a study conducted across five countries showing that when forgiveness is taught, practiced and achieved, the result is better mental and overall well-being.  Worthington developed workbooks and included exercises and prompts that allow people to explore feelings of anger and resentment and learn to let go of them.  The latest version, which is free to download in five languages, promises that you can become a more forgiving person in about two hours, and includes thought exercises to help explore specific transgressions and work through feelings of anger and resentment. It’s based on the most effective exercises used in prior research, and has been condensed to save time and make the program more accessible. The randomized study, which was conducted among 4,598 participants in Hong Kong, Indonesia, Ukraine, Colombia and South Africa, asked half the participants to complete the workbook exercises over a two-week period. (The other half were allowed to try the workbook later.) After two weeks, the study showed that the workbook had promoted forgiveness and shown a statistically meaningful reduction in depression and anxiety symptoms among users compared with the control group. The research is being presented this weekend at Harvard University at an interdisciplinary conference on forgiveness.  ”

988 Lifeline sees boost in use and funding in first months, by Rhitu Chatterjee, NPR, Jan 16 2023.

“The 988 Suicide and Crisis Lifeline received over 1.7 million calls, texts and chats in its first five months. That's nearly half a million more than the old 10-digit Suicide Prevention Lifeline fielded during the same period the year before.  Launched in mid-July last year, the 988 number is modeled on the 911 system and is designed to be a memorable and quick number that connects people who are suicidal or in any other mental health crisis to a trained mental health professional.  "We see the uptick in volume as an indicator that more people are aware of the service and are able to access it," says Kimberly Williams, the president and CEO of Vibrant Emotional Health, the non-profit that oversees the national 988 network of nearly 200 crisis centers spread across the nation. ”

Mental health-related emergency department visits and revisits are on the rise among children, study finds, by Jacqueline Howard, CNN, Dec 27 2022.

“Emergency department visits and revisits in children’s hospitals that are related to mental health are “increasing rapidly,” a new study suggests.  Between 2015 and 2020, mental health visits in pediatric emergency departments increased by 8% annually, with about 13% of those patients revisiting within six months, according to the study published Tuesday in the journal JAMA Pediatrics. Whereas, all other emergency department visits increased by 1.5% annually.  Mental health revisits increased by 6.3% annually, but in general, the percentage of mental health visits that had a subsequent revisit remained stable, “which may reflect that the factors associated with revisit did not change substantially during the study period, even as the pediatric mental health crisis worsened,” wrote the researchers, from Children’s Hospital Los Angeles, the University of Southern California and Boston Children’s Hospital.  The ongoing surge in pediatric mental health emergency department visits may be associated with “a combination of factors, including a worsening crisis of pediatric mental illness and shortage of mental health clinicians,” the researchers wrote.  The most common diagnoses among the mental health emergency department visits were suicidal ideation or self-harm, representing 28.7% of patients; mood disorders at 23.5%; anxiety disorders at 10.4%; and disruptive or impulse control disorders at 9.7%. ”

Teen brains aged faster than normal from pandemic stress, study says, by Katherine Lewis Reynolds, The Washington Post, Dec 1 2022.

“The stress of pandemic lockdowns prematurely aged the brains of teenagers by at least three years and in ways similar to changes observed in children who have faced chronic stress and adversity, a study has found.  The study, published Thursday in Biological Psychiatry: Global Open Science, was the first to compare scans of the physical structures of teenagers’ brains from before and after the pandemic started, and to document significant differences, said Ian Gotlib, lead author on the paper and a psychology professor at Stanford University.  Researchers knew teens had higher “levels of depression, anxiety and fearfulness” than “before the pandemic. But we knew nothing about the effects on their brains,” said Gotlib, who is director of the Stanford Neurodevelopment, Affect, and Psychopathology Laboratory. “We thought there might be effects similar to what you would find with early adversity; we just didn’t realize how strong they’d be.”  Premature aging of children’s brains isn’t a positive development. Before the pandemic, it was observed in cases of chronic childhood stress, trauma, abuse and neglect. These adverse childhood experiences not only make people more vulnerable to depression, anxiety, addiction and other mental illnesses, they can raise the risk of cancer, diabetes, heart disease and other long-term negative outcomes. ”

In one first-grade classroom, puppets teach children to 'shake out the yuck', by Cory Turner, NPR, Nov 11 2022.

“The five-minute video students watch is part of a series produced through a new pilot program called Feel Your Best Self, or FYBS. Each video is built around a simple strategy to help kids recognize and manage their feelings – or to help friends who are struggling.  "It's taking what we know works," says Emily Iovino, a trained school psychologist who is part of the FYBS team.  What works, Iovino says, is something called cognitive behavioral therapy, which involves all sorts of practical skill-building, including learning to change negative thinking patterns, better understand others' motivations and face fears that may fuel unhealthy avoidance behaviors.  It may sound simple, but Iovino says, it's a strategy known as "cognitive restructuring, which is teaching someone how to recognize an emotion, name that emotion, and then be able to work to shift thoughts – to feel something different." While the videos may be steeped in research, they sport kid-friendly names like "Float Your Boat" and "Chillax In My Head," and spotlight puppet heroes CJ, Mena and Nico, who are rendered in warm purples and reds, with emotive smiles and saucer eyes reminiscent of "Sesame Street."  Denoya, the first-grade teacher at Natchaug Elementary, has seen it firsthand: Kids returned from the pandemic with missing or rusty social and emotional skills. They had trouble sharing, learning how to take turns and dealing with disappointment.  "There's just things that they missed out on with not having that socialization, and so we need to find a place to teach it at school too," Denoya says. ”

10 ways to get mental health help during a therapist shortage, by Lindsey Bever, The Washington Post, Oct 29 2022.

“Anxiety and depression have been on the rise in the United States since the start of the pandemic. This has led to a crisis in mental health that has been worsened by the shortage of mental health counselors.  A significant number of mental health professionals are not accepting new clients. Others have long waiting lists.  The Washington Post asked mental health professionals what advice they would give people who are struggling to find a therapist. About 300 experts from across the country responded with advice on getting an appointment — and tips on what people can do in the meantime to try to help themselves. Here are their recommendations. ”

Long waiting lists, long drives and costly care hinder many kids’ access to mental health care, by Brenda Goodman, CNN, Oct 6 2022.

“Norris is one of more than 2,000 adults surveyed this summer by CNN and the Kaiser Family Foundation about mental health issues in America. The nationally representative sample included more than 500 parents.  Nearly half of those parents, 47%, say the pandemic has negatively affected their kids’ mental health, with 17% saying it had a major negative impact.  More than 8 out of 10 parents said they’re at least somewhat worried about depression, anxiety, alcohol and drug use negatively affecting the life of US teens, while roughly three-quarters said they were worried about self-harm or pandemic-related loneliness and isolation.  More than 4 in 10 said they were very worried about alcohol and drug use, anxiety and depression affecting teens. Lower-income parents – those making less than $40,000 a year – were more likely than those in higher-income households to say they’re very worried about self-harm, eating disorders, depression and alcohol and drug use.  According to the survey, more than half of Americans (55%) think most children and teenagers in the US aren’t able to get the mental health services they need. ”

4 emotional workouts to help you feel empowered and promote resilience, by Juli Fraga, The Washington Post, Sep 28 2022.

“As the pandemic continues, so does the mental health crisis. Many of us are struggling with the grief and trauma the coronavirus unleashed, as well as stressors such as mass shootings and climate change. With so much suffering, there is a greater need for therapy, but many psychotherapists — myself included — can’t meet the rising demand.  One possible solution, says clinical psychologist Emily Anhalt, is to add an “emotional workout” to your self-care regimen. “Just like working out prevents high blood pressure and heart disease, emotional fitness can be a proactive stance toward stress management,” says Anhalt, the co-founder of Coa, a gym for mental health.  Self-care tools can be helpful, especially when barriers such as high-deductible insurance plans, high co-pays and living in remote areas can make mental health care difficult to afford or access. And while the pandemic isn’t solely to blame for the lack of therapists, it’s certainly made things worse, says Vaile Wright, the senior director of health-care innovation at the American Psychological Association.  With too few mental health resources, we need innovative ways to make psychological care more accessible, she says. If you’re waiting to see a therapist, can’t afford mental health care or have recently finished therapy, emotional exercises are one way to strengthen your psychological muscles. While these workouts aren’t meant to replace individual or group therapy, Anhalt says they can promote resilience and help you feel empowered. ”

4 emotional workouts to help you feel empowered and promote resilience, by Juli Fraga, The Washington Post, Sep 28 2022.

“Self-care tools can be helpful, especially when barriers such as high-deductible insurance plans, high co-pays and living in remote areas can make mental health care difficult to afford or access. And while the pandemic isn’t solely to blame for the lack of therapists, it’s certainly made things worse, says Vaile Wright, the senior director of health-care innovation at the American Psychological Association.  With too few mental health resources, we need innovative ways to make psychological care more accessible, she says. If you’re waiting to see a therapist, can’t afford mental health care or have recently finished therapy, emotional exercises are one way to strengthen your psychological muscles. While these workouts aren’t meant to replace individual or group therapy, Anhalt says they can promote resilience and help you feel empowered. ”

Youth Mental Health Was Declining in the U.S. Long Before COVID-19, by Brian Mastroianni, Healthline, Sep 26 2022.

“There have been several studies that have zeroed in on the state of mental health for young people today, both in the United States and around the world.  Now, a recent report is shedding light on mental health trends for children and adolescents, giving clarity to the fact that a lot of these problems (while exacerbated by the global pandemic) have been present before the emergence of the coronavirus outbreak and likely will continue to be a major issue as it subsides.  Experts say research like this is important in providing a pathway for educators, policymakers, and parents and guardians alike to provide better systems of support and interventions for young people as they encounter the realities impacting their mental health today. ”

In a first, health panel calls for routine anxiety screening in adults, by Rachel Zimmerman, The Washington Post, Sep 20 2022.

“The draft recommendations, from the U.S. Preventive Services Task Force, are designed to help primary care clinicians identify early signs of anxiety during routine care, using questionnaires and other screening tools.   Anxiety disorders are often unrecognized and under detected in primary care: One study cited by the task force found the median time for initiating treatment for anxiety is a staggering 23 years.  ”

As school starts, teachers add a mental-health check-in to their lesson plans, by Rhitu Chatterjee, NPR, Sep 2 2022.

“As the new school year begins, teachers at many schools across the country are adding a new component to their routines: a mental health check-in with their students. The idea is to open up conversations around how kids are feeling emotionally, and to connect them to help before issues escalate to a crisis. [...] The new approach comes after two and a half rocky years of pandemic, with kids' lives disrupted by bouts of remote schooling and many families in economic stress, which worsened the already shaky state of children's mental health in the U.S. In 2020, the CDC reported a greater proportion of kids showing up at emergency rooms in a mental health crises: serious suicide attempts, eating disorders, aggressive behaviors. "The thing that's most concerned us was really the number of significant self-harm and suicidal ideation that we've seen in an emergency room," says Dr. Smriti Khare, pediatrician and the chief mental and behavioral health office at Children's Wisconsin, in Milwaukee, which saw a 40% rise in visits to the ER after the start of the pandemic in 2020 compared to the year before. ”

The Mental Health Effects of Ghosting, by Dan Mager, MSW, Psychology Today, Aug 31 2022.

“Other research indicates the adverse effects that ghosting can have on mental health and emotional well-being.[3] Short-term consequences included overwhelming rejection and confusion along with wounded self-esteem. Contributing factors involved the lack of closure and clarity—not knowing why communication abruptly stopped, leaving the person being ghosted trying to make sense of the situation. Long-term effects for “ghostees” centered around feelings of mistrust that developed over time, in some cases spilling over to future relationships. Such experiences often precipitated internalized rejection, self-blame, and feelings of low self-worth. However, there were also psychological consequences for those perpetrating ghosting. Approximately 50 percent of those who ghosted others experienced feelings of guilt or remorse or guilt. Findings also suggested that as people increasingly utilize ghosting as a way of ending relationships and essentially practice “serial ghosting,” it can become habitual. This has the potential to inhibit personal growth as genuine intimacy becomes more unfamiliar and “ghosters” become more and more comfortable avoiding it. ”