Publications - Anxiety Disorders

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. ”

Confronting Health Worker Burnout and Well-Being, by Vivek H. Murthy, M.D., M.B.A., New England Journal of Medicine, Aug 18 2022.

“Expressions of gratitude have too often been replaced by hostility, anger, and even death threats toward health workers, as health misinformation has exploded, eroding trust in science and public health experts. Yet doctors, nurses, pharmacists, social workers, respiratory therapists, hospital security officers, and staff members of health care and public health organizations continue showing up to battle the pandemic and its sequelae — long Covid, mental health strain, widening health disparities, and 2 years’ worth of deferred care for myriad conditions.  The toll on our health workers is alarming. Thousands of them have died from Covid. More than half of health workers report symptoms of burnout,1 and many are contending with insomnia, depression, anxiety, post-traumatic stress disorder, or other mental health challenges.2  ”

Men’s Body-Image Issues Got Worse During the Pandemic—Even if Many Didn’t Realize It, by Heidi Mitchell, The Wall Street Journal, Aug 14 2022.

“Having a negative body image has long been considered a female problem. Countless books, videos and after-school specials have been devoted to highlighting the concern and the damage it does to girls and women.  But men are nearly as likely to suffer from negative body-image concerns—and studies suggest that the stress and anxiety of the pandemic only made things worse.  Body dysmorphic disorder (BDD)—a clinical disorder in which people become preoccupied with a perceived imperfection in their physical appearance to the point that it causes them significant emotional distress or interferes with their day-to-day functioning—was first listed in the Diagnostic and Statistical Manual of Mental Disorders in the 1980s. Population studies show that 2.4% of Americans currently suffer from BDD, though most experts believe this number is underreported and may impact up to 3% of the population. [...] Without proper treatment, the consequences for men with BDD can be severe. About 80% of these men have had suicidal ideation at some point during their lives, and about 25% have attempted suicide. Signs of BDD include spending at least one hour a day thinking about perceived defects, obsessively looking at or avoiding mirrors, compulsively comparing oneself to others, missing work or school, an increased likelihood of alcohol or drug abuse, anabolic steroid usage (among men with muscle dysmorphia), and a feeling that one looks unattractive or even hideous. ”