TED Talk: Sebastian Junger "Our lonely society makes it hard to come home from war"

Today we watched a TED Talk about PTSD and its causes. Sebastian Junger states that he had a minor case of Temporary PTSD when he came home from a trip to war, but ended up having it go away rather quickly. The problem is, however, when soldiers come back from war and they end up with chronic PTSD that lasts for years and years, and the rates seemed to be going up.

TED Talk Sebastian Junger 

Junger concluded that the PTSD rates that were going up weren't from more trauma, but by how the soldiers were treated when the war was over. He thought over the Apaches and Cherokee Indian tribes that he had studied in college and wondered why the rates of PTSD hadn't been high in these nations that battled frequently with the US or other tribes. He decided that the reason was because they went home to a tribe that understood what they'd been through. He realized that since these soldiers were leaving their close knit platoon to a lonely society, they were going to have higher rates of trauma that might not actually be there. He says that depression in society goes up the wealthier people are because people lose those bonds. After 9/11 people all bonded over that trauma, so soldiers were less traumatized after war during the time the country was unified. Now that the country is starting to break apart again, people are experiencing more long term PTSD.

Depression in Young People

These are notes taken about a webinar by the National Institute of Mental Health. This is a review of everything talked about during the webinar. 

Why is there Depression?

Sadness and depression can be an evolutionary protection device from negative outcomes. It may be a physic pain or a way of changing one's environment. There may be positivity to negativity. It may be a protection from infections or how we focus on the past (an analytical rumination of thinking).

Is this sadness or depression? For about 3 weeks, a girl named Christina's mood is low, she spends her time alone. Her grades are lowering and she cannot concentrate. Her parents separated very recently.

Five of the following symptoms are present for two or more weeks:

Depressed mood for most of the day, or irritable mood, it has to be present most of the time
Markedly diminished interest or pleasure at all
Significant change in weight when not dieting or weight gain
Insomnia or Hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
Diminished ability to think or concentrate
Recurrent thoughts of death (not just fear of dying) recurrent suicidal ideation without a specific plan or an attempt or specific plan to commit suicide

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Prevalence

10-17% In adults
1-2% in pre-pubertal children
Adolescents with depression are 30% more likely to die of suicide
In its severe form, it affects 9% of adolescents
Second leading cause of people living with disability
More prevalent than other diseases, even cancer

Genes and Environment: Potential Causes

Genes: 30-50% of the liability to depression
Gene-environment correlation: e.g. Increased genetic liability for lifetime traumas
Gene-environment interaction: different genotypes respond to environmental variability in different ways

Ex. Christina's mother is diagnosed with depression during pregnancy. It may pass down to the child. Christina's father lives far away and sees her rarely. He drinks and his company went bankrupt. Since Christina shares genes with both of these people, she has a higher liability in having depression. They also experienced traumatic events, which may affect her more. But since they are correlated, they may end up working together passively or actively. Ex: Since Christina's mother is depressed, they may both become depressed since they share the same genes and experiences.

Dr Kendler used a study on identical and fraternal twins to see how much environment affects liability. Having a traumatic life event increases the chances dramatically. The lowest chances are the ones with genetics that don't react as strongly. The opposite leads to a higher chance of depression in the presence of a life event. So some people may have completely different reactions to the same event.

With the onset of puberty, girls are more likely to have depression than boys. There is a 1 to 2 ratio. It may have to do to with cognitive processing, greater exposure to psychological stressors, or hormonal mechanisms. Girls with an earlier start in their menstrual cycle are more likely to become depressed, it may be because of hormones, or a psychological stressor, or over exposure to other people, they feel uncomfortable around.

There is a debate on whether childhood depression correlates with adult depression, but adolescent depression has shown pathways to adult depression.
Anxiety: early on anxiety precedes depression
Alcohol: Probably an "internalising" way of handling depression
ODD/CD: The strongest predictors for later depression
Behaviour problems and depression are related
40% had disruptive behaviour in their childhood
Highest risk in girls
Youth with CD are twice more likely to have it
Irritable and disruptive behaviour are shown to be directly correlated. What we need to find out is how this transition starts and finding out who has depression and who doesn't.

Depression is a heterogeneous syndrome. It is useful to think of two abnormalities

-Negativity bias and missing the positive
It is more common for someone with anxiety or depression to misinterpret a neutral face as sad or angry.
-They will pick up what is negative in their environment
They will be more likely to miss the positive, such as a smile. A depressed person will relate a smile back to positive less than someone else. Anti-depressants work highly in these areas.
Motivation and reward processing
-Most people go after rewards and feel good when they get it
Anticipatory anhedonia: People with depression will not take the effort to get that reward
People will see this as lazy or a motivation problem, but with depression, it is more that the person can't see why this would be important
Ex: Christina used to dance, but she stopped because they are "no fun at all" She has stopped sending texts to her friends.
People with no processing in the longitudinal segment of the brain are more likely to be depressed in life; this is the segment of the brain that has reward processing.

Phycological and Medical Treatments

Christina's diagnosis was delayed for 18 months. Why?
Parents focused on irritability/oppositionality
Teachers focused on academic performance
She herself could not talk about it, except in terms such as "boring", "annoying" etc.
She was only diagnosed after she took her first overdose and then it became apparent that she had been "cutting" for a while.
It was still hard to explain to her parents the meaning of the problem
She herself was still perplexed

Awareness is key to diagnosis.
Screening is only appropriate in samples that are at high risk. Screening can range from single questions to a questionnaire. Diagnosis should also address the presence of manic symptoms, underlying medical causes (rare), risk assessment, such as past attempts of suicide and cases of depression. They shouldn't have access to guns or drugs.

Not all causes are changeable, such as environment or genes. You may be able to change the relationship between the mother and child or the father and child. Medication can have an effect on behaviour, feelings, and thoughts through the brain, but so does psychological treatments.

The first treatment is a reuptake in serotonin, fluoxetine, sertraline, citalopram
Psychological treatments such as interpersonal treatment or cognitive therapy

There haven't been any sign that one is better than the other. In mild cases, start with CBT/IPT
Some studies show that using them both may be the best
About 60% of young people respond to an antidepressant, however, 50% respond to placebo. This may be related to the severity of the depression, the higher the severity of the depression, the lower they affect to placebo.
The numbers needed to treat a person are 10 and the numbers needed to harm is 112. This is particularly important in the context of suicidality debate and the black box warning.

NEW Core Romeo and Juliet Final

During the entirety of the Mental Health Unit for our core classes we were reading the play Romeo and Juliet. To finish off the unit, two groups had to work together to film an adaptation of the play using a specific theme. My group had to do Act III with a western theme.

Here is the video:

We had about 4 hours to give each other roles and rewrite the script so it would fit inside a ten minute video and be adapted. Then we had 2 more hours to actually execute and film it, then the break to edit and upload. The other themes were:
Act I:  Hunger Games
Act II: Keeping up with the Kardashians
Act III: Western
Act IV: Harry Potter
Act V: Real Housewives

Eating Disorders

Today in NEW, the students had discussions about eating disorders. In groups of three, each person researched a specific disorder. Here are the links to information about each of these disorders, along with key facts discussed among the group.

Anorexia Nervosa 
Anorexia Nervosa is the physiatric disease with the highest death rate (5%-20%). It is most commonly found in women, but there have been growing numbers of men who have also contracted this disease. It is a mental disorder that makes the person feel like they have to lose weight or else they feel worthless. The individual has irregular eating behaviors that lead to them not eating what is necessary for them to survive, as they feel guilt when eating. They essentially end up starving themselves, which is what leads to the high mortality rate. The physical causes have been tied to genetics, nutritional deficiencies, and irregular hormone functions. There are many environmental factors as well, such as careers that promote weight loss, trauma, thin culture in media and peer pressure.

Bulimia Nervosa 
The individual binge eats then feels guilt from eating and purges themself. It can be vomiting, laxatives, over-exercising. They usually have low self-esteem, they can have discolored teeth, callouses. They might have swelling in their jaw and cheek area. They're isn't any dramatic weight change. They won't eat in front of people and make trips to the bathroom after eating. It affects 1-2% of people, 80-90% of them are women and is usually paired

Binge Eating Disorder
Most common eating disorder in America. It is when they get anxious about how they eat and eats a lot in one sitting. They can end up having diabetes and being overweight, feeble bones, fatigue. Eating episodes are usually caused by anxiety, some people who binge eat don't realize it. Some people do it while watching TV. They usually eat foods high in sodium and fat. 3.5% of the population has this disease.

Teens and Mental Health: Suicide Prevention

Today the people of Project SUCCESS came to talk to us about mental health. People don't tend to talk about mental health as much as physical health. Project SUCCESS is a student support program. They provide free counseling, groups, and substance abuse groups.

Now, what is a mental illness?
Some people see a stigma around mental illness as if it doesn't exist and the person is just 'crazy' or 'worried' or 'sad'. Mental disorders is a diagnosable illness that affects a person's thinking, emotional state, and behavior. It disrupts the person's ability to work or attend school, carry out daily activities or engage in satisfying relationships.
Diagnosis
The only way to get a diagnosis is if you meet certain criteria by a medical professional.
What is anxiety?
When I think of anxiety, I think of someone who is nervous and has trouble putting themselves out there in worry that it would add up to regrets.
There is normal anxiety and then there is problematic anxiety. When anxiety is good it keeps you on your toes and ready to perform, like before a test or public speaking. It keeps you ready to go.
The problem is when there is a persistent or severe worry that becomes hard to control. This is when the anxiety is greater than the actual situation. Symptoms must be present for 6 months or longer. There are many versions of anxiety.
Some symptoms of anxiety:
Emotional: Feeling of dread, difficulty to concentrate, tense, nervous, expecting the worst, short-tempered, restless, jittery, watching for signs of danger, feeling like your mind has gone blank
Physical: Heavy heart rate, sweating, shortness of breath, nausea, insomnia
It becomes a problem once the anxiety is constant and overwhelming, interferes with relationships and activities, and interrupts daily activities, such as going to school, work, hanging out with friends, going to the store, etc.
Types of anxiety
Generalized anxiety: having an obsessive and constant worry
Social anxiety: overwhelming worry and self-consciousness about everyday social situations
Specific phobias: intense fear of a specific object
Panic disorder: feelings of terror that strike suddenly and repeatedly with no warning
Others: Obsessive Compulsive Disorder and Post Traumatic Disorder
What could be causes of anxiety?
Anxiety can be caused by genetics, substance abuse, medical conditions or brain chemistry. It can be caused by environmental reasons like abuse, trauma, high stress and violence. It can also be caused by life circumstances such as significant losses and major disappointments, divorce, stressful situations, unresolved family conflict, extremely high expectations of yourself or put on by others.
What is depression?
When someone has depression they have a loss of enjoyment or depressed mood for two or more weeks. Impairment function socially, occupationally, and or educationally.
5 or more of the following symptoms:
Depressed mood or irritability
Decreased interest or pleasure in most activities
Significant weight change or change in appetite
Change in sleep; insomnia or hypersomnia
Change in activity, agitation or apathy
Fatigue or loss of energy
Guilt/worthlessness
Concentration: diminished ability to think or concentrate
Suicidality: thoughts of suicide or has a plan

Sadness and Depression are very different
Sadness is a normal human emotion all people experience it, usually caused by a difficult, challenging, hurtful, or disappointment, feeling bad about something in particular and when something changes, it goes away
Depression: Isn't caused by a certain event, and it won't just go away
Some causes for Depression: Trauma, loss, it might be hereditary, or in your brain chemistry, or environmental reasons, or medications or alcohol or drugs. Depression can also occur without any of these causes.
Treatments for mental disorders
It is a necessity to help get over it.
There's psychotherapy, and/or medication, most effective if put together
To receive treatment, visit your doctor. they can rule out and medical issues, refer to any necessary resources and prescribe medication if needed.
Seek out counseling resources: involves talking with a mental health professional about medical problems.
Why is it necessary?
Without treatment: the symptoms can get worse, other problems can occur
Problems in school, running away, social isolation, drug and alcohol abuse, internet addiction, reckless behavior, violence, low self-esteem, self-harm behaviors or suicide.
Teen suicide
There is a difference between self-harm and suicide.
People can see suicide as the only way to recover.
Not a lot of people with a mental disorder commit suicide but
90% of people who commit suicide are untreated or under-treated.
2nd leading death for 10-24 year olds.
QPR
Warning signs of suicide: Talking about death, they give out their possessions, self-harm, if someone who is usually depressed is suddenly happy, threats to kill themselves, making a plan, strong wish to die, preoccupied with death, anxious and depressed, not sleeping, abusing substances.
Behavioral clues: Previous attempt, acquiring a gun or stocking on pills, co-occurring depression, moodiness, hopelessness, putting personal affairs in order, giving away prized possessions, sudden interest or disinterest in religion, unexplained anger, aggression and irritability.
Situational clues: Being expelled from school, fired from their job, family problems, alienation, loss of a major relationship, death of a friend or family member especially if by suicide, diagnosis of a serious or terminal illness, sudden loss of freedom, fear of punishment, a victim of assault or bullying.

Q uestion .... a person about suicide
P ersuade ....them to get help
R efer .... to other resources
You can be direct about it and ask, "are you suicidal? are you thinking of ending your life?, do you wish you were dead?" etc. Always ask, but if you can't get someone who can have resources available.
Persuade them by saying "will you let me help you, will you go with me to get help?"
Suicide is not the problem, only the solution to a perceived unsolvable problem
Refer them to others like teachers, counselors, student advisors.
Say "I'm on your side, I want you to live" etc. At school you can refer to academic counselors, teachers, CAPE, on-site counselors.
Outside of school:
Police officers, therapists, a trusted adult/parent, suicide hotline, any emergency room.
Call 911 if:
they have a weapon
overdose on pills
immediate intent to kill self or others
posts on social media threatening suicide

Guest Speakers: Alcoholics Anonymous

This week, guest speakers from Alcoholics Anonymous, a non-profit dedicated to helping people get sober, came to talk to us about their organization and what to do if we ever come across a situation involving alcoholism. Alcoholics Anonymous is an organization that involves meetings with other people with the same problem. Each meeting is different, led by different people so they do different things. People with alcoholism problems can find help through the program, only having to pay for individual meetings, and not being forced to do anything they don't want to. Alcoholism is a constant struggling disease, people with it have trouble not going back to their old habits. It can change the way you think about life, ruin relationships and cause serious damage to your life. Alcoholics Anonymous also has programs for people who know alcoholics so they can help themselves and the alcoholic. If you feel that you are falling into a routine that involves drinking uncontrollably, or you know someone who does, see if there's an AA meeting fitting your demographic near you.

A Glass of Water

Emily Gonzalez

Neto

Tucker

12/6/16

A Glass of Water

Eyes opened, light flooded into my eyes. The doors slammed into the wall, my eyes fluttering open with it. A foggy image of reality fell around me. I heard mumblings, they sounded like my mother, and the doctor. I reached my hand to wipe away at my puffy eyes. Even as I blinked, nothing seemed to stay in focus. I waddled a little while getting up, and the sounds of speech bounced through my ear, bouncing across the inside of my skull, falling down to my throat. My eyes heated up, I choked back my food. I breathed hard, hoping the others didn’t notice, then sat back.

My mom reached for my hand. I smiled. I still couldn’t see every line of her face, but I could feel the warmth in her hand. The doctor was still speaking. I managed to catch a few words, even if they were all just falling to my stomach. More treatments, a surgery. He said it wouldn’t be long before we got out of here. It cheered me up, very little. I could finally stop stealing away all of our money, my future, my life back at home. I could go home, to a warm bed with plush bears and pillows. I could get back to school work, something I’d never thought I’d say positively.

My heart beat a little faster. I noticed that the feeling wasn’t going away, I still felt as if two text books were being pushed against each of my ears, the bed was floating in the ocean, and clouds were over my eyes. I started to yawn, but almost gagged. I clenched my stomach. They looked at me, so I tried to say I was okay. I was trying to wrap my tongue around the words, but just signaled it with my hands. They went back to talking.

That’s when I noticed the glass of water next to me, from the night before. There was food, sure, but I didn’t want to put that in my stomach, it already had enough knots in it, I didn’t need more. The glass was out of reach, but if I got it the other day, I could get it now. I lifted my arm up, but my mom talked to me again. She pointed at the food, but I rolled my eyes and shook my head. I could tell my mom was stern, pointing at the food. I sighed and grabbed a fork, and my mom sighed before going back to talking about prices and insurance and the whatnot, something I wasn’t old enough to understand, or at least that’s what she told me when I asked about it. I kept on looking back at the glass. I put a roll in my mouth, which felt more like a sponge that took in all my built-up saliva. I sniffed and wiped away the tears my eyes kept on making.

Even if all I could focus on was a glass of water, it was something. My focus kept on going from my mom, to the doctor, to the background, to the window that led to the world I hadn’t seen in days, weeks now? How long had it been? Why, why couldn’t I remember...why wasn’t I speaking? Had something gone wrong, what was going on? I reached for breath. Heart beats pushed at my ears so hard my eyes were watering, there was bread at the back of my throat. I gasped for air.

My dry lips stung. I lifted my arm to grab the glass. No one saw. I pushed myself over, noticing my wobble, my eyes refocusing. I did it again, again, until I was sure the bread would spill out of my mouth any minute. I reached up to the glass. I put my hand around it. I put all my energy to move every finger, every bone, until they fit around. Wait, why was I overthinking this? It was just a glass? I took in a deep breath, letting a few tears fall. I took advantage that they still hadn’t seen. I pushed my palm against the glass, then pulled back. That’s when all my attention went into the glass. My fingers...they weren’t working. In a split second, I had lost control. The glass slipped, I felt the cold run through my fingers like silk. My heart stopped when I couldn’t feel it anymore, when gravity took its toll. The shattered glass punctured my inner ears, bursting my brain. The mosaic of a mess painted the floor. My tears weren’t distinguishable from the water.

That’s when they turned back. I jumped back. I held my head in my hands, warming them with wet tears. I couldn’t look at them. My mom moved closer, trying to comfort me, I pushed her back. The doctor called for someone to clean the mess. He tried to comfort me too, but I pushed him back too. I held my head in my hands again, trying to find comfort in the home that was my mind, my, my mind. The mind that couldn’t even lift a glass. Would I ever be able to lift one again?

When time died down my shock, when the glass was gone, and when the room was silent, I finally answered them. I pushed at my chest, trying to get the air to talk, “I-I w-was thirsty.”

They said they could have given it to me. I looked down at the ground, realizing that they thought I was upset at breaking the glass. They got me another glass. They were giving all their attention to me. Pins pierced the back of my neck as I looked up at them. Eyes watering, my back tingling, with a foggy mind and clouded eyes, and stomach that wouldn’t hold. I smiled. I even laughed.

“Don’t worry, it was just a glass of water…”

Works Cited

"Medulloblastoma." St. Jude Children's Research Hospital. N.p., n.d. Web. 07 Dec.                       2016.

"Cerebellum." Cerebellum Function, Anatomy & Definition | Body Maps. Healthline, 5 Mar. 2015. Web. 07 Dec. 2016.

Foundation, Brain Science. "Coping With Personality and Behavioral Changes." Coping With Personality & Behavioral Changes. Brain Science Foundation, 2003. Web. 07 Dec. 2016.