TIME Mental Health/Psychology

What 28-Years of Solitary Confinement Does to the Mind

Alone prisonner
Getty Images

One Louisiana prisoner may get out of solitary confinement after nearly 30 years

Kenny “Zulu” Whitmore, 59, has spent the last 28 consecutive years in solitary confinement in Louisiana State Penitentiary at Angola, but a prison warden says he may be released to the general inmate population.

Whitmore reportedly spends 23 hours a day in a 6-foot by 9-foot cell. “We will get him out,” Warden Burl Cain, warden of the prison, told the Medill Justice Project, a group that investigates potentially wrongful convictions. “We’d rather him out. I need his cell. I’ve got some young people, predators, that need to be in that cell. When I can conclude he’s not going to cause me the blues, then he can come out of the cell.” Whitmore is in prison for second-degree murder.

According to the Medill Justice Project, Whitmore’s eyesight has deteriorated and he has hypertension. And if he’s similar to other cases of prisoners in solitary confinement, his health and mental health have likely deteriorated in other ways, too.

“Human beings require two very basic things: social interaction and meaningful activity. By doing things we learn who we are and we learn our worth as a person. The two things solitary confinement does is make people solitary and idle,” says Dr. Terry Kupers, a professor of psychiatry at the Wright Institute in Berkeley California, who has spent over 40 years interviewing thousands of solitary confinement prisoners.

Though the impact of solitary confinement can differ person to person, there are some basic symptoms that are particularly widespread among inmates. Prisoners of long-term confinement—which Kupers says that’s about three months, though for some effects start to appear much sooner—often experience high anxiety that can cause panic attacks, paranoia and disordered thinking, as well as anger and compulsive actions, like pacing or repeatedly cleaning the cell. Basic cognitive functions are also dulled. “I have prisoners tell me they quit reading, which is one of the only things you can sometimes do,” says Kupers. “I ask why, and they say it’s because they can’t remember what they read three pages before.”

Prisoners in solitary confinement often develop confusion over when to be alert and when to sleep. In a report, Psychiatric Effects of Solitary Confinement, Stuart Grassian, a former faculty member at the Harvard Medical School and a consultant in criminal cases writes: “[Solitary confinement prisoners] often find themselves incapable of resisting their bed during the day—incapable of resisting the paralyzing effect of their stupor—and yet incapable of any restful sleep at night. The lack of meaningful activity is further compounded by the effect of continual exposure to artificial light and diminished opportunity to experience natural daylight.”

Grassian tells TIME that without stimulation, people’s brains will move toward stupor and delirium—and often people won’t recover from it.

Even when prisoners are let out of solitary confinement, Grassian says, they are so overwhelmed by stimulus that they become incapable of tolerating their new environment and have trouble integrating back into the general population. Their brain waves jump and they become highly reactive. “I’ve talked to many of these prisoners who say it’s hellish for them,” says Grassian. “The often end up spending a tremendous amount of time in their cell.”

Whether Whitmore will be released into the general prison population remains uncertain but the fact that he has been attempting to take legal action against the prison may work in his mental favor, since Grassian says thinkers tend to do better.

“People that can use their minds tend to do relatively better,” he says. “They are able to maintain a degree of stimulation internally.”

And that’s all many can rely on.

TIME Aging

3 Simple Lifestyle Habits That May Slow Aging

There's more evidence for eating well, sleeping, and exercising

Stress makes our bodies age faster, but thankfully we can combat that with healthy eating and exercise, a new study says.

When cells age, telomeres—tips at the end of chromosomes—shorten. Telomeres help regulate the aging of cells, and their length has been used to determine the body’s current state of health. Things like stress and lifestyle behaviors can influence their length, as compelling earlier research has shown. In the new study, University of California, San Francisco, researchers looked at 239 post-menopausal women for a year and found that for every major life stressor they experienced during the year, there was a significant shortening in their telomere length.

That’s not great news, but the researchers also discovered that the women who ate a healthy diet, exercised and slept well had less shortening of their telomeres. It could be that the women’s healthy habits actually protect them from cellular aging, even in the face of life’s stresses.

The study, which is published in the journal Molecular Psychiatry, is observational, which means the researchers cannot say with certainty that it was these healthy lifestyles alone that offered them protective benefits. But at the very least, it shows once again that doing our best to eat well, sleep, and exercise can give us an edge.

TIME Diet/Nutrition

Probiotics Primer: What Science Says About Using Bacteria to Treat Disease

A rustic bowl of natural yogurt with blueberries
J Shepherd—Getty Images

Confused about the "good bacteria" that can help health rather than make you sick? Here's the latest on which bugs are the most effective, and for which conditions.

After training ourselves for so long to avoid bacteria — they’re responsible for serious illnesses, some of which can be life-threatening — it may be time to re-think microbes. Or at least think more broadly about them. We live in concert with millions of bacteria — on our skin and in our mouths, noses guts and reproductive tracts — and these bugs are essential to helping us digest food and keep some of their more unhealthy bretheren at bay.

But do we need to help these invisible populations along by taking probiotics, concoctions of live microorganisms in things like yogurt or increasingly in supplements, that mimic those living in the body? Recent studies link probiotics and healthy bacteria to improving a wide range of health issues, from allergies to obesity. But manipulating the microbiome, as this universe is known, is still based on a very preliminary understanding of what these bugs do and how changing their communities can affect human health. There is a lot, experts say, that we don’t know. Here’s the latest on whether we should be considering probiotics and if so, when and how to take them.

How do I know if I need probiotics?

You probably don’t. Bacterial populations can’t be measured like cells in blood tests, and what’s more important, there’s little solid evidence yet about whether there is a “normal” healthy microbiome. That also means that it’s not clear whether changes in these communities can actually cause disease, or that “fixing” these differences can treat disease symptoms.

The exception may be some severe digestive and gastrointestinal problems, for which doctors may recommend probiotics. Some doctors are using probiotics to combat diarrhea associated with antibiotic use among kids, for example. But these conditions affect only a small percent of the population and don’t involve regular and constant doses of probiotics.

Do we need to be taking probiotic supplements?

No. The supplement industry may suggest that probiotics taken regularly in pill form can be helpful for almost everyone, but there isn’t much science to support that idea, at least not yet. “The supplement industry will often take early science and run with it,” says Gail Cresci of the department of gastroenterology and hepatology at the Cleveland Clinic. She also notes that since supplements are not regulated in the strict way drugs are, consumers won’t know which strains they’re getting when the pick up probiotic supplements, and they also won’t know if those strains are right for treating whatever it is that ails them.

Each of us is home to about 8,000 strains of bacteria, and very few of these have been studied enough to know that they can provide a definite health benefit if we boost their numbers. That’s largely because the microbiome is constantly changing, and even if one strain helps address a child’s diarrhea after taking antibiotics, it may not have the same effect in adults. Our microbiomes change with age, our diet and other factors. “The general, average Joe, does not need to be taking any [probiotic] supplements,” says Cresci. “By taking a supplement, you do not know if the strains included will help you or not. You’re wasting your money.”

What about yogurt?

According to Cresci, the definition for a probiotic is very stringent. While there’s plenty of different bacteria out there, to be considered a probiotic, the bacteria has to be able to survive the environment in the intestines, colon, and provide some sort of benefit for the host. The average yogurt bacteria doesn’t meet these standards, and even if companies toss in another strain, there is still no telling whether it will provide you with any benefit at all. That’s why Dannon, makers of Activia and DanActive, agreed to remove claims that its probiotic products relieved irregularity and could lower the chances of catching a cold or flu when the Federal Trade Commission considered the marketing as false advertising. (There are plenty of other healthy reasons to eat yogurt, such as for the protein and calcium; just don’t expect it to make you regular.)

So, what are probiotics good for?

So far, evidence suggests that probiotics, in addition to other treatments, might be helpful for restoring the balance of microbial communities in digestive tract conditions like inflammatory bowel diseases, which include disorders like Crohn’s. And it may help with constipation, and for preventing diarrhea–especially caused by antibiotics. They are also being studied for treatment for skin infections, allergies, blood pressure, and immune system disorders. But all of these potential uses are still being investigated.

What should I do for good gut health?

If you want to stay regular and maintain a healthy digestive system, says Cresci, “Keep a healthy diet and maintain the good bacteria community already in your gut. Taking a random supplement is just a drop in the ocean.”

We may one day turn to probiotics to help with a number of conditions, but the time, say experts isn’t now.

TIME Infectious Disease

There’s a Vaccine Against Cancer, But People Aren’t Using It

The only vaccine to protect against cancer, the HPV shot, isn't being used by young people who could benefit most

In a new report on immunization rates among young people, the Centers for Disease Control (CDC) reports relatively low numbers of adolescents getting the HPV vaccine, the only vaccine that can protect against cancers — in the cervix, anus and mouth — caused by the human papillomavirus virus.

The new data, published in the CDC’s Morbidity and Mortality Weekly Report, shows that only about one-third of adolescent girls between the ages 13 and 17 got all three doses of the HPV vaccine, which the CDC says is about the same as last year. The shot is recommended to protect adolescents before they become sexually active. Only about 57% of adolescent girls and 35% of adolescent boys for whom the shot is recommended received one or more doses.

The vaccine continues to face challenges from parents concerned that it would promote sexual activity among pre-teens and adolescents, despite data showing that immunized teens aren’t more promiscuous. The CDC data also shows that doctors can play a critical role in discussing the shot with parents and improving vaccination rates. Among parents whose daughters were vaccinated against HPV, 74% said their doctors recommended the vaccine. But the data also showed that among parents who did not vaccinate their girls, nearly half were never told by their doctor that they should consider it. The effect was even greater among boys, where only 26% of parents who did vaccinate their son received any advice from their doctor about it.

To boost vaccination rates, some researchers are investigating whether fewer doses of the vaccine could be effective, and so far those studies look promising.

TIME Stress

Watching TV to Relieve Stress Can Make You Feel Like a Failure

Television set
Getty Images

Losing yourself to the small screen may seem like a good way to relieve stress, but it may only make things worse

It’s almost a reflex — after a tough day, you turn on the TV, or binge-watch your favorite show on Netflix. Getting lost in other people’s troubles, or laughing your way through a sitcom, is a good way to forgot your own worries, right? Turns out that people who rely on TV or video games to relax actually end up feeling like failures afterwards.

Some research has shown that using media can make you more relaxed, since it provides a momentary escape from whatever stresses are eating away at us, but researchers found that particularly busy and fatigued people actually felt guilty about spending so much time in front of the TV. In their study, published in the Journal of Communication, the scientists surveyed 471 people about their previous day, how they felt after work, and what media they turned to at the end of the day.

People who felt especially wiped out saw their media time as a form of procrastination, and felt they were avoiding other important things on their to-do lists. These participants were likely to describe “giving in” to media use, and that feeling prevented them from benefiting from the down time and relaxing. “We are starting to look at media use as a cause of depletion. In times of smartphones and mobile Internet, the ubiquitous availability of content and communication often seems to be a burden and a stressor rather than a recovery resource,” study author Leonard Reinecke of the Johannes Gutenberg University Mainz, Germany said in a statement.

It seems, however, that the content of what people watch on TV can alleviate some of this guilty pleasure perception. Other studies have shown that intellectually stimulating media content (like a History Channel segment or a documentary) can positively impact people’s emotional states, so the study authors believe that watching “low-brow” forms of entertainment (we’re guessing reality TV qualifies here) are more likely to make people feel guilty about using it as a stress-reliever.

The researchers acknowledge that their test set-up can’t prove that watching TV will make you feel worse about yourself; there are certainly other variables that could impact how people feel about their media consumption. If people weren’t satisfied with what they watched, for example, they might have been more likely to feel it was a waste of their time and not as stress-relieving as it could have been. If TV seems too hit-or-miss, there’s always exercise and meditation to help you forget your day.

TIME Heart Disease

Mississippi Men Learn About Heart Disease — At the Barber

172251811
John Sigler—Getty Images

Barbershops may be the new doctor's office, at least in Mississippi where African American men are learning about high blood pressure...while they get their hair cut

Barber shops and hair salons are great community hubs where residents gather for both grooming and gossip. So public health experts in the Mississippi Delta have decided to exploit these social meccas to connect with groups that don’t often see health care providers, including African American men.

Heart disease and stroke, for example, disproportionately affect this population of men, partly due to genetics, and partly due to lifestyle behaviors. But in places like the Mississippi Delta region, these men also do not get regular heart disease screenings. They do, however, go to barbershops for trims and to catch up on community news. So the Centers for Disease Control and Prevention (CDC) is funding a barbershop initiative called Brothers (Barbers Reaching Out to Help Educate Routine Screenings) located throughout the Mississippi Delta, where heart disease and stroke are the second and fourth leading causes of death in black men.

The Mississippi Department of Health spent a year recruiting and training barber shop workers on how to read a blood pressure screening, and discuss risk factors. During appointments, barbers talk to their clients about heart health, take their blood pressure, and refer them to a physician if they need further counseling. Recruitment was, and continues to be a challenge since some of the barbers were on board with the benefits of educating their clients, but worried about whether the program would hurt their business.

So far, thought, the barbers are being pretty persuasive. The project, which involves 14 barbershops that have so far served 686 men, just released its first set of data. Only 35% of the customers said that they had a doctor and 57% did not have health insurance. Among the men who received blood pressure readings, 48.5% had prehypertension, and 36.4% had high blood pressure. The findings, published in the journal Preventing Chronic Disease, shows that the program provides care to men who need it, as well as gives public health care workers a better idea of how prevalent heart disease is in the region, and how many patients are in need of medical care. The next step for the researchers is to create a community health worker network that could introduce these men to the health care system and help them navigate more regular screenings and better treatment of their condition.

Shifting health care from the clinic to the community isn’t a new idea; in some areas, health screenings and education are conducted in churches. But the faithful are a select group, and the study’s lead author says it’s important to bring services to hard-to-reach populations, such as young black men, to where they are. “We realized in our standard community health screenings–which were happening in churches–that we were not reaching adult black men,” says lead study author Vincent Mendy, an epidemiologist at the Mississippi State Department of Health. “We think the best way to reach them is through barbershops.” The program is part of a partnership between the CDC and the Mississippi State Department of Health, and is funded through September 2015.

Mendy is hopeful that the program will reach more men and bring them into treatment, since a similar 2011 initiative in Texas, funded by the National Institutes of Health, found that barbers helped to lower blood pressure in a population of African American men by 20%. Based on this growing body of research, the CDC is considering relying on community health workers to help improve the health of minority groups that have a disproportionate risk of disease and death in the U.S. — but are often outside of the health care system. Barbershops aren’t clinics, but they do seem to be a good place to get health messages across.

TIME Cancer

HPV Test vs. The Pap Smear: Which Detects Cancer Better?

New studies are supporting the role that HPV tests can play in detecting cervical cancer.

When it comes to detecting cervical cancer, the Pap test has been the gold standard for more than 60 years. But as the role of human papillomavirus virus (HPV) in contributing to the cancer has emerged in recent years, screening for HPV has started to rival the Pap. And last week, a study of more than one million women added to HPV test’s utility; it found that the HPV test was more successful in assessing cervical cancer risk than the Pap smear.

With a Pap smear, health care providers scrape cells from the surface of the cervix and analyze them under a microscope for abnormal ones that could turn in to cervical cancer. The HPV test, on the other hand, detects the presence of two strains of HPV, which is responsible for about 70% of cervical cancer cases.

In the recent study, published in the Journal of the National Cancer Institute, women with a negative HPV test had half the risk of developing cancer over three years as women who had a negative Pap test, and similar rates to women who were negative on both tests (known as a co-test). Because most cases of cervical cancer are caused by an infection with HPV, women who don’t show signs of the virus are at a very low risk of developing the cancer –even lower than women who have a negative Pap test.

For that reason, says the study’s lead author Julia Gage of the division of cancer epidemiology and genetics at the National Cancer Institute, “We think that HPV primary screening might be a viable alternative to Pap screening as well as co-testing.”

The potential role of HPV testing as a first line screening tool for detecting cervical cancer is also supported by an April study published in the Lancet that looked at four randomized controlled trials in Europe and concluded that the HPV test was the superior screening method. Other studies in rural populations have also been able to cut down on advanced cervical cancers and deaths using just HPV screening.

That’s why in April, the Food and Drug Administration unanimously approved an HPV DNA test developed by Roche as a primary screening tool for cervical cancer for women ages 25 and older. The test screens for the strains most commonly linked to the cancer — HPV 16 and HPV 18 — as well as for others. Along with the approval, the FDA offered guidelines for how the test should be used, advising that women who test positive for HPV 16 or HPV 18 should have a colposcopy, or a procedure that magnifies the cervix so physicians can take a better look at abnormal cells and take biopsies if needed. If women test positive for other strains of HPV, they should have a Pap test as a follow-up to determine the state of their cells.

Still, while the data appears to be showing that the HPV test is a more accurate predictor of cervical cancer, it’s unlikely it will replace the Pap smear any time soon. “There’s not enough evidence accumulated to have a guideline revision at this point,” says Gage. There’s concern, for example, that HPV tests could lead to more unnecessary and invasive procedures, since just the presence of the virus doesn’t always mean cancer will follow; many cases of infection resolve on their own.

And many physicians have relied on the Pap for so long, that implementation will not be prompt. “I understand that something that’s gospel one year may not be gospel the next, but I still tend to lean towards doing the Pap smear than just an HPV test alone,” says Dr. Mary Jane Minkin, a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine.

Most health groups have adopted a similar wait-and-see approach, relying on a combination of Pap and HPV tests. In 2012, for example, the U.S. Preventive Services Task Force (USPSTF) released updated guidelines for cervical cancer screening, advising Pap testing for women between the ages of 21 to 65 every three years, or co-testing with a Pap smear and HPV test every five years for women ages 30 to 65 with normal screening results. Younger women, experts believe, may be more likely to clear HPV infections so wouldn’t benefit as much from regular HPV testing.

Now that studies are suggesting that HPV may be a useful addition, if not replacement, for Pap testing, doctors and their patients may be able to better exploit opportunities to detect and prevent cervical cancer and keep rates of the disease as low as possible.

TIME Infectious Disease

CDC Lab Director In Anthrax Incident Resigns

MED CDC Anthrax
A sign marks the entrance to the federal Centers for Disease Control and Prevention in Atlanta on Oct. 8, 2013. David Goldman—AP

The lab director is now permanently out of the job

The director of the bioterror lab involved in an incident which caused over 80 lab workers to be potentially exposed to anthrax has resigned.

Michael Farrell, head of the Centers for Disease Control’s Bioterror Rapid Response and Advanced Technology Laboratory had submitted his resignation on Tuesday. The resignation was first reported by Reuters and has been confirmed by TIME.

Last month, the CDC reported that procedures to deactivate anthrax when leaving a lab were not followed and that while the workers were protected, the bacteria was passed to other labs. When it was determined that anthrax had not been deactivated, the labs and CDC building were shut down and decontaminated. Lab workers have not contracted the disease.

Last month, Dr. Farrell was reassigned as the CDC conducted its investigation. Earlier this month, CDC Director Dr. Thomas Frieden said the incident was due to a lack of oversight, and that the CDC would increase safety precautions.

 

TIME Research

Survey: Teen Use of Human Growth Hormones Surges

Rate of high schoolers admitting use of synthetic hGH, or performance enhancing drugs, jumps from 5% to 11% in one year

The number of teens using synthetic human growth hormones (hGH) without a prescription have doubled, according to a new survey of high school students.

A survey from the Partnership for Drug-Free Kids found that 11% of the 3,705 high schoolers surveyed reported “ever having used” synthetic hGH without a prescription. That’s a jump from the last four years: in 2012 and 2011 the number of teens using hGH was 5%. The survey also found that steroid use among teens went up from 5 to 7%.

African-American and Hispanic teens were the most likely to say they’ve used synthetic hGH, and the researchers found that both boys and girls had claimed to use hGH and steroids without a prescription. The awareness of online steroid and hGH marketing among teens also rose from 17% in 2012 to 22% in 2013, and kids are less likely to think there is a high or moderate risk associated with them compared to earlier years.

The data shows that about one in five teens says they have at least one friend who uses steroids, and another one in five teens say it’s easy to get them.

Prescription and over-the-counter hGH are considered safe for uses that include treatment for muscle deterioration due to HIV/AIDS and longterm treatment for kids of short stature. But as the report points out, some supplement products that are not regulated by the FDA and not safe for teen consumption can make it onto store shelves, and many are sold online.

“The proliferation of commercially available products that are marketed saying they contain synthetic hGH, or promote the natural production of hGH within the body, is staggering,” said Steve Pasierb, president and CEO of the Partnership for Drug-Free Kids in a statement.

Teens tend to use synthetic hGH and steroids–which can be injected or taken orally–to improve their athletic performance or physical appearance. The Partnership for Drug-Free Kids encourages parents and coaches to talk to young people about the risks. The group has also collaborated with the Major League Baseball Charities to create a program that teaches young athletes about the dangers of performance-enhancing drugs.

TIME Obesity

Most Overweight Kids Don’t Think They’re Overweight, a New Study Finds

New data from the CDC shows many kids and adolescents misperceive their weight status

About 81% of overweight boys and 71% of overweight girls believe they are about the right weight, according to recent data released by the U.S. Centers for Disease Control and Prevention (CDC) from the National Health and Nutrition Examination Survey.

Overall, the survey, which collected data on the weight of U.S. adolescents between the ages of 8 and 15 from 2005 to 2012, found that about 30% of children and adolescents perceive their weight status incorrectly. That’s estimated to equate to about 9.1 million young people.

While the majority of overweight kids incorrectly classified their weight status, general weight misperception in the study also meant that kids who were not obese could think that they were, or that they could incorrectly consider themselves underweight.

The data also shows that weight misperceptions tended to be slightly higher among boys than girls, and had a higher prevalence among non-Hispanic black and Mexican-American kids. Weight misperception was significantly lower among kids and adolescents in higher-income families compared with kids in lower-income families.

Sadly, these are the same populations whose parents are more likely to be overweight, Dr. Daniel Neides, medical director for the Wellness Institute at the Cleveland Clinic, tells TIME. That suggests the possibility that overweight kids view their weight status as normal because that’s what they see in their own families. “As our country gets heavier, children don’t necessarily see it as abnormal,” he says. (Neides was not involved with the survey.)

The trouble is also that parents often don’t want to hear that their child is overweight. Prior research has shown that only about a quarter of parents of overweight kids say a doctor has told them that their kids were overweight. “People are very sensitive to weight and to growth charts, and [parents] will argue it hasn’t been updated in years,” says Neides. “We feel like young people are immortal and will be fine, and that population also doesn’t see the long-term implications.”

But overweight children is serious business. Kids are increasingly being diagnosed with diseases that usually only appear in adults, like Type 2 diabetes. A 2013 Harvard Medical School study also found a 27% increase in the proportion of children ages 8 to 17 with elevated blood pressure. “I am seeing people younger and younger coming into my office with osteoarthritis from weight,” says Neides. “We weren’t learning about kids with these problems when I was in medical school.”

The new data should serve as a warning to families and physicians that young people are confused about their weight status, and that if overweight kids continue to believe they’re the right weight, it could have detrimental effects on progress being made against the obesity epidemic.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser