TIME Mental Health/Psychology

More Than 200,000 Vietnam Vets Still Have PTSD

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New research reveals considerable PTSD in some vets, even decades after war

Many veterans who served in the Vietnam War still have war-zone-related post-traumatic stress disorder, according to a new study published in JAMA Psychiatry.

The researchers, led by Dr. Charles R. Marmar, of the New York University Langone Medical Center, wanted to look at the prevalence of PTSD over time. Thanks to the National Vietnam Veterans Longitudinal Study, a study of PTSD in Vietnam vets done more than 25 years ago, they had historic data on the prevalence of PTSD; they conducted a follow-up to the study by gathering new data from the 1,450 veterans who were still alive and willing to participate in another round of PTSD assessments. From 2012-2013, researchers gathered from each vet a self-report health questionnaire, a telephone health survey or a clinical interview by phone. (Some vets participated in two or all three of the measures.)

MORE: Meet 15 Extraordinary Wounded Warriors Who Are Stronger Than Ever

The team determined that even now—40 years after the war ended—about 271,000 Vietnam vets have full war-zone-related PTSD plus war-zone PTSD that meets some diagnostic criteria. More than a third of the veterans who have current war-zone PTSD also have major depressive disorder.

MORE: “Hidden Wounds”: Battling PTSD With Music

Men who served in the Vietnam war had a war-zone-related PTSD prevalence of 4.5%; when factoring in vets who met some of the criteria, that number climbed to almost 11%. For women veterans, those prevalences were about 6% and 9%, respectively.

“An important minority of Vietnam veterans are symptomatic after four decades, with more than twice as many deteriorating as improving,” the study authors write. “Policy implications include the need for greater access to evidence-based mental health services; the importance of integrating mental health treatment into primary care in light of the nearly 20 percent mortality; attention to the stresses of aging, including retirement, chronic illness, declining social support and cognitive changes that create difficulties with the management of unwanted memories; and anticipating challenges that lie ahead for Iraq and Afghanistan veterans.”

TIME mental health

There’s a New Treatment for Severe Depression—With Fewer Side Effects

Brief pulses of electricity have fewer side effects than one prolonged jolt

One of the most common ways to treat for severe depression has been electroconclusive therapy (ECT), where electric currents are passed through the brain to trigger brief, intentional seizures to stabilize brain chemistry.

New research published Tuesday in the Journal of Clinical Psychiatry suggests, however, that a new method—ultra-brief pulse right unilateral, or (RUL) ECT—may have fewer negative side effects, like confusion, and memory and heart problems.

The study used data from 689 patients with a median age of 50 from six countries. “Our analysis of the existing trial data showed that ultra-brief stimulation significantly lessened the potential for the destruction of memories formed prior to ECT, reduced the difficulty of recalling and learning new information after ECT and was almost as effective as the standard ECT treatment,” saud Colleen Loo, professor at the University of New South Wales.

While ECT sends a single, controlled electric current to the brain’s prefrontal cortex—shown to be underperforming in patients suffering from severe depression—(RUL) ECT sends brief pulses of electricity, reducing total stimulation of the prefrontal cortex by one-third.

Loo noted that more research is needed, but emphasized the study’s promising outlook on not only being more efficient and safer for patients but also reducing the stigma depressed patients suffer.

“This new treatment, which is slowly coming into clinical practice in Australia, is one of the most significant developments in the clinical treatment of severe depression in the past two decades,” she said in a press release. “We are still working hard to change the broader medical profession’s and general public’s perception of ECT, which has struggled to shake off the tarnished image given to it by popular movies such as the 1975 film, One Flew Over the Cuckoo’s Nest.”

TIME Tennessee

Chattanooga Shooter Suffered From Depression, Family Says

His family says he was not the son they knew

CHATTANOOGA, Tenn. — The family of the man who authorities say killed four Marines and a sailor in Chattanooga said in a statement that their son suffered from depression and was not the son they knew.

“There are no words to describe our shock, horror, and grief,” said the statement, provided Saturday to the Associated Press by a lawyer representing the family of Muhammad Youssef Abdulazeez. “The person who committed this horrible crime was not the son we knew and loved. For many years, our son suffered from depression. It grieves us beyond belief to know that his pain found its expression in this heinous act of violence.”

“We understand there are many legitimate questions that need to be answered,” the statement said. “Having said this, now is the time to reflect on the victims and their families, and we feel it would be inappropriate to say anything more other than that we are truly sorry for their loss.”

The family added that they are cooperating with the investigation.

In Chattanooga, a city that prides itself on strong ties between people of different faiths, some Muslims feared the community’s perception of them had changed after the shooting rampage Thursday.

Mohsin Ali, a member of the Islamic Society of Greater Chattanooga, said he hoped the local community didn’t dissolve into turmoil the way others have in the region over the building of mosques and other matters. Peaceful coexistence has largely prevailed here.

“We, our kids, feel 100 percent American and Chattanoogan,” said the Pakistani-born Ali, who is a child psychiatrist. “Now they are wondering if that is how people still look at them.”

As FBI agents served a warrant on the Abdulazeez home Thursday, two women wearing Islamic head coverings were seen being led away in handcuffs. But FBI agent Jason Pack said Saturday that no arrests have been made in the case.

Authorities are looking into the shooting as a terrorism investigation and whether Abdulazeez was inspired or directed by any terrorist organization. They still don’t know what motived Abdulazeez.

The president of the Islamic Society of Greater Chattanooga said Abdulazeez’s father told him he felt blindsided and did not see any recent changes in his son.

“He told me that he had never seen it coming, and did not see any signs from his son that he would be that way and do something like that,” Bassam Issa said.

Meanwhile, governors in at least a half-dozen states ordered Guardsmen to be armed, and Florida Gov. Rick Scott moved his state’s Guard recruiters from storefronts in urban areas to armories.

Ali said immigrants such as himself owe a debt of gratitude to America and the armed forces protect it, because they often know firsthand what it means to live in countries without personal freedoms or the rule of law. Near the end of the service Friday night, at Ali’s urging, dozens of Muslims received a standing ovation as they stood in support of their city and in allegiance to their nation.

It was a remarkable show of togetherness in a region where relations have sometimes been tense since the terror attacks of Sept. 11, 2001.

Still, the events of the last few days have left some on edge, particularly the young. The end of Ramadan is usually a time for celebration, but events at the Islamic Center were canceled after the shootings. A sign on the door Friday encouraged visitors to go to the memorial service instead.

Khadija Aslam, 15, didn’t wear her head covering in the car while riding to prayer services after the shootings for fear of attracting attention, and 15-year-old Zoha Ahmad said her family is worried about the possibility of vandalism at their home.

“A lot of people know we live there and that we’re Muslims,” she said.

Ali said he plans to offer group counseling for concerned members of the Islamic community at his home, and that might help ease concerns. But, he isn’t sure.

“We’ll see,” said Ali.

TIME Innovation

How 3D-Printing Gave One Girl a New Lease on Life

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

These are today's best ideas

1. Doctors in China 3D-printed a new skull for a little girl.

By Lizette Borreli in Medical Daily

2. Learn the secret behind this low-income high school’s 100% graduation rate for black men.

By Meredith Kolodner at Hechinger Report

3. Your phone can tell whether you’re depressed.

By Mandy Oaklander in Time

4. Find out how repealing a century-old protectionist law could save Puerto Rico.

By Patrick Holland in E21

5. Iran deal or no deal, it’s time for Arab governments to take charge in the region.

By Tamara Cofman Wittes in Lawfare

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Mental Health/Psychology

Children With Mental Health Problems Are Also at Risk as Adults

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A new study suggests that psychiatric problems in childhood are linked to several negative outcomes in adulthood

Having psychiatric problems in childhood is challenging enough, but new evidence suggests that these problems can lead to issues as an adult—even if the problems do not persist into adulthood.

A new study published in JAMA Psychiatry used data from a survey of 1,420 children from 11 counties in rural North Carolina. The children were followed over time and assessed annually between ages 9 and 16 for common psychiatric problems, like depression, anxiety and behavioral issues. The researchers found that 26% of children in the group suffered some form of behavioral or emotional disorder; another 31% displayed “subthreshold” psychiatric problems, or a few symptoms of psychiatric problems without being diagnosed with the condition.

“In terms of most types of health problems, kids are the healthiest,” says lead author Dr. William Copeland of Duke University Medical Center. Most chronic health diseases take hold during middle age, but “one exception is mental health problems, which occur at the onset of childhood and adolescence,” he says. These can include ADHD, behavioral or conduct problems, anxiety and depression.

Out of the initial survey group, 1,273 people were later re-evaluated three times at the outset of adulthood—ages 19, 21 and 25—to see how the now-young adults had fared in four areas: health, the legal system, personal finances and social functioning. These included negative life events like being incarcerated, dropping out of high school, having trouble keeping a job and having a serious health problem or addiction, Copeland says. “Nineteen and 21 are a peak period in terms of criminal behavior, substance problems, and transitioning from the home,” he says, and age 25 is when things typically start to stabilize.

Of the young adults who had suffered from a subthreshold psychiatric problem in childhood, 42% suffered an adverse outcome in adulthood. Of the kids who had behavioral or emotional issues as kids, 60% of them reported having trouble as adults. By comparison, just 20% of the young adults who had no psychiatric issues reported adult problems.

In other words, having a diagnosed psychiatric issue as a child made him or her six times more likely to experience at least one adverse effect as an adult and nine times more likely to suffer from two or more adverse outcomes. Children who had subthreshold symptoms without an official diagnosis faced three times the risk of having one adverse outcome and five times the risk of having two or more adverse outcomes.

Copeland thinks this is proof that mental health needs to be addressed early on and without stigma. “We need to focus on prevention and intervention,” he says. “If we want to reduce the cost and distress associated with many social problems, we really need to address them earlier.”

TIME Mental Health/Psychology

Your Phone Knows If You’re Depressed

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Elizabeth Renstrom for TIME

Phone data could predict with 87% accuracy whether someone had depressive symptoms

Most of us are pretty attached to our phones, and researchers are starting to figure out what that connection can tell us about our health, including our mood. In fact, your phone may be able to tell if you’re depressed even better than a self-assessment of your own depression can, according to a small new study published in the Journal of Medical Internet Research.

“We found that the more time people spend on their phones, the more likely they are to be more depressed,” says David Mohr, one of the authors of the study and director of the Center for Behavioral Intervention Technologies at Northwestern University Feinberg School of Medicine. The researchers also found that spending lots of time at home was linked to depression—and that phone data like this could predict with 87% accuracy whether someone had symptoms of depression.

Northwestern researchers recruited 28 people ages 19-58 from Craigslist and souped up their smartphones with location-and-usage monitoring software. At the start of the study, they took a standardized questionnaire that measures depressive symptoms; half of the subjects had symptoms of depression, and half did not. For two weeks, the phones tracked GPS location information every five minutes and pinged the users with questions about their mood several times a day.

The phone data the researchers collected were rich: how many places the participants visited each day, how much time they spent in each of those places and how frequently they used their phones, says Sohrob Saeb, one of the study’s authors and a postdoctoral fellow and computer scientist in preventive medicine at Feinberg. The researchers then correlated this objective data with their depression test scores.

What they hoped to find was a connection between the objective markers of behavior—such as where the people were and how often they changed locations—and their depression test results. That way, the data derived from phones could become a useful way to track depression without the user having to report how they were feeling, which is often a barrier to depression treatment, says Mohr, who has studied depression for about 20 years. “One of the things that we find over and over again is that people don’t answer questions,” he says. “In apps, they’ll respond to questions for a few days and then get tired of it.”

Mohr and his team indeed found a strong correlation between these objective markers and depression. Phone data were even better than the daily questions the users answered to predict depression test results. “People who tend to spend more time in just one or two places—like people who stay at home or go to work and go back home—are more likely to have higher depression scores,” says Mohr. When a person moved around was important, too; people who stuck to a regular pattern of movement tended to be less depressed, they found. “This fits into a larger body of clinical research showing that people with mental health problems in general, their circadian rhythms get thrown off,” Mohr says. “Usually it’s looked at with sleep and activity, but here we’re seeing it also in terms of their movement through geographic space.” When people get depressed, he says, their mood may pull them off their routine.

Depressed people, too, spent an average of 68 minutes using their phones each day, while people without depression only spent about 17 minutes on their phones. The software didn’t track what people did on their phones—just whether or not they were using it. But the authors have some ideas about why they saw phone activity rise with depression. “One of the things we see when people are depressed is that people tend to start avoiding tasks or things they have to do, particularly when they’re uncomfortable,” Mohr explains. “Using the phone, going in and using an app, is kind of a distraction.”

It’s preliminary research, but Mohr hopes to add to the number of smartphone sensors and use these to subtly help manage depression and spot it more quickly, without requiring any work on behalf of the user. “Being able to get people timely treatment for depression is a critical failure point in public health right now,” Mohr says. An app that people download on their phones—without having to answer any questions—may help pinpoint their depressive states more effectively and help them get treatment.

TIME Mental Health/Psychology

These Antidepressants May Be Riskier For Pregnant Women, Study Says

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Treating depression properly is important, but a new analysis found a link between certain SSRIs and birth defects

In a study published in the BMJ, researchers conducted the most thorough study to date looking at how popular SSRI antidepressants taken by pregnant women affect their unborn children.

Previous studies, most of which investigated individual medications and their potential effects on the still-developing fetus, have resulted in conflicting results; some have found associations between the antidepressants and birth defects, while others have not.

In the BMJ study, Jennita Reefhuis, team lead in the birth defects branch at the U.S. Centers for Disease Control and Prevention, and her colleagues analyzed data from six existing studies of selective serotonin reuptake inhibitors, called SSRIs—a class of antidepressants—and their relationship with birth defects, as well as the National Birth Defects Prevention Study, which collected birth defect information from hospitals in 10 U.S. cities. The added data from nearly 18,000 mothers who had children with birth defects provided more power to the analysis that Reefhuis and her team performed.

MORE: Therapy and Antidepressants Work Better Together Than Just Pills Alone

Overall, they found that two SSRIs—fluoxetine (Prozac) and paroxetine (Paxil)—were linked to seven specific birth defects, including those involving heart structures, abnormal brain formation and the growth of the intestines outside of the body. The other SSRIs studied—citalopram (Celexa), escitalopram (Lexapro), and sertraline (Zoloft)—did not show strong associations with birth defects.

The researchers don’t yet know exactly why these SSRIs were linked to birth defects, and Reefhuis stresses that the risks she uncovered are small. For example, a heart structural defect occurs normally in about 10 per 10,000 births, and for women taking paroxetine, that risk doubled to 24 per 10,000. “But two times a small number is still a small number,” she says.

MORE: Why Some Antidepressants Make You Feel Worse Before Better

Still, the results should provide better information for doctors and women who want to start families about how to balance the benefits of antidepressants like SSRIs in treating depression and the potential risks the medications can pose to the baby. “I think our data points in the direction that maybe they could choose an SSRI that has not been shown to be associated with, or has been associated with fewer, birth defects,” she says. But more studies like this are needed to confirm and expand on what we know about how specific antidepressants are linked to specific birth defects. “This information is most helpful in trying to unravel this mystery,” says Reefhuis. “I really hope it provides options for treating women who need treatment for depression during pregnancy.”

TIME Mental Health/Psychology

Can Negative Thinking Make You Sick?

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A growing body of research points to a 'yes'

By now, the mind-body connection is a familiar idea. Most people are aware, for example, that stress can produce physical symptoms like an upset stomach, or that depression often physically hurts. But a growing body of research suggests that negative emotions and thoughts may also have links to other serious health problems, like heart disease.

“Many negative emotions such as anger, fear, and frustration become problematic when those emotions turn into a more permanent disposition or a habitual outlook on the world,” explains Emiliana Simon-Thomas, PhD, science director of the Greater Good Science Center at UC Berkeley.

Take cynicism, for example: A 2014 study published in the journal Neurology linked high levels of cynicism later in life, i.e. a general distrust of people (and their motives), to a greater risk of dementia compared to those who were more trusting, even after accounting for other risk factors like age, sex, certain heart health markers, smoking status, and more.

This way of thinking may also hurt your heart. A 2009 study from the journal Circulation looked at data from nearly 100,000 women and found that the most cynical participants were more likely to have heart disease than the least cynical folks. The more pessimistic women also had a higher chance of dying over the study period, versus those who were more optimistic about humanity.

Another bad attitude that’s been linked to poor health outcomes: hostility. According to a 2014 study published in the journal Stroke, people who scored higher on measures of unfriendliness, as well as those with chronic stress and depressive symptoms, had a higher risk of stroke than the friendlier, kinder participants.

Finally, there’s depression, which is a serious diagnosis that can have repercussions far beyond feeling sad or losing your appetite. It’s been connected with an increased risk for type 2 diabetes, heart attack, and a greater chance of disability later in life. (This is another reason why it’s so important to seek help for depression.)

Our thoughts and emotions have widespread effects on bodily processes like metabolism, hormone release, and immune function, Simon-Thomas says. One theory is that when you’re stressed or depressed, cortisol levels increase, making your immune system less able to control inflammation, which could lead to disease over time.

It could also be that people who feel bad—be it depressed, stressed, cynical, or otherwisemay also be more likely to smoke or drink alcohol, or less likely to be physically active, all things that can affect your health, of course. Or it’s possible that negative emotions might be an early symptom of a health problem, rather than a cause.

All this said, there is a big bright spot for every Negative Nancy out there: by simply changing your perspective, you may just improve your health. “We know that neural pathways are changing every minute of your entire life and that your brain is generating new cells throughout your life. And this neurogenesis is not only associated with the formation of new memories, but with mood stability, as well,” Simon-Thomas says.

So cynics take heart—you have control over your attitude (and your well-being). As Simon-Thomas put it: “We can be deliberate about shifting our habits of feeling and thinking in the world.”

This article originally appeared on Health.com

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TIME Crime

U.S. Police Killed Someone in Mental or Emotional Crisis Every 36 Hours This Year, Report Says

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In most cases, police were called not because of a crime but by a concerned bystander or loved one

Reporting released by the Washington Post on June 30 depicts an apparently stark reality when it comes to confrontations between police and people with mental illness in the U.S. The article draws from the newspaper’s tracking of every fatal police shooting in the country in the first six moths of 2015 — 462 in all — to present an in-depth look at those confrontations involving disturbed or distressed individuals.

During that time, police killed someone in mental or emotional crisis every 36 hours, including three men within 10 hours on April 25, the Post reports.

In most of those cases, the paper says, officers were not called to the scene because of reports of a crime but were rather responding to concerned bystanders or loved ones. Out of the 124 shootings examined in the report, 50 involved explicitly suicidal individuals. In 45 cases, police were explicitly asked for medical assistance or called after the individual had attempted to get medical assistance elsewhere. Nearly a dozen of those killed were veterans, and several suffered from PTSD.

Many of the responsible police agencies do not train their officers adequately to deal with distressed people, the article concludes. According to the Police Executive Research Forum, officers in training spend up to 60 hours learning to handle a gun and only eight hours each learning to neutralize taut situations and interact with mentally ill individuals. In fact, many of the tactics learned in training, such as shouting commands, can worsen the situation for already fragile people.

“This a national crisis,” Chuck Wexler, executive director of the Police Executive Research Forum, told the Post. “We have to get American police to rethink how they handle encounters with the mentally ill. Training has to change.”

Read more at the Washington Post

TIME Diet/Nutrition

The Strange Link Between Junk Food and Depression

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Elizabeth Renstrom for TIME

Some—but not all—sugars were associated with depressive disorders

Of our many modern diseases, one of the biggest burdens on society is an unexpected one: depression, according to the World Health Organization. And what we eat may be contributing, finds a new study published in the American Journal of Clinical Nutrition.

James E. Gangwisch, PhD, assistant professor at Columbia University in the department of psychiatry, wanted to find out whether foods with a higher glycemic index (GI)—a scale that ranks carbohydrate-containing foods by how much they raise your blood sugar—would be associated with greater odds of depression. “When I was a kid, I was almost like a candy junkie,” Gangwisch says. “I noticed for myself, if I eat a lot of sugar, it makes me feel down the next day.” Gangwisch says he stopped eating added sugar years ago but remained curious about whether a junk food diet could make people depressed.

He and a team of researchers looked at data from food questionnaires and a scale that measures symptoms of depressive disorders from postmenopausal women in the Women’s Health Initiative Observational Study. The data came from roughly 70,000 women, none of whom suffered from depression at the study’s start, who had baseline measurements taken between 1994 and 1998, and then again after a three-year follow-up.

Diets higher on the glycemic index, including those rich in refined grains and added sugar, were associated with greater odds of depression, the researchers found. But some aspects of diet had protective effects against developing depression, including fiber, whole grains, whole fruits, vegetables and lactose, a sugar that comes from dairy products and milk that sits low on the glycemic index.

Added sugars—but not total sugars or total carbohydrates—were strongly associated with depression.

Though the authors couldn’t pinpoint a mechanism from this study—it was associative—they note that one possibility is that the overconsumption of sugars and refined starches is a risk factor for inflammation and cardiovascular disease, both of which have been linked to the development of depression.This kind of diet could also lead insulin resistance, which has been linked to cognitive deficits similar to those found in people with major depression.

Further research is needed, Gangwisch says, and it’s not yet known whether the results would translate to a broader group of people, including men and younger women. But even now, diet may be worth discussing with people who suffer from depression, Gangwisch says—even though doing so may be difficult. “It’s hard enough to get the general public to avoid those kinds of foods, but it’s even harder to get someone who suffers from depression to avoid them and give them up,” he says. “You don’t want people to feel guilty either…to say, ‘Your diet’s bad and you should change it,’ would take kind of a soft sell approach.” Still, he believes the effort is worth it. “I think it’s important and I think it has a big effect on your mood and how you feel and your energy level,” he says. “If it’s something that people can change, they really would benefit from it.”

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