TIME mental health

Shirtless Marines March in ‘Silkies’ to Raise Suicide Awareness

Each day, 22 former servicemembers commit suicide

A group of Marines is marching 22 kilometers, or about 13.5 miles, wearing nothing but short shorts—called “silkies”—and hauling 22 kilograms, or about 50 pounds, of gear to honor the 22 service members who commit suicide every day.

“Imagine a pub crawl with all your Marine buddies wearing nothing but silkies and rucks on the most crowded and beautiful boardwalk in California. That’s what’s going on here,” a Facebook page for Sunday’s event, “22, with 22, for the 22, in silkies,” says. The event is co-sponsored by two veteran support groups, Irreverent Warriors and VETality Corp.

The journey begins at South Mission Beach Jetty in San Diego and will end at La Jolla Cove.

Each day, 22 veterans—or about 8,000 former military servicemembers—commit suicide.

 

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 mental health

Study Finds That Women Slip Into Dementia Faster Than Men

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The study has no medical implications quite yet

Women who develop slight memory deficits and mental decline slide faster toward dementia than men, according to a new study presented Tuesday at the Alzheimer’s Association International Conference in Washington.

Researchers were quick to note that the study’s findings aren’t reflective of a difference in brain chemistry between genders and have no medical implications just yet. “All we can say at this point is that there appears to be a faster trajectory for women than men” in the direction of dementia, said P. Murali Doraiswamy, a professor of psychiatry at Duke University’s Institute for Brain Sciences and lead author of the study.

The study used cognitive test scores from 398 participants of both genders who were primarily in their 70s. After controlling for outside variables like education and genetics, the researchers found that women’s test scores fell by an average of two points per year, compared to just one point for men. This wasn’t the only negative effect for women: their standard of life—how they performed at home, work, and with family—also fell faster than men.

A vast majority—nearly two-thirds of the five million Americans afflicted with Alzheimer’s disease—are women, which scientists note can be traced to the fact that women live longer, but the reasons for their decline have remained indeterminate.

[New York Times]

 

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 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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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 psychology

Get Better Sleep: 5 Powerful New Tips From Research

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Eric Barker writes Barking Up the Wrong Tree.

Ever have trouble getting to sleep? Or staying asleep? Or you get plenty of shut-eye but you’re not refreshed? Everyone wants to get better sleep. But sleep trouble is incredibly common.

And feeling tired the next day isn’t the half of it. By not getting enough sleep you’re reducing your IQ.

Via Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School:

Take an A student used to scoring in the top 10 percent of virtually anything she does. One study showed that if she gets just under seven hours of sleep on weekdays, and about 40 minutes more on weekends, she will begin to score in the bottom 9 percent of non-sleep-deprived individuals.

And losing “beauty sleep” really does make you less attractive. Seriously.

Want to be miserable? Being tired actually makes it harder to be happy.

Via NurtureShock:

The result is that sleep-deprived people fail to recall pleasant memories, yet recall gloomy memories just fine.

And if that’s not enough, lack of sleep could contribute to an early death.

Via Night School:

The results, published in 2007, revealed that participants who obtained two hours less sleep a night than they required nearly doubled their risk of death.

We need answers before sundown. So I figured I’d call somebody who has them.

Richard Wiseman is professor of psychology at the University of Hertfordshire and the bestselling author of many books including: Night School: Wake up to the power of sleep.

On his YouTube channel he has a number of great videos including this one on sleep tips.

Richard is going to tell you the #1 mistake you make when it comes to sleep, how to take awesome naps, how to get more quality sleep and the surprising secret to why you wake up in the middle of the night. And much more.

If you’re not too tired to keep reading, let’s get to it…

 

The #1 Mistake That’s Screwing Up Your Sleep

If you’re already exhausted, here’s the main takeaway you need from this interview:

Your smartphone is the devil. Your iPad is Lucifer. Your TV cackles with glee when you have insomnia.

They all give off blue light that your brain mistakes for sunshine. And that tells your grey blob it’s time to wake up, not go to bed.

Stay away from them during the hour before you try to nod off. Here’s Richard:

Ten minutes of a smartphone in front of your nose is about the equivalent of an hour long walk in bright daylight. Imagine going for an hour long walk in bright daylight and then thinking, “Now I’ll get some sleep.” It ain’t going to happen. In the middle of the night you wake up and think, “Aw, I’ll just check Twitter, email or Facebook,” and, of course, you’re being flooded with that blue light. You’re not going to be getting back to sleep very easily for the next hour or so.

So your smartphone is the devil? Okay, not really. In fact, sometimes it can be the best friend your sleep schedule has. Huh?

When you’re dealing with jet lag, I encourage you to indulge in all the blue light device bliss you so urgently crave.

They can help shift your circadian rhythm forward. Awesome, right? Your phone has a new feature you didn’t even know about. Here’s Richard:

You can use that blue light to your advantage, because when you’re bathed in blue light you become more alert. To get your circadian rhythm where it needs to be in the new time zone you can stimulate yourself with the blue light from smartphones and iPads.

(To learn the 4 things astronauts can teach you about a good night’s sleep, click here.)

Okay, modern technology is a double-edged sword. What else are you doing wrong?

 

A Good Nightly Routine Is Key

Just like a good morning routine is incredibly powerful, one before bed is a game changer as well. First step?

No booze. It seems like it helps but it’s actually a big no-no. Here’s Richard:

Drinking alcohol an hour or two before you go to bed is not a good idea. You’ll fall asleep quicker, but it keeps you out of deep sleep. In the morning you wake up feeling pretty terrible.

Richard says thinking positive thoughts before you go to bed is helpful and can promote good dreams. One of the biggest things that causes insomnia is thatanxiety about getting to bed.

When those awful thoughts start running through your head at night, try this little game. Here’s Richard:

Just think about a country or a vegetable or a fruit for each letter of the alphabet. You just slowly work your way through and that can take your mind off negative thoughts.

Worrying keeping you awake? Richard says to keep a pad and pen by the bed and write those thoughts down to dismiss them. Mindfulness training can help with this too so give meditation a try. (Here’s how.)

Still can’t sleep? Get up. Don’t accidentally make a Pavlov-style association between your bed and *not* sleeping. Here’s Richard:

The issue is often they’re staying in bed awake for ten minutes or more and they start to associate bed with being awake instead of being asleep. Get up, do something which is not stimulating, and then get back to bed.

(For more science-backed tips on a nightly routine that will bring you amazing sleep, click here.)

So your winding down ritual is in order. What about naps? (Yes, I know they’re amazing.) How can you and I make them *more* amazing?

 

How To Nap Like A Pro

Don’t go down for more than an hour. 20-30 minutes is great — but even five minutes can give you a big boost. Here’s Richard:

Anything over an hour is probably not a great idea, but twenty or thirty minutes of napping is incredibly good for creativity and focus. Naps can make a massive, massive difference. Even five minutes increases reaction time and focus.

NASA found pilots who take a 25 minute nap are 35% more alert and twice as focused.

Via Night School:

Research by NASA revealed that pilots who take a twenty-five-minute nap in the cockpit – hopefully with a co-pilot taking over the controls – are subsequently 35 per cent more alert, and twice as focused, than their non-napping colleagues.

NASA found that naps made you smarter — even in the absence of a good night’s sleep.

Via Dreamland: Adventures in the Strange Science of Sleep:

If you can’t get in a full night’s sleep, you can still improve the ability of your brain to synthesize new information by taking a nap. In a study funded by NASA, David Dinges, a professor at the University of Pennsylvania, and a team of researchers found that letting astronauts sleep for as little as fifteen minutes markedly improved their cognitive performance, even when the nap didn’t lead to an increase in alertness or the ability to pay more attention to a boring task.

Worried you won’t wake up in time for something important? Richard recommends drinking a cup of coffee immediately before laying down. The caffeine will kick in after about 25 minutes.

(To learn the 5 scientific secrets to naps that will make you smarter and happier, click here.)

All this is great for getting some sleep… but what about when you can’t stay asleep? Not a problem. Literally.

 

Waking Up In The Middle Of The Night Is Natural

Research shows we evolved to sleep in two distinct phases. So don’t worry. Do something for a little while and then head back to bed for round 2. Here’s Richard:

We’ve evolved to have what’s called segregated sleeping. If you wake up in the middle of the night that’s perfectly natural. Before electric light people would talk about “first sleep” and “second sleep.” In between they’d go and visit their friends or play games. So if you do wake up in the middle of the night, that’s fine. Get out of bed for twenty minutes and do something. Don’t lay there feeling anxious.

Is this fragmented sleep bad? Far from it. Bloodwork showed that the time between the two sleeping periods was incredibly relaxing and blissful.

Via Dreamland: Adventures in the Strange Science of Sleep:

The results showed that the hour humans once spent awake in the middle of the night was probably the most relaxing block of time in their lives. Chemically, the body was in a state equivalent to what you might feel after spending a day at a spa…

(For more on the science of why we sleep in two chunks, click here.)

But here’s a problem everyone has had: ever sleep for over eight hours and you still feel groggy and awful? Here’s why.

 

Want To Get Better Sleep? Remember “The 90 Minute Rule”

Your body goes through sleep cycles of 90 minutes. Wake up in the middle of one and you’ll feel lousy no matter how long you’ve been in bed. So plan your sleep schedule in increments of an hour and a half. Here’s Richard:

Sleep scientists all use the “90-minute rule” which is basically a sleep cycle which is moving from light sleep, to deep sleep to dreaming and repeating that again and again. That cycle is roughly ninety minutes. You’re best off waking up at the end of a cycle. Plan your sleep in ninety minute blocks to tell you the best time to be falling asleep. Then you go to bed about ten, twelve minutes before that because that’s how long it should be taking you to fall asleep.

(For more on how to have the best night’s sleep of your life, click here.)

I could use a nap now, frankly. But before any of us nod off, let’s round up what Richard had to say so tonight is a restful one. (And we’ll get one more tip that can help make sure your nighttime habits don’t backfire.)

 

Sum Up

Here’s what Richard had to say about getting more quality zzzzzzzz’s:

  • Avoid smartphones and devices at night. But they’re great when you’re dealing with jet lag.
  • A good nightly routine is key. No alcohol before bed, think positive thoughts and play the alphabet game.
  • Naps are awesome. Just keep them under 30 minutes. Drink a cup of coffee before you lay down.
  • Sleeping in two chunks is natural. Get up and do something for a little while and then go back to bed.
  • Remember the “90 minute rule.” Think about when you need to be up and count back in increments of 90 minutes so you wake up sharp.

Sometimes we’re our own worst enemy. We stay up surfing the net or watching Netflix. How can we behave better?

John Durant offers a piece of advice I follow: forget the morning alarm clock; set an alarm to remind you when to go to bed.

Via The Paleo Manifesto: Ancient Wisdom for Lifelong Health:

A useful technique is setting an alarm clock—not to wake up, but to get ready for bed. Set an alarm for an hour before bedtime. When it goes off, finish up any work on the computer, turn off the TV, turn off any unnecessary lights, and start to wind down for the day.

I wish you great sleep and blissful dreams.

And as Anthony Burgess once said:

Laugh and the world laughs with you, snore and you sleep alone.

Join over 190,000 readers. Get a free weekly update via email here.

This piece originally appeared on Barking Up the Wrong Tree.

Related posts:

5 Scientific Secrets To Naps That Will Make You Happier And Smarter

4 Things Astronauts Can Teach You About A Good Night’s Sleep

These Six Things Will Bring You A Great Night’s Sleep

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

Postpartum Depression Can Arise Months After Screenings

A new study shows that women who seem healthy after giving birth can develop symptoms of depression months later

Screening women for symptoms of postpartum depression shortly after they give birth may not be a sufficient, a new study found. Many women show signs of depression months after having a baby, and those who initially appeared the least likely to develop depression were later found to be at the highest risk, a study published in the Annals of Family Medicine found.

Researchers analyzed data from 1,432 women across the U.S., about a third of whom were first-time mothers. The women were asked to rate from 0 (none) to 3 (daily) their feelings of sadness, lack of appetite, thoughts of self-harm and other symptoms. Those with total scores of 10 or higher were identified as at-risk.

All of the women scored below 10 in their first screening, conducted four to 12 weeks after giving birth. Six months after giving birth, 10.9% of the women scored 10 or higher, and a year in, 16.9% of women did.

Though the American Academy of Pediatrics and American College of Nurse Midwives have advocated for regular screenings of postpartum depression during primary care visits, the U.S. Preventative Services Task Force has said they worry about the repercussions of possible misdiagnoses on women and children.

About 15% of American women experience postpartum depression within a year of giving birth, according to the Centers for Disease Control and Prevention. Obesity, domestic violence and several other factors contribute to the likelihood of experiencing depression symptoms. The researchers at the Olmstead Medical Center in Rochester did not have access to data about the women’s personal lives.

TIME justice

HBO Documentary Highlights Gun Violence

Filmmakers Shari Cookson and Nick Doob attend the HBO screening of 'Requiem For The Dead' at HBO Theater on June 15, 2015 in New York City.
Stephen Lovekin—2015 Getty Images Filmmakers Shari Cookson and Nick Doob attend the HBO screening of 'Requiem For The Dead' at HBO Theater on June 15, 2015 in New York City.

A new HBO documentary about gun violence will air Monday, just days after a deadly massacre at a Charleston, South Carolina, church.

Requiem for the Dead uses documentary material such as Facebook status updates, 911 calls, news reports and police investigations to tell the stories of some of the estimated 8,000 people who died from gunfire between March and June of 2014.

“People now document themselves in these very intimate ways,” co-director Shari Cookson tells TIME. “It was like reading a diary.”

“Every story,” her filmmaking partner Nick Doob adds, “is a kind of Greek tragedy.”

In one example, a 12-year-old boy confesses to police that he killed his 11-year-old friend while showing off his father’s loaded handgun.

Another example, about a 12-year-old who shot his sister eight times before turning the gun on himself, is accompanied by a montage of photographs of his belongings, including the Call of Duty and Grand Theft Auto videogames, a Hunter Education certificate and a picture of him beaming, one hand clutching a rifle and another caressing an antler.

While the directors say they emphasized character portraits over a political agenda, many of the examples in the documentary seem to highlight incidents that could have been prevented by proper gun storage or better mental health treatment.

“Of course,” Doob admits, “we want to foster dialogue. We want the film to open people to talk so that even NRA people can look at this.”

TIME Healthcare

5 Sleep Problems Nobody Talks About

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From teeth grinding to jittery legs

You drift off at night like a newborn baby, yet can’t recall the last time you woke up truly refreshed. It may not seem that weird: “People tend to assume that because our modern lives are so hectic, nobody feels rested,” says Meir Kryger, MD, a professor at the Yale School of Medicine. But the reality is, you might have a sleep disorder and not even know it. There are a handful of problems that can cheat you out of quality slumber, leaving you more tired in the morning than you were when you went to bed. Find out what could be going on between your sheets and how to catch more restorative z’s, starting tonight.

Sleep Problem No. 1: You snore like a saw

Those snuffle-snorts mean that your slack tongue and throat muscles are narrowing your airway, possibly due to the shape of your soft palate or any extra weight you’re carrying.

Although you’re likely to wake up if you get short of breath, it may not be for long enough to remember. Some people wake dozens or even hundreds of times a night—a disorder known as sleep apnea that increases the risk of heart disease, stroke and possibly osteoporosis, according to a new study in the Journal of Bone and Mineral Research. “Those repeated awakenings are as disruptive as someone pinching you every two minutes all night long,” says Safwan Badr, MD, chief of the division of pulmonary, critical care and sleep medicine at Wayne State University School of Medicine in Detroit.

Sleep aid: If you rarely wake up feeling bright-eyed, see a specialist to get checked for sleep apnea.(Three to 9 percent of women between the ages of 30 and 70 suffer from it.) If you have the condition, a CPAP machine and mask can help by keeping your pharynx open with a steady stream of air.

To quiet your snore, avoid rolling onto your back—a position that makes your airway more likely to collapse. Rachel Salas, MD, associate professor of neurology at Johns Hopkins University School of Medicine, suggests this little trick: Sew a tennis ball into the pocket of a sweatshirt and wear it backward to bed.

Sleep Problem No. 2: You grind your teeth

Do you wake up with a sore jaw or get chronic headaches? If so, you may be gnashing your ivories overnight. All that clenching can cause enough pain to interfere with your shut-eye (not to mention wear down your enamel). Experts believe that teeth grinding, which about 16 percent of us do, is associated with anxiety—though an abnormal bite and antidepressants can also play a role.

Sleep aid: A dentist will fit you with a mouth guard. If you’re clamping down because you’re overwhelmed and overloaded, find a healthier way to manage stress, urges Michael A. Grandner, PhD, an instructor in psychiatry at the Perelman School of Medicine at the University of Pennsylvania. “It’s also crucial to spend plenty of time winding down before bed so you drift off in a calm, relaxed state,” he adds.

Sleep Problem No. 3: Your body clock is off

Not even drowsy until the wee hours? Delayed sleep-phase syndrome (DSPS) is the technical term for this disorder, which afflicts 10 percent of people who seek help for insomnia. It involves a biological glitch that prevents your body from making melatonin (the sleep hormone) until 12 a.m. or later. A prime sign you’ve got DSPS: You’ve been a night owl since high school. The syndrome is common among teenagers and sometimes persists into adulthood. If you’re not squeezing in at least seven hours of z’s a night, you’re at greater risk of high blood pressure and diabetes. What’s more, a recent study published in Cognitive Therapy and Research found that people who nod off late (and get less sleep as a result) tend to experience more negative thoughts.

Sleep aid: Begin by improving your sleep hygiene. Cut back on caffeine. Avoid tech and television starting 90 minutes before bedtime. Create a soothing wind-down routine. And get some sun first thing in the morning to help reset your body’s 24-hour rhythm. “In 80 percent of cases, these strategies lead people to conk out earlier,” Dr. Badr says. If they don’t do the trick, a specialist may prescribe synthetic melatonin, as well as light therapy with a medical lamp to use in the morning.

Sleep Problem No. 4: Your legs feel jittery at night

That creepy-crawly feeling—aptly called Restless Legs Syndrome (RLS)—troubles as many as 1 in 10 people and is thought to be linked to a dysfunction in the way the brain processes the neurotransmitter dopamine. However, in some cases it suggests a nutritional deficiency, Dr. Kryger notes: “With people who have low iron, there seems to be overactivity in parts of the brain that results in an urge to move the legs.”

Sleep aid: Ice packs, warm packs, massages, a bath—any of these remedies might help, says David N. Neubauer, MD, associate professor of psychiatry at Johns Hopkins University School of Medicine: “Different things seem to work for different people.”

Also, talk to a sleep doc about trying an RLS drug. Be sure to mention your current prescriptions because some meds (including certain antidepressants) reduce dopamine activity. Get your iron levels checked, too, Dr. Gardner advises: “Sometimes a supplement is the only treatment necessary.”

Sleep Problem No. 5: You sleepwalk—and even sleep eat

For reasons that aren’t completely understood, somnambulists are partially aroused in the night—often from the deepest stage of slumber (called slow-wave)—and proceed to wander around the house. The behavior, which may affect up to 4 percent of the population, appears to run in families and is more likely to occur with sleep deprivation. Another trigger: taking zolpidem (one of the most popular sedatives), according to Robert S. Rosenberg, DO, author of Sleep Soundly Every Night; Feel Fantastic Every Day.

Additionally, 1 to 3 percent of people who experience such a zombie-like state actually raid the kitchen. Called sleep-related eating disorder, this condition often strikes women on a diet, who go to bed hungry.

Sleep aid: Benzodiazepines (aka tranquilizers) can sometimes help, and so does getting more sleep. As long as your nocturnal adventures don’t involve anything risky (like, for example, baking cookies), you may not need medication, Rosenberg says: “Just make sure you safety-proof your home by clearing out clutter and stowing away sharp objects.” If you’re a nighttime roamer, let your partner know that the ideal approach is to gently lead you back to bed.

This article originally appeared on Health.com.

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