TIME neuroscience

A ‘High’ From Marijuana Is Really the Opposite in Your Brain

Daily Life In South Africa
A youth smokes marijuana in Soweto township, near Johannesburg, on July 2, 2013 Christopher Furlong—Getty Images

Marijuana dulls your response to dopamine

A new study suggests marijuana blunts the brain’s reaction to dopamine, making users less responsive to the chemical responsible for feelings of reward and pleasure.

In the study published Monday in the journal Proceedings of the National Academy of Sciences, the researchers studied the brains of 24 marijuana abusers — that is, people who smoked multiple times a day — and how they reacted to methylphenidate, a stimulant often used to treat ADHD and narcolepsy. Using personality tests and brain imaging, the researchers found the pot users had blunted behavioral, cardiovascular and brain responses to methylphenidate compared with control participants. Marijuana abusers scored lower on tests of positive emotional activity and higher on negative emotional reactions.

The researchers believe that pot not only dampens the brains’ dopamine reaction to stimulants but also influences the area of the brain involved in reward processing. The participants had lower reward sensitivity, higher levels of irritability, and likely more depression and anxiety.

The researchers conclude that the way pot interferes with the brain may contribute to drug cravings. And that a “high” is really the opposite in the brain.

TIME Research

Women More Likely Than Men to Seek Mental Health Help, Study Finds

And women seek help earlier

Women with chronic physical illnesses are 10% more likely to seek support for mental health issues than men with similar illnesses, according to a new study.

The study from St. Michael’s Hospital and the Institute for Clinical Evaluative Science also found that women tend to seek out mental health services months earlier than men. Researchers looked at people diagnosed with at least one of four illnesses: diabetes, high blood pressure, asthma or chronic obstructive pulmonary disease.

Of people diagnosed with these conditions, women were not only more likely than men to seek mental health services, but they also used medical services for mental health treatment six months earlier than men in any three-year period.

For the purposes of the study, “mental health services” were defined as one visit to a physician or specialist for mental health reasons, such as depression, anxiety, smoking addiction or marital difficulties.

“Our results don’t necessarily mean that more focus should be paid to women, however,” study author Flora Matheson, a scientist in the hospital’s Centre for Research on Inner City Health, said. “We still need more research to understand why this gender divide exists.”

The findings, published in the British Medical Journal’s Journal of Epidemiology & Community Health, could suggest various conclusions about the way that different sexes use mental health services. It may mean that women feel more comfortable seeking mental health support than men or that men delay seeking support. The study could also imply that symptoms are worse among women, which would encourage more women to seek help and to do so sooner.

“Chronic physical illness can lead to depression,” Matheson said. “We want to better understand who will seek mental health services when diagnosed with a chronic physical illness so we can best help those who need care.”

MONEY Kids and Money

How to Get a Grip on Your Child’s Therapy Bills

Parent and journalist Beth Pinsker explains how to get your kid the mental health treatment he or she needs without breaking the bank.

When I signed up my kids for therapy after my divorce, I made some financial mistakes. The biggest was choosing an out-of-network provider, over one who takes my insurance.

Instead of a simple $20 co-pay, I spent $150 out of pocket and get 70 percent of it reimbursed, which works out to about $1,000 more over a school year. In contrast, I have a friend whose child’s therapy sessions require no co-pays at all.

In this way, mental health coverage has a lot in common with airline pricing, where seats on the same plane may sell at many different price points.

Overall, Americans spend about $2,100 per child for healthcare, according to the Health Care Cost Institute’s report for 2007-2010. During that period, HCCI says, the use of mental health services by children jumped 24 percent.

At the same time, nearly half of all psychiatrists no longer take insurance, according to JAMA Psychiatry, with a similar portion of psychologists now only accepting private payment.

Add to that an overall shortage of providers – there are 8,700 child and adolescent psychiatrists, compared to about 50,000 for adults, according to Dr. Paramjit Joshi, division chief of psychiatry and psychology at Children’s National Health System – and you have a supply and demand problem that makes cost a real issue for parents.

Stay in-network

Finding a provider in your area may be easy enough, but finding one whose availability suits your child’s schedule could be downright impossible.

That’s why I went the private-pay route. My area of Brooklyn has no shortage of doctors on my plan, but after calling a dozen and finding that an after-school slot would entail a months-long wait, I went with a personal recommendation.

To avoid the appointment runaround, lean on your plan’s customer service department to make calls for you, says Dr. Ian Shaffer, executive medical director for behavioral health for Healthfirst, a New York health plan.

Need a therapist with a specialty? You may be able to get that provider covered if you ask, Shaffer says.

He cited a case where the family wanted a therapist who shared their ethnic heritage, and had been recommended someone who charged an eye-popping $350 a visit. Healthfirst found them another therapist with the same credentials, and covered the visits.

Reduce co-pays

My friend with the zero co-pay has insurance through the state’s child health plan, but enrolment in the plan is possible only if you don’t have access to other coverage.

Most people who are on health plans through their workplace don’t have payment wiggle room, but you can ask individual providers what they can do to help, especially if you have a high deductible.

Many private-pay therapists have sliding scales based on income; others have lower fees if you work with a trainee. Since the latter are supervised grad students, “it’s like getting two doctors for the price of one, says Clair Mellenthin, director of child and adolescent services at Wasatch Family Therapy in Salt Lake City, Utah.

Also check state resources to help pay for therapy, especially if treatment is needed for some kind of trauma following a crime. Many states have victim funds, says Mellenthin.

Mark progress

Therapy can seem like an endless process, so parents need to make sure it’s staying on track, says Mitchell Prinstein, a professor of psychology at the University of North Carolina at Chapel Hill.

After the initial evaluation, make sure you have a clear treatment plan and markers to help you figure out if your child is making progress. If there’s little improvement, get a second opinion, Prinstein says. And don’t feel bad about moving on if the therapist is not the right fit.

Fight for your rights

For ongoing treatment, it’s important to make sure the insurance company is not crimping your coverage.

Even though parity clauses in the new healthcare laws say you should get as many sessions as you need, that’s not always the case.

After a while, insurers may start saying the sessions are no longer medically necessary. This is especially true if your child has a serious ongoing problem, says Alan Nessman, senior special counsel for the American Psychological Association.

Any denial of coverage can be costly.

Joe Hoyle’s bill for one month of his daughter’s treatment for a serious illness was $125,000 after his insurance company denied the claim (he negotiated a lower payment with the hospital directly). To obtain ongoing coverage, Hoyle and his wife, who live in Virginia, got her on Medicaid.

“They say they cover things, but then they get to decide when things are ‘stable,'” he says.

Hoyle urges parents to get care early for their children to try to head off bigger problems.

“You can go along for 10 or 12 years and think your kid is just quirky, then almost literally overnight, it can go to full-blown mental illness,” he says. “You hate to talk about it, but people need to know because state governments need to do more to help people out.”

TIME mental health

Australian Woman Poisons Daughter to Get Facebook Attention

After being close to death last year, the girl has made a full recovery

An Australian mother has been jailed for deliberately poisoning her otherwise healthy 4-year-old daughter with chemotherapy drugs.

Over a nine-month period, the 23-year-old woman used the Internet to procure the cancer treatment drug cyclophosphamide — the lesser side effects of which include hair loss and fertility impairment — and then fed the chemicals to her child, who consequently came to suffer from near-fatal bone-marrow failure, reports AFP.

Her motive, say prosecutors, was attention. As her daughter’s health deteriorated, the woman turned to Facebook to chronicle the ongoing “fight for life,” attempting to evoke sympathy by describing the stricken child’s dire need for a bone-marrow transplant.

Although at one point close to death, the girl has since made a good recovery, the court heard, and has been placed in the custody of her grandparents. Her mother, who cannot be named to protect the victim’s identity, was sentenced to six years in prison after pleading guilty to grievous bodily harm. The crime carries a maximum penalty of 25 years’ imprisonment in Australia.

According to her legal team, the woman suffered from factitious disorder by proxy, defined by the Diagnostic and Statistical Manual of Mental Disorders as “the deliberate production or feigning of physical or psychological signs or symptoms in another person who is under the individual’s care.”

TIME Newsmaker Interview

Va. State Senator Tells Parents of Troubled Kids: You’re Not Alone

VA State Senator Creigh Deeds Discusses Mental Health Care Reform
Virginia State Senator Creigh Deeds speaks about mental health reform at The National Press Club, March 31, 2014 in Washington. Drew Angerer—Getty Images

Creigh Deeds, whose son attacked him and then committed suicide last November, talks to TIME about what the parents of mentally ill children can learn from his experience and that of recent mass killings like the Santa Barbara shooting rampage

Creigh Deeds, a 56 year-old Virginia state senator, can sympathize better than most with the father of Elliot Rodger, the 22-year old who killed six students in Santa Barbara last month before shooting himself. Last November, Creigh’s son, Gus, who had been suffering from mental illness, stabbed his father before committing suicide.

There are similarities in the deadly situations: the parents, divorced, worked together to help their troubled son. The public safety net meant to deal with such situations failed to prevent the tragedies. A month before Rodger’s rampage, the police visited Rodger, 22, after his mother alerted mental health authorities, but left after concluding that Rodger was not a threat. Thirteen hours before his death, Gus, 24, sought psychiatric treatment but was turned away at a local facility that said it didn’t have any available beds. Both families were wracked by their son’s death and have said it is now their responsibility to prevent similar tragedies in the future.

Deeds led the effort to successfully pass a mental health bill in Virginia earlier this year, and he told TIME in a short email exchange Monday that America’s privacy laws make it “exceedingly difficult” for parents of adult children to advocate for their children. He also had a message to parents: “be open to the unthinkable,” “stay involved” in your children’s lives and lobby elected officials on how to fix flaws in the system. He also tells parents of children struggling with mental illness, “you are not alone.”

Please find below TIME’s conversation with Creigh Deeds.

What was your reaction when you heard the news about the Santa Barbara shooting?

My reaction was probably similar to that of just about everybody else. I was shocked and saddened. The sadness deepened after I saw the snippet of YouTube video and learned of Elliot Rodger’s extensive history with mental health professionals and law enforcement.

The parents of the shooter had expressed concern about their son to the local police, and the police had three previous encounters with Elliot Rodger, but that did not prevent what happened. What can be done to make sure mass shootings don’t happen again?

I wish it were that easy. In a free society, I am afraid that we cannot completely eliminate the chance that a mass shooting, or any other crime, will occur. But I do not think we should ever be satisfied thinking that they are inevitable.

While an individual with mental illness is more likely to be a victim of a violent crime than a perpetrator, the recent high profile mass shootings shine a spotlight on mental health. We have to work hard to remove the stigma associated with mental health. We have to talk about mental health issues. We have to hold uncomfortable discussions with loved ones, roommates, or coworkers in need and seek treatment for those we care about. We have to understand that we are our brother’s keeper. We have to constantly be thinking about the needs of other people. As parents, we need to stay involved in our children’s lives and be open to the unthinkable, that our children may need help. And, when that important step is taken, the services must be there to meet the need.

What is your advice to other parents who are struggling with potentially dangerous children struggling with mental health problems? Who should they turn to?

Parents need to love their children, and sometimes that means protecting them from themselves. As soon as problems are identified, professional help should be sought. If you notice an escalation in behavior, do not hesitate to contact law enforcement or initiate proceedings to have your child evaluated. Educate yourself on mental illness and become involved in an advocacy organization. You are not alone. And if you encounter flaws in the system, a lack of services, or a problem, share you story with your elected officials.

Based on the volume of calls, emails, and letters I have received from throughout the United States since last fall, I know there are significant lapses in services and people have limited places to turn for help in many areas of this country. Moreover, our laws to protect patient privacy make it exceedingly difficult for parents of adult children to advocate for their children. Despite those barriers, parents must never give up.

Is there anything you learned as a parent or lawmaker after your son’s death that you wish you had known before?

There are many things I wish I had known, but none of them will bring my son back. The key lesson in all of this is that as parents, we have to develop strong relationships with our children and stay involved in their lives, especially if there are signs that the child, no longer a child, is in trouble.

Does the issue of handling mentally ill youth need a greater national focus?

Yes. The issue of handling mentally ill youth does need a greater national focus. Many mental illnesses, particularly schizophrenia and schizoaffective disorder, do not become apparent until people are in their late teens or early twenties. Part of the national discussion needs to be a greater understanding that mental illness affects one in four Americans, nearly every family, and people need to be better equipped to identify problems before they manifest themselves into dangerous illnesses. Moreover, there are some necessary changes, HIPPA [privacy rule] reform for example, that can only take place at the federal level.


Here’s What Happens To The Mind After 5 Years of Captivity

Captured US Solider
Sgt. Bowe Bergdahl in an undated image provided by the U.S. Army. U.S. Army/AP

Sgt. Bowe Bergdahl has a lot of healing to do after five years of captivity. The physical scars may fade, but the emotional ones can sometimes be too deep to heal completely

U.S. Army Sergeant Bowe Bergdahl, the last known American POW, was finally returned home over the weekend after five years held in captivity in Afghanistan. Since Bergdahl’s return, curious details have emerged about his mental state before and after capture. And it all begs the question: What does five years in captivity do to the human mind?

Bergdahl’s repatriation is going to be a challenge, and piecing together the psychologically and physically broken veteran is a delicate process. After all, an abduction is the ultimate exchange of power, spurring the start of a complicated relationship based on both deep distrust and reliance, say experts. “He’s to some degree merged with those who held him,” says Brian Engdahl, professor of PTSD Research and Neuroscience at the University of Minnesota. “He was totally dependent on them for food, shelter, clothing. It can reduce a person to a weak state where their entire life revolves around how their captors are treating them.” A morsel of food becomes a generous gift, only to be withheld at the next feeding.

Many POWs find physical and mental strength by relying on their fellow captured soldiers, but Bergdahl was alone. Speculation about whether he suffered from Stockholm Syndrome—the phenomenon where captives identify with their captors—are not unwarranted, though so far evidence hasn’t suggested this to be true.

Studies of POWs from the Korean War show that the psychological injuries from captivity stem from two types of trauma. The first is physical and usually short-term, caused by malnutrition and injury. The more persisting trauma is, of course, psychological. At Landstuhl Regional Medical Center in Germany, which treats U.S. vets from Afghanistan and Iraq, Bergdahl is likely being tested for depression, anxiety, and PTSD, says Engdahl. “Beyond that, he could be feeling deep guilt, shame, bewilderment, and a lost sense of identity,” says Engdahl. If his English is poor, as has been reported, it’s likely from lack of speaking.

Once home, psychological challenges won’t likely abate overnight, says Barbara Rothbaum, the associate vice chair of clinical research in the department of psychiatry at Emory School of Medicine. “But even if the trauma is over, it’s not really over,” she says. POWs often experience flashbacks, and will wake up in the middle of the night thinking they are still in captivity. Many victims become avoidant and don’t want to talk about their experience because they are afraid it will trigger memories, she says. It’s one of the reasons many will forgo treatment.

“I’ve had veterans tell me they were drunk for a year,” says Rothbaum. But avoidance is one of the worst ways to deal with the harsh return, and Rothbaum’s research has shown that talking about experiences early can actually help prevent the onset of PTSD.

“People want to avoid talking about the worst parts, the most shameful, the most embarrassing,” says Rothbaum. “But it will help.”

MONEY Careers

Reading This From Behind a Desk? You’re More Likely to Have a Fatter Wallet—and a Fatter Waist

While better paid, office workers are more likely to be overweight than their non-desk jockey peers. Use these tips to make sure your wallet is the only thing that's plump.

Spend most of your workday behind a desk? First, the good news: You probably make more money than someone who doesn’t, according to a new survey. CareerBuilder has found that workers in desk jobs are twice as likely to make more than $100,000, compared to those who do not work behind a desk.

Now for the not-so-good news: You’re also more likely to be overweight.

Nearly six in 10 of desk jockeys identify as overweight vs. five in 10 non-desk workers. And 46% report that they have gained weight in their current jobs.

Researchers have long known that sedentary work puts adults at a higher risk of obesity. But desk workers also told CareerBuilder about the psychic toll. Half of the respondents say that they feel “stuck inside,” and 56% say they spend most of their time staring at computer screens.

If you’re tied to a desk, here are some ways to stay fit and fight burnout:

Work on your feet

Citing the long-term dangers of sedentary work, the American Medical Association urges employers to let workers use standing desks or isometric balls. Ask your boss if you can make some changes to your workspace and spend more time on your feet.

Take a hike

Researchers have found that even short breaks from sitting are associated with better health outcomes. Every once in a while, remember to get up and walk around the office.

Do some desk exercises

One study suggests that workers today burn about 100 fewer calories than workers did in 1960. Adding short periods of exercise—such as these that you can do without leaving your workspace—to your daily routine could help keep off the extra pounds.

TIME psychology

The Importance of Daydreaming

Your best thinking occurs when your mind wanders

Last year’s great book was Daniel Goleman’s Focus: The Hidden Driver of Excellence. In it, Goleman shows how keeping your eye on the ball, focusing your undisciplined mind on the tasks at hand, is the key to success in life. Focus enables us to solve problems, to achieve goals.

But this is my encomium to the glory of a mind adrift. Your best thinking occurs when your mind wanders. Cognitive scientists say you have an incorrigibly distracted mind. The wandering mind is our brain’s default mode. Left to their own devices, our brains go to the beach when they’re not working on calculus or Angry Birds.

See? Even now your mind wanders. I’m desperate to stimulate your cerebral cortex in focusing on the wonders of neuroscience, and the lower functions of your brain are dragging you to think about what’s in the refrigerator.

A 2009 neurological study shows that half of your thoughts are daydreams. Even as your mind drifts away from neuroscience, Goleman says, maybe it is wandering toward a consideration of pressing personal problems or unresolved dilemmas. Sometimes we are so intimidated by the magnitude of a problem that we dare not consciously think about it. But then, when we’re half asleep or bored by an op-ed piece, our minds wander toward intimidating mental challenges. And it’s then that we unthinkingly do our best thinking.

True, sometimes mind wandering impairs focus on a task at hand. Yet Goleman says the time a distracted brain spends tackling tough challenges makes up for diminished productivity. Sorry, you math nerds who excel at cognitive control and disciplined attentiveness — you test poorly in creativity. Among the benefits of mind wandering, Goleman lists generating future scenarios, self-reflection, navigating complex social situations and incubating new ideas, to say nothing of giving your brain a rejuvenating vacation.

As G.K. Chesterton said of his deductive detective, Father Brown, “In that instant he lost his head. His head was most valuable when he had lost it. In such moments he put two and two together and made four million.”

The most brilliant research chemist I’ve ever known had a pathologically wandering mind. Each afternoon graduate students helped him hunt for where he had parked — not easy since he couldn’t remember the color or make of his car. The theory in the department was that he made amazing discoveries because his disordered mind, unconstrained by cherished hypotheses, made unexpected connections and stumbled upon serendipitous solutions.

But I digress.

Daydreaming can be the mind’s incubator. When we’re hyperfocused, the possibility of the mind reaching into its reservoir and making an “Aha!” diminishes. In daydreaming there’s no controlling censor to whisper, “That’s ridiculous” or “Completely impractical.”

Here’s good news: 10% of you are ADD, even though half of you are undiagnosed. A 2011 study showed that we adults with attention deficit disorder show higher levels of original creative thinking and more actual creative achievements than you bean counters who are good at attentiveness. Richard Branson, creator of Virgin Air, said the secret of his spectacular entrepreneurial success was that “I’m ADD. I kept being distracted by ideas for making money that nobody else would waste time on.” When asked the source of his comedy, Bill Cosby replied, “I’m ADD.”

Sadly, only 4% carry our ADD into adulthood; we’re doomed to get focused, buy a minivan, go to Harvard and vote Republican.

In 2011 a bunch of brain scientists got a government grant to study the brains of rappers as they freestyled, improvising tunes and lyrics in the moment. The rappers showed unusually heightened activity in the mind-wandering circuitry of the brain, “allowing fresh connections between far-ranging neural networks.” I digress.

The challenges before us present a puzzle. Global warming. National debt. Justin Bieber. Sadly, we focus on short-term, immediate payoffs. The future belongs to those who go beyond facts and think globally and synthetically, make serendipitous associations and devise surprising, novel combinations.

Daydreamers, time wasters, goof-offers, attention-deficited — unite! Throw off the chains of in-the-box, focused, well-disciplined attentiveness! Kick off your shoes. Go skinny-dipping in the fountain. Take a pointless detour to Detroit or Des Moines. Dare your imagination to roam, thereby to come up with the “Aha!” that will enable our civilization to stumble upon a brighter future than can be had merely through clear thinking.

I read a book on the history of scientific discovery (though it has nothing to do with anything I do for a living) and noted not the importance of a good graduate-school education but rather the value of a walk in the woods, an overly long bath, hours wasted in a garden. That playful, legendary daydreamer Einstein said, “The intuitive mind is a sacred gift; the rational mind is a faithful servant. We have a society that honors the servant and has forgotten the gift.” Both Play-Doh and Silly Putty were discovered by mistake.

It’s the 100th anniversary of the neurasthenic Marcel Proust, who dips a cookie into a cup of tea, lets his mind wander and then writes the world’s greatest novel — 1,000 pages of literary digression.

I digress.

Willimon is a prolific writer, retired United Methodist bishop and professor at Duke Divinity School in Durham, N.C. This piece is a version of his graduation address at Durham Academy on May 23.

TIME mental health

Bad News For Ivy Leaguers: ADHD Drugs Hurt Your Memory

Cultura/Frank and Helena—Getty Images

Smart drugs used to boost performance in the short term have long term damage for the young brain, a new study says

Prescription drug abuse is rampant, and for a third of Americans, the first drug of any kind that they take—including illicit drugs—is an Rx that has not been prescribed to them. That’s not surprising when you consider how many students abuse ADHD drugs for performance. But new research shows that recreational use of smart drugs comes at a cost.

Researchers from the University of Delaware and Drexel University College of Medicine reviewed the latest research on the effects of medications like Ritalin and Proviigil on the juvenile brain and discovered smart drug use is certainly not benign. The new research published in the journal Frontiers in Systems Neuroscience shows that while a drug like Ritalin may offer a boost in mental performance, it’s a short-term crutch that can actually adversely impact the brain’s plasticity, interfering with people’s ability to plan ahead, switch between tasks and be overall flexible in their behaviors.

For instance, the researchers looked at one of the most popular smart drugs on the market: Methylphenidate (otherwise known as Ritalin and Concerta). The drug is meant to treat ADHD, and about 1.3 million U.S. teens have reportedly used the drug without a prescription in the last month. Rat studies have shown that young brains are very sensitive to methylphenidate and that even low doses can harm nerve activity in the brain as well as memory and complex learning abilities. For a drug that’s supposed to offer better mental performance, the long term effects appear to do the opposite.

The study also took a look at the drug modafinil, also known as Proviigil which is used for sleep disorders like narcolepsy. The drug can help boost memory and is abused for various mental tasks, especially tasks related to numbers. But once again, the drug has very similar long-term effects on the young brain.

Finally, the researchers looked at a lesser-used class of drugs called ampakines, which are being studied by the military to increase alertness. They are known to improve memory and cognition, but for young people, unsupervised use can result in an overstimulated nervous system which could actually kill nerve cells.

“The desire for development of cognitive enhancing substances is unlikely to diminish with time; it may represent the next stage in evolution—man’s desire for self-improvement driving artificial enhancement of innate abilities,” the authors write.

And there’s no arguing with that. Other recent research looking at the use of smart drugs among Ivy League students found that many use ADHD drugs for academic performance, and they don’t think it constitutes as cheating. The study found that a third of the students in the study said using ADHD drugs for performance enhancement did not count as cheating, 41% said it was cheating, and 25% said they were not sure. People who used ADHD meds were also more likely to think it was a commonplace on campus.

The use of ADHD and other smart drugs has long been an ethical issue, and a growing one at that. Increasingly more people are being diagnosed with ADHD, even adults. The amount of adults taking ADHD drugs rose by over 50% between 2008 and 2012, according to a recent report. But now, emerging research shows the issue is also a biological one, and the early findings are not pretty.

The researchers of the latest study conclude that scientists and the medical community have a responsibility to very carefully evaluate and research each no drug to gain a greater understanding of drugs’ impact on the brain.


TIME Smoking

The Weird Link Between E-Cigarettes and Mental Health Disorders

This September 25, 2013 photo illustration taken in Washington, DC, shows a woman smoking a "Blu" e-cigarette (electronical cigarette). PAUL J. RICHARDS—AFP/Getty Images

A new study finds elevated rates of depression, anxiety and other mental disorders among users of e-cigarettes

A new study has found that people suffering from depression, anxiety and other mental disorders are more than twice as likely to spark up an e-cigarette and three times as likely to “vape” regularly than those without a history of mental issues.

Researchers at the University of California, San Diego drew their findings from an extensive survey of American smoking habits. Among 10,041 respondents, 14.8% of individuals suffering from mental health disorders said they had tried an e-cigarette, compared with 6.6% of individuals who had no self-reported history of mental disorders.

The e-smokers’ elevated rates of mental disorders reflected the elevated rates of mental illness among smokers in general. The authors note that by some estimates, people suffering from mental disorders buy upwards of 50 percent of cigarettes sold in the U.S. annually.

Many respondents said they switched to e-cigarettes as a gateway to quitting. The FDA has not yet approved e-cigarettes as a quitting aide.

“People with mental health conditions have largely been forgotten in the war on smoking,” study author Sharon Cummins said in a university press release. “But because they are high consumers of cigarettes, they have the most to gain or lose from the e-cigarette phenomenon.”

The study will run in the May 13 issue of Tobacco Control.

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