Recovery Michigan

We launched this blog to help share the efforts of the Veterans Legacy Program, a new effort launched by VA’s National Cemetery Administration to provide opportunities for students, teachers and the general public to learn and explore how the stories of Veteran service and sacrifice are woven into U.S. history, local history and contemporary issues.  Through this blog we will feature NCA professionals, students, teachers and the general public contributing to this work.

A critical component of this effort will come from the partnerships we are planning to create with schools and universities around the country.  These partnerships will be rooted in inquiry, researching and developing educational materials for students and the general public on the inherited veterans legacy enshrined in the local national cemetery.

Thank you for joining me on this journey as we “Discover their history and honor their sacrifice.”

With men more reluctant than women to seek help for depression or suicidal thoughts, the Black Dog Institute hopes an online program can help with specific coping strategies.

Developed for the institute's My Compass website, which helps people improve their mental health, the Man Central program helps men identify early warning signs of depression, monitors their moods and provides tips on how to cope.

Dr Kristine Kafer, a clinical psychologist and consultant with the institute, said men's depression tends to be hidden and isn't always picked up by traditional screening tools.

The online program was based on research carried out in 2014 that explored common risk factors for men having suicidal behaviour and how to intervene in their downward spiral.

It also identified a "tool box" of strategies men use to cope when they feel sad and ones they use to stop the "black dog" creeping up on them.

Common coping mechanisms included taking time out, doing something they enjoy, keeping busy, exercising and spending time with a pet.

To prevent depression, men liked to eat healthily, keep busy and maintain a sense of humour.

Dr Kafer said the research found ideas about masculinity and stoicism often meant many men blamed themselves and felt ashamed if they were depressed.

In late spring of this year, researchers at the Centers for Disease Control and Prevention published a troubling data analysis of suicides in the United States. Between 1999 and 2014, suicide rates increased by 24%, in both males and females, and in all age groups studied. While deaths due to disease are declining, suicides are increasing. Right now, suicide is one of the 10 leading causes of death overall in the United States and in every age group from ages 10 to 64.

Particularly alarming: a sharp increase in suicides — a 200% increase, in fact — among girls ages 10 to 14, with the steepest rate of rise after 2006. The numbers have many experts wondering what is going on.

He points out that there is a range of factors that put children — boys and girls —at risk for suicide. These include substance use disorders and prior attempts to harm themselves. But one of the biggest risk factors is depression.

According to theAmerican Academy of Child and Adolescent Psychiatry, there are roughly 8,300 trained physicians for approximately 15 million children in need of their expert help.

That’s woefully inadequate.

One result of the extreme scarcity in pediatric and adolescent psychiatrists is that depression is widely diagnosed and treated by primary care physicians. Most primary care doctors (pediatricians, internists, and family doctors) do not receive formal training in diagnosing and treating psychiatric disorders, including when and how to prescribe antidepressants, and yet they are on the front lines in doing just that. As a primary care doctor, I can tell you from my own experience that this is very true.

Other factors that contribute to suicide in girls

One of these is the “online life” of children — including social media with its relatively new phenomenon of cyberbullying. According to Dr. Beresin, “This is potentially dangerous. We don’t yet have the data on cyberbullying and suicides, but, in my opinion, cyberbullying may be a major factor in the suicide rates, particularly in young girls. Girls are the best at verbal bullying, very vicious. Boys tend to be physical, girls tend to be emotional. I’m not against social media at all, there are good things about it, but when a kid is cyberbullied, the ‘abuse’ can spread quickly and widely. Rumors that might have been contained to the high school can spread quickly and easily to a much, much larger population. The shame and humiliation can be devastating. So, the high rates of suicides in girls 10-14 may reflect a greater impact of social media cyberbullying among girls than boys. This is not a definite, but it needs to be considered and studied.” What might surprise people is that both the kids who do the bullying as well as their targets are at greater risk for suicide, andcyberbullying appears particularly dangerous.

“Copycat suicide in adolescents is a fact. The data suggest that when suicides are reported in the news and glamorized and sensationalized, there is a well-documented two-week window during which there is a ‘burst’ of suicides,” says Dr. Beresin. Considerable research from countries around the world shows that this two-week window of copycat suicides is a real phenomenon. Finally, in general, access to firearms increases the chances of death by suicide.

During the recent IFA conference here in Berlin, Philips presented the Dream Family solution designed to improve the sleep therapy experience for people with obstructive sleep apnea(OSA). More than 100 million people worldwide are estimated to have OSA, a serious condition that is treated with positive airway pressure (PAP) therapy. The Dream Family, comprised of the DreamWear mask, DreamStation PAP device, and DreamMapper patient engagement app, is designed to engage sleep apnea patients with one of the most comfortable and effective therapies available.

The components of the Dream Family were inspired by feedback from more than 900 patients as well as insights from clinicians who treat sleep apnea. This input combined with Philips’ more than four decades of experience developing revolutionary patient-centric solutions led to the award-winning design of the Dream Family. Since their launch in October 2015, DreamWear and DreamStation have been honored for excellence in design, including recent iF Design, Red Dot, Good Design Australia, and Core77 accolades.

One in ten children and young people suffer from some kind of mental health problem, including depression and anxiety.   Concerns about under-diagnosis and under-treatment contrast with worries about over-prescribing and the medicalisation of unhappiness in young people.

The research found that:

• Antidepressant prescribing rose significantly, by 28%, mainly in older adolescents
• Depression diagnoses showed a steady decline by just over a quarter, while symptoms of depression more than doubled
• Unlicensed citalopram prescribing occurs outside current guidelines, despite its known toxicity in overdose
• Just over half of new antidepressant prescriptions were associated with depression.  The rest were associated with diagnoses such as anxiety and pain

The findings led the researchers to call for new strategies to implement current guidance for managing depression in children and young people.

Washington State University researchers have found that treatments of pure oxygen in a high-pressure chamber can relieve the symptoms of opiate withdrawal.

Ray Quock - a pharmacologist and WSU psychology professor - gave morphine-addicted mice pure pressurized oxygen before they began withdrawal from the drug. The mice had far less severe withdrawal symptoms than addicted mice that did not receive the treatment.

Outwardly, said Quock, the treated mice appeared "much calmer. You can tell the difference."

Initial effort toward FDA approval for fighting epidemic

Writing this month in the journal Brain Research, Quock and his colleagues say implications of the discovery are of "profound importance." While current therapies for treating heroin addiction can provide relief from withdrawal, they themselves can be addictive.

Moreover, the finding comes amid a national heroin epidemic in which use of the drug has doubled among young adults over the past decade, according to the U.S. Centers for Disease Control. Meanwhile, withdrawal symptoms can be so severe that some addicts will continue taking the drug to avoid the process, said Quock.

But while the U.S. Food and Drug Administration has approved using hyperbaric oxygen therapy for 14 specific indications - including carbon monoxide poisoning, decompression sickness and wound healing - it is not approved for drug withdrawal. A physician could administer the therapy for such an off-label use, said Quock, but it would not be covered by medical insurance.

"Our research and work that we hope to do in the future should stimulate some clinical researchers to come up with clinical evidence to convince the FDA that this should be an approved indication," he said.

The Food and Drug Administration is warning that patients and doctors should more fully understand the potentially life-threatening risks of combining anti-anxiety or sleep medications with prescription opioids.

To that end, the agency is requiring that nearly 400 products carry a "black box warning" highlighting the risks from combined use, it said in a press releaseWednesday. The risks include extreme sleepiness, respiratory depression, coma and death.

The move comes after an extensive review of scientific evidence by the FDA showing that physicians have been increasingly prescribing these drugs together. There was also a request for action in February, when health officials in cities and states across the country petitioned the agency for the change to the drug labels, citing an increase in overdoses from simultaneous use of the drugs.

"As an emergency physician, I have seen so many patients who are prescribed opioids and benzodiazepines together," wrote Dr. Leana Wen, Baltimore's health commissioner and a leader of the effort, on Twitter Wednesday. "A black box warning is a powerful education tool and thank [you to the FDA] for taking action to help prevent deaths from this dangerous combination."

Laura Reppenhagen always had an annual conversation with teachers about her daughter's mental illness, like other mothers might warn a teacher about their child's allergies.

Mickayla Reppenhagen has been diagnosed withschizoaffective disorder, a condition that falls on the severe end of the bipolar spectrum and causes mood swings — from deep depression to days of sleepless energy — and occasional hallucinations. Her mother said she always found the frank conversations "gave the teachers the knowledge to know this is why she's behaving this way" and helped the school give her daughter the help she needed.

But the Elsie mother said she also knows parents who won't get their children antidepressants because they don't want the pharmacist to know.

"Stigma is really kind of our worst enemy in mental health," said Krissy Dristy, a statewide youth peer support coordinator for the Association for Children's Mental Health, who has struggled herself with anxiety and depression.