Accommodating Mental Illness In The Workplace

http://goo.gl/XM0YwC

(NAPSI)—For people with mental illness, getting and keeping a job can present some unique challenges. Unlike physical disabilities that can be seen and recognized, employers may not realize that a person is experiencing mental health issues or may not understand behaviors as stemming from an illness. They may also not know they have to provide workplace accommodations to help mentally ill people who require adjustments to remain employed and productive.

Not every person experiencing mental illness will have difficulty at work, but some will. "Hidden" disabilities such as depression, post-traumatic stress disorder (PTSD), schizophrenia, obsessive-compulsive disorder, traumatic brain injury, and intellectual and learning disabilities (e.g., attention deficit disorder and attention deficit/hyperactivity disorder) can affect a person's ability to perform a job.

Also, shifts in mental health can trigger and recede without warning. When someone experiences a mental health issue, it can be difficult to focus, process, think clearly, remember details, organize thoughts and tasks, and stop and start activities.

For these individuals, Title I of the Americans with Disabilities Act Amendments Act of 2008 (ADAAA) requires employers to make "reasonable accommodations" to help people with mental health disorders do their jobs. The ADAAA does not list medical conditions that are disabilities, but rather gives a general definition of disability. A doctor may be required to validate the need for accommodation.

"Employers don't always know what a person is living with," says Beth Loy, Ph.D., who is a principal consultant with the Department of Labor's Job Accommodation Network (JAN). "There may be limitations due to medication, or a flexible schedule might be needed for a person to go to therapy appointments."

The JAN is a comprehensive resource for people who want to understand their rights regarding disabilities and possible accommodations. Individuals can access information on JAN's website or reach out to it directly with questions.


People with alcohol dependency lack important enzyme

http://goo.gl/4ktbNX

A research group under the leadership of Linköping University Professor Markus Heilig has identified an enzyme whose production is turned off in nerve cells of the frontal lobe when alcohol dependence develops. The deficiency in this enzyme leads to continued use of alcohol despite adverse consequences.

The enzyme, PRDM2, has previously been studied in cancer research, but we didn't know that it has a function in the brain," says Markus Heilig, professor of psychiatry and head of the Center for Social and Affective Neuroscience (CSAN) at Linköping University.

He and his research group are linking together research into alcoholism and other addictive illnesses with advanced brain research. It has long been suspected that people with alcohol dependence have impaired function in the frontal lobes of the brain, but the underlying biological mechanisms have not been known. The research team behind the paper, which includes researchers from both Linköping University and University of Miami, is the first to identify this molecular mechanism.

If frontal function is impaired, it is difficult for us to control our impulses. A person with intact impulse control can walk past a bar on a warm day and think 'A beer would be nice, but I can't have one now because I have to get back to work'. An alcoholic does not have sufficient impulse control to refrain, thinking: 'It's hot and I'm thirsty'.

"PRDM2 controls the expression of several genes that are necessary for effective signalling between nerve cells. When too little enzyme is produced, no effective signals are sent from the cells that are supposed to stop the impulse," Professor Heilig tells us.

Study Examines PTSD and Cognitive Impairment in World Trade Center Responders

http://goo.gl/a6u2vn

New research published by the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoringconfirms the connection between posttraumatic stress disorder (PTSD) and cognitive impairment – in this case, among those who helped with search, rescue and cleanup efforts following the 2001 World Trade Center (WTC) attacks.

“To our knowledge, this is the first study to examine the association of PTSD and major depressive disorder (MDD) with cognitive impairment in a large group of civilian World Trade Center responders without head injury,” said Sean A. Clouston, Ph.D., first author on the article.

In the study population of more than 800 WTC responders:

  • Approximately 12.8% (104) had scores indicative of cognitive impairment (CI) and 1.2% (10) had scores suggesting possible dementia.
  • Current PTSD and MDD were associated with CI.
  • Re-experiencing symptoms (e.g., flashbacks, nightmares) was consistently associated with CI.
  • Since 2002, more than 33,000 responders have enrolled in a Centers for Disease Control and Prevention-sponsored WTC Health Program.

According to the authors of this new study, if the findings from their group are representative of actual prevalence of CI in the full cohort, results may translate into 3,740-5,300 individuals with CI and 240-810 individuals with dementia.

“These numbers are staggering, considering that the average age of responders was 53 during this study,” Clouston said.

Sleep apnoea blamed for schizophrenia complications

Interesting idea, especially considering how sleep problems affect inflammation....

http://goo.gl/Yb1Mf9

Lead researcher Hannah Myles said 45 per cent of the patients in the study were diagnosed with sleep apnoea and eight of them were diagnosed with severe sleep apnoea.

She said the results showed that many symptoms previously thought to have been caused by schizophrenia or medication could have been caused by sleep apnoea instead.

"We found that they had very high rates of sleep apnoea - about three times more likely to have severe sleep apnoea than someone in the general population," Dr Myles said.

"In the last 10 years or so it has become a lot more well known that people who suffer from schizophrenia suffer from cardiovascular disease and obesity. Another thing we noticed was a lot of our patients lost a significant amount of weight - the average weight loss was about 13kgs.

"We are hoping that the results of our study would lead to more people with schizophrenia being offered sleep studies and the sleep apnoea being diagnosed and treated."

Researchers used CPAP (Continuous Positive Airway Pressure) machines - commonly used for treating sleep apnoea - to measure its effectiveness at treating people with both schizophrenia and severe sleep apnoea.

The positive airway pressure was found to restore normal brain activity during sleep and improved the severity of sleep apnoea. It also improved memory and the overall health of participants.

Experimental depression therapy showing promise

http://goo.gl/BJX8Hj

By the summer of 2014, 17-year-old Timothy Bates had all but given up.

On a steady stream of depression medications since he was 14 and prone to self-harm that included cutting – "I loved my razor blades for a while," he said – the Wyoming teen was depressed and suicidal when he was checked into Billings Clinic's psychiatric department for a two-week stay, his second such trip in just a few months.

"I was pretty much done," said Bates, now 19. "I had given up on all of it."

Bates' turnaround was so dramatic and it piqued staff's interest so much that the psychiatric department sought and gained approval to undertake what appears to be one of the first studies on the effectiveness of the treatment, called triple chronotherapy, in teenagers.

Triple chronotherapy involves three distinct parts, beginning with 36 hours of sleep deprivation for the patient.

That is followed by advancing the patient's sleep cycle to a normal bedtime over the next three days. A typical cycle might begin with having the patient sleep from 6 p.m. to 1 a.m. on the first day, 8 p.m. to 3 a.m. and finally from 10 p.m. to 5 a.m., followed by a regular 10 p.m. to 6 a.m. sleep schedule.

Finally, every morning beginning after the first night of sleep deprivation, the patient undergoes 30 minutes of light therapy at the same time each day using a specialized, but common, light box.

The box is the same type used to help patients suffering from seasonal affective disorder and, for the purposes of the clinic's work, is a 10,000-lux light. 

The therapy should never be done without supervision from trained medical professionals.


9 mobile apps designed to help veterans

http://goo.gl/5Csge5

Last week we published a gallery that featured 8 different apps designed to help veterans, and today we want to give you that same info in one easy-to-read article. For some screenshots of the apps in action check out the gallery, or keep reading to get all the important info right here!

The Veterans Administration app store

If you've tried searching iTunes or the Play store for VA apps you may have been disappointed at what you found. There are native iOS and Android apps that the VA made, but they're nowhere near as robust as what's available on the VA App Store.

This mobile site runs "apps" that are formatted for mobile users but available on all platforms. You can sort by type of app and platform, as well as being able to manually search for what you want.

The one drawback of the VA App Store platform is that it's a bit confusing, especially if you're not a tech-savvy vet. Most of the things you can do on the App Store are available on websites or native mobile apps, which might be easier if you don't feel like learning a new system.


Understanding the unhappy side of serotonin

I had the opposite reaction. I had relief from social anxiety immediately....

http://goo.gl/tPC2Ev

Findings showed that increasing the activity of these pathways reduced the fear anxiety caused by the foot-shock treatment in the mice. Decreasing it raised anxiety levels.

Prozac, or fluoxetine, boosts serotonin levels. When the scientists exposed 2C-receptor BNST neurons to Prozac, it increased the effect of the 2C-receptor neurons on the neighboring VTA- and LH-projecting neurons. The mice became more fearful and anxious.

To find out how to stop this effect, senior author Thomas L. Kash and his team focused on the anxiety-mediating BNST neurons. They noticed that these neurons expressed a molecule, known as corticotropin releasing factor (CRF). CRF is a stress-signaling neurotransmitter. It is sometimes called corticotropin releasing hormone (CHR).

When the team added a compound to block CRF activity, the fear and anxiety that had been triggered by the Prozac were greatly reduced.

A placebo can work even when you know it’s a placebo

Not new idea, but interesting application....

http://goo.gl/On3LgU

But what if people were told, up-front, that they were getting a placebo and not an active medication? It stands to reason the placebo would have no effect. Right?

Wrong.

In one study, Kaptchuk looked at people with irritable bowel syndrome (IBS), a common condition that causes abdominal cramping and diarrhea or constipation that can be debilitating for many. Half of the study volunteers were told they were getting an “open-label” placebo and the others got nothing at all. He found that there was a dramatic and significant improvement in the placebo group’s IBS symptoms, even though they were explicitly told they were getting a “sugar pill” without any active medication.

Kaptchuk says placebos won’t work for every medical situation—for example, they can’t lower cholesterol or cure cancer. But they can work for conditions that are defined by “self-observation” symptoms like pain, nausea, or fatigue.

“People can still get a placebo response, even though they know they are on a placebo,” he adds. “You don’t need deception or concealment for many conditions to get a significant and meaningful placebo effect.”

Study shows high engagement with digital therapy for schizophrenia spectrum disorders

http://goo.gl/J5sJRV

Patients were given a research version of Thrive to see whether they would engage with it, and found that 74 percent of the patients were successfully able to use the digital therapy three to six months after discharge, and, on average, using the therapy for 82 percent of the weeks they had the mobile phone.

The researchers also found that patients engaged with the app every other day, and when engaged, they used the on-demand features more than once per day. Those who used the app for the entirety of the study used it an average of 4.3 days per week.

"Patients with schizophrenia are traditionally considered a high risk patient population and the period immediately following hospitalization is of particularly high risk.  This study debunks the concern that patients who are not clinically stable are not capable of using mobile interventions," Dr. Dror Ben-Zeev, PhD, Director of the mHealth for Mental Health Program at Dartmouth College, who led the study, said in a statement.


Disruptions to sleep patterns lead to an increased risk of suicides

http://goo.gl/n0XSs6

The link between sleep problems and suicidal thoughts and behaviours is made starkly clear in new research from The University of Manchester, published in the BMJ Open.

In this study, conducted by researchers from the University's School of Health Sciences alongside the University of Oxford, 18 participants were interviewed about the role sleep problems have on suicidal tendencies.

Three inter-related pathways to suicidal thoughts were identified arising from sleep problems. The first was that being awake at night heightened the risks of suicidal thoughts and attempts, which in part was seen as a consequence of the lack of help or resources available at night.

Secondly, the research found that a prolonged failure to achieve a good night's sleep made life harder for respondents, adding to depression, as well as increasing negative thinking, attention difficulties and inactivity.

Finally, respondents said sleep acted as an alternative to suicide, providing an escape from their problems. However, the desire to use sleep as an avoidance tactic led to increased day time sleeping which in turn caused disturbed sleeping patterns - reinforcing the first two pathways.