Children with pre-existing mental health issues thrived during the early phase of the pandemic.
- While COVID-19 physically affects adults more than children, mental health distress has increased across all age groups.
- Children between 5 and 17 sought help for mental health issues at much higher rates in 2020.
- However, a new study found children with pre-existing mental health issues experienced reduced symptoms when lockdowns began.
While the physical effects of COVID-19 have dominated headlines for the last 13 months, mental health effects are considered a simultaneous pandemic that could outlast the virus. Children have generally been resilient against the novel coronavirus (though at least one variant is hitting that demographic harder). In terms of depression and anxiety, however, children are on par with adults.
Emergency hospital visits for mental health issues in the 12-to-17-year-old demographic have jumped 31 percent since the pandemic began. Younger children have fared only slightly better: a 24 percent increase for children ages 5 to 11. In Germany, one in three children has suffered anxiety or depression over the past year. On top of this, children are having trouble learning in remote education environments.
However, at least one demographic fared better than normal, at least during the early phase of lockdowns. According to a new study, published in the Journal of the American Academy of Child and Adolescent Psychiatry, middle school children from a predominantly Latinx community with higher-than-normal levels of mental distress experienced a reduction in symptoms.
Children with previous mental health problems saw reduced internalizing (behaviors including being withdrawn, nervous, lonely, unwanted, or sad), externalizing (behaviors including lying, acting irresponsibly, breaking the law, or displaying lack of remorse), and other problems.
Those without mental health issues benefited as well, at least in terms of internalizing and overall behavior; there was no change in attentional issues or externalizing.
The researchers began tracking 322 children (average age 12) in January 2020, before the pandemic took hold in America. They were studied until May 2020. While this only represents a sliver of time in lockdown, senior author Carla Sharp, a psychology professor at the University of Houston, says the results have important clinical implications.
"First, promoting family functioning during COVID-19 may have helped protect or improve youth mental health during the pandemic. Further, it is important to consider cultural factors, such as familism and collectivism in Latinx communities that may buffer the early effects of disasters on mental health to COVID-19 stress."
Seven-year-old Hamza Haqqani, a 2nd-grade student at Al-Huda Academy, uses a computer to participate in an E-learning class with his teacher and classmates while at his home on May 01, 2020 in Bartlett, Illinois.Photo by Scott Olson/Getty Images
Many have decried what we've lost during this past year. Indeed, the issues are many and complex. Yet we've also seen reductions in environmental damage (including noise pollution) and increased savings. We also have a greater awareness of how factory farming helps viruses proliferate. And, despite the obvious challenges of earning a living with so many businesses and industries shuttered, this time has afforded some an opportunity to reconnect with their family.
Study co-author Jessica Hernandez Ortiz says this research could inspire new avenues of addressing mental health issues in children.
"Our findings underline the importance of the family environment and Latinx collectivist values of community connection for promoting child resilience and brings into stark focus the possibility that school environments may exacerbate mental health difficulties. Removal from that context into a less pressured environment immediately and positively impacts mental health."
Since the study ended shortly into the pandemic, the novelty of family togetherness could have diminished as families became economically strained and realized that spending all their time together was more taxing than initially imagined. That said, humans are social animals that require regular contact with family and peers. The latter group might not have been available, but at least for some children, their families filled in the gaps, especially for those that did not thrive in a traditional school environment.
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
Intrinsic religiosity has a protective effect against depression symptoms.
- According to new research, intrinsic religiosity has a protective effect against depression symptoms.
- Religion was only a pipeline, however—a sense of meaning mattered most.
- With increasing rates of depression globally, religion could be a "natural antidepressant" for some.
The question of meaning remains one of life's greatest inquiries. Is religion necessary for deriving meaning? Can a modern, secular Buddhist approach work better, in which meaning is derived in moment-by-moment perception instead of reserving faith for a revelation at some future point?
These questions won't be answered here, though new research from Brazilian researchers has found that religion alleviates depressive symptoms in believers. Published in the journal Trends in Psychology, the researchers asked 279 volunteers (72 percent female) to respond to an online questionnaire that focused on intrinsic religiosity, meaning in life, and levels of anxiety and depression.
The team concludes, "intrinsic religiosity has a protective effect against depression symptoms; however, it occurs indirectly, via meaning in life."
The authors note that 4.4 percent of the global population suffers from depression, with women 1.5 to 3 times more likely to experience depressive symptoms. Religion, it appears, provides a bedrock for communing with the sacred. They define religion as the general "beliefs, practices, and rituals related to the sacred and vary according to each religious tradition." Intrinsic religiosity, the focus of this research, skews toward individual relationships with the sacred, not utilitarian values—the extrinsic dimension.
Religion Is Nature's Antidepressant | Robert Sapolsky
The question of meaning in life and religion has been a hot topic of late. Leigh Stein recently pinpointed the emerging trend of influencers being treated as moral authorities, to which she pointed to decreasing faith as a potential reason: void of traditional religion, people are searching for meaning in digital spaces.
She writes that 22% of millennials now identify as "nones." The broader religious landscape in America has shifted dramatically in the last generation. According to a 2019 Pew poll, American adults claiming Christianity dropped 12 points in the last decade. Overall, 26% of adults identify as "none."
"None" is an umbrella term signifying an atheist, agnostic, or someone not interested in anything in particular. Sometimes this includes dabblers who pull from a variety of traditions without feeling invested in one. Stein noticed that wellness influencers have rushed in to fill a void, intentionally or not. As she writes,
"I was once one of those millennials who made politics her religion; I lasted three years as a feminist activist and organizer before I burned out in 2017. That's when I began noticing how many wellness products and programs were marketed to women in pain, and how the social media industry relies on keeping us outraged and engaged. It's no wonder we're seeking relief."
Shadi Hamid occupies a similar place, though he identifies tribal political affiliations as the replacement for religion—specifically, to replace meaning. He claims a quarter of American adults qualify as "none," noting that less than half are traditionally religious, i.e. Christan church attendees, based on a 2019 Gallup poll. Hamid argues that this pivot occurred when religion left our lives.
"As Christianity's hold, in particular, has weakened, ideological intensity and fragmentation have risen. American faith, it turns out, is as fervent as ever; it's just that what was once religious belief has now been channeled into political belief. Political debates over what America is supposed to mean have taken on the character of theological disputations. This is what religion without religion looks like."
Credit: sutichak / Adobe Stock
Hamid believes the Left and Right channel their political-religious hybrids differently: the woke Left repurpose original sin, atonement, ritual, and excommunication as pathways to creating a more just society while the Right has stripped much of the religion from their religion in order to focus their existential angst into blood and soil themes. QAnon, for example, is essentially a religious doctrine, requiring of its devotees the same leaps of faith.
Stein looks at the politicization of religion—really, the religiosity of politics—as a failure of imagination. Why, she wonders, have people put their faith in memoir-selling, supplement-slinging influencers instead of people who have actually accomplished something in their lives other than turnkey marketing campaigns? Why would we turn to so-called leaders incapable of even attempting to answer life's big questions, or at the very least offer solace in the face of uncertainty, the classical role of religious leaders?
"There is a chasm between the vast scope of our needs and what influencers can provide. We're looking for guidance in the wrong places. Instead of helping us to engage with our most important questions, our screens might be distracting us from them. Maybe we actually need to go to something like church?"
The research team in Brazil might agree. One defining symptom of depression is an inability to foresee a better future. The global number might be 4.4 percent, but in America, the number is closer to 8 percent. America, now considered the twelfth wealthiest country in the world, ranked third in terms of depression. Money is never going to buy happiness.
Will religion? While the track record is spotty, this new research entertains an intrinsic sense of belief in the sacredness of life as a natural antidepressant, as Robert Sapolsky phrased it. During a time of growing unease, the suspension of disbelief might be what the doctor ordered—for some at least.
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
New study suggests the placebo effect can be as powerful as microdosing LSD.
- New research from Imperial College London investigated the psychological effects of microdosing LSD in 191 volunteers.
- While microdosers experienced beneficial mental health effects, the placebo group performed statistically similar to those who took LSD.
- Researchers believe the expectation of a trip could produce some of the same sensations as actually ingesting psychedelics.
Swiss physician Paracelsus knew chemicals that heal in small doses can be toxic in large doses. The 16th-century "father of toxicology" spent his career investigating the effects of chemistry on human biology—and consciousness.
Psychedelics offer some of the most profound changes in consciousness known to humankind. As with the work of iatrochemists (chemists that provide chemical treatments for disease, a discipline vocally championed by Paracelsus), modern researchers recognize that understanding the dosage requirements of psychedelics is essential for determining efficacy. While overdosing can be psychologically damaging, psychedelics are generally not deadly, making them ideal for study.
Most people don't worry about overdoing LSD or psilocybin, however. The current trend is almost homeopathic in nature. Microdosing has become the productivity pastime of the Silicon Valley set, with knowledge workers swearing that minute quantities of LSD help them focus. Given the legal status of psychedelics, however, research has been scarce, though growing.
Imperial College London's Centre for Psychedelic Research has led the way in clinical trials. Director Robin Carhart-Harris has published over 100 papers on the effects of psychedelics on a variety of mental health issues. The center recently produced one of the first large-scale studies on microdosing, with a caveat—the psychedelics were self-supplied (to skirt legal issues) and the psychological results self-reported.
Psychedelics: The scientific renaissance of mind-altering drugs
For the study published in eLife, the team recruited 191 citizen cosmonauts to microdose either LSD or a placebo over the course of several weeks and note the psychological effects. Volunteers were already microdosing LSD, so there was no true control. Each volunteer was given instructions on creating their own low-dose gel capsules, some containing LSD, others not. Then they mixed the capsules in envelopes so they didn't know if they were taking the real thing or not.
The trial design was ingenious: each capsule featured a QR code that was scanned after the addition of ingredients but before they were placed in the envelope so that researchers knew what they were ingesting.
The problem: volunteers sourced their own LSD. Lack of quality control could have had a profound effect on the results.
The results: LSD microdosers reported feeling more mindful, satisfied with life, and better overall; they also noticed a reduction in feelings of paranoia.
The catch: the control group felt the same thing, with no statistical difference between the groups.
Lead author Balázs Szigeti comments on the findings: "This suggests that the improvements may not be due to the pharmacological action of the drug but can instead be explained by the placebo effect."
Credit: Alexander / Adobe Stock
Psychedelics are notoriously difficult to control for given the intensity of the experience. Yet there is precedent for the above findings. A 2019 study found that 61 percent of volunteers that took a placebo instead of psilocybin felt some psychedelic effects, with a few volunteers experiencing full-on trips.
"Several stated that they saw the paintings on the walls 'move' or 'reshape' themselves, others felt 'heavy. . . as if gravity [had] a stronger hold', and one had a 'come down' before another 'wave' hit her."
The Imperial team believes the expectation of a trip might have been enough to produce similar results. Senior author David Erritzoe is excited for future studies on the topic, believing they tapped into a new wave of citizen science that could push forward our knowledge of psychedelic substances.
"Accounting for the placebo effect is important when assessing trends such as the use of cannabidiol oils, fad diets or supplements where social pressure or users' expectations can lead to a strong placebo response. Self-blinding citizen science initiatives could be used as an inexpensive, initial screening tool before launching expensive clinical studies."
As investments into the psychedelics market explode, with one company reaching a $2 billion valuation, a recurring irony appears in the long arc of psychedelics and research: the power of our minds might be enough to feel greater life satisfaction and a deeper sense of mindfulness. If that's possible with a placebo, we have to question why the rush to create more pharmacology is necessary.
This is, mind you, a separate conversation over the role of psychedelics and rituals for group bonding. The function of group cohesion around consciousness-altering substances will continue to play an important role in many communities.
Of course, we should continue to explore the efficacy of psychedelics on anxiety, depression, suicidal ideation, PTSD, and addiction. Pharmacological dependence is a stain on the psychiatry industry. Whether or not psychedelics can be prescribed for daily use remains to be seen, but we know a moneyed interest is expecting a return on investment—the above company, ATAI Life Sciences, raised $157 million in its Series D round.
When it comes to wellbeing, some things money just can't buy. How we navigate the tricky terrain of mainstreaming psychedelics remains to be seen.
Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
And if they could, would they care, asks philosopher John Gray in his new book.
- In "Feline Philosophy," philosopher John Gray argues that self-awareness isn't the epitome of evolution—and it leads to suffering.
- Gray investigates Pascal, Spinoza, and Lao Tzu to understand why humans are so uncomfortable with themselves.
- Whether or not humans aspire to become like cats, Gray says nature teaches us the lessons felines inherently know.
There she lies, basking in the sunlight sliver that creeps through the kitchen window every morning around this time. What thoughts must run through her feline brain as she curls to lick a paw or turn an ear toward the garbage truck barreling down the street? The complexities of karma, her pending mortality, the bitcoin downturn?
Rubbish, all of it. Time, karma, mortality (and definitely bitcoin) don't enter her consciousness, or so claims English political philosopher John Gray. The former London School of Economics and Political Science professor has written influential books on global capitalism (bad) and atheism (good). Now he trains his sights on our most profound teachers—so profound they have no concern over whether we learn a thing from them or not.
In "Feline Philosophy: Cats and the Meaning of Life," Gray writes,
"Humans cannot become cats. Yet if they set aside any notion of being superior beings, they may come to understand how cats can thrive without anxiously inquiring how to live."
The bulk of Gray's fantastic book does not concern cats, however. They offer an aspirational model, certainly, yet Gray focuses on humanity's insatiable (and predominantly fruitless) attempts at happiness and our inability to reckon with the illusion of morality. Unlike the modern rebranding of eastern practices as a salve for suffering, he points out that Taoism, in particular, has always been more pragmatic than metaphysical.
Referencing Lao Tzu's straw dog commentary on the basic irrelevance of humans—at best, we're not special—Gray writes,
"The universe has no favourites, and the human animal is not its goal. A purposeless process of endless change, the universe has no goal."
John Gray: Cats, Humans and the Good Life
Cats, like humans and all other animals, do have goals: food, sex, shelter. Certainly not existential distress. Gray notes that the technological fervor dreamed up by transhumanists in their quest for disembodied consciousness is nothing more than a Theosophical fever dream. We haven't really traveled as far forward as our self-appointed credit pretends.
Humans are not designed to understand the complexities of the universe, nor even of our own biology. Even the notion of morality, as often marketed by religious traditions, is a farce, since people are only really "expressing their emotions." The only recourse we have for discussing emotions—physiological changes that disrupt homeostasis and warrant explanation—is language, and language is a powerful but limited mechanism for discussing reality.
And what is reality again?
She turns onto her back to expose her belly to the sunlight.
Metacognition, often championed as the great divine upgrade elevating humans above the pack (instead of, say, opposable thumbs, group fitness, or an incomprehensible ability to inflict violence), is actually the "chief obstacles to a good life," as Taoists phrase it.
Gray leans heavily on a number of thinkers—Aristotle, Hume—but the minds of Pascal and Spinoza prove most feline. Pascal knew sitting silently in a room is harrowing—pre-smartphone! We need diversions, he knew, endless entertainment and amusements to distract a mind as uncomfortably matched to its environment as our own.
Spinoza is the most Taoist of Western thinkers. Gray finds solidarity between Lao Tzu and ol' Benedict in the latter's notion of conatus, "the tendency of living things to preserve and enhance their activity in the world." Sadly, our enhancements cost the weight of the world. Despite what we believe, other animals don't aim to become more human-like, nor did evolution finalize its process with us. Other species have little problem becoming what they are. That's a uniquely human deficiency.
Humans, Gray writes, find actual fulfillment by applying a "Spinozist-Taoist ethic." We can actually be happy by being ourselves.
"A good life is not shaped by their feelings. Their feelings are shaped by how well they have realized their nature."
Photo: ViRusian / Adobe Stock
In the end, we become like cats thanks to an indifferent world. Only humans invent stories that reflect reality not whatsoever. Our brains chronically fill in knowledge gaps; those gaps often offer incorrect assessments. Existence is conditional to our environment regardless of how we try to manipulate it in our favor. You can only exploit nature for so long before she grows bored or angered by our tinkering—but there we go assigning human traits to a process that will never play by our rules.
This the cat knows—by not knowing, or caring, at all.
Despite the persistent myth, cats do display affection; they can learn to love their human roommates. Do our three cats climb into bed with my wife and me every night out of comfort or simply to keep warm? Irrelevant. Humans are conditional animals too. At least cats don't confuse pragmatism with emotion. They're content with what comes. We are not.
"If cats could understand the human search for meaning they would purr with delight at its absurdity. Life as the cat they happen to be is meaning enough for them. Humans, on the other hand, cannot help looking for meaning beyond their lives."
Gray offers a prescription for our duress. His ten feline commandments are ultimately for us; cats would use the pages for litter if given the opportunity. Consider the following three cliff notes for the anxious animals that we are. The irony: to achieve them you need to stop trying to achieve them—another paradox cats have no issue embodying.
- Do not become attached to your suffering, and avoid those who do.
- Forget about pursuing happiness, and you may find it.
- Beware anyone who offers to make you happy.
Contrary to what some might think, the brain is a very plastic organ.
As with many other physicians, recommending physical activity to patients was just a doctor chore for me – until a few years ago. That was because I myself was not very active.
Over the years, as I picked up boxing and became more active, I got firsthand experience of positive impacts on my mind. I also started researching the effects of dance and movement therapies on trauma and anxiety in refugee children, and I learned a lot more about the neurobiology of exercise.
I am a psychiatrist and neuroscientist researching the neurobiology of anxiety and how our interventions change the brain. I have begun to think of prescribing exercise as telling patients to take their “exercise pills." Now knowing the importance of exercising, almost all my patients commit to some level of exercise, and I have seen how it benefits several areas of their life and livelihood.
We all have heard details on how exercise improves musculoskeletal, cardiovascular, metabolic and other aspects of health. What you may not know is how this happens within the brain.
How exercise improves the brain.
Brain biology and growth
Working out regularly really does change the brain biology, and it is not just "go walk and you will just feel better." Regular exercise, especially cardio, does change the brain. Contrary to what some may think, the brain is a very plastic organ. Not only are new neuronal connections formed every day, but also new cells are generated in important areas of the brain. One key area is the hippocampus, which is involved in learning and memory and regulating negative emotions.
A molecule called brain-derived neurotrophic factor helps the brain produce neurons, or brain cells. A variety of aerobic and high-intensity interval training exercises significantly increase BDNF levels. There is evidence from animal research that these changes are at epigenetic level, which means these behaviors affect how genes are expressed, leading to changes in the neuronal connections and function.
Moderate exercise also seems to have anti-inflammatory effects, regulating the immune system and excessive inflammation. This is important, given the new insight neuroscience is gaining into the potential role of inflammation in anxiety and depression.
Finally, there is evidence for the positive effects of exercise on the neurotransmitters – brain chemicals that send signals between neurons – dopamine and endorphins. Both of these are involved in positive mood and motivation.
Exercise improves clinical symptoms of anxiety and depression
Researchers also have examined the effects of exercise on measurable brain function and symptoms of depression and anxiety. Exercise improves memory function, cognitive performance and academic achievement. Studies also suggest regular exercise has a moderate effect on depressive symptoms even comparable to psychotherapy. For anxiety disorders, this effect is mild to moderate in reducing anxiety symptoms. In a study that I conducted with others among refugee children, we found a reduction in symptoms of anxiety and PTSD among children who attended eight to 12 weeks of dance and movement therapies.
Exercise could even potentially desensitize people to physical symptoms of anxiety. That is because of the similarity between bodily effects of exercise, specifically high-intensity exercise, and those of anxiety, including shortness of breath, heart palpitation and chest tightness. Also, by reducing baseline heart rate, exercise might lead to signaling of a calmer internal physical environment to the brain.
It is important to note that the majority of studies examined the effects of exercise in isolation and not in combination with other effective treatments of clinical anxiety and depression, such as psychotherapy and medication. For the same reason, I am not suggesting exercise as a replacement for necessary mental health care of depression or anxiety, but as part of it, and for prevention.
There are other perks besides the neurobiological impacts of exercise. When going out for a walk, one gets more exposure to sunlight, fresh air and nature. One of my patients befriended a neighbor during her regular walks, leading to regular taco Tuesdays with that new friend. I have made some great friends at my boxing gym, who are not only my motivators, but also a great supporting social network. One might pick a dog as their running mate, and another might meet a new date, or enjoy the high energy at the gym. Exercise can also function as a mindfulness practice and a respite from common daily stressors, and from our electronic devices and TV.
By increasing energy and fitness level, exercise can also improve self-image and self-esteem .
Practical ways for a busy life
So how can you find time to exercise, especially with all the additional time demands of the pandemic, and the limitations imposed by the pandemic such as limited access to the gyms?
- Pick something you can love. Not all of us have to run on a treadmill (I actually hate it). What works for one person might not work for another. Try a diverse group of activities and see which one you will like more: running, walking, dancing, biking, kayaking, boxing, weights, swimming. You can even rotate between some or make seasonal changes to avoid boredom. It does not even have to be called an exercise. Whatever ups your heartbeat, even dancing with the TV ads or playing with the kids.
- Use positive peer pressure to your advantage. I have created a group messaging for the boxing gym because at 5:30 p.m., after a busy day at the clinic, I might have trouble finding the motivation to go to the gym or do an online workout. It is easier when friends send a message they are going and motivate you. And even if you do not feel comfortable going to a gym during the pandemic, you can join an online workout together.
- Do not see it as all or none. It does not have to be a one-hour drive to and from the gym or biking trail for a one-hour workout vs. staying on the couch. I always say to my patients: "One more step is better than none, and three squats are better than no squats." When less motivated, or in the beginning, just be nice to yourself. Do as much as possible. Three minutes of dancing with your favorite music still counts.
- Merge it with other activities: 15 minutes of walking while on the phone with a friend, even around the house, is still being active.
- When hesitant or low on motivation, ask yourself: "When was the last time I regretted doing it?"
- Although it can help, exercise is not the ultimate weight loss strategy; diet is. One large brownie might be more calories than one hour of running. Don't give up on exercise if you are not losing weight. It is still providing all the benefits we discussed.
Even if you do not feel anxious or depressed, still take the exercise pills. Use them for protecting your brain.