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Concerns high for mental health crisis caused by COVID-19 pandemic

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Stressed from home-schooling your kids? Lonely from lockdown? Worried about a sick loved one isolated in a nursing home? Worried you might lose your job?

The ongoing COVID-19 pandemic is affecting everyone’s mental health in ways small and large, and experts are concerned that for many, today’s anxiety will become a tidal wave of mental health problems in the years ahead.

The pandemic is adding to what already was an underrecognized mental health crisis in the United States, according to Dr. Don Mordecai, national mental health and wellness lead at Kaiser Permanente in Oakland, Calif.

Rates of anxiety and depression have steadily risen for years, as have deaths of despair related to suicide and drug overdose, he said during a HD Live! interview.

“All those things have been going up for decades, really, and now you bring the pandemic in,” Mordecai said. “It’s not like we were in good shape in terms of our mental health and now it’s getting worse. It’s more like we were not in good shape, and then you bring in another big stressor.”

Clinical psychologist Jelena Kecmanovic also is concerned about the toll of the anxiety-provoking changes to everyday life that people are enduring.

“Anxiety is exhausting and terrifying,” said Kecmanovic, director of the Arlington/DC Behavior Therapy Institute in Arlington, Va. “If it is happening long enough, you’re going to get depressed about it. You’re going to get hopeless and maybe even suicidal.”

She expects some long-lasting emotional scars.

“This is going to go on long enough and it’s going to be traumatic enough for enough people that it’s not realistic to expect we’ll spring back to normal,” Kecmanovic said.

America’s pandemic-related mental health crisis hasn’t rolled out as you might think, she said. There wasn’t much of an initial uptick in people seeking help even as the lockdown altered everyday life in profound ways.

“After these couple of first months, when reopening started, that’s when we started really seeing people’s mental health worsen quite a bit,” she said.

What changed?

“What’s dawning on us is the realization that we’re in this for the long haul,” Kecmanovic said. “The uncertainty is really hitting people, that this is going to be a year or a year and a half living with this ever-changing normal. The new normal is changing every day, every week.”

Surveys have shown that people are concerned about the pandemic’s effect on their mental health, and symptoms of anxiety and depression are on the rise, Mordecai said.

But “that’s different from a full-blown mental health disorder,” he noted. “I think it remains to be seen how it translates long term.”

The folks most at risk for long-term problems are those most directly impacted by COVID-19, Mordecai and Kecmanovic said. These include front-line health care workers, people who have been infected, and people who have lost loved ones.

“There’s going to be a &hellip tremendous amount of grief that’s not being processed,” Kecmanovic said, adding that it’s impossible to paper over it. “It’s going to catch up with you eventually.”

All this sounds dire, but both experts predict most people will bounce back.

“I am hoping that essential human resilience will prevail — people might not be able to snap their fingers and be back to normal, but they will generally be fine,” Kecmanovic said.

Mordecai said past experience offers reason for hope.

“When we look at studies of past natural disasters and pandemics, most people do OK, which I think gives me some reason for optimism,” he said. “But there will be some people who have long-term effects. It’s people who’ve been profoundly affected by the pandemic.”

People worried about their own mental state should double down on efforts to stay healthy and happy, Mordecai said.

“The greatest risk is that when people get socially isolated, they drop their routines around maintaining their mental health and their physical health — that’s really a set up,” he said.

A daily workout can do much to lower your stress. People should also consider meditation or yoga as a means of reducing stress, as well as limiting their news intake, Mordecai added.

Don’t dwell on the news, he advised.

“It’s important to stay up to date, but that doesn’t require hours and hours a day,” Mordecai said. “If the TV’s on in the background, maybe turn it off, because it’s a constant message that’s anxiety-provoking.”

It’s also important to acknowledge how you’re feeling, and that your feelings are valid, Kecmanovic said. “These are crazy times. These are unprecedented times. No wonder I’m feeling anxious, and it’s OK,” she said.

Some potential bright spots could come out of the pandemic, too. Some people might emerge with a sense of pride in enduring the crisis, she said.

“It can be realizing &hellip I’m stronger than I thought I would be,” Kecmanovic said. “I never thought of myself as a strong and hearty person, but what I’ve lived through for the last year and a half, it’s amazing I was able to go through this.”

The experts also hope that what people have endured will help them empathize with those who struggle with their mental health.

“One of the silver linings here may be that so many of us have had to deal with symptoms of anxiety and concerns about isolation,” Mordecai said. “Those are things that people with mental health conditions have known for a long time. If the rest of us essentially get a taste of it, does that allow us all to talk more openly about it? I hope so.”

More information

The U.S. Centers for Disease Control and Prevention has more about coping with stress during COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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Common meds linked to faster mental decline in seniors

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A group of widely used medications might speed up older adults’ mental decline — especially if they are at increased risk of dementia, a new study hints.

The medications in question are called anticholinergics, and they are used to treat a diverse range of conditions — from allergies, motion sickness and overactive bladder to high blood pressure, depression and Parkinson’s disease.

The drugs are known to have short-term side effects such as confusion and fuzzy memory.

But studies in recent years have turned up a more troubling connection: a heightened risk of dementia among long-term users.

The new findings, published Sept. 2 in Neurology, add another layer: Healthy older adults on these medications had an increased risk of developing mild cognitive impairment. That refers to subtler problems with memory and thinking that may progress to dementia.

And the link, researchers found, was strongest among two groups of people already at heightened risk of Alzheimer’s disease: those who carry a gene variant that raises the odds of the disease, and people with certain biological “markers” of the disease in their spinal fluid.

The results do not prove anticholinergic drugs are to blame, cautioned Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

“This study shows an association in a very specific population, but it does not prove causation,” said Snyder, who was not involved in the research.

However, it is biologically plausible that the drugs could increase dementia risk, said Dr. Allison Reiss, an associate professor at NYU Long Island School of Medicine.

The medications, she said, block a chemical called acetylcholine, which transmits messages among nerve cells. Acetylcholine is involved in memory and learning, and is typically low in people with Alzheimer’s.

“The preponderance of evidence suggests it’s better to avoid these medications in older adults,” said Reiss, who is also an advisory board member at the Alzheimer’s Foundation of America.

That’s especially true, she added, when alternatives exist.

Many medications sold for allergies, colds and coughs have anticholinergic properties — and are available over-the-counter. So it’s important, Reiss said, that older adults be aware that non-prescription drugs are not automatically “safe.”

“You don’t want to add any medications that aren’t necessary,” said Reiss, who had no role in the study.

Meanwhile, certain prescription drugs for depression, high blood pressure, Parkinson’s disease and schizophrenia have anticholinergic properties, as do medications for overactive bladder and urinary incontinence.

Reiss said that people with questions about their prescriptions should talk to their doctor.

For the new study, researchers led by Lisa Delano-Wood, from the University of California, San Diego, followed 688 older adults who initially had no problems with memory or thinking skills. One-third said they’d been regularly taking anticholinergic drugs for more than six months — usually far more than one.

In fact, they were taking an average of almost five medications per person.

Over the next 10 years, people on anticholinergics were more likely to develop mild cognitive impairment, which was gauged through yearly tests. Over half — 51% — developed the condition, versus 42% of older adults not taking anticholinergics.

The researchers did consider other factors that affect dementia risk — such as people’s education levels and history of heart disease or stroke. And after adjusting for those factors, older adults on anticholinergics were still 47% more likely to develop mild impairment.

The link was even stronger among people who carried a gene variant that raises Alzheimer’s risk: Anticholinergic use more than doubled their risk of impairment. A similar pattern was seen among study participants with Alzheimer’s-linked proteins in their spinal fluid.

That, Reiss said, suggests the medications might have “accelerated a process that was already in place.”

Snyder said the results “illustrate that we need better treatments — not only for Alzheimer’s and other dementias, but for other common conditions associated with aging.”

More information

The University of British Columbia has more on anticholinergic drugs.

Copyright 2020 HealthDay. All rights reserved.



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Even ‘social smokers’ up their odds of death from lung disease

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Even light smokers are much more likely to die of lung disease or lung cancer than nonsmokers, a new study warns.

“Everyone knows that smoking is bad for you, but it’s easy to assume that if you only smoke a little, the risks won’t be too high,” said study co-leader Pallavi Balte, of Columbia University Irving Medical Center, in New York City.

The new study shows how wrong that thinking can be. It included nearly 19,000 people in the United States, average age 61, who were followed for an average of 17 years. During that time, nearly 650 died of lung disease (such as emphysema) and 560 died of lung cancer.

Among nonsmokers, less than 2% died from lung disease and less than 1% died from lung cancer. But among social smokers (fewer than 10 cigarettes a day), those numbers were over 3% and close to 5%, respectively.

Not surprisingly, heavy smokers (more than 20 cigarettes a day) fared worst, with more than 10% dying from lung disease and about 13% from lung cancer, the study found.

After accounting for other potential factors — such as age, sex, race, level of education and body weight — the researchers concluded that social smokers were 2.5 times more likely to die of lung disease and 8.6 times more likely to die of lung cancer than nonsmokers.

Social smokers had around half the rate of death from lung disease as heavy smokers, but their rate of lung cancer death was two-thirds that of heavy smokers, according to the study.

The results were scheduled for presentation at a virtual meeting of the European Respiratory Society. Data and conclusions presented at meetings should be considered preliminary until peer-reviewed.

The findings show that cutting down on smoking is no substitute for quitting, the researchers concluded.

“Previous research suggests that people are cutting down on smoking. For example, in the U.S.A., the proportion of smokers smoking less than 10 cigarettes per day has increased from 16% to 27%,” Balte said in a society news release.

“You might think that if you only smoke a few cigarettes a day you are avoiding most of the risk. But our findings suggest that social smoking is disproportionately harmful,” Balte said.

If you don’t want to die of lung cancer or respiratory disease, the best action is to quit completely, she added.

More information

The U.S. Centers for Disease Control and Prevention offers a guide for quitting smoking.

Copyright 2020 HealthDay. All rights reserved.



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Antidepressant use rising in U.S., mostly in women, CDC says

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Sept. 4 (UPI) — Nearly 18% of all adult women in the United States used antidepressant medication between 2015 and 2018, compared to just over 8% of men, according to data released Friday by the Centers for Disease Control and Prevention.

Overall, during the decade between 2009-2010 and 2017-2018, antidepressant use increased to 14% from 11%, the agency found. Use increased more for women — to 19% from 14% — than for men — to 9% from 7%.

In 2018, slightly more than 7% of adults in the United States said they suffered from a “major depressive episode,” the agency said.

The findings are based on an analysis of data from the National Health and Nutrition Examination Survey for the 10-year period between 2009 and 2018.

Depression is a mental health disorder in which sufferers experience a persistent depressed mood or loss of interest in activities, causing significant impairment in daily life, according to the National Institute of Mental Health.

Antidepressant medications are used to reduce the symptoms of depression, and include selective serotonin reuptake inhibitors, or SSRIs, and serotonin and norepinephrine reuptake inhibitors, or SNRIs.

From 2015 through 2018, antidepressant use increased with age and was highest among women aged 60 and over, at slightly more than 24%, the CDC found.

In addition, use of the drugs was higher among non-Hispanic White adults, at 17%, compared with non-Hispanic Black adults, at 8%, and non-Hispanic Asian adults, at 3%.

Adults with at least some college education were more likely to use antidepressants than those with a high school education or less, the agency said.



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