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Sleep Disorders May Influence Preterm Birth

Sleep Disorders May Influence Preterm Birth

A new review by researchers at University of California, San Francisco (UCSF) finds that pregnant women who are diagnosed with sleep disorders appear to be at risk of delivering their babies before reaching full term.

Investigators found the link was associated with conditions such as sleep apnea and insomnia.

The prevalence of preterm birth — defined as delivery before 37 weeks’ gestation — was 14.6 percent for women diagnosed with a sleep disorder during pregnancy, compared to 10.9 percent for women who were not.

The odds of early preterm birth — before 34 weeks — was more than double for women with sleep apnea and nearly double for women with insomnia.

Importantly, researchers discovered complications were more severe among early preterm births.

In contrast to the normal sleep changes that typically occur during pregnancy, the new study focused on major disruptions likely to result in impairment.

Unfortunately, the true prevalence or the number of pregnant women experiencing sleep disorders, is unknown because the sleep issue is often un-diagnosed among pregnant women.

Researchers believe treating sleep disorders during pregnancy could be a way to reduce the preterm rate, which is about 10 percent in the United States — more than most other highly developed countries.

The study is the first to examine the effects of insomnia during pregnancy. Because of a large sample size, the authors were able to examine the relationship between different types of sleep disorders and subtypes of preterm birth.

Investigators were able to examine factors associated with early vs. late preterm birth, or spontaneous preterm labor versus early deliveries that were initiated by providers due to mothers’ health issues.

Study findings appear in the journal Obstetrics & Gynecology.

In the case-control study, researchers were able to separate the effects of poor sleep from other factors that also contribute to a risk of preterm birth.

This involved matching 2,265 women with a sleep disorder diagnosis during pregnancy to controls who did not have such a diagnosis, but had identical maternal risk factors for preterm birth, such as a previous preterm birth, smoking during pregnancy, or hypertension.

“This gave us more confidence that our finding of an earlier delivery among women with disordered sleep was truly attributable to the sleep disorder, and not to other differences between women with and without these disorders,” said Jennifer Felder, Ph.D., a postdoctoral fellow in the UCSF Department of Psychiatry and the lead author of the study.

Investigators were surprised by how few women in the dataset — well below one percent — had a sleep disorder diagnosis, and suspect that only the most serious cases were identified.

“The women who had a diagnosis of a sleep disorder recorded in their medical record most likely had more severe presentations,” said Aric Prather, Ph.D., assistant professor of psychiatry at UCSF and senior author of the study.

“It’s likely that the prevalence would be much higher if more women were screened for sleep disorders during pregnancy.”

Researchers note that cognitive behavioral therapy has been shown to be effective in the general population and does not require taking medications that many pregnant women prefer to avoid.

To find out if this therapy is effective among pregnant women with insomnia, and ultimately whether it may improve birth outcomes, Felder and colleagues are recruiting participants for the UCSF Research on Expecting Moms and Sleep Therapy (REST) Study.

“What’s so exciting about this study is that a sleep disorder is a potentially modifiable risk factor,” said Felder.

Source: UCSF

Study Finds Work is Intense and Emotionally Exhausting for Most US Workers

Study Finds Work is Intense and Emotionally Exhausting for Most US Workers

New research confirms what many Americans already know — that their jobs are hard and draining, and it is difficult to separate work from home.

The new study finds that workers frequently face unstable work schedules, unpleasant and potentially hazardous working conditions, and an often hostile social environment.

The findings stem from research conducted by investigators at the RAND Corporation, Harvard Medical School and University of California, Los Angeles. Investigators analyzed responses from the American Working Conditions Survey, one of the most in-depth surveys ever done to examine conditions in the American workplace.

Remarkably, more than one in four American workers say they have too little time to do their job, with the complaint being most common among white-collar workers.

In addition, workers say the intensity of work frequently spills over into their personal lives, with about one-half of people reporting that they perform some work in their free time in order to meet workplace demands.

Despite these challenges, American workers appear to have a certain degree of autonomy on the job, most feel confident about their skill set and many do report that they receive social support while on the job.

“I was surprised how taxing the workplace appears to be, both for less-educated and for more-educated workers,” said lead author Dr. Nicole Maestas, an associate professor at Harvard Medical School and an adjunct economist at RAND.

“Work is taxing at the office and it’s taxing when it spills out of the workplace into people’s family lives.”

Researchers say that while eight in 10 American workers report having steady and predictable work throughout the year, just 54 percent report working the same number of hours on a day-to-day basis.

One in three workers say they have no control over their schedule. Despite much public attention focused on the growth of telecommuting, 78 percent of workers report they must be present at their workplace during regular business hours.

Nearly three-fourths of American workers report either intense or repetitive physical exertion on the job at least a quarter of the time. While workers without a college education report greater physical demands, many college-educated and older workers are affected as well.

Emotional stress and challenges to mental health are a relatively common experience at the worksite. Researchers discovered more than half of Americans report exposure to unpleasant and potentially hazardous social environments.

Nearly one in five workers — a “disturbingly high” fraction, researchers said — say they face a hostile or threatening social environment at work. Younger and prime-aged women are the workers most likely to experience unwanted sexual attention, while younger men are more likely to experience verbal abuse.

The findings are from a survey of 3,066 adults who participate in the RAND American Life Panel, a nationally representative, computer-based sample of people from across the United States. The workplace survey was fielded in 2015 to collect detailed information across a broad range of working conditions in the American workplace, as well as details about workers and job characteristics.

Despite the importance of the workplace to most Americans, researchers say there is relatively little publicly available information about the characteristics of American jobs today.

The American Working Conditions survey is designed to be harmonious with the European Working Conditions Survey, which has been conducted periodically over the last 25 years among workers from a broad range of European nations.

The American Working Conditions Survey found that while many American workers adjust their personal lives to accommodate work matters, about one-third of workers say they are unable to adjust their work schedules to accommodate personal matters.

In general, women are more likely than men to report difficulty arranging for time off during work hours to take care of personal or family matters.

Jobs interfere with family and social commitments outside of work, particularly for younger workers who don’t have a college degree. More than one in four reports a poor fit between their work hours and their social and family commitments.

The report also provides insights about how preferences change among workers as they become older.

Older workers are more likely to value the ability to control how they do their work and setting the pace of their work, as well as less physically demanding jobs. Older workers are also generally less likely than younger workers to have some degree of mismatch between their desired and actual working conditions.

The survey also confirms that retirement is often a fluid concept. Many older workers say they have previously retired before rejoining the workforce, and many people aged 50 and older who are not employed say they would consider rejoining the workforce if conditions were right.

Other highlights from the report include:

  • The intensity of work such as pace, deadlines, and time constraints differ across occupation groups, with white-collar workers experiencing greater work intensity than blue-collar workers.
  • Jobs in the U.S. feature a mix of monotonous tasks and autonomous problem solving. While 62 percent of workers say they face monotonous tasks, more than 80 percent report that their jobs involve “solving unforeseen problems” and “applying own ideas.”
  • The workplace is an important source of professional and social support, with more than one half of American workers describing their boss as supportive and that they have very good friends at work.
  • Only 38 percent of workers say their job offers good prospects for advancement. All workers — regardless of education — become less optimistic about career advancement as they become older.
  • Four out of five American workers report that their job provides “meaning” always or most of the time. Older college-educated men were those most likely to report at least one dimension of meaningful work.
  • Nearly two-thirds of workers experience some degree of mismatch between their desired and actual working conditions, with the number rising to nearly three-quarters when job benefits are taken into account. Nearly half of workers report working more than their preferred number of hours per week, while some 20 percent report working fewer than their preferred number of hours.

Future reports will explore how conditions of the American workplace compare to those in Europe and in other parts of the world and selected findings from follow-up surveys using the same panel of participants.

Source: RAND Corporation

suicide is forever

suicide loss doesn’t stop hurting after one month or one year or one decade. i am 21 years into this journey and the impact is still there. the fallout is forever. i try my best to be positive and hopeful, to remember that i can deal with this and that i am a survivor. but some days, some weeks, i don’t feel like a survivor. i feel like i am just surviving.

that moment when i walked into the laundry room and found my dad is forever. it went somewhere deep inside of me and lodged itself into the core of who i am. i have been in years of therapy. i have reached out for help and talked to so many people. i have done my best to be aware of what i need and to take care of myself to the best of my ability. i write write write it out and process through this blog. but that moment is still there. the terror is still there. the abandonment is still there. the traumatized little girl is still there. maybe not as bad today as it was 21 years ago. but suicide is forever.

the abandonment i experienced when i lost my dad, the pain that my entire family experienced is forever. at 13 years old i was faced with a loss that was bigger and more complicated that i could comprehend. i was so sad that i couldn’t even cry. i was so scared that i didn’t even know it. and that feeling lasted in a conscious way for years and then went below the surface and is still present today. what if i fail? what if you don’t like me? what if you see who i really am and then you leave me? suicide is forever.

there is no road map for surviving a suicide loss. and especially as a child, i didn’t have the emotional framework to begin to process what had happened. i wasn’t even diagnosed with ptsd until i was 31, because back when my dad died ptsd was something that veterans experienced. not seventh grade girls. so many of my symptoms went untreated and i developed unhealthy ways of coping with the trauma. obsessive thoughts and behaviors to control my surroundings. checking checking checking to be sure that the people still closest to me were not going to leave. shopping to fill the empty space inside and to have a momentary rush of feeling beautiful, desirable, wanted. i am working on them, i am trying to change but i still do all of those things today. suicide is forever.

sometimes it feels that just when i have gotten to the bottom of my dad’s suicide it drops out again and i have to go deeper. there is always more to work on. there is always more to learn about myself. during weeks like this one it feels almost maddening. how many more layers are there to peel away? how can i work so hard at this and still feel stuck in the same behaviors i exhibited at 13, 15, 18 years old? i try to be kind to myself as i go through this process but that in and of itself is one of the biggest consequences of my grief and early trauma: on a deep-down level i see myself as not good enough. so i put myself down, over and over again. i try to grow and make different choice but it’s still inside of me. suicide is forever.

i want to scream at my dad, take him by the shoulders and shake him really hard.

look at this, look at what you left me with. look at what you did to me. did you know? did you think? did you realize?

suicide is forever.


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Mom’s Response to Baby’s Distress May Predict Attachment Style

Mom's Response to Baby's Distress May Predict Attachment Style

A new study, published in the journal Child Development, set out to measure the emotional and physiological responses of new mothers toward their distressed infants in order to identify any factors that might predict an insecure type of attachment, such as infant avoidance and resistance.

Although most infants develop secure attachment relationships with their mothers, about 40 percent of babies establish insecure attachments and are at risk for problems later in life.

Some of these insecurely-attached babies develop what is called insecure-avoidant attachments (minimizing expressing negative emotions and avoiding contact with their mothers when they’re afraid or uncertain), while others develop insecure-resistant attachments (becoming emotionally overwhelmed and inconsolable by their mothers in these circumstances).

“Identifying factors that contribute to infants’ avoidance and resistance is important for developing effective interventions that promote babies’ attachment security, and in turn, positive child development,” said Ashley M. Groh, assistant professor of psychological sciences at the University of Missouri, Columbia, who led the study.

For the study, researchers from the University of Missouri, the University of North Carolina and Pennsylvania State University evaluated an ethnically and economically diverse group of 127 mothers and their infants.

Half of the families were African American and half were European American. Half of the families lived below the 2002 federal poverty line (that is, annual income below $15,000 for a family of three) and half lived above that line.

Researchers analyzed the mothers’ respiration sinus arrhythmia (RSA), or the variability in their heart rate over the breathing cycle, when they interacted with their distressed babies at six months of age.

Decreases in RSA when faced with a challenge, such as a crying baby, reflect better physiological regulation that supports actively coping with that challenge. Researchers also observed how the mothers expressed emotion when they interacted with their distressed infants.

Six months later, when the infants were 12 months old, researchers assessed their attachments to their mothers using the Strange Situation procedure, which involves going through a series of separations and subsequent reunions with their mothers. Research has shown that an infant’s behavior when reunited with his or her mother tells us about the pattern of attachment.

When reunited with their mothers, insecure-avoidant infants ignore their mothers, while insecure-resistant infants become very distressed and simultaneously seek and resist their mothers.

The study findings show that mothers who had smaller decreases in RSA — meaning, less physiological regulation — when they interacted with their distressed infants at six months were more likely to have avoidant infants at 12 months. This type of physiological response might undermine a mother’s ability to cope with her infant’s distress. The baby may view her as a less effective source of comfort and ultimately be less likely to seek her out when upset or uncertain.

Mothers who were more emotionally neutral (versus positive) when their infants were distressed at six months were more likely to have resistant infants at 12 months. This suggests that a mother’s emotionally muted response toward her distressed infant might lead the baby to increase his or her expressions of distress.

“This study provides evidence that we can better understand babies’ and mothers’ experiences in these important encounters when babies need reassurance and support if we consider both the mothers’ emotional response and her physiological regulation in these challenging caregiving contexts,” said Martha Cox, professor of psychology at the University of North Carolina, Chapel Hill.

“The evidence can inform efforts aimed at promoting attachment security. Such efforts might target the specific challenges mothers face when confronted with their babies’ distress.”

Source: Society for Research in Child Development

Top Mental Health Books

Top Mental Health Books

In this video, I’m delighted to collaborate with vlogger ‘LikeKristen‘ in the US to discuss our favourite mental health books. Books are invaluable tools when…

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what i really need is love

img_5263hello. my name is amy and i have a shopping problem.

(hello, amy).

for me, shopping isn’t shallow. it runs deep, deep, deep into my past. underneath appearances and right into the heart of how i coped with pain.

aside from the night before he died, my last memory of my dad is in a store in santa barbara, california. we were on a family vacation and he offered to buy me something new. i picked out a bright orange polyester dress (that was totally cool by nineties standards). when i thanked him, he said to me, “that’s what dads do for their daughters.” and i felt loved.

one month later he died. and my whole world fell apart.

in the months following his suicide there was so very little pleasure in my life or in the life of my family. it seemed that the only weekend activity we could come up with was shopping. so at fourteen i began making my weekly pilgrimage to tysons corner. for a couple of hours i got a break from the bleak and shitty reality of life after my dad’s suicide. i got to walk around a world that was bright, organized, friendly. (to this day, the smell of the mall makes my brain flood with dopamine). salespeople approached me, asking how they could help. i felt taken care of. i could pick out something new that would make me feel temporarily put together, temporarily ok. and i could put that item in a bag and take it home with me to wear the next day. a little bright spot, a little present for a sad little girl whose father went away.

the habit sunk in – my solitary teenage coping skill. when i was a sophomore in high school my mom had a bizarre health scare where she lost her short-term memory for 48 hours. i was scared out of my mind but i had no parents to console or reassure me – one was dead and the other was in the hospital. so i went to my room and took the several hundred dollars i had been saving for a trip overseas. i drove myself to my safe place – the mall – and spent it all on whatever i wanted. giving myself the gift of momentary relief from a chaotic and frightening reality.

i kept it up, through high school, through college and as an adult. my need for shopping grew and grew from a teenage passtime into an adult problem. i was drawn to it as a means of coping with mental illness – it was an outlet for my anxiety and offered some relief from the persistent sadness of depression. by looking good on the outside i could mask what was happening on the inside.

but i began to realize just how much time and money i was spending on shopping. how i frequently invented reasons to buy something new. i purchased more clothes than i could ever wear. i felt compelled by a gnawing anxiety that kept me hunting, searching for that sense of completion that i felt when i would buy. and the “high of the buy” didn’t last very long – i almost immediately moved on to the next thing that i had to have. addiction is a vicious and unrelenting cycle and i found myself sucked in.

i have often asked myself, “what are you looking for? what is it that you really want to buy?” because i am a smart girl. i know deep down that no outfit will give me permanent satisfaction. so what is it that compels me to spend hours and weeks and months and years searching online, wandering the aisles and driving around in circles?

i don’t think it’s about the stuff. i think it’s about self care. i was so young when my dad died – just 13. i didn’t have an adult set of coping skills or an emotional and mental framework within which to process his suicide. at the time of his death, i was a teenager and shopping made me feel good. i knew how to do it. and not too long before he died, he told me that buying things was one way to show someone that you love them. maybe i have been chasing that connection with him. maybe i have been trying desperately to take care of myself, trying to create a moment in which i am loved.

so what do i deserve? on the surface i feel like i deserve to shop and buy what i want. i fight giving it up – i want to hold on to it. after all of the pain and loss i have experienced i wonder what is so wrong with shopping? i could be shooting up heroin or have failed out of school. things could be worse. but what do i deserve? is shopping the best i can do for me? for my marriage? for my life? is shopping giving me the care i deserve? does shopping produce results that i deserve? is shopping the best way to cope with depression and anxiety? i know that the extent of my shopping denies me time, resources and connection with the people i love. and connection with myself. this behavior is hard, so very hard, for me to change. it’s my oldest refuge, it’s my instinct. “let me have it,” i think. “just let me have it.”

isn’t it frustrating to watch yourself acting out an old pattern of behavior that just doesn’t work anymore? like an old sweater that is too tight or an old shoe that is too small, it is squeezing the life out of me. it’s time to turn the conversation around. instead of “why can’t i have it” i try to ask myself what can i have, what do i need. what do i really need. and i look at what i feel. what i really feel. it’s so hard to sit with feelings of fear, or abandonment, or sadness. but maybe that’s what i need to do. to stop and acknowledge what is painful and then offer myself a loving response.

yes, i have been through hard times. life hasn’t always been fair to me. and yes, i deserve to be loved. i deserve my time. i deserve my relationships. i deserve financial security and a hopeful future.

can i give myself that moment? what i really need is love.

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Brain Inflammation Tied to Suicidal Thoughts

Brain Inflammation Tied to Suicidal Thoughts

New research finds that patients with major depressive disorder (MDD) have increased levels of brain cell inflammation.

Importantly, researchers at the University of Manchester discovered that the inflammation was present only in patients with MDD who were experiencing suicidal thoughts.

This link suggests nerve cell inflammation, rather than a diagnosis of MDD, is associated with suicidal thoughts. The research, led by Dr. Peter Talbot and colleagues appears in the journal Biological Psychiatry.

“Our findings are the first results in living depressed patients to suggest that this microglial activation is most prominent in those with suicidal thinking,” said Dr. Talbot. Previous studies suggesting this link have relied on brain tissue collected from patients after death.

“This paper is an important addition to the view that inflammation is a feature of the neurobiology of a subgroup of depressed patients, in this case the group with suicidal ideation,” said Dr. John Krystal, Editor of Biological Psychiatry.

“This observation is particularly important in light of recent evidence supporting a personalized medicine approach to depression, i.e., that anti-inflammatory drugs may have antidepressant effects that are limited to patients with demonstrable inflammation.”

In the study, first author Dr. Sophie Holmes and colleagues assessed inflammation in 14 patients with moderate-to-severe depression who were not currently taking any antidepressant medications.

Immune cells called microglia activate as part of the body’s inflammatory response, so the researchers used a brain imaging technique to measure a substance that increases in activated microglia.

The evidence for immune activation was most prominent in the anterior cingulate cortex, a brain region involved in mood regulation and implicated in the biological origin of depression. This finding confirmed the results of a previous study that identified altered microglial activation in medication-free MDD patients. Smaller increases were also found in the insula and prefrontal cortex.

“The field now has two independent reports — our study and a 2015 report by Setiawan and colleagues in Toronto — showing essentially the same thing: that there is evidence for inflammation, more specifically microglial activation, in the brains of living patients during a major depressive episode,” said Dr. Talbot.

This link suggests that among depressed patients, neuroinflammation may be a factor contributing to the risk for suicidal thoughts or behavior.

According to Dr. Talbot, the findings “emphasize the importance of further research into the question of whether novel treatments that reduce microglial activation may be effective in major depression and suicidality.”

Source: Elsevier

The Void Part 2

The Void Part 2

By Anonymous  Thank you all for your comments. I don’t really consider myself to be a writer, (neither did my school English teacher)! But writing…

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Why eating sounds can make people agitated, How long do panic attacks last

Can eating sounds cause a panic attack. How long do panic attacks last Why some people become enraged by sounds such as eating or breathing has been explained by brain scan studies. How long do the panic attacks last. The condition, misophonia, is far more than simply disliking noises such as nails being scraped down […]