Wednesday February 7, 2024

By Courtney Wise

Greetings, MindSite News Readers! In today’s Daily, immigrants in Chicago find support for the trauma they’ve endured in informal support groups and each other. The field of addiction medicine shifts as the definition of sobriety becomes more flexible. And why it’s in your best interest to tell your therapist the truth. 

Plus, a new film about a country that prioritizes people’s happiness. And a new study finds that women with polycystic ovarian syndrome are at increased risk of suicide.

In Chicago, informal support groups work to help new immigrants cope with their pain and trauma

For Jorge Rubiano, coming to America was a matter of life or death. He says he was forced to flee his native Columbia over a land dispute in which the government threatened his life. Today he’s one of some 30,000 migrants and asylum seekers who have arrived in Chicago since August 2022 – many of them bussed there by Republican Gov. Greg Abbott of Texas. Rubiano told WBEZ reporter Kristen Schorch he was held for a month by kidnappers before finally escaping. 

Nearly all have stories of trauma: Women enduring rape by gang members. A young girl nearly drowning in a river, saved by her pregnant mother. Then upon arriving, the search for safety, shelter, and work often leads to more trauma. “I’m still in between two dangers,” Rubiano says. “If I return it’s very possible they kill me, and if I stay I don’t know what can happen here.” 

It’s a recipe for serious mental health problems – but for the moment, most are too concerned with simply surviving to think much about their mental health. “They’re in survival mode,” said school social worker Sharon Davila, who has interviewed new arrivals in screenings. “They need their basic needs met. The number one thing is they’re looking for jobs.” Stigma is powerful too, especially for men, who are less likely to disclose their emotional pain.

Laura Pappa, a psychologist and US citizen who immigrated to the U.S. from Argentina as a teen, says not dealing with trauma can have ripple effects for years to come, making you more vulnerable to depression, anxiety and physical ailments. Social worker Veronica Sanchez leads an informal circle on Monday nights at a local insurance office. Attendees share the pain of being separated from their loved ones and dealing with unprovoked mistreatment. One man said he worked for days and never got paid. A woman spoke of the heartbreak in leaving her children behind. “Maybe we have answers. Maybe we don’t. But when you open up a safe space where you can share your sorrows… you don’t feel so alone,” Sanchez tells them.

Amber Kumar Gurung has a big job: Increasing the gross national happiness of his country, Bhutan

Bhutan is often described as the happiest place on earth. But all that happiness doesn’t just happen on its own. The goal of increasing happiness is enshrined in the constitution of the mostly Buddhist country. Ensuring that the country is meeting the happy goal requires careful monitoring – with 148 different questions.

“How happy and satisfied are you with your life, on a scale from 1 to 10?” Amber Kumar Gurung asks a Bhutanese woman. He may follow up with other questions, says a reporter for NPR: “How many goats do you have? How often do you meditate? Do you feel selfish? Jealous? Angry?”

Gurung is the subject of a documentary, Agent of Happiness. It shows him traveling the country, which sits high in the eastern Himalayas, as he interviews citizens to find out whether they’re happy. The pursuit of happiness officially began in the 1970s, when the country’s king declared that “gross national happiness is more important than gross national product.” In 2008, the country began measuring just how happy people actually are. 

“It’s a very collectivist society” that has very different notions from Western cultures about what contributes to happiness, says Robert Waldinger, a happiness researcher at Harvard University who is also a Zen priest.

Ironically, Gurung himself isn’t all that happy right now. His mother is sick and he’s unmarried but wishes to be, a condition complicated by his lack of technical citizenship in the country. His citizenship was revoked some 40 years ago, when he was 2 years old, according to NPR, because of his Nepali heritage during a time of ethnic conflicts. He discloses his own self-rated happiness in the film – a 5 out of 10 – as he records himself dancing in a video he will send to his girlfriend.

Still the work done by Gurung and his colleagues itself helps create happiness, said Arun Bhattarai, one of the filmmakers. “The act of happiness agents knocking on people’s doors and coming into their homes, asking if they were happy or not – it made people feel cared for by the government,” he said.

New definitions of sobriety shake up the field of addiction medicine

Tiffany Fede met her husband in opioid recovery circles, and she learned that total abstinence from substances was the only path to sobriety. To her, abstinence was the heartbeat of recovery so she watched him closely, got his drug dealer to back off, and rejected his suggestion that psychoactive mushrooms might help curb his opioid use. Then he died of a methadone overdose. Now, Fede told the New York Times, she wonders if using magic mushrooms instead of opioids might have kept him alive. Today, the appeal of “California sober” – reducing substance use by replacing highly addictive drugs with more benign ones, is growing, even among some mental health clinicians. 

Nora Volkow, a psychiatrist and the longtime director of the National Institute on Drug Abuse (NIDA) said she was trained to believe that “the only way out of an addiction is total and full sobriety.” But her experience with patients has taught her that’s not a realistic goal for everyone. “You come to realize that there are people that are able to recover and yet they are not absolutely free of every substance,” Volkow said.

This concept has flipped the field of addiction medicine on its head – or at least turned it sideways. While recovery models like Alcoholics and Narcotics Anonymous have long emphasized total abstinence, the continued rise of overdose deaths has prompted NIDA to fund research exploring the potential of psychedelics to treat addiction to other substances. The studies are promising, she says, but she worries that the excitement has grown faster than the science. And, as with most drugs, responses can vary from person to person: Cannabis can sometimes be addictive; psychedelics occasionally induce psychosis. “For some people an experience with some of these substances can be very revealing, but for others it can be very traumatizing,” Volkow said.

Joseph Lee, a psychiatrist who heads the Hazelden Betty Ford Foundation, worries that the primary goal of emerging cannabis and psychedelic ventures is to grow their sales. “They know exactly who they are targeting, and those people who are being targeted are misassessing their risk,” he said.  He notes that people with serious addiction problems are typically ill-equipped to make sensible choices about drug use of any kind. “One truth about risk, “ he says, “is that we all do a very poor job of assessing our own risk.” 

In other news…

Your therapist knows you lie to them sometimes…but they really wish you wouldn’t: If you’ve been to therapy, chances are you’ve lied to your therapist. It’s not an assumption; one study of 500 therapy-goers found that 90 percent fibbed to their therapist at least once. People lie about all sorts of things – to their own detriment. Common reasons include fear of being criticized, fear of embarrassment, trying to please the therapist, and wanting to avoid difficult feelings. But San Francisco-based therapist Juli Fraga said therapists can handle the truth. She told the Washington Post that being dishonest “comes at a cost” – making treatment less effective and causing some patients to end therapy too soon.

Women with PCOS have increased suicide risk. A new study from Taiwan found that women there with polycystic ovarian syndrome, or PCOS, are eight times more likely to die by suicide than women without the condition, Medical News Today reports. The condition affects 8 to 13 percent of women of reproductive age, according to the World Health Organization and is a leading cause of infertility. It can cause irregular periods, irregular hair growth, acne, obesity, ovarian cysts, and other challenges. For the study, published this week in the Annals of Internal Medicine, researchers from Taipei Veterans General Hospital analyzed nationwide data from the years 1997 to 2012, including 19,000 women and girls aged 12 to 64 diagnosed with PCOS. The increased suicide risk was associated with all age groups – adolescents, young adults, and older adults. 

Previous studies have also linked the condition to mental health challenges. “It’s a tough medical condition,” G. Thomas Ruiz, an OB/GYN unaffiliated with the study, told Medical News Today. “The basic challenge [can be that] you’re overweight…You’re a woman that may be growing a beard. You’re not getting periods…And what if you want to get pregnant? Well, you can’t get pregnant if you’re not ovulating.”

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.