Monday, June 26, 2023

By Don Sapatkin

Good Monday morning! In today’s Daily: A psychiatrist celebrates the therapeutic power of Taylor Swift (and turns into a Swiftie). Psyche-delics are going mainstream: Take it from former Texas Gov. Rick Perry, a Republican, and the 11,000 people who registered for a psychedelics conference. 

Plus: A new report underscores the link between long Covid and mental illness. And indigenous therapists are helping Indigenous people process their pain in Texas.

Taylor Swift Has Rocked My Psychiatric Practice

“Many of my patients are adolescent girls and young women, and they have leaned on Taylor Swift as a kind of big sister through the daily agonies of being a teenage girl: unsteady friendships, the 24-hour firing squad of the internet and, of course, the endless longing to feel seen and valued,” psychiatrist Suzanne Garfinkle-Crowell  writes in the opening of an illuminating New York Times essay
Garfinkle-Crowell described herself as a casual fan – until Swift’s tour approached.

Photo: Shutterstock

That’s when “the Taylor-based therapy issues” − How to stay calm beforehand? How to return to regular life afterward? − “reached a boiling point.”  To help them, she wrote, we “explored these patients’ relationships to anticipation, to enjoyment, to self-regulation, to suffering.” She tried to “understand why this artist and this tour were so powerful” – and then she accompanied her 9-year-old daughter to a Taylor Swift concert. “And now,” she writes, “I, too, cannot remain calm.”

Garfinkle-Crowell peppers the piece with links to 22 carefully chosen video and audio files that evoke the pleasures and pains, fears and dreams that fill the life experience of today’s young women. And for those of us who are aren’t in that demographic, Garfinkle-Crowell explains why Swift has become “the poet laureate of this generation” and why her music, lyrics and persona so resonate with this group:

Teenagers suffer for many reasons. One is being fragile and in formation – a human construction site. Another is being surrounded by others who are fragile and in formation. Ms. Swift articulates not only the treachery of bullying but also the cruelty just shy of it that is even more pervasive: meanness, exclusion, intermittent ghosting. She says: Borrow my strength; embrace your pain; make something beautiful with it – and then you can shake it off.

Swift has created “a cohesive community” for a generation whose social connections have been frayed by the pandemic, Garfinkle-Crowell says. She notes that while her private patients have a professional to help them work through complicated feelings and harmful patterns, “few teenagers have access to this kind of support.” “It’s confusing to be human and to be female, and I’m glad, both for my patients in their midnights and for their populous, shimmering community, that they have someone so articulate, so generous and so endlessly present to talk to.”

Psychedelics for everyone

There may be no better evidence of the long, strange trip psychedelics have been on, from counterculture to mainstream, than having Rick Perry – former Texas governor and Republican culture warrior – walk on stage at the Psychedelic Science 2023 Conference in Denver to tout the wonders of psychedelics. The excellent Microdose newsletter was there to cover the ups and downs with daily dispatches.

Psychedelics going mainstream was the unofficial theme of the five-day confab that attracted more than 11,000 medical professionals, politicians, celebrities, practitioners and psychonauts to the mile-high city. Discussions ranged from the business of psychedelics to the use of psilocybin, MDMA and ketamine for treating a range of psychiatric conditions. 

Today, only Oregon allows psilocybin-assisted therapy. But Coloradans voted last fall to create a framework to get there and several states have loosened penalties or decriminalized psychedelics – even though they remain illegal at the federal level. While some studies have found remarkable benefits, research is early and long-term risks not fully understood. A theme of one panel was balancing hype and hope. 

Other sessions explored the potential of non-hallucinogenic psychedelics and how an ayahuasca ceremony affected women migrants from the Middle East and North Africa. For a quick what-you-need-to-know about the state of psychedelics, read the Axios advancer. But for the full effect, check out Microdose writer Jane Hu’s snappy daily dispatches on behalf of the U.C. Berkeley Center for the Science of Psychedelics.

Health advisory urges doctors to take seriously the elusive link between long Covid and mental illness

People grappling with the debilitating impact of long Covid have long complained that mainstream medicine has paid little heed to the mental health effects, despite a growing body of evidence associating multiple conditions with long Covid. (See this MindSite News story from last year.) Now a new advisory issued by the federal government suggests things may be changing. 

The detailed advisory lists nine specific conditions − fatigue, cognitive impairment or “brain fog,” anxiety, depression, obsessive-compulsive disorder, sleep disorders, PTSD, psychotic disorder, and initial onset of substance-use disorder − along with their frequency, symptoms and average duration. Determining whether mental illness is the result of long Covid or something else can be challenging. Whatever the reason, “treating symptoms is vital to recovery,” the Substance Abuse and Mental Health Services Administration advises.

Because long Covid can be debilitating, the document suggests doctors approach patients as they would someone who has undergone trauma. It also urges them to listen to – not dismiss – their patient’s stories, the Los Angeles Times reported. Doctors should manage symptomsand concede the uncertainty of prognosis as they “provide hope while helping set realistic recovery goals.”

Home-grown clinics offer hope to Indigenous people 

Nury Márquez, born and raised in Zacatecas, Mexico, migrated to Texas with her family when she was a kid. By her 20s, she saw there were thousands of people like her but not enough therapists who could understand their experiences. About 40% of Texans are Latino, but only 15% of recently surveyed mental health providers identified that way. Now 32 and a licensed clinical social worker, Márquez this year opened her own mental health clinic in Dallas’s Oak Cliff neighborhood. “She named it Papalotl, which means butterfly in Nahuatl, the language of the Aztecs, to represent her culture and honor her indigenous ancestors,” Medical Xpress reports.

American Indians and Alaska Natives make up about 2.6% of the U.S. population but carry a disproportionate burden of mental health problems compared with other Americans, especially for substance abuse, PTSD and suicide. Yet only 0.13% of active psychologists come from those communities, according to Census Bureau data

Texas Native Health is on a mission to make therapy more accessible. The Dallas clinic (formerly the Urban Inter-Tribal Center of Texas) will serve any enrolled tribal member who lives in the state − 3,000 to 5,000 patients a year. Artist and designer Dora Brought Plenty first came to the clinic in the 1970s when she was 21, and trying to process her experiences at a government boarding school. “Being mistreated and going through all the abuse in the Indian boarding schools, it changes the whole dynamics of who we are,” Brought Plenty told public broadcaster KERA News. She sought help for years from other mental health professionals, but they “had not a clue how to teach or treat us.” But this clinic, she said, has provided a “safe haven” and has helped keep her alive.

In other news…

“When does anxiety become a problem?” a New York Times column asks. With new guidelines released last week calling for doctors to screen all adults under 65 for anxiety disorders, the Times piece explored how much anxiety is too much. “Some signs to be on the lookout for include a sense of dread or worry that just won’t go away or having trouble sleeping or eating,” said Petros Levounis, president of the American Psychiatric Association. But, he added, “we all feel anxious from time to time.”

A phone-free isle of health. The island of Ulko-Tammio, off the coast of Hamina in Finland’s Eastern Gulf National Park, is marketing itself as a no-phone zone to tourists looking to turn off and tune out, Euronews Travel reports. It helps that the island is largely uninhabited, although there are plenty of birds and the mobile network reportedly still functions. You can catch a water taxi from Varissaari to your tent or cabin.

The library social worker is in. Ashley Hammond, LCSW, just finished her first year as the Boise Public Library’s first mental health coordinator. She told Boise State Public Radio that she’s helped nearly 200 patrons. The No. 1 service request for assistance: “affordable housing.”

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.

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Type of work:

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...