March 17, 2022

Good morning MindSite News readers. In today’s newsletter, you’ll learn about the link between air pollution levels and depression in teens, ways to better support transgender and nonbinary youth, and the debate over involving people with suicidal thoughts in clinical trials involving antidepressants.

Air pollution linked to depression in teens

Photo: Shutterstock

Teens exposed to relatively higher levels of ozone air pollution show increased depressive symptoms over time, even in neighborhoods that met air quality standards, according to new research published earlier this week in Developmental Psychology. Researchers analyzed four years of mental health data from 213 adolescents, ages 9 to 13, in the San Francisco Bay Area and controlled for sex, age, race, household income, parents’ education, and neighborhood wealth. Lead researcher Erika Manczak, an assistant professor of psychology at the University of Denver, said in a press release that “state and federal air quality standards should be stricter, and we should have tighter regulations on industries that contribute to pollution. Our findings and other studies suggest that even low levels of ozone exposure can pose potentially serious risks to both physical and mental health.”

How to support trans and nonbinary youth

In the wake of a flurry of anti-LGBTQ legislation, including Florida’s recently passed “Don’t Say Gay” bill and Texas governor Gregg Abbott’s move to criminalize gender-affirming medical care for transgender youth, The New York Times interviewed several gender-focused child health care experts for guidance on the ways adults can support youth on the gender spectrum. Why? Because studies show that trans and nonbinary children and teens have better mental health outcomes when they receive gender affirming care. Here’s the advice they offered:

Research all treatments and get expert help. Support is available for youth and adults at local gender clinics, or you can find direct support through online resources, like the “find a provider” tool through the World Professional Association for Transgender Health or Gender Spectrum, a nonprofit that creates gender inclusive environments for youth.

Language matters, so widen your gender vocabulary and use the terms people ask you to use, said Laura Anderson, a child and family psychologist who specializes in gender development. “When one’s gender identity does not match how they are treated by others, it can lead to psychological distress,” she said. It’s understood that mistakes in language may occur, but when they do, they should be acknowledged, apologies should be made, and a genuine effort to not repeat the mistake should be put forth.

Don’t force a conversation about gender, but if a child brings one up, respond with curiosity rather than judgment or concern. According to Dr. Daniel Summers, ask questions like, “When do you think you started wondering about this?” or “How should I learn about it?” The point is to set the stage for connection, rather than a power struggle, and make it clear that the child is loved and accepted no matter what.

Acceptance and commitment therapy proves useful to runners

“What’s more important for runners — mental flexibility or mental toughness?” That’s the question Canadian Running magazine asked. The answer: While mental toughness is useful, mental flexibility offers greater value in the thick of race day. Fortitude and grit, they argue, helps one push through pain to finish a race, but mental flexibility helps runners overcome factors they cannot anticipate, ones that shake up their competition plans. 

Acceptance and Commitment Therapy (ACT) proves an effective strategy for responding with mindfulness and acceptance to uncontrollable experiences, the magazine reports. It enables one to feel and acknowledge thoughts and emotions—both positive and painful—in pursuit of a goal, while not allowing those feelings to direct their actions. Imagine, for example, that a hill comes into view and triggers the thought, “I’m not good at hills.” The mental flexibility accessible through ACT teaches runners, and others, how to acknowledge that thought as a symptom of the challenge, without submitting to it as fact. That skill can translate to overall improved performance.

People with suicidal ideation are often excluded from antidepressant drug trials. Why?

It’s quite the paradox: People at risk of suicide – most of whom suffer from depression – are typically left out of clinical trials for new antidepressants in an effort to protect them, according to a deeply reported essay for the BBC. The idea is that people considered to be at risk of committing suicide are vulnerable and thus should be protected from the risk of harm in trials of a new drug. Numerous studies have found an increased risk of suicide in some groups taking antidepressants, especially at the onset of use. 

But some researchers are beginning to wonder if this approach should change. The writer of the BBC story, who suffers from depression himself, notes that 50-66% of people who die by suicide also suffer from a mood disorder. (He also notes that only 2% to 4% of people treated for depression die by suicide). Excluding people from clinical trials because they have other illnesses, have struggled with a substance use disorder or have a heightened risk of suicide means that the trials don’t actually represent the people who might take the medication in the real world. “You can’t actually extrapolate to the broader population of people,” said Michael Hengartner, a senior lecturer and researcher at the Zurich University of Applied Sciences.   

Arif Khan, medical director at the Northwest Clinical Research Center in Bellevue, Washington, believes that using suicide risk scales to exclude people at greatest risk for self-harm is beneficial and ethical. According to his own 2018 research, screening patients has led to significantly lower rates of suicide in clinical trials.

In other news…

In an effort to address teacher burnout, the Illinois legislature is considering a bill to offer teachers mental health days at full pay or other options to use sick leave for mental health concerns. The bill is supported by  the Illinois Education Association but some teachers question whether it goes far enough, an article from Chalkbeat Chicago reports. Briana Morales, a fifth-year English teacher, wants districts to provide more mental health support for educators as it is starting to do for students and families.

Shelters for the unhoused that offer temporary housing for the homeless are popping up quickly in California, yielding profits for developers and satisfying city leaders by getting people off of the streets, according to a report from Reuters. Unfortunately, as helpful as they are, such temporary options don’t come close to addressing the problem of a massive shortage of permanent and affordable housing.

Of orchids, dandelions and tulips. In recent years a theory has emerged among child development researchers that some children – dubbed as orchids – are highly influenced by their environment, while others – dandelions – are influenced very little. A third group, called tulips, are somewhere in the middle. But Jay Belsky, a child psychologist and professor of human development at the University of California, Davis, says this line of thinking is too narrow, and that most children are more like a mosaic of traits and influences. In Scientific American, he writes, “Our findings on peer and parental influence suggest that therapists or teachers need individualized treatments to help children with psychological and behavioral problems. In some cases, they should consider family environment first – but in others, they should focus on peers. In other words, we should recognize each child as unique when it comes to what will and won’t shape their development. Vive la différence!”

If you or anyone you know is considering suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255. And if you’re a veteran, press 1.

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Type of work:

Courtney Wise Randolph is a native Detroiter and freelance writer. She is the host of COVID Diaries: Stories of Resilience, a 2020 project between WDET and Documenting Detroit which won an Edward R. Murrow...