Monday, July 31, 2023

By Don Sapatkin

Good Monday morning! Scratching (like yawning) is indeed contagious, researchers tell Medscape, and likely serves as a form of biologically induced empathy. In today’s Daily: Extreme heat can rock your mental health. Mississippi routinely jails people for being mentally ill. Tributes pour in for Sinéad O’Connor, who battled trauma and hypocrisy with the power of her voice. Post-concert blues are especially real for those already coping with depression. And more.

The mental health risks of super-hot days

Photo: Shutterstock

Extreme heat can endanger your health – and mounting evidence suggests it’s bad for your mental health, too. A study published in JAMA Psychiatry last year analyzed 3.5 million warm-season emergency department visits over a decade and found that the number of mental health-related visits were 8% higher on the hottest days of summer compared with the coolest days, and with almost no difference among age groups.

Perhaps the biggest reason, first author Amruta Nori-Sarma told Vox, is that “extreme heat disrupts sleep.” Her study found that ED visits increased for several mental health conditions that are biologically very different from each other, suggesting that “heat is an external stressor that’s somehow exacerbating people’s existing symptoms.”

Nori-Sarma, an assistant professor at Boston University School of Public Health, is also concerned that the high levels of stress and anxiety many people, especially young people, already feel about climate change “might limit our ability to cope as these events are occurring.” One antidote to that, she says, is “feeling like you’re prepared in case an extreme heat period happens − so knowing what resources are available to you.” Find out if your community has cooling centers. Make plans to stay hydrated and avoid spending a lot of time outdoors. If you might need it, buy an air conditioner or at least some good fans. And mobilize social networks – so you and your friends and family are all prepared and checking in on each other. You’ll feel better.

In Mississippi, people with mental illness are routinely jailed without charges, investigation finds

In Mississippi, people going through mental health crises and thought to be a danger to themselves or others are routinely jailed while awaiting evaluation and treatment − even when they haven’t been charged with a crime.

An investigation by Mississippi Today and ProPublica examined practices in all 50 states and determined Mississippi was “an extreme outlier” in jailing mentally ill people alongside regular criminal defendants. Many were shackled when they left their cells. The investigation found that people awaiting evaluation and treatment for behavioral health conditions were held in jail without charges at least 2,000 times from 2019 to 2022, sometimes for days or weeks. Since 2006, the news organizations found, at least 13 people have died in Mississippi county jails as they awaited treatment for mental illness or substance abuse.

MindSite News republished the investigation here.

‘Post-concert depression’ is really bad for the already depressed. But there are ways to cope

It’s a thing: the sadness that sets in when “you’ve made an upcoming concert your personality for months, assembling a unique outfit, planning transportation and memorizing the lyrics to every song in case your favorite artist [see: Taylor Swift] performs it,” as USA Today put it.  And then, “it abruptly ends. What then?”

An energy-depleting let-down, sure. But post-concert depression can be much more agonizing and long-lasting for people with depression, Douglas Mennin, a professor of clinical psychology at Columbia University, told the news outlet. “It’s hard for them to see that the thing that has been good will be around again,” Mennin said. “There’s a sense of ‘this won’t happen again. I won’t be able to get back to that.’”

Advice from experts: Find ways to remember the night fondly. Plan other exciting activities more consistently. Avoid isolation, which make the negative emotions worse. Don’t depend on social media to cope. Allow other activities to be less exciting, i.e. accept that seeing the new “Barbie” film probably won’t quite match Taylor Swift live. (And speaking of her, check out “Taylor Swift Has Rocked My Psychiatric Practice” in case you missed it in this space last month.)

“I love red hot people, and she was fire.”

Simon Napier-Bell, Sinéad O’Connor’s manager from 2014 to 2015, from a collection of memories from her friends and collaborators in the Guardian.

Sinéad O’Connor, the passionate Irish singer-songwriter who composed haunting, vulnerable songs like her breakout hit single Nothing Compares 2 U, died last week at 56 following decades of openness about her mental health struggles. (The cause of death has not been released.) Her death sparked an outpouring of tributes for her fearless honesty – most indelibly when she ripped up a photo of Pope John Paul II on Saturday Night Live while singing from a Bob Marley song about “the victory of good over evil.”  

O’Connor’s activism on behalf of abused women and children, LGBTQ+ people, AIDS patients and other disenfranchised people was rooted in personal experience. She wrote about the physical abuse she suffered at the hands of her mother. As a teenager she was sent to a so-called Magdalene Laundry, an asylum for “fallen women” run by the Catholic Church where she likely witnessed or experienced abuse. As an adult, she suffered from fibromyalgia and bipolar disorder and last year endured the suicide of her son, Shane. In 2007, she told Oprah Winfrey that she’d experienced thoughts of suicide and overwhelming fear. “It’s like being a bucket with holes in it. Just leaking tears from every pore,” O’Connor said.

Fintan O’Toole, an Irish Times columnist, told the New York Times that O’Connor had exposed, and even embodied, the pain of women in a misogynistic society. “But she did that not through self-pity but with defiance, humor, beauty and brilliance…She turned her fragility into a form of strength. She will be terribly missed.”

The facts on kratom, and the potential risks

Kratom − an herbal product that some users claim can substitute for opioids to treat physical and mental pain − has not been approved for any medical use and research on its risks and benefits is scant. But it’s available everywhere from gas stations to online, and 1.7 million Americans used it in 2021. The “natural” label is a big part of kratom’s appeal, although it is essentially a drug.

The New York Times reviewed what is and isn’t known about kratom: Most people who take capsules or brew tea with the leaves are attempting to self-treat depression, anxiety disorders or opioid withdrawal. But while those benefits may be plausible, no clinical trials have proven them. Kratom appears to act as a stimulant for some people and a relaxing sedative for others, particularly at higher doses.

Limited research has found that most side effects are minor, like profuse sweating or chills. But larger doses can be more problematic. The FDA warns of a “risk of serious adverse events,” including seizures and liver toxicity. Recent lawsuits allege that kratom consumption may have contributed to several deaths. It has the potential to be addictive and some users can go into withdrawal, one researcher told the Times. “No one needs to pick up a kratom habit,” said another.

In other news…

Preterm births are more likely when either mothers or fathers have psychiatric histories and even higher when both parents do, Managed Healthcare Executive reported. The risk of early birth was 12% higher when fathers had a psychiatric diagnosis, 31% higher when mothers did, and 52% higher when both parents had such a diagnosis, according to a study in PLOS Medicine of nearly 1.5 million live births over 10 years in Sweden. The authors suggested that additional social support might be needed when both parents have psychiatric histories.

A group of hedge funds is working on a plan to take control of the drugmaker Mallinckrodt and cut about $1 billion that the company had pledged to pay people suffering from opioid addiction and to state and local health departments for addiction services, the Wall Street Journal reported. Mallinckrodt, one of the nation’s largest opioid manufacturers, agreed last year to resolve thousands of lawsuits by paying a fine of $1.7 billion. The hedge funds want to acquire Mallinckrodt through a bankruptcy filing, according to the Journal.

Psychiatric admissions plummeted in states that legalized recreational marijuana, according to research in Health Economics. The study analyzed federal data from 2007 to 2019 and found that treatment admissions remained steady in the years before the laws changed, and then declined by an average 37% in up to four years following legalization in 10 states. While the analysis doesn’t show cause and effect, study author Alberto Ortega, an assistant professor at Indiana University, speculated that increased marijuana use might improve mental health or that people who might otherwise have sought mental health treatment self-medicated instead.

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...