New fears, new frontiers in mental health

Wednesday, February 15, 2023

By Courtney Wise

In today’s roundup, we’re sharing information about moms who turn to microdosing to help treat mood disorders, consider family medicine as a new frontier in mental health, and see that alarming numbers of teen girls and LGBTQ+ youth are experiencing violence and mental despair. Plus, Dr. Kizzmekia Corbett talks about the pressure of making Black history, a psychologist provides tips on how to sleep through the night, and we reshare some help from Sesame Street on how to talk about trauma.

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Moms turn to psychedelic therapies to overcome anxiety and depression 

As psychedelics like psilocybin become decriminalized across the country, psychologists and therapists who specialize in perinatal mental health find themselves working with more moms interested in microdosing psychedelics to treat anxiety and depression.

“All of my mom friends are microdosing mushrooms, and I want to try it, too,” one of Melissa Whippo’s patients told her during a therapy session. Whippo works in partnership with a psychiatrist to provide ketamine-assisted therapy at her California-based practice. “Many [women] feel more comfortable taking something they feel is more ‘natural’ such as psilocybin, which they don’t have to take daily, rather than a daily pill like Prozac,” she wrote in a column for the Washington Post.

Microdosing involves taking 5% to 10% of a “normal” dose of a psychedelic every couple of days. Whippo’s patient reported reduced anxiety and less pressure to “do it all” as a mom. But while microdosing can be helpful, psychedelics won’t “do your work for you,” said Brooke Novick, a licensed marriage and family therapist. “There is no magic pill or plant that allows you to bypass the healing of childhood trauma, symptoms of anxiety or depression. This sacred medicine, when used with intention, respect and care, can powerfully support us on our paths of healing and evolution.”

With that in mind, Whippo offers four points for people to note before starting a microdosing regimen:

1. Familiarize yourself with psychedelic microdosing research. It’s not a legal treatment for postpartum mood concerns, though a 2021 study found that men and women experienced reduced symptoms of depression, anxiety, and stress while microdosing.
2. Work with responsible mental health and medical providers. You’ll need to trust them and be honest about your medical history and any medications you take that might interact with the psychedelic.
3. Ensure your psychedelics are provided by a safe and ethical source. Know who makes your medicine, where they grow it, and how the Indigenous communities who shared these medicines with the West are benefiting from the sales, among others.
4. Prepare properly. Though microdosing should not impact your ability to engage in your normal daily activities, you should still prepare for how your body and mind may respond to consuming psychedelics.

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Can family medicine address mental health?

Physical and mental health are two sides of the same coin. Primary care doctors tend to patients navigating diabetes and depression, asthma and stress. “Primary care physicians…are the front line. They know the patients. They know the families. They know when someone is struggling,” said Sarah Abdelsayed, a family and addiction medicine physician at the University of Buffalo. “Some people might not be comfortable going to a therapist’s office. They might not be comfortable hearing the word [therapy].” 

As a result, more providers are integrating behavioral health into their practice to lower barriers to mental health access, the Washington Post reports. The federal government is incentivizing the shift, awarding 24 medical schools and hospitals a total of $60 million to train current primary care physicians to address mental health needs.

In an integrated care model, patients who need support beyond what a primary care physician has to offer can still go to the primary doctor’s office to get help from an onsite team that might include social workers, therapists or psychiatrists. This eases access to care and offers patients discretion and dignity.

“We’ve grown comfortable with colleagues having diabetes, having serious things like cancer, but if they say they have a behavioral or substance use issue,” that same grace often is not extended, said Millard Collins, professor and chair of the family and community medicine department at Meharry Medical College. “If I’m suffering, especially in the day of the cell phone, I don’t want to walk into a place that shouts my business.”

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Behind rising rates of despair and suicide in girls, LGBTQ+ youth: shocking rates of sexual violence

Teens girls and LGBTQ+ youth are facing unprecedented levels of violence, sadness, and despair, according to an analysis of the Youth Risk Behavior Survey, the most recent data available.  “There is no question from this data [that] young people are telling us that they are in crisis,” Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, told NPR.

According to survey responses, 18% of girls and 22% of LGBTQ+ youth faced sexual violence in the past year, as did 11% of all teens. More than one in ten girls had been raped in their lifetime. “That is just an overwhelming finding,” said Ethier. “So, not surprisingly, we’re also seeing that almost 60% of teen girls had depressive symptoms in the past year, which is the highest level in a decade.” Nearly one in three girls admitted to contemplating suicide within the past year – a startling 60% rise from the previous decade. More than half of LGBTQ+ teens said they’d struggled with their mental health and 20% reported actually attempting suicide during that time.

Most youth admitted to psychiatric emergency rooms with suicidal thoughts are trauma survivors. Other social and environmental factors are also at play, including early puberty. Puberty is starting earlier for growing numbers of girls and “hormones certainly start to differentiate issues for females versus males,” said Stephanie Eken, a Wisconsin-based pediatrician and child and adolescent psychiatrist. “When…[girls] start to hit puberty, [they] start to have increasing rates of depression and anxiety. So there are the hormonal factors that we think could play a role.” 

Schools “are on the front lines of dealing with the mental health crisis that we’re experiencing in this country,” Ethier said. They can make sure teachers are trained in dealing with mental health issues that arise in their classrooms, help get young people out into their communities to provide service and help them connect with mentors, she said. For a look at how one program does it, see this story from last year on Michigan’s TRAILS program.

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In other news…

Kizzmekia Corbett, a Black scientist, made history in 2020, leading a team of scientists at the NIH to develop a highly effective, easily manufactured vaccine against COVID-19. Last week, she spoke to the New York Times about the emotional impact of such an achievement. On the one hand, she felt “excitement about being able to prove myself and my work to the world.” On the other: “If I fail as a Black woman, this department at Harvard will overlook Black women until infinity. People at the NIH would have overlooked Black women if I failed. Being the first in so many kinds of these spaces has so much pressure.”

Do you wake up repeatedly at night? The Washington Post spoke to a psychologist about ways to help you sleep through the night – or at least not lay in bed for hours if you still have to get up. 

Big Bird and Elmo help us navigate trauma – again: In the wake of yet another mass shooting, this time at Michigan State University, we’re resharing a piece from KQED that ran in last week’s parenting newsletter about the work being done by Sesame Workshop via their Sesame Street in Communities programming to support children and adults in talking about difficult situations and traumatic events.

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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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