SOVA Blog

Antidepressant Warnings

June 20, 2018 in Educate Yourself

4394344343_abb6fe120d_o-768x576It’s important to understand the risks of taking any medication. But it’s also important to understand where those risks came from.

There is a black box warning on antidepressants for children and young adults. This is a warning put out by the Food and Drug Association (FDA) to say that the medication might cause serious injury.

This warning is based on research studies which looked at the possible risks of taking an antidepressant. The studies done on medication are usually randomized controlled trials. The researchers will set certain rules about who can be in the study. Then once they agree to be in the study, the person is randomly selected either to get the real medicine or to get a fake medicine (placebo) which looks the same—or sometimes a different medicine. In the best studies, neither the patient nor the healthcare practitioner evaluating how well they are doing  know which medicine they received. (See this link for more information explaining clinical trials.)

In 2004, the FDA looked at a study which combined the results of different studies or a meta-analysis of studies looking at children and adolescents taking antidepressants. They found that no one in these studies died from suicide. But some people did have more thoughts of suicide, or they attempted suicide.

  • In the group that didn’t get medicine, suicidal thoughts or behavior happened in 2% of the people.
  • In the group that did get medicine, suicidal thoughts or behavior happened in 4% of all the people.

Overall the risk was low in both groups. The risk in the group taking medicine then is thought to be higher by 2 people in 100 (2%).

The problem is, it is tough to know whether antidepressant medications increase the risk of suicide, because the illness they’re designed to treat—depression—increases the risk for suicide. We do know that many more young people experience benefits from antidepressants than experience suicidal thoughts or behavior.

Although it is hard to say what caused what, after the FDA warning came out in 2004, there were fewer antidepressant prescriptions. At the same time, suicide rates went up in young people. 

It can be hard to know what to do. This is where health providers can be helpful to patients in thinking about how to weigh the risks and benefits.

  • What are the risks of doing nothing? What are the risks of doing something?
  • What are the benefits of doing nothing? What are the benefits of doing something?
  • What are the different alternatives for that something?

Either way it really helps to have a professional monitor you no matter what you decide to do, but especially when you start to take an antidepressant.

Does the research make sense to you? What further questions do you have that we can help answer?

Grrr! Irritability And What It Means

May 15, 2018 in Educate Yourself

grr01Listen to this scenario and see if it sounds familiar: some people are really annoying. Other people just don’t mind their own business. Why is that person staring at me? Why won’t my friend text me back? Why can’t I get this phone, this app, this car to work? Everything is always breaking! Nothing goes my way.

Some days are just rough, and sometimes things just don’t work out. But adolescents who have depression can feel like this every day. And they can’t figure out why.

This situation is a mood called irritability. And it can be a major part of adolescent depression. Sometimes irritability makes depression hard to identify in adolescents, who get nasty labels attached to them all the time, like “angry,” “uncooperative,” “insubordinate,” “impolite,” “antisocial.” But underneath it all is this feeling of irritability that they can’t shake off. And they don’t understand why it’s so persistent.

The things we look for in depression in adults are different from what we look for in adolescents. To diagnose a major depressive episode in an adult, there need to be symptoms which make the adult not function well and are not present because of substance use or another medical problem.

The adult’s experience needs to fit these criteria:

  • have symptoms for a two-week period
  • these symptoms are a change from how the adult was functioning before
  • have at least five of these symptoms:
    • a depressed mood most of the day, nearly every day
    • losing interest in activities
    • change in appetite
    • change in sleep
    • feeling a slowing-down or agitation in the body
    • feeling a lack of energy
    • feeling worthless
    • trouble concentrating or making decisions
    • thinking about ending one’s life

For an adult to have depression, one of the symptoms they have to have is either a depressed mood or a loss of interest in life.

But if you are an adolescent, you can have depression if your mood is depressed—or irritable.

Irritable depression can be hard to diagnose, but it is still depression, and the treatments that help with depressed mood can also help with irritability. To get to the right help, it’s important to make the right diagnosis and to take your symptoms and experiences seriously and not just attribute them to “being an adolescent.”

Feeling irritable all the time is no fun, but it’s treatable! It’s important to know that you’re not just doomed to be a Scrooge for life.

Have you dealt with irritable depression? If you had treatment, did it help your irritability?

Who Are You?

April 25, 2018 in Educate Yourself

What words describe you? If someone did not know you at all—how would you describe yourself? You could probably make a long list of things. People are not one-dimensional. And even if most of the time you are one way, in certain situations you might be the opposite. Let’s say most of the time you are a peacemaker—but if someone makes fun of your sister, you will pick a fight with them. There may even be things about you that seem to be opposites—but they are both there inside your character.

drawingYou might have a lot of skill in math and science—but when it comes down to it, you could spend all your days just drawing with a charcoal pencil. I think you get it. People have many sides to them. And in one snapshot of their lives—they are one way—at another stage they might have left certain things behind and now there are new adjectives to describe who they are.

All this being said, what does it mean to get a mental health diagnosis? Is this now something else that describes you? Does it put a damper on your life—what does it mean when someone uses a word to describe you? He’s a depressed guy. She is an anxious girl. Sometimes when people use labels on you, it feels like a condemnation. Maybe it feels to you like they are really saying, He’s depressed—that means he is weak, no good, a failure at life, and he’ll never amount to anything. Maybe it feels like they are really saying, She’s anxious—that means she worries too much for no good reason, she takes everything seriously, and cries and complains too much about everything.

Think a minute, though. Are those things true? Is it really possible that you were something else—and now this label makes you a one-sided person?

label02A diagnosis can feel like a label, and sometimes labels make us feel so very small, or as if we are doomed to some fate we did not choose.

In medicine, a more humanizing way to talk about any illness is this: instead of saying, “Sally is a depressed 15-year-old girl,” we say, “Sally is a 15 year-old girl who has depression.” Does using language that’s a little bit different really make that much of a difference?

Yes! The difference is that Sally is a multi-dimensional person, and the fact that she has depression is only one part of her experience and life.

Some people do not want to get help because they don’t want to wear a label. Here’s the truth: no one is a label. For the sake of figuring out how to help people, sometimes medical people will use categories or labels so they can formulate a plan to help someone. But in the patient’s real life, everyone’s illness is unique and different, has a different course, and could have been caused by different factors. Using these labels is a simple way to talk to each other so we can communicate and try to help. Remembering each person is unique and not a label is always something to keep in mind.

Have you ever felt ashamed of being labeled as being sick or “mentally ill”? What strategies did you use to cope with this?

When I Grow Up, I Don’t Want To Be Like You

April 18, 2018 in Educate Yourself

Photo Credit: Jose Chavarry via Compfight cc

Do you have friends or family members who have a mental illness and have had a lot of trouble dealing with it or did not get treatment? Many of us do.

It can be tough to watch them suffer. Maybe they are someone you enjoy spending time with sometimes, but other times you feel let down because they neglect you or hurt your feelings. When a person’s mental illness is not treated, often they don’t do things to take care of themselves—and if they’re not being good to themselves, it can be hard for them to cultivate relationships with others.

What if then someone tells you that you also may have a mental illness? Your immediate thought might be, No, that’s not me. I’m not like my family member at all, and there’s no way my life will turn out like theirs.

It’s understandable that you might get upset and worried. Accept that you feel that way, but then take some time to think about it a little more. It’s true that mental illness can run in families, yet every person is unique and mental illnesses affect each person in different ways.

Also, we are learning more and more about treating mental illness. Some of our older family members maybe did not receive enough treatment when they were younger, and we know the sooner you get treatment, the more it helps.

If you feel worried about your genetics, remember we are like our family and then we are not like our family. Focus on yourself. Sometimes when we do that, others notice and in time, help themselves as well.

And just because mental illness might run in your family, remember that science shows that your genes are not set in stone!—read our post on epigenetics to find out more about that.

Have you experienced worries your life would be similar to a family member’s who did not get treatment for their mental illness? How did you cope with these concerns? Let us know in the comments!\]\\

When I Grow up, I Don’t Want to Be Like You

March 20, 2018 in Educate Yourself

Do you have friends or family members who have a mental illness and have had a lot of trouble dealing with it or did not get treatment? Many of us do. It can be tough to watch them suffer. Maybe they are someone you enjoy spending time with sometimes, but other times you feel let down because they neglect you or hurt your feelings.

Having a mental illness that is not treated often means they are not doing things to be good to themselves—and if they’re not being good to themselves, it is hard to cultivate quality relationships with others.

What if someone then tells you that you also may have a mental illness? Your immediate thought might be—No, that’s not me … I’m not like my family member at all, and there’s no way my life will turn out like theirs.

It’s understandable that you might worry or be upset. But then take some time to think about it a little more. It’s true that mental illness can run in families, yet every person is unique and mental illness affects each person in different ways.

Also, we are learning more and more about how to treat mental illness. Some of our older family members maybe did not receive enough treatment when they were younger, and we know getting treatment when you are younger helps more.

If you feel this way, remember we are like our family and then we are not like our family. Focus on yourself. Sometimes when we do that, others notice, and in time they will help themselves, too.

Have you experienced worries your life would be similar to a family member’s who did not get treatment for their mental illness? How did you cope with these concerns?

Reel Teens Pittsburgh Facebook Live Town Hall

November 9, 2017 in Educate Yourself

If it’s your first time to sova.pitt.edu, welcome! Some of you may be just finding out about our site after watching the Reel Teens Pittsburgh Facebook Live Town Hall. The Reel Teens are an awesome group of local young filmmakers who interviewed me, Dr. Radovic, for their film about mental health.  The film features the award-winning work of Stand Together, a peer-to-peer group organized through the Allegheny County’s Office of Behavioral Health. Stand Together encourages local middle and high school students to start talking and thinking about the stigma associated with mental illness and substance use. It’s something we and our SOVA ambassadors write a lot about on SOVA because we want to help young people understand that its okay to ask for help – becoming interdependent (knowing who and when to ask for help), not independent, is the goal of turning into an adult – and we want to help change negative attitudes about mental illness.

Over the next week, we’ll be featuring articles that help answer some of the questions that came up during the Town Hall – and we hope that you will continue the conversation with us and our online community. Make sure you register so that you can log-in and comment – it is essential to helping us keep the site safe and bullying-free.

If you haven’t seen the Reel Teens’ video check it out below:

What did you think of the video? Let us know below!

Which health app is right for me?

October 13, 2017 in LINKS

Have you ever downloaded an app to help you with your health? What happened? Was it useful or did you end up deleting it when you were cleaning up your phone later?

One problem currently with apps available for download is it can be hard to figure out whether it will actually be helpful to you or not. Apps are advertised and users leave ratings. Which ones show up first is determined by an algorithm – or formula – made up by that specific app search engine (like the iOS app store). Its kind of like healthy diet books. Some of them might have really pretty book covers and claims from famous people that they work – but then you try it out only to find its not what you were looking for.

http://myhealthapps.net/about

http://myhealthapps.net/about

Myhealthapps.net is trying to provide a solution to that problem. It is a website collecting apps for health and providing information from patient reviewers about what worked for them.

You can browse by health category and see a lot of information about each app including whether it is free and whether the app includes different features like:

  • support to deal with symptoms
  • social network
  • reminders
  • keep track of symptoms
  • self-monitoring

They even have a place where you can submit apps you have found useful too.

If you find a useful app through myhealthapps.net, share with us below!

How to use mindfulness every day: Part 2

October 10, 2017 in Educate Yourself

In a previous post we talked about a situation where you could use mindfulness if you feel stressed out before a job interview. We also told you about some great websites to check out in that post. Let’s say you read about mindfulness, even listened to some audio, and now you are about to knock on that door, and still you are freaking out! What can you do?

Interview

Well first things first, practicing mindfulness in non-stressful situations will help you be able to solidify it as a tool in your toolbox. Then it will be easier to use it when needed. Once you’ve done this, using mindfulness in a stressful moment might go something like this:

You thinking: Wow, my stomach feels really tight and my hands are sweaty. This is what happens when I’m nervous. Wow I am pretty nervous. [take a mindful pause] When I’m nervous, it helps me to pause. Okay pause. [literally focus on what is happening right in the present] Look around – what is around you? Okay there is a little toy truck that’s yellow, I’m carrying a blue folder with my resume, okay the door in front of me is wooden and white, I can hear myself breathing – okay slow down breathing – slow down – in, out. [focus on breathing which is always something you can be present with] Okay, I feel my stomach relaxing, I think it’s okay to knock now.

Knock, knock:

Manager: Hi, are you Damian?

You: Yes, nice to meet you. Thanks for the interview.

Manager: No problem. I was impressed by your resume and the extracurricular activities you’ve been able to take on with school. In this job, you’d have to be good at handling stress because sometimes parents and kids are demanding! Do you have any example of a stressful situation you’ve been in with kids and how you’ve handled it?

You thinking: What! I have no idea? Stress? kids? I’m stressed right now. Oh man stomach getting tight again. Oh man, getting nervous again. Okay what is she wearing – she’s wearing a red hat, it says Little’s Toys, there’s a picture of her with her 2 kids, okay she’s a real person – she just wants to get to know me, no big deal, okay focus on breathing, breathe…breathe…okay I work with Sunday school kids…okay let me focus on that now…

You: I can definitely tell you about that. I’m an assistant at our church Sunday School and the kids there just want to have fun all the time instead of listening….etc.

Using mindfulness in the moment can be tough! But the more you practice, the better you get! What do you think about this story? Does it seem like something you could do or have done before? 

How to use mindfulness every day: Part 1

October 3, 2017 in Educate Yourself

We have written about mindfulness before, but how can you practice it everyday?

You’ve just applied for a summer job at a small independent toy store. They called you yesterday and asked if you can come in for a short interview today with the manager. You were excited they called. Now you’re standing in front of the manager’s office door and about to knock. You are SO nervous. Wow. Really, what is the big deal? What is with you? You are breathing fast, sweating, and your stomach feels like its tight and in knots. How are you going to get through this?

Every day we experience emotions and sometimes they take our bodies and minds into directions we hadn’t planned to go. But they are part of being a human. So what can we do? Luckily there are some tools you can learn to use to help regulate these emotions.

Mindfulness

One of them is mindfulness. Mindfulness is being aware of what is going on at that moment – and importantly, being nonjudgmental about whatever that is. There are many resources that you can use to learn about mindfulness.

Here are a few resources we highly recommend:

Dr. Dzung Vo’s website about mindfulness for teens

Mindfulness explanation and audio recordings for youth

Ohio State University’s mindfulness audio recordings

How could you use mindfulness in the above situation? In a later post, we’ll give some ideas of how. 

Because I felt like I didn’t deserve to get better

August 15, 2017 in Educate Yourself

In interviews I did with adolescents who have depression and were in treatment, some of them said that at first, they didn’t want to go to therapy because they didn’t feel like they deserved to get better.  This was so sad to me because guilt and shame like feeling like you don’t deserve something are actually symptoms of depression.

The fact that they were feeling that way is exactly why they needed to get help. Because they felt they are bad. But they are not bad. They needed some help to feel better and feel that their life is worth living.

Its kind of like if someone had a broken leg. And then they said, well I can’t go to see my physical therapist because I can’t walk. But they need to see their physical therapist so that they CAN walk.

Guilt_Shame

I am grateful that the adolescents I spoke with had all gotten help in treatment. In the long run, they realized their feelings of guilt and shame were part of the depression, and not something that defined who they are.  They were able to learn the coping skills to get to a better place and sense of self.

Have you ever felt guilty for something you realized later was not actually your fault?