Sebastian Junger's Ted Talk

"Our lonely society makes it hard to come home from war."

- On average 22 vets kill themselves every day

- Sebastian Junger believes that the trauma in war effects the war vets, but the society they come back to does

- In war you have a tribe, you trust others with your life but in modern society there is so much alienation and depression

- Huge gap between rich and poor and major racial profiling 

- The country the vets fought for is not stable or safe enough for them to come back too

- Poor women in Nigeria are less depressed than rich women in North America\

- Our country divides itself instead unifying 

- PTSD rates declined after 9/11 because one major trauma unifies people 

- Need to fix our society so we can also help the vets

- Why is it that people only come together when it effects them personally? 

- How can we make it our common goal to try and fix society?

Mental Illness Unit

Depression in Teens Webinar 

Why is there depression? 

 Some evolutionary theories of depression:

- Protection from negative outcomes

- Psychic pain (analogous to bodily pain)

- A way of changing one's own environment

Standard definition of Major Depressive Disorder

- Depressed mood most of the day, nearly every day

- diminished interest in or pleasure in all or most activites 

- significant weight loss when not on diet 

- insomnia or too much sleep

- psychomotor agitation or retardation 

- fatigue or loss of energy nearly every day

- feelings of worthlessness or excessive guilt

- diminished ability to think or concentrate 

- recurrent thoughts of death

Symptoms cause significant distress in social, occupational

Epidemiology of depression

- adolescents with major depression are up to 30 times more likely to die from suicide 

- In its severe form it affects about 9% of adolescents 

- Second leading cause of years lived in disability 

Aetiology of depression 

Genes and environment: 

- Genes: 30-50% of the liability to depression is due to genetic factors

- Gene- environment correlation: increased genetic liability for lifetime traumas 

- Gene- environment interraction: responding differently to situations of stress

- Traumatic life event increases probability in depression for certain family members

- Interplay between environment and genetic makeup in depression 

Development and depression

Sex and Pubertal effects on depression

- Difference in cognitive processing 

- Greater exposure or sensitivity to psychosocial 

- Hormonal mechanisms- girls who start menstrual cycle earlier are more likely to have depression 

Continuities, homtypic:

- Childhood depression does not predict adult depression 

- Anxiety- early on anxiety precedes depression

- Alcohol- an "internalising" pathway to depression 

- OCD

Behavior problems and depression 

- 40% of depressed young adults have had serious disruptive problems

- What exactly explains the transition between irritability and depression? 

Neurobiology of depression

- Depression is probably a heterogeneous syndrome

- Negativity bias and missing the bias 

- People who suffer from depression are more likely to pick up the negative 

- Miss positive parts of life due to negativity caused by depression 

- Money is People who don't expose effort to get a reward 

- Unable to see why something rewarding is positive 

- Processing reward in brain is important but people who have depression have low activity in this area

- Does treatment change reward processing? 

- Can we target our treatments on reward processing 

Diagnosis 

- Diagnosis will take longer of parents focus of irritability and oppositionality 

- Teachers focused on academic performance 

- Cannot bring oneself to speak about it 

- (In ex) Christina only diagnosed after she took first overdose 

- Awareness is key to diagnosis 

- Screening only in high risk situations 

- Diagnosis should address: presence of manic problems, underlying medical causes, risk assessment 

Downstream effects of genes and environment 

- Medications and psychological treatment are trying to target behavior, feelings, and thoughts 

Treatments 

- Pharmocology

- Psychological therapy: CBT and IPT 

- in mild cases start with psychological treatment

- Combining may be better 

- 60% of young people respond to an antidepressant 

- 50% respond to placebo

- The higher the severity of depression the lower the placebo response 

- 10 antidepressant needed to treat person and 112 needed to harm ( important when talking about suicidality)

Mental Illness Guest Speaker 

What is a mental disorder?
- Affect's a person's thinking, emotional state, and behavior
- Disrupts the person's ability to work or attend school
- Unable to carry out daily activities
- Have stable relationships

What is anxiety?
- Normal response to stress
- Anxiety can be good & keep you on your toes, make you want to succeed
- Anxiety disorder- persistent fear or worry, can't manage with it
- Need symptoms for 6 months to be diagnosed by doctor

Symptoms of anxiety
- unsocial, restlessness, feeling tense, trouble concentrating, fatigue, insomnia, sweating, pounding heart, dizziness, shortness of breath, muscle tension

Types
- panic disorder, specific phobia, social anxiety, generalized anxiety, ocd, ptsd

Causes
- school, life events, abuse, high stress, violence, heredity, brain chemistry, medical conditions

Statistics 
- 32% of teens will experience anxiety
- 80% will not receive treatment
- Average age when anxiety starts is 6 years old

Depression
- mood or loss of interest in favorite activities
- change in sleep and activities
- guilt, worthlessness
- thoughts of death and suicide

Causes
- trauma, environment, stress, hereditary, medications, alcohol and drug abuse

Statistics
- 20% of teens will experience depression before reaching adulthood
- Teenage boys report suffering from depression more than teenage boys

Suicide and self harm
- suicide, attempt to die
- suicide is second leading cause of death in ages 10-24
- self-harm is a negative coping tool

Warning
- threats to kill or harm him or herself
- making a plan for suicide
- abusing substances
- current talk of suicide

QPR 
- Q- question
- P- persuade
- R- refer
- Do not wait! Always ask question.

Eating Disorders 

 Binge Eating Disorder:

• Eating disorder characterized by eating large quantities of food in a short amount of time until point of discomfort and then feeling shame and guilt and even the need to begin purging                                   
• Most common eating disorder in the U.S. affecting 3.5% of women, 2% of men and 1.6% of adolescents                                                                                                                                       
• Symptoms and diagnostic criteria include: Recurrent episodes of binge eating, Marked distress regarding binge eating, the binge eating occurs at least once a week for 3 months, the binge eating is not associated with anorexia or bulimia                                                                                               
• Behavioral Characterisitcs- secretive eating habits, disruption in normal eating behaviors, periodic dieting or fasting, has periods of impulsive eating without purging, creating schedules that include binge eating                                                                                                                                                
• Emotional and Mental- anger, anxiety, worthlessness, depression, avoiding conflict, working hard to please others                                                                                                                                     
• Health risks- high blood pressure and cholesterol, heart disease, type II diabetes, gallbladder disease, sleep apnea                                                                                                                                       
• Causes- unknown but genetics, biological factors, long-term dieting and psychological issues increase your risk                                                                                                                                           
• Psychotherapy and medication used to treat binge eating 

 Anorexia:

• excessive weight loss and self- starvation
• Warning signs: dramatic weight loss, preoccupation with weight gain, refusal to eat certain foods, binge/purging, excessive exercise 
• 90-95% of anorexia sufferers are girls and women, 5-20% will die, one of the highest death rates of any mental health disorder 
• Treatments: therapy and medications to treat anxiety and depression as well 

 Bulimia:

• Symptoms: consuming very large amounts of food followed by vomiting, feeling out of control during these episodes
• Warning signs: evidence of purging behaviors (frequent visits to bathroom after meals), excessive exercise regimen, calluses on back of hands and knuckles from self- induced vomiting, unusual swelling of the cheeks and jaw area, tooth decay from staining of stomach acids 
• Health consequences: electrolyte imbalance, inflammation and possible rupture of esophagus, tooth decay from frequent vomiting