Ant McPartlin has no reason to apologise. His addiction is not his fault | Chris Owen

The TV star says he feels he’s let people down. But after spending time in rehab I know how important it is that addiction is seen as an illness, not as self-inflicted

The weekend brought the news that Ant McPartlin, one half of Ant and Dec – PJ of PJ and Duncan fame – has checked into rehab for addiction problems with alcohol and drugs. He’s to spend a couple of months in recovery, where – hopefully – he’ll come out armed with the knowledge of how he became unwell in the first place, and how he can keep himself safe and sober in the long term.

Related: Ant McPartlin speaks out about depression and addiction

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Number of under-18s on antidepressants in England rises by 12%

Data shows over 166,000 were given such medication between April 2015 and June 2016, including 537 aged six or under

Tens of thousands of young people in England, including children as young as six, are being prescribed antidepressants by their doctors. The figures have prompted concern that medics may be overprescribing strong medication because of stretched and underfunded mental health services.

Data obtained by the Guardian shows that 166,510 under-18s, including 10,595 seven-to-12-year-olds and 537 aged six or younger, were given medication typically used to treat depression and anxiety between April 2015 and June 2016. The figures, released by NHS England under the Freedom of Information Act, show a 12% rise in the numbers taking the drugs over the same time period.

Related: Antidepressants prescribed far more in deprived English coastal towns

Related: Antidepressant prescriptions in England double in a decade

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Cognitive behavior therapy significantly reduced depression and anxiety in chronic pain patients

The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.

This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.

For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).

“To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.

ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility.” ACT focuses on behaviour change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.

In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients’ outcome measures were available for a retrospective analysis.

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Materials provided by European League Against Rheumatism. Note: Content may be edited for style and length.

Meditation and yoga can ‘reverse’ DNA reactions which cause stress, new study suggests

Mind-body interventions (MBIs) such as meditation, yoga and Tai Chi don’t simply relax us; they can ‘reverse’ the molecular reactions in our DNA which cause ill-health and depression, according to a study by the universities of Coventry and Radboud.

The research, published in the journal Frontiers in Immunology, reviews over a decade of studies analysing how the behaviour of our genes is affected by different MBIs including mindfulness and yoga.

Experts from the universities conclude that, when examined together, the 18 studies — featuring 846 participants over 11 years — reveal a pattern in the molecular changes which happen to the body as a result of MBIs, and how those changes benefit our mental and physical health.

The researchers focus on how gene expression is affected; in other words the way that genes activate to produce proteins which influence the biological make-up of the body, the brain and the immune system.

When a person is exposed to a stressful event, their sympathetic nervous system (SNS) — the system responsible for the ‘fight-or-flight’ response — is triggered, in turn increasing production of a molecule called nuclear factor kappa B (NF-kB) which regulates how our genes are expressed.

NF-kB translates stress by activating genes to produce proteins called cytokines that cause inflammation at cellular level — a reaction that is useful as a short-lived fight-or-flight reaction, but if persistent leads to a higher risk of cancer, accelerated aging and psychiatric disorders like depression.

According to the study, however, people who practise MBIs exhibit the opposite effect — namely a decrease in production of NF-kB and cytokines, leading to a reversal of the pro-inflammatory gene expression pattern and a reduction in the risk of inflammation-related diseases and conditions.

The study’s authors say the inflammatory effect of the fight-or-flight response — which also serves to temporarily bolster the immune system — would have played an important role in humankind’s hunter-gatherer prehistory, when there was a higher risk of infection from wounds.

In today’s society, however, where stress is increasingly psychological and often longer-term, pro-inflammatory gene expression can be persistent and therefore more likely to cause psychiatric and medical problems.

Lead investigator Ivana Buric from the Brain, Belief and Behaviour Lab in Coventry University’s Centre for Psychology, Behaviour and Achievement said:

“Millions of people around the world already enjoy the health benefits of mind-body interventions like yoga or meditation, but what they perhaps don’t realise is that these benefits begin at a molecular level and can change the way our genetic code goes about its business.

“These activities are leaving what we call a molecular signature in our cells, which reverses the effect that stress or anxiety would have on the body by changing how our genes are expressed. Put simply, MBIs cause the brain to steer our DNA processes along a path which improves our wellbeing.

“More needs to be done to understand these effects in greater depth, for example how they compare with other healthy interventions like exercise or nutrition. But this is an important foundation to build on to help future researchers explore the benefits of increasingly popular mind-body activities.”

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Materials provided by Coventry University. Note: Content may be edited for style and length.

State medical licensing boards’ practices may hurt physician mental health

Sharing a history of mental health issues with an employer is difficult for anyone.

It’s that much harder if reporting an old or well-controlled condition could lead to restrictions on your professional license — as some physicians well know.

A new study found state medical boards ask physicians much more extensive and intrusive questions about mental health conditions than for physical health conditions. Despite national concern about physician suicide and well-being, research shows that even if physicians struggle with depression, they are reluctant to disclose and seek treatment because it could have serious consequences when they apply for their medical license.

Katherine J. Gold, M.D., M.S.W., M.S., assistant professor in the University of Michigan’s Department of Family Medicine, recently led a study published in the Society of Teachers of Family Medicine that examined how state medical licensing boards across the 50 states and Washington, D.C., evaluated mental illnesses compared to physical illnesses or substance use on state licensing forms.

What she found is cause for alarm.

“The differences were really quite striking,” says Gold. “States were significantly more likely to ask if physicians had been diagnosed, treated or hospitalized for mental health or substance abuse verses for physical health disorders, often asking about many years in the past.”

Many of the questions violated the Americans with Disabilities Act as well, the study finds.

“The problem is that states don’t ask, ‘Do you have a problem right now that affects your ability to provide good care for patients?'” Gold explains. “(Instead) they ask broad questions that intrude on physician privacy and prevent doctors from seeking care, but don’t necessarily pick up on impaired physicians.”

A similar number of states asked about both physical and mental health, but the content and nature of the questions varied. Physical health questions tended to be much more lenient and vague while questions about mental health and substance abuse were much more specific, and at times, even intrusive, Gold says.

Fear and female physicians

Last year Gold led a survey that asked 2,100 female physicians who were also mothers about their mental health history and treatment.

Nearly half said they believed they met the definition for a mental illness at some point in their career, but had not sought treatment. Two-thirds reported that fear of stigma, including fear of reporting to state medical boards, drove them to keep their worries quiet.

Only 6 percent who had ever been diagnosed had reported it to their state licensing board, as most felt their condition didn’t affect the care they gave.

“I actually had a physician email me a month ago, and she was really worried because she had postpartum depression several years ago,” says Gold. “[She] reported this to her state medical board and shared all of her treatment records but was still fearful that they would limit her license, despite the fact that there were no problems with her work and she was now doing much better. She was really terrified.”

How state licensing boards respond to disclosures made by physicians about their mental health cannot be predicted and varies state by state, says Gold.

“It completely depends on the board,” she says. “It could range from the board saying, ‘Just send us a letter from your doctor, to send us all of your medical records from all of your treatment, to come before the board and give us your defense as to why you are fit to practice,’ or even calling for ongoing monitoring and license restrictions.”

Physician and patient safety

There is minimal data examining the impact of physician mental health on patient outcomes, Gold says. But conclusions can be drawn about how this issue affects doctors.

“Asking about prior problems or mental health diagnoses make it less safe for physicians because it creates an enormous pressure not to seek mental health treatment,” says Gold.

“It affects physician identity. If you’ve trained for all these years as a physician and then you can’t practice because back 10 years ago you had postpartum depression, that’s really threatening. A lot of people just don’t get help, and if they do get help, it’s often off the books or informal help, which is not ideal.”

Because of attention on the issue from the American Medical Association, there has been a sharp uptick in media focus on physician burnout and mental health, as well as the willingness of some doctors to tell their stories, and reporting on physician suicides.

A number of hospitals nationwide, including Michigan Medicine, are implementing programs to help residents and physicians individually improve their overall wellness and resilience.

Although health systems should promote healthy lifestyles for doctors, more comprehensive and system-level changes should occur as well, Gold says.

“We’re not going to improve physician health until we can take away some of the barriers to seeking help,” she says. “We know that reporting this level of detail to state licensing boards is a huge barrier for physicians because of self-stigma and fears about their license and not being able to practice.”

As a first step to make changes, Gold suggests making sure all questions about mental health on state medical licensing applications comply with the Americans with Disabilities Act. She also says questions should only ask about current conditions causing impairment. This ensures physicians aren’t punished for disclosing an issue in their past that they’ve correctly addressed.

Gold also indicates the Federation of State Medical Boards must take action.

“I think that’s where change has to come from. It has to come from the group that is advising the state medical boards,” she says. “They don’t have regulatory authority over the boards, but certainly they can recommend best practices for the states.”

 

Women can still have it all. Can’t they? | Victoria Coren Mitchell

Over tea and muffins, I was almost convinced of the case for tighter apron strings. Oh, crumbs!

Last week was a significant one for me because I nearly changed my mind about something. And who ever does that? I didn’t change my mind (nobody ever does, about anything) but I did have – I think – a small insight. I won’t say “epiphany”. Not least because I find it hard to pronounce. But I will say insight.

It came about over a cup of tea with a friend, whom I won’t name for fear that people will find her on Twitter and shout at her. Let’s just call her @elspeth157. I’m joking. We’ll call her Janet.

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Model Adwoa Aboah: ‘In 2017, there is more than one way to be beautiful ​and cool’

The in-demand face of Gap and Versace is changing the rules of how to make it big in fashion. She talks about authenticity, her depression – and why her shaved head was a two fingers to the industry

Adwoa Aboah is ridiculously beautiful, but that is not what makes her the most in-demand model of the moment. Sure, the razor-sharp cheekbones and the blown-glass lips don’t do her prospects any harm. But there is something in her gaze to camera that makes her beauty seem as if it’s not the most compelling thing about her. It is this that has raised Aboah – face of a new Gap campaign, muse to Donatella Versace, booked for the catwalk by everyone from Christian Dior and Chanel to Marc Jacobs and Alexander Wang – above the modelling rank and file.

My first appointment with Aboah is cancelled because she hasn’t yet got out of bed. So far, so supermodel. But when we finally speak, it becomes clear that this Linda Evangelista moment is about as far as Aboah goes in terms of conformity to the modelling tradition of aloof, enigmatic beauty. After our interview, she has a busy day ahead. First, a meeting with Dr Lauren Hazzouri, a psychologist specialising in young women’s mental health. After that, it’s off to Gurls Talk, the online platform she founded to enable discussion about mental health, body image and sexuality, to plan an upcoming event. Forget castings and go-sees: Aboah is changing the rules of how a modern model makes it big.

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‘I can stop and breathe’: the people taking ketamine for depression

It has a reputation as a party drug, but some patients say it has transformed their lives after no other treatments helped

When depression takes hold of Helen it feels like she is drowning in a pool of water, unable to swim up to the world above. The 36-year-old former nurse has had mental health problems most of her life. No drugs, hospital stays or therapies have been able to help.

Then one day, during yet another spell in hospital, her consultant told her about a psychiatrist treating patients with ketamine. The psychiatrist in question visited her to discuss using the drug. He warned there were no guarantees, but it had helped some patients.

Related: Ketamine could help thousands with severe depression, doctors say

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Depression, opportunity and that life abroad – podcasts of the week

Rowan Slaney brings you three podcasts that chime with three significant events from her ‘teenageish’ years

• Don’t forget to subscribe for your weekly dose of podcast gold

Hear here is here. Hooray! Now, first things first. An incredible number of people have subscribed to this column. What a joy that there are so many of you who love the medium as much I do. If you’ve emailed in with your recommendations, I promise I’ll listen to them – I’ve made an excel spreadsheet and everything – but there have just been so many, it’s incredible.

Please keep them coming in, I want to listen to all the podcasts I can fit into my ears. If you haven’t subscribed yet, come and join us. It’s great fun.

You’d be forgiven for thinking that a podcast about mental health would be, well, a bit of a downer. In fact, it could be the type of podcast that people who live with depression, and those around them, might want to avoid. But then you probably haven’t listened to John Moe.

John isn’t a therapist or a counsellor or a psychiatrist or any sort of mental health professional. He’s actually a writer and radio presenter, and a long-term sufferer of depression. He’s also quite a funny guy, and that’s what makes The Hilarious World of Depression special.

The BitterSweet Life is a great example of an immersive podcast experience and of excellent storytelling. My favourite episodes are those where Tiffany and Katy record outside in the plazas of Rome, or visit different churches to find Caravaggio paintings. The splash of water from the fountains, customers chattering in Italian in the bakery, the screaming swallows overhead. I feel transported to Rome, and with very itchy feet, every time I listen to these episodes.

Secondly, the story of Katy’s year was an ongoing narrative that I invested in so much that I had to hold back tears in the episode when Katy was due to leave. The podcast shifts a little in content and feel when Katy returns to Seattle, obviously due to the changed circumstances. However, I continue to listen as I enjoy the relationship between the two friends. The episodes where they record WhatsApp messages to each other in the aftermath of the election of Trump, I thought, was a stroke of storytelling genius.

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Ketamine could help thousands with severe depression, doctors say

Psychiatrists hail benefits of ‘transformational’ drug, and call for more trials to explore its potential

Thousands of people with severe depression could obtain urgent relief if experimental treatment using ketamine were made more widely available, medical experts say.

The drug has been championed by doctors and psychiatrists as a potentially life-changing treatment for those with depression who are resistant to medication or suicidally depressed. Medics are calling for more specialists centres and trials to be set up to explore the drug’s potential under controlled conditions.

Related: Royals launch campaign to get Britons talking about mental health

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‘Moral enhancement’ technologies are neither feasible nor wise

A recent study by researchers at North Carolina State University and the Montreal Clinical Research Institute (IRCM) finds that “moral enhancement technologies” — which are discussed as ways of improving human behavior — are neither feasible nor wise, based on an assessment of existing research into these technologies.

The idea behind moral enhancement technologies is to use biomedical techniques to make people more moral. For example, using drugs or surgical techniques to treat criminals who have exhibited moral defects.

“There are existing ways that people have explored to manipulate morality, but the question we address in this paper is whether manipulating morality actually improves it,” says Veljko Dubljevic, lead author of the paper and an assistant professor of philosophy at NC State who studies the ethics of neuroscience and technology.

Dubljevic and co-author Eric Racine of the IRCM reviewed the existing research on moral enhancement technologies that have been used in humans to assess the effects of these technologies and how they may apply in real-world circumstances.

Specifically, the researchers looked at four types of pharmaceutical interventions and three neurostimulation techniques:

  • Oxytocin is a neuropeptide that plays a critical role in social cognition, bonding and affiliative behaviors, sometimes called “the moral molecule”;
  • Selective serotonin reuptake inhibitors (SSRIs) are often prescribed for depression, but have also been found to make people less aggressive;
  • Amphetamines, which some have argued can be used to enhance motivation to take action;
  • Beta blockers are often prescribed to treat high blood pressure, but have also been found to decrease implicit racist responses;
  • Transcranial magnetic stimulation (TMS) is a type of neurostimulation that has been used to treat depression, but has also been reported as changing the way people respond to moral dilemmas;
  • Transcranial direct current stimulation (TDCS) is an experimental form of neurostimulation that has also been reported as making people more utilitarian; and
  • Deep brain stimulation is a neurosurgical intervention that some have hypothesized as having the potential to enhance motivation.

“What we found is that, yes, many of these techniques do have some effects,” Dubljevic says. “But these techniques are all blunt instruments, rather than finely tuned technologies that could be helpful. So, moral enhancement is really a bad idea.

“In short, moral enhancement is not feasible — and even if it were, history shows us that using science to in an attempt to manipulate morality is not wise,” Dubljevic says.

The researchers found different problems for each of the pharmaceutical approaches.

“Oxytocin does promote trust, but only in the in-group,” Dubljevic notes. “And it can decrease cooperation with out-group members of society, such as racial minorities, and selectively promote ethnocentrism, favoritism, and parochialism.”

The researchers also found that amphetamines boost motivation for all types of behavior, not just moral behavior. Moreover, there are significant risks of addiction associated with amphetamines. Beta blockers were found not only to decrease racism, but to blunt all emotional response which puts their usefulness into doubt. SSRIs reduce aggression, but have serious side-effects, including an increased risk of suicide.

In addition to physical side effects, the researchers also found a common problem with using either TMS or TCDS technologies.

“Even if we could find a way to make these technologies work consistently, there are significant questions about whether being more utilitarian in one’s decision-making actually makes one more moral,” Dubljevic says.

Lastly, the researchers found no evidence that deep brain stimulation had any effect whatsoever on moral behavior.

“Our goal here is to share a cautionary note with those who are discussing different techniques for moral enhancement,” Dubljevic says. “I am in favor of research that is done responsibly, but against dangerous social experiments.”

 

Potential risks of common MS treatment

In one of the most comprehensive studies to date, UBC researchers have identified potential adverse reactions of a commonly used multiple sclerosis drug.

The study aimed to identify potential adverse events related to beta-interferon treatment for relapsing-remitting multiple sclerosis by analyzing health records of over 2,000 British Columbians with multiple sclerosis between 1995 and 2008.

“Once a drug is released on the market, there are very few ways to systematically monitor adverse events,” said Helen Tremlett, senior author of the study and a professor in the department of medicine at the Djavad Mowafaghian Centre for Brain Health. “Clinical trials cannot identify all adverse effects of a drug treatment partly due to small sample sizes and relatively short follow-up periods.”

The study found an increased risk of events such as stroke, migraine and depression, as well as abnormalities in the blood with taking beta interferon for multiple sclerosis.

“Beta interferons are generally thought of as having a favourable safety profile, especially compared to the newer therapies for multiple sclerosis. And that is still the case; our study does not change that,” said Tremlett, Canada Research Chair in Neuroepidemiology. “However, very few studies had comprehensively and quantitatively assessed their safety in real world clinical practice. Our findings complement and extend on previous observations.”

The researchers found that there was a 1.8-fold increased risk of stroke, a 1.6-fold increased risk of migraine and a 1.3-fold increased risk of both depression and abnormalities in the blood. The researchers stress that patients and physicians should not change their treatment plans. The study is based on population-level data and the risk to individual patients will vary greatly depending on individual factors.

Tremlett hopes that their study will lead to further research to develop biomarkers to help identify patients who are at the greatest risk of having an adverse event.

“Further advances could enable personalized or precision medicine where patients who are at increased risk of having an adverse reaction can be identified. This could help guide discussions about individual treatment options and considerations,” she said.

“It is important for patients with multiple sclerosis to have ongoing review of the benefits and risks of therapy, and to identify supportive strategies, such as diet and exercise, that could optimize their brain health” said Dr. Anthony Traboulsee, co-author of the study, associate professor of neurology and director of the MS Clinic at UBC.

In addition to the negative effects, Tremlett and her colleagues identified a positive relationship. They found a reduced risk of bronchitis and upper respiratory infections with taking beta interferon for more than two years. These infections can be common and problematic in people with multiple sclerosis.

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Materials provided by University of British Columbia. Note: Content may be edited for style and length.

It’s good to talk about mental health. But is it enough? | Eva Wiseman

With Princes William and Harry speaking up about the death of their mother, mental health awareness has had a much needed boost. But it’s what happens next that really counts

My toddler has recently learned to talk, and she speaks as if she’s recording her podcast, an unedited till roll of thoughts with a small pause for congratulations at the end. Occasionally she will prod me for praise. “That was a lovely story I just told wasn’t it?” Yes baby. “I piggy pardon?” Yes, that was a lovely story.

It very often is a lovely story, but a time will have to come, maybe when she turns three, when she will learn that talking is not enough. Talking is rarely the end – talking is the vehicle, the bus, the bike. The meandering journey to another place.

May has pledged to tackle the ‘stigma’ of mental health. But the crisis has been fuelled by her party’s cuts

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LGBT people are prone to mental illness. It’s a truth we shouldn’t shy away from | Alexander Leon

We should be defiant in our acceptance of mental health problems in the same way that we would about our sexuality or gender identity

I almost didn’t write this. It wasn’t from not wanting to. I cradled my head in my hands, desperate to contribute to the reams of social media positivity I had seen surrounding Mental Health Awareness Week.

I almost didn’t – couldn’t – because I was depressed.

Related: Gay men are battling a demon more powerful than HIV – and it’s hidden | Owen Jones

Related: Theresa May wants to scrap the Mental Health Act. Here’s what should replace it | Mark Brown

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What I wish I could tell my boss: ‘When I told you I was depressed, you fired me’

Watching you talk about how you support people will mental health makes me anxious – I hope no one else has to endure what I did

Before I started working for you, I idolised you. Your office looked incredible and I couldn’t think of anything better than having dogs running around my feet as I worked, and in-office play equipment which took me back to the days I spent running around soft play areas as a child. I couldn’t have been more infatuated, until you started talking about mental health. When you told the camera how supportive your company was, I knew I needed to work for you.

Related: What I wish I could tell my boss: ‘I was broken, and you fixed me’

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