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Mental Health Research News

Top headlines, latest headlines.

• Heightened Sensitivity to PTSD in Autism
• Chaotic Household and Mental Health Issues
• Treating Depression With Magnetic Fields
• Low Light to Fight Effects of Chronic Stress
• Depression During the Perimenopause
• Psychedelic Therapy: Clinician-Patient Bond
• Heart Disease Deaths: Air Pollution, Depression
• Low Intensity Exercise: Less Depression
• Exercise Cuts Stress-Related Brain Activity
• Teen Stress and Depression in Adults

Earlier Headlines

Thursday, april 11, 2024.

• Study Finds Increased Anxiety and PTSD Among People Who Remained in Ukraine
• Scientists Use Wearable Technology to Detect Stress Levels During Sleep
• AI Model Can Accurately Assess PTSD in Postpartum Women

Wednesday, April 10, 2024

• Brain Stimulation Treatment May Improve Depression, Anxiety in Older Adults

Monday, April 8, 2024

• Heart Disease, Depression Linked by Inflammation
• New Study Highlights the Benefit of Touch on Mental and Physical Health

Thursday, April 4, 2024

• Prairie Voles Display Signs of Human-Like Depression
• Feeding the Lonely Brain

Wednesday, April 3, 2024

• Researchers Map How the Brain Regulates Emotions

Monday, April 1, 2024

• New Initiative Improves Detection, Evaluation of Attention Deficit Hyperactivity Disorder
• Pilot Study Shows Ketogenic Diet Improves Severe Mental Illness

Thursday, March 28, 2024

• Positive Associations Between Premenstrual Disorders and Perinatal Depression
• For Younger Women, Mental Health Now May Predict Heart Health Later

Wednesday, March 27, 2024

• People With Depression See No Immediate Change from Common GP Assessment, Study Shows

Tuesday, March 26, 2024

• Large-Scale Animal Study Links Brain pH Changes to Wide-Ranging Cognitive Issues

Wednesday, March 20, 2024

• Treating Anxiety, Depression in People With Heart Disease Reduced ER Visits, Hospitalizations

Monday, March 18, 2024

• Study Eases Concern at Antipsychotics Use in Pregnancy

Thursday, March 14, 2024

• How Fear Unfolds Inside Our Brains

Wednesday, March 13, 2024

• Researchers Identify Brain Connections Associated With ADHD in Youth

Monday, March 11, 2024

• 'Study Drugs' Set the Stage for Other Drug Use and Mental Health Decline

Wednesday, March 6, 2024

• New Study May Broaden the Picture of the Consequences of Childhood Adversity

Monday, March 4, 2024

• It's Not Just You: Young People Look, Feel Older When They're Stressed

Friday, March 1, 2024

• Link Between Adversity, Psychiatric and Cognitive Decline
• Study Paves the Way for Better Diagnosis and Treatment of Endocrine Diseases

Tuesday, February 27, 2024

• Teens Benefit from 'forest Bathing' -- Even in Cities

Monday, February 26, 2024

• Gut-Brain Communication Turned on Its Axis
• Intervention Reduces Likelihood of Developing Postpartum Anxiety and Depression by More Than 70%
• Yoga Provides Unique Cognitive Benefits to Older Women at Risk of Alzheimer's Disease

Wednesday, February 21, 2024

• Maternal Mental Conditions Drive Climbing Death Rate in U.S., Evidence Review Finds

Tuesday, February 20, 2024

• Wildfires Linked to Surge in Mental Health-Related Emergency Department Visits
• Stress During Pregnancy Can Lead to Early Maturation of First-Born Daughters

Monday, February 19, 2024

• Understanding the Relationship Between Our Sleep, Body Clock and Mental Health

Thursday, February 15, 2024

• Burnout: Identifying People at Risk

Tuesday, February 13, 2024

• A Closer Look at Cannabis Use and Binge Eating

Thursday, February 8, 2024

• Benefits of Resistance Exercise Training in Treatment of Anxiety and Depression
• Ketamine's Promise for Severe Depression Grows, but Major Questions Remain

Wednesday, February 7, 2024

• Researchers Make Progress Toward Developing Blood Tests for Psychiatric and Neurological Disorders
• Stress Influences Brain and Psyche Via Immune System

Tuesday, February 6, 2024

• Bullied Teens' Brains Show Chemical Change Associated With Psychosis

Monday, February 5, 2024

• Are Body Temperature and Depression Linked? Science Says, Yes

Thursday, February 1, 2024

• Psychological Care Delivered Over the Phone Is an Effective Way to Combat Loneliness and Depression, According to a Major New Study

Wednesday, January 31, 2024

• Potential Link Between High Maternal Cortisol, Unpredicted Birth Complications

Tuesday, January 30, 2024

• Researchers Find Early Symptoms of Psychosis Spectrum Disorder in Youth Higher Than Expected

Wednesday, January 24, 2024

• Mood Interventions May Reduce Inflammation in Crohn's and Colitis

Thursday, January 18, 2024

• Relationships With Caring Adults Provide a Buffer Against Depression, Anxiety, Regardless of Adverse Childhood Experiences

Wednesday, January 17, 2024

• Therapy Versus Medication: Comparing Treatments for Depression in Heart Disease

Friday, January 12, 2024

• Psychotherapy Effective in Treating Post-Traumatic Stress Disorder Following Multiple Traumatic Events, Meta-Study Finds
• Stress, Via Inflammation, Is Linked to Metabolic Syndrome

Wednesday, January 10, 2024

• Feeling Depressed Linked to Short-Term Increase in Bodyweight
• Newly Identified Genes for Depression May Lead to New Treatments
• Reduced Drug Use Is a Meaningful Treatment Outcome for People With Stimulant Use Disorders, Study Shows

Monday, January 8, 2024

• Clear Link Between Autoimmune Disease and Perinatal Depression

Thursday, January 4, 2024

• Bipolar Disorder Linked to Early Death

Thursday, December 21, 2023

• Psychologist Publishes Most Thorough Compilation of Sleep and Emotion Research to Date
• Connection Between Light Levels and Mental Health -- Climate Change Could Also Have an Impact in the Future

Thursday, December 14, 2023

• Genetic 'protection' Against Depression Was No Match for Pandemic Stress

Wednesday, December 13, 2023

• Unravelling the Association Between Neonatal Proteins and Adult Health
• Body Dissatisfaction Linked With Depression Risk in Children

Tuesday, December 12, 2023

• Caregiving Can Be Stressful, but It Could Also Lower Risk of Depression

Thursday, December 7, 2023

• Discrimination During Pregnancy May Alter Circuits in Infants' Brains

Tuesday, December 5, 2023

• Depression, Constipation, and Urinary Tract Infections May Precede MS Diagnosis

Monday, December 4, 2023

• New Study Maps Ketamine's Effects on Brain

Wednesday, November 29, 2023

• AI May Aid in Diagnosing Adolescents With ADHD
• Mindfulness-Based Intervention Shows Promise for PTSD in Cardiac Arrest Survivors

Tuesday, November 28, 2023

• Understanding Subjective Beliefs Could Be Vital to Tailoring More Effective Treatments for Depression and ADHD

Monday, November 27, 2023

• Discrimination During Pregnancy Can Affect Infant's Brain Circuitry

Thursday, November 16, 2023

• A Small Molecule Blocks Aversive Memory Formation, Providing a Potential Treatment Target for Depression
• High Levels of Maternal Stress During Pregnancy Linked to Children's Behavior Problems
• New Studies of Brain Activity Explain Benefits of Electroconvulsive Therapy

Tuesday, November 14, 2023

• US Men Die 6 Years Before Women, as Life Expectancy Gap Widens
• Genetic Testing Could Greatly Benefit Patients With Depression, Save Health System Millions
• Reducing 'vivid Imagery' That Fuels Addiction Cravings

Monday, November 13, 2023

• Early-Life Stress Changes More Genes in Brain Than a Head Injury

Thursday, November 9, 2023

• Brain Imaging Identifies Biomarkers of Mental Illness
• Study Shows Link Between Mental and Physical Health

Monday, November 6, 2023

• Location of Strong Sense of Discomfort in Brain Found

Friday, November 3, 2023

• Paid Family Leave Boosted Postpartum Wellbeing, Breastfeeding Rates

Thursday, November 2, 2023

• New Clues to the Mechanism Behind Treatment-Resistant Depression

Wednesday, November 1, 2023

• Contraceptive Pill Users Less Likely to Report Depression

Monday, October 30, 2023

• The Genetic Heritage of the Denisovans May Have Left Its Mark on Our Mental Health

Thursday, October 26, 2023

• Youngest Children in Class With ADHD as Likely to Keep Diagnosis in Adulthood as Older Pupils, Find Scientists

Wednesday, October 25, 2023

• New Distractibility 'd Factor' May Be Linked With ADHD

Monday, October 23, 2023

• Researchers Use Pioneering New Method to Unlock Brain's Noradrenaline System
• Heated Yoga May Reduce Depression Symptoms, According to Recent Clinical Trial

Friday, October 20, 2023

• Pupil Response May Shed Light on Who Responds Best to Transcranial Magnetic Stimulation for Depression
• Consistent Lack of Sleep Is Related to Future Depressive Symptoms

Thursday, October 19, 2023

• Researchers Confirm Postpartum Depression Heritability, Home in on Treatment Mechanism
• Ketamine's Effect on Depression May Hinge on Hope
• Study Finds Men's Antidepressant Use Did Not Negatively Impact IVF Success

Tuesday, October 17, 2023

• Adults With ADHD Are at Increased Risk for Developing Dementia
• Study Reveals Health Impact of Eating Disorders
• Depression, Anxiety Common Among College Students

Thursday, October 5, 2023

• Psychedelics Improve Mental Health, Cognition in Special Ops Veterans

Wednesday, October 4, 2023

• Strong Link Between ADHD and Car Crashes in Older Adult Drivers
• Should Fathers Be Screened for Postpartum Depression? Pilot Study

Monday, October 2, 2023

• Study Indicates Possible Link Between Chronic Stress and Alzheimer's Disease

Friday, September 29, 2023

• Increased Risk of Depression and Anxiety When in Higher Education, Study Finds

Thursday, September 28, 2023

• Grandparent Childcare May Not Help the Wellbeing of Mums or Reduce Mother-Child Conflict, Study Suggests

Monday, September 25, 2023

• Depression, Anxiety May Be Among Early Signs of MS

Friday, September 22, 2023

• Study Shows Millions of People Live With Co-Occuring Chronic Pain and Mental Health Symptoms
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The New Mental Health: The Latest Approaches to Well-Being

Integrative methods to mental wellness are gaining in popularity and evidence..

Posted March 31, 2023 | Reviewed by Lybi Ma

• What Is Integrative Medicine?
• Find a therapist near me
• Mental health is not only what you think. It's also what you eat and how you move. It's your whole body.
• Facing mental health challenges is normal, or at least pretty common.
• This new understanding of the multifactorial nature of mental health means that elevating mental health is more possible than we ever imagined.

We’ve all heard that we are in a mental health crisis. But what you may not have heard is that we are also at the beginning of a mental health renaissance . A massive breakthrough in how we view psychological well-being is underway. Our methods of cultivating mental, emotional, and spiritual well-being are rapidly expanding.

A renaissance is a period of time when people wake up. They start to do things and see things in completely different ways. The culture transforms. New inventions permeate society, and everything changes until it’s hard to remember that it used to be any other way. This is what’s happening with mental health.

Here’s what we are learning about the new mental health:

Mental Health Challenges Are Common

We used to think that psychological well-being was the norm. That if you were “normal” then you would be fine, and if you were “abnormal” you might have (often said in a whisper) “a problem.” That a few poor souls, unfortunately, had mental health issues or disorders, and if they were able to be helped they might return to “normal.”

• One in four people meet the criteria for a mental health disorder in any given year.
• That doesn’t count everyone who experiences mental health symptoms.
• A substantial proportion of us will experience some level of mental health symptoms at one time or another.
• Nearly every one of us will have a friend or family member who experiences mental health symptoms or disorders.
• That means nearly everyone reading this either has, or knows someone who’s faced, depression , abuse, substance dependence, bipolar mood, obsessive-compulsive disorder, or other conditions.

Facing mental health challenges is normal, or at least pretty common. The sooner we begin to recognize this, the easier it will be for people to talk about it, and the more likely we can all agree to cultivate mental well-being practices from an early age and intervene early when mental health symptoms begin.

It’s Not What You Think

Or, it is not only what you think. Mental health is not just in our heads.

It is in our whole bodies. A growing body of research indicates that our hormones , our glucose levels, our gut, our energy, and our spirituality — all affect our mental well-being. For example, studies show that a healthy microbiome (particularly the gut microbiota or the types of bacteria that live in our gastrointestinal tract) is related to anxiety and depression, and that probiotics have effectively mitigated anxiety and depressive symptoms similar to conventional prescription medications.

And, mental health is not just limited to our insides—it relies on our outsides as well: our relationships, surroundings, communities, environments, and society. It is impacted by power, privilege, culture, racism , sexism, and other -isms. In short, mental health is not just in your head, it’s everywhere.

If this is the case, it simply doesn’t make sense to focus our treatments on a single person, and only above their neck. It’s time to move from a sole focus on the brain and mind to whole-person (and whole-community) approaches to treating mental disorders and promoting mental well-being.

The Good News

This new understanding of the multifactorial (many factors) nature of mental health means that elevating mental health is more possible than we ever imagined . Tons of evidence-based approaches are making their way into use. The mental health benefits of psilocybin, for example, have been researched in recent times. In one study, subjects with depression were given psilocybin and they reported less neuroticism , more openness , and more positivity overall.

If you’ve ever dealt with your own or loved ones’ mental health challenges, you know it can feel impossible, like banging our heads against the same wall over and over again. The new mental health gives us a reason for hope, and not just hope, but actual evidence-based pathways toward greater mental well-being. Emerging mental health treatments and well-being practices include therapies that involve ketamine , transcranial magnetic stimulation , trauma recovery and posttraumatic growth , exercise, nutrition , and mind–body practices, among others.

See this TEDx talk on the topic.

The Mental Health and Well-Being Global Summit: An upcoming online summit is being hosted by the John W. Brick Mental Health Foundation and Wisdom for Life . Speakers include Deepak Chopra, Tara Brach, Andrew Weil, and Sharon Salzberg.

Bratman, G. N., Hamilton, J. P., & Daily, G. C. (2012). The impacts of nature experience on human cognitive function and mental health. Annals of the New York academy of sciences , 1249 (1), 118-136.

Cherak, S. J., Fiest, K. M., VanderSluis, L., Basualdo-Hammond, C., Lorenzetti, D. L., Buhler, S., ... & Fenton, T. R. (2020). Nutrition interventions in populations with mental health conditions: a scoping review. Applied physiology, nutrition, and metabolism , 45 (7), 687-697.

Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and practice , 7 (4), 987.

Craft, L. L., & Perna, F. M. (2004). The benefits of exercise for the clinically depressed. Primary care companion to the Journal of clinical psychiatry , 6 (3), 104.

Corey L. M. Keyes. (2002). The Mental Health Continuum: From Languishing to Flourishing in Life. Journal of Health and Social Behavior , 43 (2), 207–222. https://doi.org/10.2307/3090197

Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? BMJ. 2020 Jun 29;369:m2382. doi: 10.1136/bmj.m2382. Erratum in: BMJ. 2020 Nov 9;371:m4269. PMID: 32601102; PMCID: PMC7322666.

Godos, J., Currenti, W., Angelino, D., Mena, P., Castellano, S., Caraci, F., ... & Grosso, G. (2020). Diet and mental health: Review of the recent updates on molecular mechanisms. Antioxidants , 9 (4), 346.

House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science , 241 (4865), 540-545.

Johnson, M. W., & Griffiths, R. R. (2017). Potential therapeutic effects of psilocybin. Neurotherapeutics , 14 (3), 734-740.

Knudsen GM (2022) Sustained effects of single doses of classical psychedelics in Humans. Neuropsychopharmacology.

Lackey, N. Q., Tysor, D. A., McNay, G. D., Joyner, L., Baker, K. H., & Hodge, C. (2021). Mental health benefits of nature-based recreation: a systematic review. Annals of Leisure Research , 24 (3), 379-393.

Lucchetti, G., Koenig, H. G., & Lucchetti, A. L. G. (2021). Spirituality, religiousness, and mental health: A review of the current scientific evidence. World Journal of Clinical Cases , 9 (26), 7620.

McIntyre, R. S., Ismail, Z., Watling, C. P., Weiss, C., Meehan, S. R., Musingarimi, P., & Thase, M. E. (2022). Patient-reported outcome measures for life engagement in mental health: a systematic review. Journal of Patient-Reported Outcomes , 6 (1), 1-11.

Smith, P. J., & Merwin, R. M. (2021). The role of exercise in management of mental health disorders: an integrative review. Annual review of medicine , 72 , 45.

Shoubridge, A. P., Choo, J. M., Martin, A. M., Keating, D. J., Wong, M. L., Licinio, J., & Rogers, G. B. (2022). The gut microbiome and mental health: advances in research and emerging priorities. Molecular psychiatry , 27 (4), 1908-1919.

Suldo, S. M., & Shaffer, E. J. (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37(1), 52–68. https://doi.org/10.1080/02796015.2008.12087908

Tudor, K. (1996). Mental health promotion: Paradigms and practice. East Sussex: Routledge.

Vieten, C; Lubarsky, O., Sprengel, M. (2021) Move your mental health: A review of the scientific evidence on the role of exercise and physical activity in mental health. John W. Brick Mental Health Foundation, https://www.johnwbrickfoundation.org/move-your-mental-health-report/

Wang, J., Lloyd-Evans, B., Giacco, D., Forsyth, R., Nebo, C., Mann, F., & Johnson, S. (2017). Social isolation in mental health: a conceptual and methodological review. Social psychiatry and psychiatric epidemiology , 52 (12), 1451-1461.

Yu, C.L., Liang, C.S., Yang, F.C., Tu, Y.K., Hsu, C.W., Carvalho, A.F., Stubbs, B., Thompson, T., Tsai, C.K., Yeh, T.C. and Yang, S.N., 2022. Trajectory of antidepressant effects after single-or two-dose administration of psilocybin: a systematic review and multivariate meta-analysis. Journal of clinical medicine , 11 (4), p.938.

Cassandra Vieten, Ph.D., is a licensed clinical psycholoigst, Executive Director at the John W. Brick Mental Health Foundation, and Visiting Scholar at UC San Diego.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that threatens to derail our entire day. Here’s how we can face our triggers with less reactivity so that we can get on with our lives.

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Healthy lifestyle can help prevent depression – and new research may explain why

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A healthy lifestyle that involves moderate alcohol consumption, a healthy diet, regular physical activity, healthy sleep and frequent social connection, while avoiding smoking and too much sedentary behaviour, reduces the risk of depression, new research has found.

Although our DNA – the genetic hand we’ve been dealt – can increase our risk of depression, we’ve shown that a healthy lifestyle is potentially more important. Barbara Sahakian

In research published today in Nature Mental Health , an international team of researchers, including from the University of Cambridge and Fudan University, looked at a combination of factors including lifestyle factors, genetics, brain structure and our immune and metabolic systems to identify the underlying mechanisms that might explain this link.

According to the World Health Organization, around one in 20 adults experiences depression, and the condition poses a significant burden on public health worldwide. The factors that influence the onset of depression are complicated and include a mixture of biological and lifestyle factors.

To better understand the relationship between these factors and depression, the researchers turned to UK Biobank, a biomedical database and research resource containing anonymised genetic, lifestyle and health information about its participants.

By examining data from almost 290,000 people – of whom 13,000 had depression – followed over a nine-year period, the team was able to identify seven healthy lifestyle factors linked with a lower risk of depression. These were:

• moderate alcohol consumption
• healthy diet
• regular physical activity
• healthy sleep
• never smoking
• low-to-moderate sedentary behaviour
• frequent social connection

Of all of these factors, having a good night’s sleep – between seven and nine hours a night – made the biggest difference, reducing the risk of depression, including single depressive episodes and treatment-resistant depression, by 22%.

Frequent social connection, which in general reduced the risk of depression by 18%, was the most protective against recurrent depressive disorder.

Moderate alcohol consumption decreased the risk of depression by 11%, healthy diet by 6%, regular physical activity by 14%, never smoking by 20%, and low-to-moderate sedentary behaviour by 13%.

Based on the number of healthy lifestyle factors an individual adhered to, they were assigned to one of three groups: unfavourable, intermediate, and favourable lifestyle. Individuals in the intermediate group were around 41% less likely to develop depression compared to those in the unfavourable lifestyle, while those in the favourable lifestyle group were 57% less likely.

The team then examined the DNA of the participants, assigning each a genetic risk score. This score was based on the number of genetic variants an individual carried that have a known link to risk of depression. Those with the lowest genetic risk score were 25% less likely to develop depression when compared to those with the highest score – a much smaller impact than lifestyle.

In people at high, medium, and low genetic risk for depression, the team further found that a healthy lifestyle can cut the risk of depression. This research underlines the importance of living a healthy lifestyle for preventing depression, regardless of a person's genetic risk.

Professor Barbara Sahakian, from the Department of Psychiatry at the University of Cambridge, said: “Although our DNA – the genetic hand we’ve been dealt – can increase our risk of depression, we’ve shown that a healthy lifestyle is potentially more important.

“Some of these lifestyle factors are things we have a degree control over, so trying to find ways to improve them – making sure we have a good night’s sleep and getting out to see friends, for example – could make a real difference to people’s lives.”

To understand why a healthy lifestyle might reduce the risk of depression, the team studied a number of other factors.

First off, they examined MRI brain scans from just under 33,000 participants and found a number of regions of the brain where a larger volume – more neurons and connections – was linked to a healthy lifestyle. These included the pallidum, thalamus, amygdala and hippocampus.

Next, the team looked for markers in the blood that indicated problems with the immune system or metabolism (how we process food and produce energy). Among those markers found to be linked to lifestyle were the C-reactive protein, a molecule produced in the body in response to stress, and triglycerides, one of the primary forms of fat that the body uses to store energy for later.

These links are supported by a number of previous studies. For example, exposure to stress in life can affect how well we are able to regulate blood sugar, which may lead to a deterioration of immune function and accelerate age-related damage to cells and molecules in the body. Poor physical activity and lack of sleep can damage the body’s ability to respond to stress. Loneliness and lack of social support have been found to increase the risk of infection and increase markers of immune deficiency.

The team found that the pathway from lifestyle to immune and metabolic functions was the most significant. In other words, a poorer lifestyle impacts on our immune system and metabolism, which in turn increases our risk of depression.

Dr Christelle Langley, also from the Department of Psychiatry at the University of Cambridge, said: “We’re used to thinking of a healthy lifestyle as being important to our physical health, but it’s just as important for our mental health. It’s good for our brain health and cognition, but also indirectly by promoting a healthier immune system and better metabolism.”

Professor Jianfeng Feng, from Fudan University and Warwick University, added: “We know that depression can start as early as in adolescence or young adulthood, so educating young people on the importance of a healthy lifestyle and its impact on mental health should begin in schools.”

This study was supported by grants from organisations including the National Natural Science Foundation of China and the Ministry of Science, China*.

Reference Zhao, Y & Yang, L et al. The brain structure, immunometabolic and genetic mechanisms underlying the association between lifestyle and depression. Nature Mental Health; 11 Sept 2023; DOI: 10.1038/s44220-023-00120-1

*A full list of funders can be found in the paper.

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The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection.

CHILD AND ADOLESCENT PSYCHIATRY

Bright light therapy for adolescents with unipolar major depression (April 2024)

Although bright light therapy is a standard treatment for seasonal affective disorder, the benefit for nonseasonal depression is not established. A recent four-week randomized trial compared adjunctive morning bright light therapy with placebo red light in 224 adolescent inpatients with major depression who were receiving multimodal usual care [ 1 ]. Improvements in depressive symptoms were comparable in both groups. However, the results may not be generalizable to outpatients, who receive less intense treatment than inpatients. Adjunctive bright light therapy for nonseasonal major depression in adolescent outpatients is reasonable, based upon its tolerability and safety, as well as positive studies in adults. (See "Overview of prevention and treatment for pediatric depression", section on 'Adjunctive interventions' .)

Antidepressant-induced mania in children (February 2024)

Pediatric unipolar depression is often treated with antidepressants, but the risk of inducing mania or hypomania is uncertain. In a 52-week registry study of children and adolescents with unipolar depression who either received antidepressants (eg, fluoxetine or sertraline ) or did not, incident mania/hypomania by week 12 was comparable [ 2 ]. However, by week 52, incident mania/hypomania had occurred more often in those who received antidepressants. We recommend that as part of monitoring, clinicians assess patients for treatment-emergent mania or hypomania. (See "Pediatric unipolar depression and pharmacotherapy: General principles", section on 'Antidepressant-induced mania' .)

Dialectical behavior therapy for adolescents with bipolar disorder (January 2024)

Several trials have demonstrated that dialectical behavior therapy can reduce suicide attempts in youth who are suicidal, but most excluded patients with bipolar disorder. A recent randomized trial in adolescents with bipolar disorder who all received pharmacotherapy found fewer suicide attempts over one year follow-up among those who received adjunctive dialectical behavior therapy rather than usual psychotherapy [ 3 ]. Although multiple psychotherapies are reasonable for youth with bipolar disorder, we suggest dialectical behavior therapy for those at increased risk of suicide (eg, lifetime history of suicide attempt). (See "Pediatric bipolar disorder: Efficacy and core elements of adjunctive psychotherapy", section on 'Dialectical behavior therapy' .)

NEUROCOGNITIVE DISORDERS

Adult-onset ADHD and dementia (December 2023)

Individuals with adult-onset attention deficit hyperactivity disorder (ADHD) may have difficulties compensating for deficits from neurodegenerative or cerebrovascular processes, but any association with dementia has been inconsistent. In a prospective study including over 100,000 adults without ADHD or dementia at baseline, those who were subsequently diagnosed with adult-onset ADHD were more likely to receive a diagnosis of dementia (adjusted relative risk 2.8) [ 4 ]. Whether symptoms that resulted in the ADHD diagnosis were early or prodromal dementia symptoms is uncertain; nevertheless, these findings suggest that caregivers be alert for signs of dementia in individuals with adult-onset ADHD. (See "Attention deficit hyperactivity disorder in adults: Epidemiology, clinical features, assessment, and diagnosis", section on 'Comorbidity' .)

DEPRESSIVE DISORDERS

Dexmedetomidine and postpartum depression (April 2024)

Dexmedetomidine is an anesthetic that is also used to treat acute psychotic or manic agitation. In a randomized trial of 338 individuals who were undergoing elective cesarean delivery and screened positive for antenatal depression, adding dexmedetomidine to standard patient-controlled intravenous analgesia reduced subsequent rates of depression at 42 days postpartum (11 versus 30 percent with standard analgesia plus saline placebo) [ 5 ]. However, the study sample represents a relatively small portion of the population at risk for postpartum depression, and the drug remains an investigational approach until additional data confirm its benefit. (See "Postpartum unipolar depression: Prevention", section on 'Investigational interventions' .)

Perinatal depression and mortality (March 2024)

Perinatal depression is associated with an increased risk of death. An analysis of a national register from Sweden compared outcomes among individuals with and without a diagnosis of depression during pregnancy or postpartum, matched by age and year of delivery [ 6 ]. After controlling for potential confounding factors, all-cause mortality was greater in those with perinatal depression over 18 years of follow-up; the increased risk was largely driven by suicide. These results confirm previous data on the risks of perinatal depression and support our practice of screening for depression during pregnancy and postpartum. Services to ensure follow-up for diagnosis and treatment should accompany screening efforts. (See "Unipolar major depression during pregnancy: Epidemiology, clinical features, assessment, and diagnosis", section on 'All cause' .)

Exercise for treating depression (March 2024)

Evidence supports moderate to vigorous aerobic exercise for treating depression; however, the efficacy of other types of physical activity is less clear. A recent network meta-analysis of 218 randomized trials suggests that even light to moderate physical activity can improve depression [ 7 ]. Walking or jogging, dance, yoga, strength training, and tai chi significantly reduced depressive symptoms compared with active controls, and the magnitude of the effects was similar to those with standard treatments (ie, cognitive behavioral therapy or antidepressant treatment). Although the quality of evidence from most trials was low, these results support specific activity options for patients with depression who cannot engage in aerobic exercise. (See "Major depressive disorder in adults: Treatment with supplemental interventions", section on 'Type, intensity, and frequency' .)

NEURODEVELOPMENTAL DISORDERS

Pharmacotherapy for ADHD and mortality risk (April 2024)

Attention deficit hyperactivity disorder (ADHD) is associated with higher mortality than in the general population; whether treatment modifies that risk is unclear. In an observational study of nearly 149,000 individuals with ADHD in Sweden (mean age 17 years), initiation of medication within three months of diagnosis was associated with lower all-cause mortality (hazard ratio [HR] 0.79) as well as lower mortality from unnatural causes (eg, suicide, unintentional injury, and accidental poisoning; HR 0.75) over the ensuing two years [ 8 ]. While the study could not control for unmeasured confounders that may have impacted mortality risk (eg, lifestyle factors, social support), these data generally lend further support for pharmacotherapy of ADHD. (See "Attention deficit hyperactivity disorder in adults: Treatment overview", section on 'Benefits of stimulant treatment' .)

SUBSTANCE USE DISORDERS

Initiation of medications for alcohol use disorder during hospitalizations (May 2024)

Medications for the management of alcohol use disorder are effective but underutilized. Hospitalization may be an opportune time to initiate them. In an observational study of over 6700 individuals hospitalized at least once for alcohol-related disorders, initiation of medications for alcohol use disorder at discharge was associated with a 42 percent lower rate of all-cause death, emergency department visits, and readmission at 30 days and a 51 percent lower rate of alcohol-related emergency visits or hospitalization [ 9 ]. These findings support efforts to initiate medications for alcohol use disorder at hospital discharge. (See "Alcohol use disorder: Pharmacologic management", section on 'Patients hospitalized for alcohol-related disorder' .)

Hepatitis C virus antiviral treatment for patients with opioid use disorder (May 2024)

Despite concerns about adherence to antiviral therapy among individuals with opioid use disorder, hepatitis C virus (HCV) treatment can be highly successful in this population, particularly in nontraditional care settings. In a cluster-randomized trial that included 600 individuals with chronic HCV infection who were engaged in an opioid treatment program, provision of antiviral therapy through the program, directed by an HCV specialist over telemedicine, increased rates of antiviral initiation (92 versus 40 percent) and sustained virologic response (85 versus 30 percent) compared with traditional referral to a specialist clinic for treatment [ 10 ]. These data highlight the impact of reducing barriers to care for individuals with opioid use disorder and support our recommendation to treat all patients for chronic HCV, regardless of active drug use. (See "Patient evaluation and selection for antiviral therapy for chronic hepatitis C virus infection", section on 'Active drug use' .)

Congenital anomaly risk with methadone or buprenorphine exposure (April 2024)

Data regarding the teratogenic risk of medications for opioid use disorder (MOUD) are limited. In a population-based study comparing over 9500 pregnancies exposed to buprenorphine in the first trimester with nearly 3900 methadone-exposed pregnancies, buprenorphine use was associated with a lower overall risk of congenital anomalies (5 versus 6 percent) [ 11 ]. Although the analysis adjusted for multiple potential confounding factors, unmeasured confounders may explain some of the observed associations. We base the choice of buprenorphine versus methadone for MOUD on other factors ( table 1 ). (See "Opioid use disorder: Pharmacotherapy with methadone and buprenorphine during pregnancy", section on 'Risk of structural anomalies' .)

Delta-8 tetrahydrocannabinol use by United States adolescents (March 2024)

Delta-8 tetrahydrocannabinol (THC) is typically a minor cannabinoid found in cannabis, but can also be synthesized. It is increasingly found in United States (US) cannabis products, often marketed as low delta-9 THC. A survey of US twelfth graders in 2023 found that 11 percent reported using delta-8 THC within the past 12 months, compared with 30 percent reporting marijuana use [ 12 ]. Delta-8 THC use was lower in states with cannabis legalization (8 versus 14 percent) or delta-8 THC regulation (6 versus 14 percent). These findings suggest that delta-8 THC is a public health concern in adolescents, particularly in states that do not regulate it and have not legalized marijuana for adult use. (See "Cannabis (marijuana): Acute intoxication", section on 'Cannabis formulations' .)

Mortality risk in alcohol-associated liver disease (January 2024)

Few studies have reported the long-term outcomes of patients with alcohol-associated liver disease (ALD). In a national registry study including over 23,000 patients with ALD diagnosed at median age 58 years, 67 percent died during >100,000 person-years of follow-up and liver disease was the primary cause of death in 45 percent [ 13 ]. The 5- and 10-year mortality rates due to liver disease were 26 and 31 percent, respectively. These data emphasize the importance of treating patients with alcohol use disorder and may inform strategies to prevent liver-related mortality in those with ALD. (See "Management of alcohol-associated steatosis and alcohol-associated cirrhosis", section on 'Mortality' .)

TRAUMA - AND STRESSOR-RELATED DISORDERS

Written exposure therapy for posttraumatic stress disorder (November 2023)

Many effective psychotherapies for posttraumatic stress disorder (PTSD), such as prolonged exposure therapy, are time- and resource-intensive; written exposure therapy (WET) is emerging as an alternative brief intervention. In a randomized trial, WET resulted in largely similar improvements in PTSD symptoms compared with prolonged exposure therapy and had a lower dropout rate (13 versus 36 percent) [ 14 ]. In addition to an earlier study in which WET compared favorably with cognitive processing therapy, these findings suggest that WET may be a viable psychotherapeutic option for individuals with PTSD who cannot participate in more intensive options. (See "Posttraumatic stress disorder in adults: Psychotherapy and psychosocial interventions", section on 'Efficacy of exposure therapy' .)

OTHER PSYCHIATRY

Solriamfetol for ADHD in adults (January 2024)

Stimulants are typically first-line pharmacotherapy for attention deficit hypersensitivity disorder (ADHD) in adults but may be poorly tolerated and suboptimally effective in some patients. Solriamfetol , a selective dopamine/norepinephrine reuptake inhibitor used to treat narcolepsy, may be an effective alternative. In a trial of adults with ADHD, six weeks of solriamfetol resulted in higher rates of being "much improved" or "very much improved" (45 versus 6 percent) and higher rates of remission (24 versus 3 percent) compared with placebo [ 15 ]. While the treatment group had more adverse effects overall (ie, decreased appetite, insomnia, cardiovascular), all side effects related to treatment medication were mild or moderate in severity. Further trials are needed to determine the role of solriamfetol in adult ADHD treatment. (See "Attention deficit hyperactivity disorder in adults: Treatment overview", section on 'Treatments with limited supporting data in adult ADHD' .)

• Legenbauer T, Kirschbaum-Lesch I, Jörke C, et al. Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression: A Randomized Clinical Trial. JAMA Psychiatry 2024.
• Virtanen S, Lagerberg T, Takami Lageborn C, et al. Antidepressant Use and Risk of Manic Episodes in Children and Adolescents With Unipolar Depression. JAMA Psychiatry 2024; 81:25.
• Goldstein TR, Merranko J, Rode N, et al. Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2024; 81:15.
• Levine SZ, Rotstein A, Kodesh A, et al. Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia. JAMA Netw Open 2023; 6:e2338088.
• Zhou Y, Bai Z, Zhang W, et al. Effect of Dexmedetomidine on Postpartum Depression in Women With Prenatal Depression: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2353252.
• Hagatulah N, Bränn E, Oberg AS, et al. Perinatal depression and risk of mortality: nationwide, register based study in Sweden. BMJ 2024; 384:e075462.
• Noetel M, Sanders T, Gallardo-Gómez D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ 2024; 384:e075847.
• Li L, Zhu N, Zhang L, et al. ADHD Pharmacotherapy and Mortality in Individuals With ADHD. JAMA 2024; 331:850.
• Bernstein EY, Baggett TP, Trivedi S, et al. Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge. JAMA Netw Open 2024; 7:e243387.
• Talal AH, Markatou M, Liu A, et al. Integrated Hepatitis C-Opioid Use Disorder Care Through Facilitated Telemedicine: A Randomized Trial. JAMA 2024; 331:1369.
• Suarez EA, Bateman BT, Straub L, et al. First Trimester Use of Buprenorphine or Methadone and the Risk of Congenital Malformations. JAMA Intern Med 2024; 184:242.
• Harlow AF, Miech RA, Leventhal AM. Adolescent Δ8-THC and Marijuana Use in the US. JAMA 2024; 331:861.
• Kann AE, Jepsen P, Madsen LG, et al. Cause-specific mortality in patients with alcohol-related liver disease in Denmark: a population-based study. Lancet Gastroenterol Hepatol 2023; 8:1028.
• Sloan DM, Marx BP, Acierno R, et al. Written Exposure Therapy vs Prolonged Exposure Therapy in the Treatment of Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2023; 80:1093.
• Surman CBH, Walsh DM, Horick N, et al. Solriamfetol for Attention-Deficit/Hyperactivity Disorder in Adults: A Double-Blind Placebo-Controlled Pilot Study. J Clin Psychiatry 2023; 84.

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Mental health and the pandemic: What U.S. surveys have found

The coronavirus pandemic has been associated with worsening mental health among people in the United States and around the world . In the U.S, the COVID-19 outbreak in early 2020 caused widespread lockdowns and disruptions in daily life while triggering a short but severe economic recession that resulted in widespread unemployment. Three years later, Americans have largely returned to normal activities, but challenges with mental health remain.

Here’s a look at what surveys by Pew Research Center and other organizations have found about Americans’ mental health during the pandemic. These findings reflect a snapshot in time, and it’s possible that attitudes and experiences may have changed since these surveys were fielded. It’s also important to note that concerns about mental health were common in the U.S. long before the arrival of COVID-19 .

Three years into the COVID-19 outbreak in the United States , Pew Research Center published this collection of survey findings about Americans’ challenges with mental health during the pandemic. All findings are previously published. Methodological information about each survey cited here, including the sample sizes and field dates, can be found by following the links in the text.

The research behind the first item in this analysis, examining Americans’ experiences with psychological distress, benefited from the advice and counsel of the COVID-19 and mental health measurement group at Johns Hopkins Bloomberg School of Public Health.

At least four-in-ten U.S. adults (41%) have experienced high levels of psychological distress at some point during the pandemic, according to four Pew Research Center surveys conducted between March 2020 and September 2022.

Young adults are especially likely to have faced high levels of psychological distress since the COVID-19 outbreak began: 58% of Americans ages 18 to 29 fall into this category, based on their answers in at least one of these four surveys.

Women are much more likely than men to have experienced high psychological distress (48% vs. 32%), as are people in lower-income households (53%) when compared with those in middle-income (38%) or upper-income (30%) households.

In addition, roughly two-thirds (66%) of adults who have a disability or health condition that prevents them from participating fully in work, school, housework or other activities have experienced a high level of distress during the pandemic.

The Center measured Americans’ psychological distress by asking them a series of five questions on subjects including loneliness, anxiety and trouble sleeping in the past week. The questions are not a clinical measure, nor a diagnostic tool. Instead, they describe people’s emotional experiences during the week before being surveyed.

While these questions did not ask specifically about the pandemic, a sixth question did, inquiring whether respondents had “had physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart” when thinking about their experience with the coronavirus outbreak. In September 2022, the most recent time this question was asked, 14% of Americans said they’d experienced this at least some or a little of the time in the past seven days.

More than a third of high school students have reported mental health challenges during the pandemic. In a survey conducted by the Centers for Disease Control and Prevention from January to June 2021, 37% of students at public and private high schools said their mental health was not good most or all of the time during the pandemic. That included roughly half of girls (49%) and about a quarter of boys (24%).

In the same survey, an even larger share of high school students (44%) said that at some point during the previous 12 months, they had felt sad or hopeless almost every day for two or more weeks in a row – to the point where they had stopped doing some usual activities. Roughly six-in-ten high school girls (57%) said this, as did 31% of boys.

On both questions, high school students who identify as lesbian, gay, bisexual, other or questioning were far more likely than heterosexual students to report negative experiences related to their mental health.

Mental health tops the list of worries that U.S. parents express about their kids’ well-being, according to a fall 2022 Pew Research Center survey of parents with children younger than 18. In that survey, four-in-ten U.S. parents said they’re extremely or very worried about their children struggling with anxiety or depression. That was greater than the share of parents who expressed high levels of concern over seven other dangers asked about.

While the fall 2022 survey was fielded amid the coronavirus outbreak, it did not ask about parental worries in the specific context of the pandemic. It’s also important to note that parental concerns about their kids struggling with anxiety and depression were common long before the pandemic, too . (Due to changes in question wording, the results from the fall 2022 survey of parents are not directly comparable with those from an earlier Center survey of parents, conducted in 2015.)

Among parents of teenagers, roughly three-in-ten (28%) are extremely or very worried that their teen’s use of social media could lead to problems with anxiety or depression, according to a spring 2022 survey of parents with children ages 13 to 17 . Parents of teen girls were more likely than parents of teen boys to be extremely or very worried on this front (32% vs. 24%). And Hispanic parents (37%) were more likely than those who are Black or White (26% each) to express a great deal of concern about this. (There were not enough Asian American parents in the sample to analyze separately. This survey also did not ask about parental concerns specifically in the context of the pandemic.)

Looking back, many K-12 parents say the first year of the coronavirus pandemic had a negative effect on their children’s emotional health. In a fall 2022 survey of parents with K-12 children , 48% said the first year of the pandemic had a very or somewhat negative impact on their children’s emotional well-being, while 39% said it had neither a positive nor negative effect. A small share of parents (7%) said the first year of the pandemic had a very or somewhat positive effect in this regard.

White parents and those from upper-income households were especially likely to say the first year of the pandemic had a negative emotional impact on their K-12 children.

While around half of K-12 parents said the first year of the pandemic had a negative emotional impact on their kids, a larger share (61%) said it had a negative effect on their children’s education.

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John Gramlich is an associate director at Pew Research Center .

How Americans View the Coronavirus, COVID-19 Vaccines Amid Declining Levels of Concern

Online religious services appeal to many americans, but going in person remains more popular, about a third of u.s. workers who can work from home now do so all the time, how the pandemic has affected attendance at u.s. religious services, economy remains the public’s top policy priority; covid-19 concerns decline again, most popular.

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ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

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Are We Talking Too Much About Mental Health?

Recent studies cast doubt on whether large-scale mental health interventions are making young people better. Some even suggest they can have a negative effect.

By Ellen Barry

In recent years, mental health has become a central subject in childhood and adolescence. Teenagers narrate their psychiatric diagnosis and treatment on TikTok and Instagram. School systems, alarmed by rising levels of distress and self-harm, are introducing preventive coursework in emotional self-regulation and mindfulness.

Now, some researchers warn that we are in danger of overdoing it. Mental health awareness campaigns, they argue, help some young people identify disorders that badly need treatment — but they have a negative effect on others, leading them to over-interpret their symptoms and see themselves as more troubled than they are.

The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness , cognitive behavioral therapy and dialectical behavior therapy did not emerge healthier than peers who did not participate, and some were worse off, at least for a while.

And new research from the United States shows that among young people, “self-labeling” as having depression or anxiety is associated with poor coping skills, like avoidance or rumination.

In a paper published last year , two research psychologists at the University of Oxford, Lucy Foulkes and Jack Andrews, coined the term “prevalence inflation” — driven by the reporting of mild or transient symptoms as mental health disorders — and suggested that awareness campaigns were contributing to it.

“It’s creating this message that teenagers are vulnerable, they’re likely to have problems, and the solution is to outsource them to a professional,” said Dr. Foulkes, a Prudence Trust Research Fellow in Oxford’s department of experimental psychology, who has written two books on mental health and adolescence.

Until high-quality research has clarified these unexpected negative effects, they argue, school systems should proceed cautiously with large-scale mental health interventions.

“It’s not that we need to go back to square one, but it’s that we need to press pause and reroute potentially,” Dr. Foulkes said. “It’s possible that something very well-intended has overshot a bit and needs to be brought back in.”

This remains a minority view among specialists in adolescent mental health, who mostly agree that the far more urgent problem is lack of access to treatment.

About 60 percent of young Americans with severe depression receive no treatment, according to Mental Health America, a nonprofit research group. In crisis, desperate families fall back on emergency rooms, where teens often remain for days before a psychiatric bed opens up. There is good reason to embrace a preventive approach, teaching schoolchildren basic skills that might forestall crises later, experts say.

Dr. Foulkes said she understood that her argument runs counter to that consensus, and when she began to present it, she braced for a backlash. To her surprise, she said, many educators reached out to express quiet agreement.

“There’s definitely a fear about being the one to say it,” she said.

A deflating result

In the summer of 2022, the results of a landmark study on mindfulness training in British classrooms landed — like a lead balloon.

The trial, My Resilience in Adolescence, or MYRIAD, was ambitious, meticulous and expansive, following about 28,000 teenagers over eight years. It had been launched in a glow of optimism that the practice would pay off, improving the students’ mental health outcomes in later years.

Half of the teenagers were trained by their teachers to direct their attention to the present moment — breathing, physical sensations or everyday activities — in 10 lessons of 30 to 50 minutes apiece.

The results were disappointing . The authors reported “no support for our hypothesis” that mindfulness training would improve students’ mental health. In fact, students at highest risk for mental health problems did somewhat worse after receiving the training, the authors concluded.

But by the end of the eight-year project, “mindfulness is already embedded in a lot of schools, and there are already organizations making money from selling this program to schools,” said Dr. Foulkes, who had assisted on the study as a postdoctoral research associate. “And it’s very difficult to get the scientific message out there.”

Why, one might ask, would a mental health program do harm?

Researchers in the study speculated that the training programs “bring awareness to upsetting thoughts,” encouraging students to sit with darker feelings, but without providing solutions, especially for societal problems like racism or poverty. They also found that the students didn’t enjoy the sessions and didn’t practice at home.

Another explanation is that mindfulness training could encourage “co-rumination,” the kind of long, unresolved group discussion that churns up problems without finding solutions.

As the MYRIAD results were being analyzed, Dr. Andrews led an evaluation of Climate Schools, an Australian intervention based on the principles of cognitive behavioral therapy, in which students observed cartoon characters navigating mental health concerns and then answered questions about practices to improve mental health.

Here, too, he found negative effects. Students who had taken the course reported higher levels of depression and anxiety symptoms six months and 12 months later.

Co-rumination appears to be higher in girls, who tend to come into the program more distressed, as well as more attuned to their friends, he said. “It might be,” he said, “that they kind of get together and make things a little bit worse for each other.”

Dr. Andrews, a Wellcome Trust research fellow, has since joined an effort to improve Climate Schools by addressing negative effects. And he has concluded that schools should slow down until “we know the evidence base a bit more.” Sometimes, he said, “doing nothing is better than doing something.”

The awareness paradox

One problem with mental health awareness, some research suggests, is that it may not help to put a label to your symptoms.

Isaac Ahuvia, a doctoral candidate at Stony Brook University, recently tested this in a study of 1,423 college students . Twenty-two percent “self-labeled” as having depression, telling researchers “I am depressed” or “I have depression,” but 39 percent met the diagnostic criteria for depression.

He found that the students who self-labeled felt that they had less control over depression and were more likely to catastrophize and less likely to respond to distress by putting their difficulties in perspective, compared with peers who had similar depression symptoms.

Jessica L. Schleider, a co-author of the self-labeling study, said this was no surprise. People who self-label “appear to be viewing depression as a biological inevitability,” she said. “People who don’t view emotions as malleable, view them as set and stuck and uncontrollable, tend to cope less well because they don’t see a point to trying.”

But Dr. Schleider, an associate professor of medical social sciences at Northwestern University and the director of the university’s Lab for Scalable Mental Health, pushed back on the prevalence inflation hypothesis. She disagreed with the claim that students are overdiagnosing themselves, noting that Mr. Ahuvia’s findings suggest otherwise.

Awareness campaigns are bound to have multiple effects, helping some students and not others. And ultimately, she argued, the priority for public health should be reaching young people in the most distress.

“The urgency of the mental health crisis is so clear,” she said. “In the partnerships that I have, the emphasis is on the kids truly struggling right now who have nothing — we need to help them — more so than a possible risk for a subset of kids who aren’t really struggling.”

Maybe, she said, we need to look beyond the “universal, school-assembly-style approach,” to targeted, light-touch interventions, which research has shown can be effective at decreasing anxiety and conduct disorders, especially in younger children.

“There is a risk of throwing the baby out with the bathwater,” Dr. Schleider said. “The response can’t be ‘Forget all of it.’ It should be ‘What about this intervention was unhelpful?’”

Other researchers echoed her concern, pointing to studies that show that on average, students benefit from social and emotional learning courses.

One of the largest, a 2023 meta-analysis of 252 classroom programs in 53 countries, found that students who participated performed better academically, displayed better social skills and had lower levels of emotional distress or behavioral problems. In that context, negative effects in a handful of trials appear modest, the researchers said.

“We clearly have not figured out how to do them yet, but I can’t imagine any population-based intervention that the field got right the first time,” said Dr. Andrew J. Gerber, the president and medical director of Silver Hill Hospital and a practicing child and adolescent psychiatrist.

“Really, if you think about almost everything we do in schools, we don’t have great evidence for it working,” he added. “That doesn’t mean we don’t do it. It just means that we’re constantly thinking about ways to improve it.”

‘We want everyone to have it’

These debates are taking place a long way away from classrooms, where mental health curriculums are increasingly commonplace.

Allyson Kangisser, a counselor at Woodsdale Elementary School in Wheeling, W.Va., said the focus in her school is on basic coping skills. In the early grades, students are asked, “What things can you do to take care of yourself when you’re having big feelings?”

Starting in third grade, they take on more complex material, such as watching cartoon characters to distinguish transient stress from chronic conditions like depression. “We’re not trying to have them diagnose themselves,” Ms. Kangisser said. “We are saying, what do you feel — this one? Or this one?”

At the school’s sixth annual mental health fair last month, Woodsdale students walked through a giant inflatable brain, its lobes neatly labeled. They did yoga stretches and talked about regulating their emotions. Ms. Kangisser said the event is valuable precisely because it is universal, so troubled children are not singled out.

“The mental health fair, everybody does it,” she said. “It’s not ‘You need it, and you don’t.’ We want everyone to have it, because you just never know.”

By the time the students reach college, they will have absorbed enormous amounts of information about mental health — from school, but also from social media and from one another.

Dr. Jessica Gold, chief wellness officer for the University of Tennessee system, said the college students she sees are recognizably different — more comfortable speaking about their emotions and more willing to be vulnerable. They also overuse diagnostic terms and have the self-assurance to question a psychiatrist’s judgment.

“It’s sort of a double-edged sword,” she said. “We want people to talk about this more, but we don’t want that to lead to overdiagnosis or incorrect diagnosis or overtreatment. We want it to lead to normalizing of having feelings.”

Lucy Kim, a Yale senior who has lobbied for better mental health support on campus, described the prevalence inflation hypothesis as “disheartening, dismissive and potentially dangerous,” providing another way to discount the experiences of young people.

“As a college student, I see a generation of young people around me impacted by a depth and breadth of loneliness, exhaustion and disillusionment suggestive of a malaise that goes deeper than the general vicissitudes of life,” said Ms. Kim, 23.

Overdiagnosis does happen, she said, and so does glorification of mental health disorders. But stigma and barriers to treatment remain the bigger problem. “I can confidently say I have never heard anyone respond to disclosures of depression with ‘That’s so cool, I wish I had that, too,’” she said.

Ellen Barry is a reporter covering mental health for The Times. More about Ellen Barry

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Supportive sports environments reduce depression and anxiety in girls, new report shows.

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NEW YORK, NEW YORK - OCTOBER 16: Billie Jean King speaks at The Women in Sports Foundation 40th ... [+] Annual Salute to Women in Sports Awards Gala, celebrating the most accomplished women in sports and the girls they inspire at Cipriani Wall Street on October 16, 2019 in New York City. (Photo by Theo Wargo/Getty Images for Women In Sports Foundation)

A new study conducted by the Women’s Sport Foundation reveals that girls’ participation in supportive sport environments can significantly lessen mental health issues, including depression and anxiety. The report, Thriving Through Sport: The Transformative Impact on Girls’ Mental Health, examined not only the relationship between sport participation and mental health, but also the types of sport environments that yield the most significant mental health benefits for participants.

Karen Issokson-Silver , Vice President, Research & Education at the Women’s Sports Foundation (WSF), shared that the motivation behind the study stemmed largely from a lack of previous research and the notable increase in youth mental health issues. She noted, “though there was some existing research on the connection between sport participation and mental health, it was limited. The Women’s Sport Foundation wanted to dive deeper into the topic to better understand the relationship between sport and mental health, with a focus on girls. Importantly, we wanted to learn more about how the different conditions within sport settings impact mental health, so we could offer data-driven insights about how to support girls more holistically.”

UNITED STATES - AUGUST 28: Tennis pro Gigi Fernandez watches approvingly as a youngster hits a ... [+] return during a Leadership Day for Girls clinic at the U.S. Open at Flushing Meadows-Corona Park. Fernandez has won two Olympic gold medals. (Photo by Corey Sipkin/NY Daily News Archive via Getty Images)

Key Findings

Overall, the findings of this study strongly suggest that engaging in sports within high-quality environments can reduce depression and anxiety, enhance peer relationships, and provide a sense of purpose and meaning. According to Issokson-Silver, “this new report makes clear that sport is not a nice to have, but a must have. The data shows that sport can play a powerful role in improving mental health.” Several key findings from the study include:

• Mental health disorders are roughly 1.5-2.5x lower for girls who play sports once compared to girls who have never played.
• Moderate-to-high levels of depression symptoms are found in 29% of girls who have never played sports, compared to 17% of girls who currently participate.
• Among girls who have never participated in sports, 21% experience moderate to high levels of anxiety symptoms, compared to 11% of girls currently playing sports.
• Depression symptoms are notably lower (9.3%) in sport environments emphasizing effort, improvement, and teamwork, compared to settings where winning is prioritized and success is measured by outperforming others (24.7%).
• Girls currently playing sports have approximately 1.5 times higher odds of having moderate-to-high scores in peer relationships or feelings of meaning and purpose, compared to girls who have never participated in sports.
• Compared to girls involved solely in non-sport activities, those participating in sports show lower levels of depression and anxiety, as well as higher levels of peer relationships and feelings of meaning and purpose, even when considering factors like the number of activities, years engaged, and hours per week of participation.

LITTLETON, CO - FEBRUARY 24: Former NBA player Keith Van Horn talks with his girl's U13 team at 24 ... [+] Hour Fitness on February 24, 2016 in Littleton, Colorado. Van Horn, the second overall pick in the 1997 NBA Draft, created one of the top basketball organizations in Colorado, Colorado Premier, which recently became part of the Nike EYBL circuit, which features only the top 32 club teams in America. Van Horn retired from the NBA in 2006 as a member of the Dallas Mavericks. (Photo by Brent Lewis/The Denver Post via Getty Images)

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Baby reindeer piers morgan seeks richard gadd for interview after real martha segment, tyson fury vs oleksandr usyk results winner scorecard and reaction, supportive sport environments.

The study also identifies crucial elements within sport settings, such as levels of autonomy and the nature of coach relationships, that contribute to positive outcomes for girls. According to Issokson-Silver, “when girls have the opportunity for “voice and choice,” which means they are encouraged to express themselves, share ideas, interests, and concerns, this goes a long way to boosting their mental health. When sport settings prioritize the development of skills over time and personal goal setting, and when players are encouraged to learn from their mistakes, they thrive. This stands in contrast to sport settings in which the focus is on winning above all and where social comparisons dominate the culture and tone.”

Previous research has highlighted the adverse effects of a win-at-all-costs mindset among coaches. Environments driven by coaches' relentless pursuit of victory often breed narcissistic leadership behaviors, impacting both employees and players negatively. This previous study indicates that when winning becomes the sole focus, leadership adopts harmful practices, prioritizing victory over all other organizational and personal goals. When considering the findings from the WSF’s report, it becomes evident that athletes, including young girls, face heightened risks of mental health issues due to these toxic win-at-all-costs cultures, which may also increase the likelihood of strained relationships with their coaches.

Inglewood, CA - August 19: A player from King/Drew girls flag football goes up for a pass against ... [+] Crenshaw at halftime during the Rams and Raiders preseason game at SoFi Stadium on Saturday, Aug. 19, 2023 in Inglewood, CA. (Jason Armond / Los Angeles Times via Getty Images)

As noted by Issokson-Silver, “strong relationships nurture girls’ confidence and overall well-being. This includes the relationship between coaches and players and the relationships that are fostered between players and their peers. Above all, environments that are inclusive, welcoming, and create a sense of belonging are enormously supportive of positive mental health... when coaches highlight the small wins that happen every day, and not just the outcomes of competition, girls’ confidence is nurtured and reinforced. Coach training around promoting mental health is essential. We want all coaches to be equipped to help girls thrive physically and mentally.”

Policy and Practice

The insights from this study provide important avenues for policy and practice recommendations. According to Issokson-Silver, “all sport programs, regardless of the level of play, should prioritize player well-being, both in terms of physical and mental health... [the] WSF’s advocacy and community impact work is fueling this message by supporting programs through the delivery of grants, leadership training, and capacity building. A good example of that work is WSF’s Sports 4 Life program, a national initiative co-founded by ESPN and now also supported by Gatorade. The program seeks to increase the participation and retention of Black, African American, Hispanic, and Native American girls in sport to improve their physical and mental health and leadership skills. This year, Sports 4 Life is celebrating its 10-year anniversary and the outcomes from this program reflect the powerful data in the new research. We see that when sport programs are done well, girls thrive.”

OAKTON, VA - SEPTEMBER 12: Flint Hill's bench celebrates a score in the 3rd set during Flint ... [+] Hill's defeat of Georgetown Day 3 sets to 0 in girls volleyball at Flint Hill School in Oakton, VA on September 12, 2023. (Photo by John McDonnell/The Washington Post via Getty Images)

Alongside policy adjustments, the landscape of women’s sport has witnessed an expansion in role modeling opportunities in recent years, which will likely increase awareness of and participation in sport. Women's sports have seen a surge in viewership and attendance , likely fueling further increases in girls' participation across various sports for years to come. Today's young girls may find it challenging to recall a time when accessing their favorite teams on linear or streaming TV networks was difficult. With this surge in growth, participation opportunities in sports should consistently prioritize inclusivity, individual development, and encouragement for all participants. The undeniable advantages of high-quality sport experiences necessitate that organizations and leaders focus on cultivating supportive environments for girls in order to fully capitalize on these benefits.

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Sad Girl Playlists Aren’t Just Trendy—Study Finds Sad Music Can Boost Your Mental Health

• New research suggests that listening to sad music can positively impact a person’s mood based on the sense of connectedness it provides.
• Experts cite three responses to sad music: grief, melancholia, and sweet sorrow.
• Experts agree that music of all kinds can play a role in people’s mental health and mood, but music is a personal, unique experience for each listener.

A new study found that listening to sad music can impact a person’s mood positively, based on a revived sense of connectedness.

When you’re at a party or social gathering you may queue an upbeat song, such as “That’s What I Like” by Bruno Mars. On other days, you might just want to listen to something that’s a bit more gloomy and relatable like Taylor Swift’s “Anti-Hero.”

Whatever music you enjoy listening to most, whether that be hip-hop, country, rock, or jazz, it can oftentimes influence your mood and feelings.

This is especially true when it comes to sad music. Various features of a song, including tempo, mode, instrument choice, and dynamics, can prompt negative emotions in listeners, Tara Venkatesan, PhD, a cognitive scientist at Oxford University and an operatic soprano, told Health.

However, a new study published in the Journal of Aesthetic Education , which Venkatesan was a part of, suggests that while listening to sad music can certainly make people feel sad, doing so may also impact a person’s mood positively and allow them to feel a sense of connectedness.

“Our main point is that the value of sad music lies in its ability to create a sense of connection, regardless of whether it actually evokes sadness in the listener,” Venkatesan clarified. “And it’s that sense of connection, not necessarily the experience of sadness itself, which is what makes listening to sad music really great!”

Getty Images / Westend61

Why Do People Love Sad Music?

The researchers hypothesized that people value sad music for the same reasons they might value sad conversations—a sense of genuine connection.

For example, when someone tells you about their horrible break up, you might feel sad yourself because of how genuinely devastated and lonely they are feeling, Venkatesan explained. However, as you continue talking, you might feel like there’s something meaningful about that interaction and connected with this person in a unique way.

The research team demonstrated sad music’s ability to provide a sense of connection in two parts.

In the first part, the researchers wanted to show that emotional expression is a characteristic value of what music is all about. They gave nearly 400 participants a description of four different songs including:

• A song that “conveys deep and complex emotions” but is “technically very flawed”
• A song that is “technically flawless” but “does not convey deep or complex emotions”
• A song that is “deeply emotional” and “technically flawless”
• A song that is both unemotional and “technically flawed”

Participants were asked to rank songs based on which pieces embodied “what music is all about.”

They found that participants valued emotional expression more than technical proficiency when reviewing their song choices. Highly emotional songs, even of lesser technical value, were chosen at a much higher rate.

For the second part of their experiment, the authors asked 450 new participants to rate how connected they felt when listening to music or participating in conversations that expressed 72 different emotions, including inspiration, love, sadness, contempt, etc.

They found that the emotions that make people feel connected in conversation are also the emotions whose expression in music matched the “what music is all about” highly rated songs: sadness, love, joy, loneliness , and sorrow.

Furthermore, participants said that songs expressing sad emotions like suffering and despair are unpleasant to listen to but still capture the essence of what music is all about and make for high-connection conversations.

“In other words, regardless of whether we enjoy sad music, we value sad music because it creates a sense of connection,” Venkatesan explained.

Other research has suggested that people listen to sad music for no particular motivation other than the fact that they like this music or band. In fact, a 2014 study highlights that nearly a third of participants listened to sad music when they were in a positive mood.

Does Listening to Sad Music Evoke Sadness? 

Whether or not sad music makes a person feel sad depends on each individual and their experience, Shannon Bennett, PhD , site clinical director for NewYork-Presbyterian’s Center for Youth Mental Health, told Health .

For example, a person might feel sad when they hear a certain song because that song might be connected to a particular memory. Since our emotions and memories are very connected, when we listen to a song that evokes a certain memory, it can cause us to feel sad.

“If a piece of music is connected to either of those experiences that could then bring on a real feeling of sadness,” Bennett explained. “But that to me is a more personal experience in terms of how intense that feeling is, how long it lasts, and then importantly what we do with it.”

This aligns with a 2016 study that found people who listen to sad music can perpetuate cycles of negative thinking and often prompts them to think about sad memories or negative thoughts.

Music, and our response to it, is a unique and personal experience.

While sad music can generally make people feel sad, depending on the mental health state of an individual, it can evoke other emotions as well, added Venkatesan. She cited previous research on people’s experience of sad music and noted three main categories expressed: grief, melancholia, and sweet sorrow.

“While grief consisted mainly of negative emotions like despair, both melancholia and sweet sorrow consisted of more mixed emotions like longing and nostalgia and even positive emotions like comfort and pleasure,” she said.

Music and Mental Health

Bennett clarified that sad music does not automatically indicate sad emotion for the listener—it can actually impact the listener’s mental health positively.

“Music can be a way to practice just sitting with a feeling that sometimes is harder to sit with and that is actually emotionally very helpful,” she added. “We call that an emotional exposure that in fact is used in some very well-researched therapy protocols to help us to sit with emotions that we sometimes don’t want to sit with.”

Sad music can also make people feel connected in the same way a heartfelt conversation makes us feel connected, said Venkatesan. “It is very likely that the sense of connection we experience when listening to sad music has positive health benefits.”

Some studies suggest that listening to sad music creates a feeling of “emotional communion” where you share feelings of sadness with the singer or composer. Venkatesan explained that in this case, listening to sad songs may act as a form of virtual contact which can help people feel accepted, understood, and less lonely.

She added that other studies suggest that listening to sad songs allows us to connect with ourselves and reflect on our own emotional experiences which can help with mood regulation.

Venkatesan noted that music, in general, has a profound effect on our brains and physiology and therefore can also impact our mood.

For example, some research suggests that relaxing music can decrease levels of salivary cortisol and psychological stress, which is an indicator of decreased stress and better regulation when responding to a stressor.

Bennett noted in the same way that a sad song might evoke a sad emotional state, there are ways to use music to evoke a positive emotional state. There are also ways that people can choose positive behaviors that might move them in the direction of positive emotion.

Bennett concluded, “My hope is that this research will help people just recognize that feeling sad is okay and also that there are things that we can do to help us move out of that feeling.”

Attie-Picker M, Venkatesan T, Newman GE, Knobe J. On the value of sad music . J Aesthet Educ . Published online April 18, 2023.

Tallahassee Memorial Healthcare. How music affects your mind, mood and body. 

Taruffi L, Koelsch S. The paradox of music-evoked sadness: an online survey . PLoS One . 2014;9(10):e110490. doi:10.1371/journal.pone.0110490

Garrido S, Schubert E, Bangert D. Musical prescriptions for mood improvement: an experimental study . Arts Psychother . 2016;51:46-53. doi:10.1016/j.aip.2016.09.002

Van den Tol AJM, Edwards J, Heflick NA. Sad music as a means for acceptance-based coping . Music Sci . 2016;20(1):68-83. doi:10.1177/1029864915627844

Ooishi Y, Mukai H, Watanabe K, Kawato S, Kashino M. Increase in salivary oxytocin and decrease in salivary cortisol after listening to relaxing slow-tempo and exciting fast-tempo music . PLoS One . 2017;12(12):e0189075. doi:10.1371/journal.pone.0189075

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