A mental health crisis has been swelling in the United States—and far too little has been done on a national level to improve how we identify, diagnose, and treat people who are living with conditions like anxiety and depression. Now, public health experts are taking a step toward getting people the care they need. In a draft recommendation published in late September, the US Preventive Services Task Force, a national panel of medical experts, said plans should be made to screen adults under the age of 65 for anxiety.In many ways this recommendation—which is the first of its kind—makes sense, given everything we’ve all had to cope with in the past couple of years. Even before the pandemic hit, feelings of mental and emotional distress were becoming more common, especially among young people and marginalized communities. Then, COVID happened, and the effects of the unrelenting stress that came with it were hard to ignore. The World Health Organization (WHO) estimates that the pandemic fueled a whopping 25% increase in anxiety and depression globally. An estimated 31% of adults will experience an anxiety disorder at some point in their lives, per the National Institute of Mental Health, while roughly 8% of adults experienced a major depressive episode in the last year.Yet, many people living with mental health conditions continue to go undiagnosed, in part because the symptoms are more difficult to recognize and come to terms with than, say, a physical issue like a broken bone or a heart attack, David Spiegel, MD, associate chair of psychiatry and behavioral sciences and director of the Center on Stress and Health at Stanford University, tells SELF. Stigma is another huge factor; people often feel “ashamed to come forward with what’s bothering them,” he adds.That’s why the idea of routine anxiety screenings is appealing; these exams could help health care providers ID people who are struggling much earlier so they can get the care they need to avoid “preventable suffering,” Dr. Spiegel says.The draft recommendation suggests that screenings should be done by primary care doctors. People would fill out questionnaires that explore mental health symptoms, the draft says. If they “screen positive,” they would then move on to a more thorough assessment to gauge the severity of the situation. Primary care doctors may then recommend and prescribe medication, if necessary, or they may decide to refer their patients to a licensed mental health professional.Of course, that process is overly simplified in many scenarios. Mental health care should be individualized because what works for one person may not work for another—but even just starting the conversation about what kind of help a person may need is a step in the right direction, experts say.The task force also acknowledged in the draft that there are a few key barriers to address to make these screenings feel worthwhile. First, even though primary care doctors are a go-to source for most health concerns, they usually aren’t specialists. That means they may not have the in-depth knowledge needed to help people with complex mental health circumstances, or they may simply not feel comfortable doing these screenings. On top of that, systemic issues like racial bias can absolutely interfere with effective screening and reaching an accurate diagnosis, the draft notes. (Only one in three Black adults who have a mental illness get the care they need, per the National Alliance on Mental Illness; they’re also less likely to receive consistent, culturally competent care, and they’re underrepresented in mental health research.)Many experts have also called out a major hole in this recommendation: As a country, we simply may not have the resources to keep up with a significant rise in mental health diagnoses, which seems to be a given if regular screenings are implemented. Sure, we can identify people who need help—but we also need enough helpers. Right now we’re facing a national shortage of mental health care workers; even when people can find a licensed mental health professional near them, there’s often a lengthy wait list that prevents them from getting timely care.The draft recommendation is a solid first step, and it will be considered for final approval after October 17—but we can’t just stop at screening. There needs to be a clear plan for next steps in place too. If we can pull that off, then many people will benefit from regular check-ins, says Dr. Spiegel, and hopefully, a plan that gets them the support they need.Related:
For the past 20 years, Botox has been the go-to wrinkle-reducing treatment for millions of people looking to minimize fine lines around their forehead, eyes, cheekbones, you name it. There are three similar injectables—Dysport, Xeomin, and Jeuveau—but none of these drugs, known as neuromodulators, have been able to compete with the popularity of Botox.Now, some dermatologists say a new injectable drug called Daxxify, recently approved by the US Food and Drug Administration (FDA), may change that. That’s largely because its wrinkle-reducing effects are expected to last longer than other neuromodulators on the market (including Botox, the effects of which typically last three to four months). The gist: Instead of scheduling injections three or four times a year for maintenance, people who opt for Daxxify may only need two treatments a year, depending on their personal results.In phase 3 clinical trials, researchers tested Daxxify, made by pharmaceutical company Revance Therapeutics, on nearly 2,700 people. They found that roughly 98% of these participants experienced a significant reduction in wrinkles within four weeks of receiving a Daxxify injection. The effects kicked in fast, typically within two days of treatment, and lasted six months on average. For a small percentage of people, the results lasted up to nine months.Here’s what you should know about Daxxify, including how it works, possible downsides, and how much it’s expected to cost.How does Daxxify work, exactly?Like Botox, when Daxxify is injected into the face, it delivers a botulinum toxin to block certain nerve signals from interacting with the targeted facial muscles. This means the muscles are temporarily unable to move or contract, relaxing wrinkles and fine lines in the process. Though the muscles won’t function as they usually do, they aren’t actually paralyzed, George Bitar, MD, FACS, a board-certified plastic surgeon in Washington, DC, tells SELF.In addition to having longer-lasting effects compared to other neuromodulators, Daxxify’s formula makes use of peptides, which are short chains of compounds called amino acids; this makes it the only neuromodulator that’s free of human serum albumin (a protein found in human blood) or animal-based components, a spokesperson for Revance tells SELF.Available neuromodulators are also commonly used to alleviate certain health issues, including migraine, TMJ-related jaw pain, and hyperhidrosis (excessive sweating). For now, Daxxify has only received FDA approval for cosmetic treatments, but Dr. Bitar expects it may be used for similar off-label purposes. “I would use Daxxify for the same things I have used Botox and Dysport for the last 20 years,” he says. That said, it’s unclear if Daxxify’s results would also last longer for non-cosmetic concerns.What are the possible downsides of Daxxify?In order for a drug to receive FDA approval, it must be deemed safe and effective. However, similar to other neuromodulators, you may experience potential side effects—like a headache, injection site pain and swelling, drooping eyelids, and facial asymmetry—after receiving a Daxxify injection.
The buzz around ketamine, a dissociative anesthetic drug, is booming. More and more research continues to suggest the drug has the potential to help people with severe mood disorders, including a new study that was just published in The Journal of Clinical Psychiatry.For the study, researchers evaluated the drug’s effects in more than 400 people who received ketamine infusions in three unregulated private clinics in Virginia; people were paying for these treatments out of pocket and, on average, they received six infusions within 21 days. During each visit, the participants filled out surveys about their physical and mental well-being. The researchers found that 50% of people who were dealing with suicidal thoughts were in remission after six infusions, while 75% of them no longer experienced suicidal thoughts after 10 infusions. People also had a 30% reduction in anxiety symptoms within six weeks. The researchers note that the study is exciting because the findings shed some light on ketamine’s effectiveness in a “real-world” setting.But the strongest studies on ketamine therapy—and other forms of psychedelic therapy—have been done in tightly-controlled research settings, often with the addition of talk therapy, for a valid reason. “This treatment really does offer hope to a lot of people and it is very promising,” Gerard Sanacora, MD, PhD, a professor of psychiatry and the director of the Yale Depression Research Program who was not directly involved in the new study, tells SELF. “But it really needs to be used with caution and responsibility,” he says, because there’s always a risk of worsening certain mental health conditions when ketamine isn’t used appropriately. Here’s how this new research is contributing to experts’ understanding of this controversial drug.First, a little ketamine 101.Ketamine is an anesthetic that has some hallucinogenic effects, which is why you’ve probably heard of it making the rounds at music festivals. It can also cause dissociation, a short-lived mental state in which people feel disconnected and detached from reality. Though ketamine has psychedelic properties, many experts don’t classify it as a genuine psychedelic because it impacts a different part of the brain compared to drugs like LSD, as SELF previously reported.In 2019, the Food and Drug Administration (FDA) approved a nasal-spray medication derived from ketamine, esketamine, for treatment-resistant depression; no other form of ketamine is approved for the treatment of any mental health disorder. There’s a bit of a loophole, though. Ketamine is FDA-approved for general anesthesia, which means it’s legal to prescribe. Because of this, doctors are able to recommend ketamine “off-label” to people with severe mood disorders. This essentially means a health care provider prescribes an approved drug in a way that it wasn’t approved to be used, which is a relatively common practice even outside the world of psychedelic therapy.A growing body of research is starting to back up ketamine’s potential.Clinical study after clinical study has suggested ketamine, typically delivered via intravenous infusions, may help reduce depression, alleviate anxiety, and quell suicidal thoughts. “There is really strong evidence that it has a rapid onset of antidepressant effects that can be sustained with repeated dosing over time,” Dr. Sanacora explains.
The monkeypox outbreak in the US seems to be slowing down slightly—a positive bit of news after many months of confusion and uncertainty. Still, experts say we’re not totally in the clear. Researchers are continuing to study the disease and are taking a closer look at the potential risks, as the virus has spread to dozens of countries outside of endemic areas, according to the Centers for Disease Control and Prevention (CDC).Case in point: New research suggests monkeypox may lead to neurological complications in very rare instances. In many people, though, the disease can cause distressing psychological symptoms, including anxiety and depression.For the meta-analysis, recently published in the journal eClinicalMedicine, researchers in the UK analyzed the findings of 19 studies that included a total of 1,512 participants, 1,031 of whom tested positive for monkeypox. (It’s important to note that these studies were done using data from prior outbreaks.) The researchers found that up to 3% of people with monkeypox developed rare but severe neurological complications like seizures, confusion, or a type of brain inflammation called encephalitis.That sounds scary, but don’t stress about this too much just yet, experts say. “We are not expecting a tide of severe brain problems with monkeypox, but complications like encephalitis and seizure may occur in small proportions of people,” study co-lead author James Badenoch, MBChB, an academic foundation doctor at Barts Health NHS Trust and the Preventative Neurology Unit at Queen Mary University London, tells SELF. “Although monkeypox mainly causes flu-like symptoms and skin problems, neuropsychiatric symptoms are also frequently reported.” These range from more likely side effects—such as headache, muscle aches, and fatigue—to rare brain complications, he adds.More frequently, people with monkeypox seemed to experience a pretty noticeable dip in their moods. One of the studies included in the review found that over a quarter of people who were hospitalized for monkeypox in Nigeria, where the virus is endemic, experienced anxiety or depression that required counseling. The researchers were unable to determine just how common the mental health symptoms may be due to differences in how the studies were conducted, but many reports in the review suggest that up to half of people with monkeypox may experience some type of psychological or neurological issue—most commonly a headache.Scientists are still trying to figure out why some people with monkeypox experience these side effects—and what types of factors influence a person’s risk—but they suspect some symptoms may stem from intense inflammation, a psychological response to being sick, or, perhaps, the virus’s ability to directly infect the central nervous system; in some cases, it may be a mix of all three, but more research is needed to know for sure.Viral infections are known to set off an influx of inflammation throughout the body, including the brain, which can either trigger new psychological symptoms or a flare-up of an underlying mental health condition, according to Daniel Pastula, MD, an associate professor of neurology, medicine, and epidemiology at the University of Colorado Anschutz Medical Campus. In general, the body doesn’t do well with inflammation from any cause, and the central nervous system appears to be especially vulnerable. Think of any time you’ve been sick and felt a little loopy: “It’s just that inflammatory soup in the body that your brain doesn’t like,” Dr. Pastula, who recently published a review on monkeypox’s neuroinvasive potential, tells SELF.Another possible, and probably more likely, explanation: The stigma associated with monkeypox, the stress of having a painful and potentially disfiguring skin rash, and the two to four months of social isolation that is often required during the illness may, understandably, cause immense anxiety and depression, Dr. Badenoch says.The bottom line: Neurological complications are a possible risk if you contract monkeypox, but these effects are incredibly rare based on what experts know so far. That said, if you do become infected, it’s more likely that your mental health may take a hit as your body tries to recover from the virus—so do your best to follow the CDC’s monkeypox prevention tips to reduce your chances of becoming infected, get vaccinated if you are eligible, and try to go easy on yourself if you do get sick.Related:
We already know your emotional well-being can impact your body in many ways—from your heart health to your digestion. Now, new research suggests feelings like stress, depression, and even loneliness may increase your risk of developing a condition experts are just starting to learn more about: long COVID, which is estimated to affect between 20% and more than 50% of people who test positive for the virus.For the study, which was recently published in JAMA Psychiatry, the researchers asked nearly 55,000 people—none of whom had previously tested positive for COVID and 38% of whom were health care workers—to complete self-reported questionnaires about their mental health between April 2020 and November 2021. Using these responses, the researchers measured levels of depression, anxiety, loneliness, perceived stress, and general worry about COVID. (Only people who were not active health care workers were asked about stress and loneliness.) They also tracked who tested positive for COVID, and of those who did, whether they experienced “post-COVID-19 conditions,” which the Centers for Disease Control and Prevention (CDC) describes as a “wide range of ongoing health problems” that can “last more than four weeks or even months after infection.”During the study, 6% of the participants (3,752 people) reported testing positive for COVID and about 44% of them said they experienced long COVID symptoms, such as lingering fatigue, problems with their taste or smell, shortness of breath, brain fog, and memory issues. All of the emotional states listed above were associated with a greater risk of long COVID—between 32% to 46%—but people who had “high levels” of two or more types of psychological distress before their infection had a nearly 50% higher risk of long COVID compared to those who did not feel a significant dip in their mood.“These results really reinforce the importance of mental health,” Erica Cotton, PsyD, a psychologist with the Northwestern Medicine Comprehensive COVID-19 Center who was not directly involved with the study, tells SELF. Having a greater awareness of this potential link may help doctors correctly diagnose people and appropriately treat them after symptoms develop, she adds.The study’s researchers stressed that their findings do not suggest that mental health issues can directly cause long COVID. They also argue that their research does not support theories that say long COVID symptoms are simply psychosomatic.Dr. Cotton says the study’s findings are actually pretty in-line with what experts know about how mental health can contribute to or exacerbate other physical health issues. Psychological distress, for example, has previously been linked to severe symptoms from various respiratory infections, including pneumonia, bronchitis, sinusitis, and the flu. The study authors also note that prior research has found that psychological distress may also be associated with long-term symptoms after a Lyme infection and in chronic conditions, like fibromyalgia, that can present with symptoms similar to long COVID.
There is no clear data on the vaccine’s efficacy in the current monkeypox outbreak since the disease has only been spreading in non-endemic countries since May 2022, and the Jynneos vaccination campaign only recently began in the US. We’ll likely have some more answers on how well the shot’s working sometime next year.How long is too long to wait for the second dose?According to Dr. Gandhi, there’s strong evidence to suggest that spacing out vaccine doses can improve a person’s immune response in the long term. This has even been observed with the COVID vaccines, for example; preliminary evidence suggests that waiting up to 11 or 12 weeks between doses may provide stronger protection than giving the shots three weeks apart. “If you exceed the one-month interval [with the Jynneos vaccine], you’re still fine—in fact, you may be even better off,” Dr. Schaffner says, as long as you eventually complete the full monkeypox vaccination series.So, is there an amount of time that could be too long to wait for the second dose? The short answer is no, according to Dr. Schaffner. This hasn’t been specifically studied in the Jynneos series, but past research strongly reinforces this line of thinking. “We’re really quite confident that even if you go two, five, six, eight months, a year later and you get that second dose, that your immune system—primed by the first dose—will have a really big second-dose response,” Dr. Schaffner says.The FDA also recently decided that the Jynneos vaccine, which was originally approved for subcutaneous (beneath-the-skin) use, can be given intradermally (between layers of skin) and at lower doses. It based that decision, in part, on a 2015 study that found intradermal injections at 1/5th the dose led to a similar immune response compared to those who got the full dose injected into the arm muscle.How to stay safe until you can get your second monkeypox vaccineAll that said, the full two-dose series is needed for optimal protection against monkeypox. “Until you get your second dose, you could assume that maybe you have partial protection, but probably not full protection,” Dr. Gandhi says. Peak protection kicks in about two weeks after you receive the second dose.Monkeypox can spread in various ways, but intimate, prolonged skin-to-skin contact is driving the current outbreak, the CDC says. While you’re waiting for your second dose, the most effective way to lower your risk is to limit intimate or sexual activity, says Dr. Gandhi, or at least be especially cautious about it. Practicing good hand hygiene (which we’re sure you know how to do by now!) and avoiding close skin-to-skin contact with anyone who has a suspected monkeypox rash can also reduce your chances of infection.In the meantime, rest assured that more doses are coming. The US Department of Health and Human Services recently ordered an additional 5.5 million doses of the Jynneos vaccine and public health experts expect them to become available later this year. Because an ample supply of Jynneos doses is on the horizon, public health experts do not expect the country to use the ACAM2000 vaccine. Dr. Schaffner says he’s not even aware of any providers that carry ACAM2000, since it’s associated with adverse effects and is more difficult to administer.Unfortunately, just as experts learned during the height of the COVID pandemic, only time will tell us just how effective the one-dose strategy is. As the monkeypox public health emergency accelerates, health officials say the most prudent thing to do is to make sure vulnerable people have at least some protection against the virus while we wait.Related:
The “journal” doesn’t have to be anything fancy—a paper notebook, an app, or the notes feature on your phone will do. Think about how you feel while wearing a particular outfit, noting specific emotions that come up or your overall mood for the day. Did that blazer make you feel like a powerful force during your work presentation? Did that flowy dress you wore to the beach bring out your free-spirited nature? On the flipside, did a pair of jeans make you feel uncomfortable and kind of insecure? These are all valid feelings to tap into. Additionally, jot down any positive feedback you received from others about your clothes—and how that made you feel. Reviewing your notes can help you spot trends in the type of clothes that bring you pleasure (and help you figure out what you should probably donate).2. Choose colors that excite you.Consider the colors you’re drawn to if you don’t know where to start. “Everyone has a color or two they like,” Dr. Johnson says. If you’re stumped, you can look to the psychology of color, which is somewhat universal, according to Dr. Johnson. For example, the color “Baker-Miller Pink”, which has a bubble gum hue, can have a calming effect6. Want to feel a little more vibrant? Try orange hues, which research shows are stimulating and playful7. For a happy vibe, try yellow7, which is associated with warmth and cheer.All of that said, context is important when it comes to color, Dr. Benkendorf says. In addition to current trends, your memories, family traditions, and personal beliefs can influence how you perceive color8. So even though research says some shades of pink may be calming, you may find the hue repulsive if you associate it with a bad memory. In that case, avoid it!3. Experiment with textures.Wearing your favorite, worn-in cotton T-shirt can feel as inviting as a hug—and there’s a reason for that. The tactile effects of clothing texture can make you feel a particular way. For example, soft fabrics like flannel can put you in a cozy mood,9 while silk can make you feel sensual9. Try wearing clothes made of different materials and pay attention to how you feel in them. Doing so can help you pick the right texture to match the mood you desire.The visual and audible effects of material can affect how you feel, too. For instance, research suggests that visually, satin gives a sophisticated vibe. In contrast, opaque fabrics tend to look sporty. Clothes that make a faint rustling sound, like taffeta, can make a person feel elegant9.Regardless of the fabric you choose, it’s important to feel comfortable. If a particular item feels scratchy or stiff against your skin, then you probably won’t feel very good in it, Dr. Benkendorf says.4. Capture your personality with accessories or undergarments.Research10 shows that you likely try to balance two competing forces when deciding on how you want to present yourself: the desire to fit into a social group and the need to be recognized as an individual, Dr. Johnson explains. You may grapple with balancing the two, for instance, if you wear a uniform or suit to work. Outfits devoid of your personality may not foster any strong positive emotions, but you can inject pizazz with accessories, like a colorful handkerchief or a bold necklace.