But the main concern for clinicians and school administrators, and community leaders after the Sept. 10, 2025, university killing of Charlie Kirk isn’t whether trauma will appear, because it will, but how to minimize PTSD development while supporting long-term recovery.

Who is at risk?

The extent of trauma exposure determines PTSD risk levels because it depends on how close people were to the event and how intense and significant the experience was for them. Someone doesn’t need to be at an event to suffer, and I would suspect that some are still suffering the effects of viewing the events in Ohio, where students were killed by National Guardsmen.

A survey of 10,000 U.S. adults indicated that 7% of participants had experienced a mass shooting firsthand and 2% had suffered physical injuries during such incidents. The research, however, suggests that younger people face greater danger than older individuals and that exposure rates differ between male and female participants and even between different racial groups.

The numbers would seem to advise that individuals should receive screening tests following major public violence incidents. How we would do that and how far-reaching it would need to be is the question. Barring such monitoring means that people will suffer with the disorder in silence because they will not be in the pool being assessed for it. In fact, they may not even know that they are experiencing vicarious PTSD.

It’s not a question of being at the spot of the trauma. The study and conclusions underscore the danger of viewing violent events through the media multiple times, which can lead to stress symptoms. Experts are expressing a concern that gun-violence exposure affects two-thirds of U.S. adults through direct contact and media exposure, while demonstrating significant racial and gender differences. They believe that research is proving that media violence exposure can cause psychological damage to students who frequently watch violent video clips.

Even the professionals who help others should expect to develop secondary traumatic stress, too, according to clinicians. The 2025 research study about therapists working through mass violence events showed that their burnout and distress levels rose because of their work with grieving clients, which created an impact that weakened the essential recovery workforce.

What should the immediate response look like?

The initial response period focuses on establishing safety while providing stabilization, practical help, and emotional connection rather than forcing people to deal with the traumatic event. The National Child Traumatic Stress Network (NCTSN) and National Center for PTSD provide field guides that support Psychological First Aid (PFA) as the evidence-based approach for handling disasters and violent situations. The PFA-Schools model from the National Child Traumatic Stress Network (NCTSN) helps schools to provide the Psychological First Aid program to their students and staff members who experienced the event directly or are mourning its loss.

Multiple guidelines and summarized reviews demonstrate that mandatory psychological debriefing for unscreened groups should be avoided because it produces no PTSD prevention and potentially creates additional symptoms in some individuals. The evidence shows that this approach fails to stop PTSD development and actually may create additional symptoms in particular cases. The recommended approach involves a stepped care model, which involves normalizing typical responses while conducting ongoing screenings to direct affected individuals to trauma-focused treatment when their symptoms persist and cause impairment.

A 2025 SAMHSA roadmap provides universities with operational trauma-sensitive approaches to handle mass violence through memorial services and anniversary management, spiritual leader support, and mental health emergency response planning. The combination of academic requirements, public service obligations, and ceremonial activities in universities makes this approach particularly important for their settings.

Screening, timing, and differential trajectories

Not everyone who experiences traumatic events will develop PTSD. Most individuals go through short-term stress reactions that resolve within a few weeks. The first step in evidence-based treatment involves specific screening tests conducted at two to four weeks and again at six to eight weeks for those with high levels of exposure, using the PTSD Checklist for DSM-5 for self-assessment and the Clinician-Administered PTSD Scale for diagnostic interviews. These tools are standard in clinical practice because they have strong psychometric properties and include updated guidelines for healthcare providers.

The assessment process should focus closely on students and staff members who have experienced past trauma, lack social support, and face ongoing threats at the exact location. It should also consider those showing functional problems such as classroom panic, sleep disturbances, and campus avoidance. Supervisors of providers, too, need to monitor their workloads and offer structured supervision to prevent secondary traumatic stress from developing in their staff members.

The 2025 American Psychological Association (APA) guideline identifies individual trauma-focused psychotherapies as the first-line treatments for patients. The recommended first-line treatments for adults with PTSD symptoms include Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), and Eye-Movement Desensitization and Reprocessing (EMDR). The most successful protocol is highly dependent on the individual’s needs and ability to respond. There is no one-size-fits-all here, as in anything else.

The primary treatment for early intervention may not be medication, but it serves as a secondary option. Clinical practice guidelines support using specific SSRIs/SNRIs for PTSD patients who can’t access psychotherapy or refuse it, or who need additional treatment. Still, there is no solid evidence for using these medications as a preventive measure after trauma, and propranolol has not been viewed as standard prevention.

The most effective school-based interventions for children and adolescents who attend college part-time (dual-enrollment students and teen attendees) involve family-inclusive CBT approaches. Debriefing of young people is strictly prohibited under current guidelines.

Communal grief and polarization

The act of public assassination creates dual effects on trauma responses because it combines moral harm with political affiliation. The clinical presentation of patients includes anger, cynicism, and withdrawal behavior when they experience hostile online interactions. Research on collective and occupational trauma shows that structured peer support, together with clear institutional values and guided meaning-making processes, helps reduce distress among professionals who work with trauma victims. Universities should implement transparent safety updates, low-stimulation memorial areas, and voluntary small-group support sessions with trained facilitators, rather than conducting large-scale “processing” events.

There are steps outlining practical actions that universities and mental health professionals should take. What are the researchers and the professionals recommending? Here is a preliminary list:

1) Map exposure tiers. The assessment process should identify three groups of people: those who experienced the event directly, those who witnessed it from a distance, and first responders, family members, friends, and staff members who faced high exposure. The outreach process should use specific approaches instead of sending general invitations to all people.

2) Establish PFA (psychological first aid) services, which should become available within 24 to 72 hours after the event. The program should provide quiet spaces, assistance with transportation and housing adjustments, and educational materials about typical reactions and resources.

3) Screen and proceed. The PCL-5 screening tool should be administered to exposed groups between 2 and 4 weeks after the event, followed by referrals to PE, CPT, or EMDR therapy with trained therapists for those experiencing persistent impairment. The CAPS-5 functions as a diagnostic tool for both standard and complex cases.

4) The practice of mandatory debriefing sessions should be avoided, and the organization should replace single-session “venting” events with brief skills-based support sessions. These programs teach breathing techniques, sleep hygiene, and grounding methods, and establish clear paths to therapy access.

5) Support the helpers. The organization should establish monitoring systems that provide clinicians and staff members with supervision to prevent secondary traumatic stress and burnout.

6) Plan for anniversaries. The team should prepare for increased symptoms during the first month and first year after the event by scheduling communication plans, memorial services, and clinical support services.

The treatment of survivors who witness public killings requires more than one established protocol to reduce their suffering. The past ten years of PTSD research give universities, clinicians, and communities clear guidance: first, stabilize patients; then, conduct careful screening; and finally, apply trauma-focused treatment when necessary, while avoiding ineffective methods. Combining disciplined compassion with evidence-based practices helps survivors heal, supports helpers in maintaining their endurance, and allows communities to remember without being overwhelmed by it.

We are living in a world that is transformed from that of our parents, and we must adapt to this change. It is unlikely that there will be a cessation of community violence, given the widespread rhetoric that appears to underpin much of it. What can we do? Provide fact over fiction, utilize our critical thinking skills, and maintain our sense of hopefulness.

The post The Trauma of Witnessing Charlie Kirk’s Murder and PTSD appeared first on Medika Life.

In what ways might art therapy be utilized?

Art therapy is a versatile approach that does not necessitate high levels of artistic ability. Each patient’s demands will determine the art medium used in therapy.

Intentionally exposing you to non-traditional art materials (such as tree branches and leaves) may let you express yourself more fully. Doodling, abstract designs, and contour drawing are all ways to experiment with new ways of expressing yourself.

If you think doodling isn’t helpful, consider the famous doodlers: Samuel Beckett; the poet and physician John Keats, who doodled in the margins of his medical notes; Sylvia Plath; and the Nobel laureate (in literature, 1913) poet Rabindranath Tagore. Doodling was typical among US Presidents, including Thomas Jefferson, John Quincy Adams, and John F. Kennedy.

One of the most famous doodlers of all time was Leonardo da Vinci, who made copious notes and doodles in the margins of his notebooks. Just like the rest of us, Leonardo doodled and scribbled: you can see it in his digitized notebooks. But the prototypical Renaissance man, both unsurprisingly and characteristically, took that scribbling and doodling to a higher level entirely. His margin notes and sketches are not only elegant but also reveal his early insights into important subjects.

Doodling can help you process and visualize things. It may, unintentionally spark some creativity that you didn’t realize you possessed. Don’t feel the need to be another Leonardo; this activity is about reducing stress, not adding to it by feeling competitive.

Depending on your requirements, art therapists can guide you in a form of creative expression. But even if you aren’t working with an art therapist, using art yourself can prove a stress reducer.

In research studies utilizing art therapy, there was less burnout and reduced work dissatisfaction among the study’s participants. Those who took part in the creative arts therapy program saw reductions of 28% in anxiety, 36% in depression, 26% in PTSD, and 12% in emotional tiredness as a result of burnout. These enhancements persisted for a full year following the program’s end. The use of art therapy has also been seen to help healthcare professionals deal with their experiences of burnout.

But while we know that art therapy works, how does it work in the brain? Researchers are posing this question and hope to answer it. One answer seems to be that it has the power to stimulate the activation of various brain areas that may be involved in perception and emotion.

Modern imaging techniques have improved our understanding of the many brain regions and functions involved in processing information. Stimulating the senses is the most fundamental level of intervention using art mediums.

The visual information processing system’s ventral and dorsal branches handle visual feature recognition and spatial placement. Mood-state drawings capture the variations in brain region activation accompanying distinct emotional states. Art therapy provides an opportunity to work with fundamental sensory components for processing information and emotions. Even the most basic kinds of expression could provide a window into the brain’s anatomy. It is an exciting opportunity for mental health and all forms of mental functioning.

But other than imaging, one other means of measuring stress is via the stress hormone cortisol levels in saliva. The biological basis of creative self-expression has been the subject of ongoing investigations. Salivary cortisol has been studied as a noninvasive biomarker and a surrogate for human stress experience.

No matter the participant’s demographics, level of art experience, or preferred medium, the results show that even a short art-making experience can have a physiological effect on cortisol levels. The importance of this cannot be overstated, since we know that cortisol can be destructive at relatively consistently high levels. Research has shown that it can be involved in tissue damage.

Expressive writing has been associated with health benefits and reduced stress levels over the long run. There is some evidence that creative expression, such as through music or painting, can have a beneficial influence on physiological and mental health, similar to the effects of expressive writing.

An interesting aspect of writing is when you use cursive form rather than a computer or a typewriter. We know that many famous writers have produced their first drafts by hand on legal tablets. However, not many of them realized that the very fact of moving their hand to produce letters and words has an important effect on their brain’s activities in areas where creativity may be sparked.

Cursive writing should never be dismissed as an antiquated form of writing and should be included in your life and the education of children, as I have noted in previous articles I have written on medium. So, get a line or online journal for yourself and begin this excellent doodling adventure or cursive writing exercises. Either one will benefit you.

Research has made the case for using art therapy, in any form, to assuage stress levels and improve mental and physical health. No matter the means used, individuals can benefit from anything from writing to music to any form of art, such as painting, sculpting, or working with other mediums.

It is now up to each of us to decide which form is most appropriate for us as a stress-reduction method, and although professionals are available in the area of our therapy, that is not a mandate for us. We can begin our own form of therapy at any time we wish.

The post Fire Up the Power of Art Therapies Against Stress and Help Yourself appeared first on Medika Life.

Research over the years has shown the war’s far-reaching and current effects on those involved in war-torn areas. Living in conflict areas, being subjected to warfare, and being forced to migrate have all been repeatedly linked to increased dangers to one’s physical and mental health. Being in a combat zone has direct implications that can include physical harm, disease, psychological anguish, and even death. One of the most common and crippling effects is post-traumatic stress disorder (PTSD). In Kosovo, Iraq, and Lebanon, 87–97.5% of children affected by war have been reported to have PTSD.

How could children and adults not be so seriously affected? They can’t, and therein lie the issues that must be addressed now, not in the future when these disorders all manifest themselves.

Once the outbreak of war in Ukraine began, one study of Polish children had troubling results. According to the findings, children who are not directly involved in the conflict may also experience mental health issues. Polish youngsters had far greater rates of emotional difficulties and low self-esteem in the early months after the war began and in the early phases of the present refugee crisis. In addition, it seemed that the amount of time that had passed since the conflict began had an impact on how one saw the world and oneself.

Therefore, it’s not simply how they view the war, but themselves and their self-esteem and confidence. This corrosive effect needs attention immediately, but how do you do that while a war is still in progress? There are no simple answers, but aren’t some answers better than denying the existence of difficulties for these children?

The war in Gaza hasn’t resulted in the deaths of “civilians,” but of troubling numbers of children and created hoards of orphans who have had their parents killed in the bombing. How will they cope as they are moved as refugees without protection, perhaps to lands with foreign languages and cultures where they don’t fit in? We are looking at one or two generations that will be seriously impacted mentally by what they’ve seen and to which they have been exposed.

One thing I learned when I did intake interviews with children of Holocaust survivors was that no one wanted to talk about the horrors they’d experienced. But the mental effects were there despite this tendency to secrecy or to “forget” it all. Even when children wanted to understand and talk about it, they were shut down quickly or referred to others in the family who, similarly, refused to discuss it. They tried to seal the scar over with silence, and their children experienced the results of these efforts.

I only met one older woman who proudly discussed her experiences as a resistance fighter in France during WWII and how they killed Nazis with guns they’d never used before. She made it her mission to not only write a book about it but to travel to schools to give lectures and to try to provide answers to difficult questions.

Even children not exposed directly to war will need help in their psychological reaction to what they’ve seen or heard. Sitting safely in the United States will not ensure that they are untouched because we know that PTSD, surprisingly, can arise as a result of tangential exposure. UNICEF has eight suggestions for parents seeking guidance:

1. Find out what they know and how they feel
   Choose a time and place when you can bring it up naturally, and your child is more likely to feel comfortable talking freely, such as during a family meal. Try to avoid talking about the topic just before bedtime.
2. Keep it calm and age-appropriate. Use age-appropriate language, watch their reactions, and be sensitive to their level of anxiety.
3. Spread compassion, not stigma. Remind your children that everyone deserves to be safe at school and in society. Bullying and discrimination is always wrong and we should each do our part to spread kindness and support each other.
4. Focus on the helpers. It’s important for children to know that people are helping each other with acts of courage and kindness. Find positive stories, such as the first responders assisting people, or young people calling for peace.
5. Close conversations with care. It’s important to make sure that you are not leaving your child in a state of distress. Try to assess their level of anxiety by watching their body language, considering whether they’re using their usual tone of voice and watching their breathing.
6. Continue to check in. Continue to check in with your child to see how they’re doing. How are they feeling? Do they have any new questions or things they would like to talk about with you?
7. Limit the flood of news. Be mindful of how exposed your children are to the news while it’s full of alarming headlines and upsetting images. Consider switching off the news around younger children.
8. Take care of yourself. You’ll be able to help your kids better if you’re coping, too. Children will pick up on your own response to the news, so it helps them to know that you are calm and in control.

These are all good suggestions, and I would suggest you read the full page in order to get the full benefit of everything they are recommending. Our children are precious, and we must do what we can to help them in these times of serious crisis.

The post War Tears Children Apart in Invisible, Prolonged Ways Into Their Futures appeared first on Medika Life.

Some of you will talk about tucking under desks or lining up against walls for nuclear attack practice. Families with money and houses built bomb shelters in their back yards. Black and yellow signs on buildings and subways pointed to bomb shelter areas.

We took home large posters from my school that gave detailed illustrations regarding protecting ourselves if Russia attacked with an atom bomb. Yes, it was Russia even then.

We were all issued dog tags with our name, birthdate, and religion on them and always instructed to wear them around our necks. It never occurred to me that they would use it for identifying my dead body in the event of an attack. After all these years, I have no idea where mine is, but I remember wearing them.

Those were upsetting times that students tried to see as common as fire drills, but they weren’t; it was preparation for destruction, disappearing in a flash. We had so little concern (forget any fear) because our teachers modeled the calm behavior that we then incorporated into our thinking. If they weren’t afraid, why should we be, was our attitude. No parents in my neighborhood ever brought up the topic and dutifully hung up the posters as though they were artwork.

No one talked to us about death and destruction, only that we were expected to act a certain way and things would be OK. But, if they were going to be “OK,” why did we need those dog tags or the posters? The question never entered our minds, seemingly.

How many of you sat in your living room with all the drapes drawn, daring not to whisper a word as the local air raid warden made rounds? As a very young child, my family did, and I can still recall, what it was like to have a rudimentary, pump-action fire extinguisher in the hallway outside our apartment in a poorly constructed wooden building. Ironically, the “fire extinguisher” never contained water.

The invasion in Ukraine is disturbing to us adults, but for the children, what is it, and how will it affect them? I heard one little boy on TV say, “They’re going to kill us.” The saying we often use is only the strong survive, but overt survival doesn’t tell the deeper story and any damage done.

Incredibly, some research points toward children being more resistant to after-war effects. “Yet many practitioners recognized that even amidst armed conflicts or recent mass displacement, children and adolescents exhibit agency that is an important resource for coping, adjustment, and resilience.”

But as opposed to wars in the past where the military were the primary targets, wars now are considered low intensity where “under these…circumstances civilians, including children, as well as the infrastructure of the society become targets.” The entire social fabric of society is damaged in its entirety, leaving some of the citizens terrorized. How will this affect the future of that generation and the generation they are raising?

Exposure to war violence is viewed as intergenerational, and its effects may play out in many areas; violence, mental health issues, and physical health. Children enmeshed in the turbulence of a war zone may be desensitized or immune to violence. Can anyone dare to predict how they will be affected?

Much of the research has mentioned PTSD, primarily in domestic situations, but there is a lack of longitudinal study with children and war experiences at this point. We know trauma can affect brain development, and we might conclude that these children could have stunted growth in some areas of their brains, personalities, and ability to relate to others.

Right now, what would seem to be the one thing that may be most helpful for children in these situations? I think it might be what it was during our atom bomb drills; parental reassurance and support, as well as teachers who model appropriate behavior and provide extra help when needed.

We can’t stop unconscionable, murderous dictators, who are more criminal than politicians, but we can help our kids and adults. Continuing to plan for a more promising future, maintaining close social connections, and caring for each other are three means to a brighter future.

Holding a position of hope is one power we retain in the direst of situations.

The post War Leaves a Tormenting Stain on Children’s Minds and Forges Life Changes? appeared first on Medika Life.

We serve no worthwhile purpose when we slander anyone, least of those sworn to protect us. Yes, I know I may be accused of being too pro-police because I have many law enforcement relatives, but I am a citizen who views the problems from a professional standpoint. I hope I can be unbiased, and I have tried my best, as all of us, to try to clarify some factors contributing to this bloodshed.

I can’t imagine what it must be like to be a POC in this country and have teenage boys in the family who, indeed, must feel targeted for arrest or worse for nothing more than a broken taillight on a car or jogging on a road in broad daylight.

The questions of mental illness and auditory hallucinations are not at issue here because neither was involved in the killing of Ahmaud Arbery. His death was precipitated by his jogging in an area where there had been recent criminal activity. If a neighbor were thinking “citizen’s arrest,” would he have needed the firepower he carried with him? In this death, the police were not involved.

The town where I live asked me to provide a few classes for their officers regarding dealing with persons with mental illness. I quickly discovered that the police officers were similar to the security personnel at a psychiatric hospital where I had worked; they bought into the myths about mental illness.

Many of you have probably heard the myth about how powerful someone with such an illness can be and how dangerous. It is endemic in our culture, and we need to address it because people are endangered by it. Studies have shown that a lack of training and procedures can result in a self-fulfilling prophesy of mental illness and dangerousness.

“…departments lack written policies and procedures for management of persons with mental illness. The lack of education, training, policies, and procedures has a tendency to cause line officers to respond improperly. Instead of approaching the call as a person with an illness, oftentimes police officers will approach as though the patient is a dangerous felon.” When we combine all the myths, especially those where people believe the mentally ill have super strength, the result can be a tragedy.

I recall a young, immature, and almost seven-feet-tall patient on a unit where I worked. He thought it was great fun to tell tall tales about hiding alcohol on the grounds. Unfortunately, he “acted up” on the unit, and the security team was called in. These men have previously worked in law enforcement locally or in the military. Four men jumped on top of him and pulled him to the ground, where the skirmish resulted in one officer having a broken finger and another a severely sprained wrist.

They put shackles and handcuffs on him and pushed him into a grounds’ car to take him to the police station, where they pressed charges of assault against him. He was a young kid who laughed through the entire “fight,” viewing it as fun rather than fear on their part. He hadn’t attacked them; it was the other way around, but he was charged.

Another factor that may play a significant role in irrational police actions of any type may be the stress of the job, which can lead to depression and affect their work. But, along with the stress comes preexisting bias and racism; we cannot deny that.

Police culture has also played a role in how the officers respond to a situation involving a mentally ill person. We have already seen that there may be inadequate training regarding these interactions, but how much has been researched regarding the inherent fear of officers?

The stigma in the culture of the police workplace prohibits any display of what may be seen as fear. But aren’t all of us vulnerable to fear, especially when placed in a perceived life-and-death situation? Doesn’t our adrenaline kick in when danger is apparent?

Police officers are not immune to this natural, biological response. Their ability to control the reaction determines the situation’s outcome. But how many are willing to tell others of their fear? They are also victims of stigma, but here it is of appearing fearful in any situation.

The work of the police is essential, but their humanity must also be important. Just as the military has had to deal with mental health issues, such as PTSD, anxiety, and depression, police officers must be seen in this enlightened light.

The post Police Unreasonable Fear May Be Deadlier Than Racism appeared first on Medika Life.

We know police officers have three things they may share with those who wish to end their misery; high rates of suicide, substance abuse disorders, and marital difficulties. Mental health disorders do not disappear once a uniform is donned. The nature of the job brings them into contact with trauma on a daily, weekly, and monthly basis. It is not a job for the faint of heart.

A review of research over the past 20 years on those who choose to commit suicide by cop indicates that the typical perpetrator is a younger white male experiencing romantic relationship conflicts. There is also a significant mental health and criminal history.

The individual is often intoxicated at the time of the incident and is mentally impaired in their ability to recognize what they are pursuing. The most effective interventions by police are expected to be limited to verbal interactions related to the individual’s presenting problems. It’s a process of understanding and going slow. But there’s something more than an attempt at suicide here.

An important aspect of suicide by cops which cannot be ignored is the long-term effects of these types of situations for the police involved, who may experience a level of PTSD not previously explored. And let’s not forget that the incident may happen in a shool where the individual has many students who can be victims which escalates the deadliness of the situation.

In fact, school shootings have become endemic in our 21 Century culture with the ease of obtaining deadly weapons and protective gear. The number of students exposed to school gun violence since the killings at Columbine is an astounding 278,000 at 298 schools. How many of those kids will go on to have lives seriously affected by these shootings?

We know that the police incidence of PTSD related to violence in their line of work is also of great concern. “Approximately 15% of the police officers in the U.S. and globally experience symptoms of PTSD. Numbers can be much higher based on exposure, such as after natural disasters or tragedies like 9/11.”

But one other factor here is the fact that not all police personnel will report their difficulties or seek counseling, fearing it will affect their careers or how they are seen by others. We see the same reluctance to seek help in the military and healthcare professions. The numbers may be quite conservative.

Whether the shooters intended to kill as many victims as possible and, in the process, go out in a blaze of police gunfire is immaterial. The fact remains that mental health issues are becoming a serious concern for police, school safety officers, school administrators, teachers and ancillary school personnel. Anyone is fair game in these shootings and some will be collateral damage of stray bullets in the foray.

How many kids are, realistically, expressing a reluctance or refusal to go to school fearing they may be killed? This is no longer the attachment problems or school concerns we used to see. These kids are terrified and yet we expect them to return to a school where perhaps nothing happened, but they know all about the schools where kids and teachers were killed.

The danger isn’t necessarily from someone who comes into the school; they’re fellow students. Not even the metal detectors (and not all schools have them) are reassurance. Guns aren’t always the weapons used, as we’ve seen in other countries where knives and hammers have been used to harm or kill children.

The kids in Oxford, Michigan had been hearing of concerns about danger and it wasn’t just a silly fantasy, students died. When a ten-year-old boy tells his mother he doesn’t want to go to school and he’s seen the school psychologist once (did the psychologist think that was enough?), what does a parent do? Kids are asking who’s next? One survey found 91% of teachers are stressed.

Will home schooling become more prevalent as little is done to control the killings in schools by controlling their access to guns or treatment for their mental health problems? How many schools have a full-time school nurse available, much less a psychologist or other counselor? The need increase while the access decreases.

The generation growing up now will be in a world very different from the one we knew. Walking to school has already become unacceptable, going to a school wearing a bulletproof backpack may be suggested and school shooting drills will replace the nuclear bomb ones of the 1950s. Now, however, the fear is real, not a world away, but only a classroom away.

Our kids and our police need our support and our help in more ways than we currently know. How can each of us help? The question is vital and we must include it in discussions at school and in our homes.

The post Suicide by Cop Results in Shared Pain and Mental Illness appeared first on Medika Life.

US maternal morbidity and mortality are now a hot topic. Physicians and nurse leaders across the country are focused. Few are talking about the disparity in care and attention to maternal mental health. I saw an opportunity to make a difference.

A nurse on a mission

When I started this journey to address the mental health of the moms in our community, a well-respected physician with deep roots in community service told me I was asking the right questions but did not have the answers. He said, “you can’t fix a problem until you understand it.” He was right!

The disconnect between obstetric care and behavioral health specialists was rampant. The availability of resources to the uninsured and those on Medicaid was limited and poorly organized. One in seven women suffers from postpartum depression. Almost half go undiagnosed and untreated. We could no longer offer excuses for ignoring this issue.

With a team of nurses and physician supporters, we set out to build a program to identify women at risk for mood and anxiety disorders in the perinatal period. While still a work in progress, we have an excellent basis for families to get the help they need.

We want women to know that they are not alone.

Help is available to get them through the dark.

Postpartum depression can occur anytime

Postpartum depression is a misnomer. Perinatal mood and anxiety disorders can occur anytime from conception to one year after the delivery of a baby. These disorders are quite distinct from the baby blues.

The Baby blues are a common issue occurring in 50–80% of women and peaks between postpartum days 2–14. The baby blues are related to fluctuating hormones and lack of sleep. Although new moms are concerned when they openly sob at a TV commercial, baby blues will resolve without treatment.

Perinatal depression is much darker and debilitating. A mom feels unable to function for an extended period. Women need to know that when certain symptoms are present, it is time to talk to someone.

These include: crying spells, feeling sad, feelings of hopelessness, and feeling guilty. Some may express a lack of happiness or feel the absence of bonding with the baby. Some may have feelings of hurt yourself or your baby. All of these symptoms indicate it is time to seek medical attention.

Help is here. You are not alone.

Moms negative thoughts prevent the help she needs

Shame, guilt, and feelings of inadequacy prevent moms from reaching out for help. Moms fear judgment. They wonder “what is wrong with me” for not feeling blissful over the birth of their child. They fear their family will judge them. Others fear they may lose their baby if they express their true feelings out loud.

Some moms have intrusive thoughts. She becomes afraid of them. She needs to know that negative thoughts do not necessarily equal behavior. Help is available to manage these thoughts.

We want moms to know we want to take care of her. We want to see her with a happy, healthy family. Our goal is to help her succeed. We do not want women to be afraid to speak out and ask for help. We should be as comfortable talking about depression and anxiety disorders as we are about other pregnancy complications such as gestational diabetes or pre-eclampsia.

Moms life is at stake

Suicide is the leading cause of death of new mothers in the first year postpartum. Infants of mothers suffering from perinatal depression are at increased risk for impaired development, poor communication skills, and future mental health problems. Perinatal depression is not a woman’s problem. It is a family problem. Everyone suffers. We must help women feel safe to come forward and get the help they deserve. Every life matters.

Depression is just the tip of the iceberg

Perinatal anxiety is another important aspect of mental health for new moms. Anxiety is something we have historically written off as “normal” for a parent. Most moms worry over their children, their husbands, and their homes.

However, for those with an anxiety disorder, worry becomes consuming and all-encompassing. Panic attacks may be frequent, leaving mom to feel she has no control.

Panic attacks can be terrifying because of the physical symptoms that occur, racing heart, sweating, chills, and chest pain. These symptoms lead to a constant sense of doom or failure.

Post Traumatic Stress Disorder can occur after delivery

A woman can experience Post Traumatic Stress Disorder after having a baby. This concept surprises some.

After all, no one’s been to war or been attacked by a stranger. PTSD is real for these mothers and their families. Childbirth does not always go according to plan. The birth may not live up to the expected birth plan she had imagined. The beautiful delivery experience may have turned tragic or life-threatening?

Emotional and mental turmoil is real for a mom who almost died from postpartum hemorrhage or the dad who almost lost his wife.

There is hope for those suffering

Moms and their families need to know that they will get better with help. The type of help needed may be different for everyone. Many benefit from a no-judgment zone support group where a group of moms can get together and talk. Others may benefit from medications to help control symptoms.

Whatever help looks like, the first step is reaching out and communicating your feelings. Available resources include mom groups on social media and in-person counselors, psychiatrists, and community resources for help with job searches, food, and clothing.

You are a priority for us

We are raising the bar and setting high expectations for moms. We hope other hospitals and medical groups will also follow this path.

Implement universal screening programs for perinatal depression and anxiety. Provide education programs to nurses and community physicians.

Provide education during routine prenatal care. Build community support groups through social media. Remove the fear. Help these women come out of the shadows.

Let women suffering from perinatal mood disorders know it is safe to seek the help they deserve.

The post Never Feel Ashamed or Afraid to Speak up About Postpartum Depression appeared first on Medika Life.

Research shows veterans, people with PTSD and their partners, racial minorities and women are at higher risk of developing heart conditions resulting from poor mental health.

Mental health is an important part of overall health and refers to a person’s emotional, psychological, and social well-being. Mental health involves how we think, feel, act, and make choices.

Mental health disorders can be short- or long-term and can interfere with a person’s mood, behavior, thinking, and ability to relate to others. Various studies have shown the impact of trauma, depression, anxiety, and stress on the body, including stress on the heart.^(1-3)

What mental health disorders are related to heart disease?

Some of the most commonly studied mental health disorders associated with heart disease or related risk factors include the following:

• Mood Disorders: People living with mood disorders, such as major depression or bipolar disorder, find that their mood affects both psychological and mental well-being nearly every day for most of the day.
• Anxiety Disorders: People respond to certain objects or situations with fear, dread, or terror. Anxiety disorders include generalized anxiety, social anxiety, panic disorders, and phobias.
• Post-Traumatic Stress Disorder (PTSD): People can experience PTSD after undergoing a traumatic life experience, such as war, natural disaster, or any other serious incident.
• Chronic Stress: People are in a state of uncomfortable emotional stress—accompanied by predictable biochemical, physiological, and behavioral changes—that is constant and persists over an extended period of time.

What is the connection between mental health disorders and heart disease?

A large and growing body of research shows that mental health is associated with risk factors for heart disease before a diagnosis of a mental health disorder and during treatment. These effects can arise both directly, through biological pathways, and indirectly, through risky health behaviors.⁽⁴⁾

People experiencing depression, anxiety, stress, and even PTSD over a long period of time may experience certain physiologic effects on their bodies, such as increased cardiac reactivity (e.g., increased heart rate and blood pressure), reduced blood flow to the heart, and heightened levels of cortisol. Over time, these physiologic effects can lead to calcium buildup in the arteries, metabolic disease, and heart disease.

Evidence shows that mental health disorders—such as depression, anxiety, and PTSD—can develop after cardiac events, including heart failure, stroke, and heart attack.⁽⁴⁾ These disorders can be brought on after an acute heart disease event from factors including pain, fear of death or disability, and financial problems associated with the event.⁽⁵⁾

Some literature notes the impact of medicines used to treat mental health disorders on cardiometabolic disease risk. The use of some anti-psychotic medications has been associated with obesity, insulin resistance, diabetes, heart attacks, atrial fibrillation, stroke, and death.⁽⁶⁾

Mental health disorders such as anxiety and depression may increase the chance of adopting behaviors such as smoking, inactive lifestyle, or failure to take prescribed medications.⁽⁵⁾ This is because people experiencing a mental health disorder may have fewer healthy coping strategies for stressful situations, making it difficult for them to make healthy lifestyle choices to reduce their risk for heart disease.⁽⁴⁾

Who is most at risk from higher rates of heart disease from mental health disorders?

Specific populations, such as the following, show higher rates of heart disease as a result of pre-existing mental health disorders:

• Veterans. Studies found that veterans are at a higher risk for heart disease, mainly due to PTSD as a result of combat.
• Women. Studies exclusively focused on women found that PTSD and depression may have damaging effects on physical health, particularly with increased risk for coronary heart disease (CHD)–related morbidity and mortality.^(7,8)
• Couples with someone who has PTSD. Comparative studies found that couples where one or both partners had PTSD experienced more severe conflict, greater anger, and increased cardiovascular reactivity to conflict discussions than couples where neither partner had PTSD. Anger and physiological stress responses to couple discord might contribute to CHD and heart disease risk within these relationships.^(9,10)
• Racial and ethnic minorities. Studies focused on racial or ethnic minority groups found that depression, stress, and anxiety due to disparities in social determinants of health,⁽¹¹⁾ adverse childhood experiences,⁽¹²⁾ and racism/discrimination⁽¹³⁾ could place certain subpopulations at a higher risk for hypertension, cardiovascular reactivity, heart disease, and poor heart health outcomes.

How to reduce your risk if you fall into one of these categories

Recognize the signs and symptoms of mental health disorders and heart disease. For mental health you can make yourself aware of the following conditions and be on the lookout for any symptoms you may be experiencing.

Anxiety Disorders: People with anxiety disorders respond to certain objects or situations with fear and dread. Anxiety disorders can include obsessive-compulsive disorder, panic disorders, and phobias.

Behavioral Disorders:Behavioral disorders involve a pattern of disruptive behaviors in children that last for at least 6 months and cause problems in school, at home and in social situations. Examples of behavioral disorders include Attention Deficit Hyperactive Disorder (ADHD), Conduct Disorder, and Oppositional-Defiant Disorder (ODD).

Eating Disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Eating disorders can include anorexia, bulimia, and binge eating.

Mental Health and Substance Use Disorders: Mental health problems and substance abuse disorders sometimes occur together.

Mood Disorders: Mood disorders involve persistent feelings of sadness or periods of feeling overly happy, or fluctuating between extreme happiness and extreme sadness. Mood disorders can include depression, bipolar disorder, Seasonal Affective Disorder (SAD), and self-harm.

Obsessive-Compulsive Disorder: If you have OCD, you have repeated, upsetting thoughts called obsessions. You do the same thing over and over again to try to make the thoughts go away. Those repeated actions are called compulsions.

Personality Disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and may cause problems in work, school, or social relationships. Personality disorders can include antisocial personality disorder and borderline personality disorder.

Psychotic Disorders: People with psychotic disorders experience a range of symptoms, including hallucinations and delusions. An example of a psychotic disorder is schizophrenia.

Suicidal Behavior:Suicide causes immeasurable pain, suffering, and loss to individuals, families, and communities nationwide.

Trauma and Stress Related Disorders: Post-traumatic stress disorder (PTSD) can occur after living through or seeing a traumatic event, such as war, a hurricane, rape, physical abuse or a bad accident. PTSD makes you feel stressed and afraid after the danger is over.

Heart Related symptoms to be on the lookout for include

• Chest pain or discomfort that doesn’t go away after a few minutes
• Pain or discomfort in the jaw, neck or back
• Weakness, light-headedness, nausea (feeling sick to your stomach), or a cold sweat.
• Pain or discomfort in the arms or shoulder
• Shortness of breath

If you think that you, or someone you know, is having a heart attack, call 9-1-1 immediately. Lastly, here are a few more things you can address to ensure both your mental and heart health.

• Talk with your health care professionals about potential heart conditions in relation to your mental health disorder and treatment options.
• Know that your family history and genetic factors likely play some role in your risk for heart disease.
• Know which conditions increase the risk of heart disease.
• Maintain a healthy lifestyle. Regular exercise and access to fresh food and a balanced diet are key for both mental and heart health.

References

1. Bremner JD, Campanella C, Khan Z, Shah M, Hammadah M, Wilmot K, et al. Brain correlates of mental stress-induced myocardial ischemia. Psychosom Med 2018;80(6):515–25.
2. Del Gaizo AL, Elhai JD, Weaver TL. Posttraumatic stress disorder, poor physical health and substance use behaviors in a national trauma-exposed sample. Psychiatry Res 2011;188(3):390–5.
3. Sowden GL, Huffman JC. The impact of mental illness on cardiac outcomes: a review for the cardiologist. Int J Cardiol 2009;132(1):30–7.
4. Abed MA, Kloub MI, Moser DK. Anxiety and adverse health outcomes among cardiac patients: a biobehavioral model. J Cardiovasc Nurs 2014;29(4):354–63.
5. Lett HS, Blumenthal JA, Babyak MA, Catellier DJ, Carney RM, Berkman LF, et al. Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction. Health Psychol 2007;26(4):418–27.
6. Olff M, Meewisse ML, Kleber RJ, van der Velden PG, Drogendijk AN, van Amsterdam JG, et al. Tobacco usage interacts with postdisaster psychopathology on circadian salivary cortisol. Int J Psychophysiol 2006;59(3):251–8.
7. Kubzansky LD, Koenen KC, Jones C, Eaton WW. A prospective study of posttraumatic stress disorder symptoms and coronary heart disease in women. Health Psychol 2009;28(1):125–30.
8. Schwartzman JB, Glaus KD. Depression and coronary heart disease in women: implications for clinical practice and research. Prof Psychol Res Pract 2000;31(1):48–57.
9. Caska CM, Smith TW, Renshaw KD, Allen SN, Uchino BN, Birmingham W, et al. Posttraumatic stress disorder and responses to couple conflict: implications for cardiovascular risk. Health Psychol 2014;33(11):1273–80.
10. Troxel WM, DeSantis A, Germain A, Buysse DJ, Matthews KA. Marital conflict and nocturnal blood pressure dipping in military couples. Health Psychol 2017;36(1):31–4.
11. Belgrave FZ, Abrams JA. Reducing disparities and achieving equity in African American women’s health. Am Psychol 2016;71(8):723–33.Lehman BJ, Taylor SE, Kiefe CI, Seeman TE. Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study. Health Psychol 2009;28(3):338–46.
12. Lehman BJ, Taylor SE, Kiefe CI, Seeman TE. Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study. Health Psychol 2009;28(3):338–46.
13. Moody DLB, Chang YF, Pantesco EJ, Darden TM, Lewis TT, Brown C, et al. Everyday discrimination prospectively predicts blood pressure across 10 years in racially/ethnically diverse midlife women: study of women’s health across the nation. Ann Behav Med 2019;53(7):608–20.

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