How Your Smartphone Is Affecting Your Mental Health

by Bill Nguyen

Smartphones have become embedded in our society, defining our casual and even professional interactions. However, some people fear the mental health implications of smartphones, and thus, rumors are created and spread, regardless of their validity. To clear up any misunderstandings and acknowledge legitimate concerns, listed are various mental health effects of smartphones along with recommended solutions.

Sleep Disruption

Shorter wavelength blue light, released by computer monitors, televisions, and smartphones, confuses one’s circadian rhythm and disrupts sleep if exposed to after sundown.

Solution: Limit smartphone use after dark. An alternative option is downloading a smartphone application that greatly reduces blue light emission. This setting is known as “Night Mode” on Android devices and “Night Shift” on iOS devices.

Distraction

Smartphones often distract their users. This is especially detrimental when considering the implications for health care professionals. One study by Risk Management and Healthcare Policy demonstrated that, when health practitioners are interrupted by their smartphone even once during a patient visit, the chance of the practitioner mischecking or misdiagnosing the patient increases by at least 12%.

Solution: When performing critical tasks, it is best to refrain from using your smartphone. Muting or silencing your smartphone can greatly help with this. Furthermore, during a medical checkup with your provider, feel free to politely ask them to set aside their smartphone.

Impaired Social Interaction

The ease of sending a text message as opposed to talking in-person has led to many individuals (particularly teenagers) sacrificing real-life interactions with virtual ones. This can cause a lack of empathy or trust among those communicating and ultimately disrupts the intimacy many have during physical interactions. In fact, even the presence of a smartphone during interactions can inhibit the closeness of those interactions. Interestingly, teenagers who participate in more social activities tend to have lesser risks of depression and suicide.

Solution: Put your smartphone completely away or hidden when interacting with others. In addition, make the effort to arrange physical meetups with friends and families to preserve intimacy and bonding. Remember the importance of engaging in social activities, such as joining a club or sport.

Addiction

The satisfaction and dopamine acquired from receiving a notification or Facebook “react” is thrilling--and can be addicting. This may lead an individual to constantly crave this sense of fulfillment gained from their smartphone, leading to significant overuse. This can induce all the problems discussed previously, as well as the countless physical health issues not mentioned.

Solution: Set restrictions on smartphone use. These restrictions can take the form of completely turning off your smartphone when not in use or downloading apps that restrict access to the most enduring parts of the phone. Setting your smartphone in a separate room can also help with resisting its use.

 

Sources:

Smartphone Dangers: Could Your Cell Phone Be Bad for Your Health? (OnHealth)

Cellphones and unhealthy side effects (The Washington Times)

Phone Addiction is Real -- And So Are Its Mental Health Risks (Forbes)

Mental Health Of Transgender People Is Under Stress, Study Finds

Diana Feliz Oliva, a 45-year-old transgender woman who grew up outside Fresno, Calif., remembers being bullied when she was younger and feeling confused about her gender identity. She was depressed and fearful about being found out, and she prayed every night for God to take her while she slept.

“I was living in turmoil,” said Oliva, who now works as health program manager in a clinic for transgender people at St. John’s Well Child & Family Center in Los Angeles. “Every morning, I would wake up and I knew I would have to endure another day.”

Oliva’s experience is strikingly consistent with the findings of a new report from UCLA that shows transgender adults in California are more likely to have suicidal thoughts than other adults in the state, and more likely to have attempted suicide.

They are also more likely than their non-transgender peers to face severe psychological distress and to be disabled because of a physical or mental health condition, the report found.

The mental health gap is worrisome because it points to ongoing discrimination and bias, the study’s authors said.

The data — released Tuesday as part of the annual UCLA California Health Interview Survey — highlight health disparities among a marginalized population. The survey, a collaboration between the UCLA Center for Health Policy Research and the Williams Institute at UCLA School of Law, covers demographics, access to health care and health status.

California prohibits discrimination against transgender people in employment, insurance, housing and public accommodations. Williams Institute researcher Bianca Wilson said the UCLA report underscores the need to determine how well these anti-discrimination policies are being implemented throughout the state. Across the nation, 30 states lack similar anti-discrimination laws, according to the study.

“There are also national debates and national policies that impact individual trans folks regardless of where they live in the country,” said Wilson, a senior scholar at the institute. “And on the national front, we still have a lot of work to do.”

Around the country, controversy has raged about transgender bathroom access and military service. The White House order banned transgender troops from serving in the military, but a federal judge on Monday blocked that policy temporarily, finding that it was probably unconstitutional.

“We have made some really great strides, but with this new political administration, people are living with an increased amount of anxiety and depression. Our community is at risk,” said Oliva.

In her late 20s, Oliva moved to Los Angeles, earned money as a sex worker and ended up spending time in jail. That’s when she decided she had better figure out who she truly was and what she wanted. She started her gender transition in her 20s and went to school at Cal State Los Angeles to study social work, eventually earning her master’s at Columbia University in New York.

The UCLA report, she said, is spot on. “Everything that report says is everything I experienced. I have gone through all the barriers and struggles and challenges.”

The data used in the UCLA study were collected in 2015 and 2016. About 92,000 Californians between the ages of 18 and 70 are living with a different gender identity than the one they had at birth, according to the study. Nearly half identify as transgender, while 32 percent identify as female and 7 percent as male. About two-thirds identify as non-Hispanic white — a higher percentage than among other adults. Transgender adults are also less likely to be Latino.

Transgender people differ markedly in sexual orientation from other adults. Just 28 percent of them said they were heterosexual, compared with 93 percent of adults who aren’t transgender.

They have similar levels of education, citizenship and poverty as those who aren’t transgender. They also have similar rates of diabetes and asthma, but higher rates of HIV. The report found that transgender adults have similar health care access overall, but are more likely to delay filling prescriptions made by a doctor — or not get the prescriptions at all.

Stigma and bias likely contribute to the mental health problems among transgender people, said Cecilia Chung, senior director of strategic projects for the Oakland-based Transgender Law Center. Recent prohibitions — including on bathroom access and military service — have created a crisis in the transgender the community, she said.

“Their poor mental health will continue and worsen if our government continues to show hostility toward transgender people,” said Chung, a transgender woman. “The well-being of transgender citizens of our country is not being prioritized.”

More than 20 percent of transgender adults have attempted suicide, compared with about 4 percent of those who are not transgender. And they are over three times more likely to have had suicidal thoughts. One-third of transgender adults suffered serious psychological distress in the past year, compared with 9 percent of those who are not transgender.

Jody Herman, a scholar at the Williams Institute, said the study underscores the need for more training on transgender issues for mental health professionals. The study’s authors also urged more research on the health of the transgender population and of possible solutions to improve their mental and physical well-being.

Chung said she would like to see better answers to explain the differences in mental health — especially given the demographic similarities between transgender and non-transgender populations. “What actually sets them apart in terms of the health outcomes?” she asked. “What is the reason for the higher rates of suicide attempts?”

Oliva said that although she now has a job, insurance and an apartment, she still worries every day about getting physically assaulted for being a transgender woman. “My constant prayer on a daily basis is to make sure I stay alive,” she said.

This story was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.


Republished from California Healthline's Insight. Insight provides an in-depth look at health care issues in and affecting California.

Mental Effects of Sleep Deprivation (and How to Get Better Sleep)

by Bill Nguyen

The average American is notorious for being sleep-deprived. In fact, according to a report released by the Centers for Disease Control and Prevention, 1 in 3 Americans do not get sufficient sleep on a regular basis. Results were based on identifying a healthy sleep duration as seven or more hours per night. But what harm can missing a few hours of nightly winks cause? And what steps can one take to ensure a better night’s rest?

REM sleep is a phase of sleep in which one’s ability to learn and memorize is enhanced. When this period of rest is interrupted or not reached at all, one may experience faltered memory or impaired thinking. This may affect how one functions throughout the day and may stunt productivity, as the person is in a constant state of drowsiness. Effects of sleep-deprivation may also prove lethal. For example, a weary individual may drive comparably (and, in some cases, worse than) someone who is under the influence of alcohol. The National Highway Traffic Safety Administration marks driver fatigue as causing 100,000 motor vehicle accidents and 1,500 deaths every year.

But before solutions for achieving better sleep can be discussed, one must first address the factors contributing to bad sleep. Mental illness may play a paramount role in one’s inability to sleep. Individuals suffering from depression, anxiety, or ADHD may experience regular difficulty sleeping, inducing the aforementioned effects of sleep deprivation. However, a lack of sleep is commonly a result of an individual’s inability to maintain a regular and healthy sleep schedule, oftentimes due to a tight workload or poor time-management skills.

So what can one do to ensure a good night’s rest and avoid the detriments of sleep fatigue? For starters, an individual can greatly reduce their intake of caffeine, alcohol, and nicotine before going to bed as the three substances are infamous for causing restlessness. Eliminating their consumption entirely would be ideal, but a significant reduction in consumption would serve as a viable alternative. For those suffering from anxiety or any form of restlessness, meditation can help clear the mind from intrusive thoughts and allow one to fall asleep comfortably. Furthermore, those with busy schedules or poor time-management skills can reflect upon their situation and create a schedule that will best allow for regular sleep. Exercise can also lead to better sleep as it causes one to fall asleep faster and with fewer interruptions. Additionally, the National Sleep Foundation offers a resource for improving sleep hygiene. However, for those struggling with serious mental disorders or cases of restlessness, medication may be necessary for allowing proper sleep.

Sleep is vital to preserving one’s mental wellbeing. In order to remain healthy and alert, one must aim for at least seven hours of sleep per night (although the exact number varies depending on the individual). An individual struggling from sleep deprivation must take time to thoroughly address their situation, identify steps that can be taken to ensure a better night’s rest, and consider seeking support from a medical professional or psychologist specializing in sleep psychology.

Sources and Further Readings:

Centers for Disease Control and Prevention Report

Harvard University Article on Sleep Deprivation

Lesser-Known Facts on Sleep

National Sleep Foundation Resource

 

ADHD: Dire, yet Severely Misunderstood

By Bill Nguyen

Attention deficit-hyperactivity disorder, often referred to simply as ADD or ADHD, is a neurobehavioral condition that affects how an individual reacts to his or her surroundings. With the disorder being muddled in misconceptions and controversy, it is important to become educated on the legitimate symptoms and treatments of ADHD in order to judge the condition appropriately.

Those struggling with ADHD are commonly characterized as having fragile attention spans and extreme hyperactivity. This two-dimensional image, when coupled with ADHD’s flamboyant portrayal in popular media, leads to a shallow and inaccurate understanding of the disorder. In reality, those diagnosed with ADHD display myriad minute and apparent symptoms, with many of the symptoms notably developing with age. Children with the condition may become easily distracted, possess a tendency to squirm or fidget, have difficulty interacting with other children, or experience slow emotional development. It is a misconception that children with ADHD gradually “lose” their symptoms as they become adults. This is far from the case; as children mature, their symptoms evolve accordingly. Adults with ADHD tend to experience poor time management skills, restlessness, irritability, and an uncontrollable urge to interrupt others. Note that the symptoms displayed by adults directly parallel the symptoms found in children.

Conflict and disagreement persist within the medical community on whether or not ADHD is being overdiagnosed or underdiagnosed. Those arguing the former believe in the inaccuracies surrounding self-reported symptoms, asserting that small irritations are being dramatized or that symptoms are a result of a separate condition entirely. Conversely, those siding with the latter argue that ADHD is being popularly regarded as a fake condition, despite the undeniability of the harm it does to lives. Consequently, people suffering from the disorder are refraining from seeking treatment. The conflict possesses great implications: if individuals are misdiagnosed, they may suffer the side-effects of wrongfully-prescribed medication, but if undiagnosed ADHD victims are not treated, they risk permanently living with the symptoms.

Thus, it is imperative that more in-depth diagnoses are conducted on individuals at risk of ADHD. This would, in turn, mitigate the threat of a misdiagnosis and the harm of having no diagnosis. However, there are many more ways individuals with ADHD can cope with the condition. Organizations like Attention Deficit Disorder Association (ADDA) provide free webinars, online resources, and support groups for people suffering from ADHD.

ADHD is a condition rife in misconceptions and controversy. However, becoming educated on the disorder will allow individuals to make appropriate judgments and not fall victim to stigma and misinformation. With controversy surrounding ADHD brewing, being educated on the disorder is becoming increasingly critical.

Sources and Further Readings:

https://add.org/resources/

https://www.pearsonclinical.com/landing/adhd-resources.html?utm_medium=email&utm_source=ADHD_CLINA15774_12956&utm_campaign=7010N0000003TSW&cmpid=7010N0000003TSW

https://www.pearsonclinical.com/landing/adhd-resources/adhd-in-adults.html

https://www.psychologytoday.com/us/blog/the-distracted-couple/201403/adult-adhd-overdiagnosed-underdiagnosed-or-both

 

UNAIDS Warns - Progress Slowing and Time Running Out to Reach 2020 HIV Targets

New HIV infections are rising in around 50 countries, AIDS-related deaths are not falling fast enough and flat resources are threatening success. Half of all new HIV infections are among key populations and their partners, who are still not getting the services they need
 

PARIS/GENEVA, 18 July 2018—UNAIDS is issuing countries with a stark wake-up call. In a new report, launched today in Paris, France, at an event co-hosted with Coalition PLUS, UNAIDS warns that the global response to HIV is at a precarious point. At the halfway point to the 2020 targets, the report, Miles to go—closing gaps, breaking barriers, righting injustices, warns that the pace of progress is not matching the global ambition. It calls for immediate action to put the world on course to reach critical 2020 targets.

“We are sounding the alarm,” said Michel Sidibé, Executive Director of UNAIDS. “Entire regions are falling behind, the huge gains we made for children are not being sustained, women are still most affected, resources are still not matching political commitments and key populations continue to be ignored. All these elements are halting progress and urgently need to be addressed head-on.”

HIV prevention crisis

Global new HIV infections have declined by just 18% in the past seven years, from 2.2 million in 2010 to 1.8 million in 2017. Although this is nearly half the number of new infections compared to the peak in 1996 (3.4 million), the decline is not quick enough to reach the target of fewer than 500 000 by 2020.
The reduction in new HIV infections has been strongest in the region most affected by HIV, eastern and southern Africa, where new HIV infections have been reduced by 30% since 2010. However, new HIV infections are rising in around 50 countries. In eastern Europe and central Asia the annual number of new HIV infections has doubled, and new HIV infections have increased by more than a quarter in the Middle East and North Africa over the past 20 years.

Treatment scale-up should not be taken for granted

Due to the impact of antiretroviral therapy roll-out, the number of AIDS-related deaths is the lowest this century (940 000), having dropped below 1 million for the first time in 2016. Yet, the current pace of decline is not fast enough to reach the 2020 target of fewer than 500 000 AIDS-related deaths.
In just one year, an additional 2.3 million people were newly accessing treatment. This is the largest annual increase to date, bringing the total number of people on treatment to 21.7 million. Almost 60% of the 36.9 million people living with HIV were on treatment in 2017, an important achievement, but to reach the 30 million target there needs to be an annual increase of 2.8 million people, and there are indications that the rate of scale-up is slowing down.

West and central Africa lagging behind

Just 26% of children and 41% of adults living with HIV had access to treatment in western and central Africa in 2017, compared to 59% of children and 66% of adults in eastern and southern Africa. Since 2010, AIDS-related deaths have fallen by 24% in western and central Africa, compared to a 42% decline in eastern and southern Africa.

Nigeria has more than half (51%) of the HIV burden in the region and there has been little progress in reducing new HIV infections in recent years. New HIV infections declined by only 5% (9000) in seven years (from 179 000 to 170 000) and only one in three people living with HIV is on treatment (33%), although HIV treatment coverage has increased from just 24% two years ago.

Progress for children has slowed

The report shows that the gains made for children are not being sustained. New HIV infections among children have declined by only 8% in the past two years, only half (52%) of all children living with HIV are getting treatment and 110 000 children died of AIDS-related illnesses in 2017. Although 80% of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their child in 2017, an unacceptable 180 000 children acquired HIV during birth or breastfeeding—far away from the target of fewer than 40 000 by the end of 2018.

“One child becoming infected with HIV or one child dying of AIDS is one too many,” said Mr Sidibé. “Ending the AIDS epidemic is not a foregone conclusion and the world needs to heed this wake-up call and kick-start an acceleration plan to reach the targets.”

Key populations account for almost half of all new HIV infections worldwide

The report also shows that key populations are not being considered enough in HIV programming. Key populations and their sexual partners account for 47% of new HIV infections worldwide and 97% of new HIV infections in eastern Europe and central Asia, where one third of new HIV infections are among people who inject drugs.

“The right to health for all is non-negotiable,” said Mr Sidibé. “Sex workers, gay men and other men who have sex with men, prisoners, migrants, refugees and transgender people are more affected by HIV but are still being left out from HIV programmes. More investments are needed in reaching these key populations.”
Half of all sex workers in Eswatini, Lesotho, Malawi, South Africa and Zimbabwe are living with HIV. The risk of acquiring HIV is 13 times higher for female sex workers, 27 times higher among men who have sex with men, 23 times higher among people who inject drugs and 12 times higher for transgender women.

 “Communities are echoing UNAIDS’ call,” said Vincent Pelletier, positive leader and Executive Director of Coalition PLUS. “We need universal access to adapted prevention services, and protection from discrimination. We call upon world leaders to match commitments with funding, in both donor and implementing countries.”

Stigma and discrimination persists

Discrimination by health-care workers, law enforcement, teachers, employers, parents, religious leaders and community members is preventing young people, people living with HIV and key populations from accessing HIV prevention, treatment and other sexual and reproductive health services.

Across 19 countries, one in five people living with HIV responding to surveys reported being denied health care and one in five people living with HIV avoided visiting a health facility for fear of stigma or discrimination related to their HIV status. In five of 13 countries with available data, more than 40% of people said they think that children living with HIV should not be able to attend school with children who are HIV-negative.

New agenda needed to stop violence against women

In 2017, around 58% of all new HIV infections among adults more than 15 years old were among women and 6600 young women between the ages of 15 and 24 years became infected with HIV every week. Increased vulnerability to HIV has been linked to violence. More than one in three women worldwide have experienced physical or sexual violence, often at the hands of their intimate partners.

“Inequality, a lack of empowerment and violence against women are human rights violations and are continuing to fuel new HIV infections,” said Mr Sidibé. “We must not let up in our efforts to address and root out harassment, abuse and violence, whether at home, in the community or in the workplace.”

90–90–90 can and must be achieved

There has been progress towards the 90–90–90 targets. Three quarters (75%) of all people living with HIV now know their HIV status; of the people who know their status, 79% were accessing treatment in 2017, and of the people accessing treatment, 81% had supressed viral loads.

Six countries, Botswana, Cambodia, Denmark, Eswatini, Namibia and the Netherlands, have already reached the 90–90–90 targets and seven more countries are on track. The largest gap is in the first 90; in western and central Africa, for example, only 48% of people living with HIV know their status.

A big year for the response to tuberculosis

There have been gains in treating and diagnosing HIV among people with tuberculosis (TB)—around nine out of 10 people with TB who are diagnosed with HIV are on treatment. However, TB is still the biggest killer of people living with HIV and three out of five people starting HIV treatment are not screened, tested or treated for TB. The United Nations High-Level Meeting on Tuberculosis in September 2018 is an opportunity to bolster momentum around reaching the TB/HIV targets.

The cost of inaction

Around US$ 20.6 billion was available for the AIDS response in 2017—a rise of 8% since 2016 and 80% of the 2020 target set by the United Nations General Assembly. However, there were no significant new commitments and as a result, the one-year rise in resources is unlikely to continue. Achieving the 2020 targets will only be possible if investments from both donor and domestic sources increase.
 
Ways forward

From townships in southern Africa to remote villages in the Amazon to mega-cities in Asia, the dozens of innovations contained within the pages of the report show that collaboration between health systems and individual communities can successfully reduce stigma and discrimination and deliver services to the vast majority of the people who need them the most.

These innovative approaches continue to drive the solutions needed to achieve the 2020 targets. When combination HIV prevention—including condoms and voluntary medical male circumcision—is pursued at scale, population-level declines in new HIV infections are achieved. Oral pre-exposure prophylaxis (PrEP) is having an impact, particularly among key populations. Offering HIV testing and counseling to family members and the sexual partners of people diagnosed with HIV has significantly improved testing access.

Eastern and southern Africa has seen significant domestic and international investments coupled with strong political commitment and community engagement and is showing significant progress in achieving the 2020 targets.

“For every challenge, there is a solution,” said Mr. Sidibé. “It is the responsibility of political leaders, national governments, and the international community to make sufficient financial investments and establish the legal and policy environments needed to bring the work of innovators to the global scale. Doing so will create the momentum needed to reach the targets by 2020.”

In 2017, an estimated: 

  • 36.9 million [31.1 million–43.9 million] people globally were living with HIV
  • 21.7 million [19.1 million–22.6 million] people were accessing treatment
  • 1.8 million [1.4 million–2.4 million] people became newly infected with HIV
  • 940,000 [670,000–1.3 million] people died from AIDS-related illnesses

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030. Learn more at unaids.org and connect with us on FacebookTwitterInstagram and YouTube.  

CONTACT

UNAIDS Geneva: Sophie Barton-Knott
Tel: +41 22 791 1697
bartonknotts@unaids.org

Developing and Funding Your Great Research Ideas

Academic, discipline-based research is key to the research institute's mission. Of note, research is increasingly accessing expertise of multidisciplinary collaborative groups. Team science is the collaborative effort that addresses a scientific challenge while leveraging the strengths and expertise of professionals trained in different fields. Any member of IBHRI may propose the formation of a new research project. Individuals who would like to establish a new project should convey their interest to the Board President and Vice-President.

The Proposal

Begin with a Project Summary (or Abstract) and Specific Aims. Identify yourself as the lead research scientist and be certain to include the title of the proposed research project. The Project Summary/Abstract should be a brief paragraph (200 to 250-words) that describes the research question(s), the anticipated approach to answer the questions, and overall focus and intent of the proposed research project.

The Specific Aims page should be no more than one page (single spaced) and should detail the objectives of your planned research project. You should be able to accomplish your objectives within a reasonable period of time. Start with an emphasis on the significance of the project and how it will move the field forward. Then, focus on generating experiments with clear endpoints that can be readily assessed. Limit your project to a few specific aims (objectives) and keep your project manageable.

Some researchers begin with their Specific Aims and then develop a hypothesis. Others do the reverse. Use the approach that works for you and your project. Each specific aim should be tied to a hypothesis that you have about the research questions addressed in your abstract (and restated in your specific aims document). The proposal should be specific enough to allow potential research scientist partners to make educated judgments about scientific merit and whether or not to join the effort. Remember that at this stage, it is only a draft. It will continue to be worked through. 

Research at IBHRI

The Integrative Behavioral Health Research Institute (IBHRI) is a tax-exempt 501(c)(3) organization. The purpose of the Institute's empirically-driven research on a variety of behavioral health topics is to help key stakeholders in society - policymakers, media, nonprofit organizations, and the public at large - make decisions about programs, services, policies, and the field at large. As documented in our bylaws, our activities are funded through grants and individual donations. Research scientists with a proposed project should proactively seek appropriate funding and request a budget that sufficiently supports the activities of the research project. 

Additionally, IBHRI is seeking opportunities to partner strategically with funders who share our commitment to impartial research and data that drives discussion and improvement in the health and behavioral health fields. Board members are supportive of research scientists' efforts and may provide support with identifying funders. Also, a number of resources are available online for identifying entities that provide support for research. As a research scientist seeking funding for your work, consider that a major barrier to collaborative research activities is the lack of funding to support the required infrastructure for multi-site studies. Thus, identifying individuals, institutions, or foundations that offer infrastructure support for collaborative studies will ensure that your multi-site, team science study is appropriately funded. 

While a number of funding opportunities may be available, they are extremely competitive. It is essential to have thought through the significance of the study, the impact it will make in the field, the team of investigators, and the approach (including your timeline) that will be taken in the endeavor.

For more information, please contact a board member or fellow research scientist at IBHRI.