Category: research news

Cancer patient caregivers deal with significant impact to emotional health

Researchers conclude that caregivers for older patients with advanced cancer are a vulnerable group

The number of informal caregivers who look after older adults with cancer is on the rise. Caregivers could be relatives, partners, or even friends who provide assistance to people in order to help them function. Most older people with cancer live at home and are dependent on informal caregivers for support with their cancer treatment, symptom management, and daily activities. Caregiving itself can also take a toll on a caregiver's own physical and emotional well-being, which makes it important to ensure the proper supports are in place.

Until now, no large study has evaluated whether or not caring for older adults with advanced cancer is linked to caregivers' emotional health or to their quality of life. Recently, researchers studied a group of adults aged 70 or older who had advanced cancer (as well as other challenges). This study used information from older patients with advanced cancer and their caregivers from local oncology practices enrolled in the "Improving Communication in Older Cancer Patients and Their Caregivers" study conducted through the University of Rochester National Cancer Institute Community Oncology Research Program Research Base between October 2014 and April 2017. Results from the study were published in the Journal of the American Geriatrics Society.

Cancer patient caregivers deal with impact to emotional and physical health

The researchers learned that the health problems of older patients with cancer were linked to a poorer quality of life for their caregivers, including poorer emotional health. This fact is confirmed by many other studies, which show that caregivers may even experience more emotional health challenges (such as anxiety, depression, and distress) than the people they care for, the researchers added. What's more, poorer patient health (measured by a geriatric assessment) was also associated with higher levels of caregiver distress.

The average caregiver in the study was 66 years old, though 49 percent of the caregivers were aged 70 or older. The majority of caregivers were female and white (non-Hispanic), and 67 percent were the patient's spouse or partner who lived with them. Close to 40 percent of the caregivers had serious chronic illnesses of their own. Nearly half (43.5 percent) said they experienced moderate to high distress, 19 percent reported having symptoms of depression, and 24 percent were anxious.

Interestingly, older caregiver experienced less anxiety and depression and better mental health, said the researchers. However, they were in poorer physical health. Being female was associated with experiencing less distress. An income of more than $50,000 a year also was linked to having better physical and mental health.

The researchers concluded that caregivers for older patients with advanced cancer are a vulnerable group. Thankfully, there are strategies caregivers can incorporate into their routines to help keep their own health and well-being top-of-mind. Talk with a healthcare provider about your own stress related to caregiving. If you prefer, you can ask to talk privately, without the person you care for present. Your healthcare provider may suggest ways to address the burdens you may experience with caregiving. There are strategies that have been found to help with specific tasks and challenges, decrease caregiver stress, and improve quality of life. You can learn more -- and take a free and private assessment of caregiver health -- at HealthinAging.org.

Story Source: Article provided by Science Daily ---> American Geriatrics Society. "Caring for an older adult with cancer comes with emotional challenges for caregivers, too." ScienceDaily,  www.sciencedaily.com/releases/2019/04/190402124355.htm.


Dr. Jenny HollandAccording to the AARP as many as 43.5 million Americans provide unpaid care for an adult or child. It's extremely important that caregivers pay attention to and honor their own needs. Without self-care in mind caregivers risk burning out and becoming unable to care for their loved ones. In fact, one of the most reported factors in a family’s decision to move an ailing relative to a long-term care facility is the caregiver’s own failing physical and emotional health.

Long-term caregivers are also vulnerable to something called compassion fatigue. When this occurs caregivers may experience symptoms including; exhaustion, trouble sleep, increased anxiety, frequent headaches and stomach upset. When irritability, numbness, loss of purpose and emotional disconnection sets in the caregiver may also experience problems with their own personal relationships and suffer health issues. Finding a balance between the needs of family and self is key for caregivers to remain healthy in mind and body. It's important for family caregivers to reach out for help when they need it to create a plan for maintaining health, including tending to their own medical concerns and taking respite from their roles.

Dr. Holland works with caregivers suffering from overwhelm, burnout and caregiver fatigue. She helps clients to creatively work with the situation to discover a renewed sense of meaning and purpose, as well as important ways to stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others. Call 707-479-2946 to schedule a free consultation today.

Domestic violence leads to mental health setbacks

Relationship violence created signs of mental illness in both women (depression) and men (anxiety disorders)

Some forms of domestic violence double victims' risk of depression and anxiety disorders later in life, according to new research. The study found many victims of intimate partner violence at 21 showed signs of mental illness at the age of 30, with women more likely to develop depression and men varying anxiety disorders. Intimate partner violence classifies physical abuse as pushing, shoving and smacking.

University of Queensland researcher Emeritus Professor Jake Najman said the team also found equal levels of abuse by men and women. "The number of men and women who experience intimate partner violence is very similar, leading us to believe couples are more likely to abuse each other," Professor Najman said. "People generally don't end up in the hospital or a shelter, but there is a serious mental burden from this type of abuse."

The research showed defacto couples and those from lower socioeconomic backgrounds were more likely to be involved in these types of abusive relationships. Emotional abuse involves comments that make the person feel worthless. Then there is harassment -- a constant and distressing nagging that may have long-term consequences for those on the receiving end.

"It also raises the question, to what extent is this type of violent behavior not just a characteristic of the relationship the couple has with each other, but with other people around them and possibly their children," Professor Najman said. "There is a range of treatment and counseling programs available for couples and families to try and improve the way they relate to one another."

Story provided by Science Daily: University of Queensland. "Unhealthy and unhappy: Mental toll of troubled relationships." ScienceDaily 29 January 2020. www.sciencedaily.com/releases/2020/01/200129091511.htm.


Dr. Jenny HollandDomestic violence can take the form of either physical or psychological abuse, or both, and it can affect anyone regardless of gender, race or sexual orientation, economic status or education. Domestic violence can manifest in behaviors meant to scare, physically harm or dominate a partner. This type of violence typically involves an unequal power dynamic where one partner tries to assert control over the other in a variety of ways. Narcissism can also be considered a form of domestic violence.

Women are most often the battered party in a violent relationship according to statistics which report that more than 38 million American women have been victims of domestic violence. Men can be victimized as well, in both heterosexual and same-sex relationships. Therapy in domestic violence situations often focuses on the client's inevitable loss of self-worth, feelings of anxiety and bouts of depression. Most victims of domestic violence need time and counseling to overcome the overall sense of helplessness that can be the hallmark of abuse.

To make an appointment, or to schedule a free consultation call 707-479-2946 or visit the contact page to send an email now.

Therapy dog study results: students reported feeling more supported, less stressed

Therapy dog sessions for stressed-out students proving beneficial for mental health

Therapy dog sessions for stressed-out students are an increasingly popular offering at North American universities. Now, new research from the University of British Columbia confirms that some doggy one-on-one time really can do the trick of boosting student wellness. "Therapy dog sessions are becoming more popular on university campuses, but there has been surprisingly little research on how much attending a single drop-in therapy dog session actually helps students," said Emma Ward-Griffin, the study's lead author and research assistant in the UBC department of psychology. "Our findings suggest that therapy dog sessions have a measurable, positive effect on the wellbeing of university students, particularly on stress reduction and feelings of negativity."

In research published today in Stress and Health, researchers surveyed 246 students before and after they spent time in a drop-in therapy dog session. Students were free to pet, cuddle and chat with seven to 12 canine companions during the sessions. They also filled out questionnaires immediately before and after the session, and again about 10 hours later. The researchers found that participants reported significant reductions in stress as well as increased happiness and energy immediately following the session, compared to a control group of students who did not spend time at a therapy dog session. While feelings of happiness and life satisfaction did not appear to last, some effects did.

"The results were remarkable," said Stanley Coren, study co-author and professor emeritus of psychology at UBC. "We found that, even 10 hours later, students still reported slightly less negative emotion, feeling more supported, and feeling less stressed, compared to students who did not take part in the therapy dog session."

While previous research suggested that female students benefit from therapy dog sessions more than male students, the researchers found the benefits were equally distributed across both genders in this study. Since the strong positive effects of the therapy dog session were short-lived, the researchers concluded that universities should be encouraged to offer them at periods of increased stress.

"These sessions clearly provide benefits for students in the short-term, so we think universities should try to schedule them during particularly stressful times, such as around exam periods," said Frances Chen, the study's senior author and an assistant professor of psychology at UBC. "Even having therapy dogs around while students are working on their out-of-class assignments could be helpful."

The therapy dog sessions were organized in partnership with UBC's Alma Mater Society and Vancouver ecoVillage, a non-profit organization that provides therapeutic services, including therapy dog sessions, and mental health wellness services.


Story Source: Article provided by Science Daily & University of British Columbia. "Sit, stay, heal: Study finds therapy dogs help stressed university students." ScienceDaily. www.sciencedaily.com/releases/2018/03/180312085045.htm.


Dr. Holland offers Canine Assisted Therapy

Dr. Jenny HollandConnecting with a dog can be powerfully healing and comforting for individuals of all ages and walks of life. In some cases, it can help an otherwise “stuck” patient overcome hurdles in treatment and begin making progress again. The friendly, accepting nature of these beautiful animals makes them ideal “co-therapists”. Canine-assisted therapy has been around for several decades, and will continue to be used for years to come due to its many benefits. The use of dogs as part of therapy and other forms of treatment can be beneficial for a wide range of disorders, issues, and conditions.


About Tallulah – Canine Assisted Therapy

Tallulah is a highly trained service dog who works with Dr. Holland to provide assistance to clients in a variety of ways. She is warm, friendly, and very intuitive. This Labrador Retriever provides a connection that goes beyond words and straight to the heart.  Depending on your needs, Tallulah can be merely a quiet presence in the room or be actively involved in therapy.

Empathy and closeness enhanced in siblings of children with disabilities

Siblings of children with intellectual disabilities score high on empathy and closeness

New study reveals that relationships between children and their siblings with intellectual disabilities can be incredibly positive

The sibling relationship is the longest most people will enjoy in their lifetimes and is central to the everyday lives of children. A new Tel Aviv University and University of Haifa study finds that relationships between children and their siblings with intellectual disabilities are more positive than those between typically developing siblings. The research examines the relationships of typically developing children with siblings with and without intellectual disabilities through artwork and questionnaires. It was conducted by Prof. Anat Zaidman-Zait of the Department of School Counseling and Special Education at TAU's Constantiner School of Education and Dr. Dafna Regev and Miri Yechezkiely of the University of Haifa's Graduate School of Creative Art Therapies. The study was recently published in Research in Developmental Disabilities.

"Having a child with a disability in a family places unique demands on all family members, including typically developing siblings," Prof. Zaidman-Zait explains. "Although challenges exist, they are often accompanied by both short- and long-term positive contributions. Through our research, we found that relationships among children with siblings with intellectual disabilities were even more supportive than those among typically developed siblings. Specifically, we found that children with siblings with intellectual disabilities scored higher on empathy, teaching and closeness and scored lower on conflict and rivalry than those with typically developing siblings."

Until now, research on how having a sibling with a developmental disability affects children's social-emotional and behavioral outcomes generated mixed findings. At times, the findings suggested that having a sibling with developmental disabilities led to greater variability in typically developing children's behavior and adjustment.

"But these studies did little to tap into the inner worlds of children, which really can only be accessed through self-expression in the form of art or self-reporting, independent of parental intervention, which is the route we took in our study," Prof. Zaidman-Zait says. The scientists assessed some 60 children aged 8-11, half with typically developing siblings, half with intellectually disabled siblings, through drawings and a questionnaire about their relationships with their siblings. Mothers of both sets of siblings were also asked to answer a questionnaire about their children's sibling relationship quality.

"We drew on the basic assumption that artistic creation allows internal content to be expressed visually and that children's self-reports have special added value in studies measuring sibling relationship qualities, especially in areas where parents might have less insight," Prof. Zaidman-Zait says.

Both sets of typically developing children, with and without siblings with intellectual disabilities, were asked to draw themselves and their siblings. Licensed art therapists then used several set criteria to "score" the illustrations: the physical distance between the figures; the presence or absence of a parent in the illustration; the amount of detail invested in either the self-portrait or the sibling representation; and the amount of support given to a sibling in the picture. The children were then asked to complete the Sibling Relationship Questionnaire, which assessed the feelings of closeness, dominance, conflict and rivalry they felt for their siblings.

Reviewing the children's illustrations and questionnaires, as well as the questionnaires completed by the children's mothers, the researchers found that the children with siblings with intellectual disabilities scored significantly higher on empathy, teaching and closeness in their sibling relationship and scored lower on conflict and rivalry in the relationships than those with typically developing siblings.

"Our study makes a valuable contribution to the literature by using an art-based data gathering task to shed new light on the unique aspects of the relationships of children with siblings with intellectual disabilities that are not revealed in verbal reports," Prof. Zaidman-Zait concludes. "We can argue that having a family member with a disability makes the rest of the family, including typically developing children, more attentive to the needs of others." The researchers hope their study, supported by The Shalem Foundation in Israel, will serve as a basis for further research into art-based tools that elicit and document the subjective experience of children.

Story Source: ScienceDaily, 14 January 2020. www.sciencedaily.com/releases/2020/01/200114123525.htm.


Dr. Jenny Holland"As a physically disabled person and a parent of a disabled child, I have a unique perspective on parenting children with disabilities. I am offering two new support groups beginning in January that are geared toward helping both parents of children with disabilities and teens & young adults with disabilities to gain a sense of empowerment and control. We will offer coping and practical skills as well. The goal of the groups is to give participants a chance to talk openly and honestly about feelings, share stories and gain support through the process."

More about upcoming support groups:

Parent Support Group

Support group for teens with disabilities

Dr. Holland also offers counseling services for people with disabilities on a on-going basis. To learn more visit Living with Disabilities or call 707-479-2946.

Parental coaching can help kids navigate peer rejection, bullying and conflict

Parents can offer support and advice to youth as they navigate social challenges

During early adolescence, especially the transition to middle school, kids face a number of challenges both socially and academically. Peer rejection, bullying, and conflict with friends are common social stressors. These challenges can affect adolescents' ability to form positive peer relationships, a key developmental task for this age group. Parents can act as social "coaches," offering support and advice to youth as they navigate these challenges by offering specific suggestions for facing challenges head-on or by encouraging kids' autonomy, to "figure it out" on their own. University of Illinois researchers are finding that not all kids benefit from the same types of parental coaching because kids respond to stress differently.

In a recent study, published in the Journal of Applied Developmental Psychology, researchers report on the connection between how mothers advise their children to respond to specific peer stress scenarios and youth stress responses during conversations about real peer experiences. They also identify what mothers do or say that is particularly helpful in facilitating youth adjustment and well-being in the face of these stressors. "As we're thinking about the transition to middle school, we're looking at the extent to which mothers are encouraging their child to use active, engaged coping strategies, such as problem solving, help-seeking, or reframing or thinking about the situation in less threatening or negative ways," says Kelly Tu, assistant professor of human development and family studies at U of I.

The study also looks at how mothers may recognize that their children are transitioning into adolescence and looking for more autonomy and independence. "We wanted to examine the extent to which mothers are taking a step back, saying, 'I'm going to let you handle this in your own way -- what you think is best or what works for you,'" Tu says. Mothers and youth in the study participated during the transition from fifth grade to sixth grade. Mothers were given hypothetical peer stress scenarios such as peer exclusion, peer victimization or bullying, and anxiety about meeting new peers, as well as a variety of coping suggestions. Mothers were asked to report on how they would typically advise their child to respond.

Researchers also observed conversations between youth and their mothers about real peer stress situations. Common topics that were discussed included being around kids who are rude, having problems with a friend, and being bullied, teased, or hassled by other kids. During the conversations, researchers measured skin conductance level -- the electrical activity happening in the skin as part of the physiological "fight or flight" stress response system -- from youth's hands. "We assessed youths' physiological arousal during these problem-solving discussions to examine how the different levels of reactivity may indicate different needs of the adolescent," Tu explains.

For instance, greater reactivity during the conversations may reflect youths' higher levels of physiological arousal or anxiety in recalling that stressful experience and talking it through with the mother. Whereas less reactivity during the problem-solving conversation might serve as an indicator of youths' insensitivity to the stressful experience. And these different response patterns may require different parenting approaches. "We found that mothers' active, engaged coping suggestions were more beneficial for low reactive youth. Low reactive youth may not be attending to cues in these conversations about stressful or challenging peer experiences, and so they may behave in ways that are unexpected, non-normative, or inappropriate. But when parents give them specific advice for how to manage challenging peer situations, this appears to be helpful," Tu says. However, the same active, engaged approached predicted worse adjustment for kids exhibiting higher arousal. "Instead, self-reliant suggestions actually predicted better adjustment for these kids," Tu explains.

"These findings are interesting because this suggests that a multi-step process might work best for kids who are exhibiting high physiological arousal related to peer problems. If you're anxious or stressed, and your parent is telling you to face the problem head on, that might actually create more anxiety. But when a parent gives a highly aroused youth more autonomy about how to cope with the peer stressor, this seems to be more beneficial because parents are giving them more space and time to work through the situation in their own way," Tu says. Thus, parents may want to consider the match of their coping suggestions with adolescents' stress reactivity.


This article provided by Science Daily: University of Illinois College of Agricultural, Consumer and Environmental Sciences. "Parental coaching adolescents through peer stress."ScienceDaily, 18 December 2019. www.sciencedaily.com/releases/2019/12/191218153402.htm.


Dr. Jenny HollandThere are situations that arise for every child - spanning infancy to adolescence, that benefit from a parents’ ability to acknowledge the worthiness of the child's feelings. To be the loving, compassionate and unflappable parent requires the ability to manage your own feelings and frustrations. Over the years studies have pointed out that the best-adjusted children are nurtured by parents who find a way to combine warmth and sensitivity with clear behavioral expectations.

Dr. Holland has been in private practice for more than 17 years, helping patients to reach new levels of self-understanding and emotional well-being.  Dr. Holland will customize treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment, or call 707-479-2946.

 

Report finds burnout prevalent in health care community

Addressing clinician burnout will require a deliberate and substantive health care system redesign

Clinician burnout is affecting between one-third and one-half of all of U.S. nurses and physicians, and 45 to 60% of medical students and residents, according to a National Academy of Medicine (NAM) report.
Vanderbilt University Medical Center is among 32 institutions and foundations that sponsored the 296-page report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," which investigates the causes of widespread clinician burnout and offers solutions to address the problem at its source.

"There's an all too direct connection between clinician burnout and health care safety and quality. While clinician burnout isn't a new problem, its worsening prevalence and impact are due to system factors inherent in the modern health care system," said Matthew Weinger, MD, professor of Anesthesiology and Norman Ty Smith Chair in Patient Safety and Medical Simulation at VUMC, and a member of the NAM authoring committee for the new report.

"The Committee came to realize that addressing clinician burnout will require a deliberate and substantive health care system redesign with a focus on those activities that deliver the most value to patients while enabling and empowering clinicians to deliver high-quality care," he said.

The report discusses key issues that need to be addressed:

  • Clinician burnout needs to be tackled early in professional development and special stressors in the learning environment need to be recognized. Leaders in health care and health professions education have a responsibility to foster, monitor and continuously improve work and learning environments.
  • While some health care technologies appear to contribute to clinician burnout (poorly designed electronic health record systems, for example), there is real potential for well-designed and implemented technologies to help reduce burnout.
  • Federal and state governments, other payors and regulators and the health care industry itself have important roles to play in preventing clinician burnout. Increasing administrative burdens and distracting clinicians from the care of their patients can directly affect burnout.
  • Medical societies, state licensing boards, specialty certification boards, medical education and health care organizations all need to take concrete steps to reduce the stigma for clinicians seeking help for psychological distress and make assistance more easily available.

The report concludes with goals and recommendations centered on creating more positive work and learning environments, reducing administrative burden, enabling technology solutions, providing more support to clinicians and learners, and investing in research to address clinician burnout.


Story Source: Materials provided by Science Daily ---> Note: Content may be edited for style and length. Vanderbilt University Medical Center. "Consensus report shows burnout prevalent in health care community." ScienceDaily. ScienceDaily, 23 October 2019. www.sciencedaily.com/releases/2019/10/191023172121.htm.


Dr. Jenny Holland"On the job burnout reduces productivity and saps energy, causing feelings of being helpless, hopeless, cynical and resentful. The negative effects of burnout will eventually spill over into every area of life—including home, work and social life. Burnout can also cause long-term physical changes and increased vulnerability to illnesses like colds and flu. Because of its many consequences, it’s important to work through feelings of burnout with a counselor."

Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to help you discover new meaning in your work and offer ways you can stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.

Physical activity found to be protective for people at risk for depression

Physical activity can influence depression in a positive way

Scroll Down for Dr. Holland's Perspective on this article

Increased levels of physical activity can significantly reduce the odds of depression, even among people who are genetically predisposed to the condition, according to a new study from researchers at Massachusetts General Hospital (MGH). In a paper published in the journal Depression and Anxiety, the team reported that individuals who engaged in at least several hours of exercise each week were less likely to be diagnosed with a new episode of depression, even in the face of high genetic risk for the disorder.

Drawing on genomic and electronic health record data from nearly 8,000 participants in the Partners Healthcare Biobank, the new study is the first to show how physical activity can influence depression despite genetic risk. Researchers followed patients who filled out a survey about their lifestyle habits (including physical activity) when they enrolled in the Biobank. They then mined millions of electronic health record data points over the next two years and identified people who received diagnoses related to depression. They also calculated genetic risk scores for each participant, combining information across the entire genome into a single score that reflects a person's inherited risk for depression.

What they found was that people with higher genetic risk were more likely to be diagnosed with depression over the next two years. Significantly, though, people who were more physically active at baseline were less likely to develop depression, even after accounting for genetic risk. In addition, higher levels of physical activity were protective for people even with the highest genetic risk scores for depression.

"Our findings strongly suggest that, when it comes to depression, genes are not destiny and that being physically active has the potential to neutralize the added risk of future episodes in individuals who are genetically vulnerable," says Karmel Choi, PhD, of MGH and the Harvard T.H. Chan School of Public Health, and lead author of the study. "On average, about 35 additional minutes of physical activity each day may help people to reduce their risk and protect against future depression episodes."

The researchers found that both high-intensity forms of activity, such as aerobic exercise, dance and exercise machines, and lower-intensity forms, including yoga and stretching, were linked to decreased odds of depression. Overall, individuals could see a 17 percent reduction in odds of a new episode of depression for each added four-hour block of activity per week.

Depression represents the leading cause of disability worldwide. Despite its massive health burden, strategies to combat depression remain limited and the public's understanding of robust and modifiable protective factors is incomplete. "We provide promising evidence that primary care and mental health providers can use to counsel and make recommendations to patients that here is something meaningful they can do to lower their risk even if they have a family history of depression," says Choi.

Senior author Jordan Smoller MD, added, "In general our field has been lacking actionable ways of preventing depression and other mental health conditions. I think this research shows the value of real-world healthcare data and genomics to provide answers that can help us to reduce the burden of these diseases."

Beyond physical activity, the MGH team continues to leverage the Partners Biobank and other large-scale studies to explore modifiable ways that individuals might reduce their risk of depression. "We believe there may be many factors could be part of an overall strategy for improving resilience and preventing depression," emphasizes Choi. "The magnitude of depression around the world underscores the need for effective strategies that can impact as many people as possible."

Materials provided by Massachusetts General Hospital. Note: Read this article on Science Daily ---> Massachusetts General Hospital. "Physical activity may protect against new episodes of depression." ScienceDaily. ScienceDaily, 5 November 2019. www.sciencedaily.com/releases/2019/11/191105113510.htm.


Dr. Holland's Perspective

"Studies have repeatedly shown that the most effective treatment for depression is cognitive behavioral therapy. This type of therapy addresses problematic thought patterns by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood. Certainly, physical activity combined with cognitive therapy is a positive way to approach depression. In addition to the positive effects of exercise mentioned in this study, evidence also shows that regular mindfulness meditation, on its own or combined with cognitive therapy, can also help stop depression before it starts."

Therapy for Depression

  • Do you find yourself feeling sad, empty tired, guilty or hopeless. Are you to the point where nothing makes you happy?
  • Have you become more isolated or lonely than usual, and feel like you can’t reach out to people?
  • Does life seem like more trouble than it’s worth?

Everyone experiences the blues sometimes. But clinical depression is more than just feeling down, unhappy or a sad feeling. Major depression is not a simple emotion. It is a medical disorder that affects more than 10 percent of adults annually. Women are twice as likely to get depression as men. The earlier treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

With depression, you may feel sad and hopeless and you may not understand why you feel this way. Unlike sadness or the blues, depression is actually a biochemical disorder that can affect just about every area of a person's life. Some people with depression may even have had self-destructive or suicidal thoughts. If this is your experience, it is crucial that you seek help.

Contact Dr. Holland for more information and to get help with depression.

Unresolved childhood trauma linked to poorer health for women

Researchers have long known that childhood trauma is linked to poorer health for women at midlife.

Researchers identify one specific way childhood trauma can affect women

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The national study of more than 3,000 women is the first to find that those who experienced childhood trauma were more likely than others to have their first child both earlier in life and outside of marriage -- and that those factors were associated with poorer health later in life. The findings have implications for public programs to prevent teen pregnancy, said Kristi Williams, lead author of the study and professor of sociology at The Ohio State University. These results suggest that early trauma -- such as the death of a parent, physical abuse or emotional neglect -- may affect young people's decision-making in ways that they can't entirely control.

"It's easy to tell teens that they shouldn't have kids before marriage, but the message won't be effective if they haven't developed the capacity to do that because of trauma they experienced in childhood," Williams said. "It may be necessary to do different kinds of interventions and do them when children are younger." Williams conducted the study with Brian Karl Finch of the University of Southern California. Their results were published today (Sept. 17, 2019) in the Journal of Health and Social Behavior.

Early childhood trauma is "shockingly" common in the United States, the researchers said in the study. One national study conducted between 1995 and 1997 found that only 36 percent of respondents reported having no such adverse childhood experiences. Other research has shown that childhood trauma is strongly associated with multiple health risks, including cancer, diabetes, stroke and early death, Williams said. Much of this work has focused on how early adversity may have biological and neurological effects that would lead to worse health throughout life. "But there hasn't been any attention given to how childhood adversity may affect social and developmental processes in adolescence and young adulthood -- factors that we know are also strong predictors of later health," she said. One of those factors in women is the timing and context of first birth.

Data for this new study came from the 1979 National Longitudinal Survey of Youth, which includes a representative sample of people who were aged 14 to 22 in 1979. The NLSY is run by Ohio State's Center for Human Resource Research. Participants were interviewed every year through 1994 and once every two years since. The final sample for this study included 3,278 women. Each participant reported whether she experienced one or more of six adverse childhood experiences before age 18: emotional neglect, physical abuse, alcoholism in the home, mental illness in the home, death of a biological parent and parental absence. The researchers examined data on how old each participant was when she first gave birth and whether she was married, cohabiting or neither at the time. Finally, participants rated their health at or near age 40.

Findings showed that each additional childhood trauma experienced by the participants was associated with earlier age at first birth and a greater probability for a first birth during adolescence or young adulthood compared to later (age 25 to 39). In addition, each additional trauma was associated with a 24 percent increase in the probability of being unmarried and not cohabiting at first birth compared to the likelihood that they were married when their first child was born. The researchers then conducted statistical tests that showed early and non-marital births were a key reason why children who experienced trauma were more likely to report poorer health at midlife.

"It is the idea of 'chains of risk' -- one thing leads to another," Williams said. "Childhood trauma leads to social and biological risks that lead to early and nonmarital birth which can lead to health problems later in life." The findings also cast doubt on the notion that childbearing decisions are the result only of the culture in which children grow up, she said. Some policymakers have claimed that some people don't value marriage enough, and if they were just encouraged not to have kids until after they're married, they would be better off, Williams said. "You can promote this 'success sequence' -- go to college, get a job, get married and have a child -- exactly in that order. But the reason some people don't do that isn't just cultural, it is structural," Williams said. "When people experience traumas early in life, it makes it less likely that they will be able to make those positive choices."


Dr. Holland's Perspective

"If we experience an extremely stressful or disturbing event, it can us feeling helpless and emotionally out of control. Psychological trauma can cause a person to struggle with upsetting emotions, recurring memories and every day anxiety. Unresolved childhood trauma can also cause feelings of being numb, disconnected and unable to trust other people. Whether the trauma happened in your childhood or just yesterday, it is important to understand that you can make healing changes and move on with your life in positive ways."

Experiencing trauma in childhood can result in a severe and long-lasting effect. When childhood trauma is not resolved, a sense of fear and helplessness carries over into adulthood, setting the stage for more trauma. There are steps you can take to overcome the pain, learn to trust and connect to others again, and regain your sense of emotional balance. To learn more or to schedule an appointment with Dr. Holland call 707-479-2946.

New study reveals art therapy benefits for stressed caregivers of cancer patients

A recent study showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.

A cancer diagnosis is incredibly stressful for the person receiving the diagnosis. But those caring for the patient, both informally and formally, also experience stress, which can affect their own health and the patient's outcome. A study, led by researchers from Drexel University's Creative Art Therapies department in the College of Nursing and Health Professions, as well as researchers in the Perelman School of Medicine at the University of Pennsylvania, showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.

"Families of cancer patients experience emotional trauma around the diagnosis, stress of treatment, financial concern, among others," said lead author of the study, Girija Kaimal, EdD, an assistant professor in the College of Nursing and Health Professions. "While addressing their needs understandably comes second to the patient's needs, the stressors families experience often go unaddressed." Kaimal also added oncology professionals, such as nurses, therapists and physicians, experience their own set of negative effects, like compassion fatigue and not taking time for self-care. This can lead to avoidance of empathetic care, mistakes in patient care, high turnover, health problems and burnout.

As important as their own health is, addressing the caregivers' and oncology professionals' psychosocial needs also helps to improve the patient's treatment compliance and outcomes. The mixed-methods study, supported through a cooperative agreement with the National Endowment for the Arts Research Labs program, was conducted in Penn's department of Radiation Oncology. Researchers compared two arts-based approaches for caregivers -- single sessions of coloring and open-studio art therapy. A total of 34 caregivers (25 healthcare professionals and nine family caregivers) were randomly assigned to 45 minutes of an independent, open-studio art therapy or an active-control coloring session, with all sessions run by trained art therapists.

A variety of art materials were available to participants in the open-studio session. The art therapist facilitated the session, offering guidance and interacting with the participant. With five minutes left in the session, the art therapist would process the artwork created by the participant, giving them an opportunity to discuss their work and reflect on the process. In the coloring session, participants chose a coloring sheet and were provided with markers and coloring pencils. The art therapist did not interact with the participant while they colored.

Before and after each session, participants were given surveys to self-report their positive and negative feelings, such as stress and anxiety. After both the art therapy and coloring sessions, participants expressed increases in positive affect, pleasure and enjoyment and decreases in negative affect, anxiety, perceived stress, and burnout. Many expressed a desire to continue to make art in the future, as taking time out of their busy schedules to engage in art helped them to focus on something other than their caregiving.

These findings suggest that even brief art-making interventions can be beneficial for stressed caregivers of cancer patients. The study's senior author, William Levin, MD, an associate professor of Radiation Oncology at Penn, also points out that creative activities like art-making are mindful practices, allowing patients and caregivers to stay in the moment, which by definition can free them from the stress that cancer brings. "These results show the importance of treating the mind as well as the body of cancer patients, and it is further evidence that we're on the right track as we continue our push toward a more holistic approach to cancer therapies," Levin said.

Penn recently opened a dedicated multi-purpose room to expand its ability to offer these kinds of interventions to patients, something the study's authors point out is now further supported by science. "We recommend that oncology units have similar, dedicated studio spaces with therapeutic support and different forms of art-making available to meet individual caregiver needs," said Kaimal.


Story Source: Materials provided by Drexel University. Note: Content may be edited for style and length. Chicago Drexel University. "The art of cancer caregiving: How art therapies benefits those caring for cancer patients." ScienceDaily. ScienceDaily, 21 October 2019. www.sciencedaily.com/releases/2019/10/191021094020.htm.


Providing Compassion with Life Transitions Therapy

Life Transitions Therapy is helpful for adults with serious, life-limiting medical illness, life-threatening illness as well as caregivers and those who are bereaved. Change is hard, even in the best of circumstances. Adjusting to major life transitions can be difficult. Coping and navigating the stress of a major change can cause depression and anxiety, evoke fear and confusion.

If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping.

Art Therapy with Dr. Holland -- Art therapy involves the use of creative techniques such as drawing, painting, collage, coloring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art. As a credentialed art therapist Dr. Holland assists clients to understand the nonverbal messages, symbols, and metaphors often found in the unique art forms they create, which often leads to a better understanding of feelings and behavior so they can move on to resolve deeper issues.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Companion Pets Help to Ease Symptoms of Grief

Florida State University researchers have found the companionship of a pet after the loss of a spouse can help reduce feelings of depression and loneliness in older adults. The study, funded by The Gerontological Society of America and the WALTHAM Centre for Pet Nutrition and published in The Gerontologist, examined depressive symptoms and loneliness among people age 50 and older who experienced the loss of a spouse through death or divorce.

"Increasingly, there's evidence that our social support networks are really beneficial for maintaining our mental health following stressful events, despite the devastation we experience in later life when we experience major social losses," said Dawn Carr, lead author and FSU associate professor of sociology. "I was interested in understanding alternatives to human networks for buffering the psychological consequences of spousal loss."

Carr and her team compared individuals who experienced the loss of a spouse to those who stayed continuously married. Then they explored whether the effects of spousal loss differed for those who had a pet at the time of the death or divorce.

They found all individuals who lost their spouse experienced higher levels of depression. However, people without a pet experienced more significant increases in depressive symptoms and higher loneliness than those who had pets. In fact, those who had a pet and experienced the death or divorce of their spouse were no lonelier than older adults who didn't experience one of those events.

"That's an important and impressive finding," Carr said. "Experiencing some depression after a loss is normal, but we usually are able to adjust over time to these losses. Persistent loneliness, on the other hand, is associated with greater incidents of mortality and faster onset of disability, which means it's especially bad for your health. Our findings suggest that pets could help individuals avoid the negative consequences of loneliness after a loss."

Carr's team used data from a sample of older adults who participated in an experimental survey about human animal interaction as part of the University of Michigan's Health and Retirement Study in 2012, and linked the data with additional data collected between 2008 and 2014. They identified pet owners as those participants who either had a cat or a dog.

"In everyday life, having a cat or dog may not make you healthier," Carr said. "But when facing a stressful event, we might lean on a pet for support. You can talk to your dog. They're not going to tell you you're a bad person, they're just going to love you. Or you can pet your cat, and it's calming."

The researchers noted that additional studies should be conducted to explain why having pets helps maintain mental health better. However, Carr suggested part of it may relate to whether you feel like you matter to someone.

"Oftentimes, the relationship we have with our spouse is our most intimate, where our sense of self is really embedded in that relationship," Carr said. "So, losing that sense of purpose and meaning in our lives that comes from that relationship can be really devastating. A pet might help offset some of those feelings. It makes sense to think, 'Well at least this pet still needs me. I can take care of it. I can love it and it appreciates me.' That ability to give back and give love is really pretty powerful."

The findings have potential consequences for social policies. For instance, it may be beneficial to include companion animals in the treatment of people residing in senior-living facilities, or reducing barriers to pet ownership in such settings.


Read this article on Science Daily:  Materials provided by Florida State University. Florida State University. "Furry friends ease depression, loneliness after spousal loss." ScienceDaily. ScienceDaily, 5 September 2019. www.sciencedaily.com/releases/2019/09/190905102549.htm.


Dr. Holland offers Canine Assisted Therapy

Connecting with a dog can be powerfully healing and comforting for individuals of all ages and walks of life. In some cases, it can help an otherwise “stuck” patient overcome hurdles in treatment and begin making progress again. The friendly, accepting nature of these beautiful animals makes them ideal “co-therapists”. Canine-assisted therapy has been around for several decades, and will continue to be used for years to come due to its many benefits. The use of dogs as part of therapy and other forms of treatment can be beneficial for a wide range of disorders, issues, and conditions. Learn more ....

Grief & Bereavement

Clients who are facing significant life changes and ongoing adjustment due to  death of a loved one benefit from Dr. Holland Grief Therapy Services. Life Transitions Therapy is also beneficial for friends and family members of one who may be confronted with serious or terminal illness or injury, or friends and family of someone who has passed away after a long illness, or sudden death. Learn more ...

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.