By The IBX Insights Team

For the past few years, there has been a lot of focus on the mental health of children and adults, and most of the news hasn’t been good. However, a recent study is giving us a reason to be hopeful.

According to the 2024 National Survey on Drug Use and Health, American teens are experiencing fewer suicidal thoughts and behaviors. Whether that’s due to reduced stigma around mental health, celebrities sharing their mental health journeys, increased access to online mental health resources, or other factors, it’s a step in the right direction.

Knowing the risks and signs

Suicide is a public health crisis that impacts everyone. In 2024, nearly 14.3 million adults reported having serious thoughts of suicide, with 2.2 million adults attempting suicide in the past year.

People at increased risk for suicidal thoughts and behaviors include:

• Middle-aged men• Young Black men• Veterans• Adults older than 75 years of age• Members of the LGBTQIA+ community• Native American/First Nation populations• Non-Hispanic white individuals• People who have disabilities• Individuals who self-identify as perfectionists

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Lots of factors can trigger a suicidal crisis, including difficulties at work or school, loss of an important relationship, significant health challenges, legal or financial troubles, substance use disorder, and sexual assault or abuse.

If you suspect someone might be struggling with suicidal thoughts, look for the following behaviors:

• Extreme mood swings• Changes in sleeping or eating habits• Lack of interest in things they used to enjoy• Decreased social interactions• Participating in increasingly risky activities• Feeling worthless, hopeless, or burdensome to others

Dr. Ryan Connolly, senior medical director of behavioral health at Independence Blue Cross (IBX), says that if you notice any of these signs in a friend or loved one, you should talk to them. “People who have suicidal feelings often feel disconnected from others. Showing them you care can disrupt those negative feelings. Using positive, caring “I” statements can help people feel like they matter to someone. For example, “I feel like you might be struggling with something. I want to help, and I’m here to listen.”

Build up to questions like, “Have you thought about suicide?”, “Do you have a plan?”, and “Do you have the means to carry it out?” If the answers to these questions are yes, the situation is serious. Gently remind them that 24/7 support is available through the National Suicide and Crisis Lifeline at 1-800-273-TALK (8255) or text 988.

Lowering the risk for suicide

According to Dr. Connolly, “Nearly 25% of American adults have a mental health issue like depression or an anxiety disorder. People with mental illness are at increased risk for suicidal thoughts and actions, but there are protective behaviors that can help reduce this risk and foster overall well-being.”

Dr. Connolly suggests adding these behaviors to your regular routine:

- Embrace joy. Dedicate time each day to activities that make you feel good, such as exercising, spending time with a pet, writing in a gratitude journal, or listening to music.

- Talk with someone you trust. Humans thrive when they spend time with people who genuinely care about them. Connecting with others also increases feelings of belonging and self-esteem.

- Make time for self-care. Nurture your body and mind by getting enough rest, eating a balanced diet, and practicing meditation or deep breathing to relax.

- Cultivate problem-solving skills. Successfully navigating challenges boosts resilience. Use your talents to turn negatives into positives. Start with small challenges so you can build momentum with each “win.”

- Seek help when needed. If you feel sad or depressed for longer than two weeks, talk with a behavioral health professional. Emergency hotlines can provide immediate support in times of crisis.

Supporting survivors of suicide

The term “survivors of suicide” refers to individuals who have lost a loved one to suicide. The aftermath of such a loss can be devastating. Survivors may struggle with shock, grief, anger, and guilt. They may blame themselves or think they could have done something to prevent it, even though this is not the case.

Older individuals and people with certain cultural or religious beliefs may find it difficult to cope with a loved one’s suicide because of stigma and fear of being judged, so they might hide their pain.

And even when survivors feel like they have processed the loss, mentions of suicide on tv, in movies, or in the news, can be triggering.

If someone you know has been affected by suicide, offer compassionate support. Holidays can be particularly tough for survivors. Giving survivors a safe space to share feelings about their loved one can be comforting. You may want to encourage them to talk with a behavioral health professional, as therapy can also be helpful.

- MORE ON MENTAL HEALTH:

- The differences between stress, anxiety, and depression

- Turning parental stress into family strength

- The difference between everyday worries and anxiety disorders

IBX members have access to a network of behavioral health providers. Call our Behavioral Health Care Navigation team at 1-800-688-1911. They can match you with an in-network provider that meets your needs and schedule an appointment in as quickly as 1 – 2 days.

Our members also have access to Brightside Health’s Suicide Prevention Program, a national telehealth program that delivers targeted care for individuals with elevated suicide risk.

If you or someone you know is in immediate distress or is thinking about hurting themselves, call or text the National Suicide and Crisis Lifeline toll-free at 988.

For more information about self-care strategies for mental health and where to find help, visit ibx.com/knowyourmind. https://standingabovethecrowd.com/?p=16187

Grief can make special days harder

Writer: Rachel Ehmke

Clinical Expert: Jamie Howard, PhD

What You'll Learn

- How might kids feel on important days after someone has died?

- What can parents do to help children process their grief?

- How can families make special days easier for kids?

- Quick Read

- Full Article

- Acknowledge emotions

- Make a plan

- Memorialize

- Ask for help

The year after a loved one has died is especially hard. The first Thanksgiving, Mother’s Day or special event like a graduation can make kids feel sad. You may think the best idea is to skip the celebration. But skipping it can sometimes make kids feel even worse. Thinking and planning ahead can make these hard days easier and even bring some joy to them.

It’s important to let your kids know that it’s OK for them to feel sad. Trying to pretend that everything is fine just makes kids feel like it’s not OK to have feelings. On the other hand, it’s probably best if you don’t let your kids see you at your most upset moments, since they might feel scared.

It’s very normal for kids to go in and out of sadness. They may be sad one minute and want to play the next. That’s very healthy, especially for little kids who might not get exactly what’s going on.

It can really help to plan out the day. Let kids know what’s going to happen and who will be there. That gives kids a sense of control and security. It also helps to include favorite family traditions. Those shouldn’t disappear because a loved one has died. In fact, they can make the day feel special.

Finding a way to talk or share memories about the person who died or do something that they loved can also help kids deal with grief. And parents need help on hard days, too. It’s good to get family and caregivers to take some of the burden off you or just give you a break.

When you’ve lost someone you love, the year that follows is inevitably a year of firsts without that person. Celebrations like the first Thanksgiving, birthday or Mother’s Day without someone who played a major role in your and your family’s life will be especially hard. This is also true for personal milestones, like graduations and first days of school, many of them involving children. What’s the best way to face these days when, rather than feeling festive, you’re feeling the loss most keenly?

Depending on the occasion and your grief, you may even be wondering if you should skip the day altogether. Trying to ignore important occasions can also be painful, so that probably isn’t the best strategy. For families coping with bereavement, it isn’t uncommon to experience moments of joy along with some sorrow on significant days. Thinking ahead of time about how to make the day easier for your family can help.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Acknowledge emotions

First, acknowledge that this will likely be a difficult day for your family. Recognizing this is important. Sometimes families — both parents and children — feel they need to put on a brave face when they are feeling sad. But it is OK to feel sad and show grief. “As a rule of thumb, avoidance is a bad idea because it makes us feel worse in the medium and long term,” notes Jamie Howard, PhD, a clinicial psychologist who specializes in trauma. “Our emotions don’t really respond well to being closeted. They find a way out.” Hiding your own grief can also make your children feel like the sadness they may be feeling is bad. However, try not to let children see you at your most upset moments, as they may begin to worry about you or feel insecure.

Let the children know that however they are feeling is fine, and they don’t need to hide it. If they want to say, “I really miss him,” that’s OK. On the other hand, kids also shouldn’t feel that they are expected to be miserable all day. It is common and healthy for kids to go in and out of grief, and take comfort in playing. Younger children in particular, who might not realize the significance of the day, will probably want to play and have fun, and that’s fine, too.

Make a plan

Dr. Howard says it’s a good idea to make a plan for how the day will look, and to share that plan with the kids. Making it somewhat predictable, so they know what to expect, who will be there, and what it will be like can make everyone feel like they have a little more control.

If you are churchgoers, you might plan to go to church first thing and then go home and have breakfast. Or maybe you’ll wake up, make pancakes together and then take a walk. If people are coming over for lunch, let the children know who will be coming over. Then maybe next on the schedule they’ll have some free time to play or hang out before dinner.

Do what you can to include favorite traditions when you are planning your day, too. It may feel bittersweet, but people find comfort in traditions, and they can help the day feel special.

Memorialize

Remembering is part of grieving and part of healing, so think about doing something to memorialize your loved one. It will be sad, but Dr. Howard says it can help in the grieving process. In the case of a deceased parent, for example, maybe that means taking the occasion to talk to the kids about how special their mother was, tell favorite stories, and let the kids know that some of the things that she taught them will be with them forever, even though she isn’t here now. If she really liked flowers, maybe you could plant some flowers in honor of her. If she liked to collect things, maybe you could put her collection in a place you’ll pass by it frequently, and think of her.

Ask for help

One very important consideration when making a plan for the day is for parents and caregivers to consider what they can get through emotionally, and what might be helpful to them. Parents should certainly ask for other family members and close friends to be on hand to support them  if that would be useful. Maybe a relative could help make dinner, play a game with the kids, or even just be present  to backstop or take over if a break is needed.

Frequently Asked Questions

How might kids feel on holidays after the loss of a loved one?

What can families do to support kids on holidays after the death of a loved one?

Should you skip holiday celebrations the first year after a loved one has died?

No, you probably shouldn’t skip holiday celebrations the first year after a loved one has died. For families coping with bereavement, it isn’t uncommon to experience moments of joy along with some sorrow on significant days. Just acknowledge that this will likely be a difficult day for your family. https://standingabovethecrowd.com/?p=16165

The fear and avoidance they inspire can be seriously impairing

Writer: Caroline Miller

Clinical Expert: Jerry Bubrick, PhD

What You'll Learn

- What are the symptoms of a panic attack?

- When does a panic attack become panic disorder?

- What are the best ways to treat panic attacks?

- Quick Read

- Full Article

- Ambushed by panic

- Panic disorder

- Panic plus agoraphobia

- Avoidance widens

- Treatment for panic disorder

- Medication treatment

- Being open about panic attacks

People toss around the words “panic attack” a lot, but the symptoms of a true panic attack are very specific. They include feelings like a racing heart, sweating, dizziness, shortness of breath, and nausea. The person may feel like they’re dying. Panic attacks usually peak at 10 minutes and get better in about 30 minutes. People who’ve had panic attacks often link them with places or situations. Then they feel anxious about having another attack in that same situation.  

Panic attacks develop into panic disorder?when a person worries so much about having another attack that they start avoiding places or situations. This can mean planes, trains, cars, movie theaters, elevators or social situations like parties. They may also avoid situations that remind them of the physical symptoms of a panic attack. For example, they might avoid exercising at the gym because it makes them sweat. Avoiding another attack can seriously affect all aspects of the person’s life. Panic disorder usually shows up in the teen years.  

The best treatment for panic attacks is cognitive behavioral therapy (CBT). CBT helps the person feel calm and learn to tolerate their physical symptoms. They learn that the feelings aren’t really going to hurt them. Therapists may have the person do things like jumping jacks to get their heart racing so they can practice skills to feel calm during the physical experience of a panic attack. Often antidepressant medications are used to help the therapy work better. They work by lessening the intensity of the worry.  

When the teen has less fear, the therapist will have them try out things they associate with the attacks, little by little. This makes them feel more confident and gives them more freedom.  

“Panic attack” is a term that has come to be used very loosely for an anxious reaction. “You hear a lot of people say things like, ‘When I’m around dogs I have a panic attack, ’” says Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “Most likely what they mean is they get panicky, but they’re not having a real panic attack.”

A real panic attack is when you experience sudden, intense physical symptoms — racing heart, sweating, shaking, dizziness, shortness of breath, nausea — and you interpret them to mean something is terribly wrong. People often believe they’re dying. Or “going crazy.”

“All of a sudden, you have this explosion of physical symptoms that are really uncomfortable,” explains Dr. Bubrick. “A lot of times, people think that they’re having a heart attack and they go to the emergency room.”

Andrea Petersen describes having a panic attack at 20, on an “ordinary morning” when she was a sophomore in college registering for classes. “All of a sudden my heart rate kicked up, I was short of breath, and the words I was reading started to morph, to dip and buckle,” she recalls. “I was gripped with this overwhelming terror. I felt like I was going to die. Something in my body or brain had gone horribly wrong.”

Ambushed by panic

What you’re experiencing in a panic attack is your body’s alarm system — which is wired to prepare you physically to handle an emergency — going off without a real threat. Panic attacks usually peak at 10 minutes and abate by about a half hour. But some people report ongoing symptoms.

Petersen, whose memoir On Edge: A Journey Through Anxiety, chronicles her experience, as well as the latest research on anxiety, spent a month on her parents’ couch, immobilized by intense physical sensations as well as overwhelming terror and dread. “I think of it as a month-long panic attack,” she says. “Yes there were peaks and valleys. But it was a full-body and consuming experience, and incredibly disabling. And, it turns out, not actually that unusual.”

Often, as with Petersen’s experience, a panic attack happens out of the blue, and you have no clue what triggered it. Clinicians call those unexpected panic attacks.

But people who’ve had panic attacks often associate them with places or situations where they’ve occurred, and anticipate with mounting anxiety having another attack in that situation. That makes them prone to what clinicians call expected panic attacks.

Panic disorder

A panic attack develops into something called panic disorder when a person worries so much about having another attack that they begin to avoid places or situations that they associate with them.

Not everyone who has a single panic attack goes on to develop a full-blown disorder. Some have the experience but dismiss it as an uncomfortable aberration that they hope won’t happen again. But in someone who is predisposed to anxiety disorders, Dr. Bubrick notes, the pathway in the brain that assesses for threats may be hyperactive. Avoiding another attack becomes an overriding priority.

For Petersen, whose panic disorder wasn’t diagnosed for a year, “My world just got smaller and smaller. If I was in the line at the coffee shop, and I felt panicky, I wouldn’t go to the coffee shop again. I stopped going to movies. I stopped going to parties. I stopped doing pretty much anything besides going to the couple of classes I was able to take — I had to drop half my courses — and my room in the sorority house.”

Panic plus agoraphobia

Because part of the experience of a panic attack is an intense need to flee, people who’ve had them often avoid situations where it would be difficult to get away if an attack occurred, such as cars, trains, planes, crowds. This avoidance of places deemed difficult to escape is agoraphobia.

“Agoraphobia just means the fear of not being able to escape a situation in case you have a panic attack,” says Dr. Bubrick. That often includes enclosed spaces. “People will say, ‘You know what, it’s fine. I just won’t cross a bridge, ever. I won’t go on a plane. I don’t need to fly anywhere,’” he adds. But it could also be at a baseball game with friends who wouldn’t take kindly to having to leave in the fifth inning. Or at the theater, or a movie.

Petersen, a Wall Street Journal contributing writer who is an ambitious traveler despite her anxiety, notes that even now she doesn’t drive on the highway, after a “terrible” panic attack driving between San Diego and Los Angeles.

Avoidance widens

People with panic disorder also can develop intense fear of the physical sensations associated with panic — like an elevated heart rate, sweating, shortness of breath — even when they’re not in the context of a panic attack. That might lead them to avoid exercise because they interpret those physical sensations as dangerous, even though they’re actually signs of a healthy, strenuous workout.

“You can imagine a lot of people then don’t go to the gym,” Dr. Bubrick notes. “People don’t want to be in situations where it’s hot, because that might trigger them, or in situations where they think they’re going to have that physical distress like on a roller coaster or an airplane. “

While young children can have fearful or panicky episodes, true panic disorder doesn’t appear until the teen years. Panic attacks can also develop as a feature of another kind of anxiety, like social anxiety with panic attacks, or specific phobia with panic attacks.

Treatment for panic disorder

Research shows that the most successful treatment for panic disorder is a combination of antidepressant medication and cognitive behavioral therapy (CBT). Many clinicians recommend CBT as the first-line treatment, with medication added if necessary to make the patient comfortable enough to participate in CBT.

In treating someone who has panic disorder with CBT, the clinician starts by working with the patient to think more flexibly about their anxiety. Rather than viewing the physical symptoms as dangerous, they practice tolerating them, knowing that they aren’t harmful.

To help the person disconnect the negative feelings associated with attacks, the therapist induces those physical sensations — the patient does jumping jacks or stair climbing to get the heart racing, spinning to get dizzy, breathing through a coffee straw to get shortness of breath. “We’re exposing you to the actual, physical feelings of a panic attack, one symptom at a time,” Dr. Bubrick explains.

Then, instead of simply tolerating the anxiety and waiting for it to subside, the person is taught how to do deep-breathing techniques to calm the physical symptoms down. Some clinicians don’t do the deep breathing, on the grounds that the symptoms will pass on their own. But Dr. Bubrick likes to give kids tools to give them a sense of empowerment, “to have them feel that they can control the symptoms.”

As the fear of attacks diminishes, attacks themselves grow less severe and less frequent. The person is also ready to start venturing into real-world situations associated with their panic attacks. “Now we can go onto buses or subways or movie theaters, wherever it is they were avoiding, knowing that if they have a panic attack they have a way of dealing with it.”

Patients who’ve been treated with CBT sometimes return for “maintenance sessions,” to refresh their skills. “When I start to feel anxiety kick in, and I feel a relapse is possible,” Petersen says, “I go for CBT again.”

Medication treatment

If you think of panic attacks as a malfunctioning alarm system, antidepressants called selective serotonin reuptake inhibitors (SSRIs) make the system less reactive.

Petersen describes the effect of SSRIs as reducing the intensity of worry. “Over several weeks I notice that if worry was taking up 70 percent of my brain before, space is opening up, and worry is taking only 40 percent,” she says. “I find myself more present in the moment, able to have conversations, actually hearing what the other person is saying. The worry monologue can be so loud and so distracting.” And she says, over time there are fewer panic attacks.

It’s not uncommon for people who experience panic attacks to be prescribed a sedative such as Klonapin, Xanax or Ativan to be taken if they have an attack. But since panic attacks are short-lived, clinicians note that it’s easy to misinterpret the diminishing symptoms as the effect of the medication, and develop a psychological dependency. And these medications, called benzodiazepines, have to be taken very carefully, as they can become addictive, and have dangerous interactions with other medications.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Being open about panic attacks

While panic attacks are much more widely understood than they were when Petersen was first experiencing them, she notes that research shows that people who have panic disorder often wait years before they discuss symptoms with a medical professional — or even other people. It’s easy to feel ashamed by the symptoms — if you’re not dying, does that mean there’s something terribly wrong with your brain?

When she was struggling in college and didn’t know what was wrong with her, she notes, “I told friends that I had mono.”

But later, after some bad experiences with romantic partners who weren’t supportive, she says, “I made a vow to tell every person I dated about my anxiety up front, as if it was a communicable disease. Being around people who can accept that part of you and support you is super important.”

Frequently Asked Questions

How do you treat a child with panic attacks?

You treat a child with panic attacks with cognitive behavioral therapy (CBT) and sometimes antidepressant medication. Clinicians recommend CBT as the first line of treatment for panic attacks in kids, with medication added if necessary. https://standingabovethecrowd.com/?p=16159

Finding is one of most direct statements from the tech company on how AI can exacerbate mental health issues

More than a million ChatGPT users each week send messages that include “explicit indicators of potential suicidal planning or intent”, according to a blogpost published by OpenAI on Monday. The finding, part of an update on how the chatbot handles sensitive conversations, is one of the most direct statements from the artificial intelligence giant on the scale of how AI can exacerbate mental health issues.

In addition to its estimates on suicidal ideations and related interactions, OpenAI also said that about 0.07% of users active in a given week – about 560,000 of its touted 800m weekly users – show “possible signs of mental health emergencies related to psychosis or mania”. The post cautioned that these conversations were difficult to detect or measure, and that this was an initial analysis.

As OpenAI releases data on mental health issues related to its marquee product, the company is facing increased scrutiny following a highly publicized lawsuit from the family of a teenage boy who died by suicide after extensive engagement with ChatGPT. The Federal Trade Commission last month additionally launched a broad investigation into companies that create AI chatbots, including OpenAI, to find how they measure negative impacts on children and teens.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

OpenAI claimed in its post that its recent GPT-5 update reduced the number of undesirable behaviors from its product and improved user safety in a model evaluation involving more than 1,000 self-harm and suicide conversations. The company did not immediately return a request for comment.

“Our new automated evaluations score the new GPT?5 model at 91% compliant with our desired behaviors, compared to 77% for the previous GPT?5 model,” the company’s post reads.

OpenAI stated that GPT-5 expanded access to crisis hotlines and added reminders for users to take breaks during long sessions. To make improvements to the model, the company said it enlisted 170 clinicians from its Global Physician Network of health care experts to assist its research over recent months, which included rating the safety of its model’s responses and helping write the chatbot’s answers to mental-health related questions.

“As part of this work, psychiatrists and psychologists reviewed more than 1,800 model responses involving serious mental health situations and compared responses from the new GPT?5 chat model to previous models,” OpenAI said. The company’s definition of “desirable” involved determining whether a group of its experts reached the same conclusion about what would be an appropriate response in certain situations.

AI researchers and public health advocates have long been wary of chatbots’ propensity to affirm users’ decisions or delusions regardless of whether they may be harmful, an issue known as sycophancy. Mental health experts have also been concerned about people using AI chatbots for psychological support and warned how it could harm vulnerable users.

The language in OpenAI’s post distances the company from any potential causal links between its product and the mental health crises that its users are experiencing.

“Mental health symptoms and emotional distress are universally present in human societies, and an increasing user base means that some portion of ChatGPT conversations include these situations,” OpenAI’s post stated.

OpenAI’s CEO Sam Altman earlier this month claimed in a post on X that the company had made advancements in treating mental health issues, announcing that OpenAI would ease restrictions and soon begin to allow adults to create erotic content.

“We made ChatGPT pretty restrictive to make sure we were being careful with mental health issues. We realize this made it less useful/enjoyable to many users who had no mental health problems, but given the seriousness of the issue we wanted to get this right,” Altman posted. “Now that we have been able to mitigate the serious mental health issues and have new tools, we are going to be able to safely relax the restrictions in most cases.”

- In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org

- https://standingabovethecrowd.com/?p=16094

James Donaldson on Mental Health - Panic Attacks and How to Treat Them

The fear and avoidance they inspire can be seriously impairing

Writer: Caroline Miller

Clinical Expert: Jerry Bubrick, PhD

What You'll Learn

- What are the symptoms of a panic attack?
- When does a panic attack become panic disorder?
- What are the best ways to treat panic attacks?
- Quick Read
- Full Article
- Ambushed by panic
- Panic disorder
- Panic plus agoraphobia
- Avoidance widens
- Treatment for panic disorder
- Medication treatment
- Being open about panic attacks

People toss around the words “panic attack” a lot, but the symptoms of a true panic attack are very specific. They include feelings like a racing heart, sweating, dizziness, shortness of breath, and nausea. The person may feel like they’re dying. Panic attacks usually peak at 10 minutes and get better in about 30 minutes. People who’ve had panic attacks often link them with places or situations. Then they feel anxious about having another attack in that same situation.  

Panic attacks develop into panic disorder?when a person worries so much about having another attack that they start avoiding places or situations. This can mean planes, trains, cars, movie theaters, elevators or social situations like parties. They may also avoid situations that remind them of the physical symptoms of a panic attack. For example, they might avoid exercising at the gym because it makes them sweat. Avoiding another attack can seriously affect all aspects of the person’s life. Panic disorder usually shows up in the teen years.  

The best treatment for panic attacks is cognitive behavioral therapy (CBT). CBT helps the person feel calm and learn to tolerate their physical symptoms. They learn that the feelings aren’t really going to hurt them. Therapists may have the person do things like jumping jacks to get their heart racing so they can practice skills to feel calm during the physical experience of a panic attack. Often antidepressant medications are used to help the therapy work better. They work by lessening the intensity of the worry.  

When the teen has less fear, the therapist will have them try out things they associate with the attacks, little by little. This makes them feel more confident and gives them more freedom.  

“Panic attack” is a term that has come to be used very loosely for an anxious reaction. “You hear a lot of people say things like, ‘When I’m around dogs I have a panic attack, ’” says Jerry Bubrick, PhD, a clinical psychologist who treated many children with anxiety and OCD at the Child Mind Institute. “Most likely what they mean is they get panicky, but they’re not having a real panic attack.”

A real panic attack is when you experience sudden, intense physical symptoms — racing heart, sweating, shaking, dizziness, shortness of breath, nausea — and you interpret them to mean something is terribly wrong. People often believe they’re dying. Or “going crazy.”

“All of a sudden, you have this explosion of physical symptoms that are really uncomfortable,” explains Dr. Bubrick. “A lot of times, people think that they’re having a heart attack and they go to the emergency room.”

Andrea Petersen describes having a panic attack at 20, on an “ordinary morning” when she was a sophomore in college registering for classes. “All of a sudden my heart rate kicked up, I was short of breath, and the words I was reading started to morph, to dip and buckle,” she recalls. “I was gripped with this overwhelming terror. I felt like I was going to die. Something in my body or brain had gone horribly wrong.”

Ambushed by panic

What you’re experiencing in a panic attack is your body’s alarm system — which is wired to prepare you physically to handle an emergency — going off without a real threat. Panic attacks usually peak at 10 minutes and abate by about a half hour. But some people report ongoing symptoms.

Petersen, whose memoir On Edge: A Journey Through Anxiety, chronicles her experience, as well as the latest research on anxiety, spent a month on her parents’ couch, immobilized by intense physical sensations as well as overwhelming terror and dread. “I think of it as a month-long panic attack,” she says. “Yes there were peaks and valleys. But it was a full-body and consuming experience, and incredibly disabling. And, it turns out, not actually that unusual.”

Often, as with Petersen’s experience, a panic attack happens out of the blue, and you have no clue what triggered it. Clinicians call those unexpected panic attacks.

But people who’ve had panic attacks often associate them with places or situations where they’ve occurred, and anticipate with mounting anxiety having another attack in that situation. That makes them prone to what clinicians call expected panic attacks.

Panic disorder

A panic attack develops into something called panic disorder when a person worries so much about having another attack that they begin to avoid places or situations that they associate with them.

Not everyone who has a single panic attack goes on to develop a full-blown disorder. Some have the experience but dismiss it as an uncomfortable aberration that they hope won’t happen again. But in someone who is predisposed to anxiety disorders, Dr. Bubrick notes, the pathway in the brain that assesses for threats may be hyperactive. Avoiding another attack becomes an overriding priority.

For Petersen, whose panic disorder wasn’t diagnosed for a year, “My world just got smaller and smaller. If I was in the line at the coffee shop, and I felt panicky, I wouldn’t go to the coffee shop again. I stopped going to movies. I stopped going to parties. I stopped doing pretty much anything besides going to the couple of classes I was able to take — I had to drop half my courses — and my room in the sorority house.”

Panic plus agoraphobia

Because part of the experience of a panic attack is an intense need to flee, people who’ve had them often avoid situations where it would be difficult to get away if an attack occurred, such as cars, trains, planes, crowds. This avoidance of places deemed difficult to escape is agoraphobia.

“Agoraphobia just means the fear of not being able to escape a situation in case you have a panic attack,” says Dr. Bubrick. That often includes enclosed spaces. “People will say, ‘You know what, it’s fine. I just won’t cross a bridge, ever. I won’t go on a plane. I don’t need to fly anywhere,’” he adds. But it could also be at a baseball game with friends who wouldn’t take kindly to having to leave in the fifth inning. Or at the theater, or a movie.

Petersen, a Wall Street Journal contributing writer who is an ambitious traveler despite her anxiety, notes that even now she doesn’t drive on the highway, after a “terrible” panic attack driving between San Diego and Los Angeles.

Avoidance widens

People with panic disorder also can develop intense fear of the physical sensations associated with panic — like an elevated heart rate, sweating, shortness of breath — even when they’re not in the context of a panic attack. That might lead them to avoid exercise because they interpret those physical sensations as dangerous, even though they’re actually signs of a healthy, strenuous workout.

“You can imagine a lot of people then don’t go to the gym,” Dr. Bubrick notes. “People don’t want to be in situations where it’s hot, because that might trigger them, or in situations where they think they’re going to have that physical distress like on a roller coaster or an airplane. “

While young children can have fearful or panicky episodes, true panic disorder doesn’t appear until the teen years. Panic attacks can also develop as a feature of another kind of anxiety, like social anxiety with panic attacks, or specific phobia with panic attacks.

Treatment for panic disorder

Research shows that the most successful treatment for panic disorder is a combination of antidepressant medication and cognitive behavioral therapy (CBT). Many clinicians recommend CBT as the first-line treatment, with medication added if necessary to make the patient comfortable enough to participate in CBT.

In treating someone who has panic disorder with CBT, the clinician starts by working with the patient to think more flexibly about their anxiety. Rather than viewing the physical symptoms as dangerous, they practice tolerating them, knowing that they aren’t harmful.

To help the person disconnect the negative feelings associated with attacks, the therapist induces those physical sensations — the patient does jumping jacks or stair climbing to get the heart racing, spinning to get dizzy, breathing through a coffee straw to get shortness of breath. “We’re exposing you to the actual, physical feelings of a panic attack, one symptom at a time,” Dr. Bubrick explains.

Then, instead of simply tolerating the anxiety and waiting for it to subside, the person is taught how to do deep-breathing techniques to calm the physical symptoms down. Some clinicians don’t do the deep breathing, on the grounds that the symptoms will pass on their own. But Dr. Bubrick likes to give kids tools to give them a sense of empowerment, “to have them feel that they can control the symptoms.”

As the fear of attacks diminishes, attacks themselves grow less severe and less frequent. The person is also ready to start venturing into real-world situations associated with their panic attacks. “Now we can go onto buses or subways or movie theaters, wherever it is they were avoiding, knowing that if they have a panic attack they have a way of dealing with it.”

Patients who’ve been treated with CBT sometimes return for “maintenance sessions,” to refresh their skills. “When I start to feel anxiety kick in, and I feel a relapse is possible,” Petersen says, “I go for CBT again.”

Medication treatment

If you think of panic attacks as a malfunctioning alarm system, antidepressants called selective serotonin reuptake inhibitors (SSRIs) make the system less reactive.

Petersen describes the effect of SSRIs as reducing the intensity of worry. “Over several weeks I notice that if worry was taking up 70 percent of my brain before, space is opening up, and worry is taking only 40 percent,” she says. “I find myself more present in the moment, able to have conversations, actually hearing what the other person is saying. The worry monologue can be so loud and so distracting.” And she says, over time there are fewer panic attacks.

It’s not uncommon for people who experience panic attacks to be prescribed a sedative such as Klonapin, Xanax or Ativan to be taken if they have an attack. But since panic attacks are short-lived, clinicians note that it’s easy to misinterpret the diminishing symptoms as the effect of the medication, and develop a psychological dependency. And these medications, called benzodiazepines, have to be taken very carefully, as they can become addictive, and have dangerous interactions with other medications.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

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Being open about panic attacks

While panic attacks are much more widely understood than they were when Petersen was first experiencing them, she notes that research shows that people who have panic disorder often wait years before they discuss symptoms with a medical professional — or even other people. It’s easy to feel ashamed by the symptoms — if you’re not dying, does that mean there’s something terribly wrong with your brain?

When she was struggling in college and didn’t know what was wrong with her, she notes, “I told friends that I had mono.”

But later, after some bad experiences with romantic partners who weren’t supportive, she says, “I made a vow to tell every person I dated about my anxiety up front, as if it was a communicable disease. Being around people who can accept that part of you and support you is super important.”

Frequently Asked Questions

How do you treat a child with panic attacks?

You treat a child with panic attacks with cognitive behavioral therapy (CBT) and sometimes antidepressant medication. Clinicians recommend CBT as the first line of treatment for panic attacks in kids, with medication added if necessary.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-panic-attacks-and-how-to-treat-them/

Depression in young adulthood has a stronger hereditary component and is associated with a higher risk of suicide attempts than depression that begins later in life, according to a new study published in Nature Genetics by researchers at Karolinska Institutet, among others.

“We hope that genetic information will be able to help healthcare professionals identify people at high risk of suicide, who may need more support and closer follow-up,” says Lu Yi, senior researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, and one of the study’s corresponding authors.

Depression is a common mental illness that can affect people at different stages of life. The new study shows that depression that begins before the age of 25 has a stronger hereditary component than depression that begins late in life.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Major genetic differences

The study, based on medical records and genetic data from over 150,000 people with depression and 360,000 controls in Denmark, Sweden, Norway, Finland and Estonia, compared genetics and risk of suicide attempts in people who had their first depression before the age of 25 (early onset) and those diagnosed after the age of 50 (late onset).

The genetic differences between the groups were large. The researchers identified twelve genetic regions that were linked to early onset and two regions that were linked to late onset. One in four people with a high genetic risk of early-onset depression attempted suicide within ten years of diagnosis, which was about twice as many as people with a low genetic risk.

“We show that early-onset depression has partly different genetic causes than depression that affects older individuals and that the risk of suicide attempts is increased,” says Lu Yi. “This is an important step towards precision medicine in psychiatry, where treatment and preventive measures are tailored to each individual.” 

Suicide prevention in healthcare

The researchers now plan to investigate how the genetic differences are related to brain development, stress and life experiences, and whether genetic risk profiles can be used in suicide prevention in healthcare. https://standingabovethecrowd.com/?p=16156

James Donaldson on Mental Health - My daughter is worrying about her upcoming graduation and the future. Lately she can't sleep and her heart is racing. Is she having panic attacks?

Writer: Rachel Busman, PsyD, ABPP

Clinical Expert: Rachel Busman, PsyD, ABPP

Question

My daughter who is graduating high school this year is having trouble with anxiety issues. She worries over graduating, college, and future events in her life, which seems normal to me, but lately she says she can't sleep and her heart races sometimes while she is just sitting in her room. What could be causing this? Is this really a panic attack, or is she imagining this?

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

It’s so great that you’re reaching out with this question. You’re absolutely correct that young adults can worry about transitioning to college, the future and being an adult. Having those worries can be very normal. However, it sounds like your daughter’s sleep might be being impacted and she might be having some bodily sensations related to anxiety, which could be cause for concern.

A panic attack is a surge of physical sensations and/or intense fears that come seemingly out of the blue and last for a discreet period of time. A racing heart is one of the symptoms, but not being able to fall asleep isn’t. For your daughter to be having a panic attack she would need to be experiencing at least three more of the following panic attack symptoms:

- Palpitations, pounding heart, or accelerated heart rate
- Sweating
- Trembling or shaking
- Shortness of breath
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, or faint
- Chills or heat sensations
- Numbness or tingling sensations
- Derealization (feelings of unreality) or depersonalization (being detached from oneself)
- Fear of losing control or “going crazy”
- Fear of dying

Even if your daughter isn’t having panic attacks, you are still picking up on some feelings of distress that are outside of the norm for your daughter, so it is good that you are asking questions. It may well be that her impending graduation is causing some situational stress. She may find it very helpful to talk to a mental health professional about some of the stress that she’s having. A mental health professional could also help determine if her sleep disturbances and other symptoms are transient in nature or more chronic, or if she is also struggling with other things like a depressed mood. Either way, talking to someone may help her with managing the stress that’s coming in the next couple months with her graduation and transition to college.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-my-daughter-is-worrying-about-her-upcoming-graduation-and-the-future-lately-she-cant-sleep-and-her-heart-is-racing-is-she-having-panic-attacks/