It can be a serious disease for younger people, and many millennials have chronic physical and mental health conditions.
March 20, 2020
Until several days ago, some bars and restaurants were still packed with St. Patrick’s Day crowds. Beaches were full. And it seemed as though many young adults were slow to take steps to curb the spread of the coronavirus.
“I kept hearing, ‘Eighty percent of cases are mild,’” said Christian Heuer, 32, of Los Angeles, who tested positive for the virus last week and has been running a low-grade fever for six days. “But this is not just a sniffly runny nose. It’s the real deal. You’re really sick.”
His girlfriend, Natasha Wynnyk, 28, felt fine for several days after Mr. Heuer got sick, and she thought she might be impervious to infection. Then her fever spiked on Monday evening, and she started experiencing severe and sharp aches in her back, joints and fingers, which she compared to a feeling of being stabbed.
The couple are part of a worrying trend suggesting that young people may have contributed to the pandemic’s spread in the United States and other countries by going about business as usual for too long, perhaps believing that being young and healthy protected them from infection. But preliminary figures released on Wednesday by the Centers for Disease Control and Prevention show that adults ages 20 to 44 represent nearly one-third of U.S. coronavirus patients whose ages are known.
Younger adults are generally more resilient than older people, but an increase in chronic health conditions among millennials, in their 20s and 30s now, has made them less hardy than they might think. They have seen rising levels of obesity and illnesses such as Type 2 diabetes and high blood pressure, as well as an increase in heart disease and some cancers. These are strongly associated with poor outcomes from coronavirus infection.
In addition, some 17 percent of men and 12 percent of women ages 18 to 44 smoke cigarettes, and 4 percent to 7 percent use e-cigarettes, according to national figures. Both increase the risk of respiratory illness.
How members of this generation will adapt to life during the pandemic might also dovetail with other problems. Compared with members of Generation X, in their 40s and 50s now, millennials have higher rates of behavioral health problems like depression — which affects one in 20 adults who are in their mid-30s, according to one report — and a significant number have alcohol and substance abuse problems, which are easily aggravated by social and economic turmoil and dislocation, experts say.
Millennials make up the largest share of the labor force and are a vital part of the economy, but they also face unique financial struggles. Many millennials juggle several jobs in the gig economy, and they are more likely than any other age group to be uninsured. Many are also burdened by student debt and contend with increasingly unaffordable housing. As a generation, they have borne the brunt of drug overdose deaths. Many have postponed marriage and starting a family for financial reasons.
While they have heard that by engaging in social distancing they can play an important role in reducing the spread of the coronavirus to others more vulnerable than they are, they are not immune.
Although the risk of hospitalization or dying from Covid-19, the disease caused by the virus, increases with each decade of life, according to the C.D.C.’s recent analysis of cases, the agency found that young adults can develop severe disease: Of 508 patients admitted to hospitals, 20 percent were 20 to 44 years old. Some younger people do die of the disease, at a rate of about one or two per 1,000 cases.
The report’s authors cautioned that their analysis was limited because much of their data was incomplete, and that information about chronic health conditions that affect the severity of disease was missing.
A report on millennials’ health by the Blue Cross Blue Shield Association, released last year, said chronic physical health conditions that are more common among millennials compared with Generation X members include high blood pressure, which affects more than one in eight adults in their mid-30s, and Type 2 diabetes, which affects one in 25. The report analyzed claims from the large insurer’s database.
Obesity, which has increased in prevalence for all Americans, is also considered a risk factor for the coronavirus, experts say.
But many news reports have consistently emphasized that the elderly and those in poor health are the most vulnerable and most likely to die.
“The message has been that if you’re younger and generally healthy, you’re going to be fine, and I think that’s the wrong message,” said Mila Clarke Buckley, 30, who writes about living with Type 2 diabetes on her blog, Hangry Woman, and creates sponsored content for FreeStyle Libre, a continuous glucose monitoring system. “It makes young people feel that invincibility they already feel about their health.”
Living with diabetes puts Ms. Buckley at heightened risk for severe illness if she were to become infected, she said, so she has stopped traveling out of town. She is also staying home more and practicing social distancing — even with her husband, who is still going out to work.
“He has a cold right now, so we are sleeping in separate bedrooms,” Ms. Buckley said from her home in Houston. “We know that if I get sick it’s a big deal — it may impact me a lot harder.”
Will Lanier, 34, at the gym he frequents in Austin, Tex. He worries about how people his age will cope with social isolation brought on by adapting to the coronavirus.Credit...Ilana Panich-Linsman for The New York Times
Ms. Buckley said she had turned down a tempting invitation from her sister-in-law, who had invited the entire extended family over for dinner, now that restaurants were offering limited service. But the family is large, Ms. Buckley said, and she declined.
“We told her we don’t think it’s a good idea to gather, and perhaps she should rethink it,” she said.
To catch up with her friends, Ms. Buckley said, she made a date for a FaceTime Happy Hour for this week.
“We’ll each pick out our own favorite wine and jump on FaceTime at 7 o’clock,” she said.
But staying home and practicing social distancing may take a greater toll on young adults as they face additional mental health challenges, especially if they live alone or struggle with anxiety or depression, said Benjamin F. Miller, a psychologist who is the chief strategy officer for Well Being Trust, a national foundation focusing on mental and spiritual health.
Young adults are less likely than older adults to be married, and a 2018 Cigna survey of 20,000 Americans found that many reported feeling lonely and left out. Those who are 18 to 37 were more likely than older adults to report they had no meaningful relationships, did not share ideas and interests with anyone, felt isolated and did not feel close to anyone.
“Many of our millennials already feel socially disconnected, and this exacerbates those ongoing feelings these folks already had,” Dr. Miller said.
The Blue Cross report said that six of the top 10 conditions taking the heaviest toll on young adults were behavioral health conditions like substance abuse and mental health problems.
Like many millennials, Will Lanier, a 34-year-old from Austin, Tex., works at home, running the Out Foundation, a wellness and fitness organization for LGBTQ people that he founded. (A survivor of ulcerative colitis and colon cancer, he serves as a patient advocate on a Pfizer advisory board, for which he receives some financial compensation.) He lives alone and worries about the desolation he might feel if classes at his CrossFit gym are shut down.
“FaceTime can only do so much, and human interaction is so important,” Mr. Lanier said.
While people often make a point of reaching out to older relatives or neighbors who live alone and may be lonely, he said, “people don’t check on young people.”
“It’s just me and my dog — I’ll go days without talking with someone,” he said. “If I slipped in the shower, it’d be days before anyone found me.”
New York Times - Young Adults Come to Grips With Coronavirus Health Risks - It can be a serious disease for younger people, and many millennials have chronic physical and mental health conditions.
By Roni Caryn Rabin
March 20, 2020
Few people worry about spending too much time in bed. An extra hour or two of stolen sleep on Sunday can feel like heaven after a long week of work and family activities. But did you know that clocking more than the recommended amount can negatively impact your health?
For most adults, getting between seven and nine hours of sleep a night is ideal. Although a small percentage of people actually need 10 hours, for most adults sleeping more hours than the recommended amount may indicate an underlying health concern. In addition, regularly sleeping more than the suggested amount may increase the risk of obesity, headache, back pain, and heart disease. And a recent study discovered that oversleeping can put the body at risk for metabolic issues. Learn more about how excessive sleep can impact your metabolism.
What the Science Says
In a recent study, researchers analyzed the health, medical histories, and sleep totals of a group of more than 130,000 men and women ages 40 to 69. With this data, researchers were able to link sleeping less than six hours, as well as sleeping more than 10 hours, to cases of metabolic syndrome and related symptoms.
Understanding Metabolic Syndrome
People diagnosed with metabolic syndrome have at least three of the following symptoms: Excess fat around the middle, hypertension, low levels of HDL or “good” cholesterol, high fasting blood glucose and high triglyceride levels. In the study, 29 percent of men were deemed to have metabolic syndrome, while a quarter of women showed signs of it.
There are some notable differences between genders when it comes to sleep and metabolism. In particular, women who sleep less than six hours a night may have more belly fat than those who sleep longer, while men are likely to have both bigger waists and metabolic syndrome if they sleep less than six hours. On the other hand, women who sleep 10 or more hours have a much higher risk for metabolic syndrome, while in men it correlates to higher triglyceride levels as well.
Red Flags for Metabolism Issues
For most people, feelings of excessive sleepiness that arise even if they meet the recommended seven to nine hours a night may reflect recent lifestyle changes, such as a new work schedule, job relocation, or increase in physical exercise. It could also be a sign of a disorder such as sleep apnea that results in poor sleep quality, leaving people tired in the morning. But because there may be other health issues at play, including Parkinson’s, depression, anxiety, infections and gastrointestinal disorders, if you are experiencing excessive sleepiness, it’s important to mention it to your doctor. Take the time to describe your symptoms in detail which will help your doctor diagnose your condition and recommend the best treatment fit for you.
This Is Your Body on No Sleep
A missed night of sleep is a fairly common experience for young people, new parents, and all kinds of busy adults. And while sometimes it’s because you’re having fun (New Year’s Eve!) and other times it’s because you must (an infant in the house), the end result of a sleepless night is the same: Your body has been deprived of an essential component for good health and energy.
Most adults do best with between seven and nine hours of sleep a night, but nearly 30 percent get less than six, and some occasionally miss a night entirely, resulting in a slow accumulation of sleep debt that can affect your appearance, your immune system, and even the way your brain functions. Read on to discover a few of the ways a sleepless night affects your body.
Puffy eyes and a pasty complexion aren’t what you want to see when you wake up in the morning, but your appearance can be affected when you get too little sleep. Missing a night’s sleep can cause fluid to accumulate below your eyes, leading to circles and swelling.
Lack of sleep changes the way your body interprets hunger signals, leaving you with cravings that can be hard to control. In fact, women who sleep five hours or less a night are 15 percent more likely to become obese during the next decade.
Missing a night of sleep increases the likelihood that you will feel forgetful or experience slow reaction times, which can result in small mistakes (typos on a work presentation) or very big ones (impaired driving).
An itchy, drippy nose is another potential side effect of a missed night of sleep. Your immune system may also be affected, leaving you more susceptible to colds.
Fatigue is a big factor when it comes to being in the mood for sex. In National Sleep Foundation’s Sleep in America poll, about a third of women say they put sexual activity with their partner on the back burner when they are sleep-deprived.
A single night without sleep isn’t usually a big deal, but over time, these occasional lapses can lead to more serious conditions. Longer term, too little sleep may contribute to heart disease, high blood pressure, diabetes, obesity, and stroke. The big takeaway here to a healthy life is to strive to practice good sleep habits, including getting to bed on time.
How Your Body Uses Calories While You Sleep
Burning calories is a term most often associated with aerobic exercise and physically taxing jobs. But actually, you don’t need to be engaged in strenuous activity to burn calories. Your body uses them up around the clock, even when you are asleep. Learn more about the functions your body performs at night, and exactly how it uses calories while you sleep.
How REM Uses Energy
Despite the fact that you are resting, your body still consumes energy when you sleep. Energy use is particularly high during REM (rapid eye movement) sleep. During this time, your brain is highly active and you burn the most glucose, your body’s source of fuel. Your heart rate and blood pressure also rise during this time, which burns more calories.
Other Calorie-Burning Activities During Sleep
During the night, your body goes to work repairing any damage done on a cellular level during your waking hours. For instance, if you exercise during the day, your muscles will recover and repair themselves at night, which requires energy. Food digestion also uses energy, as your body breaks down your meal into usable fuel for the following day.
How Many Calories Can You Burn?
The amount of energy you use during sleep depends on a number of factors, including your basal metabolic rate (BMR), which determines the amount of energy your body needs to maintain its most basic functions. This includes breathing, blood circulation, and keeping your organs running. How much you weigh plays a role in setting your BMR: The more pounds you are carrying, the more energy you use. Finally, the amount of sleep a person gets influences calories burned as well. For example, a healthy person who weighs 125 pounds burns approximately 38 calories per hour of sleep, so you can multiple that number by number of sleep hours to see approximately how many calories are being burned.
The Right Amount of Sleep
Although too little sleep has been linked to weight gain, too much sleep can have a similar effect, as you are expending less energy overall during the course of the day. (You burn more calories when you are awake and moving around than when you are at rest.) In addition to getting a healthy amount of sleep, you can increase the number of daily calories burned by incorporating exercise into your routine. Focusing on eating smaller meals and avoiding alcohol before bed can also help with your metabolism.
SAMHSA addresses the impact of trauma on individuals, families, and communities as a behavioral health concern that requires a healing and recovery process.
Trauma and violence are widespread, harmful, and costly public health concerns. SAMHSA describes individual trauma as resulting from "an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being."
Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, or sexual orientation. Trauma is a common experience for adults and children in American communities, and it is especially common in the lives of people with mental and substance use disorders. For this reason, the need to address trauma is increasingly seen as an important part of effective behavioral health care and an integral part of the healing and recovery process.
The effects of traumatic events place a heavy burden on individuals, families, and communities. Although many people who experience a traumatic event will go on with their lives without lasting negative effects, others will have difficulties and experience traumatic stress reactions. How someone responds to a traumatic experience is personal. If there is a strong support system in place, little or no prior traumatic experiences, and if the individual has many resilient qualities, it may not affect his or her mental health.
Research has shown that traumatic experiences are associated with both behavioral health and chronic physical health conditions, especially those traumatic events that occur during childhood. Substance use (e.g., smoking, excessive alcohol use, and taking drugs), mental health conditions (e.g., depression, anxiety, or PTSD), and other risky behaviors (e.g., self-injury and risky sexual encounters) have been linked with traumatic experiences. Because these behavioral health concerns can present challenges in relationships, careers, and other aspects of life, it is important to understand the nature and impact of trauma, and to explore healing.
Seclusion and restraint were once perceived as therapeutic practices in the treatment of people with mental and/or substance use disorders. Today, these methods are viewed as traumatizing practices and are only to be used as a last resort when less-restrictive measures have failed and safety is at severe risk.
Seclusion is defined as the involuntary, solitary confinement of an individual. Restraint refers to any method, physical or mechanical device, or material or equipment that immobilizes or reduces an individual’s ability to freely move his or her arms, legs, body, or head. A drug or medication also might be used to restrict behavior or freedom of movement.
Studies have shown that the use of seclusion and restraint can result in psychological harm, physical injuries, and death to both the people subjected to and the staff applying these techniques. Injury rates to staff in mental health settings that use seclusion and restraint have been found to be higher than injuries sustained by workers in high-risk industries. Restraints can be harmful and often re-traumatizing for people, especially those who have trauma histories. Beyond the physical risks of injury and death, it has been found that people who experience seclusion and restraint remain in care longer and are more likely to be readmitted for care.
SAMHSA is committed to reducing and ultimately eliminating the use of seclusion and restraint practices in organizations and systems serving people with mental and/or substance use disorders. SAMHSA’s goal is to create coercion- and violence-free treatment environments governed by a philosophy of recovery, resiliency, and wellness. Successful efforts have eliminated these practices in psychiatric hospitals, forensic psychiatric settings, therapeutic schools, residential treatment centers, and jails and criminal justice settings.
Last Updated: 05/22/2019
During the past year the United States has suffered several tragedies, including the Oklahoma tornados, the Boston Marathon bombing, the Sandy Hook School massacre, Hurricane Sandy, and the Aurora, Colorado shooting. With each passing year these events will be pushed further into our country’s collective past, but our sadness will never diminish. Although less than 20% of those exposed to traumatic events are expected to develop Post-Traumatic Stress Disorder (PTSD)1, a large percentage of victims will suffer from distressing post-trauma reactions that interfere with life.
The American Psychiatric Association’s Diagnostic and Statistical Manual-V2 classifies PTSD as a trauma- and stress-related disorder that includes four symptom clusters: intrusion symptoms, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. While a mental health professional’s assessment is required for a diagnosis of PTSD, the first steps toward a diagnosis (and therefore treatment) are 1) an improved understanding of the signs of PTSD, 2) a self-evaluation of the post-trauma reactions negatively affecting you and those you love, and 3) a willingness to ask for help. After all, we cannot address problems we do not recognize!
Post-trauma reactions occur after exposure to traumatic events such as motor vehicle accidents, sexual assault, terrorist attacks, natural disasters, and many other tragedies. During these events individuals experience terror, and they often feel helpless to stop the event. In the weeks, months, and even years following a trauma, substantial changes in a person’s thoughts, emotions, and behaviors may occur. Because such changes can be warning signs of PTSD or other serious post-trauma reactions, it is crucial for trauma survivors to be aware of how the trauma has affected them. How do you know if you or someone you love might be suffering from post-traumatic stress? Eight of the most common cognitive and emotional indicators of PTSD include:
1. Sleep Difficulties: Problems may include falling asleep, staying asleep, or experiencing frequent nightmares.
2. Anger: The person may feel irritable, and may experience frequent anger outbursts that are difficult to control.
3. Numbness and Disconnection: Trauma victims may feel disconnected from others. They may also feel numb and have difficulty accessing the loving feelings they know they have for loved ones.
4. Depression: Depressed mood, hopelessness, and a loss of interest in previously enjoyed activities are common.
5. Chronic Anxiety: Individuals often report feeling on guard and hypervigilant, and they have difficulty relaxing and “unwinding.”
6. Reliving the Trauma: Highly distressing thoughts and memories of the event may repeat in the mind, despite the individual’s attempts to avoid or stop them.
7. Feeling Unsafe: The person may experience intense feelings of fear or impending doom even when no danger is present. They may also feel as though it is impossible to ever feel safe again.
8. Thoughts of Suicide: Suicidal thoughts may be active, with an intention and plan to commit suicide (“I will purchase a firearm to shoot myself”). Conversely, these thoughts may be passive (“Things would be better if I just weren’t around anymore”).
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In addition, many trauma survivors exhibit significant behavioral changesafter suffering a traumatic event. Such changes in behavior may become apparent in several domains of a person’s life, some of which include:
1. Relationships with Others: Increased conflict with others, withdrawal from relationships, and decreased trust and intimacy are common PTSD indicators.
2. Self-Esteem/Relationship with Self: Changes may also take place in an individual’s relationship with themself. Self-harm behaviors, thoughts of suicide, and reduced self-care and self-esteem can be signs of a serious post-trauma reaction.
3. Work Performance: Those suffering from PTSD often experience difficulty concentrating, sometimes due to thoughts about the trauma, or to lack of sleep. This in turn may compromise one’s ability to complete daily tasks or to perform well at work.
4. Lifestyle: After a trauma some individuals go to great lengths to avoid reminders of the event. For instance, they may isolate and give up hobbies or activities they used to enjoy. The purpose of this may be to feel safer and less vulnerable, and to reduce reminders of the trauma. For example, a combat veteran who was bombed in a crowd oversees may avoid concerts despite his love of music, in order to feel safe.
5. Coping: Ineffective coping strategies may be adopted after trauma. For instance, an individual may begin drinking alcohol or using drugs to cope with their symptoms. Often, these unhealthy ways of coping help the individual temporarily avoid reminders of the traumatic event.
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In the first few weeks following a trauma, most people will experience at least a few post-trauma reactions and symptoms. However, if you experience these changes for more than one month, if they interfere with your daily life, or if you have thoughts of hurting yourself, it is important to seek professional help as soon as possible. The following websites offer assistance to those looking to connect with a mental health professional:
• Substance Abuse and Mental Health Services Administration, Disaster Distress Helpline: disasterdistress.samhsa.gov/
• Psychology Today: therapists.psychologytoday.com
• GoodTherapy.org: www.goodtherapy.org/
• NetworkTherapy.com: A Mental Health Network: www.networktherapy.com
1. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048-1060.
2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.