Promentis Pharmaceuticals Announces Successful Completion of Phase 1 Studies for SXC-2023 Targeting Novel …

MILWAUKEE, Nov. 16, 2018 /PRNewswire/ — Promentis Pharmaceuticals, Inc., a privately-held biopharmaceutical company developing innovative therapies for neuropsychiatric disorders, today announced it has completed Phase 1 single ascending dose and multiple ascending dose studies for its lead compound, SXC-2023.  SXC-2023 has demonstrated a compelling profile across a range of non-clinical studies. Promentis is developing SXC-2023 and other compounds that engage System xc-, a central nervous system (CNS) target addressing glutamatergic imbalance and oxidative stress, to treat impulse control disorders, obsessive-compulsive disorder and other neuropsychiatric diseases.

The aim of the Phase 1 studies was to evaluate the safety, tolerability and pharmacokinetics of single and multiple ascending oral doses of SXC-2023.  In the first study, single ascending doses were evaluated in six cohorts, with a total of 48 subjects. In the second study, SXC-2023 was administered daily for 14 days within four different dose groups. SXC-2023 proved to be safe and well-tolerated over a wide dose range in healthy volunteers in both the SAD and MAD studies, and demonstrated a very consistent PK profile. There were no significant adverse events and no treatment-related discontinuations in either study. 

“We are very pleased with these results, which show SXC-2023 to be very safe and well-tolerated, and to possess a very well-behaved PK profile,” said Dr. Tom Beck, CMO of Promentis. “We believe that the mechanism and excellent safety profile of the drug are consistent with potential applications in a wide variety of impulse control disorders, both as monotherapy and in combination with other treatments. These results reinforce our interest and enthusiasm in SXC-2023 as we look to the near-term commencement of our Phase 2 program.”

Glutamatergic dysfunction is a hallmark feature of many neuropsychiatric indications, including a broad range of impulse control disorders (ICDs), which is Promentis’ initial therapeutic focus.

Promentis’ first ICD monotherapy indication is trichotillomania, a disabling and underrecognized condition characterized by recurrent hair pulling, leading to noticeable hair loss and substantial adverse impact on quality of life. Trichotillomania is more common in women than men and has been estimated to affect approximately 1% of the US population. No medications are approved by the US Food and Drug Administration for the treatment of this chronic disorder. Obsessive-compulsive disorder is the company’s first add-on indication, and the company is also exploring additional CNS indications where glutamatergic imbalance and oxidative stress contribute to impaired functioning.

About Promentis Pharmaceuticals

Promentis Pharmaceuticals, Inc. is a privately-held biopharmaceutical company developing innovative therapies for neuropsychiatric disorders. Promentis’ drug development efforts are focused on a unique approach to addressing glutamatergic imbalance and oxidative stress. The Company’s first indication is trichotillomania, a highly prevalent disorder for which there is no approved therapy, and for which there are no other known treatments in development.

Promentis is led by Klaus Veitinger, M.D., Ph.D. (CEO, Chairman of the Board for Promentis and OrbiMed Venture Partner). The team also includes Tom Beck, M.D. (Chief Medical Officer and Board Member for Promentis and F-Prime Capital Executive Partner), Daniel Lawton (President and Board Member) and Chad Beyer, Ph.D. (Senior VP RD).

About Trichotillomania and Other Obsessive-Compulsive and Addictive Disorders

Obsessive-compulsive and related disorders, as defined by DSM-5, represents a broad category of neuropsychiatric disease, including OCD, excoriation (skin-picking) disorder and trichotillomania. Trichotillomania is a disabling and underrecognized condition characterized by recurrent hair pulling despite repeated attempts to stop the behavior, leading to noticeable hair loss. Trichotillomania is associated with a range of psychosocial problems, including low self-esteem, social anxiety, avoidance of intimacy, occupational impairment and an overall decrease in quality of life. In addition, a significant number of trichotillomania patients ingest their hair after pulling, which can lead to life-threatening gastrointestinal blockages requiring surgery. 

Alterations in glutamate signaling within brain regions implicated in urge control and executive function have been proposed to contribute to the underlying pathology of trichotillomania, as well as other obsessive-compulsive disorders, addictive disorders and other CNS conditions. No medications are approved by the US Food and Drug Administration for the treatment of trichotillomania, nor are there any other known treatments in development. For more information regarding trichotillomania, see:

Contact: Tiberend Strategic Advisors, Inc.

Janine McCargo, 646-604-5150,

SOURCE Promentis Pharmaceuticals, Inc.

Fearless: Breaking Anxiety Down

Today I discuss six common thinking errors (or maladaptive beliefs) in obsessive-compulsive disorder. These are different from the ten cognitive thinking errors I have discussed previously. I divide these OCD-related thinking errors into three groups:

  1. Control of intrusive thoughts
  2. Exaggerated threat and responsibility
  3. Intolerance of uncertainty and perfectionism

To explain these patterns of maladaptive beliefs, I use the example of an individual who has checking compulsions regarding his family’s safety. He worries that strangers will break into his house and harm his wife and his little son. So he tries to reassure himself not only through walks around the house before leaving for work, but by calling home many times a day, calling the neighbors, checking the local news for reports of break-ins, etc.

Important uncontrollable intrusions

To explain these first two thinking errors, let us consider the individual in our example, who despite reassuring himself that everything is okay, is tormented by thoughts such as: Am I certain there was nothing suspicious around the house?

Why do these thoughts cause him such anguish? Because to many with obsessive-compulsive disorder, intrusive thoughts are important. It is as though such intrusive obsessions increase the likelihood of bad things happening. Therefore, people with obsessive-compulsive disorder try to suppress threatening worries.

However, it is very difficult to control one’s thoughts. To see for yourself, try this exercise: For five minutes, do not think of a purple kite, in the shape of a pig with wings. It is crucial that you don’t!

Set the timer for five minutes.

Okay, how did you do?

Compared to thoughts regarding a purple kite, obsessions are even more difficult to control because they are threatening. It is difficult to ignore thoughts like: What if I have AIDS and don’t know it? What if there was a rare virus on my hand when I put a band-aid on my daughter’s injury? What if I did not do my prayers right and go to Hell? Etc.

The more one tries to suppress such obsessions, the more powerful they seem to become.

Exaggerated threat and responsibility

To examine the next two thinking errors, let us return to the person in our example. He now obsesses about the possibility that this morning he failed to notice two strangers standing next to a tree, a block away. To him, such an error would be costly. Why?

Because those with obsessive-compulsive disorder overestimate both the likelihood and severity of something terrible happening. So two strangers a block away could not be tourists, photographers, people considering buying a house, someone’s guests…but criminals. And not thieves or swindlers, but unstoppable murderers who will break into this individual’s home and kill his powerless and defenseless wife and child.  This is a horrifying possibility. But a rare one.

Many things in life are possible but not probable. Just as it is possible that today, as you drive to work, you have an accident and become paralyzed from the neck down. Again, horrifying, but rare possibility.

Of course, it is rational to prevent harmful things from happening when their likelihood multiplies. For instance, it would not be a good idea to drive drunk, when the weather is terrible, or when your car’s brake is malfunctioning.

Let us talk about the other thinking error, that of responsibility. Our individual’s pseudo-prophetic vision of his family getting murdered is too powerful to ignore, so in a sense it becomes his responsibility to prevent their murder. Only he—not his wife, the neighbors, the police, etc—can anticipate or stop this tragedy. So he checks and checks and checks….

Uncertainty and “not just right” feelings

The last two thinking errors in obsessive-compulsive disorder are intolerance of uncertainty and “not just right” feelings. I start with the first.

Life is filled with uncertainties. Awful things could happen to anyone. Usually, we do not worry about such events because we can tolerate uncertainties.

But low probabilities are no source of comfort to one who can not tolerate uncertainty; for instance, for a person who needs to feel absolutely certain about the safety of his family, and for whom “good enough” is not good enough. Nothing short of perfect certainty will do.

Perhaps related to this is the maladaptive pattern of “not just right experiences.” People with obsessive-compulsive disorder have difficulty tolerating feelings of incompleteness and imperfection.

Being told that a negative event is unlikely provides no comfort when things do not feel right.

Case in point, the individual in our example needs to examine his surroundings until it feels right; until he feels a sense of balance, of things being just right. Only then can he stop obsessing.

Summary of thinking errors in OCD

People with obsessive-compulsive disorder

  1. Often consider intrusive thoughts to be important, and they try to control them.
  2. Exaggerate a threat’s likelihood and severity, and feel responsible for stopping the dreaded event from occurring.
  3. Have trouble tolerating uncertainty and “not just right” feelings.

Inflammatory Th17 Cells Seen to Trigger Obsessive Compulsive Disorder in MS Mouse Model

The pro-inflammatory Th17 cells that characterize multiple sclerosis (MS) may also underlie symptoms of obsessive-compulsive disorder (OCD), results of a mouse study show.

The study, “Auto-Reactive Th17-Cells Trigger Obsessive-Compulsive-Disorder Like Behavior in Mice With Experimental Autoimmune Encephalomyelitis,” was published in the journal Frontiers in Immunology.

“For the first time, we are reporting a likely link between OCD and an important arm of cell-mediated immunity,” Avadhesha Surolia, the study’s senior author, and an honorary professor at the Indian Institute of Science in Bengaluru, India, said in a press release.

“Until now, we have looked at neuropsychiatric diseases as purely a neurological problem, ignoring rather completely the immunologic contribution,” Surolia added.

Patients with autoimmune diseases like multiple sclerosis can develop OCD, an anxiety disorder. But central mechanisms linking these disorders remain elusive.

Researchers at the institute used the chronic experimental autoimmune encephalomyelitis (EAE) model, an established MS mouse model, to characterize the psychological abnormalities associated with MS.

Ten days after the induction of MS-like symptoms, they saw that mice developed a repetitive behavior similar to OCD — the animals spent an excessive amount of time, 60 to 70 percent more than a healthy control group of mice, grooming themselves Excessive behavior was also seen in compulsive nestlet shredding and marble burying.

Researchers then focused on a group of cells, called Th17 lymphocytes, known for their pro-inflammatory properties. Th17 cells play a key role in the destruction of the nerve cells’ protective myelin layer, a hallmark of MS.

To determine the relative contribution of Th17 cells to the OCD-like symptoms, they infused Th17 cells into the EAE mice. They also infused mice with Th1 cells, another group of autoreactive immune cells also linked with MS.

Although both groups of animals developed signs of MS, only mice given Th17 cells showed a significant increase in grooming activity, as well as marble burying and nestlet shredding behavior.

“We observed unexpectedly high grooming activities in diseased mice which in some cases manifested as hair-less patches and/or injuries,” the researchers wrote. “The repetitive behavior was noted to be quite similar to OCD in human subjects … firstly, diseased mice devoted unusually greater time in grooming themselves which can be viewed as over-grooming; second, the grooming behavior was rigid in pattern and rigidity is a characteristic feature of OCD; thirdly, the behavior had a[n] anxiety component.”

Brain analysis of Th17-infused mice with excessive grooming behavior showed that these cells lodged primarily in two brain areas known to regulate grooming in mice — the brainstem (the region that connects the cerebrum with the spinal cord) and the brain cortex.

EAE mice treated with digoxin, a selective inhibitor (blocker) of Th17 differentiation, reduced by half the animals’ grooming activity.

Neurotransmitters, like serotonin, were previously linked with OCD, and researchers saw a considerable reduction in serotonin levels in the brain stem and cortex of the EAE mice. Mice treated with an antidepressant that boosts the uptake of serotonin, like fluoxetine (sold as Prozac), reduced their obsessive grooming behavior.

These results suggest that the infiltrating Th17 cells eventually may disrupt serotonin signaling, triggering the OCD-like symptoms. Additional neurotransmitters, like glutamate, may also play a role in the compulsive behavior — perturbed glutamate signaling is known to underly several neuropsychiatric disorders, including OCD.

“[I]t could be proposed that autoimmunity due to Th17-cells or any condition leading to a persistent increase in this particular repertoire of immune cells is a risk factor for neuropsychiatric illnesses,” the study concluded.

Its researchers suggest that therapies targeting the pro-inflammatory Th17 cells may help to halt the development of OCD in people with MS and possibly other autoimmune diseases.

“In this way we will be able to treat the root cause of the malady rather than targeting its manifestation and the symptoms,” Surolia said.

Are you afraid of fear?

Fear. What is your response when you think about the following words that describe the fear feeling? Shock, distressed, anxious, alarm, panic, frightened, terror.

The emotion called “fear” is the most researched of all human emotions. Fear is a survival mechanism. Pick up a poisonous snake and what might happen after it bites you? Learning to fear something dangerous helped our ancestors to survive. Try to pet a T-Rex and you would be eaten for dinner?

Humans need to be able to experience healthy fear for safety and to stay away from danger. Fear serves a purpose.

Fear and the Brain

Fear is created in both the brain and the body. The amygdala, an almond-shaped structure in the limbic system, is considered the seat of fear in the brain. Our “thinking brain” gives feedback to our “emotional brain” and perceives the environment as dangerous or safe.

Fear is a neuro-physiological response to a perceived or actual threat. Fear activates our fight, flight, or freeze response by stimulating the hypothalamus, which directs the sympathetic nervous system and the adrenal-cortical system to prepare our bodies for danger.

Anxious: Using the Brain to Understand and Treat Fear and Anxiety is a book by neuroscientist Joseph LeDoux (Publisher: Penguin, 2015). “Together, fear and anxiety disorders are the most prevalent of all psychiatric problems in the United States…”

Disorders of anxiety and fear include phobias, social phobia, generalized anxiety disorder, panic disorder, separation anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

Common phobias include the following: fear of public speaking, flying, spiders, needles, heights, enclosed or open spaces, storms, snakes. A specific phobia is an intense, irrational fear of something that poses little or no actual danger.

Is Fear Holding You Back?

Humans fear loss, risk, and failure. A doctor who fails to pass the licensure test cannot practice medicine, so he/she procrastinates on signing up to take it. Fear of bodily harm prevents some humans from skydiving—the risk is not worth the temporary pleasure. A fear of snakes may prevent camping trips. Do you like stability and security or change and risk?

Fear can stop someone from following his/her dreams and achieving goals. Fear can stop someone from socializing in public. Fear can stop someone from leaving his/her home. Fear of what? Fear of failure, being judged, being harmed.

Have you felt so afraid of failing at something that you decided not to try it at all? Some people fear success. What if I lose it all after I get it?

Adolescents fear being embarrassed in front of peers or being judged as less than. Children fear the dark, monsters, and being picked last for a game at recess. Both youth and adults fear rejection and betrayal.

Entering a haunted house during Halloween is different from being chased down a dark alley by a stranger. Do you like to watch scary movies or not?

Others have a fear that they cannot control the terrifying unknown (their perception of what is horrifying).

Zach William’s song is called Fear is a Liar. The chorus is the following:

“Fear, he is a liar

He will take your breath

Stop you in your steps

Fear he is a liar

He will rob your rest

Steal your happiness

Cast your fear in the fire

‘Cause fear he is a liar”

Fear is a universal emotion. Every person on planet Earth has experienced fear.

“This song is my anthem, and I pray it encourages others to break up with fear too.” Francesca Battistelli sings the Breakup Song:

“Fear, you don’t own me

There ain’t no room in this story

And I ain’t got time for you

Telling me what I’m not

Like you know me well guess what?”

Managing Fear

“No one is immune to fear. Even courageous people experience fear. Courage is not the absence of fear, but the management of fear,” according to a 2015 article in The Washington Post.

Information about fear can bring awareness, curiosity, and questioning to promote understanding about why humans experience certain reactions to perceived or real threats. Acknowledge the fear and take action.

Seek out a mental health therapist if needed to address debilitating fear that impairs daily functioning.

“Faith is a place of mystery, where we find the courage to believe in what we cannot see and the strength to let go of our fear of uncertainty.”—Brene Brown

By Melissa Martin

Reach:Melissa Martin, Ph.D, is an author, columnist, educator, and therapist Contact her at

Reach:Melissa Martin, Ph.D, is an author, columnist, educator, and therapist Contact her at

In Search of the Ultimate High

The world offers up an enticing smorgasbord of pastimes – all claiming to offer you an endorphin rush not to be missed. These thrill-seeking activities such as drug and alcohol use, casual sex, and escapism though non-stop entertainment, promise much but deliver little in terms of long-lasting satisfaction.

It seems our relentless search to be high is because we feel so consistently low. Look around you and you will see that joy is notably absent. It is ironic that America is ravaged by misery though widely recognised as a land of plenty. This fact alone lends resonance to Jesus’ statement that, “…life is not measured by how much you own” (Luke 12:15, NLT).

Statistics show that, “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.” These disorders range from general anxiety disorder, to panic disorder, social phobias, obsessive compulsive disorder and post-traumatic stress disorder.

In this article, we will consider three types of highs in particular. They all carry health warnings, or risks to life, limb, and well-being.

Thrill-Seeking High

A 2018 study revealed that between 2011 and 2017, 259 people died in pursuit of extreme selfies. Two people forming a couple, aged 29 and 30 years old, respectively, recently fell to their deaths whilst taking a photo of themselves on a granite ledge with no railings in the Yosemite National Park in California. They flirted with death for the temporary adrenalin rush of taking an extraordinary selfie, but they will never live to see how many “likes” they would have gained on Instagram or other social media sites; nor will they be able to share with friends and family what it felt like to experience that moment before their tragic accident.

There is something about getting up high, scaling physical heights or defying gravity which induces a spike of endorphins, such as when riding on a Ferris wheel at a carnival, riding in a helicopter or experiencing the view from the Empire State building. These times signify rising above our mundane problems and the tedium of everyday life, and savoring the sublime – if only for a fleeting moment. But to what lengths are we willing to go to achieve this high, and is it all worth it?

Drug-Induced High

Drug-taking is a popular means of escape, and the stigma surrounding marijuana is being replaced by mainstream approval. For example, on October 17, 2018, cannabis use was legalised in Canada – second only to Uruguay in achieving this historic feat. But pro-marijuana advocates do not want to stop there, they desire a global trend in legalizing marijuana for recreational use. Apart from medical marijuana, is this drug as harmless as many claim it to be? According to research from the Canadian Centre on Substance Use and Addiction (CCSA), “Teens who start smoking marijuana early and do so frequently risk lowering their IQ scores.”

As well as the potential to lower IQ, marijuana use tends to lower motivation, breed addiction and its smoke contains many of the same irritants and toxins as tobacco smoke which increases the user’s chances of developing chronic bronchitis, emphysema and cancer. Apart from deciding whether the money spent on buying marijuana is worth it, users will need to assess whether the high it yields from the psychoactive tetrahydrocannabinol or THC ingredient is worth the risk to their life and physical and mental health. Furthermore, marijuana is known to be a gateway drug, no doubt because over time it will deliver diminishing returns. This means that users will need stronger doses to get the same effect, and so many will move to stronger drugs.

Alcohol-Induced High

A recent report from the World Health Organisation reveals that one in 20 deaths worldwide are linked to alcohol. This number spans deaths resulting from road traffic accidents, digestive diseases and suicide. Research from the Washington School of Medicine confirms that daily consumption, even if it is light, increases your chances of premature death by 20%. Current health guidelines on safe levels of social drinking are now being revised. Scientists now hold to the view that whatever benefits are gained by light drinking, are outweighed by the risks.

A Supernatural High

This high cannot be granted by another human being, and there is no amount of money which can buy it. It won’t cost you anything monetarily, yet it costs everything – a lifetime of trusting and following Jesus. This yields a guaranteed high from knowing that your sins are forgiven, you will spend eternity with God, and that God will be your faithful companion and provide for all your needs. Life will not always be a blissful road, but it is possible to experience a high that does not result in premature death, an impaired mind or physical disease. By choosing the path of life found in a relationship with Jesus Christ and by casting all your cares on his supernatural shoulders, “…then you will experience God’s peace, which exceeds anything we can understand” (Philippians 4:7, NLT). This is the only high from which there are no withdrawal symptoms – because it lasts from now until eternity.

—Carla Cornelius, ph.D., gained her doctorate from Trinity School of the Bible and Theological Seminary in Newburgh, Indiana. Her dissertation proposed a biblical model of counseling the suicidal based on the book of Ecclesiastes. Because the causes of suicide are multifactorial, she endeavors to bring a psycho-spiritual perspective to this complex and ever-pressing issue. She is the author of five books including “Culture Detox: Cleansing our minds from toxic thinking,” “Captive Daughters: Breaking the chains” and “No Way Out: Keys to avoiding suicide.”

Chronically anxious? Deep sleep may take the edge off

Extreme angst is on the rise nationally and globally, especially among teens and millennials. Among other factors, preliminary findings from UC Berkeley sleep researchers point to a chronic lack of deep restorative sleep.

Investigating the neural link between sleep and anxiety, UC Berkeley neuroscientists Matthew Walker and Eti Ben Simon are finding that non-Rapid Eye Movement (NREM) sleep plays a key role in calming the overactive brain, especially in the brain regions that process and regulate emotions.

“The more time you spend in deep non-REM sleep, the less anxious you are in the morning,” said Ben Simon in reporting her preliminary findings at the Society for Neuroscience annual meeting this week in San Diego.

Using functional Magnetic Resonance Imaging (fMRI), among other measures, Ben Simon and Walker tracked the anxiety levels and brain activity of 18 healthy young adults, first during and after each participant enjoyed a regular night of sleep, and next after the same study participants stayed awake for 24 hours.

Each morning, study participants viewed emotionally evocative video clips while inside a brain scanner so that researchers could observe changes in their emotional brain activity after a night of no sleep.

Chronically anxious? Deep sleep may take the edge offChronically anxious? Deep sleep may take the edge offIn the evenings, researchers found nearly identical anxiety levels across all the participants. However, after a night of no sleep, study participants reported a 30 percent increase in anxiety compared to the way they felt after a good night’s sleep.

Moreover, brain scans taken as sleep-deprived participants watched video clips in the morning showed increased activity in such emotion centers as the amygdala “fight-or-flight” reflex, while the medial frontal cortex, which helps temper emotional responses, was virtually shut down.

As for study participants who benefitted from a full night of sleep, those who enjoyed longer periods of non-REM deep sleep reported the lowest levels of anxiety the next morning and showed the least emotional reactivity.

“A good night of deep non-REM sleep can benefit us in terms of anxiety and emotional regulation,” said Ben Simon, a postdoctoral fellow in Walker’s Center for Human Sleep Science at UC Berkeley.

One U.S. adult in five is estimated to have been diagnosed with an anxiety disorder, a mental health category that includes panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder and generalized anxiety disorder, and up to 80 percent of anxiety patients complain about poor or disturbed sleep.

Add to that an epidemic in which one U.S. adult in three fails to get the recommended nightly eight hours of sleep, and a connection between sleep and anxiety emerges, Walker points out.

On a positive note, Walker says, “Deep sleep provides a nocturnal soothing balm, taking the sharp edges off our lives and lowering our anxiety. It’s a form of nocturnal therapy that many of us shortchange in this modern era of insufficient sleep.”

Final results of a study by Ben Simon and Walker on the neural link between sleep and anxiety disorders are forthcoming.

Americans: Get ready for the post-millennial generation. They have a lot to say.

Alex Sayres, 12, speaks during an Oct. 29 rally in Seattle by youth activists and others demanding action by the federal government on climate change. (Elaine Thompson/AP)
Valerie Strauss

The U.S. Supreme Court has refused to stop a lawsuit filed by young Americans who want to force the federal government to take action on climate change. The Trump administration had asked the court to stop the suit, which was filed in 2015, but it did not.

The suit was filed in Oregon by 21 young people, many of them minors, who are arguing that the federal government’s refusal to take action to fight climate change violates their constitutional right to a clean environment.

Whatever ultimately happens with the suit, it remains a reflection of the activism of young people, which, the author of the following post says, is in some ways unique. Sarah Vander Schaaff, a freelance writer, looks at what she calls the postmillennial generation, people born after 1996, and describes what she found.

Vander Schaaff has written some extraordinary pieces for The Washington Post, including one about her struggle with obsessive-compulsive disorder and generalized anxiety disorder, and another about how obsessive-compulsive disorder affected the life of one young man and his struggles to get through school. In another post for this blog, she wrote about a mother who realized that her young son — who threw a computer at his teacher in second grade — was mentally ill, and the help she got him and other children. And she wrote why the only charter school in Princeton, N.J., had become a flash point. Here’s her latest piece.

By Sarah Vander Schaaff

It doesn’t take a social scientist to tell you change is coming. It only takes a parent. And the contrast is staggering — between the leaders in Congress (whose average age is among the oldest of any Congress in U.S. history, according to the Congressional Research Service) and the generation of young people we are raising in our homes and schools.

Stand in the hallway of a school when students are walking from class to class. Observe students. Read the headlines of the student newspaper. Go to a game or performance. Notice themes in the emails from school administrators. The issues that occupy our worries and ignite our grown-up debates, including climate change, gender identity, sexual misconduct, digital privacy, economic opportunity and the threat of gun violence, are palpable. These are not opportunities to wield political power; they are part of the complex foundation out of which these young people must grow. They are trying to figure it out.

They have to figure it out.

Some dismiss this young generation’s determination, calling it naive or predictable. But others, like me, sense that there is some special combination of opportunity and outrage that gives this diverse and collaborative cohort a quality we can’t quite define. Moral energy. Passion. Whatever it is, it seems to be less about youth and more about responsibility.

Gary Lundgren, associate director of the National Scholastic Press Association who runs the organization’s Pacemaker Award for outstanding student journalism, said this young generation realizes its voice matters. Student journalists in high school and middle school have shown great interest in covering national issues at the local level, looking at #MeToo, mass shootings, the opioid crisis, body awareness, and vaping, and in some cases educating their parents.

“They have communication tools that are immediate and by and large the same tools professionals have,” he said.

These kids, born after 1996, are a generation without an official name. What is known is that they come after millennials, the cohort defined by the Pew Research Center as born between 1981 and 1996. Post-millennials are the most racially and ethnically diverse generation in our country’s history. Unlike millennials, who are recognized for adapting to social media and constant connectivity, these young people have essentially never lived in a world without them.

But the uniqueness of this generation goes beyond technology. KJ Dell’Antonia, former lead editor of the New York Times’s Motherlode blog and author of the book, “How to be a Happier Parent,” said the current generation is growing up in a different terrain than many of its Generation X parents.

“We grew up in a climbing gym. There were handholds. If I do this, then that will follow. If I get a good grade, this will follow. If I ace the SAT, this will follow,” Dell’Antonia said. Now, she said, “It’s a bare wall. A cliff face.”

In the face of that uncertainty, some see the post-millennials taking heightened responsibility. It’s a “post-trust” world in which the sentiment is: If we don’t step up and try to take care of this, nobody else is going to take care of us.

It’s both heartening and heartbreaking to see young people fill the void. Three years ago, students at Walter Johnson High School in Montgomery County, Maryland, pushed for more mental health classes after a classmate died by suicide. Suicide is a growing concern for many young people, because it is the third leading cause of death for people ages 10 to 24, and rates have tripled since the 1940s, according to the Centers for Disease Control and Prevention.

Student survivors of the mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., energized a movement with March for Our Lives. Since the 1999 Columbine shooting, 219,000 children at 223 schools have been exposed to gun violence during school hours, according to figures tabulated by The Washington Post. The updated database indicates the date of the most recent shooting. As I type this, the update reads “five days ago.”

The editorial board of Chicago’s University High School’s student newspaper, whose piece, “Conservative Students Entitled to Safe Space, Too” was selected as a Pacemaker Award finalist this year, called for fellow students to stand by their school’s founding ideals, defending the need for “more spaces where students can learn from and even respectfully disagree with one another.”

Some efforts seamlessly link the personal with the global and the imperative of the present moment, such as the young student at my daughter’s school who held a bake sale to help her father’s family in Chennai, India, devastated by 10 days of heavy rains and government failure to the manage water supply.

In his recent story in the Harvard Graduate School of Education’s magazine Ed, “Student Activism 2.0,” Zachary Jason looks at an essential question about such activism: Does it make a difference? From the student strike at the Sorbonne in the year 1229 through the activism of Never Again, he cites variables that determine and sustain success. College students, for example, find more success when linking a world issue to a campus policy. Younger students generally do better with issues that are not a direct challenge to their school. And students of color face another challenge: prejudice.

But youthful generations, of course, become adults, and formative life experiences “such as world events and technology, economic and social shifts” interact with the “aging process to shape people’s views of the world,” according to the Pew Research Center. So how will the divisive tone of today’s politics shape the postmillennial mind-set for problem-solving and political engagement in their adulthood?

They could expand on the footprint of millennials, a generation that has the highest proportion of voters who identify as independent, and for whom, even among Republicans, a majority says that there is “solid evidence of global warming” and that “Americans’ openness to people from all over the world is essential to who we are as a nation,” as noted in the Pew Research Center’s report “The Generation Gap in American Politics.”

They could reject the premise that issues once considered taboo are still divisive. Pew’s report shows, for the first time, “a majority of baby boomers express support of same-sex marriage.” And multiple surveys show a majority of parents in both major political parties support comprehensive sex education in school.

“There’s no ambiguity there,” said Bonnie Rough, author of “Beyond Birds and Bees.” The idea that sex education is considered improper by Americans is an outmoded idea but one with lingering consequences not only for sexuality, she said, but for gender equality. The United States ranks 49th in a Global Gender Gap Report by the World Economic Forum.

The moment could be an opportunity for schools to rehabilitate the “disappearing center,” said one school administrator with 14 years of experience. He suspects the new generation will begin to find a new framework and norms to replace the ones that are outdated.

“Societies have been through watershed moments before when older ways of thinking begin to collapse or show signs of their age,” he said. “Inevitably, during this turbulent transition period, the old ways aren’t working, but we haven’t figured out what a new way will look like. Eventually something will emerge. It always does. I wouldn’t be surprised if the current generation of students are leaders in that.”

There are many ways to lead, of course. The oldest of these post-millennials are just reaching voting age, capturing 5 percent of the adult population.

They can run for Congress in 2022.

Anxiety In Kids: Parents Can Help Nervous Children Develop Coping Strategies

Every child experiences anxiety on occasion, but healthy children are fairly relaxed most of the time. So children who routinely experience fear and nervousness or demonstrate shyness may be suffering from an anxiety disorder. It is crucial that parents understand the warning signs of social anxiety in children and respond appropriately—which may require seeking medical assistance — rather than assuming that reticence is just a stage. That can be the case and separation anxiety, in particular, is fairly common. But it isn’t always so it’s important that parents be honest in their assessment of the issue.

Childhood mental health problems are surprisingly common. The Child Mind Institute estimates that 49.5 percent of American youth will be diagnosed with a mental health illness before age 18. Anxiety disorders are, by far, the most common and account for about half of these psychiatric conditions. Studies suggest up to 80 percent of children with anxiety disorders are not receiving treatment. Part of the problem may be the tender age at which anxiety first manifests. Unlike ADHD and mood disorders, conditions that usually show up in the early teen years, the median age of onset for anxiety disorders in children is a mere six years old.

Childhood anxiety disorders comprise a family of psychiatric conditions, and impact children’s lives in different ways. Generalized Anxiety Disorder, one of the most difficult to diagnose, is characterized by excessive worry about grades, family issues, relationships with peers, or performance in sports. It can be difficult to distinguish GAD from perfectionism, or simple conscientiousness but, as with most psychiatric disorders, the diagnosis comes down to a question of quality of life. If a child is suffering from the drive to succeed, GAD is a possibility.

More specifically, children may suffer from panic disorders (at least two unexpected panic or anxiety attacks, followed by at least one month of concern over having another attack), separation anxiety disorder (when a child is unable to leave a family member), and social anxiety disorder (intense fear of being called on in class, or starting a conversation with a peer). In extreme cases, children with anxiety disorders may suffer from selective mutism and intense phobias. Obsessive-compulsive disorder and posttraumatic stress disorder, while not traditionally considered anxiety disorders, are often associated with the more extreme cases.

Cognitive behavioral therapy is the preferred treatment method for anxiety disorders, because it is not particularly invasive and, in children, has particularly high rates of success. Therapy usually involves identifying and interrogating unhealthy patterns of thinking, and teaching children strategies to conjure more positive thoughts and feelings in their stead. If therapy is ineffective, or a child has a particularly severe case of anxiety, prescription medications (usually selective serotonin reuptake inhibitors, or SSRIs) are an option. Studies suggest that therapy and antidepressants, together, can be more effective than either treatment in isolation.

Awareness is the key to protecting your children, and ensuring that those who are suffering actually get help. “Parents should not dismiss their child’s fears,” according to a statement from the American Academy of Child Adolescent Psychiatry. “Because anxious children may also be quiet, compliant, and eager to please, their difficulties may be missed. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications.”

6 Unexpected Differences Between OCD And Hypochondria

Although Obsessive Compulsive Disorder (OCD) and Illness Anxiety Disorder (hypochondria) are different disorders, they both can involve a person worrying excessively about their health. This can make the disorders seem similar, and although may have overlapping symptoms, there are quite a few differences between OCD and Hypochondria. Both OCD and hypochondria can involve anxiety about about illness, but in order to get the correct treatment, it’s important to differentiate between the two mental health issues.

“Hypochondria and Obsessive-Compulsive Disorder (OCD) can overlap in many ways, which may make the diagnoses difficult to tease apart even for a seasoned mental health professional,” Dr. Lindsay Henderson, PsyD, a psychologist who treats patients virtually via telehealth app, LiveHealth Online, tells Bustle “To an observer, both involve what seem to be an abundance of seemingly improbable concerns about one’s physical health.”

OCD involves a cycle of obsessions (or intrusive and uncomfortable thoughts) that the individual seeks to relieve by engaging in some sort of compulsion — health worries are just one type of obsession someone with OCD may have, says Henderson. Hypochondria, on the other hand, involves an excessive fear of having a serious illness.

Although both conditions can cause great distress and can impact someone’s ability to function and maintain healthy relationships, there are key differences between the two. Here are six unexpected differences between OCD and hypochondria, according to experts.

1Those With OCD Tend To Have Greater Insights Into Their Thoughts Behaviors

Natalia Lebedinskaia/shutterstock

“A person with OCD tends to have greater insight into their thoughts and behaviors as being problematic than someone with hypochondria has,” says Dr. Henderson. Those with hypochondria often do not have this insight and hold on very strongly to the belief that their medical issues are not psychological in nature at all.

2In OCD, There May Not Actually Be Symptoms Present


With hypochondriacs, the presence of actual symptoms is what triggers a fear of a greater health issue. This leads to excessive worry about these physical symptoms, says licensed psychologist Laura Chackes, Psy.D. However, in OCD, there may or may not be actual physical symptoms present.

3OCD Fears Are More Future-Oriented

Ashley Batz/Bustle

“In OCD the fears related to illness are typically future-oriented, such as the fear that touching something contaminated will make the person or others sick,” says Dr. Dr. Chackes. On the flip side, people with hypochondria tend to focus on already having an illness.

4Those With Hypochondria Don’t Often Engage In Behaviors To Alleviate Their Anxieties

OLEH SLEPCHENKO/shutterstock

“In OCD, there are always repetitive behaviors such as hand-washing, repeatedly asking others about symptoms, searching online for answers, and/or mental compulsions like reassuring themselves or trying to figure out whether they’re sick or not,” says Dr. Chackes. “In [hypochondria,] the individual does not exhibit compulsions aimed at reducing their anxiety as occurs in OCD.”

5Someone With OCD Is More Likely To Seek Psychological Help Than Medical Assistance


Because those with OCD have more insight into their anxieties than someone with hypochondria, they tend to seek out different avenues of assistance. “Someone with OCD may be more likely to seek help from a mental health professional, whereas someone with hypochondriasis may be more likely to seek medical interventions,” says Dr. Henderson.

6Each Disorder Shows Different Brain Activity

Rocketclips, Inc./shutterstock

Single photon emission computed tomography (SPECT) scans show different brain activity between people with OCD and people with hypochondria. “OCD SPECT scans show a hyper-frontal pattern, which means the frontal lobes work too hard,” psychiatrist Dr. Daniel Amen tells Bustle. This area of the brain is concerned with behavior, learning, personality, and voluntary movement. But different areas of the brain are active in hypochondriacs. “Hypochondria SPECT scans show increased activity in the insular cortex, which is associated with feeling body sensations,” he says.

Although both disorders can involve worries about one’s physical health, OCD and hypochondria are separate conditions that may be managed and treated differently. If you have symptoms that fit into both categories, see a medical professional, who can help give you the proper diagnosis.

Jacqueline Sperling, PhD

Jacqueline Sperling, PhD, is a clinical psychologist who specializes in implementing evidence-based treatments, such as cognitive-behavioral therapy (CBT), and in working with youth who present with anxiety disorders and obsessive-compulsive disorder (OCD). In addition, she is experienced in providing parents with guidance on how to manage children with internalizing and externalizing behavior issues.

Dr. Sperling helped develop the McLean Anxiety Mastery Program (MAMP), an intensive group-based outpatient program for children and adolescents ages 6 to 19 with anxiety disorders and OCD at McLean Hospital. Currently, she is the director of training and research at MAMP. She also is an instructor in psychology at Harvard Medical School and Harvard Extension School and has a private practice in Cambridge, MA.

Follow us on Twitter @HarvardHealth

Posts by Jacqueline Sperling, PhD

Helping a child with obsessive-compulsive disorder

Posted November 1, 2018, 10:30 am

Jacqueline Sperling, PhD

If a child has obsessive-compulsive disorder, the condition affects everyone else in the family. Understanding OCD and learning helpful strategies to support the child can ease distress all around.

Mental health conditions on the rise among US students

As more and more people discuss mental health issues in public forums, it seems to be lifting some of the stigma surrounding the topic. New research reveals that the number of students seeking help for mental health problems has risen considerably between 2009 and 2015.

Anxiety, depression, and panic attacks are on the rise among U.S. college students, suggests a new study.

Sara Oswalt, from the University of Texas at San Antonio, is the lead author of the new study, which was published in the Journal of American College Health.

According to estimates that the scientists cite, around 26 percent of people aged 18 and above in the United States live with a mental health condition in any given year.

Moreover, it is believed that half of all serious adult psychiatric conditions — such as major depressive disorder, anxiety disorders, and substance abuse disorder — start as early as the age of 14. Around three-quarters of serious mental health issues start by the age of 25.

How has the prevalence of mental health issues among young people evolved over time? Does the fact that mental health problems are discussed more openly lead to an increase in diagnosis?

New research aimed to shed some light on these questions by examining the data on almost half a million U.S. undergraduate students between the years 2009 and 2015.

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Trends in 12 mental health conditions

Oswalt and her colleagues studied the trends in diagnosis and treatment for a dozen mental health conditions: “anorexia, anxiety, attention deficit and hyperactivity disorder (ADHD), bipolar disorder, bulimia, depression, insomnia, obsessive-compulsive disorder (OCD), panic attacks, phobia, schizophrenia, and substance abuse/addiction.”

The researchers applied statistical tools to a large dataset obtained from the American College Health Association, looking at the use of mental health services available on campus and the willingness to use them in the future.

Overall, the study found the greatest increases in diagnoses of anxiety, depression, and panic attacks. Specifically, treatments and diagnoses for anxiety rose by 5.6 percent between 2009 and 2015, those for depression by 3.2 percent, and those for panic attacks by 2.8 percent.

Students are also more willing to seek help using the on-campus facilities. By the end of the study period, almost one-fifth of students said that they used their university’s mental health facilities, which represented an increase of over 4 percent from 2009.

Additionally, almost three-quarters of respondents said they would use the services in the future, which represents an increase of over 6 percent.

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Universities should examine their culture

Oswalt comments on the potential mechanisms behind the new findings, saying that they might be a combination of increasingly poor mental health, an increased awareness of mental health services, and the reduced stigma surrounding mental health problems.

As for what may drive the deterioration of mental health in the first place, the author says, “We don’t know that the college environment is causing or even contributing to the increase in these conditions, but campuses are going to have to address it.”

“Higher education institutions want students to be successful in college, but if mental health issues aren’t adequately addressed, it will make student success more difficult to achieve,” she continues. “Universities should first examine the overall culture surrounding mental health on their campus.”

If the overall culture is not one that promotes health, that will need to be considered before step two, which is providing support for prevention in a variety of areas. This may include sleep instruction, stress reduction, and exercise. Step three needs to be adequately staffing counseling and health centers so those in need of services can be seen.”

Sara Oswalt

“If institutions don’t have counseling services, then partnering or identifying community resources is critical to supporting their students,” she adds.

She concludes, “Each institution will need to develop strategies that work for their culture and location, and solution-focused conversations need to happen with the highest levels of administration to adequately implement and support these strategies.”

The world of anxiety (1)

Gloria Ogunbadejo

What is anxiety?

Are you anxious? Maybe you’re feeling worried about a problem at work with your boss. Maybe you have butterflies in your stomach while waiting for the results of a medical test. Maybe you get nervous when driving home in rush-hour traffic as cars speed by and weave between lanes. These are all normal symptoms of anxiety.

In life, everyone experiences anxiety from time to time. This includes both adults and children. For most people, feelings of anxiety come and go, only lasting a short time. Some moments of anxiety are more brief than others, lasting anywhere from a few minutes to a few days.

But for some people, these feelings of anxiety are more than just passing worries or a stressful day at work. Your anxiety may not go away for many weeks, months, or years. It can worsen over time, sometimes becoming so severe that it interferes with your daily life. When this happens, it’s said that you have an anxiety disorder.

What are the symptoms of anxiety?

While anxiety symptoms vary from person to person, in general the body reacts in a very specific way to anxiety. When you feel anxious, your body goes on high alert, looking for possible danger and activating your fight or flight responses. As a result, some common symptoms of anxiety include:

  • nervousness, restlessness, or being tense
  • feelings of danger, panic, or dread
  • rapid heart rate
  • rapid breathing, or hyperventilation
  • increased or heavy sweating
  • trembling or muscle twitching
  • weakness and lethargy
  • difficulty focusing or thinking clearly about anything other than the thing you’re worried about
  • insomnia
  • digestive or gastrointestinal problems, such as gas, constipation, or diarrhoea
  • a strong desire to avoid the things that trigger your anxiety
  • obsessions about certain ideas, a sign of obsessive-compulsive disorder (OCD)
  • performing certain behaviours over and over again
  • anxiety surrounding a particular life event or experience that has occurred in the past, especially indicative of post-traumatic stress disorder (PTSD)

Panic attacks

A panic attack is a sudden onset of fear or distress that peaks in minutes and involves experiencing at least four of the following symptoms:

  • palpitations
  • sweating
  • shaking or trembling
  • feeling shortness of breath or smothering
  • sensation of choking
  • chest pains or tightness
  • nausea or gastrointestinal problems
  • dizziness, light-headedness, or feeling faint
  • feeling hot or cold
  • numbness or tingling sensations (paresthesia)
  • feeling detached from oneself or reality, known as depersonalization and derealisation
  • fear of “going crazy” or losing control
  • fear of dying

There are some symptoms of anxiety that can happen in conditions other than anxiety disorders. This is usually the case with panic attacks. The symptoms of panic attacks are similar to those of heart disease, thyroid problems, breathing disorders, and other illnesses.

As a result, people with panic disorder may make frequent trips to emergency rooms or doctor’s offices. They may believe they are experiencing life-threatening health conditions other than anxiety.

Types of anxiety disorders

There are several types of anxiety disorders, these include:


People who have agoraphobia have a fear of certain places or situations that make them feel trapped, powerless, or embarrassed. These feelings lead to panic attacks. People with agoraphobia may try to avoid these places and situations to prevent panic attacks.

Generalized anxiety disorder (GAD)

People with GAD, experience constant anxiety and worry about activities or events, even those that are ordinary or routine. The worry is greater than it should be given the reality of the situation. The worry causes physical symptoms in the body, such as headaches, stomach upset, or trouble sleeping.

Obsessive-compulsive disorder (OCD)

OCD is the continual experience of unwanted or intrusive thoughts and worries that cause anxiety. A person may know these thoughts are trivial, but they will try to relieve their anxiety by performing certain rituals or behaviours. This may include hand washing, counting, or checking on things such as whether or not they’ve locked their house.

Panic disorder

Panic disorder causes sudden and repeated bouts of severe anxiety, fear, or terror that peak in a matter of minutes. This is known as a panic attack. Those experiencing a panic attack may experience:

  • feelings of looming danger
  • shortness of breath
  • chest pain
  • rapid or irregular heartbeat that feels like fluttering or pounding (palpitations)

Panic attacks may cause one to worry about them occurring again or try to avoid situations in which they’ve previously occurred.

Post-traumatic stress disorder (PTSD)

PTSD occurs after a person experiences a traumatic event such as:

  • war
  • assault
  • natural disaster
  • accident

Symptoms include trouble relaxing, disturbing dreams, or flashbacks of the traumatic event or situation. People with PTSD may also avoid things related to the trauma.

Selective mutism

This is an ongoing inability of a child to talk in specific situations or places. For example, a child may refuse to talk at school, even when they can speak in other situations or places, such as at home. Selective mutism can interfere with everyday life and activities, such as school, work, and a social life.

Separation anxiety disorder

This is a childhood condition marked by anxiety especially when a child is separated from the parent or guardian. Separation anxiety is a normal part of childhood development. Most children outgrow it around 18 months. However, some children experience versions of this disorder that disrupt their daily activities.

In adults while it is normal to be concerned about the well-being of loved ones. People with adult separation anxiety disorder experience high levels of anxiety, and sometimes even panic attacks, when loved ones are out of reach.

People with this disorder may be socially withdrawn, or show extreme sadness or difficulty concentrating when they are away from loved ones. In parents, the disorder can lead to strict, over-involved parenting. In relationships, you may be more likely to be an overbearing partner.

Other common symptoms include:

  • unfounded fears that loved ones, or yourself, will be abducted or fatally injured
  • extreme and persistent hesitancy or refusal to leave the proximity of loved ones
  • difficulty sleeping away from a loved one for fear that something will happen to them
  • depression or anxiety attacks related to any of the above topics

You may also have physical aches and pains, headaches, and diarrhoea associated with periods of anxiety.

Specific phobia

This is a fear of a specific object, event, or situation that results in severe anxiety when you’re exposed to that thing. It’s accompanied by a powerful desire to avoid it. Phobia, such as arachnophobia (fear of spiders) or claustrophobia (fear of small spaces), may cause you to experience panic attacks when exposed to the thing you fear.

What causes anxiety?

Doctors don’t completely understand what causes anxiety disorders. It’s currently believed certain traumatic experiences can trigger anxiety in people who are prone to it. Genetics may also play a role in anxiety. In some cases, anxiety may be caused by an underlying health issue and could be the first signs of a physical, rather than mental, illness.

A person may experience one or more anxiety disorder at the same time. It may also accompany other mental health conditions such as depression or bipolar disorder. This is especially true of generalized anxiety disorder, which most commonly accompanies another anxiety or mental condition.

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