The Women Change Worlds blog of the Wellesley Centers for Women (WCW) encourages WCW scholars and colleagues to respond to current news and events; disseminate research findings, expertise, and commentary; and both pose and answer questions about issues that put women's perspectives and concerns at the center of the discussion.

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Social vs. Physical Distancing: Why It Matters

Social connection and social distancing during COVID-19 coronavirus pandemicThis article was originally posted by Amy Banks, M.D., on April 12, 2020, on her Wired for Love blog on Psychology Today.

To protect ourselves, our families, and our communities from the devastation of the coronavirus health experts are strongly encouraging everyone to “socially distance” — to stay 6-10 feet away from other people.

I am concerned — not by the strategy but by the way people are enacting it. The few times I have ventured out to a grocery store or for a walk around my neighborhood, I've seen people not only keeping distant from one another but also seeming afraid. They pass each other on the street or in a store without looking at each other or exchanging greetings.

It’s as if we were each locked in a personal bubble that no one can enter. The threat of COVID-19 and the stress it induces can understandably cause individuals to become terrified and myopic — to turn inward in an attempt to stay safe. While a week of that may be more stressful to some than others, months of this type of social isolation is dangerous. Research clearly shows us that our physical and emotional health and well-being are dependent on loving relationships and physical touch. To weather this pandemic, we need one another.

Weeks ago, my colleague and friend, Roseann Adams, LCSW, recognized that the national strategy of social distancing was a double-edged sword. She identified that social distancing can be a threat to all of us as it leads some people to socially isolate potentially causing further stress and, over the long haul, impairing our bodies’ immune system. In fact, strict social distancing may set us up for other illnesses.

Within the first few days, she was encouraging people to physically distance with social connection. Differentiating physical distance from social distance acknowledges the virus’s malignant ability to be transmitted from person to person but also acknowledges that the virus has no power over our ability to support and nurture one another in this time of extraordinary threat.

Think about the power of social isolation in society. Solitary confinement is considered the worst punishment a human can receive. In fact, most civilized communities consider it a form of torture. The physical and emotional toll it takes over time includes a worsening of mental health issues, an increase in self-injurious behavior and even suicide.

Isolating individuals is perhaps the most common first step domestic abusers use to gain power and control over their victims. He or she begins to control who you can see, where you can go, what you can wear. When a person violates the rules set by the perpetrator the punishment is harsh and swift.

Social distancing, as it has been presented, can feel like that. In fact, in my work with trauma survivors during this time, I have heard people describe feeling trapped and threatened again. That is not sustainable. Becoming socially isolated may keep the majority of us alive, but not well.

By naming the national strategy as physical distancing rather than social distancing and emphasizing the need for human connection we can stay safe from the virus but also hold onto the heightened need we all have for one another right now. Each of us needs an extra dose of being seen and held within our connections during this extraordinary time. Perhaps now more than ever we must be intentional about giving our neural pathways for connection a workout.

In fact, we need to go out of our way to make eye contact, wave, move, or loudly say "hello" from behind the mask. This gives our smart vagus nerve and our mirror neurons a workout. Literally, the sound of a friendly voice and seeing the eyebrows of another person raise in greeting stimulates your social engagement system, which in turn sends a signal to your stress response system to stand down. Those moments of interaction may make the difference in the long run as to how we, as a society, survive the pandemic.

The human nervous system is amazingly adaptive. Our brains will adapt to social isolation over time, but the burden of stress the isolation causes will lead to long-term health problems. As a society we will not be well at the end of all of this — not because of COVID-19 but because of the message we take in that being with others can be dangerous.

That is why each of us must do our part to not only stay physically six feet apart and to wear masks but also to go out of our way on the street, in the grocery store, through FaceTime, Zoom, or whatever platform you can use to reach out to one another. We all must know that nurturing the relationships we have and reaching out to others who may be isolated is as essential to surviving the pandemic as physical distancing.

Let’s add another important directive to our national policy of containing the coronavirus — to reach out each day to three other people — to check in on them, simply hear their voice, or share the pain or joy of the day. This is a wider strategy to not only survive the pandemic but to keep our humanity alive.

Amy Banks, M.D., is a senior scholar at WCW and founding scholar of the International Center for Growth in Connection, which began as the Jean Baker Miller Training Institute at WCW. Dr. Banks has spoken throughout the U.S. on the neurobiology of relationships and is the co-author, with Leigh Ann Hirschman, of Four Ways to Click: Rewire Your Brain for Stronger, More Rewarding Relationships.

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Guest — Sougata Sarkar
To stand by in such moment of crisis.....is something all we need....great choice of words...liked it
Saturday, 02 May 2020 18:08
Guest — Arshad
Right now the whole world is struggling with Corona. The whole world is looking for a cure for this virus, but until it can be sol... Read More
Wednesday, 13 May 2020 22:16
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Preventing Depression in Young People

This policy brief originally appeared in the Spring/Summer 2016 Research & Action Report from the Wellesley Centers for Women as part of the multi-media series Advancing the Status of Women & Girls, Families & Communities: Policy Recommendations for the Next U.S. President.


Depression is Prevalent but Prevention Programs Are Limited

According to the World Health Organization, depression is the leading cause of disability worldwide—it is the most common psychiatric disorder in the U.S., and is particularly common among lower income populations, and among women beginning in adolescence. The average age of onset for depression is 15, and about 20 percent of all people will have experienced an episode of depression by the end of adolescence. Youth depression is associated with a host of negative and long-term consequences, including poorer school performance, difficult peer and family relationships, increased risk of substance abuse, and poorer functional outcomes in adulthood. Of particular note is the connection between youth depression and suicide. Although not all people who commit suicide were depressed at the time, depression and suicidal behavior are indeed linked. Suicide is a tremendous problem in the U.S. and is the second leading cause of death among American adolescents.

Although depression is among the most treatable of all mental illnesses, and although we have evidence-based treatment approaches for depressed youth, the reality is that only about half of all depressed children and adolescents ever receive treatment, and only about half of those who do receive treatment actually improve as a result. Nearly all of those who recover from depression will experience a subsequent depressive episode within a few years. Specifically, 40 percent of youth who have experienced a past episode of depression will relapse within two years, and 75 percent will relapse within five years. This means that a typical 15 year-old who develops an episode of depression, if she is fortunate enough to receive treatment and benefit from it, will experience another depressive episode while she is graduating from high school and transitioning to adulthood.

Although nearly one in five young people experience an episode of depression by the end of adolescence, treatment protocols for youth depression only help about half of those they target, and relapse is common and debilitating. Funding for depression prevention efforts is limited, and preventive programs are difficult to access.

Promising Prevention Efforts

Youth depression is a problem of major proportions, affecting millions of children and families and interfering with children’s social, emotional, and academic functioning. Although evidence-based treatments for youth depression have been found to work well, treatment resources often are difficult to access. Most adolescents who recover experience relapse, and the long-term consequences of youth depression are significant.

Recently, promising research has suggested that depression is among the most preventable of major mental illnesses. We now know of strategies that work to prevent youth depression, including providing cognitive behavioral interventions to adolescents at high risk and helping youth to strengthen social relationships. Based on this research, many European colleagues now encourage a focus on preventive efforts for youth at risk for depression. Although funders and policymakers in the U.S. support preventive efforts for medical concerns, such as healthy eating and exercise to address heart disease, prevention, unfortunately, is often overlooked in mental health. Researchers, policymakers, and practitioners should focus attention on identifying youth at risk for depression, providing evidence-based preventive interventions to at-risk youth and families, and assisting at-risk youth in accessing preventive and/or treatment resources, as needed.

Approaches & Recommendations

Recommendations for enhancing a focus on the prevention of youth depression include:

  • Increase use of depression prevention interventions by increasing funding for research. Although several depression prevention interventions have been found to decrease the onset of depressive symptoms or disorders among at-risk youth, such programs are still not readily available in community-based mental health settings, and many practitioners do not know how to implement evidence-based protocols. More funding is needed for large-scale effectiveness trials that examine ways of disseminating evidence-based interventions in real-world settings and for large-scale trials that compare the efficacy of different evidence-based programs for different populations.
  • Attend to family processes that influence depression risk and that promote depression prevention. Research suggests that parental depression is a significant risk factor for depression onset in youth, and that family processes both maintain and may help alleviate depression. Policymakers, funders, and practitioners must attend to the important role of families in identifying and supporting youth at risk for depression who are appropriate for preventive efforts. In addition, interventions to prevent youth depression may benefit from a focus on enhancing family understanding of youth depression, improving parenting skills, and also on addressing parental depressive symptoms that may affect the efficacy of interventions targeting at-risk youth.
  • Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings at school. Unfortunately, routine screening for depression and suicide risk is generally overlooked both in primary care and in schools, although these are the places that youth are most readily accessed and serviced. Policymakers, funders, and practitioners must support additional training for school and medical personnel in identifying at-risk youth, evaluating youth for mental health concerns, and connecting youth to appropriate mental health services. Additionally, research is needed to evaluate primary care and school-based depression prevention interventions, so that, when at-risk adolescents are identified, evidence-based depression prevention services are readily available in locations that are comfortable and accessible to those in need.

Tracy Gladstone, Ph.D. is an associate director and senior research scientist at the Wellesley Centers for Women as well as the director of the Robert S. and Grace W. Stone Primary Prevention Initiatives, which focus on research and evaluation designed to prevent the onset of mental health concerns in children and adolescents.

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Views expressed on the Women Change Worlds blog are those of the authors and do not represent the views of the Wellesley Centers for Women or Wellesley College nor have they been authorized or endorsed by Wellesley College.

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